超声引导下细针穿刺联合BRAF基因检测对甲状腺峡部结节预测效能的研究  

Predictive efficacy of ultrasound-guided fine-needle aspiration combined with BRAF gene mutation detection for thyroid isthmus nodules

作　　者：岳鑫 杨明儒 王尚 Yue Xin;Yang Mingru;Wang Shang(Department of Ultrasound,Jiaozuo People's Hospital,Jiaozuo 454000,Henan Province,China;Department of General Surgery,Jiaozuo People's Hospital,Jiaozuo 454000,Henan Province,China;Clinical Laboratory,Jiaozuo People's Hospital,Jiaozuo 454000,Henan Province,China)

机构地区：[1]焦作市人民医院超声科,焦作454000 [2]焦作市人民医院普外科,焦作454000 [3]焦作市人民医院检验科,焦作454000

出　　处：《中国基层医药》2024年第4期560-564,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的评价超声引导下细针穿刺(FNA)联合BRAF^(V600E)基因突变(GM)检测对甲状腺影像报告和数据系统(TI-RADS)峡部4a和4b类结节良恶性的诊断价值。方法回顾性分析2019年10月至2022年6月于焦作市人民医院经手术病理证实的48例TI-RADS 4类甲状腺结节患者的临床资料,以手术病理结果为金标准,分别计算细针穿刺细胞病理学、BRAF^(V600E)基因突变检测和两者联合应用对TI-RADS 4类甲状腺结节良恶性的诊断效能。结果受试者工作特征曲线(ROC曲线)分析结果显示,FNA、BRAF^(V600E)基因突变检测及联合应用对甲状腺峡部4类结节诊断的曲线下面积分别为:4a类0.876、0.852、0.952,4b类0.850、0.858、0.908,P值分别为:4a类0.010、0.016、0.002,4b类0.006、0.005、0.001。联合应用的ROC曲线下面积均大于两者单独应用。结论细针穿刺联合BRAF^(V600E)基因突变检测有助于提高甲状腺峡部TI-RADS 4a和4b类结节良恶性鉴别的ROC曲线下面积。Objective To assess the diagnostic utility of ultrasound-guided fine-needle aspiration(FNA)combined with BRAF^(V600E) gene mutation detection for discerning benign from malignant thyroid isthmus nodules classified as thyroid imaging report and data system(TI-RADS)4a and 4b.Methods A retrospective analysis was conducted on the clinical data of 48 patients with thyroid nodules of TI-RADS 4,who underwent surgical confirmation and pathological diagnosis at Jiaozuo People's Hospital between October 2019 and June 2022.Using surgical and pathological outcomes as the gold standard,the diagnostic efficacy of FNA cytopathology,BRAF^(V600E) gene mutation detection,and the combined approach were individually evaluated for benign and malignant thyroid nodules of TI-RADS 4.Results The receiver operating characteristic curve analysis revealed the diagnostic values of FNA,BRAF^(V600E) gene mutation detection,and their combined use in predicting the benignancy or malignancy of thyroid isthmus nodules.For TI-RADS 4a nodules,the areas under the curves were 0.876 for FNA,0.852 for BRAF^(V600E) gene mutation detection,and 0.952 for the combined approach.For TI-RADS 4b nodules,the areas under the curves were 0.850,0.858,and 0.908,respectively.The P-values were 0.010,0.016,and 0.002 for TI-RADS 4a nodules,and 0.006,0.005,and 0.001 for TI-RADS 4b nodules.Notably,the combined approach demonstrated larger areas under the curves compared with individual applications.Conclusion The combined use of FNA and BRAF^(V600E) gene mutation detection enhances the diagnostic accuracy for thyroid isthmus nodules classified as TI-RADS 4a and 4b,as reflected by an increased area under the receiver operating characteristic curve.

关 键 词：甲状腺结节 活组织检查 针吸 超声检查 诊断 ROC曲线 曲线下面积 

分 类 号：R581[医药卫生—内分泌]