Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, Shandong, China.
J Cancer Res Clin Oncol. 2023 Jul;149(8):4283-4291. doi: 10.1007/s00432-022-04235-3. Epub 2022 Sep 7.
Ultrasound-guided fine-needle aspiration biopsy (UG-FNAB) was implemented in Qilu Hospital of Shandong University in 2015 as a preoperative diagnostic method for thyroid surgery. BRAF p.V600E genetic testing was implemented in 2019. This study evaluated the impact of these two tests on the malignancy rate in patients undergoing thyroidectomy.
A total of 19,496 patients were included in the study. We retrospectively collected data from patients undergoing thyroid surgery in the Hospital Information System (HIS) of Qilu Hospital of Shandong University from January 2012 to December 2021. Meanwhile, data of FNAB, UG-FNAB, and BRAF p.V600E genetic testing were collected. Differences in means among groups were analyzed via one-way ANOVA, and differences in frequencies were analyzed via Pearson's chi-squared test.
In this study, the 10-year period was divided into three stages, with the implementation of UG-FNAB in 2015 and that of BRAF p.V600E genetic testing in 2019 as dividing lines. The malignancy rate in thyroid surgery increased significantly during these three stages (48.06% vs. 73.47% vs. 88.17%; P < 0.001). In the same period (May 2019 to December 2021), the malignancy rate in thyroid surgery was significantly different between the Non-FNAB, UG-FNAB, and UG-FNAB-BRAF groups (78.87% vs. 95.63% vs. 98.32%; P < 0.001).
The successful implementation of UG-FNAB and BRAF p.V600E genetic testing improved the malignancy rate in thyroid surgery and reduced unnecessary diagnostic surgery for benign and marginal lesions. It can, therefore, provide a clinical reference for other hospitals.
山东大学齐鲁医院于 2015 年开展超声引导下细针抽吸活检术（UG-FNAB）作为甲状腺手术的术前诊断方法。BRAF p.V600E 基因检测于 2019 年开展。本研究评估这两项检测对行甲状腺切除术患者的恶性率的影响。
共纳入 19496 例患者。我们从山东大学齐鲁医院医院信息系统（HIS）中回顾性收集 2012 年 1 月至 2021 年 12 月期间行甲状腺手术患者的数据。同时收集 FNAB、UG-FNAB 和 BRAF p.V600E 基因检测的数据。采用单因素方差分析比较组间均值差异，采用 Pearson 卡方检验比较频率差异。
本研究将 10 年时间分为三个阶段，以 2015 年开展 UG-FNAB 和 2019 年开展 BRAF p.V600E 基因检测为分界线。这三个阶段甲状腺手术的恶性率显著升高（48.06%比 73.47%比 88.17%；P<0.001）。同期（2019 年 5 月至 2021 年 12 月），非 FNAB、UG-FNAB 和 UG-FNAB-BRAF 组之间甲状腺手术的恶性率差异有统计学意义（78.87%比 95.63%比 98.32%；P<0.001）。
UG-FNAB 和 BRAF p.V600E 基因检测的成功开展提高了甲状腺手术的恶性率，减少了对良性和边缘病变的不必要诊断性手术。因此，可为其他医院提供临床参考。
