Combined ECT、B Ultrasonography And TSH/Tg Ratio In Differential Diagnosis Of Thyroid Nodules

Objective: To assess the efficiency of the combination of TSH/Tg ratio,ultrasound thyroid imaging and thyroid imaging for thyroid nodule evaluation.Methods: A total of 269 patients with thyroid nodules hospitalized in the department of thyroid surgery from January,2015 to December,2016 were included in this study.There were 119 patients were diagnosed as papillary thyroid carcinoma,and 150 patients were benign thyroid nodules confirmed by pathological diagnosis after operation.All patients were divided into 3 kinds: 98 Tg Ab negative patients which nodule size≥1cm,included 26 malignant patients and 72 benign patients.117 Tg Ab negative patients which nodule size<1cm,included 59 malignant patients and 58 benign patients.54 Tg Ab positive patients,included 14 malignant patients and 40 benign patients.Patients were divided into malignant and benign groups in every kind.The diagnosis efficacy of TSH/Tg ratio coincidence ultrasound thyroid imaging and thyroid imaging for thyroid nodule evaluation in Tg Ab negative patients which nodule size≥1cm 、 TSH/Tg ratio coincidence ultrasound thyroid imaging for thyroid nodule evaluation in Tg Ab negative patients which nodule size<1cm and TSH coincidence ultrasound thyroid imaging for thyroid nodule evaluation in Tg Ab positive patients were statistically analyzed separately。Results: 1、The regression equation of TSH/Tg ratio coincidence ultrasound thyroid imaging and thyroid imaging for thyroid nodule evaluation in Tg Ab negative patients which nodule size≥1cm was : Y= Y=-2.808 +1.865×ultrasound thyroid imaging score + 0.990×thyroid imaging score+1.181×TSH/Tg ratio score。The area under the receiver operating characteristic curves(AUC)of Y Value was 0.869,the sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio,diagnose accordance rate were92.31%、84.72%、68.60%、96.80%、6.04、0.09、86.70%,respectively.The diagnosis efficacy of TSH/Tg ratio coincidence ultrasound thyroid imaging and thyroid imaging for thyroid nodule evaluation in Tg Ab negative patients which nodule size≥1cm was better than that of only one method.2、The regression equation of TSH/Tg ratio coincidence ultrasound thyroid imaging for thyroid nodule evaluation in Tg Ab negative patients which nodule size<1cm was : Y= Y=-3.149 +1.721×ultrasound thyroid imaging score +2.512×TSH/Tg ratio score。The area under the receiver operating characteristic curves(AUC)of Y Value was 0.795,the sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio,diagnose accordance rate were81.40%、72.40%、75.00%、79.25%、2.95、0.26、76.92%,respectively.The diagnosis efficacy of TSH/Tg ratio coincidence ultrasound thyroid imaging for thyroid nodule evaluation in Tg Ab negative patients which nodule size<1cm was better than that of only one method.3、The diagnosis efficacy of TSH coincidence ultrasound thyroid imaging for thyroid nodule evaluation in Tg Ab positive patients was equal to the diagnosis efficacy of ultrasound thyroid imaging.The AUC of ultrasound thyroid imaging was 0.731,the sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio,diagnose accordance rate were91.20%、55.00%、77.50%、78.50%、2.03、0.16、77.80%,respectively.Conclusion 1 、 The diagnosis efficacy of TSH/Tg ratio coincidence ultrasound thyroid imaging and thyroid imaging for thyroid nodule evaluation in Tg Ab negative patients which nodule size≥1cm was better than that of only one method,which is worth clinical popularizing and application.2、TSH/Tg ratio coincidence ultrasound thyroid imaging and thyroid imaging can be carefully used for thyroid nodule evaluation in Tg Ab negative patients which nodule size<1cm.But further exam like FNAC should be needed.3、The diagnosis efficacy of TSH coincidence ultrasound thyroid imaging for thyroid nodule evaluation in Tg Ab positive patients was equal to the diagnosis efficacy of ultrasound thyroid imaging.Nowadays,ultrasound thyroid imaging seems to be the only choice to evaluated thyroid nodule in Tg Ab positive patients which have no thyroid imaging date.