Application of ultrasound-guided fine-needle aspiration combined with BRAF V600E mutation detection and ultrasound features in estimating central cervical lymph nodes metastasis of classic papillary thyroid cancer
10.3760/cma.j.issn.1004-4477.2019.12.009
- VernacularTitle: 超声引导下细针穿刺细胞学检查联合BRAFV600E突变检测及声像图特征在评估经典型甲状腺乳头状癌颈部淋巴结转移中的应用
- Author:
Ruoxuan LI
1
;
Zubang ZHOU
1
;
Jinhui XIE
2
;
Fei WANG
2
;
Xia CI
2
;
Zirong JIANG
2
;
Runli SHI
2
Author Information
1. Medical School, Lanzhou University, Lanzhou 730000, China
2. Department of Ultrasound, Gansu Province Hospital, Lanzhou 730000, China
- Publication Type:Clinical Trail
- Keywords:
Ultrasound-guided fine-needle aspiration cytology;
Papillary thyroid cancer, classic;
Central cervical lymph node;
Metastasis;
BRAF V600E
- From:
Chinese Journal of Ultrasonography
2019;28(12):1056-1060
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the correlation of ultrasound-guided fine-needle aspiration(US-FNA) combined with BRAF V600E mutation detection and ultrasound features and central cervical lymph nodes metastasis of classic papillary thyroid cancer(PTC) for providing a reliable molecular basis for clinical preoperative evaluation of patients.
Methods:Ninty-three cases of patients collected from October 2017 to November 2018 in Gansu Province Hospital were enrolled, who underwent general ultrasonic examination TI-RADS ≥4a, the US-FNA highly suspicious of PTC, thyroid surgery including total thyroidectomy and central cervical lymph node dissection, with the postoperative pathologic results of classical PTC and whether the central cervical lymph node metastasis happened in the patients. Part of the specimen applied HE staining for cytological diagnosis, the other part of specimen was used real-time for detection of BRAF V600E gene mutation by fluorescent quantitative polymerase chain reaction (PCR) method.
Results:Univariate analysis showed that the occurrence of cervical lymph node metastasis for classic PTC were significantly correlated with gender(χ2=10.303, P=0.002), BRAF V600E mutation(χ2=31.204, P=0.000) and extrathyroidal invasion(χ2=12.848, P=0.000). Multi-logistic regression analysis showed that BRAF V600E mutation(OR=13.324, 95%CI=4.058-43.744, P=0.000) and extrathyroidal invasion(OR=5.738, 95%CI=1.766-18.643, P=0.004) were the risk predictors of cervical lymph node metastasis of classic PTC. Gender(OR=0.385, 95%CI=0.112-1.324, P=0.130) was not the risk predictor.
Conclusions:US-FNA combined with BRAF V600E mutation and extrathyroidal invasion are the risk factors in predicting central cervical lymph node metastasis in classic PTC. Patients with these two risk factors should be elected to undergo prophylactic central cervical lymph node dissection.
