Bilici Suat, Yigit Ozgur, Onur Firat, Hamit Bahtiyar, Nazli Mehmet Ali, Gunver Feray, Karagoz Yesim
Department of Otorhinolaryngology & Head and Neck Surgery, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey.
Department of Otorhinolaryngology & Head and Neck Surgery, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey.
Am J Otolaryngol. 2017 Sep-Oct;38(5):608-613. doi: 10.1016/j.amjoto.2017.07.002. Epub 2017 Jul 5.
To determine the predictability of sonography for detection of calcifications in thyroid nodules by histopathologic examination and to demonstrate the association between calcification pattern and malignancy.
We prospectively evaluated 81 dominant nodules from 81 patients. Thyroid glands were assessed preoperatively with thyroid ultrasonography, and the presence of sonographic calcification was specified as intranodular macro (coarse) and micro calcification. Micro and macro calcification in surgery specimens were specified postoperatively as present or absent in the histopathological evaluation. The correlation between sonographic and histopathologic calcifications and the relationship between malignancy and calcification patterns were determined.
Calcification was detected histopathologically in 66.7% of the sonographically calcified nodules and in 12.8% of the sonographically noncalcified nodules. The sensitivity and specificity of sonography for detecting histopathologic calcification were 84.8 and 70.8%, respectively, while positive and negative predictive values were 66.7 and 87.2%, respectively. The sonographical and histopathological outcomes for detection of macro and micro calcification showed 85 and 50% compatibility, respectively. The difference in malignancy rates between sonographic macro and micro calcified nodules was not significant (p=0.976). Histopathologic detection of calcification showed no significant difference between malignant and benign nodules (p=0.129).
Histopathology confirmed a high rate of sonographic macrocalcifications. The micro and macro patterns of sonographic calcification showed no particular association with thyroid malignancy. The preoperative risk of malignancy should be determined in conjunction with other known sonographic risk factors and diagnostic tests.
通过组织病理学检查确定超声检查对甲状腺结节钙化检测的可预测性，并证明钙化模式与恶性肿瘤之间的关联。
我们前瞻性评估了81例患者的81个优势结节。术前用甲状腺超声对甲状腺进行评估，超声钙化的存在被指定为结节内大（粗）钙化和微钙化。手术标本中的微钙化和大钙化在术后组织病理学评估中被指定为存在或不存在。确定超声和组织病理学钙化之间的相关性以及恶性肿瘤与钙化模式之间的关系。
组织病理学检查发现，超声检查有钙化的结节中66.7%存在钙化，超声检查无钙化的结节中12.8%存在钙化。超声检查检测组织病理学钙化的敏感性和特异性分别为84.8%和70.8%，而阳性和阴性预测值分别为66.7%和87.2%。超声检查和组织病理学检查检测大钙化和微钙化的结果分别显示出85%和50%的一致性。超声检查大钙化结节和微钙化结节的恶性率差异无统计学意义（p = 0.976）。组织病理学检查发现钙化在恶性和良性结节之间无显著差异（p = （此处原文有误，根据上下文推测应为0.129））。
组织病理学证实超声检查大钙化的发生率较高。超声钙化的微模式和大模式与甲状腺恶性肿瘤无特定关联。术前恶性风险应结合其他已知的超声风险因素和诊断测试来确定。
