目的 研究甲状腺结节声像图特征与BRAFV600E基因突变的相关性.方法 选取2015年10月至2016年2月因甲状腺超声发现可疑结节在解放军总医院行穿刺活检的患者179例,共194个结节.结节最大径为(1.1±0.8)cm.记录结节的大小、回声、边界、形态、纵横比、钙化、包膜连续性,同时行穿刺活检获取组织,行常规病理及BRAFV600E基因检测.BRAFV600E基因突变组与BRAFV600E基因未突变组BRAFV600E基因检测与常规超声表现比较采用χ2检验,以有统计学意义的资料为自变量, BRAFV600E基因检测结果为应变量进行Logistic回归分析.结果 BRAFV600E基因突变组与BRAFV600E基因未突变组结节的纵横比、边界、包膜连续性比较,差异均有统计学意义(χ2=11.174、45.517、11.046,P均<0.05).经Logistic回归分析结节的纵横比、边界、包膜连续性是BRAFV600E基因突变的独立危险因素(OR=2.276,95% CI:1.117~4.638,P<0.05;OR=8.412,95%CI:3.836~18.448, P<0.001;OR=2.582,95% CI:1.138~5.860,P<0.05).结论 甲状腺结节纵横比、边界、包膜连续性等可作为预测结节BRAFV600E基因突变与否的征象,为临床进一步处理提供依据.%Objective To study the correlation between ultrasonographic features of thyroid nodule and BRAFV600Emutation. Methods A total of 179 patients with 194 suspicious throid nodules were included in this study. They underwent ultrasound, biopsy, pathology and BRAFV600Emutation examination between October 2015 and February 2016 at Chinese PLA General Hospital. The size of nodules were (1.1±0.8) cm. The size, echo, boundary, shape aspect ratio, calcification and capsular invasion of nodules were investigated. The correlation between ultrasonographic features of thyroid nodule and BRAFV600Emutation analyzed by chis-square test and Logistic Regression analysis using statistical data as independent variable, BRAFV600Emutation as dependent variable. Results There were significant different in nodule′s ratio, boundary, capsular invasion characteristic between the BRAFV600Epositive group and the BRAFV600Enegative group(χ2=11.174,45.517,11.046,all P < 0.05),and these signs are possibly associated with BRAFV600Emutation by logistic regression model analysis(OR=2.276,95%CI:1.117-4.638, P < 0.05; OR=8.412, 95%CI: 3.836-18.448,P < 0.001; OR=2.582, 95%CI: 1.138-5.860,P < 0.05). Conclusions The ratio, boundary, capsular invasion characteristic of thyroid nodules are possibly associated with BRAFV600Emutation. These signs can be used to predict BRAFV600Emutation and facilitate subsequent treatment for such nodules.
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