The value of BRAF V600E gene mutation and FNAC in the diagnosis of papillary thyroid carcinoma:Meta-analysis
Objective To systematically evaluate the diagnostic value of BRAF V600E gene mutation detection and fine needle aspiration cytology(FNAC)in papillary thyroid carcinoma(PTC).Methods The data of CNKI,WANFANG,VIP,PUBMED,Embase and Cochrane libraries were searched.From January 2019 to December 2022,pathological tissue diagnosis was taken as the gold standard,and the literature of BRAF V600E gene mutation detection and FNAC diagnostic tests for PTC were compared and analyzed.Review Manager 5.0 and MetaDiSc software were used for Meta analysis.The working characteristic curve(SROC curve)of summarized subjects was drawn and the area under the curve was calculated.Results Totally 7 223 thyroid nodules were included in 32 papers.The combined sensitivity of BRAF V600E gene mutation and FNAC for diagnosing PTC was 0.79(95％CI:0.78-0.80)and 0.78(95％CI:0.77-0.79),respectively;The specificity was 0.96(95％CI:0.95-0.97)and 0.90(95％CI:0.89-0.91),respectively;The diagnostic odds ratio was 64.87(95％CI:33.96-123.94)and 22.55(95％CI:14.47-35.14),respectively;The sensitivity,specificity and diagnostic ratio of the combination of the two diagnostic methods were 0.92(95％CI:0.91-0.93),0.93(95％CI:0.92-0.94)and 141.37(95％CI:85.30-234.31),respectively.The area under SROC curve was 0.89,0.88 and 0.97 respectively.Conclusions The detection of BRAF V600E gene mutation has high specificity for the diagnosis of PTC,and can effectively reduce the rate of unnecessary surgery in patients with thyroid nodules whose cytological diagnostic significance is not clear,but its low sensitivity limits its independent application in clinical diagnosis.BRAF V600E gene mutation detection combined with FNAC has high sensitivity and specificity in the diagnosis of PTC,which has important clinical significance for the preoperative diagnosis of PTC.
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