Objective To explore the risk factors that can predict the pathological diagnosis of thyroid cancer before operation.

Methods A total of 513 patients underwent surgery and received pathological diagnosis from February 2016 to February 2019 in the Jining First People′s Hospital were identified. Of these patients, 111 were males and 402 were females. Their ages ranged from 13 years old to 80 years old. The age was 49.02±12.95 years old. The patients were classified into benign and malignant groups (275 and 238 cases, respectively) according to their postoperative pathology. The biochemical parameters of thyroid stimulating hormone (TSH), thyroglobulin (Tg), thyroglobulin antibody (TgAb), and thyroid peroxidase antibody (TPOAb) were evaluated. Thyroid ultrasound and thyroid static imaging were performed, and thyroid imaging-reporting and data system were used for grading. The basic data of the two groups were compared by using Student's t test, chi-square test, and a Mann–Whitney rank sum test. The univariate regression analysis and logistic multivariate regression analysis were conducted to examine the risk of malignant thyroid nodules.

Results Differences in age (χ²=26.716, P=0.000), body mass index (t=−2.301, P=0.022), nodule function (χ²=16.882, P=0.001), nodule size (χ²=151.817, P=0.000), TSH (Z=−4.430, P=0.000), and ultrasound (χ²=225.712, P=0.000) between benign and malignant groups were observed. No significant differences were found in gender, family history of cancer, educational level, complication, weight, height, Tg, TgAb, and TPOAb. The univariate regression analysis revealed that age, weight, educational level, TSH, Tg, nodule size, and ultrasound (OR=1.004, 0.980, 0.514, 1.280, 1.002, 1.222, 0.589, all P<0.05) may be associated with malignancy. Logistic multivariate regression analysis revealed that the increase in TSH level (OR=1.198, P=0.046), young patient (OR=0.962, P=0.001) and small nodule diameter (OR=0.251, P=0.000) were independently associated with higher malignant of thyroid nodule, and ultrasound (OR=16.390, P=0.000) was significant in the prediction of pathological diagnosis.

Conclusions Ultrasound plays an important role in predicting thyroid cancer. The combination of ultrasound and other factors, such as patient age, serum TSH level, and nodular diameter, can predict the pathological diagnosis accurately.