BRAF V600E基因检测在细针穿刺活检诊断为BethesdaⅢ类中的应用价值  

Application value of BRAF V600E gene detection in cytological diagnosis of BethesdaⅢby fine-needle aspiration biopsy

作　　者：王栋[1,2] 李萍[1] 赵美丽[1] 张柳婷[1] 陈松旺 WANG Dong;LI Ping;ZHAO Meili;ZHANG Liuting;CHEN Songwang(Department of Functional Examination,Nanjing First Hospital,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing 210006,Jiangsu Province,China;Department of Ultrasound,Yangzhong People’s Hospital,Zhenjiang 212200,Jiangsu Province,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)功能检查科,江苏南京210006 [2]扬中市人民医院超声科,江苏镇江212200

出　　处：《肿瘤影像学》2023年第3期286-290,共5页Oncoradiology

摘　　要：目的:探讨BRAF V600E基因检测在诊断意义不明确的细胞非典型病变或滤泡性病变(atypia of undetermined significance or follicular lesion of undetermined significance,AUS/FLUS)结节良恶性中的临床应用价值。方法:回顾并分析南京医科大学附属南京医院(南京市第一医院)2019年3月—2022年10月术前经超声引导下细针穿刺活检(fine-needle aspiration biopsy,FNAB)诊断为AUS/FLUS,有完整超声评估报告、BRAF V600E检测结果的患者共96例,97个结节,以术后病理学检查为金标准,运用统计学方法研究BRAF V600E基因检测对诊断AUS/FLUS结节良恶性的应用价值。结果:97个AUS/FLUS结节的术后组织学病理中,良性11个,恶性86个,BRAF V600E基因突变71个,且病理学类型均为甲状腺乳头状癌(papillary carcinoma of the thyroid,PTC)。BRAF V600E基因检测诊断AUS/FLUS结节良恶性的灵敏度、特异度、准确度分别为82.6%、100.0%、84.5%。通过计算受试者工作特征(receiver operating characteristic,ROC)曲线的曲线下面积(area under the curve,AUC),证实BRAF V600E基因检测对AUS/FLUS结节的良恶性有较高的诊断价值。BRAF V600E基因突变可以提高AUS/FLUS结节的恶性检出率(P<0.05)。结论:BRAF V600E基因检测对AUS/FLUS结节良恶性具有较高的诊断价值,联合FNAB可提高AUS/FLUS结节的恶性检出率,对临床制订治疗方案有很大帮助。Objective:To explore the clinical value of BRAF V600E gene detection in diagnosing the benign and malignant nodules of the atypia of undetermined significance or follicular lesion of undetermined significance(AUS/FLUS).Methods:A retrospective analysis was performed on 96 patients(with 97 nodules)diagnosed as AUS/FLUS by fine-needle aspiration biopsy(FNAB)before surgery and with complete ultrasound evaluation report and BRAF V600E detection results from Nanjing Hospital Affiliated to Nanjing Medical University(Nanjing First Hospital)from March 2019 to October 2022.With postoperative pathology as the gold standard,the application value of BRAF V600E gene detection in diagnosing benign and malignant AUS/FLUS nodules was studied through statistical methods.Results:Among the postoperative histopathological findings of 97 AUS/FLUS nodules,11 were benign,86 were malignant,and 71 had mutations in the BRAF V600E gene,all of which were papillary carcinoma of the thyroid(PTC).The sensitivity,specificity,and accuracy of the BRAF V600E gene detection in the diagnosis of AUS/FLUS nodules were 82.6%,100.0%,and 84.5%.By calculating the area under the curve(AUC)of receiver operating characteristic(ROC)curve,it is confirmed that the BRAF V600E gene detection has a high diagnostic value for the diagnosis of AUS/FLUS nodules.BRAF V600E mutation examination can increase the malignant detection rate of AUS/FLUS nodules(P<0.05).Conclusion:The BRAF V600E gene detection has high diagnostic value for the diagnosis of AUS/FLUS nodules.Combining FNAB can improve the detection rate of malignant AUS/FLUS nodules,which is very helpful for clinical treatment planning.

关 键 词：甲状腺结节 BRAF V600E基因 细针穿刺活检 

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