BRAF 突变与美国放射学会甲状腺影像报告和数据系统及儿童甲状腺乳头状癌临床病理特征的相关性。
Associations of BRAF mutation with the American College of Radiology Thyroid Imaging Reporting and Data System and clinicopathological characteristics in pediatric patients with papillary thyroid carcinoma.
机构信息
Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, China.
Department of Ultrasound, Mawangdui District of Hunan Provincial People's Hospital, Hunan Normal University, Changsha, China.
出版信息
Pediatr Radiol. 2024 Jun;54(7):1128-1136. doi: 10.1007/s00247-024-05943-3. Epub 2024 May 21.
BACKGROUND
Identifying the associations between BRAF mutation, the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) and clinicopathological characteristics could assist in making appropriate treatment strategies for pediatric patients with papillary thyroid carcinoma.
OBJECTIVE
To retrospectively assess the associations between BRAF mutation, TI-RADS, and clinicopathological characteristics in pediatric patients with papillary thyroid carcinoma.
MATERIALS AND METHODS
Between May 2013 and May 2023, pediatric patients with papillary thyroid carcinoma who underwent thyroidectomy were retrospectively evaluated. Univariate and multivariate logistic regression analyses were performed to determine the associations between BRAF mutation, TI-RADS, and clinicopathological characteristics. The diagnostic performance of TI-RADS to predict BRAF mutation was assessed.
RESULTS
The BRAF mutation was found in 59.1% (39/66) of pediatric patients with papillary thyroid carcinoma. Multivariate analyses showed that hypoechoic/very hypoechoic [odds ratio (OR) = 8.48; 95% confidence interval (CI) = 1.48-48.74); P-value = 0.02] and punctate echogenic foci (OR = 24.3; 95% CI = 3.80-155.84; P-value = 0.001) were independent factors associated with BRAF mutation. In addition, BRAF mutation was significantly associated with TI-RADS 5 (OR = 12.61; 95% CI = 1.28-124.49; P-value = 0.03). There were no associations between BRAF mutation and nodule size, composition, shape, margin, cervical lymph node metastasis, or Hashimoto's thyroiditis (P-value > 0.05). Combined with hypoechoic/very hypoechoic and punctate echogenic foci, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 89.7%, 85.2%, 89.7%, 85.2%, and 87.9%, respectively.
CONCLUSIONS
Hypoechoic/very hypoechoic, punctate echogenic foci, and TI-RADS 5 are independently associated with BRAF mutation in pediatric patients with papillary thyroid carcinoma.
背景
确定 BRAF 突变、美国放射学院甲状腺影像报告和数据系统（TI-RADS）与临床病理特征之间的关联，有助于为儿童甲状腺乳头状癌患者制定适当的治疗策略。
目的
回顾性评估儿童甲状腺乳头状癌患者 BRAF 突变、TI-RADS 与临床病理特征之间的关系。
材料与方法
回顾性分析 2013 年 5 月至 2023 年 5 月间行甲状腺切除术的儿童甲状腺乳头状癌患者。采用单因素和多因素逻辑回归分析确定 BRAF 突变、TI-RADS 与临床病理特征之间的关系。评估 TI-RADS 预测 BRAF 突变的诊断性能。
结果
在 66 例儿童甲状腺乳头状癌患者中，BRAF 突变阳性率为 59.1%（39/66）。多因素分析显示，低回声/极低回声（比值比 [OR] = 8.48；95%置信区间 [CI] = 1.48-48.74）；P 值 = 0.02）和点状强回声灶（OR = 24.3；95% CI = 3.80-155.84；P 值 = 0.001）是 BRAF 突变的独立相关因素。此外，BRAF 突变与 TI-RADS 5 显著相关（OR = 12.61；95% CI = 1.28-124.49；P 值 = 0.03）。BRAF 突变与结节大小、成分、形状、边缘、颈部淋巴结转移或桥本甲状腺炎无相关性（P 值 > 0.05）。将低回声/极低回声和点状强回声灶相结合，其灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为 89.7%、85.2%、89.7%、85.2%和 87.9%。
结论
在儿童甲状腺乳头状癌患者中，低回声/极低回声、点状强回声灶和 TI-RADS 5 与 BRAF 突变独立相关。
Zotero 插件