甲状腺结节细针穿刺细胞学联合BRAF基因检测在甲状腺良恶性肿瘤鉴别诊断中的应用价值

打开文本图片集

中图分类号：R446.6 文献标志码：A DOI：10.11958/20241258

Abstract：ObjectiveTo explore the value of thyroid nodule fine needleaspirationcytology （FNAC）combined with BRaf proto-oncogene，serine/threonine kinase（BRAF）gene detectioninthediferential diagnosisof benignand malignant thyroid tumors.MethodsAccordingtotheresultsof pathological examination，198patientswith thyroid nodules were divided into the benign lesion group （n=1O7） and the malignant lesion group （ n 91）.All patients underwent ultrasoundguidedFNAC，and expresionofBRAFgene was detectedbyreal-time fluorescence quantitative polymerase chainreaction. The value ofFNAC，BRAF gene detectionand combined detectioninthe diferential diagnosisofbenignand malignant thyroid umors was analyzed by Kappa consistency test and receiver operating characteristic （ROC）curves.ResultsThe nodules were mostlyunder envelope inthe malignant lesion group，whilein the benign lesion group，which were mostly located within glands （ P<0.05 ）. FNAC results showed that 62 cases with type II Bethesda，26 cases with type II Bethesda， 29 cases with typeIV Bethesda，14cases withtype VBethesdaand 67cases withtype VIBethesda.There were significant diferencesindiagnosticpositiverates between FNAC，BRAF genedetection，combined detectionandpathological examination （ P<0.05 ）. The area under ROC curve （AUC）of FNAC combined with BRAF gene detection for diferentiating benign and malignant thyroid tumorswas 0.871 （95%CI： 0.816-0.914）， sensitivity was 90.11% ，specificitywas 84.11% and Kappa value was 0.737. The AUC of FNAC diagnosis was 0.833 （95%CI： 0.774-0.882），sensitivity was 76.92% ，specificity was 89.72% and Kappa value was 0.672. The AUC of BRAF gene detection was 0.829（95%CI：0.770-0.879），sensitivity was 78.02% ，specificity was 87.85% and Kappa value was O.663. ConclusionFNAC combined with BRAF gene detection can improvediferentialdiagnosisffciencyforbenignandmalignantthyroidlesions，especiallyenhancingthediagnostic

sensitivity.

Key words： thyroid tumor; ultrasonography; biopsy，fine-needle; proto-oncogene proteins B-raf

甲状腺结节是临床常见病，通常为良性，多发结节多于单发结节，甲状腺良性肿瘤以单一甲状腺结节为特征[]。（剩余8833字）