Tuzun Dilek, Ersoy Reyhan, Kilicyazgan Aylin, Kiyak GUlten, Yalcin Samet, Cakir Bekir
Department of Endocrinology and Metabolism, Ankara Atatürk Research and Training Hospital, Ankara, Turkey -
Minerva Endocrinol. 2016 Jun;41(2):157-65. Epub 2014 Oct 13.
This study evaluated the effectiveness of elastosonography (ES) scoring and strain index (SI) in diagnosing patients with thyroid nodules composed primarily of Hurthle cells.
This study retrospectively analyzed 57 patients with thyroid nodules composed predominantly of Hurthle cells on fine needle aspiration cytology (FNAC). Patients were evaluated by thyroid ultrasonography (US), ES scoring, SI, US guided FNAC, and histopathology.
Histopathologically, 12 (21.1%) nodules were malignant and 45 (78.9%) were benign. Mean age, sex distribution, thyroid function tests, and morphologic features on US were similar in the malignant and benign groups. Mean SI (40.98±31.28 vs 21.24±25.47, p=0.027) and thyroid peroxidase antibody (anti-TPOab) positivity (p=0.004) were significantly higher in malignant than in benign nodules. Receiver operating curve (ROC) analysis showed that an SI cutoff of 10.326 had a sensitivity of 91.7% and a specificity of 49%, and an SI cut-off of 64.807 had a specificity of 91.1% and a sensitivity of 25%. The optimal SI cut-off value, 17.877, had a sensitivity of 66.7%, a specificity of 66.7%, a positive predictive value (PPV) of 34.8%, a negative predictive value (NPV) of 88.2%, and an area under the ROC curve of 73.1±0.074% (95% CI: 58.7-87.6.5%). The sensitivity, specificity, PPV, NPV and diagnostic accuracy of ES scoring were 41.6%, 91.1%, 55.5%, 85.4% and 80.7%, respectively.
This is the first study to investigate ES scoring and SI in nodules composed predominantly of Hurthle cells on FNAC. ES scoring and SI may add some contribution to ultrasonography in the characterization of thyroid nodules with Hurthle cells.
本研究评估了弹性超声（ES）评分和应变指数（SI）在诊断主要由许特耳细胞构成的甲状腺结节患者中的有效性。
本研究回顾性分析了57例经细针穿刺细胞学检查（FNAC）主要由许特耳细胞构成的甲状腺结节患者。通过甲状腺超声检查（US）、ES评分、SI、超声引导下FNAC及组织病理学对患者进行评估。
组织病理学检查显示，12个结节（21.1%）为恶性，45个结节（78.9%）为良性。恶性组和良性组的平均年龄、性别分布、甲状腺功能检查及超声形态学特征相似。恶性结节的平均SI（40.98±31.28对21.24±25.47，p = 0.027）和甲状腺过氧化物酶抗体（抗-TPOab）阳性率（p = 0.004）显著高于良性结节。受试者工作特征曲线（ROC）分析显示，SI临界值为10.326时，灵敏度为91.7%，特异度为49%；SI临界值为64.807时，特异度为91.1%，灵敏度为25%。最佳SI临界值17.877的灵敏度为66.7%，特异度为66.7%，阳性预测值（PPV）为34.8%，阴性预测值（NPV）为88.2%，ROC曲线下面积为73.1±0.074%（95%CI：58.7 - 87.6.5%）。ES评分的灵敏度、特异度、PPV、NPV及诊断准确性分别为41.6%、91.1%、55.5%、85.4%和80.7%。
这是第一项研究FNAC主要由许特耳细胞构成的结节的ES评分和SI的研究。ES评分和SI可能为超声检查在许特耳细胞性甲状腺结节的特征描述中增添一些作用。
