Relationship of ARFI-VTQ and BRAF gene detection with the traditional Chinese medicine syndromes of diffuse thyroid lesions combined with thyroid cancer
Objective To analyze the role of ultrasound acoustic radiation force impulse imaging with virtual touch tissue quantification(ARFI-VTQ)and B-Raf proto-oncogene,serine/threonine kinase(BRAF)gene detection in the differential diagnosis of diffuse thyroid lesions with thyroid cancer,as well as the correlation with traditional Chinese medicine(TCM)syndromes of thyroid cancer.Methods A total of 130 patients with diffuse thyroid lesions and thyroid cancer examined in the First Department of Ultrasound,Cangzhou Hospital of Integrated TCM-WMHEBEI from January 2023 to December 2023 were included.According to the pathological examination results,the patients were divided into the benign group(n=88)and malignant group(n=42).All patients underwent ARFI-VTQ and BRAF gene testing,and classified according to TCM syndrome differentiation.Conventional ultrasound parameters,shear wave velocity(SWV),and positive rates in BRAF gene testing were compared between benign and malignant groups,and TCM syndrome type groups.The diagnostic efficacy of ARFI-VTQ and BRAF gene testing in diffuse thyroid lesions and thyroid cancer was analyzed by the receiver operating characteristic(ROC)curve.Results There were no significant differences in the boundary,shape,echo,and internal blood flow of conventional ultrasound features between the benign and malignant groups,as well as patients with different TCM syndrome types(Qi stagnation and blood stasis syndrome,liver stagnation and phlegm coagulation syndrome,Qi-Yin deficiency syndrome)in the malignant group(P＞0.05).The ARFI-VTQ showed a significantly higher SWV in the malignant group than that of the benign group(P＜0.05).There was also a significant difference in SWV among patients with different TCM syndrome types in the malignant group,with the highest in patients with Qi stagnation and blood stasis syndrome and the lowest in patients with Qi-Yin deficiency syndrome(P＜0.05).The BRAF gene testing showed a significantly lower positive rate of gene mutations in the benign group than the malignant group(P＜0.05).There was no significant difference in the positive rate of BRAF gene mutations among patients with different TCM syndrome types in the malignant group(P＞0.05).The ROC curve analysis showed that the area under the curve(AUC)of SWV and positive rate of BRAF gene mutations in distinguishing diffuse thyroid lesions and thyroid cancer was 0.759 and 0.674,respectively.The sensitivity was 88.10％and 76.19％,the specificity was 90.17％and 84.97％,and the Youden index was 0.783 and 0.612,respectively.However,a combination of both had a reduced specificity,with a Youden index of 0.369.Conclusion ARFI-VTQ examination and BRAF gene detection have important values in diagnosing diffuse thyroid lesions combined with thyroid cancer.Among them,ARFI-VTQ has an important reference value for the TCM syndrome classification of diffuse thyroid lesions combined with thyroid cancer.
万方数据
维普
