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甲状腺细针穿刺对意义不明确的结节行超声造影联合基因检测的诊断性能评估

Evaluation of the diagnostic performance of contrast-enhanced ultrasound combined with gene detection in nodules of unclear significance by thyroid fine-needle aspiration.

作者信息

Zhu Xi, Peng Xuyang, Zhu Lei, Xie Lidan, Cheng Feng, Zhou Bin

机构信息

Department of Thyroid and Breast Surgery, Lishui Hospital of Zhejiang University, Lishui, China.

Department of Cardiothoracic Surgery, Lishui People's Hospital, Lishui, China.

出版信息

Gland Surg. 2021 Jan;10(1):328-335. doi: 10.21037/gs-20-705.

Abstract

BACKGROUND

Our study aims to test the diagnostic performance of contrast-enhanced ultrasound (CEUS) combined with the detection of serine/threonine-protein kinase V600E () in nodules of unclear significance by thyroid fine-needle aspiration (FNA).

METHODS

From January 2015 to December 2019, 244 patients were subjected to ultrasonic strain imaging and elastography, CEUS, and gene detection at Lishui Hospital of Zhejiang University. Thyroid FNA does not confirm the benignancy and malignancy of the thyroid nodules. With postoperative pathology as the gold standard, the diagnostic value of CEUS, detection, and the combination in differentiating benign and malignant thyroid nodules were evaluated. The negative predictive value (NPV) and accuracy of CEUS, detection, and the combination were calculated along with sensitivity, specificity, and positive predictive value (PPV).

RESULTS

In this study, the sensitivity, specificity, PPV, NPV, accuracy, and AUC of CEUS alone in predicting benign and malignant thyroid nodules were 69.8%, 94.9%, 98.6%, 37.4%, 73.8% and 0.884, respectively. The sensitivity, specificity, PPV, NPV, accuracy and AUC of detection alone were 65.4%, 100%, 100%, 35.5%, 70.9% and 0.827, respectively. The sensitivity, specificity, PPV, NPV, accuracy and AUC of the combination were 73.2%, 94.9%, 98.7%, 40.2%, 76.6% and 0.923, respectively.

CONCLUSIONS

Therefore, compared with CEUS or gene detection alone, the combination of CEUS and gene detection has a higher sensitivity, NPV, and accuracy in the diagnosis of thyroid nodules.

摘要

背景

我们的研究旨在通过甲状腺细针穿刺活检(FNA)来测试超声造影(CEUS)联合检测丝氨酸/苏氨酸蛋白激酶V600E()在意义不明确的甲状腺结节中的诊断性能。

方法

2015年1月至2019年12月,244例患者在浙江大学丽水医院接受了超声应变成像和弹性成像、CEUS以及基因检测。甲状腺FNA不能确定甲状腺结节的良恶性。以术后病理作为金标准,评估CEUS、检测以及两者联合在鉴别甲状腺结节良恶性方面的诊断价值。计算CEUS、检测以及两者联合的阴性预测值(NPV)和准确性,以及敏感性、特异性和阳性预测值(PPV)。

结果

在本研究中,CEUS单独预测甲状腺结节良恶性的敏感性、特异性、PPV、NPV、准确性和AUC分别为69.8%、94.9%、98.6%、37.4%、73.8%和0.884。单独检测的敏感性、特异性、PPV、NPV、准确性和AUC分别为65.4%、100%、100%、35.5%、70.9%和0.827。两者联合的敏感性、特异性、PPV、NPV、准确性和AUC分别为73.2%、94.9%、98.7%、40.2%、76.6%和0.923。

结论

因此,与单独使用CEUS或基因检测相比,CEUS和基因检测联合在甲状腺结节诊断中具有更高的敏感性、NPV和准确性。

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