Preliminary Study On The Diagnostic Values Of FNAC Combine With BRAFV600E Gene Mutation In Thyroid Nodules

Objective To investigate the clinical diagnostic value of ultrasound-guided thyroid fine needle aspiration cytology(FNAC)and combined with BRAFV600 E gene mutation detection in the thyroid papillary carcinoma(PTC).Methods228 patients with thyroid nodule puncture in our hospital from May.2016 to January.2018 were selected as the experimental objects.A total of 25 patients underwent thyroid surgery,and 11 of them accepted BRAFV600E gene mutation detection(3 PTC,3 micropapillary carcinoma,5 benign nodules).All of the general information and biochemical test results were collected.We used fluorescence quantitative PCR to detect the gene mutation of thyroid nodules.To analyze the sensitivity,specificity and accuracy of FNAC combined with BRAFV600E gene mutation and compare with color Doppler ultrasound test and FNAC.Postoperative pathological results is gold standard of this study.Results1.The coincidence rate of color Doppler ultrasound TI-RADS classification with postoperative pathological diagnosis was 69.6 %,sensitivity was 70%,specificity was 69%,false positive rate was 31 %,false negative rate was 30%,positive predictive value was 63.6%.Negative predictive value was 75%.The Kappa test analyzed the consistency of ultrasound diagnostic results and the postoperative pathological results is ordinary(Kappa = 0.388,P = 0.062).2.The coincidence rate of FNAC results with postoperative pathological diagnosis was 76%,sensitivity was 66.7%,specificity was 84.6%,false positive rate was 15.3%,false negative rate was 26.6%,positive predictive value was 80%,and negative predictive value was 73.3%.The Kappa test analyzed the consistency of FNAC diagnosis results and the postoperative pathological results is moderate(Kappa = 0.516,P = 0.009).3.The coincidence rate of the combined diagnosis and pathological diagnosis was 90%,the sensitivity was 83.3%,the specificity was 100%,the false positive rate was 0%,the false negative rate was 16.7%,the positive predictive value was 100%,and the negative predictive value was 83.3%.Kappa test analyzed the consistency of FNAC combined BRAF600 E gene mutation detection results and postoperative pathological results is good(Kappa = 0.82,P = 0.006).The combined diagnosis compared to FNAC had a sensitivity of 16.6%,a specificity of 15.4%,an accuracy of 14%,a positive predictive value of 20%,and a negative predictive value of 10%.Conclusions1.The specificity and accuracy of FNAC in the diagnosis of papillary thyroid papillary carcinoma are higher than those of color Doppler ultrasound.2.FNAC combined BRAFV600 E gene mutation detection reduced the rate of missed diagnosis of papillary thyroid carcinoma,improved the sensitivity and accuracy of diagnosis,and its diagnostic value was better than FNAC alone.