Skowrońska Anna, Milczarek-Banach Justyna, Wiechno Wiesław, Chudziński Witold, Żach Marcin, Mazurkiewicz Michał, Miśkiewicz Piotr, Bednarczuk Tomasz
Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Poland.
Department of General and Endocrine Surgery, Medical University of Warsaw, Poland.
Pol J Radiol. 2018 Dec 19;83:e579-e586. doi: 10.5114/pjr.2018.81556. eCollection 2018.
To assess the clinical usefulness of the European Thyroid Imaging and Reporting Data System (EU-TIRADS) in the valuation of thyroid nodules malignancy in reference to post-surgery histological results.
Pre-operative ultrasound was performed in consecutive patients admitted for thyroid surgery between June 2017 and January 2018. Thyroid nodules were classified according to EU-TIRADS to five groups: 1-5. At least one fine-needle aspiration biopsy (FNAB)/patient (dominant or suspected nodule) was performed in an outpatient clinic. The final diagnosis was based on the histological result. The percentage of cancers in each EU-TIRADS group was evaluated. Finally, sensitivity, specificity, accuracy, as well as positive and negative predictive values for malignancy were assessed.
Fifty-two patients with a total of 140 thyroid nodules (median: 3 nodules/thyroid [minimum-maximum: 1-6]) were enrolled in the study. Thyroid cancer was diagnosed in 0% (0/6) in EU-TIRADS 2; 0% (0/92) in EU-TIRADS 3; 5.9% (2/34) in EU-TIRADS 4, and 75% (6/8) in EU-TIRADS 5. In nodules assessed as EU-TIRADS ≥ 4 sensitivity, specificity, positive and negative predictive values for malignancy were, respectively: 75% (CI 95%: 40.7-93.5), 94.1% (CI 95%: 86.0-98.5), 75% (CI 95%: 40.7-93.5), and 94.1% (CI 95%: 86.0-98.5).
EU-TIRADS is a valuable and simple tool for assessment of the risk of malignancy of thyroid nodules and demonstrates a high ultrasound correlation with histological post-surgery results. FNAB should be performed in all nodules assessed as EU-TIRADS ≥ 4, due to higher risk of malignancy.
参照术后组织学结果，评估欧洲甲状腺影像与报告数据系统（EU-TIRADS）在评估甲状腺结节恶性风险中的临床实用性。
对2017年6月至2018年1月期间因甲状腺手术入院的连续患者进行术前超声检查。根据EU-TIRADS将甲状腺结节分为5组：1 - 5组。在门诊对每位患者至少进行一次细针穿刺活检（FNAB）（针对优势或可疑结节）。最终诊断基于组织学结果。评估每组EU-TIRADS中癌症的百分比。最后，评估恶性肿瘤的敏感性、特异性、准确性以及阳性和阴性预测值。
52例患者共140个甲状腺结节（中位数：每个甲状腺3个结节[最小值 - 最大值：1 - 6]）纳入研究。EU-TIRADS 2组中甲状腺癌诊断率为0%（0/6）；EU-TIRADS 3组中为0%（0/92）；EU-TIRADS 4组中为5.9%（2/34）；EU-TIRADS 5组中为75%（6/8）。在评估为EU-TIRADS≥4的结节中，恶性肿瘤的敏感性、特异性、阳性和阴性预测值分别为：75%（95%置信区间：40.7 - 93.5）、94.1%（95%置信区间：86.0 - 98.5）、75%（95%置信区间：40.7 - 93.5）和94.1%（95%置信区间：86.0 - 98.5）。
EU-TIRADS是评估甲状腺结节恶性风险的一种有价值且简单的工具，并且与术后组织学结果具有高度的超声相关性。由于恶性风险较高，对于所有评估为EU-TIRADS≥4的结节均应进行FNAB。
