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比较BRAF标志物与手术结果在检测细针穿刺怀疑为非典型病变(AUS)的甲状腺结节患者病变类型中的诊断准确性。

Comparing Diagnostic Accuracy of BRAF Marker with Surgery Findings in Detecting the Type of Lesion in Patients with Thyroid Nodules with Suspected Fine Needle Aspiration (AUS).

作者信息

Zand Vahid, Kalantar Mehdi, Baradaranfar Mohammadhossein, Vaziribozorg Sedighe, Ebrahiminasab Mahya, Mohammadi Ahmad, Khabri Fatemeh

机构信息

Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

出版信息

Indian J Otolaryngol Head Neck Surg. 2025 Jul;77(7):2543-2547. doi: 10.1007/s12070-025-05564-8. Epub 2025 May 20.

Abstract

INTRODUCTION

In this study we compared diagnostic accuracy of BRAF marker with histopathology findings in detecting the type of lesion in patients with thyroid nodules with suspected fine needle aspiration (AUS).

METHODS

In this cross-sectional study, 70 patients with thyroid nodules and AUS cytology undergoing surgery were involved. Demographic data (age, gender), type of lesion based on histopathology findings (malignant, benign), and type of cancer in malignant lesions (Papillary Thyroid Carcinoma and Follicular Thyroid Carcinoma) was recorded in a checklist. In order to evaluate the BRAF mutation, PCR test was performed on samples obtained from the thyroid nodule site through thyroid surgery. The PCR results were compared with the histopathology findings as a pathology report. The sensitivity, specificity, positive predictive value, and negative predictive value were evaluated and analyzed.

RESULTS

Sixty patients were females and 10 were males. Forty one (58.57%) had multinodular goiter, 20 (28.57%) had PTC, 3 (4.28%) had Hashimoto's and 6 (8.58%) were diagnosed with thyroiditis. PCR test results showed that only two cases in the PTC group were heterozygous for BRAF mutation and the rest of the samples were normal. Sensitivity and specificity and positive and negative predictive value of BRAF marker showed that this marker had low sensitivity and high specificity. The positive predictive value was 91.3 and the negative predictive value was 33.4.

CONCLUSIONS

The results showed that the BRAF marker had low sensitivity and high specificity in diagnosing the type of thyroid lesions. In addition, this study was conducted to compare BRAF with standard PCR method and considering the cost-effectiveness of this method, this method could be used for AUS patients.

摘要

引言

在本研究中,我们比较了BRAF标记物与组织病理学结果在检测疑似细针穿刺结果为不典型(AUS)的甲状腺结节患者病变类型方面的诊断准确性。

方法

在这项横断面研究中,纳入了70例接受手术的甲状腺结节且细针穿刺结果为AUS的患者。在一份检查表中记录人口统计学数据(年龄、性别)、基于组织病理学结果的病变类型(恶性、良性)以及恶性病变中的癌症类型(乳头状甲状腺癌和滤泡状甲状腺癌)。为了评估BRAF突变,对通过甲状腺手术从甲状腺结节部位获取的样本进行聚合酶链反应(PCR)检测。将PCR结果与作为病理报告的组织病理学结果进行比较。评估并分析了敏感性、特异性、阳性预测值和阴性预测值。

结果

60例为女性,10例为男性。41例(58.57%)患有结节性甲状腺肿,20例(28.57%)患有乳头状甲状腺癌,3例(4.28%)患有桥本氏病,6例(8.58%)被诊断为甲状腺炎。PCR检测结果显示,乳头状甲状腺癌组中只有2例BRAF突变杂合,其余样本均正常。BRAF标记物的敏感性、特异性以及阳性和阴性预测值表明,该标记物敏感性低但特异性高。阳性预测值为91.3,阴性预测值为33.4。

结论

结果表明,BRAF标记物在诊断甲状腺病变类型方面敏感性低但特异性高。此外,本研究旨在将BRAF与标准PCR方法进行比较,考虑到该方法的成本效益,该方法可用于AUS患者。

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