Value Of Ultrasound-guided Fine Needle Aspiration Cytology Combined With Immunocytochemical On The Accuracy Of Preoperative Diagnosis Of Thyroid Cancer

ObjectiveTo evaluate the value of high-resolution ultrasound-guided fine-needle aspiration cytology and immunocytochemical staining of CK19 and TPO in the preoperative diagnosis of thyroid nodules,and whether the combined detection can improve the accuracy of preoperative diagnosis.Methods(1)A total of 53 patients with thyroid nodules were enrolled in this study.They were ultrasound and operated in The Second Hospital of Anhui Medical University on September 2019 to January 2020.And their ultrasound results suggest that thyroid nodules are all classified as TI-RADS 4b or worse.(2)Preoperative fine-needle aspiration was performed on all participants whose cell smears were tested for cytology and immunocytochemical staining of CK19 and TPO.Cytological examination were tested after surgical resection of thyroid nodules specimens.(3)Take postoperative pathological results as the gold standard for diagnosis,use SPSS21.0 for statistical analysis,observe preoperative cytopathological results and the expression of CK19 and TPO antibodies,and analyze cytological examination combined with immunocytochemical antibodies The value of detection for the preoperative diagnosis of benign and malignant thyroid nodules.Medcalc19.0statistical software was used for normal Z test to compare the accuracy differences of each diagnostic method,and P<0.05 was considered as statistically significant.Results(1)According to the preoperative cytological examination,20 patients were diagnosed as papillary carcinoma,15 cases were suspected malignant,9 were suspected benign and 9 were benign.Among the 15 cases who were suspiciously malignant nodules,it demonstrated that 11 cases were malignant and 4 were benign nodules combined with immunocytochemical staining.The postoperative pathological results showed that 9 cases were papillary carcinoma,1 case was follicular carcinoma,4 cases were benign and 1 case was follicular cell proliferation actively.Among these 9 cases of suspected benign lesions,additional immunocytochemical staining indicated that 5cases were benign and 4 cases were malignant.While the postoperative pathological revealed 5 cases were papillary carcinoma and 4 cases were benign.(2)The sensitivity,specificity and accuracy of ultrasound-guided fine needle aspiration cytology in the diagnosis of malignant thyroid nodules were 83.33%,70.59%,and76.96%.The sensitivity immunocytochemical markers CK19 and TPO in the diagnosis of malignant thyroid nodules were 88.89% and 83.33%,the specificity was 76.47% and 76.47%,and the accuracy was 82.68% and 81.29%.The sensitivity,specificity and accuracy of cytological examination combined with immunocytochemistry in the diagnosis of malignant thyroid nodules were significantly higher than those of cytological examination,which were 97.22%,94.12%,and 94.28%.(3)The ROC curve is constructed with 1-specificity as the abscissa and sensitivity as the ordinate.The area under the curve of cytology and immunocytochemistry CK19 and TPO are 0.770,0.827,0.813.The area under the curve of fine needle aspiration cytology combined with immunocytochemical markers CK19 and TPO was 0.943.(4)There was a statistically significant difference in the area under the curve between preoperative cytological examination and cytological examination combined with CK19 and TPO detection(Z=2.77,P=0.005).Compared with the area under the curve of CK19,TPO and the combined detection,the difference was statistically significant(CK19: Z=2.10,P=0.035;TPO: Z=2.16,P=0.031).ConclusionsThe sensitivity,specificity and accuracy of high-resolution ultrasound guidance fine-needle aspiration cytology and immunocytochemistry CK19 and TPO in the diagnosis of malignant thyroid nodules are high.Cytological examination combined with immunocytochemical marker analysis can help improve the accuracy of preoperative diagnosis of benign and malignant thyroid nodules,and has high clinical application value.