桥本甲状腺炎背景与单纯背景甲状腺乳头状癌C-TIRADS及BRAF V600E 基因检测的对比研究

Comparative study of C-TIRADS and BRAF V600E gene detection in papillary thyroid carcinoma with and without Hashimoto′s thyroiditis

目的:比较桥本甲状腺炎(HT)背景与单纯背景甲状腺乳头状癌(PTC)中国甲状腺影像报告与数据系统(C-TIRADS)及BRAF V600E基因检测的差异。方法:选取2019年12月~2021年5月术前完成超声及BRAF V600E基因检测的PTC手术患者,共165例196个结节,将有HT患者作为研究组,单纯背景作为对照组,对比两组临床特征、C-TIRADS及BRAF V600E基因检测的差异。结果:女性PTC患者合并HT多于男性(91.23%vs.8.77%,P=0.001)。研究组和对照组超声表现为垂直位分别为38(54.29%)、65(51.59%),实性成分分别为70(100.00%)、122(96.83%),极低回声分别为37(52.86%)、65(51.59%),微钙化分别为30(42.86%)、64(50.79%),上述阳性指标两组间差异均无统计学意义(P>0.05)。研究组和对照组PTC边缘模糊、不规则或向甲状腺外侵犯的个数分别为60(85.71%)、92(73.02%),差异有统计学意义(P=0.041)。研究组和对照组C-TIRADS 4B类及以上分别为70(100.00%)、119(94.44%),两者间差异无统计学意义(P=0.108)。研究组C-TIRADS诊断准确性高于BRAF V600E基因检测(100.00%vs.80.00%,P<0.001),对照组中两种方法差异无统计学意义(94.44%vs.92.06%,P=0.451)。结论:C-TIRADS对HT背景和单纯背景PTC均有较好的诊断准确性,且C-TIRADS对HT背景PTC诊断准确性高于BRAF V600E基因。

Objective:To study the correlation between C-TIRADS and BRAF V600E gene detection and Hashimoto′s thyroiditis(HT)in papillary thyroid carcinoma(PTC).Methods:165 patients(196 nodules)undergone preoperative ultrasound and BRAF V600E gene detection were included from December 2019 to May 2021.Patients with HT background were included in the study group,and those without HT background in the control group.The two groups were compared regarding the difference in clinical features,C-TIRADS and findings of BRAF V600E gene test.Results:HT was more common in female PTC patients than males(91.23%vs.8.77%,P<0.001).In the ultrasonic manifestations,vertical orientation,solid composition,markedly hypoechoic signs and microcalcification were 38(54.29%)and 65(51.59%);70(100.00%)and 122(96.83%);37(52.86%)and 65(51.59%);30(42.86%)and 64(50.79%),respectively for the study group and control group.There was no statistical significance in the four positive indicators aforementioned between the two groups(P>0.05).Poorly-defined or irregular margin or extrathyroidal extension was seen in 60(85.71%)and in 92(73.02%)PTC patients,respectively,in the study group and the control group.The difference was significant(P=0.041).Seventy(100.00%)and 119(94.44%)patients were at 4B or above by C-TIRADS,respectively,in the study group and the control group,yet there was no significant difference between groups(P=0.108).The diagnostic accuracy of C-TIRADS in the study group was higher than that of BRAF V600E gene detection(100.00%vs.80.00%,P<0.001),and there was no significant difference between the two methods in the control group(94.44%vs.92.06%,P=0.451).Conclusion:C-TIRADS has better diagnostic accuracy for PTC with and without HT background,and higher diagnostic accuracy for PTC with HT background than BRAF V600E gene.