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超声联合血清midkine检测用于甲状腺结节良恶性诊断的价值探讨
作者:刘雅娟1  裴玉梅2  张静2  陈春悠3 
单位:1. 唐山市第九医院 超声科, 河北 唐山 063000;
2. 唐山市工人医院 内分泌科, 河北 唐山 063000;
3. 唐山市工人医院 头颈外科, 河北 唐山 063000
关键词:超声检查 血清midkine 甲状腺结节 诊断价值 
分类号:R445.1
出版年·卷·期(页码):2018·46·第一期(27-30)
摘要:

目的:探讨超声联合血清midkine检测用于鉴别诊断良恶性甲状腺结节的价值。方法:将2015年10月至2016年10月期间收治的105例甲状腺结节患者作为观察对象,依据病理检查结果分为良性组与恶性组,另选取同期健康体检者40例作为对照组。超声检测甲状腺的各项指标,并测定血清midkine水平,分析超声联合血清midkine检测诊断恶性甲状腺结节的最佳临界值、受试者工作特征曲线(ROC曲线)下面积、敏感性及特异性。结果:恶性组血清midkine水平显著高于良性组和对照组(P<0.05);超声检查发现,恶性组在淋巴结转移、钙化、边界是否清晰、形态规则方面与良性组比较,差异有统计学意义(均P<0.05),但在回声是否均匀、单发结节及结节质地方面比较,差异无统计学意义(均P>0.05);midkine诊断恶性甲状腺结节的ROC曲线下面积为0.717(P<0.05),其最佳临界值为262.32 ng·L-1,敏感度为70.7%,特异度为75.0%;而与超声检查联合后诊断恶性甲状腺结节的ROC曲线下面积为0.834(P<0.01),其最佳临界值为322.89 ng·L-1,敏感度为85.3%,特异度为87.8%。结论:甲状腺超声联合血清midkine检测可提高甲状腺结节良恶性诊断的敏感度及特异度,对于甲状腺结节良恶性的诊断具有重要价值。

Objective:To investigate the values ofultrasound combined with serum midkine in diagnosis of malignant and benign thyroid nodule. Methods:One hundred and five patients with thyroid nodules from October 2015 to October 2016 were selected as object of study. The patients were divided into malignant group and benign group according to the pathological examination results,and in the same time 40 health peoples were selected as control group.The indexes were measured by ultrasound, and serum midkine level was detected. The optimal critical value of diagnosis, ROC curve, sensitivity and specificity were analyzed to investigate the value of thyroid ultrasound combined with serum midkine in differential dignosis of malignant and benign thyroid nodule. Results:The level of serum midkine in the malignant group was significantly higher than that in the benign group and the control group (P<0.05); The lymph node metastasis, calcification, boundary, shape were statistically different between the malignant group and benign group (P<0.05); echo, solitary nodules, nodule texture had no significant difference between thetwo groups; ROC curve area of midkine was 0.717, while the cut-off value,sensitivity and specificity were 262.32 ng·L-1,70.7% and 75.0%, respectively; the ROC curve area of thyroid ultrasound combined with serum midkine was 0.834, while the cut-off value, sensitivity and specificity were 322.89 ng·L-1, 85.3% and 87.8%,respectively. Conclusion:The combination of serum midkine with ultrasound detection to diagnose benign and malignant thyroid nodule can improve the sensitivity and accuracy, which is of great value for the early diagnosis of benign and malignant thyroid nodule.

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