The Clinical Pathological Analysis On The Clinical Epidemiology Evaluation, Misdiagnosis And Missed Diagnostic Cases Of Thyroid Nodules

Objective the clinical epidemiology analysis was made on the diagnostic methods of patients with thyroid nodules, and the significance, advantages and limitations of various diagnostic methods in the diagnosis of thyroid nodules were evaluated to provide references for the rational use of these methods in clinical. The retrospective clinical pathological analysis was made on the misdiagnosis and missed diagnosis cases in various diagnostic methods of thyroid nodules and the causes were discussed to improve the levels of diagnosis.Methods The 654 cases of patients who were treated with surgical resection in the otorhinolaryngology head neck surgery department of the affiliated hospital of Qingdao University due to thyroid diseases from Jan 1st, 2013 to December 31 st,2015 were analyzed retrospectively. The postoperative routine pathological results were taken as the gold standard and the epidemiological statistics were made on the various diagnostic methods, and four fold tables were used to make statistics, calculation, analysis and evaluation. Meanwhile retrospective clinical pathological analysis was made on various cases of misdiagnosis and missed diagnosis for the diagnostic methods.Results The degree of sensitivity and specificity for the diagnostic method of thyroid nodules respectively was: history and palpation was 41.23% and 20.23%;ultrasound was 81.89% and 85.18%;the fine needle aspiration biopsy under the guidance of ultrasound was 88.67% and 90.90%;CT examination was 52.28% and 48.42%; frozen section pathology during operations was 98.73% and 99.75%.Conclusion At present the clinical diagnosis of benign and malignant thyroid nodules has not yet formed the fixed, effective and clear means.Color Doppler ultrasonography has high degree of sensitivity and specificity with high clinical values,which still needs further improvement. The fine needle aspiration biopsy under the guidance of ultrasound has the highest degree of sensitivity and specificity, which belongs to invasive operations. Frozen section pathological examination is the effective diagnostic way for thyroid nodules, which is suitable for the patients who are not confirmed before surgery. All kinds of examination methods should be combined together to improve the level of diagnosis.