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目的:探讨超声探测甲状腺结节钙化对甲状腺结节良恶性的诊断价值。方法:回顾性分析2005年1月—2010年1月经手术治疗的4 011例甲状腺疾病患者的超声资料和临床病理结果,分析钙化与否及不同钙化类型与甲状腺结节良恶性的关系,比较单发和多发钙化结节的恶性率以及不同年龄组甲状腺结节伴钙化的恶性率。结果:甲状腺结节伴钙化的恶性率明显高于非钙化结节,微小钙化结节的恶性率明显高于非微小钙化,单发钙化结节恶性率均明显高于多发钙化结节,年龄<45岁钙化结节者的恶性率明显高于年龄≥45岁者,组间差异均有统计学意义(均P<0.05)。钙化、微小钙化、粗大钙化和环状钙化对诊断甲状腺恶性肿瘤的敏感度分别为80.42%、51.65%、26.52%、2.25%,特异度分别为67.53%、93.19%、76.79%、97.55%。39例颈部淋巴结钙化者中,37例为甲状腺乳头状癌淋巴结转移。结论:甲状腺结节钙化和微小钙化对甲状腺癌的诊断具有重要意义。单发结节伴钙化、微小钙化、年龄<45岁钙化结节患者以及淋巴结钙化者具有更高的恶性率。
Objective: To investigate the diagnostic value of ultrasound in thyroid nodule calcification of benign and malignant thyroid nodules. Methods: The ultrasound data and clinicopathological findings of 4 011 cases of thyroid diseases surgically treated from January 2005 to January 2010 were retrospectively analyzed. The relationship between calcification and different types of calcifications and benign and malignant thyroid nodules were analyzed. Malignant rates of hair and multiple calcified nodules and malignant rates of thyroid nodules with calcification in different age groups. Results: The malignant rate of thyroid nodules with calcification was significantly higher than that of non-calcified nodules. The malignant rate of microcalcified nodules was significantly higher than that of non-microcalcifications. The malignant rates of solitary calcified nodules were significantly higher than those with multiple calcified nodules, The malignant rate of 45-year-old patients with calcified nodules was significantly higher than that of those aged 45 years (all P <0.05). The sensitivities of calcification, microcalcification, calcification and ring calcification were 80.42%, 51.65%, 26.52% and 2.25% respectively, and the specificity were 67.53%, 93.19%, 76.79% and 97.55% respectively. Thirty-nine cases of cervical lymph node calcification, 37 cases of thyroid papillary carcinoma lymph node metastasis. Conclusion: Thyroid nodules calcification and microcalization are of great significance for the diagnosis of thyroid cancer. Solitary nodules with calcification, microcalcification, calcified nodules in patients younger than 45 years and lymph node calcification have a higher malignant rate.