Abstract:

Objective To determine the role of hyaluronan（HA） in the washout of ultrasound-guided thyroid nodule fine-needle aspiration（FNA） in differential diagnosis of papillary thyroid cancer. Methods Totally，60 patients who underwent ultrasound-guided thyroid nodule FNA were enrolled from Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from September 2021 to March 2022. According to the pathological diagnosis，the patients were classified into 2 groups，benign nodule group（24 cases） and thyroid cancer group（36 cases）. The HA level in FNA washout fluid and the expression of hyaluronic acid synthetase（HAS） mRNA in trace cells of FNA washout fluid were determined. Receiver operating characteristic（ROC）curve was used to analyze the diagnostic efficiency of HA in FNA washout fluid. Results The HA level of FNA washout fluid in thyroid cancer group was higher than that in benign nodule group（P<0.001）. The relative expression level of HAS2 mRNA in thyroid cancer group was higher than that in benign nodule group（P<0.05），but there was no statistical significance in the relative expression level of HAS1 mRNA and HAS3 mRNA between the 2 groups（P>0.05）. ROC curve analysis showed that the area under curve of HA level was 0.793 2. The cut-off value was 30.30 ng/mL，the sensitivity was 79.41%，and the specificity was 75.00%. Conclusions The level of HA in ultrasound-guided thyroid nodule FNA washout fluid plays a role in differential diagnosis of benign and malignant thyroid nodule diseases and may be a potential marker of papillary thyroid cancer.

Key words: Hyaluronan, Hyaluronic acid synthetase, Thyroid nodule fine-needle aspiration washout fluid, Papillary thyroid cancer