Establishment Of Clinical Diagnosis Model Of Graves' Disease And Hashimoto's Thyroiditis And Immunological Identification

Background: A clinical diagnosis model include thyroid functions,thyroid antibodies and radioactive iodine uptake(RAIU)of patients with hyperthyroidism were established and as new evaluation indicators for the differentiation of the Graves' disease(GD)and Hashimoto's thyroiditis(HT).Methods: Clinical data of patients with newly diagnosed hyperthyroidism including gender,age,thyroid function,antibodies(FT3,FT4,TSH,TPOAb,TGAb,TRAb),RAIU(2h,6h,24h)were collected.A Stepwise regression analysis was performed to establish a model based on these variables.The thyroid puncture cell was collected,and the lymphocyte ratio was gathered by flow cytometry.Results: Model 1 was subjected to stepwise regression analysis.After screening,the variables that entered the model included FT3,TGAb,TPOAb,TRAb,2-hour RAIU,24-hour RAIU and gender,in which the variables FT3,TGAb,TRAb,2-hour RAIU,24-hour RAIU,and gender were significantly different.Model 2 without RAIU was also subjected to stepwise regression analysis.After screening,the variables that entered the model included FT4,TGAb,TPOAb,TRAb and gender were statistical significant.The larger value of each variable in the two models indicated the higher probability to diagnose GD.The area under the ROC curve of model 1 was 0.843(95% CI 0.779-0.894),and the area under the ROC curve of model 2 was 0.806(95% CI 0.685-0.824),which showed good differential diagnostic value.According to the statistic results,the flow cytometry could differentiate the ratio of GD and HT was 35.9.Conclusions: GD and HT diagnosis model was established according to the variables including gender,FT3,TGAb,TRAb,the 2-hour RAIU,the 24-hour RAIU in the model 1,while the model 2 did not include the 24-hour RAIU.These models had high value to differentiate GD and HT for patients with early hyperthyroidism.