血浆甲状腺球蛋白、颈部超声以及99TcmO4-甲状腺静态显像对甲状腺结节良恶性鉴别的临床意义

目的 探讨术前血浆甲状腺球蛋白（Tg）、颈部超声及99TcmO4-甲状腺静态显像三者联合检查对鉴别甲状腺结节良恶性的临床意义.方法 对手术并有病理诊断的103例甲状腺结节患者进行回顾性资料分析.根据患者术前检查项目分为三组：三项完整检查者31例为A组,检查颈部超声和99TcmO4-甲状腺静态显像者43例为B组,仅检查颈部超声者29例为C组.按照术后病理结果分别获得三组检查结果的灵敏度、特异性和准确率.结果 A、B、C三组的灵敏度分别为28.5％、83.3％、56.2％;特异性分别为58.3％、58.1％、46.2％,准确率分别为51.6％,65.1％,51.7％.结论 颈部超声和99TcmO4-甲状腺静态显像联合检查组（B组）的灵敏度、特异性及准确率明显高于单独颈部超声检查组（C组）,A组三项联合检查的灵敏度、特异性和准确率与B,C两组相比无优势.甲状腺结节术前完善颈部超声和99TcmO4-甲状腺静态显像检查对于甲状腺结节的鉴别诊断是有必要的.

Clinical Significance of the Plasma Thyroglobulin, Neck Ultrasound and99TcmO4-Thyroid Static Imaging in Identification of Benign and Malignant Thyroid Nodule

Objective To evaluate the clinical significance of preoperative plasma thyroglobulin （Tg）, neck ultra- sound and 99Tom O4- thyroid static imaging in identification of benign and malignant thyroid nodule. Methods 103 cases of thyroid nodules with the surgical and pathological confirmed were retrospectively carried out data analysis. According to preoperative examination, the patients were divided into 3 groups： 31 cases with three full examination （Group A）, 43 cases with the neck ultrasound and 99TcmO4 thyroid static imaging （Group B）, and 29 cases with the neck ultrasound （Group C）. The sensitivity, specificity and accuracy of each examination were obtained based on the postoperative pathological results. Results The sensitivity in Group A, B and C were 28.5%, 83.3%, and 56.2% ; the specificity were 58.3%, 58.1% and 46.2% ; and the accuracy were 51.6%, 65.1%, and 51.7%, respectively. The sensitivity, specificity and accuracy by combined neck ultrasound and 99TcmO4- thyroid static ima- ging （Group B） were significantly higher than that the single neck ultrasound inspection （Group C）. There were no significant advantages in Group A over Group B and C. Conclusion The preoperative neck ultrasound and 99TcmO4- thyroid static imaging examination for differential diagnosis of thyroid nodules would be necessary.