目的 评价甲状腺癌基因检测及其联合细针穿刺抽吸活检(FNAB)和彩色超声在甲状腺结节早期诊断中的临床价值.方法 回顾性分析61例甲状腺结节手术病例,根据术后病检分为良性结节和恶性结节,运用Logistic回归分析和ROC工作曲线评价诊断指标:术前FNAB、甲状腺癌基因检测、彩色超声特征及其联合诊断模型的AUC、灵敏度、特异度.结果61例患者,良性甲状腺结节组31例,恶性结节组30例.与甲状腺癌显著相关的诊断指标及其AUC分别是:癌基因检测0.915(95% CI:0.814~0.971)、细针穿刺细胞学0.813(95% CI:0.691~0.902)、低回声0.657(95% CI:0.523~0.775)、结节大小0.623(95% CI:0.488~0.745),联合诊断模型AUC为0.957(95% CI:0.871~0.993),所建的联合诊断模型价值最高,其灵敏度为93.1%,特异度为90.3%.结论 术前癌基因检测、细针穿刺细胞学和彩色超声的联合诊断可提高甲状腺癌的的检出率,减少不必要的手术.%Objective To evaluate the clinical value of thyroid cancer gene detection and its joint diagnos-tic model in early diagnosis of thyroid nodule. Methods Retrospective study was used to analyze 61 cases of thy-roid nodules. These cases were divided into benign nodules and malignant nodules according to the pathology out-comes. We evaluated the AUC,sensitivity and specificity of preoperative fine needle aspiration biopsy(FNAB), thyroid cancer gene detection and color ultrasonography feature in the early diagnosis of thyroid nodule through lo-gistic regression analysis and ROC working curve. Results Among the 61 patients with thyroid nodules,there were 31 cases of benign thyroid nodules and 30 cases of malignant nodules.Diagnostic indexes significantly related with thyroid nodules and their AUC were listed as following:cancer gene detection 0.915(95% CI:0.814-0.971), FNAB 0.813(95% CI:0.691-0.902),low echo 0.657(95% CI:0.523-0.775),size of nodules 0.623(95% CI:0.488-0.745),joint diagnostic model respectively 0.957(95%CI:0.871-0.993). The value of joint diagnosis was the highest,whose sensitivity was 93.1% and the specificity was 90.3%.Conclusion Preoperative cancer gene de-tection joint FNAB and color ultra-sonography will improve the detection rate of thyroid cancer and reduce unneces-sary operation.
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