超声引导下细针抽吸细胞学检查联合BRAF V600E基因检测诊断甲状腺影像报告和数据系统(TI-RADS)4类结节  

Ultrasound-guided fine-needle aspiration cytology combined withBRAF V600E gene detection for thyroid imaging reportingand data system (TI-RADS) 4 nodules

作　　者：胡加银 陈潇 何霖 阳建政 程伟 杜鹏 李陶 HU Jiayin;CHEN Xiao;HE Lin;YANG Jianzheng;CHENG Wei;DU Peng;LI Tao(Department of Ultrasound,Daping Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院超声科,重庆400042

出　　处：《中国医学影像技术》2021年第4期507-511,共5页Chinese Journal of Medical Imaging Technology

基　　金：重庆市技术创新与应用示范项目(cstc2018jscx-msybX0018)。

摘　　要：目的观察超声引导下细针抽吸细胞学检查(FNAC)联合BRAF V600E基因检测对甲状腺影像报告和数据系统(TI-RADS)4类结节的诊断价值。方法回顾性分析152例TI-RADS 4类结节的超声、FNAC、术后病理及BRAF V600E基因检测等资料。FNAC以Bethesda报告系统分类≥Ⅴ类为标准诊断甲状腺癌。检测BRAF突变,以阳性预测甲状腺癌。以病理结果为金标准,分别计算FNAC、BRAF V600E基因检测及FNAC联合BRAF V600E基因检测诊断甲状腺癌的敏感度、特异度和准确率。结果BRAF V600E基因检测及超声引导下FNAC联合BRAF V600E基因检测诊断甲状腺癌的敏感度、特异度、准确率均明显高于单纯FNAC(P均<0.05)。FNAC对26个结节(26/152,17.11%)难以明确其良恶性,联合BRAF V600E基因检测后均获明确诊断,诊断敏感度、特异度及准确率分别为95.45%、100.00%及96.15%。结论超声引导下FNAC联合BRAF V600E基因检测预测TI-RADS 4类结节良恶性优于FNAC,尤其对于FNAC难以明确性质的结节有较高临床价值。Objective To explore the diagnostic value of ultrasound-guided fine-needle aspiration cytology(FNAC)combined with BRAF V600E gene detection for thyroid imaging reporting and data system(TI-RADS)4 nodules.Methods Ultrasound,FNAC,postoperative pathology and BRAF V600E gene detection data of 152 patients with TI-RADS 4 nodules were retrospectively analyzed.FNAC diagnosed malignant lesions when Bethesda reporter system classification≥Ⅴas standard,while positive BRAF V600E detection was used to predict thyroid cancer.Taken pathological results as gold standards,the sensitivity,specificity and accuracy of FNAC,BRAF V600E gene detection and FNAC combined with BRAF V600E gene detection in diagnosis of thyroid cancer were calculated.Results The sensitivity,specificity and accuracy of BRAF V600E gene detection and ultrasound-guided FNAC combined with BRAF V600E gene detection in diagnosis of thyroid cancer were significantly higher than those of FNAC alone(all P<0.05).FNAC was difficult to identify 26 nodules(26/152,17.11%)as benign or malignant,for which the diagnostic sensitivity,specificity and accuracy of combining with BRAF V600E gene detection was 95.45%,100.00%and 96.15%,respectively.Conclusion Ultrasound-guided FNAC combined with BRAF V600E gene detection was superior to FNAC alone for predicting benign and malignant TI-RADS 4 nodules,especially being valuable when FNAC was difficult to determine the nature of nodules.

关 键 词：甲状腺结节 超声检查 活组织检查 细针吸 基因检测 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]