The Establishment Of Thyroid Fine Needle Aspiration Scale And Its Application In Suspected Malignant Thyroid Nodules

Background and objective:Thyroid nodules are the most common thyroid disease.With the development of ultrasound and other imaging technologies and the improvement of residents’ health concepts,the incidence of thyroid nodules has increased year by year,especially thyroid nodules with a thyroid ≤ 10 mm,with atypical clinical symptoms.Neck physical examination is usually difficult to find.It is often found accidentally during physical examination and ultrasound.The World Health Organization defines papillary thyroid carcinoma with a diameter of less than 1 cm as papillary thyroid microcarcinoma(PTMC).Ultrasound is currently recognized by domestic and foreign scholars as the first choice for the diagnosis of thyroid nodules.It can detect PTMC primary lesions with a diameter of 2to 3 mm,but the accuracy of the ultrasonic inspection method and the clarity of the ultrasound machine and the diagnosis experience of the sonographer related.Thyroid fineneedle aspiration biopsy(FNAB)is the most sensitive and specific method for assessing benign and malignant thyroid nodules.Due to too few effective tissues and typical cells for puncture,or differences in the level of pathologists,FNAB may not be determined.Benign and malignant nodules.This study intends to develop a risk assessment scale for thyroid micropapillary carcinoma(PTMC)during thyroid fine needle aspiration(FNA),and to compare the diagnostic efficiency of this scale with thyroid fine needle aspiration biopsy(FNAB)to optimize FNAB Screening process.Methods:Selected 313 patients with suspicious malignant thyroid nodules(TI-RADS 4/5)who had undergone surgical treatment and had detailed preoperative puncture records as the research objects.The score scale was constructed through logistic regression analysis and the subjects were drawn Operating characteristic curve(ROC)evaluates its diagnostic efficiency,determines its best diagnostic node and malignant risk stratification.The area under the curve(AUC)and diagnostic test evaluation indicators were used to compare the diagnostic efficacy of the scale,FNAB and the combination of the two.Results:The scale includes the nature,morphology,boundary,calcification,aspect ratio,blood flow signal of the nodule,and the hardness of the nodule during puncture,the gritty feeling,and the movement of the nodule under ultrasound.The cut point for distinguishing good benign and malignant,and risk stratification: ≤3 points for low risk,4 to 6 points for medium risk,7 to 9 points for high risk,and ≥10 points for very high risk.The sensitivity of FNAB in diagnosing PTMC is 85.58%,the specificity is 87.50%,the accuracy is 85.71%,and the AUC is 0.865;the sensitivity of the scale to diagnose PTMC is 76.92%,the specificity is87.50%,the accuracy is 77.68%,and the AUC is 0.837;The sensitivity of the combined diagnosis of the two is 99.04%,the specificity is 87.50%,the accuracy is 98.21%,and AUC=0.933.Conclusion:The scale can be used as a synergistic method for screening patients with thyroid micronodules in FNAB.Combining FNAB can improve the diagnostic efficiency of PTMC,which may reduce the missed diagnosis rate of PTMC,and reduce unnecessary secondary puncture,surgical treatment and costs.