Objective To explore the value of CT-guided needle positioning in preoperative localization of pulmonary ground glass nodules(GGN).Methods Clinical data of 110 patients with pulmonary GGN treated in the Wuxi Hospital from March 2017 to December 2021 were collected.Before thoracoscopic surgery,CT-guided needle positioning was conducted,and the accuracy and effectiveness of positioning were observed.Results The lesions were located in the lateral side of the lungs in 72 patients and in the middle lateral sides of the lungs in 38 patients,with the puncture success rates being 93.06%and 86.84%,respectively(P<0.01).The positioning time,incidence of complications,surgical time,extubation time and hospital stay in patients with the lesions located in lateral lungs were lower than those located in middle lateral lungs.Postoperative pathological results were taken as the gold standard,and the sensitivity,specificity,and accuracy of CT-guided needle positioning were 90.20%,75.00%,and 89.09%,respectively.Conclusion Preoperative CT-guided needle positioning can help to shorten the localization time of operation,surgical time and extubation time,and reduce complications.

ABSTARCT Purpose To investigate the clinicopathologic characteristics and genetic mutations of metastatic follicular thy-roid carcinoma(FTC).Methods A total of 22 cases of meta-static FTC were collected,including previous medical history,imaging,treatments and outcomes,and next-generation sequen-cing study and Sanger sequencing were performed in 12 cases.Results There were 16 women and 6 men.Sixteen cases were older than 50 years.Seven cases presented with metastases as the first symptom.Fourteen cases developed metastases 3 to 12 years after thyroid surgery.Sixteen cases developed bone metas-tasis,10 cases had lung metastasis,and 3 cases had brain me-tastasis.Those patients with multiple bone metastases progressed during the follow-up period.The common gene mutations in me-tastases were NRAS p.Q61R(6 cases),HRAS p.Q61R(2 ca-ses)and KRAS p.Q61R(1 case),followed by TERT promoter mutation(8 cases).Other mutated genes included KEL,BRCA1/2,ALK,ROS1,ErbB4,etc.Conclusion FTC has a high misdiagnosis rate.Those diagnosed with FTC should under-go regular systemic examinations to detect potential metastasis,especially in bone,lung,and brain.Further research on the sig-nificance of NRAS and other molecular indicators in FTC metas-tasis will help to better predict its biological behaviors.