ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1626766
This article is part of the Research TopicMolecular Characterization of Thyroid Lesions in the Era of “Next Generation” Techniques: Volume IIIView all articles
Thyroglobulin-to-Tumor Volume Ratio Combined with Ultrasound Features for Diagnosing Thyroid Follicular Neoplasms
Provisionally accepted
- West China Hospital, Sichuan University, Chengdu, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: Current preoperative diagnostics inadequately differentiate benign from malignant thyroid follicular neoplasms. This study evaluated the diagnostic utility of thyroid function markers and contrast-enhanced ultrasound (CEUS) features in differentiating follicular thyroid adenoma (FTA) from follicular thyroid carcinoma (FTC), focusing on a novel parameter: the thyroglobulin-to-tumor volume ratio (Tg/Vol ratio).Methods: We retrospectively analyzed 432 resected thyroid follicular neoplasms. A comprehensive comparison was performed regarding baseline characteristics, thyroid function profiles, and CEUS features between FTA and FTC groups through univariate and multivariate binary logistic regression. Diagnostic performance was determined via receiver operating characteristic (ROC) curve analysis. The prevalence of FTC across serum marker subgroups was assessed, followed by the development of a multivariate diagnostic model integrating the Tg/Vol ratio with CEUS characteristics.Results: Among 432 patients (352 females, 81.5%) with a median age of 47 years, multivariate logistic regression analysis revealed three independent predictors of FTC: capsular involvement (odds ratio [OR] = 9.958, 95% confidence interval [CI]: 2.453 – 40.424, p = 0.001), Tg/Vol ratio >7.412 (OR = 3.508, 95% CI: 1.388 – 8.868, p = 0.008), and male gender (OR = 3.474, CI: 1.751 – 6.891, p < 0.001). Subgroup analyses revealed higher FTC prevalence in patients with Tg > 409.18 μg/L (20.41%, p = 0.002) and Tg/Vol ratio > 20.68 (20.41%, p = 0.009). The combined diagnostic model incorporating Tg/Vol ratio and CEUS features demonstrated 69.4% sensitivity, 77.0% specificity, and the area under the curve(AUC) of 0.769.Conclusion: While elevated preoperative Tg correlates with malignant potential, but the Tg/Vol ratio emerges as a more robust preoperative discriminator. The combined diagnostic model incorporating Tg/Vol ratio and CEUS features significantly improves FTC detection accuracy.
Keywords: UMP, Free triiodothyronine, FT3, Free thyroxine, FT4, Medullary thyroid carcinoma, MTC, Noninvasive follicular thyroid neoplasm with papillary-like nuclear features, NIFTP, odds ratio, OR, Papillary thyroid carcinoma, PTC, Receiver operating characteristic, ROC
Received: 11 May 2025; Accepted: 23 Jun 2025.
Copyright: © 2025 Zhu, Liu, Liu, Li and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yu Ma, West China Hospital, Sichuan University, Chengdu, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.