Risk Analysis of Papillary Thyroid Carcinoma with Undefinable Preoperative Diagnosis
Objective To investigate the risk of clinicopathological features and Braf gene detection in papillary thyroid carcinoma with undefinable preoperative fine needle aspiration cytology.Methods The clinicopathological data of 962 undefinable preoperative diagnosed patients were included from January 2017 to August 2020 in the First Affiliated Hospital of Chongqing Medical University.All patients had completed preoperative examination and underwent thyroid surgery in our hospital.The clinical characteristics and the correlation between Braf gene detection and papillary carcinoma were retrospectively analyzed.Univariate analysis and binary logistic regression analysis were used to determine independent risk factors and predict results.Results In 962 patients,Braf gene mutation(mutation rate was 89.50％)was significantly associated with PTC(OR=22.564,95％CI:10.125-50.285,P=0.000).In addition,the proportion of PTC was higher in patients with TI-RADS classification was 4B and above(OR=1.633,95％CI:1.019-2.616,P=0.041)and nodules＜1 cm(OR=0.420,95％CI:0.279-0.634,P=0.000).In the prediction of cervical lymph node metastasis,the proportion and risk of postoperative pathological lymph node metastasis were higher in BRAF gene mutation type(OR=2.126,95％CI:1.316-3.432,P=0.002),male patients(OR=2.102,95％CI:1.532-2.884,P=0.000),nodules＞1 cm(OR=1.581,95％CI:1.218-2.054,P=0.001),and TI-RADS classification of 4B and above(OR=1.368,95％CI:1.186-1.578,P=0.000).While,Age＞45 years old(OR=0.741,95％C1:0.649-0.846,P=0.000)was a protective factor for lymph node metastasis in PTC.Conclusion In patients with undefinable preoperative diagnosis,Braf gene mutation can be used as a tool to assist in the diagnosis of thyroid papillary carcinoma.Braf gene detection combined with FNAC diagnosis can increase the accuracy of preoperative diagnosis and reduce the rate of missed diagnosis.Braf gene mutation type,TI-RADS classification 4B and above,and nodule size＜1 cm can be used as independent risk factors for predicting PTC.Combined with Braf gene mutation type,male patient,age＜45 years old,TI-RADS classification of 4B and above and nodule size＞1 cm,it can be used as an independent predictor of lymph node metastasis(LNM)in PTC.
万方数据
维普
