The role of combined BRAFV600E gene detection in the diagnosis of thyroid nodule determined as Bethesda Ⅲ by fine-needle aspiration
10.3760/cma.j.cn115330-20200509-00390
- VernacularTitle:联合 BRAFV600E基因检测在甲状腺结节穿刺细胞学诊断为BethesdaⅢ类中的辅助诊断作用
- Author:
Bin ZHOU
1
;
Yifei ZHAI
;
Dongyan ZHANG
;
Dongqing WANG
;
Lin WEI
;
Jianwu QIN
Author Information
1. 郑州大学附属肿瘤医院 河南省肿瘤医院甲状腺头颈外科 450008
- Keywords:
Thyroid nodule;
Thyroid neoplasms;
Biopsy, fine-needle;
BRAF gene;
Diagnosis
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2020;55(11):1057-1062
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the malignant probability of thyroid nodules with the diagnosis of atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) determined by fine-needle aspiration (FNA) and to explore the value of the combined application of BRAFV600E gene detection for the diagnosis of benign and malignant thyroid nodules. Methods:A total of 114 patients including 20 males and 94 females, aged 16-76 years old with thyroid nodules underwent FNA examination and surgical treatment in the Affiliated Cancer Hospital of Zhengzhou University from October 2018 to November 2019 were retrospectively analyzed. Postoperative histopathological results were used as the gold standard for the diagnosis of malignant thyroid nodules. The malignant rate of thyroid nodules with the diagnosis of AUS/FLUS was evaluated. Differential diagnostic efficacy of preoperative FNA combined with BRAFV600E gene detection for papillary thyroid carcinoma (PTC) was analyzed by McNemer test and diagnostic test evaluation method. Results:The mutation rate of BRAFV600E gene was 84.76% (89/105) in PTC. PTC accounted for 57.14% (12/21) of the patients with the diagnoses of AUS/FLUS determined by FNA. The specificity, sensitivity, positive predictive value and negative predictive value of BRAFV600E mutation examination for the diagnosis of malignant thyroid nodules determined preoperatively as AUS/FLUS were 9/9, 5/12, 5/5 and 9/16, respectively. BRAFV600E mutation examination could improve the detection rate of PTC in patients with AUS/FLUS ( OR=0.438, 95% CI=0.251-0.763, P=0.016). Conclusion:FNA combined with BRAFV600E mutation examination can significantly improve the detection rate of malignant thyroid nodules diagnosed preoperatively as AUS/FLUS.
