Sharma Vijay Kumar, Sonkhya Nishi, Gupta Shubhangi, Jat Kailash Singh, Sehra Ritu, Singhal Pawan, Sharma Man Prakash, Agarwal Sunita
Department of Otorhinolaryngology, SMS Medical College, C168E, Street No. 2, Khadi Colony, Bajaj Nagar, Jaipur, Rajasthan 302015 India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):2281-2286. doi: 10.1007/s12070-020-02120-4. Epub 2020 Sep 3.
In patients with solitary thyroid nodules, the first course of action is to determine whether the nodule is benign or malignant. Many investigations are used to differentiate between benign and malignant nodules so as to avoid surgery in those who don't need it. Among these, FNAC and USG are commonly used in association with clinical features but there are drawbacks of each technique. The present study was undertaken to assess the diagnostic effectivity of thyrotropin (also known as TSH) to thyroglobulin ratio in correlation with histopathology in euthyroid patients having solitary thyroid nodule. This is a prospective study carried out on 48 euthyroid cases of solitary thyroid nodule. All patients subjected to FNAC, USG, thyrotropin and thyroglobulin assay. Then, they underwent surgery and histopathological examination (HPE) of the specimens done. Finally, the histopathology reports were correlated with the thyrotropin to thyroglobulin ratio in order to evaluate their sensitivity and specificity by statistical methods. The sensitivity and specificity of thyrotropin to thyroglobulin ratio was 100% and 100% respectively. All malignant lesions according to thyrotropin to thyroglobulin ratio were confirmed by histopathology indicating its excellence. Therefore, TSH to thyroglobulin ratio helps in planning the correct management and avoids second surgery. It was found that serum TSH:Tg is a safe, reliable and effective diagnostic modality with a high sensitivity and specificity and is the single best investigation for preoperative evaluation of solitary thyroid nodule to differentiate between benign and malignant nodules.
对于患有孤立性甲状腺结节的患者，首要行动是确定该结节是良性还是恶性。人们采用多种检查方法来区分良性和恶性结节，以避免让不需要手术的患者接受手术。其中，细针穿刺抽吸活检（FNAC）和超声检查（USG）通常结合临床特征使用，但每种技术都有其缺点。本研究旨在评估促甲状腺激素（也称为TSH）与甲状腺球蛋白的比值在组织病理学方面的诊断有效性，研究对象为患有孤立性甲状腺结节的甲状腺功能正常患者。这是一项对48例患有孤立性甲状腺结节的甲状腺功能正常病例进行的前瞻性研究。所有患者均接受了FNAC、USG、促甲状腺激素和甲状腺球蛋白检测。然后，他们接受了手术，并对标本进行了组织病理学检查（HPE）。最后，将组织病理学报告与促甲状腺激素与甲状腺球蛋白的比值进行关联，以便通过统计方法评估其敏感性和特异性。促甲状腺激素与甲状腺球蛋白比值的敏感性和特异性分别为100%和100%。根据促甲状腺激素与甲状腺球蛋白比值判断的所有恶性病变均经组织病理学证实，表明其卓越性。因此，促甲状腺激素与甲状腺球蛋白的比值有助于规划正确的治疗方案并避免二次手术。研究发现，血清促甲状腺激素：甲状腺球蛋白是一种安全、可靠且有效的诊断方法，具有高敏感性和特异性，是术前评估孤立性甲状腺结节以区分良性和恶性结节的最佳单一检查方法。
