Department of Endocrinology, Metabolism and Nuclear Medicine, Kinshasa University Clinics, Kinshasa, Democratic Republic of the Congo.
Department of Endocrinology, Metabolism and Nutrition, André Rosemon Hospital Center, University of Cayenne, Cayenne, French Guiana.
Sci Rep. 2022 Nov 2;12(1):18442. doi: 10.1038/s41598-022-22954-y.
The thyroid imaging reporting and data systems by the European Thyroid Association (EU-TIRADS) has been widely used in malignancy risk stratification of thyroid nodules. However, there is a paucity of data in developing countries, especially in Africa, to validate the use of this scoring system. The aim of the study was to assess the diagnostic value of the EU-TIRADS score in Congolese hospitals, using pathological examination after surgery as the gold standard in Congolese hospitals. This retrospective and analytical study examined clinical, ultrasound and pathological data of 549 patients aged 45 ± 14 years, including 468 females (85.2%), operated for thyroid nodule between January 2005 and January 2019. In the present study, only the highest graded nodule according to the EU-TIRADS score in each patient was taken into account for the statistical analyses. So 549 nodules were considered. Nodules classified EU-TIRADS 2 and 3 on the one hand, and, on the other hand, 4 and 5, were considered respectively at low and high risk of malignancy. The sensitivity and specificity of the EU-TIRADS score were calculated. The significance level was set at 5%. Of all patients, 21.7% had malignant nodules. They made 48.4% of the nodules in patients younger than and at 20 years old, and 31.1% in those aged 60 or over. Malignant nodules were more frequent in men than in women (30.9% vs. 20.1%; p = 0.024). Papillary carcinoma (67.2%) and follicular carcinoma (21.8%) were the main types. The malignancy rate was 39.7% and 1.5% among nodules rated EU-TIRADS 4 and 5, and those with EU-TIRADS score 2 and 3, respectively (p < 0.001). The EU-TIRADS score had a sensitivity of 96.6% and a specificity of 59.3%. The ROC curve indicated an area under the curve of 0.862. In a low-income country, a well performed thyroid ultrasound, using the EU-TIRADS score, could be an important tool in the selection of thyroid nodules suspected of malignancy and requiring histopathological examination in the Congolese hospital setting.Trial registration: The research protocol had obtained the favorable opinion of the DRC national health ethics committee no. 197/CNES/BN/PMMF/2020. The data was collected and analyzed anonymously.
欧洲甲状腺协会（EU-TIRADS）的甲状腺影像报告和数据系统已被广泛用于甲状腺结节的恶性风险分层。然而，在发展中国家，尤其是非洲，缺乏验证该评分系统的使用的数据。本研究的目的是评估 EU-TIRADS 评分在刚果（布）医院中的诊断价值，以手术后的病理检查作为刚果（布）医院的金标准。这项回顾性和分析性研究检查了 2005 年 1 月至 2019 年 1 月期间因甲状腺结节接受手术的 549 名年龄为 45 ± 14 岁的患者的临床、超声和病理数据，其中 468 名女性（85.2%）。在本研究中，仅考虑了根据 EU-TIRADS 评分在每个患者中分级最高的结节进行统计分析。因此，共考虑了 549 个结节。一方面，EU-TIRADS 2 和 3 级结节，另一方面，4 级和 5 级结节分别被认为恶性风险低和高。计算了 EU-TIRADS 评分的敏感性和特异性。显著性水平设置为 5%。所有患者中，21.7%的患者存在恶性结节。在年龄小于 20 岁和 60 岁及以上的患者中，恶性结节分别占 48.4%和 31.1%。男性恶性结节的发生率高于女性（30.9%比 20.1%；p=0.024）。乳头状癌（67.2%）和滤泡状癌（21.8%）是主要类型。EU-TIRADS 评分 4 级和 5 级的结节恶性率分别为 39.7%和 1.5%，EU-TIRADS 评分 2 级和 3 级的结节恶性率分别为 39.7%和 1.5%（p<0.001）。EU-TIRADS 评分的敏感性为 96.6%，特异性为 59.3%。ROC 曲线表明曲线下面积为 0.862。在一个低收入国家，使用 EU-TIRADS 评分进行的甲状腺超声检查可以成为刚果（布）医院中选择疑似恶性和需要组织病理学检查的甲状腺结节的重要工具。试验注册：研究方案已获得刚果民主共和国国家卫生伦理委员会的批准，编号为 197/CNES/BN/PMMF/2020。数据是匿名收集和分析的。
