Study Of Blood Indexes In Change Regulation Of Normal Population And Qualitative Discrimination Of Thyroid Nodules

Objective:The aim was to study the effect of blood indicators on healthy warning of the general population through the data of physical examination. Because the high incidence of thyroid nodules was found in the physical examination population, there was a new task to seek blood indexes in early diagnosis, benign and malignant differentiation, follow-up and prognosis of thyroid nodules. It was available for doctors to observe, diagnose, distinguish and evaluate state of thyroid nodular and was helpful to select surgery and further consultation.Methods:Blood index data of 6655 cases from regular physical examination population were enrolled in this study. At the same time, cases of thyroid nodules inpatients were collected in Chinese PL A General Hospital from September in 2013 to March in 2015. Medical records and history data of all cases were investigated in detail, and clear inclusion and exclusion scheme were set up also. All malignant cases have been diagnosed by pathology and the joint model which distinguishing malignant from benign was trained by a large number of postoperative clinical information.Results:A large number of blood index data were analyzed in physical examination persons without clinical signs. Of all blood indicators, blood glucose, urea, total cholesterol, triglyceride, carcinoembryonic antigen and carbohydrate antigen 199 protein were showed uptrend with age. High abnormal blood lipid ratio was increased. The incidence of hypertriglyceridemia was higher in male and older age groups. In clinic, the neck ultrasonic inspection was the primary way to screen early insidious thyroid nodule and to identify malignant thyroid nodule from benign one. There was lack of relative hematological markers in laboratory currently. In this study, we collected actual cases of thyroid nodule to design qualitative distinguishing model by means of combining a great deal of blood index. The aim was to improve diagnostic coincidence of ultrasonic inspection. Age, serum thyroid hormone, serum high density lipoprotein, neutrophile granulocyte, and ultrasound were included in the Logistic regression equation. The regression equation was Logit (P)= 0.301X3-1.499X8 5.335X1021.182X121.673-0.069X1. The area under the ROC curve of joint model group was 0.882. It was better than ultrasonic inspection only and the area under ROC curve was 0.759. The result was significant difference (P<0.01). And then, another group of patients have been used for validation, the results illustrated that the area under the ROC curve was 0.812.Conclusion:Blood tests were extensive used in regular physical examination and assisted diagnosis of clinical diseases by advantage of simple and convenient, fast as well as full-automatic features. Variation tendency of blood tests could provide individually early warning of sub-healthy level in non-symptomatic participant, at the same time, people should pay attention to high rate of hidden diseases during the course of regular physical examination. Our study also concluded that combining blood tests with ultrasonic inspection would be more efficiently discriminating malignant thyroid nodule which might revealed a new way for further clinical diagnosis.