BRAFV600E基因突变检测联合US-FNAB对甲状腺结节的定性诊断效能

Qualitative diagnostic efficacy of BRAF V600E gene mutation detection combined with US-FNAB in thyroid nodules

目的探讨丝/苏氨酸特异性激酶基因V600E(BRAF V600E)检测联合超声引导下细针抽吸活检(US-FNAB)对甲状腺结节的诊断价值,以期为临床早期定性诊断提供参考。方法选取2019年8月至2022年8月在成武县人民医院就诊的90例疑似恶性甲状腺结节患者作为研究对象,其中男51例,女39例,年龄(56.27±2.84)岁,入院后均行BRAF V600E基因突变检测及US-FNAB。以手术或病理活检结果为金标准,比较BRAF V600E基因突变检测、US-FNAB单独、联合诊断效能,并比较不同甲状腺结节长径患者BRAF V600E基因突变类型、US-FNAB分类。行χ^(2)检验。结果经手术或病理活检结果显示,90例疑似恶性甲状腺结节患者中,恶性62例,良性28例;经BRAF V600E基因突变检测结果显示,恶性51例,良性39例;经US-FNAB结果显示,恶性50例,良性40例;经联合诊断结果显示恶性61例,良性29例。与BRAF V600E基因突变检测、US-FNAB单独诊断比较,联合诊断的灵敏度95.08%(59/62)、准确度94.38%(85/90)较高,漏诊率4.92%(3/62)较低(均P<0.05)。不同甲状腺结节长径患者BRAF V600E基因突变类型比较差异均无统计学意义(均P>0.05);不同甲状腺结节长径患者US-FNAB检查Ⅲ类、Ⅵ类存在差异,其中Ⅵ类更为显著(均P<0.05)。结论BRAF V600E基因突变检测联合US-FNAB可有效提高甲状腺结节诊断准确性,有利于早期定性诊断,可为临床早期针对性制定干预方案提供依据。

Objective To explore the diagnostic value of serine/threonine specific kinase gene V600E(BRAF V600E)detection combined with ultrasound-guided fine needle aspiration biopsy(US-FNAB)in thyroid nodules,so as to provide reference for early clinical qualitative diagnosis.Methods A total of 90 patients with suspected malignant thyroid nodules in Chengwu County People's Hospital from August 2019 to August 2022 were selected as the study subjects,including 51 males and 39 females,aged(56.27±2.84)years.After admission,the BRAF V600E gene mutation detection and US-FNAB examination were performed.With the surgical or pathological biopsy results as the gold standard,the diagnostic efficacies of BRAF V600E gene mutation detection and US-FNAB alone and combined were compared.The BRAF V600E gene mutation types and US-FNAB classification in patients with different thyroid nodule diameters were compared.χ^(2) test was used.Results The results of operation or pathological biopsy showed that among the 90 patients with suspected malignant thyroid nodules,62 cases were malignant and 28 cases were benign.The results of BRAF V600E gene mutation detection showed that 51 cases were malignant and 39 cases were benign.The results of US-FNAB showed that 50 cases were malignant and 40 cases were benign.The combined diagnosis showed that 61 cases were malignant and 29 cases were benign.Compared with BRAF V600E gene mutation detection and US-FNAB diagnosis alone,the sensitivity and accuracy of combined diagnosis were higher at 95.08%(59/62)and 94.38%(85/90),while the missed diagnosis rate was lower at 4.92%(3/62)(all P<0.05).There were no statistically significant differences in the BRAF V600E gene mutation types among patients with different thyroid nodule diameters(all P>0.05).There were statistically significant differences in the classⅢand classⅥby US-FNAB examination among patients with different thyroid nodule diameters,among which classⅥwas more significantly different(all P<0.05).Conclusion BRAF V600E gene mutation detection combined with US-FNAB examination can effectively improve the diagnostic accuracy of thyroid nodules,which is conducive to early qualitative diagnosis and can provide a basis for early clinical intervention.