C-TIRADS及BRAF^(V600E)基因检测对细针穿刺细胞学难以定性的甲状腺结节的诊断价值  

The diagnostic value of C-TIRADS and BRAF^(V600E) gene mutation for indeterminate cytology thyroid nodules

作　　者：董维露 吴意赟 周正国 汪向前 蔡婷 孙卉娟 DONG Weilu;WU Yiyun;ZHOU Zhengguo;WANG Xiangqian;CAI Ting;SUN Huijuan(Department of Ultrasound Medicine,The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210001,China)

机构地区：[1]南京中医药大学附属医院超声医学科,江苏南京210001

出　　处：《西部医学》2023年第10期1545-1549,共5页Medical Journal of West China

基　　金：江苏省重点社会发展项目(BE2018703);江苏省第五期“333高层次人才培养工程”项目(LGY2018063)。

摘　　要：目的探讨中国版甲状腺影像数据与报告系统(C-TIRADS)、BRAF^(V600E)基因检测及二者联合对细针穿刺细胞学难以定性的甲状腺结节的诊断价值。方法纳入我院2020年1月—2021年4月的甲状腺手术患者53例行回顾性分析,术前完成超声、细针穿刺抽吸及BRAF^(V600E)基因检测,选取细针穿刺细胞学难以定性的患者作为研究对象,53例患者共62个结节。以手术病理结果作为金标准,比较C-TIRADS、BRAF^(V600E)基因检测及二者联合诊断对甲状腺结节的诊断效能。结果C-TIRADS诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为92.50%、50.00%、77.08%、78.57%、77.42%。BRAF^(V600E)基因诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为55.00%、100.00%、100.00%、55.00%、70.97%。C-TIRADS联合BRAF^(V600E)基因诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为95.00%、50.00%、77.55%、84.62%、79.03%。C-TIRADS及联合诊断对甲状腺癌诊断的敏感性高于BRAF^(V600E)基因检测(P<0.001),BRAF^(V600E)基因检测特异性及阳性预测值高于C-TIRADS及联合诊断(P<0.05)。C-TIRADS、BRAF^(V600E)基因检测及联合诊断对甲状腺癌诊断的阴性预测值和准确性差异无统计学意义(P>0.05)。结论C-TIRADS及BRAF^(V600E)基因检测对于细胞学难以定性的甲状腺结节均有良好的诊断效能,术前联合应用可以更好地评估甲状腺结节。Objective To research the diagnostic value of C-TIRADS(Chinese-TIRADS),BRAF^(V600E)gene detection and the combination of indeterminate cytology thyroid nodules.Methods To collect the patients who finished thyroid ultrasound,fine needle aspiration and BRAF^(V600E)gene detection before operation from February 2020 to April 2021,62 nodules from 53 patients with the indeterminate cytology were chosen as samples respectively.The diagnostic value of C-TIRADS(Chinese-TIRADS),BRAF^(V600E)gene detection and the combination was compared with the operative pathology as gold standard.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of C-TIRADS in the diagnosis of thyroid cancer were 92.50%,50.00%,77.08%,78.57%and 77.42%,respectively.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of BRAF^(V600E)gene in the diagnosis of thyroid cancer were 55.00%,100.00%,100.00%,55.00%and 70.97%,respectively.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of the combination were 95.00%,50.00%,77.55%,84.62%,79.03%,respectively.C-TIRADS and the combination were significantly more sensitive to thyroid cancer than BRAF^(V600E)gene(P=0.000).The specificity and positive predictive value of BRAF^(V600E)gene were significantly higher than C-TIRADS and the combination(P<0.05).The negative predictive value and accuracy of thyroid cancer diagnosis had no significant differences among C-TIRADS,BRAF^(V600E)gene detection and the combination.Conclusion C-TIRADS and BRAF^(V600E)have good diagnostic efficacy for thyroid nodules with indeterminate cytology,and the preoperative combination can evaluate thyroid nodules better.

关 键 词：甲状腺结节 中国版甲状腺影像数据与报告系统 BRAF^(V600E)基因检测 甲状腺结节细针穿刺抽吸 

分 类 号：R583.1[医药卫生—内分泌]