Application value of color Doppler ultrasonography combined with thyroid autoantibody detection in early diagnosis of thyroid cancer / 中国医师进修杂志

ABSTRACT

Objective:To investigate the clinical significance of color Doppler ultrasonography combined with detection of thyroid autoantibodies in the early diagnosis of thyroid cancer.Methods:A total of 108 patients with thyroid cancer who treated in Shaoxing Central Hospital Medical Community General Hospital from September 2019 to September 2021 were selected as the research group, and 108 patients with benign thyroid lesions during the same period were selected as the control group. The ultrasound examination results and the levels of serum thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb) and thyroid receptor antibody (TRAb) were compared between the two groups. The relationship between the thyroid autoantibodies index and the early diagnosis of thyroid cancer were analyzed by Spearman correlation analysis; the value of early diagnosis by color Doppler ultrasonography combined with detection of thyroid autoantibodies were evaluated by the receiver operating characteristic (ROC) curve.Results:The main features of ultrasonic images in the research group were unclear edge, low echo, irregular shape, chaotic blood flow distribution, internal micro calcification, no envelope and blood flow resistance index ≥0.7. The sensitivity of ultrasonography for the diagnosis of thyroid cancer was 86.11% (93/108), the specificity was 87.18% (102/117) and the accuracy was 90.28% (195/216). The levels of serum TgAb, TPOAb and TRAb in the research group were higher than those in control group (32.28 ± 2.85) kU/L vs. (21.96 ± 2.54) kU/L, (81.28 ± 7.32) kU/L vs. (51.53 ± 5.86) kU/L, (4.48 ± 1.25) U/L vs. (2.35 ± 0.63 ) U/L, there were statistical differences ( P<0.05). The levels of serum TgAb, TPOAb and TRAb in patients with lymph node metastasis were higher than those in the patients without lymph node metastasis (36.28 ± 3.12) kU/L vs. (30.60 ± 2.54) kU/L, (93.51 ± 8.57) kU/L vs. (76.13 ± 6.62) kU/L, (5.73 ± 1.54) U/L vs. (3.95 ± 1.12) U/L, there were statistical differences ( P<0.05). The levels of serum TgAb, TPOAb and TRAb in patients with stage Ⅲ-Ⅳ were higher than those in the patients with stage Ⅰ-Ⅱ (35.84 ± 3.28) kU/L vs. (29.74 ± 2.29) kU/L, (89.35 ± 8.16) kU/L vs. (75.52 ± 6.23) kU/L, (5.28 ± 1.49) U/L vs. (3.91 ± 1.25) U/L, there were statistical differences ( P<0.05). The results of Spearman correlation analysis showed that the levels of serum TgAb, TPOAb and TRAb were positively correlated with lymph node metastasis ( r = 0.758, 0.824, 0.695, P<0.05) and clinical stage of thyroid cancer ( r = 0.735, 0.796, 0.673, P<0.05). The results of ROC curve analysis showed that the area under the curve(AUC) of ultrasound examination combined with TgAb, TPOAb and TRAb for early diagnosis of thyroid cancer was 0.930, the sensitivity was 85.19%, and the specificity was 91.67%. The combined diagnostic value was better than single diagnosis. Conclusions:Ultrasound examination combined with serum TgAb, TPOAb and TRAb has high diagnostic value for early stage thyroid cancer, which is helpful to clinically clarify the condition, and provides a reliable basis for preoperative diagnosis and targeted individualized treatment plan.