[1]周一帆 季沁 陈国芳 褚晓秋 陈茉 丁文波 胡欣 相萍萍 曾铮 王建华 徐书杭 刘超.TI-RADS对细胞学结果不确定甲状腺结节的诊断价值[J].国际内分泌代谢杂志,2019,39(04):226-230.[doi:10.3760/cma.j.issn.1673-4157.2019.04.003]
　Zhou Yifan,Ji Qin,Chen Guofang,et al.Clinical value of TI-RADS in the diagnosis of thyroid nodules with indeterminate cytology[J].International Journal of Endocrinology and Metabolism,2019,39(04):226-230.[doi:10.3760/cma.j.issn.1673-4157.2019.04.003]
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TI-RADS对细胞学结果不确定甲状腺结节的诊断价值()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
39
期数:
2019年04期
页码:
226-230
栏目:
论著
出版日期:
2019-07-20

文章信息/Info

Title:
Clinical value of TI-RADS in the diagnosis of thyroid nodules with indeterminate cytology
作者:
周一帆1 季沁1 陈国芳2 褚晓秋2 陈茉2 丁文波3 胡欣2 相萍萍2 曾铮4 王建华5 徐书杭2 刘超2
1南京中医药大学研究生院 210000; 2南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)内分泌科 210028; 3南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)超声科(丁文波)210028; 4南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)病理科 210028; 5南京中医药大学附属中西医结合医院(江苏省中西医结合医院、江苏省中医药研究院)普外科 210028
Author(s):
Zhou Yifan1;  Ji Qin1;  Chen Guofang2;  Chu Xiaoqiu2;  Chen Mo2;  Ding Wenbo3;  Hu Xin2;  Xiang Pingping2;  Zeng Zheng4;  Wang Jianhua5;  Xu Shuhang2;  Liu Chao2. 1
Graduate School, Nanjing University of Chinese Medicine, Nanjing 210000, China; 2Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Traditional Chinese Medicine(Jiangsu Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine), Nanjing 210028, China; 3Department of Ultrasound, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Traditional Chinese Medicine(Jiangsu Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine), Nanjing 210028, China;
关键词:
甲状腺结节;  甲状腺影像报告和数据系统;  甲状腺细胞病理学Bethesda报告系统
Keywords:
Thyroid nodules;  Thyroid imaging reporting and data system;  The Bethesda system for reporting thyroid cytopathology
DOI:
10.3760/cma.j.issn.1673-4157.2019.04.003
摘要:
目的 探讨美国放射学会的甲状腺影像报告和数据系统(TI-RADS)对甲状腺细胞病理学Bethesda报告系统(TBSRTC)中细胞学不确定结节的诊断价值。方法 回顾性分析2012年1月至2017年6月于南京中医药大学附属中西医结合医院行甲状腺超声引导下细针穿刺细胞学检查且接受甲状腺手术确诊,行术后病理检查的494例甲状腺结节患者资料,共545个甲状腺结节。基于术后病理,分析TI-RADS、TBSRTC及其联合诊断的性能。结果 545个甲状腺结节中,共有285个不确定结节,分别有33和252个结节经术后病理证实为良性结节和甲状腺乳头状癌,恶性率为88.42%。TI-RADS对所有结节的敏感性、特异性、阳性预测值、阴性预测值、准确率和曲线下面积分别为97.20%、45.68%、91.11%、74.00%、89.54%、0.781。TI-RADS对不确定结节的敏感性、特异性、阳性预测值、阴性预测值和准确率分别为98.02%、42.42%、92.86%、73.68%、91.58%。联合诊断的灵敏性、特异性、阳性预测值、阴性预测值、准确率分别为99.17%、79.49%、97.81%、91.18%、97.24%。结论 TI-RADS对细胞学不确定结节的诊断价值值得肯定,TI-RADS联合TBSRTC能够达到最佳诊断效率。
Abstract:
Objective To investigate the application of the thyroid imaging reporting and data system(TI-RADS)introduced by the American College of Radiology in the diagnosis of thyroid nodules with indeterminate cytology in the Bethesda system for reporting thyroid cytopathology(TBSRTC).Methods A total of 494 patients with 545 thyroid nodules were enrolled from the Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Najing University of Traditional Chinese Medicine between January 2012 to June 2017. All thyroid nodules were evaluated with pre-operative ultrasound examination and ultrasound-guided fine-needle aspiration cytology. The final diagnosis was confirmed by postoperative histology. The diagnostic efficacy of TI-RADS, TBSRTC and their combined application was assessed based on the final histology.Results Among the 545 thyroid nodules, there were 285 indeterminate nodules; 33 and 252 were confirmed as benign nodules and papillary thyroid carcinoma by pathology, respectively, with a malignancy rate of 88.42%. For all thyroid nodules, the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and area under curve of TI-RADS were 97.20%, 45.68%, 91.11%, 74.00%, 89.54% and 0.781, respectively. For thyroid nodules with indeterminate cytology, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of TI-RADS were 98.02%, 42.42%, 92.86%, 73.68% and 91.58%, respectively. After combined, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 99.17%, 79.49%, 97.81%, 91.18% and 97.24%, respectively.Conclusion The diagnostic value of TIRADS for cytological uncertain nodules is worthy of recognition, and the combination of TI-RADS and TBSRTC can achieve the best diagnostic efficiency.

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备注/Memo

备注/Memo:
通信作者:徐书杭,Email:shuhangxu@163.com; 王建华,Email:311w@163.com
Corresponding author: Xu Shuhang, Email: shuhangxu@163.com; Wang Jianhua, Email: 311w@163.com
基金项目:江苏省“六大人才高峰”项目(2013-WSN-063); 江苏省医院协会医院管理创新研究课题(JSYGY-1-2018-301); 常州市武进区科技项目(WS201617)
Fund program:"Six Talent Peak" Project of Jiangsu Province(2013-WSN-063); Innovation Project on Hospital Management of Jiangsu Province Hospital Association(JSYGY-1-2018-301); Science and Technology Project of Wujin District in Changzhou(WS201617)
4Department of Pathology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Traditional Chinese Medicine(Jiangsu Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine), Nanjing 210028, China;
更新日期/Last Update: 2019-11-29