摘要
目的:探讨细针穿刺活检(fine-needle aspiration biopsy,FNAB)联合丝/苏氨酸特异性激酶(serine-threonine protein kinase,BRAF)基因V600E(BRAFV600E)突变检测在甲状腺结节诊断中的应用价值。方法:收集2010-11-10-2012-12-20首次来昆明医科大学第三附属医院头颈外科就诊住院,且按照《疾病和有关健康问题的国际统计分类》ICD-10编码诊断为甲状腺结节120例,均行体检、超声学和甲状腺功能检查,根据甲状腺结节直径分为>1.0和≤1.0cm组,均行FNAB评估和BRAFV600E突变荧光PCR检测。结果:120例甲状腺结节患者行FNAB评估,提示恶性病变35例,良性病变69例,可疑恶性和未诊断病变10例,滤泡性病变3例,滤泡性肿瘤3例。在35例恶性病变中,26例BRAFV600E突变;在69例良性病变中,3例BRAFV600E突变;在10例可疑恶性和未诊断病变中,6例BRAFV600E突变;滤泡性病变和滤泡性肿瘤中均未检出BRAFV600E突变。FNAB结合术后病理分析提示,术前诊断率为70.8%(85/120);FNAB联合BRAFV600E突变检测结合术后病理分析提示,术前诊断率为87.5%(105/120),假阳性率为46.7%(7/15),假阴性率为25.7%(27/105)。对于FNAB和BRAFV600E突变检测均为阳性的患者,与术后病理符合率为100.0%(78/78)。结论:FNAB联合BRAFV600E突变检测可提高甲状腺结节术前诊断率,方法简单,易于临床检测。
OBJECTIVE：To explore the application value of the fine-needle aspiration biopsy （FNAB） combined with the mutation detection of serine-threonine protein kinase （BRAFv600E） in diagnosis of thyroid nodules. METHODS：Totally 120 patients were collected from the head and neck surgery Department of No. 3 Affiliated Hospital of Kunming Medical University. These patients were first hospitalization for treatment from November 10,2010 to December 20,2012, and were all diagnosed with thyroid nodules according to the ICD-10 of ＂International Statistical Classification of Diseases and Related Health Problems＂. After physical examination, ultrasound and thyroid function examination, according to the size of the nodules （〉1.0 cm and ≤1.0 cm）, they were divided into two groups. FNAB evaluation was taken and BRAFv600E mutation was detected by fluorescence polymerase chain reaction （PCR）. RESULTS：FNAB evaluation suggested that there were 35 cases of malignant lesions, 69 cases of benign lesions, 10 case of suspected malignant and failure diagnosed, 3 cases of follicular lesions and 3 cases of follicular neoplasm. Among 35 malignant cases,26 cases were diagnosed with BRAFv600E mutation,3 cases were detected of BRAFv600E mutation in 69 benign cases and 6 cases were detected in 10 suspected malig- nant and failure diagnosed cases. Other two groups had no BRAFv600E mutation lesions. FNAB combined with postopera- tive pathological analysis suggested that the preoperative diagnosis rate was 70. 8% （85/120）, FNAB combined with BRAFv600E mutation detection combined with postoperative pathological analysis showed that the preoperative diagnosis rate was 87.5 % （105/120）, the false positive rate was 46.7 % （7/15）, the false negative rate was 25. 7 % （27/105）. For FNAB and BRAFv600E mutation detection positive patients, the postoperative pathology coincidence rate was 100. 0% （78/78）. CONCLUSION：Preoperative diagnosis rate can be improved by FNAB combined with BRAFv600E mutation detec- tion
出处
《中华肿瘤防治杂志》
CAS
北大核心
2014年第17期1351-1354,共4页
Chinese Journal of Cancer Prevention and Treatment
基金
国家自然科学基金(81260312)
社会发展科技计划基础研究重点项目(2009CC026)
