四维彩超联合促甲状腺激素在诊断甲状腺癌中的临床价值 促甲状腺刺激激素高

　　[摘要] 目的 评价高频彩超联合促甲状腺激素在甲状腺癌诊断中的价值，进一步提高诊断准确率，减少误、漏诊率。 方法 分析2010年1月～2011年12月在我院就诊的甲状腺癌患者45例，将上述患者按照随机对照原则分为A组（25例）和B组（20例），其中A组患者术前进行彩超诊断，B组患者术前进行四维彩超联合促甲状腺激素诊断，对两组患者的诊断率进行比较。 结果 A组患者彩超诊断甲状腺癌14例（56.0%），未能确定良恶性6例（24.0%），误诊为良性病变5例（20.0%）。B组患者四维彩超联合促甲状腺激素诊断甲状腺癌18例（90.0%），未能确定良恶性1例（5.0%），误诊为良性病变1例（5.0%）。两组患者之间诊断率比较，差异具有统计学意义（χ2 = 6.252，P < 0.05）。 结论 甲状腺癌的超声表现具有一定的特征性，应用四维彩超联合促甲状腺激素诊断甲状腺癌具有重要的临床价值。
　　[关键词] 四维彩超；促甲状腺激素；甲状腺癌；诊断
　　[中图分类号] R736.1 [文献标识码] B [文章编号] 1673-7210（2012）07（c）-0098-02
　　Value of four-dimensional color Doppler ultrasound combined with thyroid stimulating hormonein diagnosis of thyroid cancer
　　GAN Xiaohai ZENG Xianming
　　Department of First Surgery, Qishi Hospital of Dongguan City, Guangdong Province, Dongguan 523500, China
　　[Abstract] Objective To evaluate high frequency ultrasonography combined with TSH in thyroid cancer diagnosis to further improve the accuracy of diagnosis, reduce error and the rate of missed diagnosis. Methods 45 cases patients with thyroid cancer from January 2010 to December 2011 in our hospital were analyzed. The patients according to the random and control principle divided into group A (n = 25) and group B (n = 20). Group A were diagnosed by color Doppler ultrasound before operation, while group B were diagnosed by preoperative four-dimensional color Doppler ultrasound combined with TSH diagnosis. Then compared the diagnosis rate of two groups of patients. Results In the A group, patients with color Doppler ultrasound in diagnosis of thyroid carcinoma were 14 cases (56%). Failing to identify benign and malignant were 6 cases (24%). 5 cases were misdiagnosed as benign lesion (20%). The patients in the B group four-dimensional color Doppler ultrasound combined with TSH in diagnosis of thyroid carcinoma were 18 cases (90%). Failing to identify benign and malignant was 1 case (5%). 1 case was misdiagnosed as benign lesion (5%). There was statistical difference between two groups (χ2 = 6.252, P < 0.05). Conclusion Thyroid carcinoma with ultrasonography has certain characteristics. Four-dimensional color Doppler ultrasound combined with TSH in diagnosis of thyroid cancer has important clinical value.
　　[Key words] Four-dimensional color Doppler ultrasound; TSH; Thyroid Cancer; Diagniosis
　　甲状腺癌是人体内分泌系统中最为常见的恶性肿瘤，占全身恶性肿瘤的1%～5%[1]。近年来，甲状腺癌的术前检出率呈现逐年提高的趋势[2]。本文分析我院2010年1月～2011年12月收治的45例甲状腺癌患者的彩超及四维彩超联合促甲状腺激素（thyrotropin，thyroid stimulating hormone，TSH）表现，旨在提高甲状腺癌的早期诊断率，对指导临床手术以及提高患者的预后生存具有重要意义。