Objective To investigate the influence of Hashimoto's thyroiditis(HT)on the diagnostic efficacy of ultrasound-guided fine-needle aspiration cytology(US-FNAC)for thyroid nodules.Methods The medical records of 1159 patients(a total of 1383 nodules)with thyroid nodules who underwent US-FNAC and surgical resection in our hospital were analyzed.Aucording to the presence of HT,the nodules were divided into HT+group(456 nodules)and HT-group(927 nodules).The two-dimensional ultrasound findings,lymph node metastasis and BRAF V600E mutation were compared between the two groups.The diagnostic efficacy of US-FNAC for both groups was compared using surgical pathology as the gold standard.Results The surgical pathological results showed that there were 31 benign nodules and 425 malignant nodules in HT-group,the malignant rate was 93.2%.In HT+group,there were 57 benign nodules and 862 malignant nodules,8 nodules with uncertain malignant potential,and the malignant rate was 93.0%.There was no statistical significance in the malignant rate between the two groups.There were significant differences in nodule boundary,aspect ratio and blood flow between the two groups(all P<0.05).There were no significant differences in echo,size,shape and calcification.The lymph node metastasis rates of malignant nodules in HT+group and HT-group were 40.9%and 40.1%,respectively,and there was no significant difference between the two groups.A total of 705 malignant nodules were tested for BRAF V600E gene.The mutation rate of BRAF V600E in HT+group was 74.9%,which was significantly lower than that in HT-group(90.5%),and the difference was statistically significant(P<0.001).The sensitivity,negative predictive value and accuracy of US-FNAC in HT+group nodules(96.0%,40.7%,94.3%)were lower than those in HT-group nodules(98.8%,73.0%,97.1%),and the false-negative rate(4.0%)was higher than that in HT-group(1.2%),with statistically significant differences(all P<0.05).Further analysis showed that for nodules with a maximum diameter≤10 mm,the sensitivity,positive predictive value and accuracy of US-FNAC in HT+group(96.2%,97.5%,94.0%)were all lower than those in HT-group(98.8%,99.3%,98.2%),and the false-negative rate was higher than that in HT-group(3.8%vs.1.2%),with statistically significant differences(all P<0.05).For nodules with a maximum diameter>10 mm,there were no statistically significant differences between the two groups.Conclusion When the maximum diameter of thyroid nodules is≤10 mm,the HT can reduce the diagnostic efficacy of US-FNAC.
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