ABSTRACT
Objective To compare the sonographic features as well as clinical histopathological features of follicular variant papillary thyroid carcinoma(FVPTC) and conventional papillary thyroid carcinoma (CPTC) in pediatric patients.Methods From Jan.2006 to Dec.2017,26 FVPTC patients and 82 CPTC patients were enrolled in this study.The clinical histopathological findings and the sonographic features were compared between the two groups.FVPTCs and CPTCs were divided into PTC-like and follicular neoplasm(FN)-like based on sonographic characteristics.Results The mean nodule size of FVPTCs was larger than that of conventional PTCs.Extrathyroid invasion and cervical lymph node metastasis did not have significant difference between CPTC and FVPTC patients(53.8％ vs 62.2％ and 76.9％ vs 82.9％,respectively).Multiple nodules(P=0.000)and distant pulmonary metastases(P=0.024) were more frequent in CPTCs than in FVPTCs(P＜0.05).The rate of an ill-defined margin (P=0.000) and calcification (P=0.003)in terms of sonographic features were lower in FVPTCs than conventional PTCs(P＜0.05).A Ⅴ+Ⅵ diagnosis of PTC on FNAC of FVPTCs was less common than that of conventional PTCs (P=0.014).Multifocality(P=0.000),extrathyroidal invasion (P=0.000),and lymph node metastasis (P=0.000) were significantly different between PTC-like FVPTCs and FN-like FVPTCs.Conclusion FVPTC in children and adolescents shows a relatively larger size,more benign sonographic features,and a lower diagnostic rate of PTC by FNAC compared with conventional PTCs in pediatric patients.
ABSTRACT
Objective To develop a multivariate logistic regression model , and to predict the risk of ma-lignant partially cystic thyroid nodules .Methods 470 patients(662 nodules)treated with surgery and confirmed by pathological diagnosis were screened out .Their ultrasonographic morphology and vascularity of thyroid nod-ules, thyroid stimulating hormone(TSH)and clinical information were collected and analyzed retrospectively .The model was developed to calculate the individual risk and ROC curve was used to evaluate the predictive index . Results The regression model was:Z=-3.60+1.40X2+2.47X3+1.05X4+0.57X9+0.07X10+1.02X12 ( X2 represents eccentric acute-angle configuration , X3 represents microcalcification , X4 represents cystic-solid margin,X9 represents echogenecity of solid portion , X10 represents TSH,X12 represents gender );M=eZ/1+eZ (M represents probability of malignancy , e represents natural constant 2.72).When applied the model to the ver-ification group, the accuracy, sensitivity, specificity, misdiagnosis rate, missed diagnosis rate, negative likeli-hood ratio(LR-)and positive likelihood ratio(LR+)was 96.95%,100%, 96.68%, 3.32%, 0%, 0 and 30.12 respectively.The largest area under the receiver-operating characteristics curve (AUC)was 0.88,which proved the model has high diagnostic value .Conclusions The model has high accuracy to predict the risk of malignan-cy.M is closely related to malignant risk of partially cystic thyroid nodules .
ABSTRACT
Objective A multivariate logistic regression model was built to estimate the risk of malignant partially cystic thyroid nodules.Methods Data of ultrasonographic morphology,microcalcifications,margin,colloid crystals and echogenicity of 766 thyroid nodules (of 506 patients) were analyzed retrospectively.All patients underwent surgery and the diagnosis were confirmed by pathology.The model was built to calculate the individual risk and evaluate the predictive index.Results The regression model was Z =-2.30 + 1.42X2 + 2.39X3 + 1.17X4-1.35 X7 + 0.62X9 ; P =eZ/1 + ez (P represents probability of malignancy,e represents natural constant 2.72).The largest area under the receiver-operating characteristics curve (AUC) was 0.86.When apply the model to the verification group(266 nodules),the accuracy,sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,negative likelihood ratio and positive likelihood ratio were 93.61％,83.33％,94.63％,5.37％,16.67％、0.18 and 15.52 respectively.Conclusions This model based on the ultrasonographic variables increases the diagnostic accuracy of malignancy in patients with partially cystic thyroid nodules.