Analysis of the advantages of US-FNAC combined with serum CEA and TSH in the diagnosis of thyroid cancer

WANG Liwei; LI Xiaoqing; ZHAO Yan; ZHOU Weina

doi:10.3969/j.issn.1674-4136.2025.02.007

Abstract：Objective To explore the advantages of ultrasound-guided fine needle aspiration cytology of the thyroid gland(US-FNAC)combined with serum carcinoembryonic antigen(CEA)and thyroid-stimulating hormone(TSH)in the diagnosis of thyroid cancer.Methods 80 case patients who underwent thyroid nodules surgery in Baoding First Central Hospital from January 2023 to January 2025 were enrolled as the research subjects.According to the postperative pathological results,the subjects were divided into a malignant group(n=48)and a benign group(n=32).US-FNAC,serum CEA,and TSH tests were performed on both groups of patients before surgery.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of US-FNAC combined with serum CEA and TSH in the diagnosis of thyroid cancer.Results Among the 80 case patients,there were 32 cases of benign thyroid nodules(40.00%)and 48 cases of thyroid cancer(60.00%).There was no significant difference in the general data between the two groups of patients(P＞0.05).The diagnostic results of US-FNAC showed that 49 cases were diagnosed as malignant and 31 cases as benign.US-FNAC had an excellent consistency with the pathological examination results.The Kappa value was 0.869,the diagnostic sensitivity was 95.83%,the specificity was 90.63%,the positive predictive value was 93.88%,and the negative predictive value was 93.55%.The levels of serum CEA and TSH in the malignant group were higher than those in the benign group(P＜0.05).The CEA level in medullary carcinoma was higher than that in papillary carcinoma,follicular carcinoma,and undifferentiated carcinoma,and the difference was statistically significant(P＜0.05).The TSH levels in papillary carcinoma and follicular carcinoma were higher than those in undifferentiated carcinoma and medullary carcinoma,and the difference was also statistically significant(P＜0.05).The results of ROC curve analysis showed that the areas under the curves(AUC)of US-FNAC,serum CEA,and TSH in the diagnosis of thyroid cancer were 0.809,0.774,and 0.753,respectively,(95%CI:0.642-0.830,0.651-0.808,0.682-0.793).The AUC of the combined diagnosis of thyroid cancer by US-FNAC,serum CEA,and TSH was 0.878(95%CI:0.774-0.901).The predictive value of the combined prediction was better than that of the individual predictions of the three indicators(Z=3.015,2.806,2.877;P=0.015,0.023,0.020).Conclusions US-FNAC combined with serum CEA and TSH can improve the diagnostic efficacy of thyroid cancer.