Rho Miribi, Kim Eun-Kyung, Moon Hee Jung, Yoon Jung Hyun, Park Vivian Y, Han Kyunghwa, Kwak Jin Young
Department of Radiology, Yonsei University College of Medicine, Research Institute of Radiological Science, Severance Hospital, Seoul, Korea.
Ultrasound Q. 2017 Dec;33(4):284-288. doi: 10.1097/RUQ.0000000000000313.
This study aimed to investigate the usefulness of a thyroid imaging reporting and data system (TIRADS) to select thyroid nodules with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) cytology for additional BRAF mutation testing. Three hundred three thyroid nodules were included. Statistical analysis was performed at both patient and nodule levels according to BRAF mutation positivity and clinical factors. Univariate and multivariate logistic regression analyses were performed to assess independent associations between BRAF mutation positivity and clinical factors. Of 303 AUS/FLUS nodules, 16 (5.3%) of 303 nodules had the BRAF mutation. The frequency of the BRAF mutation according to the TIRADS was 35.7% for category 5, 10.8% for category 4c, 2.5% for category 4b, 1.1% for category 4a, and 0% for category 3 nodules (P < 0.001). On multivariate analysis, BRAF mutation positivity was significantly associated with high suspicion on the TIRADS (odds ratio, 15.247; P < 0.001). In conclusion, the ultrasonography patterns of the TIRADS can be used as a clinical parameter for deciding the BRAF mutation test in thyroid nodules with AUS/FLUS cytology.
本研究旨在探讨甲状腺影像报告和数据系统（TIRADS）对选择具有意义未明的非典型性/意义未明的滤泡性病变（AUS/FLUS）细胞学特征的甲状腺结节进行额外BRAF突变检测的有效性。共纳入303个甲状腺结节。根据BRAF突变阳性情况和临床因素在患者和结节层面进行统计分析。进行单因素和多因素逻辑回归分析以评估BRAF突变阳性与临床因素之间的独立关联。在303个AUS/FLUS结节中，303个结节中有16个（5.3%）存在BRAF突变。根据TIRADS分类，BRAF突变的频率在5类结节中为35.7%，4c类为10.8%，4b类为2.5%，4a类为1.1%，3类结节为0%（P<0.001）。多因素分析显示，BRAF突变阳性与TIRADS高度可疑显著相关（比值比，15.247；P<0.001）。总之，TIRADS的超声特征可作为决定对具有AUS/FLUS细胞学特征的甲状腺结节进行BRAF突变检测的临床参数。
