甲状腺影像报告及数据系统与BRAF V600E基因突变检测在甲状腺结节良恶性诊断中的应用

摘要

目的 探讨甲状腺影像报告及数据系统(TI-RADS)、BRAF V600E基因突变检测及两者联合诊断甲状腺结节良恶性的应用价值.方法 回顾性分析141个经病理证实的甲状腺结节,根据3种方法诊断结果分别进行评分、分组并构建三者的受试者工作特征(ROC)曲线,评价、比较各种方法的诊断价值.结果 TI-RADS分类诊断的灵敏度、特异度、准确性、阳性预测值、阴性预测值分别是83.1％、78.3％、82.3％、95.1％、47.4％;BRAF V600E基因突变检测的诊断效能分别是77.1％、100％、80.9％、100％、46.0％;联合应用的诊断效能分别是92.4％、78.3％、90.1％、95.6％、66.7％.三者的ROC曲线下面积(AUC)分别为0.851、0.886、0.917,联合应用的AUC最高.结论 TI-RADS分类、BRAF V600E基因突变检测对诊断甲状腺结节良恶性具有重要价值,对TI-RADS分类4类以上的甲状腺结节进行BRAF V600E基因突变检测,更有助于甲状腺结节良恶性的诊断.%Objective To evaluate the diagnostic efficacies of thyroid imaging reporting and data system(TI-RADS),BRAF V600E mutation testing and combined application of both in thyroid nodules.Methods A total of 141 thyroid nodules underwent the examinations were analyzed retrospectively.The receiver operating characteristic curve (ROC) was used to investigate the diagnostic values of each methods.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of TI-RADS were 83.1％,78.3％,82.3％,95.1％,47.4％.Those of BRAF V600E mutation analysis were 77.1％,100％,80.9％,100％,46.0％.Those of the combined test of TI-RADS and BRAF V600E mutation analysis were 92.4％,78.3％,90.1％,95.6％,66.7％.The areas under the ROC curve (AUC) were 0.851,0.886,0.917,respectively.Conclusions The combined test of TI-RADS and BRAF V600E mutation analysis has a more higher diagnostic efficacies than each of them alone.