Differentiation of ultrasound combined with serum Tg and TSH levels for preoperative T stage and N stage of differentiated thyroid cancer
[Objective]To investigate the value of ultrasound combined with serum thyroglobulin(Tg)and thyroid stimulating hormone(TSH)levels in differentiating preoperative T stage and N stage of differentiated thyroid carcinoma(DTC).[Methods]The clinical data of 124 patients with DTC diagnosed by pathological examination in our hospital from June 2020 to December 2022 were retrospectively analyzed.Ultrasound examination was performed before operation,and serum Tg and TSH levels were also detected.The postoperative pathological stage was used as the"gold standard"to evaluate the accuracy of ultrasound examination in identifying T and N stage,and the serum Tg and TSH levels of patients with different T and N stage were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the differential value of ultrasound and serum Tg,TSH alone and combined for preoperative T staging and N staging of DTC patients.[Results]Based on postoperative pathology,the accuracy of ultrasound in T,phase was 85.11％,and T2 phase was 77.14％,and T3 phase was 60.00％,and T4 phase was 58.82％,and N0 phase was 86.57％,and N1 phase was 68.42％.The serum Tg and TSH levels of patients in T2,T3 and T4 stage were higher than those in T,stage(P＜0.05),and those in T3 and T4 stage were higher than those in T2 stage(P＜0.05),and those in T4 stage were higher than those in T3 stage(P＜0.05).The levels of serum Tg and TSH in patients with N,stage were higher than those in N0 stage(P＜0.05).The sensitivity,specificity and area under the curve(AUC)of ultrasound combined with serum Tg and TSH in differentiating preoperative T1～2 and T3～4 staging of DTC patients were 84.15％,97.62％and 0.939 respectively,and the sensitivity,specificity and AUC of differentiating N0 and N1staging were 80.60％,96.49％and 0.947 respectively,and the specificity and AUC of combined identification of T1～2 and T3～4,N0 and N1 staging were higher than those of single identification(P＜0.05).[Conclusion]Ultrasound,serum Tg and TSH can differentiate preoperative T stage and N stage of DTC patients,but the combination of the three has better differential value.
万方数据
维普
