Study on differential diagnosis of thyroid follicular carcinoma and thyroid follicular adenoma based on thyroglobulin level and ultrasonograhy
10.3760/cma.j.cn113855-20240202-00102
- VernacularTitle:甲状腺球蛋白结合超声对甲状腺滤泡癌与甲状腺滤泡性腺瘤鉴别诊断的研究
- Author:
Suling WU
1
;
Juping HU
;
Xinhua YE
;
Hao ZHANG
Author Information
1. 南京医科大学第一附属医院（江苏省人民医院）超声科，南京 210029
- Publication Type:Journal Article
- Keywords:
Thyroid neoplasms;
Thyroglobulin;
Ultrasonography;
Nomograms
- From:
Chinese Journal of General Surgery
2024;39(12):935-940
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To construct model of risk factors for follicular thyroid carcinoma.Methods:Clinical, ultrasound, and pathological data of 196 patients with single thyroid follicular neoplasm who underwent initial surgical treatment at the First Affiliated Hospital of Nanjing Medical University from Apr 2018 to Oct 2023 were collected as a training cohort. The clinical, ultrasound, and pathological data of 48 patients with the same condition at the Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine were used as a validation cohort.Results:Among the training cohort, 63 cases (32.1%) were diagnosed with follicular thyroid carcinoma. Univariate analysis showed that patients with higher preoperative thyroglobulin levels [390.1(106.7-500.0)ng/ml vs. 42.6(27.7-139.2)ng/ml, Z=-5.612, P<0.001], solid internal structure on ultrasound (81.0% vs. 54.1%, χ2=13.154, P<0.001), low internal echogenicity (68.3% vs.15.0%, χ2=55.507, P<0.001), irregular tumor morphology (39.7% vs.3.0%, χ2=45.612, P<0.001), uneven tumor margins (20.6% vs. 1.5%, χ2=19.515, P<0.001), internal tumor calcification (52.4% vs.16.5%, χ2=27.201, P<0.001), absence of acoustic halo or the acoustic halo is uneven in thickness (85.7% vs. 24.8%, χ2=64.235, P<0.001), and uneven echogenicity of solid tumor portions (74.6% vs. 19.5%, χ2=55.437, P<0.001) were characteristics of follicular thyroid carcinoma. Multivariate logistic analysis demonstrated that preoperative serum thyroglobulin levels ( OR=1.001, 95% CI: 1.000-1.002, P=0.046), solid internal echogenicity of the tumor ( OR=4.967, 95% CI: 1.602-15.405, P=0.006), tumor with calcification ( OR=4.238,95% CI:1.550-11.588, P=0.005), absence of halo around the tumor ( OR=4.225,95% CI:1.353-13.192, P=0.013), uneven thickness of the halo ( OR=21.240, 95% CI: 3.242-139.160, P=0.001), and uneven echogenicity of solid tumor portions ( OR=4.580, 95% CI: 1.678-12.505, P=0.003) were independent risk factors for follicular thyroid carcinoma . A nomogram model was constructed based on these variables, and the ROC curve showed AUC values of 0.931. Conclusion:Higher preoperative serum thyroglobulin levels, solid internal echogenicity of the tumor, tumor with calcification, absence of halo around the tumor, uneven thickness of the halo, and uneven echogenicity of solid tumor portions are independent risk factors for follicular thyroid carcinoma.
