| 【Objective】Objective to explore the diagnostic value of serum anti-thyroid peroxidase antibody and anti-thyroglobulin antibody combined with thyroid color ultrasonography in nodular Hashimoto’s Thyroiditis,hoping to provide help for the differential diagnosis of thyroid nodules clinically found.【Method】From December 2010 to December 2013,thyroid nodules diagnosed by thyroid color ultrasonography were performed in our hospital within 3 years and surgical resection was performed.106 patients diagnosed with Hashimoto’s thyroiditis after paraffin pathology were evaluated retrospectively.All patients were preoperatively assessed by immunochemical chemiluminescence for TPOAb quantitative detection and radioimmunoassay for TGAb qualitative detection.At the same time,the United States GE GE Logiq9 color Doppler diagnostic apparatus with a center frequency of 9 MHz;operated by experienced ultrasound.The physician performs preoperative color ultrasonography.According to the postoperative thyroid pathology results,they were divided into simple nodular Hashimoto Thyroiditis(A group)43 cases;Hashimoto’s thyroiditis with differentiated thyroid cancer(Thyroid Carcinoma,B group)39 cases.Study of differentiated thyroid cancer including papillary thyroid cancer,follicular thyroid cancer alone;Hashimoto’s thyroiditis with nodular goiter(Nodular Goiter,group C)in 5 patients;Hashimoto’s thyroiditis with thyroid adenoma(Thyroid Adenoma Group D)19 cases;normal control group 20 cases(N group),normal control group selected physical examination center without thyroid disease and other autoimmune diseases,normal thyroid function.The differences in TPOAb titers and positive rates between the groups were compared,and the differences in TGAb antibody positive rates between the groups were compared.In addition,according to the preoperative thyroid color Doppler ultrasound examination of the etiology of thyroid nodules were grouped,compared with the surgical pathology,analysis of different causes of thyroid nodules thyroid color Doppler characteristics,and then for different causes of thyroid nodules with preoperative identification of clinical significance.【Results】A total of 106 patients were included.All of them were Hashimoto thyroiditis,including 39 cases of thyroid cancer(group B),and the remaining 67 cases were benign nodules,including Hashimoto nodules(group A),nodular goiter(group C)and thyroid adenoma(D group).The serum TPOAb levels in the observation group(group A、B、C、D)were significantly higher than those in the normal control group(N group)(P < 0.01),but there was no significant difference between the TPOAb group in the observation group(P > 0.05),but the A、B、D three group had a significant increase compared with the C group(P < 0.05).In addition,the level of serum TGAb in the observation group(group A、B、C、D)was significantly higher than that in the normal control group(group N)(P < O.01).In the observation group,the positive rate of A、B group was significantly higher than that of the observation group(P < 0.05),and the TGAb group was significantly higher than that of the A group(P < 0.05).The average accuracy rate of diagnosis of thyroid nodular lesions in patients undergoing thyroid color Doppler ultrasonography was 73.17%.The accuracy of simple nodular Hashimoto’s thyroiditis was only 53.49%.The rate of misdiagnosis and misdiagnosis was as high as 46.51%.There were 34 cases of misdiagnosis of Hashimoto’s thyroiditis with nodules of various etiologies.After misdiagnosis,the pathologically confirmed cases were mainly nodular goiter,followed by thyroid adenoma.【Conclusion】1.The TPOAb level and positive rate of nodular Hashimoto’s thyroiditis were no statistically different from those of Hashimoto’s thyroiditis with differentiated thyroid cancer,nodular goiter and thyroid adenoma,and it was significantly higher than that of normal control group.The diagnostic value of TPOAb in Hashimoto’s thyroiditis was confirmed.2.The positive rate of TGAb in Hashimoto’s thyroiditis group and Hashimoto’s thyroiditis group with differentiated thyroid cancer was higher than that of Hashimoto’s thyroiditis with nodular Hashimoto’s thyroiditis and thyroid adenoma.Therefore,when serum TPOAb levels are high and thyroid nodules are combined,nodules need to be further combined with TGAb results.If TGAb is positive,nodular Hashimoto’s thyroiditis should be considered and Hashimoto’s thyroiditis should be further excluded.Type of thyroid cancer possible.4.The false negative rate of TGAb was 0,so the result of TGAb was negative,and differentiated thyroid cancer could be basically excluded.5.For the diagnosis of nodular Hashimoto’s thyroiditis,thyroid color ultrasonography can only be used as a diagnostic reference,and serum TPOAb,TGAb detection is the main diagnostic basis. |
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