Diagnostic Value Of US-FNAC Combined With BRAF Gene V600E Mutation For Benign And Malignant Thyroid Nodules

Objective To analyze the diagnostic value of ultrasound-guided fine needle cytology combined with BRAF gene V600E mutation for benign and malignant thyroid nodules.Methods Selecting cases of suspected malignant thyroid nodules in the Department of Ultrasound,Affiliated Hospital from December 2017 to December 1818,and preparing for surgery,and living in Inner Mongolia for more than 10 years,80 cases with a total of 99 nodules FNAC and BRAF gene were detected before operation,and pathological results were given after operation.The pathological results were compared with FNAC and BRAF V600E gene detection before surgery,and compared with FNAC combined with BRAF gene test results to evaluate the diagnostic value.Results Among the 99 nodules treated,63 nodules were detected in the BRAF gene mutation.Of the surgical pathology,60 were papillary thyroid carcinoma and 3 were Hashimoto with nodular goiter.Of the 63 nodules in which the BRAF gene mutation was detected,FNAC detected 49 nodules as malignant or suspected malignant and 14 as benign nodules.There were 36 nodules with no BRAF mutation detected,of which 16 were surgically pathologically thyroid papillary carcinoma and 20 were benign nodules.FNAC detected 12 nodules in the nodules where BRAF mutations did not occur as suspected malignant,23 were benign nodules,and 1 was undefined.A total of 76 nodules of papillary thyroid carcinoma,in which 60 nodules of BRAF gene mutation were detected,the mutation rate was(60/76)78.9%.Compared with the surgical pathology gold standard,the sensitivity,specificity,positive predictive value,negative predictive value,accuracy,false positive rate and false negative rate of FNAC test were 75%,82%,93.4%,50%,76.8%,17.4%,25%.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy,false positive rate and false negative rate of BRAF V600E for thyroid nodule detection were 78.9%,86.9%,95.2%,55.6%,80.8%,13%,21.1%.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy,false positive rate and false negative rate of FNAC combined with BRAF in detecting thyroid nodules were 92.1%,78.4%,88.9%,93.3%,75%,21.7%,7.8%.The rate was compared by X~2 test.Compared with FNAC,BRAF V600E and FNAC combined with BRAF,the sensitivity of FNAC combined with BRAF V600E was higher than that of FNAC alone.The difference was statistically significant(P<0.0167).Both were specific and accurate.The difference was not statistically significant(P>0.0167).The sensitivity of FNAC combined with BRAF was higher than that of BRAF alone.The difference was statistically significant(P<0.0167).The specificity and accuracy of the two were not statistically significant.Meaning(P>0.0167).Conclusion Preoperative application of FNAC detection combined with BRAF to diagnose thyroid nodules can improve the preoperative diagnosis rate of thyroid cancer.