超声引导下细针穿刺细胞学检查联合BRAF V600E基因检测对甲状腺癌的诊断价值  

Thyroid ultrasound,ultrasound-guided fine-needle aspiration biopsy and BRAF^(V600E)gene mutation in the diagnosis of thyroid cancer

作　　者：刘宏[1] 赵亮[1] LIU Hong;ZHAO Liang(Department of Sonography, Affiliated Tumor Hospital of Xingjiang Medical University, Urumqi 830011, P.R.China)

机构地区：[1]新疆医科大学附属肿瘤医院病理科,新疆乌鲁木齐830011

出　　处：《医学影像学杂志》2020年第12期2193-2197,共5页Journal of Medical Imaging

基　　金：新疆维吾尔自治区自然科学基金资助项目(编号:2017D01C394)。

摘　　要：目的探讨甲状腺超声(US)引导下细针穿刺细胞学(US-FNAB)-BRAF V600E基因突变检测在甲状腺癌(TC)中的价值。方法选取我院检查的54例甲状腺结节病例资料,根据其病理诊断结果归为良性组(28例/30个结节)、恶性组(26例/28个结节);分析患者结节的超声征象、US-FNAB及BRAF V600E基因检测结果。结果超声声像图中,良、恶性结节病灶形态、边缘、钙化、回声性质、纵横比和病灶内血流情况均有明显差异(P<0.05);以结节检测为Ⅴ、Ⅵ级则诊断TC阳性,US-FNAB检查诊断为TC的病例为24例(26个结节);BRAF V600E基因检测为突变的病例是22例(24个结节);以病理诊断作金标准,三项联合的多层次诊断体系评估效能最高,AUC达0.982,灵敏度是96.43%、特异度100%、准确率98.29%。结论US-(US-FNAB)-BRAF V600E基因多层次诊断体系对检测TC有重要意义。Objective To analyze the value of multi-level diagnostic system for thyroid ultrasound(US)-ultrasonic guided fine needle aspiration cytology(US-FNAB)-BRAFV600E gene mutation in detection of thyroid cancer(TC).Methods The data of 54 cases of thyroid nodules examined in our hospital from December to 2018,November,2019 were reviewed and counted.According to their pathological diagnosis,they were classified as benign group(28 cases/30 nodules),malignant group(26 cases/28 nodules);the ultrasonic signs,US-FNAB and BRAF V600E gene detection results of nodules were analyzed.US,US-FNAB,BRAF V600E gene detection and the diagnostic sensitivity,specificity and accuracy of three combinations in the TC and the area under the ROC curve(AUC)were analyzed.Results There were significant differences in the morphology,margin,calcification,echogenicity,aspect ratio and blood flow in the lesions of benign and malignant nodules in ultrasound images(P<0.05);There were 24 cases(26 nodules)in which nodules were detected TC V or VI,and 24 cases(24 nodules)in which US-FNAB were diagnosed as TC;22 cases(24 nodules)in which BRAF V600E genes were detected as mutations;According to the standard of pathological diagnosis,the three combined multi-level diagnostic system had the highest evaluation efficiency,the AUC was 0.982,the sensitivity was 96.43%,the specificity was 100%,and the accuracy was 98.29%.Conclusion US-(US-FNAB)-BRAFV600E gene multi-level diagnostic system is extremely valuable for TC diagnosis and is worthy of clinical application.

关 键 词：超声检查 细胞学 基因突变 甲状腺癌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]