The value of ultrasound-guided fine needle aspiration combined with detection of BRAF V600E in diagnosis of benign and malignant thyroid nodules
10.3760/cma.j.issn.1004-4477.2018.06.009
- VernacularTitle: 超声引导下细针穿刺细胞学检查联合BRAFV600E基因检测对甲状腺良恶性结节的诊断价值
- Author:
Zhijing LUO
1
;
Ensheng XUE
;
Liyun YU
;
Yimi HE
;
Wenjin LIN
;
Qingfu QIAN
;
Xiubin TANG
Author Information
1. Department of Ultrasound, Union Hospital of Fujian Medical University, Union Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
- Publication Type:Clinical Trail
- Keywords:
Ultrasonography;
Thyroid nodule;
TI-RADS;
Biopsy, fine needle;
BRAF V600E mutation
- From:
Chinese Journal of Ultrasonography
2018;27(6):500-504
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the value of ultrasound-guided fine needle aspiration(US-FNA) combined with detection of BRAF V600E and thyroid imaging reporting and data system(TI-RADS) in diagnosis of benign and malignant thyroid nodules.
Methods:In this study, 123 operative thyroid nodules from 114 patients who underwent US-FNA and detection of BRAF V600E were enrolled. TI-RADS was apply for the classification of each nodule before surgery. Specimens from each nodule were subjected for hematoxylin and eosin (HE) staining and cytological diagnosis and detection of BRAF V600E mutation.
Results:①BRAF V600E mutation was found in 71 (71/123) nodules with histologic confirmation of papillary-thyroid carcinoma, 58 of which were cytologically diagnosed as carcinoma and 13 were indeterminate. Compared with the postoperative pathological results, US-FNA combined with BRAF V600E could improve the sensitivity and accuracy of diagnosis to thyroid nodules compared with individual US-FNA, and the difference was statistically significant(P<0.001). ②The mutation rate of BRAF V600E was associated with thyroid capsular invasion(χ2=8.44, P=0.004), and combined with TI-RADS could indicate the high-risk of this invasion. ③Among 123 operative nodules, 18 nodules were BRAF V600E negative and cytologically diagnosed as indetermination, 10 of which were TI-RADS 3b or above. After thyroidectomy, 6 nodules were confirmed as papillary-thyroid carcinoma, 1 nodule was thyroid follicular carcinoma, and 3 nodules were benign ones.
Conclusions:US-FNA combined with detection of BRAF V600E and TI-RADS can improve the diagnostic accuracy and decrease the misdiagnosis in indeterminate nodules.
