The Application Of FNA Liquid-based Cytology Combined With BRAF Gene Detection In The Diagnosis Of Papillary Thyroid Carcinoma

Objective: To explore the value of FNA liquid-based cytology combined with BRAF gene detection in the diagnosis of papillary thyroid carcinoma with fine needle aspiration.Methods: The clinical data of 90 patients undergoing thyroid nodule surgery were collected in our hospital from December 2016 to November 2017.In all the cases,thyroid nodules fine needle aspiration biopsy was performed preoperatively.Afterward,the punctured specimen was smeared both by conventional method and liquid-based cytology techniques,and BRAFV600 E gene detection was performed on puncture specimens by fluorescence PCR.Meanwhile,all the samples were subjected to postoperative histopathology detection,whose results served as a gold standard.Finally,take the result of pathological testing as the reference,the diagnostic accuracy of papillary thyroid carcinoma,among the two smear methods and liquid-based cytology combined with BRAF genetic detection,were determined.Results: Compared to conventional smear cytology,the liquid-based cytology showed cleaner microscopic visual field with less blood cells and impurities,significantly higher number and more concentrated diagnostic cells,monolayer distribution and enhanced stereovision.In addition,the polymorphism of the nucleus,irregular nuclear membrane,nuclear ditch and nuclear inclusions were more clearly visible in liquid-based cytology.In terms of thyroid nodules by fine needle aspiration cytology,the overall diagnostic accuracy was 90.00% by liquid-based cytology while 84.44% by conventional smears.The sensitivity and specificity between the liquid-based cytology and conventional smears were 85.00% VS 72.50%,88.89% VS 80.00% in the diagnosis of papillary thyroid carcinoma,respectively,which showed statistically significant difference(p<0.05).The positive rate of BRAF V600 E genetic alteration was 67.5% in papillary thyroid carcinoma while 0% in benign thyroid nodules.When combined with BRAF V600 E genetic testing,the diagnostic accuracy of liquid-based cytology detecting thyroid papillary carcinoma was improved to 95.00%.The diagnostic accuracy of liquid-based cytology was statistically significant.Conclusion: Compared to conventional smears,FNA liquid-based cytology technique significantly improves the pathological quality and diagnostic accuracy of thyroid needle aspiration.Combining with BRAF V600 E genetic diagnostics further improves the diagnostic accuracy of preoperative papillary thyroid carcinoma.In addition,preoperative assessment reduces unnecessary surgery and avoids trauma to patients.