超声引导下细针穿刺细胞病理学联合 CK19、TPO检测对 TI-RADS 4a和 4b类甲状腺结节的诊断价值

目的评价超声引导下细针穿刺( US-FNA)细胞病理学联合和细胞角蛋白 19(CK19)、甲状腺过氧化物酶抗体( TPO)检测对甲状腺影像报告和数据系统( TI-RADS)4a和 4b类甲状腺结节良恶性的诊断价值。方法收集 2020年 3月至 2021年 9月就诊于安徽医科大学第四附属医院经手术病理证实的 TI-RADS 4a和 4b类甲状腺结节，共计 148个结节符合纳入标准。以手术病理结果为金标准，计算并对比 US-FNA、CK19、TPO及三者联合对 TI-RADS4a和 4b类甲状腺结节良恶性的诊断效能。结

Diagnostic value of ultrasound-guided fine-needle aspiration cytology combined with CK19 and TPO detection in TI-RADS 4a and 4b thyroid nodules

Objective To evaluate the diagnostic value of ultrasound-guided fine-needle aspiration (US-FNA) cytopathology com bined with cytokeratin 19 (CK19) and thyroid peroxidase antibody (TPO) detection in the diagnosis of Thyroid Imaging Reporting and Da ta System (TI-RADS) 4a and 4b thyroid nodules.Methods TI-RADS 4a and 4b thyroid nodules confirmed by surgery and pathology inThe Fourth Affiliated Hospital of Anhui Medical University from March 2020 to September 2021 were enrolled in the present study. Andthere are 148 nodules that met the inclusion criteria. Then taking the postoperation pathological results as the gold standard, the diagnos tic efficacy of US-FNA, CK19, TPO and the combination of them on TI-RADS4a and 4b thyroid nodules were calculated and compared. Results The study found that the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of US-FNA combined with CK19 and TPO in the diagnosis of TI-RADS 4a and 4b thyroid nodules were 95.45% (42/44), 93.27% (97/104), 93.93%(139/148), 85.71% (42/49) and 97.98% (97/99), respectively. And these indicators were higher than those of US-FNA, CK19, TPO alone. The area under the curve of US-FNA, CK19, TPO and the combination of them were 0.839, 0.882, 0.860 and 0.944, respectively, and thedifference was statistically significant (P<0.01).Conclusion The combination of US-FNA with CK19 and TPO detectionis can help to improve the sensitivity, specificity and accuracy of thyroid TI-RADS 4a and 4b nodules in the differentiation of benign and malignant.