Correlation Analysis Of Thyroid Nodule Pathology,Cytology,Clinical And Imaging Features

Objective: Thyroid cancer is the most common head and neck malignancy.In recent years,the incidence of thyroid cancer continues to increase worldwide.In clinical practice,if we do not pay attention to the nature of thyroid nodules,and cannot effectively identify malignant or malignant nodules with high risk,misdiagnosis or missed diagnosis may occur,resulting in the patient's over treatment or condition delay.In the past,the nature of nodules was often evaluated by inquiring medical history,clinical manifestations and ultrasonic examination.In recent years,the diagnosis of thyroid nodules by ultrasound-guided fine-needle aspiration biopsy(US-FNAB)has been gradually recognized and more and more widely used in clinical practice.This study will on the basis of thyroid nodule postoperative pathology,analysis the clinical characteristics,the sonographic features and computed tomography features of thyroid cancer predictors,discusses US-FNAB value to the diagnosis of thyroid cancer,understanding of thyroid nodules pathologic classification and composition of how the integrated use of these methods for the clinical work clear nodules property,determine the best treatment plan to provide reliable basis.Methods : All the subjects of the study were 136 thyroid nodules patients(a total of 187 thyroid nodules)who visited the head and neck surgery department of the affiliated cancer hospital of Guangxi medical university from January 2016 to January 2019 after finding thyroid nodules by palpation or ultrasound examination,and underwent US-FNAB resection after improving clinical data,ultrasound and CT examination.Clinical,ultrasound characteristics and CT characteristics of the patients were retrospectively analyzed.Statistical methods of univariate analysis were used to find out the characteristics with statistical significance in the difference of malignant rate,and then the characteristics with statistical significance in univariate analysis were included in the Logistic multivariate regression analysis to find out the independent risk predictors.Clinical features observed included age,sex,clinical symptoms,family history of thyroid disease,history of neck radiation,history of rapid nodule enlargement,nodule texture,and serum thyroid hormone levels.Ultrasonic features include nodule component,echo,morphology,boundary,aspect ratio(AP/TP),calcification type,etc.CT features include nodule density,nodule boundary,nodule capsule,degree of enhancement,presence or absence of sand-like calcification,cystic degeneration and cervical lymph node enlargement,etc.Cytological diagnosis results of the patients were collected,and postoperative pathology was used as the control to calculate the sensitivity,specificity,diagnostic accuracy,positive predictive value and negative predictive value of US-FNAB in the diagnosis of thyroid cancer.The postoperative pathological data of patients were collected,and the composition ratio of each pathological type was statistically analyzed.Results: 1?136 cases of patients with thyroid nodules,single factor analysis of clinical characteristics suggest that age < 40 years old group malignrate is higher than the age of 40 or higher rate of malignant(65.85%vs44.21%,X2=5.37?P<0.05),the rate of malignant thyroid nodule differences between different age groups was statistically significant,more clinical characteristics such as gender,clinical symptoms,family history of thyroid disease,history of nodules increases rapidly,nodules texture,serum thyroid hormone levels,etc.No significant differences between groups in malignant rate,no statistical significance(P > 0.05).187 thyroid nodules,In ultrasound examination,single factor analysis suggest solid nodules,small calcification,irregularly,size/diameter(AP/TR)before and after 1 OR higher is sonographic features such as nodular malignant risk factors(P < 0.05),Logistic multifactor regression analysis suggests that tiny calcification,shape is irregular such as ultrasonic characteristics is an independent predictor of thyroid cancer,its the OR values were 9.42,3.15,tiny calcification of malignant nodules prediction effect is greater than the irregular edges.In CT examination,single factor analysis suggested that fuzzy boundary,incomplete capsule,sand-like calcification,cervical lymph node enlargement and other CT features were risk factors for malignant nodules(P<0.05),Logistic multifactor regression analysis,fuzzy boundaries,coated incomplete,cervical lymph node enlargement is an independent predictor of thyroid cancer,these factors effect on thyroid cancer prediction,the OR values were 2.77,2.73,2.98.2?The false negative rate,false positive rate,sensitivity,specificity and diagnostic accuracy of us-fnab187 thyroid nodules were 4.40%,2.22%,91.67%,98.86% and 96.32% respectively.3?Among 111 benign thyroid nodules diagnosed by pathology,nodular goiter was the most,accounting for 99,accounting for 88.29% of benign nodules.Among the 76 malignant nodules diagnosed by pathology,thyroidpapillary carcinoma was the most,accounting for 73 nodules,accounting for96.05% of malignant nodules;among the 76 malignant nodules,15 were accompanied by benign lesions,accounting for 20.0% of malignant nodules.In addition,8 of the 76 malignant nodules were microcarcinoma,accounting for10.96% of malignant nodules.Conclusion: 1.Age,ultrasound features and CT features are of certain significance in the diagnosis of thyroid cancer.Thyroid nodules' micro-calcification,irregular edges and other ultrasonic features,fuzzy boundaries,incomplete capsule after enhancement,cervical lymph node enlargement and other CT features are independent predictors of thyroid cancer.2.For the identification of benign and malignant thyroid nodules,us-fnab has a high sensitivity,specificity and accuracy,and is an extremely important and effective examination for the identification of the nature of thyroid nodules in clinical practice.3.Among thyroid nodules,nodular goiter is the most common benign nodules,and papillary thyroid carcinoma is the most common malignant nodules.The co-existence of benign and malignant nodules and microcarcinoma is not uncommon in thyroid nodules,so it should be carefully differentiated.