Diagnostic value of BRAF V600E mutation combined with 2015 American Thyroid Association ultrasound pattern in patients with cytologically indeterminate thyroid nodule
10.3760/cma.j.cn131148-20210221-00119
- VernacularTitle:BRAF V600E基因联合2015ATA超声模式在甲状腺细针穿刺意义不明确类型结节临床决策中的应用价值
- Author:
Qiang LI
1
;
Lu YANG
;
Shiyan LI
;
Leqi WANG
;
Shan JIANG
;
Jianghong LYU
;
Jiang ZHU
Author Information
1. 浙江大学医学院附属邵逸夫医院超声科 浙江大学邵逸夫临床医学研究所，杭州 310016
- Keywords:
Ultrasonography;
Thyroid neoplasms;
Fine needle aspiration biopsy;
BRAF V600E gene
- From:
Chinese Journal of Ultrasonography
2021;30(9):778-784
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of BRAF V600E mutation combined with 2015 American Thyroid Association (ATA) Guidelines ultrasound (US) pattern in fine-needle aspiration (FNA) cytology of thyroid nodules with atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS).Methods:This study retrospectively enrolled 96 consecutive patients with 101 AUS/FLUS thyroid nodules who underwent preoperative US, FNA, and BRAF V600E mutation analysis. All AUS/FLUS nodules were classified based on US pattern-based risk stratification of 2015 ATA Guidelines. With postoperative pathology as the gold standard, the diagnostic value of BRAF V600E mutation, US pattern and the combination of two methods were compared.Results:Postoperative pathology confirmed 33 benign nodules and 68 malignant nodules. The mutation rates of BRAF V600E in AUS/FLUS nodules was 51.5%. The sensitivity, specificity, and accuracy of BRAF V600E in the diagnosis AUS/FLUS nodules were 72.1%, 90.9% and 78.2%, respectively. The ROC curve demonstrated that the best cut-off of US pattern was high suspicion. The sensitivity, specificity, and accuracy of US pattern in the diagnosis of AUS/FLUS nodules were 63.2%, 81.8% and 69.3%, respectively. The accuracy of US pattern in determining AUS/FLUS nodules without BRAF V600E mutation was 70.6%. The sensitivity, specificity, and accuracy of the combination of two methods in the differential diagnosis of AUS/FLUS nodules were 89.7%, 75.8%, and 85.1%, respectively. The combination had the highest sensitivity ( P<0.05). Conclusions:BRAF V600E mutation has a good diagnostic value for differentiating benign and malignant AUS/FLUS nodules. Combined with US pattern, the differential diagnostic value for AUS/FLUS nodules without BRAF V600E mutation can be improved, and the sensitivity can be raised.
