Clinical study of preoperative fT4/fT3 quotient and thyroid function test in distinguishing benign from malignant thyroid nodules

Objective:To analyze the clinical and pathological characteristics of thyroid nodules and to explore the related risk factors of malignant thyroid nodules.Methods: According to the criteria of inclusion and exclusion, a total of 283 patients with thyroid nodules during January 2015 and December 2017 were divided into benign group (benign nodule,n =172) and malignant group (malignant nodule,n = 111) based on postoperative histopathological results. The age, sex, serum thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), thyroid stimulating hormone (TSH), free thyroxine (fT4), free three iodine thyroxine (fT3) and fT4/ fT3 ratio were subjected to univariate analysis, and the risk factors of malignant thyroid nodule were screened by multivariate logistic regression analysis.Results:Univariate analysis showed that age, TgAb, fT4 (P < 0.05) and fT4/ fT3 quotient (P < 0.01) were significantly different between the two groups. The fT4/fT3 quotient is a risk factor of malignant nodules. Multivariate logistic regression analysis indicated that the risk factors of malignant thyroid nodule were age (0R: 0.934,95% CI:0.911-0.957), TgAb(0R: 2.069,95% CI: 1.008-4.247) and fT4 (0R: 1.206,95% CI: 1.038-1.401).Conclusion: The fT4/fT3 quotient has important diagnostic value in differentiating benign and malignant thyroid nodules. When fT4 / fT3 > 3, it increases the risk of malignancy. The age, TgAb and fT4 are independent risk factors for malignant thyroid nodule, which is of great value in distinguishing benign from malignant thyroid nodules.

Correlation of the BRAFV600E and RAS mutations with clinicopathological characteristics of papillary thyroid cancer using TCGA database analysis

Objective:To investigate the occurrence of BRAFV600E and RAS mutations in thyroid papillary carcinoma (PTC) and to study their correlation with clinicopathological features of PTC. Methods Relevant information of PTC was downloaded and organized from The Cancer Genome Atlas (TCGA) via cBioPortal, then the gene mutation and clinical information of 402 PTC samples were analyzed. The correlation of BRAFV600E and RAS mutations with clinicopathological features and prognosis of PTC were subjected to univariate analysis. Secondly, we use Binary Logistic multivariate analysis to analyze the factors screened above. Results BRAFV600E mutation rate is 48.5% (195/402) and RAS mutation rate is 10.2% (41/402) in 402 cases of PTC. Univariate analysis showed that BRAFV600E mutation has nothing to do with age and sex of the patient. There is a significant correlation among BRAFV600E mutation and lymph node metastasis, extrathyroidal invasion, staging, recurrence, progression and pathological subtypes in PTC. There is no significant correlation among RAS and age, sex, staging, recurrence, progression. There is a significant correlation among RAS and lymph node metastasis, extrathyroidal invasion and pathological subtypes in PTC. Multivariate logistic regression analysis indicated that there is a significant correlation among BRAFV600E mutation and extrathyroidal invasion, pathological subtypes in PTC. There is a significant correlation among RAS and lymph node metastasis, extrathyroidal invasion and pathological subtypes in PTC.ConclusionThe mutation rate of BRAFV600E was significantly higher than that of RAS in PTC. Mutations in BRAFV600E and RAS can be used as predictors of prognosis in PTC.