TI-RADS超声分类联合BRAF^(V600E)基因突变在甲状腺结节诊断中的价值  

TI-RADS Combined with BRAF^(V600E) Mutation in Diagnosis of Thyroid Nodules

作　　者：林婉玲[1] 吕国荣[1,2] 李伯义 周爽[3] 王礼兴[3] 高宏志[3] 

机构地区：[1]福建医科大学附属第二医院超声科,福建省泉州市362000 [2]福建省泉州医学高等专科学校 [3]福建医科大学附属第二医院中心实验室,福建省泉州市362000

出　　处：《中国超声医学杂志》2017年第3期193-195,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨TI-RADS超声分类联合BRAF^(V600E)基因突变检测在甲状腺结节诊断中的价值。方法对常规超声检查发现的TI-RADS 3~5类甲状腺结节92枚(92例)行BRAF^(V600E)基因突变定性检测,比较TI-RADS超声分类及其联合BRAF^(V600E)基因诊断甲状腺结节的效能。所有结节均行超声引导下穿刺组织病理活检或术后病理检查。结果 92枚结节中病理结果良性27枚,恶性65枚;BRAF^(V600E)基因突变阳性50枚,阴性42枚。TI-RADS分类及其联合BRAF^(V600E)基因诊断甲状腺结节的灵敏度分别为72.31%、93.85%(χ~2=9.247,P<0.05)、特异度分别为74.07%、74.07%(χ~2=0.001,P>0.05)、准确度分别为72.83%、88.04%(χ~2=5.836,P<0.05)、阳性预测值分别为87.04%、89.71%(χ~2=0.211,P>0.05)、阴性预测值分别为52.63%、83.33%(χ~2=4.790,P<0.05)。结论 TI-RADS超声分类联合BRAF^(V600E)基因突变检测可以提高诊断甲状腺结节的灵敏度、准确度及阴性预测值。Objective To evaluate the value of thyroid imaging-reporting and data system （TI-RADS） combined with the BRAF（V600E） mutation in the diagnosis of thyroid nodules. Methods Ninety-two patients with thyroid nodules identified on ultrasound （TI-RADS 3-5） were enrolled. BRAF（V600E） mutation detection were performed for those patients. The diagnostic values of TI-RADS and TIRADS combined with BRAF（V600E） mutation for thyroid nodule were compared. The diagnosis of all nodules were confirmed at pathology by surgery or US-guided histological biopsy. Results Of 92 thyroid nodules, 27 were benign and 65 were malignant. BRAF（V600E） mutation were found in 50 patients, BRAF（V600E） mutation were not found in 42 patients. The diagnostic sensitivity of TI-RADS and TI-RADS combined with BRAF（V600E） mutation were 72.31% and 93.85% （X2 =9. 247,P%0.05） ;the specificity of two were 74.07% and 74.07 % （;（2 = 0.001, P〈 0.05） ; the accuracy of two were 72.83% and 88.04% （ X2 = 5. 836, P〈 0.05 ） ; the positive predictive value of two were 87.04 % and 89.71% （X2 = 0. 211, P〈0.05）;the negative predictive value of two were 52.63% and 83.33% （2 =4. 790,P〈0.05）. Conclusions TI-RADS combined with BRAF（V600E） mutation detection can improve the diagnostic sensitivity, accuracy and negative predictive value in differentiating the thyroid nodules.

关 键 词：甲状腺结节 TI-RADS BRAF(V600E)基因突变 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581[医药卫生—诊断学]