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Wenxing Guo The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China

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Long Tan The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China

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Shuyao Dong The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China

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Ya Jin The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China

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Mei Zhu The Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China

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Hongyan Wei The Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China

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Yanting Chen The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China

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Lili Fan The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China

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Cong Du The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China

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Wanqi Zhang The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
The Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China

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Objectives: The reference values for thyroid volume (Tvol) determined by ultrasound require supportive data of normal Tvol from local iodine-sufficient populations. This study aimed to explore new reference values for Tvol in Chinese adults and comprehensively evaluate the factors associated with enlarged Tvol. Methods: A cross-sectional study was conducted in Tianjin, China. Tvol was measured by ultrasound in adults with long-term iodine sufficiency. Blood and urine samples were collected to evaluate biochemical indexes, thyroid function, and iodine status. Results: A total of 1,991 adults from the urban and suburban areas were analysed. The trend of Tvol increasing with age was observed in men under age 40 years and in women under age 52 years. In the quantile regression analyses, we found that body surface area (BSA) (β = 7.22, 95% CI: 5.33, 9.12), thyroid-stimulating hormone (TSH) (β = −1.48, 95% CI: −2.39, −0.57), thyroid nodules (TNs) (β = 6.70, 95% CI: 2.19, 11.22), and metabolic syndrome (MetS) (β = 1.40, 95% CI: 0.63, 2.17) had a strong effect on Tvol at higher percentiles in males. The dominant factors influencing Tvol were BSA (β = 9.64, 95% CI: 2.66, 16.61), TSH (β = −0.78, 95% CI: −1.16, −0.39), and TNs (β = 1.11, 95% CI: 0.43, 1.79) in females. The largest reference values for Tvol based on BSA were 20.18 (17.79, 24.32) mL in males and 15.31 (14.05, 16.70) mL in females. Conclusions: Quantile regression analyses showed that a high BSA index, a decreased TSH level, and the prevalence of TNs were essential factors associated with the enlargement of the thyroid gland. Our findings reported the new reference values for Tvol determined by ultrasound based on gender and BSA in Chinese adults.

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Shaodong Hou Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China
Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan, China

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Yiceng Sun Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China

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Zeyu Yang Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China

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Mi Tang Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China

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Tingjie Yin Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China

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Cong Shao Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China

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Cunye Yan Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China

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Linlong Mo Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China

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Yuquan Yuan Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China

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Supeng Yin Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China

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Fan Zhang Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China
Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan, China

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Objective

It is crucial to diagnose lymph node (LN) metastases (LNM) before or during thyroid carcinoma surgery. Measurement of thyroglobulin (Tg) in the fine needle aspirate washout (FNA-Tg) is useful to assist in the diagnosis of LNM for papillary thyroid carcinoma (PTC). This study aimed to assess the diagnostic performance of a new technique based on a colloidal gold-based immunochromatographic assay (GICA) for intraoperative FNA-Tg in diagnosing LNM.

Clinical trial information

This study is registered with chictr.org.cn, ID: ChiCTR2200063561 (registered 11 September, 2022).

Methods

This prospective study enrolled 51 PTC patients who underwent cervical LN dissection. A total of 150 LNs dissected from the central and lateral compartments were evaluated by FNA-Tg-GICA at three different time points and compared with frozen sections and the conventional Tg measurement method electrochemiluminescence immunoassay (ECLIA). Receiver operating characteristic curve (ROC) and area under the curve (AUC), cutoff value to discriminate benign and malignant LNs, sensitivity, specificity, and accuracy were provided.

Results

The cutoff value of FNA-Tg to predict LNM was 110.83 ng/mL for ECLIA and 13.19 ng/mL, 38.69 ng/mL, and 77.17 ng/mL for GICA at 3, 10, and 15 min, respectively. There was no significant difference between the AUCs of GICA at different time points compared to using ECLIA and frozen sections. Besides, the diagnostic performance of GICA and ECLIA showed no significant difference in evaluating LNM from central and lateral compartments or between the TgAb-positive subgroup and TgAb-negative subgroup.

Conclusion

GICA is a promising method for intraoperative FNA-Tg measurement and has high value in predicting LNM. It may be a novel alternative or supplementary method to frozen section or ECLIA.

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