Clinical Investigation
Diagnostic value of BRAFV600E mutation detection in BSRTC categories Ⅰ and Ⅲ thyroid nodules
Guan Wenyan, Zheng Jingyu, Nie Ling, Yang Jun, Cui Xiaobin, Miao Shuying
Published 2023-03-25
Cite as Chin J Nucl Med Mol Imaging, 2023, 43(3): 166-170. DOI: 10.3760/cma.j.cn321828-20221102-00331
Abstract
ObjectiveTo evaluate the value of B-Raf proto-oncogene, serine/threonine kinase (BRAF)V600E mutation detection in the differentiating malignant from benign with Bethesda system for reporting thyroid cytopathology (BSRTC) categories Ⅰ and Ⅲ nodules.
MethodsFrom January 2019 to December 2020, a total of 264 nodules from 263 patients (79 males, 184 females; median age 46 years) were retrospectively enrolled and all patients underwent BRAFV600E mutation detection, fine-needle aspiration cytology (FNAC) and thyroid nodulectomy in the Affiliated Drum Tower Hospital of Nanjing University Medical School. Thirteen nodules of 12 patients had repeat aspirate samples and 51 nodules were examined with multiple genes assay in formalin fixed paraffin embedded tissues. Taken the postoperative histopathological results as the gold standard, the diagnostic efficiency of BRAFV600E mutation was analyzed by comparing the results of multiple genes assay and BRAFV600E mutation detection of repeated puncture samples.
ResultsOf 264 nodules, 230 were malignant (papillary thyroid cancer (PTC)) and 34 were benign, with BSRTC categories Ⅰ (nondiagnostic) and Ⅲ (follicular lesion) nodules of 58 and 206. The sensitivities of BRAFV600E mutation detection in BSRTC categories Ⅰ and Ⅲ nodules were 77.1%(37/48) and 78.0%(142/182), the specificities were 9/10 and 91.7%(22/24), the positive predictive values were 97.4%(37/38) and 98.6%(142/144), the negative predictive values were 45.0%(9/20) and 35.5%(22/62), and the accuracy rates were 79.3%(46/58) and 79.6%(164/206). The diagnostic concordance of BRAFV600E mutation detection was 90.2%(46/51) in the preoperative and postoperative samples of 51 nodules with preoperative BRAFV600E wild type but postoperative pathology confirmed as PTC and was 11/13 in repeat puncture samples.
ConclusionBRAFV600E mutation detection is an effective diagnostic method for BSRTC categories Ⅰ and Ⅲ nodules.
Key words:
Thyroid nodule; Proto-oncogene proteins B-raf; Mutation; Biopsy, fine-needle
Contributor Information
Guan Wenyan
Department of Pathology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Zheng Jingyu
Department of Pathology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Nie Ling
Department of Pathology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Yang Jun
Department of Pathology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Cui Xiaobin
Department of Pathology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Miao Shuying
Department of Pathology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China