甲状腺结节细针穿刺标本中BRAF^(V600E)突变的临床意义

Detection of BRAF^(V600E) mutation in fine needle aspiration specimens of thyroid nodules and its clinical implication

目的探讨BRAF^(V600E)突变率在甲状腺结节术前诊断中的意义及其可行性。方法选择2012-01—2013-01行细针穿刺术(FNA)的甲状腺结节患者337例,根据细胞学诊断分为Thy1、Thy2、Thy4和Thy5组,分别检测FNA标本的BRAF^(V600E)突变。结果 Thy5组BRAF^(V600E)突变率为22.2%;甲状腺结节的不同病理类型及BRAF突变率与桥本甲状腺炎(HT)无相关性(均P>0.05);与Thy2组比,Thy5组TSH水平较高[(2.83±2.11 VS 1.95±1.29)mU/L,t=2.251,P<0.05]。结论检测甲状腺结节FNA标本的BRAF^(V600E)突变简便、可行;对一部分因取材不满意标本可提供补充诊断;BRAF突变与HT可能无关。

Objective To investigate BRAFV600E mutation in fine needle aspiration （FNA） specimens of thyroid nodules and its clinical implication. Methods Total 349 FNA samples were col ected from patents with thyroid nodules in our hospital during January 2012 to January 2013. Based on cytological findings thyroid nodules were classified as Thy1, Thy2, Th3, Thy4 and Thy5 groups. BRAFV600E mutation was detected by sequence. Results The prevalence of the BRAFV600E mutation in FNA samples of group Thy5 was 22.2%, and the results implied no associations between BRAFV600E mutation and Hashimoto’s thyroiditis （HT）. Compared to Thy2, there were higher level of TSH in group Thy5 [（2.83±2.11vs1.95±1.29）mU/L, t=2.251, P〈0.05]. Conclu-sion Detection of BRAFV600E mutation in FNA samples before surgery is of use in diagnosis of thyroid nodules. The results of this study imply that there is no significant relation between BRAFV600E mutation and Hashimoto＆#39;s thyroiditis.