Clincal value of preoperative C-reactive protein and thyroid stimulating hormone levels in diagnosis of subacute thyroiditis / 中国基层医药

ABSTRACT

Objective:To explore the diagnostic value of preoperative serum C-reactive protein(CRP) and thyroid stimulating hormone(TSH) levels in subacute thyroiditis, so as to provide evidence for reducing clinical mistreatment.Methods:From May 2011 to January 2020, the clinical data of 3 525 cases who received thyroid nodule surgery in the First Affiliated Hospital of Anhui University of Science & Technology were retrospectively analyzed.According to the results of pathology, the patients were classified as subacute thyroiditis group, chronic lymphocytic thyroiditis group, thyroid cancer group and benign thyroid nodule group.Fifty-six cases of subacute thyroiditis group(group A) and 56 cases of Hashimoto thyroiditis group(group B) were selected to meet the conditions of the group.Fifty-six cases of thyroid cancer group(group C) and 56 cases of benign thyroid nodule group(group D) were selected according to the random number table method.The serum levels of CRP, TSH and other indicators of each group were counted and analyzed before operation.Results:The misdiagnosis rate of subacute thyroiditis was 1.7%.CRP level in group A was significantly higher than that in groups B, C and D( Z=-3.024, -6.449, -6.012, all P<0.01). The TSH level in group A was significantly lower than that in groups B, C and D( Z=-2.397, -3.877, -2.583, P=0.017, 0.000 and 0.010), while that in group C was significantly higher than group D( Z=-2.421, P=0.016). The area under ROC curve for CRP diagnosis of subacute thyroiditis was 84.3%(95% CI 0.770-0.917), when the optimal cutoff value was 3.62 mg/L, the diagnostic sensitivity and specificity were 69% and 87%, respectively. Conclusion:Familiarity with clinical manifestations and preoperative serum CRP and TSH levels as differential indicators of benign and malignant thyroid nodules can reduce misdiagnosis of subacute thyroiditis.