The Relevant Research Of Thyroid Calcified Nodules And The Inadequate Diagnostic Rate Of Ultrasound Guided Fine Needle Aspiration Cytology

Objective:To evaluate the relevant research of thyroid calcified nodules and the inadequate diagnostic rate of ultrasound guided fine needle aspiration cytology (USFNAC).Methods:447thyroid nodules in421patients were retrospective analyzed, and all of the nodules were acquired cytological diagnosis. There were micro calcification, macro calcification, circumjacent arc calcification and negative according to shapes of the calcification. Each of these were divided into3groups (group of<5mm、5-10mm、>10mm)according to the nodules’size (ultrasonic section of FNA). The nodules with macro calcification were divided into group of single and multiple according to the macro calcification’s number (ultrasonic section of FNA), and they were also divided into group of smooth and coarse according to the surface of macro calcification (ultrasonic section of FNA). There were3ratios in the macro calcified nodules in the ultrasonic section of FNA:A/B ratio (size of the calcification/left-right diameter of the nodule) means the range dimension of the calcification, C/D ratio (distance of calcification and anteroventral nodule/antero-posterior diameter of the nodule) means the place of the nodules’ inner, E/F ratio(distance of calcification and the left or right side of the nodule/left-right diameter of the nodule) means the place of the nodules’ inner. The ROC were drew according to the ratios of A/B, C/D, E/F, from which acquired the best cut-off value of inadequate diagnosis.Results:1. There were208nodules with calcification and239nodules with negative, which had the inadequate diagnostic rate of25.5%and11.7%.2. There were100nodules with micro calcification,91nodules with macro calcification and17nodules with circumjacent arc calcification, which had the inadequate diagnostic rate of16.0%,26.4%, and76.5%.3. The inadequate diagnostic rate in circumjacent arc calcification was higher than those in micro calcification,macro calcification and negative(P<0.01).4. The inadequate diagnostic rate in macro calcification was higher than those in the negative(P<0.01). The inadequate diagnostic rate was no significance difference in micro calcification and macro calcification(p>0.05).5. The inadequate diagnostic rate was no significance difference in micro calcification and the negative(p>0.05).6. There was no statistical significance difference in different size (ultrasonic section of FNA)of thyroid nodules(p>0.05).7. There were59nodules with single calcification and32nodules with multiple calcification, which had the inadequate diagnostic rate of27.1%and25.0%.There was no statistical significance difference in different number (ultrasonic section of FNA)(p>0.05).8.There were39nodules with smooth and52nodules with coarse, which had the inadequate diagnostic rate of23.1%and28.8%. There was no statistical significance difference in different surface of macro calcification (ultrasonic section of FNA)(p>0.05).9. The ratio of A/B was significantly higher in the inadequate diagnostic nodules(P <0.01). The best cut-off value was0.55, with the sensitivity, specificity, AUC of64.1%,79.2%,0.73.10. The ratio of C/D was significantly lower in the inadequate diagnostic nodules(P<0.01). The best cut-off value was0.25, with the sensitivity, specificity, AUC of75.4%,60.0%,0.74.11. The ratio of E/F was significantly lower in the inadequate diagnostic nodules(P <0.01). The best cut-off value was0.25, with the sensitivity, specificity, AUC of81.3%,62.5%,0.76.Conclusions:The inadequate diagnostic rate was higher in nodules with circumjacent arc calcification and macro calcified nodules with higher A/B, lower C/D, lower E/F. All of these should be avoid US-FNAC. The inadequate diagnostic rate was lower in nodules with micro calcification and negative. These nodules were suitable for US-FNAC.