The combination of the TSH∶Tg ratio and TI-RADS for identification of benign and malignant thyroid nodules

JIAO Yan; ZHAO Honggang; ZHANG Zuncheng

doi:10.11958/20160091

Abstract：Objective To assess the efficiency of thyroid stimulating hormone (TSH): thyroid globulin (Tg) ratio and ultrasound thyroid imaging reporting data system (TI-RADS) for thyroid nodule evaluation in euthyroid patients. Methods A total of 156 patients with thyroid nodules hospitalized in the department of thyroid breast surgery from January to December 2015 were included in this study. There were 50 patients were diagnosed as papillary thyroid carcinoma, and 106 patients were benign thyroid nodules confirmed by pathological diagnosis after operation. The ratio of TSH:Tg was calculated <br> in patients. The cut-off point was calculated using the receiver operating characteristic (ROC) curve analysis. The measurement value<tangent was 0 point, and the measurement value≥tangent was 1 point. TI-RADS diagnostic criteria was evaluated and calculated. The nodule in TI-RADS categories 1, 2 and 3 was 0 points, The nodule in TI-RADS categories 4a, 4b, 4c, 5 was 1, 2, 3, 4 points, respectively . The combination score was the sum of the TSH:Tg ratio score and TI-RADS score. Results The area under the receiver operating characteristic curves of the TSH:Tg ratio was 0.736. The sensitivity, specificity, positive predictive value, negative predictive value, diagnose accordance rate were 64.0%, 82.1%, 62.7%, 82.8%, 76.3%, respectively. The AUC of TI-RADS was 0.753, the sensitivity, specificity, positive predictive value, negative predictive value, diagnose accordance rate were 84.0%, 72.6%, 59.2%, 90.6%, 76.3%, respectively. The AUC of the combination of the TSH:Tg ratio and TI-RADS was 0.839, the sensitivity, specificity, positive predictive value, negative predictive value, diagnose accordance rate were 74.0%, 86.1%, 71.1%, 87.5%, 82.1%, respectively. Conclusion The combination diagnosis of the TSH:Tg ratio and TI-RADS for thyroid nodule evaluation in euthyroid patients is better than that of only one method, which is worth clinical popularizing and application.