Value And Correlation Between The Thyroid Imaging Reporting And Data System And BRAF^V600E Mutation

Objective To investigate the correlation between TI-RADS and the BRAF^V600E mutation.And to evaluate the value of thyroid imaging-reporting and data system（TI-RADS）combined with the BRAF^V600E mutation in the diagnosis of thyroid nodules.Methods Ninety-two patients（16 males,76 females,average age 46.46 years）with thyroid nodules those had BRAF^V600E gene mutation detection in our hospital from April 2015 to July 2016 were enrolled.Detection of BRAF^V600E gene mutation in 92 cases by fluorescence PCR.All thyroid nodules were evaluated by using TI-RADS ultrasonographic stratification and the results were compared with pathologic diagnostic analysis.The diagnostic value of TI-RADS for thyroid nodules was evaluated.TI-RADS3 4a were defined as TIRADS-benign,TIRADS4 b 5 were defined as TIRADS-malignant.The thyroid nodules were divided into the V600 E mutant-type BRAF gene group and the wild-type BRAF gene group according to the BRAF^V600E mutation.The BRAF^V600E mutation and TI-RADS ultrasonographic categories of those nodues were analyzed.Finally the values of TI-RADS and TIRADS combined with BRAF^V600E mutation were compared.The diagnosis of all nodules were confirmed at pathology by surgery or US-guided histological biospy.Conclusions（1）In 92 examined nodules,65 were malignant and 27 were benign.50 had BRAF^V600E mutation and 42 had not.（2）The area under ROC curve for TI-RADS was 0.804.（3）Univariate analysis showed The BRAF^V600E mutation was significantly associated with the following TI-RADS ultrasonographic categories:solid composition and aspect ratio ≥ 1（P < 0.05）.The BRAF^V600E mutation of TIRADS-malignant was significantly higher the TIRADS-benign（P<0.05）.（4）The diagnostic sensitivity of TI-RADS and TI-RADS combined with BRAF^V600E mutation were 72.31% and 93.85%（χ2 =9.247,P<0.05）;the specificity of twowere 74.07% and 74.07%（χ2=0.001,P>0.05）;the accuracy of two were 72.83% and 88.04 %（χ2= 5.836,P<0.05）;the positive predictive value of two were 87.04% and 89.71 %（χ2=0.211,P>0.05）;the negative predictive value of two were 52.63% and 83.33%（χ2=4.790,P<0.05）.Conclusions（1）TI-RADS has certain value in differentiating benign and malignant thyroid nodules.（2）The BRAF^V600E mutation is significantly associated with TI-RADS ultrasonographic categories,The V600 E mutant-type BRAF gene is significantly associated with solid composition and aspect ratio≥1.The BRAF^V600E mutation of TIRADS-malignantis significantly higher the TIRADS-benign.（3）TI-RADS combined with BRAF^V600E mutation detection is helpful in the differential diagnosis of thyroid nodules.