超声引导下细针抽吸细胞学检查联合BRAF^(V600E)基因检测诊断甲状腺微小乳头状癌的价值

Value of ultrasound-guided fine-needle aspiration cytology combined with BRAF^(V600E)gene detection in the diagnosis of papillary thyroid microcarcinoma

目的探讨超声引导下细针抽吸细胞学检查(FNAC)联合BRAF^(V600E)基因检测对甲状腺微小乳头状癌(PTMC)的术前诊断价值。方法选取我院经手术病理确诊的PTMC患者126例,共计126个结节,按结节二维超声所测最大径分为≤5 mm组31个,5~10 mm组95个,比较两组FNAC、BRAF^(V600E)基因检测诊断结果,分析二者联合诊断价值。结果 5~10 mm组FNAC的诊断准确率(86.32%)明显高于≤5 mm组(58.06%),两组比较差异有统计学意义(P<0.05);5~10 mm组与≤5 mm组BRAF^(V600E)基因突变率分别为92.63%、90.32%,两组比较差异无统计学意义;FNAC联合BRAF^(V600E)基因检测诊断≤5 mm组、5~10 mm组的准确率分别为93.54%、97.78%,均明显高于单独FNAC诊断,差异均有统计学意义(均P<0.05)。结论 FNAC联合BRAF^(V600E)基因检测可提高PTMC术前诊断准确率,且对5~10 mm PTMC诊断准确率更高。

Objective(FNAC)combined with BRAF^(V600E)gene detection in the diagnosis of papillary thyroid microcarcinoma(PTMC).MethodsA total of 126 nodules were selected from 126 patients with PTMC diagnosed by surgery and pathology in our hospital.According to the nodule maximum diameter measured by two-dimensional ultrasound,there were 31 nodules in the ≤5 mm group and 95 nodules in the 5~10 mm group.The results of FNAC and BRAF^(V600E)gene detection were compared between the two groups.The value of FNAC combined with BRAF;gene detection in the diagnosis of PTMC was analyzed.Results FNAC in the 5~10 mm group(86.32%)was significantly higher than that in the ≤5 mm group(58.06%),and the difference was statistically significant(P<0.05).The BRAF^(V600E)gene mutation rate in 5~10 mm group(92.63%)was higher than that in the ≤5 mm group(90.32%),and the difference was not statistically significant.The diagnostic accuracy of FNAC combined with BRAF^(V600E)gene detection in the ≤5 mm group and 5~10 mm group were 93.54% and 97.78%,respectively,which were significantly higher than that of FNAC,and the differences were statistically significant(both P<0.05).ConclusionFNAC combined with BRAF^(V600E)gene detection can improve the diagnostic accuracy of PTMC,and the diagnostic accuracy of 5~10 mm PTMC is higher.