| 摘要: |
| 目的：探讨Kwak TI-RADS与BRAFV600E基因突变检测对具有不确定意义细胞病理学结果(包含Bethesda Ⅲ、Ⅳ和Ⅴ类)的甲状腺结节良恶性诊断的应用价值。方法：回顾性分析2018年1月～ 2018年12月至我院进行细针穿刺后细胞病理学诊断结果为不确定意义的甲状腺结节患者的常规超声图像与BRAFV600E基因突变检测结果的资料,以手术病理结果或临床随访为诊断标准,比较分析Kwak TI-RADS与BRAFV600E基因突变检测对具有不确定意义细胞学结果的甲状腺结节良、恶性鉴别诊断的效能。结果：纳入的76例甲状腺结节均经手术病理或临床随访证实。术后病理结果为：甲状腺癌有50例；甲状腺良性肿瘤有26例。BRAFV600E基因突变检测阳性诊断甲状腺癌的灵敏度为62.0%,特异度为100%,准确率为75.0%；而与Kwak TI-RADS超声分类诊断标准单独使用时相比,Kwak TI-RADS超声分类诊断联合BRAFV600E基因突变检测的灵敏度从78.0%提高到88.0%、特异度从76.9%提高到84.6%、准确率从77.6%提高到86.8%,但差异不具统计学意义(P＞0.05)。 结论：对于不确定意义甲状腺结节的良、恶性鉴别诊断,Kwak TIRADS超声分类诊断具有一定的诊断价值,在Kwak TI-RADS超声分类诊断的基础上联合BRAFV600E基因突变检测可以提高其诊断灵敏度、特异度、准确率,为不确定意义甲状腺结节患者的进一步诊疗提供参考依据,减少甲状腺癌的漏诊率。#$NL关键词: 甲状腺结节; Kwak TI-RADS甲状腺影像学报告及数据系统; BRAFV600E 基因突变 |
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| DOI： |
| 投稿时间：2020-03-14修订日期：2020-11-08 |
| 基金项目:上海市卫生健康委员会（20204Y0343）；上海市第六人民医院东院科学研究基金（院人才2017011） |
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| Application value of Kwak TI-RADS and BRAFV600E gene mutation detection in indeterminate thyroid nodules with indeterminate cytological results |
| zhong ;li chang,Gu LiPing,ma fang |
| () |
| Abstract: |
| Objective To evaluate the diagnostic value of Kwak TI-RADS and BRAFV600E gene mutation detection for indeterminate thyroid nodules. Methods This retrospective study included 76 patients with 76 thyroid nodules, which were initially diagnosed as indeterminate thyroids nodules, who were underwent ultrasound and BRAFV600E gene mutation detection between January 2018 and December 2018 were included in this study. We compared the diagnostic performance of Kwak TI-RADS, BRAFV600E gene mutation and their combination use in the differential diagnosis of benign and malignant ofSindeterminate thyroids nodules. Results All 76 thyroid nodules included 26 benign and 50 malignant nodules. Compared with the gold standard based on pathological diagnosis,the sensitivity,specificity and correct diagnosis rate of BRAFV600E gene mutation were 62.0%,100%,75.0% respectively,of which Kwak TI-RADS were 78.0%, 76.9%,77.6% respectively, and of which Kwak TI-RADS combined with BRAFV600E gene mutation detection were 88.0%, 84.6%,86.8% respectively. The sensitivity, specificity, and accuracy of Kwak TI-RADS combined with BRAFV600E gene mutation detection were no statistically higher than Kwak TI-RADS. |
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