细针穿刺细胞学联合BRAF(VE1)、CyclinD1表达在甲状腺结节诊断中的应用  

Application of Fine Needle Aspiration Cytology Combined with BRAF(VE1)and CyclinD1 Expression in the Diagnosis of Thyroid Nodules

作　　者：戴素娟[1] 李俊韬[1] 郭广秀[1] 谢训禄 DAI Sujuan;LI Juntao;GUO Guangxiu;XIE Xunlu(Ganzhou People’s Hospital,Jiangxi Province,Ganzhou 341000,China;不详)

机构地区：[1]江西省赣州市人民医院,江西赣州341000

出　　处：《中国医学创新》2022年第21期118-122,共5页Medical Innovation of China

基　　金：江西省卫生计生委科技计划项目(20197458)。

摘　　要：目的:探析联合策略{超声引导下细针穿刺细胞学检查(US-FNAB)+细胞周期素D1(CyclinD1)+V-Raf鼠类肉瘤滤过性病毒致癌基因同源体B1[BRAF(VE1)]}在甲状腺结节诊断中的应用。方法:选择2019年1月-2020年6月赣州市人民医院就诊的200例择期行切除手术的甲状腺结节患者,均采用超声及免疫细胞化学染色法进行联合策略[US-FNAB+CyclinD1+BRAF(VE1)]检测。统计US-FNAB检查、ICC技术[BRAF(VE1)和CyclinD1蛋白检测]及联合策略技术阴阳性检出情况,并以术后组织病理学结果为金标准,分析不同技术的诊断价值。结果:术后组织病理学结果显示恶性结节患者63例,良性结节患者137例。三种诊断策略特异度、阳性预测值对比,差异均无统计学意义(P>0.05);而三种诊断策略敏感度、阴性预测值、准确率对比,差异均有统计学意义(P<0.05),且联合策略的敏感度(85.71%)、阴性预测值(93.48%)、准确率(91.50%)明显最高。结论:联合策略[US-FNAB+CyclinD1+BRAF(VE1)]应用于甲状腺结节性质诊断中价值较高,可以提高单一诊断敏感度、阴性预测值、准确率,降低漏诊、误诊风险。Objective:To explore the combined strategy{ultrasound-guided fine-needle aspiration cytology(US-FNAB)+cyclin D1(CyclinD1)+V-Raf murine sarcoma filtering virus oncogene homolog B1 V600E[BRAF(VE1)]}in the diagnosis of thyroid nodules.Method:A total of 200 patients with thyroid nodules who underwent elective resection in Ganzhou People’s Hospital from January 2019 to June 2020 were selected.Ultrasound and immunocytochemical staining were used for the combined strategy[US-FNAB+CyclinD1+BRAF(VE1)]detection.The negative and positive detections of US-FNAB examination,ICC technology[BRAF(VE1)and CyclinD1 protein detection]and combined strategy technology were counted,and the histopathological results after surgery were used as the gold standard to analyze the diagnostic value of different techniques.Result:Postoperative histopathological results showed that there were 63 patients with malignant nodules and 137 patients with benign nodules.There were no statistical differences in the specificity and positive predictive value of the three diagnostic strategies(P>0.05);while there were statistical differences in the sensitivity,negative predictive value and accuracy of the three diagnostic strategies(P<0.05),and the sensitivity(85.71%),negative predictive value(93.48%)and accuracy(91.50%)of the combined strategy were obviously the highest.Conclusion:The combined strategy[US-FNAB+CyclinD1+BRAF(VE1)]has high value in the diagnosis of thyroid nodules,which can improve the single diagnostic sensitivity,negative predictive value and accuracy,reduce the risk of missed diagnosis and misdiagnosis.

关 键 词：细针穿刺细胞学 BRAF(VE1) 甲状腺结节 免疫细胞化学 细胞周期素D1 

分 类 号：R653[医药卫生—外科学]