The Value of 2 Modalities of Combined Detection in the Preoperative Diagnosis of Micropapillary Thyroid Cancer
Objective To explore the value of ultrasound-guided fine needle aspiration cytology(US-FNAB)combined with BRAF V600E gene mutation detection in the preoperative diagnosis of the thyroid imaging reporting and data system(TI-RADS)type 4 papillary thyroid microcarcinoma(PTMC).Methods Taking postoperative pathologic diagnosis of PTMC as the"gold standard",51 patients who underwent ultrasound-guided thyroid puncture in Foshan Fosun Chancheng Hospital from January 2021 to June 2023 were selected because their thyroid nodule score was TI-RADS type 4.According to different admission times,the samples were divided into US-FNAB examination group(January to October 2021),BRAF V600E gene mutation detection group(November 2021 to August 2022),and combined detection group(September 2022 to June 2023),with 17 cases each.The US-FNAB group was examined by US-FNAB.BRAF V600E gene mutation detection group was tested by BRAF V600E gene mutation detection.In the combined detection group,US-FNAB+BRAF V600E gene mutation was detected.The diagnostic efficiency of the three groups was compared,and the optimal detection method for preoperative diagnosis of TI-RADS type 4 of PTMC was selected.Results The gold standard was the diagnosis of PTMC by pathological examination.6 cases were positive and 11 cases were negative in US-FNAB examination group.BRAF V600E gene mutation test group detected PTMC positive in 7 cases,negative in 10 cases.In the combined test group,PTMC was positive in 15 cases and negative in 2 cases.The sensitivity and accuracy(92.86%,82.35%)of the preoperative diagnosis of TI-RADS type 4 of PTMC combined test group were higher than those of the US-FNAB test group(35.71%,41.18%)and BRAF V600E gene mutation test group(42.86%,47.06%),the difference was statistically significant(P<0.05).There was no significant difference in diagnostic specificity,positive predictive value and negative predictive value between the combined test group and the US-FNAB test group and BRAF V600E gene mutation test group(P>0.05).Conclusion US-FNAB combined with BRAF V600E gene mutation detection is highly sensitive and accurate in the preoperative diagnosis of TI-RADS type 4 PTMC patients,which can improve the diagnostic efficiency and reduce the rate of missed diagnosis.
ultrasound-guided fine needle aspiration cytologyBRAF V600E gene mutation detectionTI-RADS 4 classesthyroid micropapillary carcinomadiagnostic effectivenessrate of missed diagnosis
万方数据
维普
