ANALYSIS OF THE INFLUENCE OF THYROID CALCIFIED NODULE CHARACTERISTICS ON THE DIAGNOSTIC EFFICIENCY OF FINE NEEDLE ASPIRATION

Hui Li^{1, 2}, Nianchun Peng¹, Qiang Zhang³, Lixin Shi^{1, *}

¹Department of Endocrine and Metabolic Diseases, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, China - ²Department of Cardiovascular Endocrinology, The Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, Guizhou 550000, China - ³Department of Thyroid Surgery, The Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, Guizhou 550000, China

Introduction: To explore the influence of thyroid calcified nodule characteristics on the diagnostic efficiency of ultrasound guided fine needle aspiration (US-FNA).

Materials and methods: A total of 478 patients with thyroid nodules who received US-FNA and underwent surgical treatment in our hospital from March 2018 to March 2021 were retrospectively analyzed, and 478 thyroid nodules were collected and divided into four groups: microcalcification, macro calcification, peripheral arcuate calcification and non calcification according to the size of calcification. The US-FNA results were categorized using the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) and the diagnosis efficacy was evaluated using the receiver operating characteristic (ROC) curves.

Results: Among 478 thyroid nodules, there were 201 benign thyroid nodules, 277 malignant thyroid nodules, and most were non calcification. The sensitivity, specificity, accuracy, positive predictive rate and negative predictive rate for the microcalcification group were 96.5, 88.9, 95.7, 98.9, 72.7%; for the macro calcification group were 97.8, 85.7, 96.9, 98.9, 75%; for the peripheral arcuate calcification group were 96.7, 80, 94.3, 96.7% and for the non calcification groups were 84.7, 96.7, 93.3, 91, 94%, respectively. The AUC values the non calcification, microcalcification, macro calcification and peripheral arcuate calcification groups were 0.8726, 0.8659, 0.8666, and 0.8838 respectively, which indicated the potential of US-FNA in the diagnosis of thyroid nodule. No significant difference was found between the diagnosis efficacy of US-FNA and postoperative pathology. Among the 478 thyroid nodules, 226 were calcified nodules, and 9 could not be diagnosed; there were 252 non calcified nodules, 17 of which could not be diagnosed. In terms of the inadequate rate, from high to low, the non calcification, peripheral arc calcification, microcalcification and macro calcification groups were in order. Different types of calcified nodules were grouped again according to the maximum diameter of thyroid nodule calcification. There was no significant difference in the inadequate rate between the groups, and the difference was not statistically significant (p>0.05); After grouping calcified nodules according to the number of calcifications, the results showed that the inadequate rate was relatively lower in the microcalcification and macro calcification groups and there was basically no difference in the inadequate rate between the multiple group and the single group (p>0.05); 

Conclusion: Fine needle aspiration has a high diagnostic value of thyroid nodule calcification, with better sensitivity and lower inadequate rate in microcalcification and macro calcification, showing the potential to guide the treatment of thyroid nodules.