超声引导下细针穿刺细胞学检查联合BRAF^(V600E)基因检测诊断甲状腺癌的临床价值  

Fine-needle aspiration cytology combined with detection of BRAF^(V600E) mutation in diagnosis of thyroid cancer

作　　者：刘颖[1] 徐潮阳 马拥军[1] LIU Ying;XU Chaoyang;MA Yongjun(Department of Clinical Laboratory,Jinhua Central Hospital,Jinhua 321000,China;不详)

机构地区：[1]金华市中心医院(浙江大学附属金华医院)检验科,321000 [2]金华市中心医院(浙江大学附属金华医院)乳腺甲状腺外科,321000

出　　处：《浙江医学》2023年第8期809-813,共5页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目面上项目(2020KY1009);金华市科技计划项目社会发展类重点项目(2021-3-072)。

摘　　要：目的探讨超声引导下的细针穿刺(FNA)细胞学检查联合BRAF^(V600E)基因检测在甲状腺癌诊断的临床价值。方法回顾2021年1至12月金华市中心医院诊断为甲状腺结节并选择手术治疗的121例患者临床资料,均接受超声引导下的甲状腺FNA检查和BRAF^(V600E)基因检测;记录FNA、BRAF^(V600E)基因检测和术后病理检查结果。分析甲状腺癌患者的临床病理特征以及FNA联合BRAF^(V600E)基因突变检测对诊断甲状腺癌的临床价值。结果121例手术治疗的甲状腺结节患者有117例术后确诊为甲状腺乳头状癌,其中甲状腺微小乳头状癌(PTMC)105例(89.7%);甲状腺乳头状癌直径>1 cm时,更易发生多发结节(P<0.05)。FNA联合BRAF^(V600E)基因检测能提高PTC诊断的灵敏度(0.957比0.727,P<0.01)。结论FNA联合BRAF^(V600E)基因检测能提高诊断PTC的灵敏度,但鉴于PTMC的高检出率,因此临床应用中应考虑是否存在过度诊断。Objective To evaluate the clinical significance of fine-needle aspiration(FNA)cytology combined with detection of BRAF^(V600E) mutation in diagnosis of thyroid cancer.Methods Clinical data of 121 patients with thyroid nodules treated at Jinhua Central Hospital from January to December 2021 were retrospectively analyzed.All patients underwent FNA cytology examination and BRAF^(V600E) mutation detection before thyroid surgery.The clinical value of FNA cytology and BRAF^(V600E) mutation in diagnosis of thyroid cancer were assessed.Results In 121 patients,117 were diagnosed as papillary thyroid carcinoma(PTC),among which 105(89.7%)were papillary thyroid microcarcinoma(PTMC).In PTC of diameter>1 cm,multiple nodules were more likely to be detected(P<0.05).The sensitivity of FNA combined with BRAFV600E mutation were significantly higher than that of FNA alone(0.957 vs.0.727,P<0.01)in diagnosis of PTC.Conclusion FNA combined with BRAF^(V600E) gene test can improve the sensitivity of PTC diagnosis,but the overdiagnosis of thyroid cancer should be considered in clinical application.

关 键 词：甲状腺癌 甲状腺乳头状癌 甲状腺微小乳头状癌 细针穿刺 BRAF基因突变 

分 类 号：R736.1[医药卫生—肿瘤]