细针穿刺细胞学联合BRAF^(V600E)基因突变检测在甲状腺结节诊断中的价值  

The value of fine-needle aspiration cytology combined with BRAF^(V600E) mutation detection in diagnosis of thyroid nodules

作　　者：张博茗 林元强[1] 隋国庆[1] 王洋[1] 赵倩倩[1] 王辉[1] 

机构地区：[1]吉林大学中日联谊医院超声科,吉林长春130033

出　　处：《肿瘤影像学》2015年第4期259-263,共5页Oncoradiology

基　　金：吉林省科技发展计划项目(No:20130206020SF)

摘　　要：目的:研究细针穿刺细胞学(fine-needle aspiration cytology,FNAC)联合BRAF^(V600E)基因突变检测在甲状腺结节诊断中的应用价值。方法:收集2014年6月—2015年6月因甲状腺结节至吉林大学中日联谊医院就诊且经超声检查可疑恶性的患者87例,均行超声引导下FNAC检查和穿刺标本BRAF^(V600E)突变荧光聚合酶链反应(polymerase chain reaction,PCR)检测。结果:术后病理诊断为恶性的64例患者中,术前FNAC阳性48例、阴性16例;BRAF^(V600E)突变40例。术后病理诊断为良性的23例患者中,术前FNAC阳性5例、阴性18例;BRAF^(V600E)突变0例。与术后病理结果对照,FNAC对甲状腺癌诊断的灵敏度为75.0%、特异度为78.3%、准确率为75.9%;BRAF^(V600E)突变检测的灵敏度为62.5%、特异度为100%、准确率为72.4%;FNAC联合BRAF^(V600E)突变检测的灵敏度为89.1%、特异度为78.3%、准确率为86.2%。结论:FNAC联合BRAF^(V600E)基因突变检测可提高甲状腺恶性结节诊断的灵敏度。Objective： To investigate the application value of fine-needle aspiration cytology（FNAC） combined with BRAF mutation detection in the diagnosis of thyroid nodules. Methods： A total of 87 patients who were diagnosed as suspicious malignant thyroid nodules by ultrasonic examination from June 2014 to June 2015 were selected. All the patients underwent FNAC and BRAF mutation detection by fluorescence polymerase chain reaction（PCR）. Results： Among 64 malignant cases, 48 cases were positive and 16 cases were negative for FNAC, and 40 cases had BRAF^V600E mutation. Among 23 benign cases, 5 cases were positive and 18 cases were negative for FNAC, and no case had BRAF^V600E mutation. Compared with the postoperative pathological results, the sensitivity was 75.0%, the specificity was 78.3%, and the accuracy was 75.9% for FNAC. The sensitivity of BRAF mutation detection was 62.5%, the specificity was 100.0%, and the accuracy was 72.4%. The sensitivity was 89.1%, the specificity was 78.3%, and the accuracy was 86.2% for FNAC combined with BRAF^V600E mutation detection. Conclusion： FNAC combined with BRAF^V600Emutation detection can improve the sensitivity of diagnosis of malignant thyroid nodules.

关 键 词：甲状腺结节 细针穿刺细胞学 BRAF基因突变检测 

分 类 号：R445.1[医药卫生—影像医学与核医学]