Analysis Of Clinical Features Of Follicular Thyroid Neoplasm

Objective: The clinical features of follicular thyroid neoplasm were analyzed retrospectively to provide certain theoretical basis for preoperative diagnosis of thyroid follicular neoplasm.Contents: We retrospectively analyzed the clinical data of 190 follicular thyroid neoplasm patients and nodular goiter patients who underwent surgical treatment with the single surgical group in Thyroid and Breast and Hernia Surgery Unit of General Surgical Department in General Hospital of Tianjin Medical University from January2015 to September 2019.Among them,33 patients diagnosed as follicular thyroid neoplasm were classified as follicular thyroid neoplasm group.157 patients with pure nodular goiter were classified as pure nodular goiter group.According to the pathological type,the follicular thyroid neoplasm group were divided into thyroid follicular adenoma group(11 cases),folliculartumor of uncertain malignant potential group(17 cases),and follicular thyroid carcinoma group(5 cases).Statistics of above cases were retrospectively analyzed and binary logistic regression analysis was used to find independent risk factors for thyroid follicular neoplasms.Results: In the analysis of preoperative blood tests data of patients in follicular thyroid neoplasm group and pure nodular goiter group,the preoperative Tg level and preoperative TPOAb positive rate of patients in follicular thyroid neoplasm group were significantly higher than those in pure nodular goiter group(290.00ng/m L vs53.45ng/m L,p=0.002),(12.1% vs 2.5%,p=0.044),the best cutoff value of the preoperative serum Tg level obtained by ROC curve was 257.00ng/m L,the sensitivity was 54.5%,the specificity was 82.8%,the positive predictive value was40.9%,and the negative predictive value was 89.7%.In the binary logistic analysis,the preoperative serum Tg>257.00ng/m L was the independent risk factor for follicular thyroid neoplasm(OR = 6.478,95% CI 2.866-14.641,p=0.000);In the analysis of preoperative sonographic data for patients in follicular thyroid neoplasm group and pure nodular goiter group,compared with pure nodular goiter,more follicular thyroid neoplasms were located in the right lobe,more at the lower pole of one side of gland or almost occupying the entire gland,and were more hypoechoic ormoderately hypoechoic nodules(69.7% vs 46.5%,p=0.015),(100% vs 79.6%,p=0.002),(69.7% vs 50.3%,p=0.042),in the binary logistic analysis,nodules located in the right lobe and located at the lower pole of one side of gland or almost occupying the entire gland were the independent risk factors for follicular thyroid neoplasm(OR=2.865,95%CI 1.229-6.679,p=0.015),(OR=8.905,95%CI1.175-67.475,p=0.034);there was no significant statistical difference in the other indicators between above two groups.In the analysis of follicular thyroid carcinoma group and follicular thyroid adenoma group,follicular thyroid carcinoma group and folliculartumor of uncertain malignant potential group,the baseline data(age,male to female ratio),preoperative blood tests data(FT3,FT4,TSH,Tg,CEA,PTH,TPOAb positive rate,TGAb Positive rate,CT elevation rate),and preoperative sonographic data(maximum nodule diameter,side,location,TI-RADS classification,border,morphology,internal structure,echo,aspect ratio,presence of calcification,blood flow)were all no significant statistical difference.Conclusions: Follicular thyroid neoplasms are mostly located in the right lobe of the thyroid gland,located at the lower pole of one side,or occupy almost the entire gland lobe,more of them preoperative serum Tg>257.00ng/m L,preoperative serum TPOAb positive,sonographic hypoechoic or moderately hypoechoic nodules.The preoperative diagnosis of patients with thyroid follicular thyroid neoplasm should pay attention to the above characteristics,in older to improve the preoperative diagnosis rate of thyroid follicular neoplasm,and reduce the rate of misdiagnosis.Through early detection,accurate diagnosis,and selection of reasonable surgical methods,the prognosis of patients with thyroid follicular neoplasm,especially thyroid follicular carcinoma,can be effectively reduced,and the pain of the disease can be effectively reduced,and the quality of life of patients can be improved.