ABSTRACT
Objective:To explore the value of high frequency ultrasound elastography in the differential diagnosis of Hashimoto’s thyroiditis (HT) with thyroid nodules.Methods:112 HT patients complicated with thyroid nodule disease in Department of Ultrasound in Yantai Yantaishan Hospital from Jan. 2017 to Jan. 2020 were randomly selected for prospective study. All patients were diagnosed by routine ultrasound and high-frequency ultrasound elastography, and underwent surgical exploration and pathological diagnosis. Taking the postoperative pathological results as the gold standard, the specificity, sensitivity, negative-positive predictive value of conventional ultrasound and high-frequency ultrasound elastography in HT complicated with thyroid nodular disease were compared and analyzed, and the diagnostic efficacy was evaluated.Results:There were 138 nodules in 112 cases, including 47 benign nodules and 91 malignant nodules. The specificity and sensitivity of routine ultrasonography were 80.85% and 78.02%, respectively; The specificity and sensitivity of high frequency ultrasound elastography were 87.23% and 90.11%. Compared with conventional ultrasound, high frequency ultrasound elastography had higher specificity and sensitivity in detecting lesions ( χ2=4.54, 4.25, P=0.026, 0.039) . The negative predictive value of routine ultrasonography was 65.52%, the positive predictive value was 88.75%, and the ROC was 0.775. The best diagnostic cut-off point was 3.04. The negative predictive value of high frequency ultrasound elastography was 82.00%, the positive predictive value was 93.18%, the ROC was 0.812, and the best diagnostic cut-off point was 32.89 kpa. Compared with conventional ultrasound, high frequency ultrasound elastography had higher negative and positive predictive values ( χ2=4.35, 4.48, P=0.031, 0.027) . Conclusion:High frequency ultrasound elastography can improve the negative predictive value and sensitivity in the diagnosis of Hashimoto’s thyroiditis and thyroid cancer, judge the benign and malignant lesions, and provide more accurate data for early surgical treatment.
ABSTRACT
BACKGROUND@#Lung cancer is one of the malignant tumors. Gene mutations associated with cellular immune function and regulating the activation and proliferation of immune cells. Several publications have explored the relationship between cytotoxic T lymphocyte antigen-4 (CTLA-4) +49 adenine (A)/guanine (G) polymorphism and susceptibility of lung cancer, but the results remain controversial. Thus, we performed this meta-analysis to derive a more comprehensive estimation of the relationship.@*METHODS@#All articles addressed lung cancer and polymorphisms of CTLA-4 were searched from the PubMed, EMBASE databases published up to June 29, 2019. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of association. Publication bias of relevant studies was examined via Begg's test and funnel plots.@*RESULTS@#The meta-analysis included 8 case-control studies covering 4,430 lung cancer patients and 5,198 healthy controls from September 2008 to April 2020. The overall eligible data indicated that CTLA-4 +49A/G polymorphisms did not correlate with the elevated lung cancer risk in all genetic comparison models (dominant model: OR=1.037, 95%CI: 0.925-1.161; recessive model: OR=0.968, 95%CI: 0.888-1.055; allele model: OR=0.992, 95%CI: 0.933-1.054; homozygous model: OR=0.980, 95%CI: 0.857-1.121; heterozygous model: OR=1.023, 95%CI: 0.906-1.154). In further stratified analyses, CTLA-4 +49A/G polymorphism was found to be significantly associated with susceptibility to NSCLC in these models (dominant model: OR=1.404, 95%CI: 1.074-1.836; allele model: OR=1.273, 95%CI: 1.034-1.565; homozygous model: OR=1.553, 95%CI: 1.044-2.310; heterozygous model: OR=1.308, 95%CI: 1.062-1.611).@*CONCLUSIONS@#CTLA-4 +49A/G polymorphism were not associated with the risk of lung cancer but might be a risk factor only in NSCLC.