ABSTRACT
Objective:To explore the relationship between serum levels of thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (Tg-Ab) and the development of papillary thyroid carcinoma.Methods:The clinical data of 574 patients with thyroid nodules who received surgical treatment in Tengzhou Central People's Hospital from January to December 2021 were retrospectively analyzed. Using histopathological diagnosis as the gold standard, the patients were divided into papillary thyroid carcinoma group (malignant group, 267 cases) and benign thyroid nodules group (benign group, 307 cases). The clinical data and the preoperative serum TSH, TPO-Ab and Tg-Ab levels were compared between the two groups. The correlation between preoperative serum TSH, TPO-Ab and Tg-Ab levels and papillary thyroid cancer was analyzed by logistic regression.Results:There were no statistical differences in the age and gender of patients between the malignant group and the benign group (all P > 0.05). TSH [2.37 mIU/L (1.43 mIU/L, 5.09 mIU/L)], TPO-Ab [17.84 IU/ml (11.94 IU/ml, 40.68 IU/ml)] and Tg-Ab [15.69 IU/ml (10.57 IU/ml, 132.00 IU/ml)] in the malignant group were higher than those in the benign group [TSH 1.60 mIU/L (0.88 mIU/L, 2.57mIU/L), TPO-Ab 14.29 IU/ml (10.00 IU/ml, 21.17 IU/ml), Tg-Ab 12.23 IU/ml (10.00 IU/ml, 16.51 IU/ml)], and the differences were statistically significant ( Z values were -6.43, -4.60 and -6.15, all P < 0.05). Multivariate logistic regression analysis showed that positive TPO-Ab ( OR = 0.996, 95% CI 0.993-0.999, P = 0.013) and positive Tg-Ab ( OR = 0.996, 95% CI 0.994-0.998, P < 0.05) were independent risk factors for papillary thyroid cancer. Conclusions:Preoperative serum TSH, TPO-Ab and Tg-Ab levels are closely related to papillary thyroid cancer, among which positive serum TPO-Ab and positive Tg-Ab are independent risk factors for papillary thyroid cancer and have important values in the differential diagnosis of benign and malignant thyroid nodules.
ABSTRACT
Objective:To systematically evaluate the diagnostic value of fine-needle aspiration washout fluid for measuring thyroglobulin (FNA-Tg) and fine-needle aspiration cytology (FNAC) in cervical lymph node metastasis of papillary thyroid carcinoma.Methods:Chinese Journal Full-Text Database, Wanfang Database, VIP Chinese Science and Technology Journal Database and other databases from January 2016 to December 2020 were retrieved. And then diagnostic trials from the databases regarding the comparison of FNA-Tg and FNAC in the diagnosis of papillary thyroid carcinoma with neck lymph node metastasis based on the histopathological diagnosis as the gold standard were included. The literatures were screened out according to the diagnostic test inclusion criteria recommended by the Cochrane Collaboration Screening and Diagnostic Test Methods Group; and then the quality of the included literatures was evaluated and feature information was extracted. Review Manager 5.0 and MetaDiSc software were used to conduct Meta analysis, and a summary receiver operating characteristic (SROC) curve of FNAC and FNA-Tg in the diagnosis of lymph node metastasis was drawn to calculate the area under the curve and to judge the diagnostic efficacy.Results:A total of 19 articles and 2 792 cervical lymph nodes were finally included. The sensitivity of FNAC and FNA-Tg in the diagnosis of cervical lymph node metastasis in papillary thyroid carcinoma was 0.80 (95% CI 0.78-0.81) and 0.92 (95% CI 0.91-0.93), respectively; the specificity was 0.93 (95% CI 0.92-0.95) and 0.91(95% CI 0.89-0.93); the diagnostic odds ratio was 51.55 (95% CI 38.61-68.81) and 110.03 (95% CI 82.18-147.32), respectively; the areas under the SROC curve was 0.900 and 0.968, respectively. Conclusions:The accuracy of FNA-Tg in the diagnosis of cervical lymph node metastasis of papillary thyroid carcinoma is higher than that of FNAC. FNA-Tg can be used as an important diagnosis supplement to FNAC and it can be widely used in clinical practice.