Department of Breast and Endocrine Surgery, Ministry of Health Ankara City Hospital, Ankara, Turkey.
Department of Breast and Endocrine Surgery, Ministry of Health Ankara City Hospital, Ankara, Turkey.
Am J Surg. 2021 Jan;221(1):117-121. doi: 10.1016/j.amjsurg.2020.08.002. Epub 2020 Aug 21.
Approximately 20% of the thyroid biopsies render an indeterminate (ID) cytology. We evaluated the diagnostic value of preoperative modified systemic inflammation score (mSIS) in predicting the malignancy of ID thyroid nodules (TNs).
Data of 162 patients with indeterminate TNs were examined retrospectively. The mSIS was calculated as follows: mSIS 0 [patients with albumin (ALB) ≥ 4.0 g/dL and lymphocyte-to-monocyte ratio (LMR) ≥ 3.4], mSIS 1 [ALB < 4.0 g/dL or LMR < 3.4], and mSIS 2 [ALB < 4.0 g/dL and LMR < 3.4].
Patients were classified into mSIS 0 (n = 105), mSIS 1 (n = 34) and mSIS 2 (n = 23) groups. The malignancy rates for the mSIS 0, 1 and 2 groups were 34.3%, 64.7% and 100% respectively. Preoperative mSIS was significantly associated with the presence of thyroid malignancy (p < 0.001).
If the mSIS of patients with ID cytology is 1 or 2, appropriate surgical treatment should be performed without delay, due to the increased risk of malignancy.
大约 20%的甲状腺活检结果为不确定（ID）细胞学。我们评估了术前改良全身炎症评分（mSIS）在预测 ID 甲状腺结节（TNs）恶性程度方面的诊断价值。
回顾性分析了 162 例 ID 甲状腺结节患者的数据。mSIS 的计算方法如下：mSIS 0 [患者白蛋白（ALB）≥4.0 g/dL 且淋巴细胞与单核细胞比值（LMR）≥3.4]、mSIS 1 [ALB<4.0 g/dL 或 LMR<3.4]和 mSIS 2 [ALB<4.0 g/dL 且 LMR<3.4]。
患者分为 mSIS 0 组（n=105）、mSIS 1 组（n=34）和 mSIS 2 组（n=23）。mSIS 0、1 和 2 组的恶性率分别为 34.3%、64.7%和 100%。术前 mSIS 与甲状腺恶性肿瘤的存在显著相关（p<0.001）。
如果 ID 细胞学患者的 mSIS 为 1 或 2，由于恶性风险增加，应立即进行适当的手术治疗。
