Primary diagnostics of thyroid neoplasms remains actual issue of modern endocrinology. Comprehensive clinical examination, ultrasound, and fine needle biopsy enable to make a conclusion about thyroid nodule properties but with a lot of mistakes, and take much time. Aims: assessment of diagnostic value of ultrasound criteria those may direct at papillary thyroid cancer. Materials and methods: one carried out observation multicenter retrospective continuous research among patients undergone for thyroid nodules surgery. It included adult patients (18-78) of both sexes. Patients’ case reports within 2013-2019 were sampled. Patients were shared into 2 groups according to final histological results. Results: the objects of research were 124 in-patients’ case reports. 32 of them were diagnosed thyroid cancer (24 - papillary, 8 – follicular), and 92 – benign nodules. Among searched criteria all (except hypoechogenicity) evidently differed between benign nodules and papillary cancer. In comparison criterion «absence of thin halo» reached the upper border of evidence of suspicion for papillary cancer. Multiple comparison indicated statistical difference between benign nodules (p<0,001) and follicular cancer (p<0,05). 2 of 24 papillary cancer patients (9%) in ultrasound did not demonstrate any criterion; all after this were arranged to benign nodules. 21 of 24 patients (88%) with 2 and more positive criteria were assessed correctly, but 51 of 92 benign nodules (56%) in ultrasound were assessed as papillary cancer.
Conclusions: ultrasound imaging accuracy in thyroid papillary cancer is approximately equal in presence of 2 to 4 criteria; maximum accuracy (74%) is reached in presence of 3 criteria. In presence of 1 or 5 criteria is significantly lower: in 1 criterion due to low specificity, in 5 criteria – due to rarity of simultaneous combination. Follicular cancer can’t be identified in ultrasound imaging.
CAN WE IDENTIFY HIGH DIFFERENTIATED CANCER IN THYROID ULTRASOUND IMAGING?
