Clinical Significance Of Combined BRAF V600E Gene Mutation Detection In The Diagnosis Of Class Bethesda Ⅲ Thyroid Nodule By Fine-Needle Aspiration Biopsy

Objective(s): To explore the clinical application value of BRAF V600 E gene in the Bethesda Ⅲ thyroid nodules diagnosed by FNAB.Methods: A retrospective analysis was conducted on the case data of 6023 thyroid nodules which underwent ultrasound guided fine-needle biopsy at the Breast and Thyroid Surgery Clinic of The First People’s Hospital of Yunnan Province from January 2019 to December 2022.A total of 1712 thyroid nodules diagnosed as Bethesda III by thyroid cell pathology were analyzed.According to the inclusion and exclusion criteria,the above patients were screened and ultimately 187 thyroid nodules were included.The postoperative pathologic findings served as the gold diagnosis standard of thyroid nodules.SPSS 26.0 software was used for statistical analysis,.To assess the malignant risk of Bethesda Ⅲ thyroid nodules,the receiver operating characteristic curve(ROC)was used to determine the diagnostic efficacy of BRAF V600 E gene mutation detection for Bethesda Ⅲ thyroid nodules.Results: Among the 187 Bethesda Ⅲ thyroid nodules,155 nodules were proved to be malignant(82.9%,155/187),the remaining 32 cases were benign(17.1%,32/187).The results showed that gender,maximum diameter of the nodules,location of the nodules,and BRAF gene mutations were statistically significant in benign and malignant nodules(P<0.05).In all cases of malignant nodules,the detection rate of BRAF gene mutations was 95.5%(148/155).The sensitivity,specificity,PPV,NPV,accuracy,and AUC of BRAF gene mutation detection in the diagnosis of Bethesda III thyroid nodules were 95.5%,81.3%,96.1%,78.8%,93.0%,and 0.884.Conclusion(s): Detection of BRAF V600 E gene mutations has good diagnostic efficacy for the thyroid nodules classified as Bethesda Ⅲ.Combining BRAF V600 E gene mutation detection for suspected nodules that have been ignored or cannot be diagnosed by FNA can help improve preoperative diagnostic accuracy,build a more complete and accurate diagnostic system,and guide the formulation of the optimal treatment plan for follow-up.