| Objective Using epidemiological and molecular epidemiological research methods research methods,the status of iodine nutrition and thyroid nodule prevalence in the physical examination population were analyzed,and the related risk factors of nodule occurrence were explored to provide reference for early prevention and intervention of the disease.By analyzing the relative expression levels of Thyroglobulin(Tg)mRNA,Thyrotropin receptor(TSHR)mRNA and Thyroid peroxidase(TPO)mRNA in peripheral blood of patients with different thyroid nodules,to explore the value of the combination of the three and high-resolution B-ultrasound in the diagnosis of benign and malignant thyroid nodules.MethodsIn this study,physical examination personnel Inner Mongolia International Travel Healthcare Center from July 2017 to July 2018 were selected as research subjects.Questionnaire survey and thyroid b-ultrasound examination were conducted on them.Meanwhile,Urine samples were ollected and their iodine content was determined.Logistic regression was used to analyze the risk factors of thyroid nodule.The expression of Tg mRNA,TSHR mRNA and TPO mRNA in different nodules were analyzed by real-time quantitative RT-PCR.Peripheral blood Tg mRNA,TSHR mRNA and TPO mRNA were used to obtain the boundary value of thyroid cancer diagnosis by using the subject's working characteristic curve,and the sensitivity,specificity,diagnostic accuracy,positive predictive value and negative predictive value of their combined application with high-resolution b-ultrasonography in the diagnosis of benign and malignant thyroid nodules were analyzed.Results 1 The median urinary iodine(MUI)of the physical examination population is160.77 ug/L,which is in an appropriate state;The difference of MUI between different salt habits was statistically significant(?~2=9.623,P=0.022).The MUI(165.59ug/L)of people who consumed iodized salt was higher than that of non-iodized salt(153.24 ug/L)?mixed with both(155.60 ug/L)and unclear(147.50 ug/L),iodine nutrition is in an appropriate state of iodine;There was no significant difference in MUI between different thyroid nodules(?~2=1.055,P>0.05).The MUI in normal thyroid gland,benign nodule,and malignant nodules were 162.79 ug/L,160 ug/L,and 161.17 ug/L,respectively,and iodine nutrition for them are all in an appropriate state.2 A total of 1546 patients with thyroid nodules were detected,and the detection rate was 51.90%.The male detection rate was 46.31%(351/758),which was Obviously lower than that of female 53.80%(1195/2221).The difference was statistically significant(?~2=12.729,P=0.000).With the increase of age,the detection rate of thyroid nodules increased,and the difference was statistically significant(Trend?~2=29.372,P=0.000);There was no statistically significant difference in the detection rate of nodules in different daily salt habits(?~2=3.419,P=0.331).3Multivariate logistic regression analysis showed that the independent risk factors for thyroid nodules were older(OR=1.82,95%CI:1.68-1.99),female(OR=1.58,95%CI:1.45-1.74),smoking.(OR=1.37,95%CI:1.26-1.48),obesity(OR=1.12,95%CI:1.06-1.18),bad mood(OR=1.61,95%CI:1.11-2.46)and family history of thyroid disease(OR=1.77,95%CI:1.62-1.95).4 The relative expressions of Tg mRNA and TSHR mRNA in the thyroid malignant nodule group were higher than those in the benign nodule group and the normal group,with statistically significant differences(P<0.05);The relative expressions of TPO mRNA in malignant nodules groups were lower than those in benign nodules group and normal group,and the difference was statistically significant(P<0.05).5 The expression levels of blood Tg mRNA,TSHR mRNA and TPO mRNA were not correlated with the concentration of urinary iodine(P<0.05).6 Peripheral blood Tg mRNA>6.52,TSHR mRNA>8.73 and TPO mRNA<3.29 were obtained by ROC as the boundary values for the diagnosis of thyroid cancer.7 The sensitivity,specificity,diagnostic accuracy,positive predictive value and negative predictive value of preoperative b-ultrasonic diagnosis of benign and malignant thyroid were 72.41%,62.50%,67.92%,70%and 65.22%,respectively.The accuracy of preoperative diagnosis of benign and malignant nodules was better than that of single use.The specificity,diagnostic accuracy and positive predictive value of peripheral blood TSHR mRNA and TPO mRNA combined with b-ultrasonography were the highest,70.83%,79.36%and 78.13%,respectively.The combined sensitivity and negative predictive value of the four groups were the highest,respectively 89.66%and 83.33%.Conclusion Different salt habits have different MUI,of which the highest iodized salt is consumed,however,iodine nutrition is in a suitable state.There was no difference in the MUI between the normal population,benign nodule and malignant nodules.The detection rate of nodules for male is lower than that of females,and it increases with age.There is no difference in the detection rate of thyroid nodules with different salt habits and there is no difference in the detection rate of thyroid nodules with different salt habits.Female,old age,smoking,obesity,bad mood and thyroid disease family history are independent risk factors for thyroid nodule.The relative expression levels of Tg mRNA,TSHR mRNA and TPO mRNA in peripheral blood of normal,benign and malignant nodules were different.The relative expression thresholds of Tg mRNA,TSHR mRNA and TPO mRNA in peripheral blood for the identification of benign and malignant nodules were 6.52,8.73 and 3.29respectively.Combined detection of peripheral blood Tg mRNA,TSHR mRNA and TPO mRNA with b-ultrasound can improve the sensitivity,specificity,diagnostic accuracy,positive predictive value and negative predictive value of preoperative diagnosis of benign and malignant nodules. |
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