Objective To explore the value of ultrasound risk stratification combined with BRAFV600E gene mutation detection in diagnosing category Ⅲ thyroid nodules in the Bethesda System for Reporting Thyroid Cytopathology (BSRTC).
Methods A total of 158 patients with thyroid nodules were conducted ultrasound examination for risk stratification and BRAFV600E gene mutation detection. Taking the pathological diagnosis results after operation as the gold standard, the diagnostic accuracies of ultrasound risk stratification alone and its combination with BRAFV600E gene mutation detection in the diagnosis of BSRTC category Ⅲ thyroid nodules were analyzed.
Results Among 158 thyroid nodules, 96 nodules were malignant and 62 nodules were benign. A total of 95 highly suspected malignant nodules and 63 moderately suspected malignant nodules were evaluated by ultrasonography. There were 80 nodules of mutant type of BRAFV600E and 78 nodules of wild type BRAFV600E, and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of mutant type of BRAFV600E to malignant thyroid nodules were 83.33%, 100.00%, 89.87%, 100.00% and 79.49%, respectively. The accuracies of highly suspected malignant judgment and highly suspected judgment in combination with mutant type of BRAFV600E in diagnosing BSRTC category Ⅲ nodules were 90.51% and 93.67% respectively, and there was no significant difference between two methods (P>0.05). The accuracy of moderate suspicious combined with mutant type of BRAFV600E in the diagnosis of BSRTC category Ⅲ nodules was 39.87%, which was significantly higher than 9.49% of moderate suspected malignant judgment alone (P < 0.05).
Conclusion Ultrasound high risk stratification combined with BRAFV600E gene mutation has a high diagnostic accuracy for BSRTC category Ⅲ thyroid nodules, and BRAFV600E gene mutation detection can increase the accuracy of ultrasonic diagnosis of BSRTC category Ⅲ thyroid nodules in moderate risk stratification.
DownLoad: