Clinical Significace Of BRAF^V600EMutation In Differentiating The Benign From The Malignant Thyroid Tumor

Objective:To explore the clinical significance of BRAF^V600E600E gene mutation in differentiating benign and malignant thyroid nodules;To investigate the relationship between BRAF^V600E600E gene mutation and thyroid papillary carcinoma;To assess the relationship between BRAF^V600E600E gene mutation and the invasiveness of thyroid cancer.Methods:1.284 patients with thyroid nodules undergoing thyroidectomy or fine needle puncture from October 2015 to February 2018 in the Second Affiliated Hospital of Nanchang University were collected.According to cytological or histopathological diagnosis,179 cases of benign nodule?group A?were selected.And 105 cases of malignant nodule?group B?were selected according to postoperative pathological diagnosis,including 74 cases of pathological diagnosis after direct thyroidectomy,and 31 cases diagnosed by fine needle aspiration cytology?FNAC?which also were confirmed by pathology after operation.According to whether the BRAF^V600E600E gene mutation in group B was divided into BRAF^V600E600E gene mutation?group B1,n=62?and BRAF^V600E600E gene wild type?group B2,n=43?.2.The clinical data of all patients and the results of thyroid ultrasound were collected and the BRAF^V600E600E gene was detected.To compare the clinical data of three groups of patients with group A?B1 and B2.To compare the mutation rate of BRAF^V600E600E gene between group A and B.To compare the results of BRAF^V600E600E gene detection between cytology and histopathology.To compare the relationship between the results of BRAF^V600E600E gene detection and the clinicopathological features of patients in group B.Results:1.No mutation of BRAF^V600E600E gene was found in group A.The mutation rate of BRAF^V600E600E gene in group B was 59%,and the difference was statistically significant?P<0.05?.2.In group B,the mutation rate of BRAF^V600Egene in papillary thyroid carcinoma?PTC?was 64.6%.The mutation rate of BRAF^V600E600E gene in small papillary carcinoma?PTMC?was 60%.,which was similar to that of PTC patients.No mutation of BRAF^V600Egene was detected in follicular thyroid carcinoma and medullary carcinoma.3.In group B,the mutation rates of BRAF^V600E600E gene were 32.3%in FNAC and and 70.3%in thyroidectomy.The difference was statistically significant?P<0.05?.4.Comparing the relationship between clinicopathological features and BRAF^V600E600E gene,there was no significant difference in whether the nodules were polyfocal or not,the diameter of nodules and the differences between male and female patients in group B?P>0.05?.But there were differences in age?<45 years,?45 years old?,whether there were punctate calcification,extracapsular invasion,lymph node metastasis,whether associated with Hashimoto's thyroiditis.In the classification and stratification of thyroid imaging report and data system?TI-RADS?,the BRAF^V600E600E gene rate of four and five types of nodules was higher than that of three types of nodules,and the difference was statistically significant?P<0.05?.Conclusion:1.The BRAF^V600Egene is valuable for differential diagnosis of thyroid benign and malignant nodules.2.The mutation rate of BRAF^V600E600E gene is high only in papillary thyroid carcinoma,which is specific for the diagnosis of papillary thyroid carcinoma.3.The BRAF^V600E600E gene has a higher mutation rate in patients with over 45 years old,punctate calcification,extracapsular infiltration,cervical lymph node metastasis,thyroid cancer with Hashimoto's thyroiditis,TI-RADS 4/5 class,and in the way of surgical sampling.4.Mutation of BRAF^V600E600E gene can be used as a risk factor for evaluation of invasive thyroid carcinoma.