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增强 CT 联合 BRAF V600E 基因检测在甲状腺乳头状癌诊断中的优势及临床意义。

Advantages and clinical significance of enhanced CT combined with BRAF V600E gene detection in the diagnosis of papillary thyroid carcinoma.

机构信息

School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China; Department of Translational Medicine Research Center, Hangzhou First People's Hospital, Zhejiang Chinese Medical University, Hangzhou, China.

Department of pathology, Hangzhou First People's Hospital, Hanzhou, China.

出版信息

Med Eng Phys. 2022 Dec;110:103862. doi: 10.1016/j.medengphy.2022.103862. Epub 2022 Jul 28.

Abstract

BACKGROUND

The diagnosis of papillary thyroid carcinoma (PTC) remains the focus of clinical research. Studies have shown that the BRAFV600E gene mutation is closely related to the development of PTC. In this study, we used the advantages and clinical significance of enhanced CT combined with BRAFV600E gene testing in the diagnosis of PTC.

METHODS

A total of 170 PTC patients who received treatment in our hospital between January 2020 and December 2020 were collected and divided into group A (enhanced CT combined with BRAFV600E gene detection) and group B (fine needle aspiration cytology, FNAC) according to different diagnostic methods. We recorded the general information of the patients and measured the levels of serum tumor markers including carcinoembryonic antigen (CEA), cytokeratin fragment 19 (CYFRA21-1), neuron-specific enolase (NSE) and carbohydrate antigen 125 (CA125). After pathological diagnosis, the specificity, sensitivity, accuracy, positive predictive value, and negative predictive value of the two diagnostic methods were contrasted. The accuracy of the two methods and the pathological test in identifying benign lesions, malignant tumors, was also compared.

RESULTS

All patients' serum tumor markers CEA, CYFRA21-1, NSE and CA125 levels were above normal. The detection rate of specificity, sensitivity, accuracy, positive predictive value and negative predictive value of enhanced CT combined with BRAF V600E gene detection were superior to those of FNAC. And the accuracy of enhanced CT combined with BRAF V600E gene detection, which was confirmed by corresponding pathological detection results, was significantly increased (P < 0.05).

CONCLUSIONS

Enhanced CT combined with BRAF V600E gene detection can improve the diagnostic accuracy of PTC, and its clinical indicators and safety are superior to FNAC.

摘要

背景

甲状腺乳头状癌(PTC)的诊断仍然是临床研究的重点。研究表明,BRAFV600E 基因突变与 PTC 的发生密切相关。本研究旨在探讨增强 CT 联合 BRAFV600E 基因检测在 PTC 诊断中的优势及临床意义。

方法

收集我院 2020 年 1 月至 2020 年 12 月收治的 170 例 PTC 患者,根据诊断方法的不同分为 A 组(增强 CT 联合 BRAFV600E 基因检测)和 B 组(细针穿刺细胞学检查,FNAC)。记录患者一般资料,检测包括癌胚抗原(CEA)、细胞角蛋白 19 片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)和糖类抗原 125(CA125)在内的血清肿瘤标志物水平。经病理诊断后,对比两种诊断方法的特异性、敏感性、准确性、阳性预测值、阴性预测值。对比两种方法及病理检查对良恶性病变的诊断符合率。

结果

所有患者的血清肿瘤标志物 CEA、CYFRA21-1、NSE 和 CA125 水平均高于正常值。增强 CT 联合 BRAF V600E 基因检测的特异性、敏感性、准确性、阳性预测值和阴性预测值检测率均优于 FNAC。与相应的病理检测结果相比较,增强 CT 联合 BRAF V600E 基因检测的准确率显著升高(P<0.05)。

结论

增强 CT 联合 BRAF V600E 基因检测可提高 PTC 的诊断准确率,其临床指标及安全性均优于 FNAC。

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