The combination of high-frequency ultrasound and thyroid-stimulating hormone/thyroglobulin ratio in the diagnostic value of benign and malignant lesions of thyroid nodules / 中国医师进修杂志

ABSTRACT

Objective:To analyze the diagnostic value of high-frequency ultrasound combined with serum thyroid-stimulating hormone (TSH) / thyroglobulin (Tg) ratio for the benign and malignant lesions of thyroid nodules (TN).Methods:A retrospective analysis was made on the clinical data of 772 patients with TN admitted to Changxing County People′s Hospital from June 2020 to June 2021. All patients received high-frequency ultrasound examination and serum TSH detection, 320 patients (41.45%) received Tg detection to calculate the TSH/Tg ratio. According to the benign and malignant thyroid nodules, they were divided into benign group and malignant group based on the pathological results as the "gold standard". The ultrasonographic characteristics, serum TSH and Tg levels and TSH/Tg ratio of the two groups were compared, and the accuracy of high-frequency ultrasound, TSH/Tg ratio and the combination in the diagnosis of benign and malignant thyroid nodules were evaluated.Results:A total of 83 patients with thyroid nodules were diagnosed as malignant by pathological results. In the malignant group, the nodules were mostly irregular in shape, extremely low in internal echo, accompanied by calcification, aspect ratio ≥1 and enlarged cervical lymph nodes. The levels of TSH and Tg as well as the ratio of TSH/Tg in the malignant group were higher than those in the benign group (16.52 ± 4.49) mU/L vs. (6.75 ± 1.18) mU/L, (11.37 ± 3.16) kU/L vs. (8.14 ± 1.40) kU/L, 1.45 ± 0.76 vs. 0.83 ± 0.06, there were statistical differences( P<0.05). The sensitivity and accuracy of high-frequency ultrasound combined with TSH/Tg ratio in the diagnosis of benign and malignant thyroid nodules were 92.77%, 95.47%, and higher than those in the single diagnosis. Conclusions:The morphological high-frequency ultrasonography features of malignant thyroid nodules are mostly irregular, with extremely low internal echo, accompanied by calcification, aspect ratio ≥1 and cervical lymph node enlargement. TSH/Tg ratio is higher than that of benign thyroid nodules. The combination of high-frequency ultrasonography and TSH/Tg ratio can improve the diagnosis rate of thyroid cancer.