目的探讨术前血清促甲状腺激素(TSH)水平联合多普勒超声诊断分化型甲状腺癌(DTC)的相关性及临床诊断意义。方法回顾性分析新疆医科大学第一附属医院血管甲状腺外科行甲状腺切除术并经病理检查确诊的200例分化型甲状腺癌(DTC)患者(DTC组)和200例甲状腺良性结节患者(对照组)的术前血清TSH及多普勒超声结果,比较两组患者的一般资料、血清TSH水平与超声指标的异同,并分析术前血清TSH与多普勒超声指标联合检测诊断DTC的ROC曲线下面积、最佳临界值、敏感性及特异性。结果 DTC组与对照组在年龄、性别、民族方面差异无统计学意义。DTC组术前血清TSH水平高于对照组(P<0.05),两组患者的超声指标中边界、形态比较差异无统计学意义(P>0.05);而数目、大小、有无沙粒样钙化灶比较差异有统计学意义(P<0.05)。术前血清TSH诊断DTC的ROC曲线下面积为0.688(P<0.05),且其最佳临界值为2.515 mIU/L,敏感度为57.5%,特异度为75.5%;而术前血清TSH联合超声指标诊断DTC的ROC曲线下面积为0.751(P<0.05)且TSH的最佳临界值为3.153mIU/L,敏感度为70.1%,特异度为80.2%。结论确诊为甲状腺结节患者完善术前血清TSH与多普勒超声诊断DTC的准确性较单独检测高,对进一步制定治疗方案有一定的指导意义。 Objective To investigate the correlation between preoperative serum thyrotropin (TSH) level and Doppler ultrasonography in diagnosis of differentiated thyroid carcinoma (DTC) and its clinical significance. Methods A retrospective analysis of 200 cases of differentiated thyroid cancer (DTC) patients and 200 cases of benign thyroid nodules (control group) underwent thyroidectomy undergoing thyroidectomy in the First Affiliated Hospital of Xinjiang Medical University was performed. Preoperative serum TSH and Doppler ultrasound results were compared between the two groups of patients with general information, serum TSH levels and ultrasound similarities and differences, and analysis of preoperative serum TSH and Doppler ultrasound combined detection of DTC ROC curve under the area , The best cut-off value, sensitivity and specificity. Results There was no significant difference in age, sex and ethnicity between DTC group and control group. The preoperative TSH level in DTC group was significantly higher than that in control group (P <0.05). There was no significant difference in borderline and morphology between the two groups (P> 0.05), while the number, size, presence or absence of calcification The difference was statistically significant (P <0.05). The area under the ROC curve of preoperative serum TSH was 0.688 (P <0.05), and the best cutoff value was 2.515 mIU / L, the sensitivity was 57.5% and the specificity was 75.5%. The preoperative serum TSH combined with ultrasonography The area under the ROC curve of the index diagnosis DTC was 0.751 (P <0.05) and the best cutoff value of TSH was 3.153mIU / L, the sensitivity was 70.1% and the specificity was 80.2%. Conclusion The diagnosis of thyroid nodules in patients with preoperative serum TSH and Doppler ultrasound diagnosis of DTC accuracy is higher than the single test, to further develop the treatment program has some guidance.