甲状腺乳头状癌与甲状腺结节钙化的关系研究

目的]探讨甲状腺结节合并钙化与甲状腺乳头状癌的关系。方法]回顾性分析240例甲状腺结节患者的彩色超声资料与病理诊断结果。结果 ]240例甲状腺结节中,甲状腺良性疾病钙化率为23.3%（38/163）,而甲状腺乳头状癌中钙化率达75.3%（58/77）,两组差异有统计学意义（χ2=58.947,P〈0.001）。钙化诊断甲状腺乳头状癌的ROC曲线下面积为0.811（95%CI：0.750~0.871）。微钙化患甲状腺乳头状癌的风险是非微钙化者的5.348倍（95%CI：2.804~10.200）,而粗钙化患甲状腺乳头状癌的风险是非粗钙化者的4.000倍（95%CI：1.564~10.230）。结论]钙化尤其是微钙化对于诊断甲状腺癌的特异性较高。当彩超发现甲状腺结节中有微小钙化时应提高警惕,尤其是微钙化,应进一步做针吸细胞学检查。

Relationship Between Papillary Thyroid Carcinoma and Thyroid Nodules with Calcification

Purpose] To investigate the relationship between thyroid nodules with calcification and papillary thyroid carcinoma（PTC）. Methods] The ultrasonographic and pathological data of 240 patients with thyroid nodules were analyzed retrospectively. Results] Among 240 patients with thyroid nodules,the rate of calcification in PTC was 75.3%（58/77）,and that in benign thyroid nodules was 23.3%（38/163）（χ2=58.947,P〈0.001）.The area under ROC curve of calcification for diagnosis of PTC was 0.811 （95%CI：0.750-0.871）. The risk of thyroid nodules with microeal- cification （OR =5.348,95% CI ： 2.804 - 10.200 ）, or with macrocalcification （OR =4.000,95% CI ： 1.564-10.230） for PTC was higher than that without microcalcification or macrocalcification re- spectively. Conclusion] Calcification in thyroid nodule under ultrasound should be vigilant, es- pecially mierocaleification, and further fine needle aspiration cytology should be performed.