The possibilities of the main research methods in diagnostics of thyroid cancer (TGC) on the “background” of the multiunit goiter (MUZ) are limited, but at the same time, their complex use allows to clarify the nature of the pathology of the thyroid gland (TGC).
Materials and methods. The method of dis-criminant analysis with mathematical modeling for the diagnosis of thyroid gland (TG) was used in 445 MUS patients. The mathematical model of prognosis of thyroid gland (TG) was developed in discriminant analysis of clinical and anamnestic data, ultrasound and cytological data in two groups of MUS patients, 61 of which had tumors: [adenoma (AH) and TG] and 56 – non-tumor diseases: [colloidal goiter (MDC), autoimmune thyroiditis (AIT)] TG.
Results and discussion. A mathematical model of thyroid cancer prognosis with an electronic variant was created based on the calculation of the corresponding attribute coefficients. The evaluation of discriminant analysis with mathematical modeling of prognosis of thyroid cancer was carried out in 445 patients, of which 57 had thyroid cancer and 388 had benign thyroid diseases. True positive results in the diagnosis of RTW were 53 out of 57 (93,0%) patients. False negative results were obtained in 4 patients, in whom the focus of rTMS was located among multiple benign formations. False-positive results were obtained in 28 patients with benign tickling diseases. In the majority of cases with benign thyroid diseases (93.8%) true-positive results were found.
Conclusions. Application of discriminant analysis with mathematical modeling as the final method of thyroid cancer diagnostics on the “background” of MUS in the preoperative period allowed increasing the level of sensitivity up to 93.0%, specificity up to 93.8%, accuracy up to 93.7%.
SONOGRAPHY CAPABILITIES IN DIAGNOSIS
Despite the fact that the neck region is well accessible for palpation, the frequency of clinical detection of metastases in these groups of lymph nodes is quite low. Palpation is often impossible to draw a clear line between reactively and metastatically altered lymph nodes (except for large lymph nodes).
The aim of the study was to improve the effectiveness of the diagnosis of metastatic lymphatic lesions in malignant tumors of the head and neck.
Ultrasound investigation was performed on 120 patients with head and neck malignancies. Ultrasound examination of patients was carried out on Aloka SSD 5500 (Aloka com.) devices with a linear sensor with a frequency of 10 MHz, using polyposition seroscale scanning (V-mode) and color Doppler mapping (CDR) in real time.
Research results. A 69% metastatic lesion of the lymph node was characterized by a circular shape with a ratio of transverse to longitudinal dimensions approaching 1.0. The structure of lymph nodes in 33% of observations was homogeneous, the echogeneity was reduced in 92%, the expansion of the cortical layer was visualized in 71%, while the hyper echogenic central part was completely absent, or there was a sharp thinning of the lymph node, which was due to total or diffuse substitution of lymph tissue with tumor tissue. In most cases, there was no differentiation between cortical substance and sinus. At 79.1% UZDH in metastatic lymph nodes that did not contain necrotic masses, there was a diffuse increase in vascularization with atypical vascular pattern.
Metastatic lesion of regional lymph nodes was diagnosed in 86.3% of cases, lymphatic hyperplasia in 13.7%. In 26.6% of cases, metastatically altered lymph nodes were detected in sonography, which were not clinically determined.