细针抽吸细胞学联合检测BRAF^(V600E)在甲状腺结节诊断中的应用价值  

The combined value of fine needle aspiration cytology and BRAFV600E gene mutation detection in the diagnosis of thyroid nodules

作　　者：黄晓萍 贺军 Huang Xiaoping;He Jun(Department of Pathology,Wenzhou Central Hospital,Wenzhou 325000,Zhejiang Province,China;B-ultrasound Room,Wenzhou Central Hospital,Wenzhou 325000,Zhejiang Province,China)

机构地区：[1]温州市中心医院病理科,温州325000 [2]温州市中心医院B超室,温州325000

出　　处：《中国基层医药》2024年第3期342-346,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨细针抽吸细胞学(FNAC)联合丝氨酸/苏氨酸蛋白激酶(BRAF^(V600E))基因突变检测在甲状腺结节术前诊断中的临床意义。方法回顾性分析温州市中心医院2022年1月至2023年1月经手术后常规组织病理确诊的126例甲状腺结节术前FNAC及检测BRAF^(V600E)基因突变结果,并与单用FNAC检查所获得的结果进行比较分析。结果FNAC联合检测BRAF^(V600E)基因突变与单用FNAC对甲状腺结节检测特异度比较差异无统计学意义(P>0.05);FNAC联合检测BRAF^(V600E)基因突变对甲状腺结节检测敏感度[97.6%(82/84)]高于单用FNAC[85.5%(65/76)],差异有统计学意义(χ^(2)=7.82,P<0.05);FNAC联合检测BRAF^(V600E)基因突变对甲状腺结节检测总准确率[96.8%(122/126)]高于单用FNAC[85.0%(96/113)],差异有统计学意义(χ^(2)=10.47,P<0.05)。结论FNAC联合检测BRAF^(V600E)基因突变在术前甲状腺结节诊断价值良好,可提高诊断敏感性和准确性,值得临床进一步推广。Objective To investigate the clinical significance of the combined use of fine needle aspiration cytology(FNAC)and BRAF^(V600E) gene mutation detection in the preoperative diagnosis of thyroid nodules.Methods A retrospective analysis was conducted on 126 cases of thyroid nodules confirmed by routine histopathology after surgery at Wenzhou Central Hospital between January 2022 and January 2023.The results of preoperative FNAC combined with BRAF^(V600E) gene mutation detection were compared with those obtained from FNAC alone.Results There was no significant difference in specificity for thyroid nodules between FNAC combined with BRAF^(V600E) gene mutation detection and FNAC alone(P>0.05).The sensitivity of FNAC combined with BRAF^(V600E) gene mutation detection was significantly higher than that of FNAC alone[97.6%(82/84)vs.85.5%(65/76),χ^(2)=7.82,P<0.05].The overall accuracy of FNAC combined with BRAF^(V600E) gene mutation detection was significantly higher than that of FNAC alone[96.8%(122/126)vs.85.0%(96/113),χ^(2)=10.47,P<0.05].Conclusion The combined application of FNAC and BRAF^(V600E) gene mutation detection holds an exceptional diagnostic value in the preoperative diagnosis of thyroid nodules.This approach not only elevates diagnostic sensitivity and accuracy,but also deserves clinical promotion.

关 键 词：甲状腺结节 癌 乳头状 病理学 抽吸 细胞学技术 敏感性与特异性 蛋白质丝氨酸苏氨酸激酶 

分 类 号：R581[医药卫生—内分泌]