目的：分析甲状腺癌（thyroid cancer,TC）早期诊断中超声引导下细针穿刺（fine-needle aspiration,FNA）细胞学检查联合BRAFV600E基因检测的临床价值。方法：选择2021年1月至2023年12月在我院收治的150例疑似TC患者为研究对象,所有患者均接受超声引导下FNA细胞学检查、BRAFV600E基因检测,以术后病理学诊断结果为金标准,比较超声引导下FNA细胞学检查、BRAFV600E基因检测单独及联合诊断阳性检出率、诊断效能,并绘制工作特征（ROC）曲线,运用曲线下面积（AUC）分析超声引导下FNA细胞学检查、BRAFV600E基因检测单独及联合诊断价值。结果：术后病理学显示,92例（61.33%）确诊为TC;超声引导下FNA细胞学检查显示,96例（64.00%）为阳性,54例（36.00%）为阴性;BRAFV600E基因检测显示,78例（52.00%）为阳性,72例（48.00%）为阴性;超声引导下FNA细胞学检查联合BRAFV600E基因检测显示,99例（66.00%）为阳性,51例（34.00%）为阴性。超声引导下FNA细胞学检查联合BRAFV600E基因检测诊断效能高于超声引导下FNA细胞学检查、BRAFV600E基因检测单独检。超声引导下FNA细胞学检查联合BRAFV600E基因检测AUC显著大于超声引导下FNA细胞学检查、BRAFV600E基因检测单独检查。结论：超声引导下FNA细胞学检查联合BRAFV600E基因检测在TC患者疾病诊断中具有重要价值,能有效提高早期诊断准确性,具有良好的临床效能。
Abstract
Objective To analyze the clinical value of ultrasound-guided fine needle aspiration (FNA) cytology combined with BRAFV600E genetic testing in the early diagnosis of thyroid cancer (TC). Methods A total of 150 patients with suspected TC admitted to our hospital from January 2021 to December 2023 were selected as study subjects. All patients underwent ultrasound-guided FNA cytology and BRAFV600E gene detection. With postoperative pathological diagnosis as the gold standard, the positive detection rates and diagnostic efficacy of ultrasound-guided FNA cytology, BRAFV600E gene detection alone, and their combination were compared. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was used to analyze the diagnostic value of ultrasound-guided FNA cytology, BRAFV600E gene detection alone, and their combination. Results Postoperative pathology showed that 92 patients (61.33%) were diagnosed with TC. Ultrasound-guided FNA cytology showed 96 positive cases (64.00%) and 54 negative cases (36.00%). BRAFV600E gene detection showed 78 positive cases (52.00%) and 72 negative cases (48.00%). When ultrasound-guided FNA cytology was combined with BRAFV600E gene detection, 99 cases (66.00%) were positive and 51 cases (34.00%) were negative. The diagnostic efficacy of ultrasound-guided FNA cytology combined with BRAFV600E gene detection was higher than that of ultrasound-guided FNA cytology or BRAFV600E gene detection alone (P<0.05). The AUC of ultrasound-guided FNA cytology combined with BRAFV600E gene detection was significantly greater than that of ultrasound-guided FNA cytology or BRAFV600E gene detection alone. Conclusion Ultrasound-guided FNA cytology combined with BRAFV600E gene detection has important value in the diagnosis of TC patients, can effectively improve the accuracy of early diagnosis, and has good clinical efficacy.
关键词
BRAFV600E基因检测 /
甲状腺癌 /
超声引导 /
细针穿刺 /
细胞学检查
Key words
BRAFV600E gene detection /
thyroid cancer /
ultrasound guidance /
fine-needle aspiration /
cytology examination
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基金
陕西卫健委科研项目“高频超声联合超声引导下穿刺活检在商洛地区乳腺癌早期筛查中的应用”（2020-Z-0103）
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