Diagnostic value of fine-needle aspiration biopsy combined with BRAFV600E gene mutation detection in elderly patients with thyroid nodules / 中华老年医学杂志

ABSTRACT

Objective To investigate the diagnostic value of fine needle aspiration biopsy combined with BRAFV600E gene mutation detection in elderly patients with thyroid nodules.Methods A total of 168 elderly patients with thyroid nodules suspicious for malignancy on ultrasound from January 2017 to December 2017 at our hospital were enrolled in this study.Using color Doppler ultrasound,185 thyroid nodules were found.Fine needle aspiration cytology(FNAC)and BRAFV600E gene mutation detection were performed before surgery and the findings were compared with postoperative pathological results.The diagnostic value of single and combined detection of FNAC and BRAFV600E gene mutation was evaluated.Results Among 185 thyroid nodules,there were 146 malignant lesions including 137 papillary carcinomas and 9 follicular carcinomas,and 39 benign lesions including 31 cases of nodular goiter,5 cases of Hashimoto's thyroiditis and 3 cases of adenoma.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of FNAC were 79.5％,59.0％,75.1％,75.2％,and 45.6％,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of BRAFV600E gene mutation detection were 78.1％,51.3 ％,72.4 ％,84.4 ％ and 51.2 ％,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the combined detection were 93.4％,77.5％,86.2％,90.8％ and 53.4％,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the combined detection were higher than those of either method used alone (all P＜0.05).Conclusions For some thyroid nodules that cannot be unequivocally diagnosed as benign or malignant by FNAC,the combined detection of FNAC and BRAFV600E gene mutation can significantly improve the sensitivity,specificity and accuracy of malignancy detection,differentiate between benign and malignant nodules,and help formulate operation plans and subsequent treatment.