Association between macrocalcification and papillary thyroid carcinoma and corresponding valuable diagnostic tool:...

Area of Science:

• Endocrinology
• Oncology
• Radiology

Background:

• Microcalcifications are known indicators of thyroid malignancy, particularly papillary thyroid carcinoma (PTC).
• The association between macrocalcification and PTC remains underexplored.
• Current screening methods like ultrasonography and ultrasound-guided fine needle aspiration biopsy (US-FNAB) have limitations in evaluating macro-calcified thyroid nodules.

Purpose of the Study:

• To investigate the relationship between macrocalcification and PTC.
• To explore the diagnostic efficiency of US-FNAB and BRAF V600E mutation testing in macro-calcified thyroid nodules.

Main Methods:

• Retrospective analysis of 2645 thyroid nodules from 2078 participants, categorized into non-, micro-, and macro-calcified groups.
• Evaluation of 100 macro-calcified thyroid nodules with available US-FNAB and BRAF V600E mutation results.
• Comparison of PTC incidence across calcification groups and diagnostic efficiency of US-FNAB alone versus combined with BRAF V600E mutation.

Main Results:

• Macrocalcification demonstrated a significantly higher incidence of PTC (31.5%) compared to non-calcification (23.2%, P<0.05).
• The combination of US-FNAB and BRAF V600E mutation testing showed superior diagnostic efficiency (AUC 0.94) compared to US-FNAB alone (AUC 0.84, P=0.03).
• Combined testing achieved significantly higher sensitivity (100.0% vs. 67.2%, P<0.01) with comparable specificity (88.9% vs. 100.0%, P=0.13).

Conclusions:

• Macrocalcification in thyroid nodules may indicate a high risk for PTC.
• Combining US-FNAB with BRAF V600E mutation analysis offers enhanced diagnostic value for macro-calcified thyroid nodules.
• This combined approach significantly improves sensitivity for identifying malignant macro-calcified nodules.