Diagnostic Efficacy of Thyrotropin to Thyroglobulin Ratio in Correlation with Histopathology of Euthyroid Patient Having
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ORIGINAL ARTICLE
Diagnostic Efficacy of Thyrotropin to Thyroglobulin Ratio in Correlation with Histopathology of Euthyroid Patient Having Solitary Thyroid Nodule Vijay Kumar Sharma1 • Nishi Sonkhya1 • Shubhangi Gupta1 • Kailash Singh Jat1 Ritu Sehra1 • Pawan Singhal1 • Man Prakash Sharma1 • Sunita Agarwal1
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Received: 22 August 2020 / Accepted: 27 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract In patients with solitary thyroid nodules, the first course of action is to determine whether the nodule is benign or malignant. Many investigations are used to differentiate between benign and malignant nodules so as to avoid surgery in those who don’t need it. Among these, FNAC and USG are commonly used in association with clinical features but there are drawbacks of each technique. The present study was undertaken to assess the diagnostic effectivity of thyrotropin (also known as TSH) to thyroglobulin ratio in correlation with histopathology in euthyroid patients having solitary thyroid nodule. This is a prospective study carried out on 48 euthyroid cases of solitary thyroid nodule. All patients subjected to FNAC, USG, thyrotropin and thyroglobulin assay. Then, they underwent surgery and histopathological examination (HPE) of the specimens done. Finally, the histopathology reports were correlated with the thyrotropin to thyroglobulin ratio in order to evaluate their sensitivity and specificity by statistical methods. The sensitivity and specificity of thyrotropin to thyroglobulin ratio was 100% and 100% respectively. All malignant lesions according to thyrotropin to thyroglobulin ratio were confirmed by histopathology indicating its excellence. Therefore, TSH to thyroglobulin ratio helps in planning the correct management and avoids second surgery. It was found that serum TSH:Tg is a safe, reliable and effective diagnostic modality with a high sensitivity and specificity and is the single best
& Kailash Singh Jat [email protected] 1
Department of Otorhinolaryngology, SMS Medical College, C168E, Street No. 2, Khadi Colony, Bajaj Nagar, Jaipur, Rajasthan 302015, India
investigation for preoperative evaluation of solitary thyroid nodule to differentiate between benign and malignant nodules. Keywords Solitary thyroid nodule Thyrotropin Thyroglobulin Histopathology Benign Malignant
Introduction Solitary thyroid nodule is a common clinical entity encountered by otorhinolaryngologists in their day to day practice. Solitary thyroid nodule has aroused interest since 1949, when Warren H Cole in his study concluded that incidence of malignancy is higher in solitary nodule when compared with multi-nodular goiter (MNG). Thyroid nodules in general population are very common with estimated prevalence that ranges from 4% by palpation to 67% by ultrasonography. Autopsy studies reveal that 50% of adults had nodules, the majority of which are impalpable. Thyroid nodules are 4 times more common in females than in men and increase in prevalence with increase in age [1]. Still there is controversy i
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