Diagnostic Value Analysis Of Ultrasound-guided Fine-needle Aspiration Cytology Combined With Imprinted Gene Detection In The Differentiation Of Benign And Malignant Thyroid Nodules

Background: In recent years,with the continuous development of medicine and the continuous improvement of ultrasound examination capabilities,the detection rate of thyroid nodules in healthy people has become higher and higher.Therefore,the preoperative identification of the nature of thyroid nodules is important for determining treatment options and monitoring recurrence.It is very important to predict the prognosis of the disease.At present,ultrasound-guided fine-needle aspiration biopsy(FNAB)has been recognized as a real-time,portable,safe,economical,and effective diagnostic method,which is widely used in clinical diagnosis and treatment,However,due to subjective and objective factors such as the small amount of fine-needle puncture materials,the failure of smears,the limited operating skills of the puncture,and the uneven experience of the cytopathologist,the pathological results are often unclear.The detection of tumor molecular markers is of great significance to further improve the accuracy of FNAB,and imprinted gene detection is a new multi-gene combined diagnosis method,which can evaluate the benign and malignant diseases by monitoring the abnormal expression of imprinted genes.More intuitive and accurate diagnosis results are expected to become a new type of detection method to be applied in clinical practice.Objective: By comparing and analyzing the ultrasound-guided fine-needle aspiration cytology results and imprinted gene detection results of suspected malignant thyroid nodules under ultrasound guidance,the postoperative histopathological results were regarded as the gold standard to explore the clinical diagnostic value of the respective and combined diagnosis of the two detection methods for the identification of benign and malignant thyroid The clinical diagnostic value of nodules.Method: A retrospective analysis of 77 patients with thyroid nodules at risk of malignancy diagnosed by ultrasound at Tai Zhou Hospital in Jiang Su Province from May 2018 to November 2020.All patients underwent ultrasound-guided FNAB examination and imprinted genetic testing.Nodules Surgical resection was performed,and the cytological pathological examination results,imprinted gene detection results and other clinical data of these patients were analyzed and counted,and the postoperative histopathological results were compared as the gold standard to analyze their sensitivity,specificity and accuracy.To evaluate the diagnostic value of FNAB examination,imprinted gene detection and the combination of the two in differentiating benign and malignant thyroid nodules.Results: 1.Among the 77 patients included,20 were diagnosed as benign lesions by postoperative histopathology,including 5 adenomas,3 subacute thyroiditis,6Hashimoto’s thyroiditis,and 6 nodular goiter;and there were 57 cases of malignant lesions,including 55 cases of thyroid papillary carcinoma and 2 cases of thyroid follicular carcinoma.2.Ultrasound-guided fine-needle aspiration cytology results of thyroid nodules in 37 cases were benign and 40 cases were malignant.Comparing the postoperative histopathological results of the patients,the sensitivity was 68.42%,the specificity was 95.00%,the accuracy rate was 75.32%,and the positive predictive value was 97.50%.,The negative predictive value was 51.35%,which was moderately consistent with the postoperative histopathological results(Kappa =0.50,P<0.05).3.The results of imprinted gene detection were 24 benign and 53 malignant.Comparing the postoperative histopathological results,the sensitivity was 92.98%,the specificity was 100.00%,the accuracy was 94.81%,the positive predictive value was 100.00%,and the negative predictive value was 83.33%.The consistency with the postoperative histopathological results was good(Kappa=0.87,P < 0.05),and the difference with FNAB examination results was statistically significant(P<0.05).4.The sensitivity of the combined diagnosis(parallel)of the two inspection methods is 98.25%%,the specificity is 95.00%,the accuracy rate is 97.40%,the positive predictive value is 98.25%,and the negative predictive value is 95.00%,which is significantly consistent with the postoperative histopathological results.(Kappa =0.93,P<0.05).5.The sensitivity of the combined diagnosis(tandem)of the two inspection methods is 63.16%,the specificity is 100.00%,the accuracy is 72.73%,the positive predictive value is 100.00%,and the negative predictive value is 48.78%,which is moderately consistent with the postoperative histopathological results(Kappa=0.47,P<0.05).Conclusion: 1.Imprinted gene detection,as a new multi-gene combined detection method,is of great significance for the early diagnosis of thyroid cancer,and it is expected to be used clinically as a new diagnostic technique.2.Imprinted gene detection can make up for the deficiencies of FNAB examination,and is of great significance for the differentiation of benign and malignant nodules with unclear meaning,and has a higher clinical value than FNAB examination.3.Imprinted gene detection combined with FNAB examination has a significant effect in improving the detection rate of malignant thyroid nodules,and the diagnostic value of combined detection is better than simple FNAB examination or imprinted gene detection.