Establishment and test of graded diagnostic model of thyroid cancer in children and adolescents

Jia LIU; Guanghan LI; Luying GAO; Zijie ZHANG; Ying WANG; Ying XIONG; Bo ZHANG

doi:10.19401/j.cnki.1007-3639.2022.05.004

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Establishment and test of graded diagnostic model of thyroid cancer in children and adolescents

Specialists' Article | 更新时间：2025-12-31

- Establishment and test of graded diagnostic model of thyroid cancer in children and adolescents
- China Oncology Vol. 32, Issue 5, Pages: 397-403(2022)
- 作者机构：
  
  1. 民航总医院超声医学科,北京 100123
  2. 中国医学科学院北京协和医学院北京协和医院超声医学科,北京 100730
  3. 中日友好医院超声医学科,北京 100029
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2022.05.004
  CLC： R736.1
- Received：09 February 2022，
  
  Revised：2022-05-09，
  
  Published：30 May 2022
- 稿件说明：
移动端阅览
Jia LIU, Guanghan LI, Luying GAO, et al. Establishment and test of graded diagnostic model of thyroid cancer in children and adolescents[J]. China Oncology, 2022, 32(5): 397-403.
DOI：

Jia LIU, Guanghan LI, Luying GAO, et al. Establishment and test of graded diagnostic model of thyroid cancer in children and adolescents[J]. China Oncology, 2022, 32(5): 397-403. DOI： 10.19401/j.cnki.1007-3639.2022.05.004.

摘要

背景与目的：

儿童及青少年甲状腺癌发病率逐年升高

且有较高的转移率及复发率。如果对儿童应用基于成人特点建立的甲状腺结节诊断标准则往往具有较高的漏诊率、误诊率和不必要活检率

本研究旨在建立儿童及青少年甲状腺结节的声像图分级诊断模型

对比其与美国放射学会（American College of Radiology

ACR）甲状腺影像报告与数据系统（Thyroid Imaging-Reporting and Data System

TI-RADS）的诊断效能。

方法：

纳入2000年1月

#x02014;2017年10月中国医学科学院北京协和医学院北京协和医院收治的144例0~18岁的甲状腺结节患者作为训练集

2015年11月

#x02014;2022年1月中日友好医院和民航总医院收治的41例0~18岁的甲状腺结节患者作为测试集

以病理学诊断作为金标准

将差异有统计学意义的超声特征进行多因素二元logistic回归分析

建立超声分级诊断模型并将模型带入测试集

比较其与ACR TI-RADS的诊断效能。

结果：

训练集中实性、低回声、纵横比

#x02265;1、边缘不规则及微钙化等差异均有统计学意义（

0.05）。Logistic回归分析显示

低回声、实性、边缘不规则及有钙化是诊断儿童及青少年甲状腺癌的独立预测因子。以上述独立预测因子建立超声分级系统

测试集中此分级模型与ACR TI-RADS相比具有更高的诊断准确率（92.7%

82.9%）。

结论：

以实性、低回声、边缘不规则及微钙化建立的分级诊断模型可用于儿童及青少年甲状腺结节的诊断

与ACR TI-RADS相比

具有更高的诊断准确率。

Abstract

Background and Purpose:

The incidence rate of thyroid cancer in children and adolescents is increasing year by year

and there is a high rate of metastasis and recurrence. The application of diagnostic criteria for thyroid nodules based on adult characteristics in children has a high rate of missed diagnosis rate

misdiagnosis rate and unnecessary biopsy. This study aimed to establish a graded diagnostic model of thyroid nodules in children and adolescents

and to compare its diagnostic efficacy with American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS).

Methods:

One Hundred and forty-four patients with thyroid nodules aged 0-18 years in Peking Union Medical College Hospital

Chinese Academy of Medical Sciences and Peking Union Medical College from January 2000 to October 2017 were included as the training set

and 41 patients with thyroid nodules aged 0-18 years in China-Japan Friendship Hospital and Civil Aviation General Hospital from November 2015 to January 2022 were included as the testing set. Taking pathological diagno

sis as the gold standard

the statistically significant ultrasonic characteristics were analyzed by multivariate binary logistic regression. The ultrasonic grading diagnostic model was established and brought into the testing set to compare its diagnostic efficiency with ACR TI-RADS.

Results:

There was significant difference in solidity

hypoechoic

taller-than-wide shape

irregular edge and microcalcification between the two groups (

0.05). Logistic regression analysis showed that hypoechoic

solidity

irregular margin and calcification were independent predictors for the diagnosis of thyroid cancer in children and adolescents. When the ultrasonic grade was established based on the above independent predictors

this graded model had higher diagnostic accuracy in the testing set compared with ACR TI-RADS (92.7%

82.9%).

Conclusion:

The graded diagnostic model based on solidity

hypoechoic

irregular margin and microcalcification can be used in the diagnosis of thyroid nodules in children and adolescents. Compared with ACR TI-RADS

it has higher diagnostic accuracy.

关键词

Keywords

references

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