目的 探讨术前超声在甲状腺癌诊断方面的准确性与漏诊率.方法 用自然语言识别的方法提取816例术前超声检查发现单发甲状腺结节并接受手术治疗患者的术前超声及术后病理资料,分析超声检查对甲状腺癌的诊断准确性与漏诊率.结果 经病理确诊甲状腺恶性肿瘤783例(96.0％),恶性潜能未定的滤泡性肿瘤6例(0.7％),良性27例(3.3％).超声检查对甲状腺结节良恶性质的预测准确性为96.1％.对甲状腺癌数量的诊断准确性为94.5％.超声发现的单发结节术后证实为2个或者多个恶性结节的比例为5.5％,2.2％ 的病例术后发现对侧并发恶性结节.对中央区淋巴结的诊断准确性为73.0％,漏诊率为38.7％;对侧颈部淋巴结的诊断准确性为88.3％,漏诊率为3.4％.结论 自然语言识别方法可以辅助临床研究.超声检查对甲状腺癌原发灶及颈部淋巴结的诊断具有重要价值,但对结节的数目存在一定的漏诊率,同时超声对中央区和侧颈部淋巴结的检查也存在诊断不足的问题.%Objective To investigate the accuracy and missed diagnosis rate of preoperative ultrasound in the diagnosis of thyroid carcinoma . Methods With the method of natural language recognition ,816 solitary thyroid nodules which received thyroidectomy were enrolled for the analysis of preoperative ultrasound examination and post-operative pathology results . The accuracy and the rate of missed diagnosis of ultrasonography for the diagnosis of thyroid carcinoma and lymph node metastasis were evaluated with the pathological results as the gold standard . Results There were 783 ( 96 .0％ ) malignant thyroid tumors ,6 ( 0 .7％ ) follicular tumor with uncertain malignant potential ,and 27 ( 3 .3％ ) benign thyroid tumors . Ultrasonography yielded an accuracy of 96 .1％ in the differential diagnosis between benign and malignant thyroid nodules and an accuracy of 94 .5％ in the quantification of nodule numbers . 5 .5％ of solitary nodules reported by ultrasound were proved to be 2 or more malignant nodules after the surgery . Regarding the diagnosis of central lymph node ,the preoperative ultrasound yielded an accuracy of 73 .0％and a misdiagnosis rate of 38 .7％ . For the lateral neck lymph node ,the accuracy was 88 .3％ ,and the misdiagnosis rate was 3 .4％ . Conclusions Natural language recognition method can assist clinical research . Ultrasonography is valuable in the diagnosis of thyroid carcinomas and neck lymph nodes . However , ultrasonography has a certain rate of misdiagnosis for the quantification of nodule numbers ,and for the diagnosis of lymph nodes in central and lateral necks .
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