Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2019, Vol. 41 ›› Issue (4): 517-523.doi: 10.3881/j.issn.1000-503X.10995

• Original Articles • Previous Articles     Next Articles

Correlation between Ultrasound-guided Fine-needle Aspiration Combined with BRAF V600EDetection and Invasive Pathological Features of Papillary Thyroid Cancer

ZHANG Ying1,2,LUO Yukun1,2(),ZHANG Yan2,ZHANG Mingbo2,GUANG Yang2,XIE Fang2,JIANG Bo2,TANG Jie2   

  1. 1 School of Medicine,Nankai University,Tianjin 300071,China
    2 Department of Ultrasound,Chinese PLA General Hospital,Beijing 100853,China
  • Received:2018-11-06 Online:2019-08-30 Published:2019-09-05
  • Contact: Yukun LUO E-mail:lyk301@163.com
  • Supported by:
    Supported by the National Natural Sciences Foundation of China(81471681);Beijing Municipal Natural Sciences Foundation(15G30083)

Abstract:

Objective To analyze the potential associations of ultrasound-guided fine-needle aspiration(FNA),BRAF V600E gene mutation detection,and the combination of these two techniques with the clinicopathological features of papillary thyroid cancer(PTC). Methods Patients with PTC confirmed by surgery from April 2016 to July 2017 were included in this study.The relationship between clinicopathological features and BRAF V600E mutation,FNA results,and the combination of them were explored. Results The sensitivity of FNA was 86.3%(227/263)and the mutation rate of BRAF V600E was 85.9%(226/263)in 263 patients with PTC.The mutation rate of papillary thyroid microcarcinoma(PTMC)was 91.1%(153/168)and that of non-PTMC was 76.8%(73/95).A total of 225 patients underwent lymph node dissection.The lymph node metastasis rate was 35.6%(80/225),and it was 23.8%(34/143)in PTMC,56.1%(46/82)in non-PTMC;in addition,9.9%(26/263)of PTC patients had extracapsular invasion.BRAF V600E mutation rate was higher in patients with the following features:aged over 45 years(P=0.043);the tumor was FNA diagnosed as malignant or suspected malignant(P=0.011);the tumor had a maximum diameter of ≤1 cm(P=0.001);and the primary tumor was in stage T1(P=0.039);however,there was no significant difference in BRAF V600E mutation rate among patients with different sex,capsule invasion,or lymph node metastasis.The diagnostic sensitivity of FNA was not statistically different under different clinical and pathological characteristics.The clinicopathologic features of FNA and BRAF V600E double-positive patients were not significantly different from those of other patients. Conclusion FNA-confirmed malignancy,BRAF V600E gene mutation,and their double-positive results are not correlated with the invasive pathological features of PTC,and thus their roles in guiding an extended operation(or not)are limited.

Key words: papillary thyroid cancer, ultrasound, fine-needle aspiration, BRAF V600E mutation, invasiveness

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