Correlation between Ultrasound-guided Fine-needle Aspiration Combined with BRAF Detection and Invasive Pathological Features of Papillary Thyroid Cancer / 中国医学科学院学报

ABSTRACT

To analyze the potential associations of ultrasound-guided fine-needle aspiration(FNA),BRAF 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 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 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 mutation rate was higher in patients with the following featuresaged over 45 years(=0.043);the tumor was FNA diagnosed as malignant or suspected malignant(=0.011);the tumor had a maximum diameter of ≤1 cm(=0.001);and the primary tumor was in stage T(=0.039);however,there was no significant difference in BRAF 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 double-positive patients were not significantly different from those of other patients. Conclusion FNA-confirmed malignancy,BRAF 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.