The Value Of Fine-needle Aspiration Cytology Combined With BRAF^V600E Mutation Detection In Diagnosis Of Thyroid Nodules

Objective:To investigate the application value of fine-needle aspiration combined with BRAF mutation detection in the diagnosis of thyroid nodules.Method:A total of 87 patients who were diagnosed as suspicious malignant thyroid nodules by ultrasonic examination were selected. All the patients underwent FNA and BRAF mutation detection by fluorescence polymerase chain reaction(PCR).Observe the nodule morphology and blood flow signal of peripheral gland tissue bofore puncture.Choose the best puncture path and puncture point, adjust the direction of the probe and the needle angle from visible blood vessels.Multiply aspirate in the area of low echo and calcification.Puncture specimen underwent FNA and BRAF mutation detection by PCR.Result:Among 64 malignant cases, 48 cases were positive and 16 cases were negative for FNA, and 40 cases had BRAFV600 E mutation.Among23 benign cases, 5 cases were positive and 18 cases were negative forFNA, and no case had BRAFV600 E mutation. Compared with the postoperative pathological results, the sensitivity was 75.0%, the specificity was 78.3%, and the accuracy was 75.9% for FNA. The sensitivity of BRAF mutation detection was 62.5%, the specificity was100.0%, and the accuracy was 72.4%. The sensitivity was 89.1%, the specificity was 78.3%, and the accuracy was 86.2% for FNA combined with BRAFV600 E mutation detection.Conclusion:(1)The specificity of BRAF mutation detection in the diagnosis of thyroid nodules is 100%,and no benign cases had BRAFV600 E mutation.The false positive rate(misdiagnosis rate) will not be raised.Conseqently,the thyroid nodules with BRAF mutation can be diagnosed as malignant.(2)The BRAFV600 E mutation detection can improve the sensitivity(detection rate) and accuracy rate of FNA examination to malignant thyroid nodules,but the specificity is invariable.The results obtained of combination method are more reliable.(3)For patients with FNA outcome uncertainly,a combination method may be recommended for repeated puncture.At the same time,it is helpful to screen out the high-risk cases of thyroid cancer,guide the operation method and postoperative follow-up treatment plan.