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Objective To investigate the diagnostic value of computed tomography (CT) histogram analysis for thyroid malignant solitary coarse calcification nodules (MSCN).Methods A total of 89 thyroid solitary coarse calcification nodules (coarse calcification ≥5 mm,no definite soft tissue around calcification) confirmed either by surgery or histopathological examination in 86 patients enrolled in this study from Jan.2009 to Dec.2015 were evaluated,including 33 MSCN from 32 patients and 56 benign solitary coarse calcification nodules (BSCN) from 56 patients.Overall,27 cut-off values were calculated by N (4 ≤ N ≤ 30) times of 50 Hounsfield units (HU) in the range of 200 HU to 1500 HU,and each cut-off value and the differences in the corresponding area percentages in the CT histogram were recorded for MSCN and BSCN.The optimal cut-off value and the corresponding area percentage were established by receiver operating characteristic (ROC) curve analysis.Results In the 24 groups with an ROC area under the curve (AUC) of more than 0.7,at a cut-off value of 1150 HU and at an area percentage of no less than 98.4％,the ROC AUC reached a maximum of 0.86,and the accuracy,sensitivity,and specificity were 70.8％,93.9％,and 57.1％,respectively.At a cut-off value of 450 HU and at an area percentage of no less than 46.3％,the accuracy,sensitivity,and specificity were 76.4％,48.5％,and 92.9％,respectively.At a cut-off value of 550 HU and at an area percentage of no less than 81.5％,the accuracy,sensitivity,and specificity were 75.3％,33.3％,and 100％,respectively.Conclusions In comparison with the cut-off value of 1150 HU with an area percentage of no less than 98.4％,the sensitivities for the cut-off value of 450 HU with an area percentage of no less than 46.3％ and for the cut-off value of 550 HU with an area percentage of no less than 81.5％ were lower;however,the specificities increased significantly,providing an important basis for reducing the misdiagnosis of MSCN.
ABSTRACT
Objective To investigate the diagnostic significance of CT in thyroid benign solitary coarse calcification nodules (BCCN).Methods A total of 56 BCCN confirmed by surgical pathology in 55 patients were evaluated,and they were compared with 33 papillary thyroid carcinoma (PTC) in 32 patients.The distribution differences of the average CT values and the maximum CT values in BCCN and PTC were observed.The optimal thresholds of the average CT values and the maximum CT values in BCCN and PTC were established by re ceiver operating characteristic(ROC) curve analysis.Results The average CT values in BCCN and PTC were significantly different (t=4.992,P=0.000).The ROC area under curve (AUC) was 0.757 (95％ confidence interval 0.0657-0.0857).When the critical value was 743.4 Hu,Youden index was the largest and the sensitivity and specificity was 48.2％ and 93.9％,respectively.When the critical value was 891.1 Hu,the sensitivity and specificity was 21.4％ and 100％,respectively.The maximum CT values in BCCN and PTC were significantly different (t=5.029,P=0.000).The ROC AUC was 0.775 (95％ confidence interval 0.0681-0.0869).When the critical value was 1201.5 Hu,Youden index was the largest and the sensitivity and specificity was 51.7％ and 91.0％,respectively.When the critical value was 1373.5 Hu,the sensitivity and specificity was 42.9％ and 100％,respectively.Conclusions CT value is of great significance to the diagnosis of BCCN and has high specificity.Compared with the average CT value,the maximum CT value has a relatively higher sensitivity,providing an important base for reducing unnecessary surgical trauma.
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Objective To investigate the clinical pathologic features of ovarian malignant mesoderm mixed tumor (malignant mixed mesodermal tumor of uterus ,MMMT ) ,and its differential diagnosis ,clinical treatment and prognosis .Methods A retrospec‐tive analysis of the clinicopathological data of 9 patients with MMMT in our hospital from January 1985 to December 1985 was per‐formed ,and the clinicopathological data included routine paraffin section of HE staining and special staining and immunohistochemi‐cal study .Results Results showed that 8 cases were examined by ultrasound with side ovarian tumor ,1 case of patients with bilat‐eral ovarian tumors .Histological examination showed that there was 5 cases of endometrial carcinoma in epithelial components ,3 ca‐ses in clear cell carcinoma ,1 case in mucous adenocarcinoma .Composition of mesenchymal cells were fusiform or irregular shape , weaving or beam pattern ,or chaotic ,which 4 cases showed chondrosarcoma ,2 cases showed bone sarcoma component and glandular epithelial cell keratin and stromal elements vimentin (Cytokeratin ,CK) of 9 cases were + ,and estrogen receptor (estrogen recep‐tor ,ER) detection of 3 cases were + ,Progesterone receptor(PR) detection of 2 cases were + ,protein (desmin) of 2 cases were + ;highly glycosylation type I transmembrane glycoprotein (CD34) of 1 case was + .Conclusion Histological appearance is the main detection methods of ovarian malignant germ layer in the diagnosis of mixed tumor ,and B ultrasonic and CA125 inspection at the same time can effciently improve the accuracy of clinical diagnosis .