甲状腺BethesdaⅢ类结节超声特征与BRAF^(V600E)基因突变的相关性研究

Association Between BRAF^(V600E)Mutation and Ultrasonographic Features in BethesdaⅢthyroid nodules

目的:探讨甲状腺BethesdaⅢ类结节中BRAF^(V600E)基因突变率及超声征象与基因突变的相关性。方法:回顾性分析烟台毓璜顶医院自2018年10月—2022年5月的261个TI-RADS 4a类以上且行BRAF^(V600E)基因检测的甲状腺BethesdaⅢ类结节,计算基因突变率并比较基因突变组和未突变组两组间超声特征差异。结果:Ⅲ类结节中BRAF^(V600E)基因突变率为11.5%(30/261),且随着TI-RADS分类级别增高,基因突变率增加。基因突变组与未突变组比较,极低回声、边界不清、纵横比≥1及包膜连续性中断的发生率较高,且均是BRAF^(V600E)基因突变的独立危险因素。结论:BethesdaⅢ类结节中,BRAF^(V600E)基因突变率随着TI-RADS分类级别增高而增加,极低回声、边界不清、纵向生长及侵犯包膜等超声特征均是基因突变的独立危险因素。

Objective To investigate the mutation rate of BRAF^(V600E)gene in BethesdaⅢthyroid nodules and the association between ultrasonographic features and mutation.Methods 261 thyroid nodules that were diagnosed as TI-RADS 4a or above and BethesdaⅢand done BRAF^(V600E)gene detection were analyzed retrospectively in Yantai Yuhuangding Hospital from October 2018 to May2022.The difference of sonographic characteristics between BRAF^(V600E)were compared.Results The mutation rate of BRAF^(V600E)inⅢthyroid nodules was only11.5%(30/261).There were significant differences in extremely low echo,the mutation rate of gene increased with the increase of TI-RADS classification level.Logistic regression analysis showed that extremely low echo,unclear boundary,aspect ratio≥1 and continuity interruption of capsule were independent risk factors for BRAF^(V600E)mutation.Conclusion For BethesdaⅢthyroid nodules,the mutation rate of BRAF^(V600E)gene increased with the increase of TI-RADS classification level.The ultrasonographic features,such as very low echo,unclear boundary,longitudinal growth and invasion of capsule,were all independent risk factors for gene mutation.