金沙萨甲状腺结节的临床、超声和解剖病理学一致性:一项横断面研究。

Clinical, ultrasound and anatomopathological concordance of thyroid nodules in Kinshasa: a cross-sectional study.

机构信息

Department of Radiology and Medical Imaging, University of Kinshasa, Kinshasa, Democratic Republic of Congo.

Department of Family Medicine and Primary Health Care, Protestant University of Congo, Kinshasa, Democratic Republic of Congo.

出版信息

BMC Endocr Disord. 2024 Sep 2;24(1):174. doi: 10.1186/s12902-024-01710-5.

Abstract

BACKGROUND

The European Thyroid Association Thyroid Imaging Data and Reporting Systems (EU-TIRADS) is widely used in the risk stratification of thyroid nodule malignancy. However, data on the subject in Sub-Saharan Africa are limited. The objective of this study is to evaluate the clinical, sonographic and histopathological concordance of thyroid nodules in the diagnosis of thyroid cancer.

METHODS

This was an analytical cross-sectional study that examined the clinical, ultrasound and pathological data of 61 patients from 4 hospitals in the city province of Kinshasa over a period of 24 months, from June 01, 2020 to May 31, 2022.

RESULTS

Of the 61 patients, their mean age was 47.38 ± 8.8 years. The mean clinical score of the patients was 3.4 ± 0.84 with the extremes ranging from 1 to 5. The majority of the patients were classified as having an intermediate risk, ie 85.2% of the cases. It was noted that 41% of the nodules had a high risk according to the EU-TIRADS score and 8.2% of the nodules were malignant after histopathological analysis. The ROC curves reported at the diagnosis of malignancy show an area under the curve of 0.709 with 95% CI (0.486-0.931), a Youden index of 0.769 for the clinical score, and an area under the curve of 0.830 with 95% CI (0.605-0.995), a Youden index of 0.772 for the EU-TIRADS score.

CONCLUSION

In a low-income country, a well-performed thyroid ultrasound and the well-applied clinical score could be an important tool in the selection of thyroid nodules suspected of malignancy and requiring histopathological examination to avoid excessive acts in the patient.

摘要

背景

欧洲甲状腺协会甲状腺影像数据和报告系统(EU-TIRADS)广泛应用于甲状腺结节恶性风险分层。然而,撒哈拉以南非洲地区的相关数据有限。本研究旨在评估甲状腺结节的临床、超声和组织病理学特征在甲状腺癌诊断中的一致性。

方法

这是一项分析性的横断面研究,对 2020 年 6 月 1 日至 2022 年 5 月 31 日期间来自金沙萨市 4 家医院的 61 例患者的临床、超声和病理数据进行了研究。

结果

61 例患者的平均年龄为 47.38±8.8 岁。患者的平均临床评分为 3.4±0.84,范围为 1 至 5。大多数患者被归类为中危,即 85.2%的病例。根据 EU-TIRADS 评分,41%的结节为高危,8.2%的结节经组织病理学分析为恶性。恶性诊断的 ROC 曲线报告曲线下面积为 0.709,95%置信区间(0.486-0.931),临床评分的约登指数为 0.769,EU-TIRADS 评分的曲线下面积为 0.830,95%置信区间(0.605-0.995),约登指数为 0.772。

结论

在低收入国家,超声表现良好的甲状腺超声和应用良好的临床评分可以成为选择疑似恶性且需要组织病理学检查的甲状腺结节的重要工具,以避免对患者进行过度治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9933/11367788/984fabaeaf5a/12902_2024_1710_Fig1_HTML.jpg

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