超声联合BRAF V600E在甲状腺弥漫性病变合并甲状腺癌诊断中的价值-东南大学学报医学版

超声联合BRAF V600E在甲状腺弥漫性病变合并甲状腺癌诊断中的价值

单位：1. 沧州中西医结合医院超声医学一科, 河北沧州 061001;
2. 沧州中西医结合医院头颈甲状腺外科, 河北沧州 061001;
3. 沧州中西医结合医院超声一科, 河北沧州 061001;
4. 沧州中西医结合医院中医内科, 河北沧州 061001;
5. 沧州中西医结合医院甲状腺内科,

关键词：超声鼠类肉瘤滤过性毒菌致癌同源体B1基因V600E突变甲状腺弥漫性病变甲状腺癌诊断价值

分类号：R736.1;R581;R445.1

出版年·卷·期（页码）：2024·43·第六期（875-882）

摘要：

目的:探究超声联合鼠类肉瘤滤过性毒菌致癌同源体B1(BRAF)基因V600E突变在甲状腺弥漫性病变(DTD)变合并甲状腺癌(TC)中的诊断价值。方法:选择2023年7月至2024年6月就诊的120例DTD患者,根据病理组织结果分为DTD组(n=34)和TC组(n=86),超声诊断仪进行超声诊断,BRAF V600E试剂盒检测BRAF V600E的表达,Kappa进行一致性比较;四格表法分析诊断的准确度。结果:TC组低回声及Ⅱ型血流信号所占比例、收缩期峰值流速、舒张期末血流速度较高,搏动指数、阻力指数较低(P<0.05);超声、BRAF V600E检测与病理诊断具有一致性(P<0.05);超声和BRAF V600E检测与患者TNM分期、淋巴结状态、血管侵犯等临床病理特征相关(P<0.05);超声联合BRAF V600E检测准确率、敏感度及阴性预测值更高(P<0.05)。结论:超声与BRAF V600E检测与病理诊断具有较高的一致性,联合诊断价值更高。

Objective: To explore the diagnostic value of ultrasound combined with v-raf murine sarcoma viral oncogene homolog B1(BRAF) gene V600E mutation in diffuse thyroid disease(DTD) combined with thyroid carcinoma(TC). Methods: 120 patients with DTD who visited our hospital from July 2023 to June 2024 were selected. According to the pathological diagnosis results, the patients were devided into DTD group(n=34) and TC group(n=86). Ultrasonic diagnosis was performed by ultrasonic diagnostic instrument, the expression of BRAF V600E was detected by BRAF V600E kit, and the consistency was compared by Kappa. Accuracy of diagnosis was analyzed by four-grid table method. Results: The proportions of low echo and type Ⅰ blood flow signals, peak systolic flow velocity, and end diastolic blood flow velocity were higher in the TC group, while the pulsatile index and resistance index were lower(P<0.05). Ultrasonic and BRAF V600E detection were consistent with the pathological diagnosis(P<0.05). Ultrasound and BRAF V600E detection were correlated with clinical and pathological features such as TNM staging, lymph node status, and vascular invasion in patients(P<0.05). Compared with individual detection, ultrasound combined with BRAF V600E detection had higher accuracy, sensitivity, and negative predictive value(P<0.05). Conclusion: Ultrasound and BRAF V600E have high consistency with the pathological diagnosis, and the combined diagnosis value is higher.

参考文献：

[1] HUANG J, ZHAO J.Quantitative diagnosis progress of ultrasound imaging technology in thyroid diffuse diseases[J].Diagnostics(Basel), 2023, 13(4):700-711.
[2] SUN J, LIU J, WU T T, et al.Sensitivity to thyroid hormone indices are associated with papillary thyroid carcinoma in Chinese patients with thyroid nodules[J].BMC Endocr Disord, 2023, 23(1):126-138.
[3] QI Q, XU P, ZHANG C, et al.Nomograms combining ultrasonic features with clinical and pathological features for estimation of delphian lymph node metastasis risk in papillary thyroid carcinoma[J].Front Oncol, 2021, 11(214):792347-792356.
[4] ZHENG L L, MA S Y, ZHOU L, et al.Diagnostic performance of artificial intelligence-based computer-aided diagnosis system in longitudinal and transverse ultrasonic views for differentiating thyroid nodules[J].Front Endocrinol(Lausanne), 2023, 127(14):11377-11985.
[5] PARK J, AN S, KIM K, et al.BRAFV600E positivity-dependent effect of age on papillary thyroid cancer recurrence risk[J].Cancers(Basel), 2023, 15(22):5395-5407.
[6] ATTIA A S, HUSSEIN M, ISSA P P, et al.Association of BRAFV600E mutation with the aggressive behavior of papillary thyroid microcarcinoma:a Meta-analysis of 33 studies[J].Int J Mol Sci, 2022, 23(24):15626-15638.
[7] ADLER D D, CARSON P L, RUBIN J M, et al.Doppler ultrasound color flow imaging in the study of breast cancer:preliminary findings[J].Ultrasound Med Biol, 1990, 16(6):553-559.
[8] 王卉, 赵珊珊, 姚劲草, 等.超声联合甲状腺球蛋白检测对甲状腺癌术前N分期的价值分析[J].中华超声影像学杂志, 2022, 31(2):122-128.
[9] 冯立新, 翟传夫, 谭清玉.LncRNA DLG1-AS1调控miR-203/ZEB2轴诱导甲状腺乳头状癌细胞恶性化生长和转移的机制研究[J].东南大学学报(医学版), 2021, 40(2):133-141.
[10] LI R, LI M, SUN B, et al.PD-L1 expression and ultrasound characteristics in papillary thyroid carcinoma and its effect on recurrence[J].In Vivo, 2023, 37(6):2820-2828.
[11] HONG S, LIN B, XU M, et al.Cell-free DNA methylation biomarker for the diagnosis of papillary thyroid carcinoma[J].EBioMedicine, 2023, 90(64):104497-104508.
[12] 孙可敏, 何秀丽, 郭玲玲.甲状腺微小乳头状癌临床及超声特征与中央区淋巴结转移的危险因素[J].临床耳鼻咽喉头颈外科杂志, 2021, 35(3):260-263.
[13] 张利群, 黄金龙.甲状腺弥漫性病变合并甲状腺癌的超声诊断价值[J].临床医学研究与实践, 2020, 5(34):135-137.
[14] LAN Y, SONG Q, JIN Z.Correction of routine ultrasound features and BRAFV600E gene to the cervical lymph node metastases of thyroid papillary carcinoma[J].Med J Chin PLA, 2019, 44(9):747-752.
[15] LI X, ZHANG H, ZHOU Y, et al.Risk factors for central lymph node metastasis in the cervical region in papillary thyroid carcinoma:a retrospective study[J].World J Surg Oncol, 2021, 19(1):138-152.
[16] 万增林.超声诊断甲状腺弥漫性病变合并甲状腺癌的临床价值[J].医疗装备, 2022, 35(4):11-12.
[17] ZHANG Z, ZHANG X, YIN Y, et al.Integrating BRAFV600E mutation, ultrasonic and clinicopathologic characteristics for predicting the risk of cervical central lymph node metastasis in papillary thyroid carcinoma[J].BMC Cancer, 2022, 22(1):461-473.
[18] 尹立平, 王文逸, 杨德仁, 等.血清TSH水平及BRAF基因V600E突变联合检测在甲状腺癌诊断中的价值[J].中国肿瘤外科杂志, 2022, 14(5):447-450.
[19] ISSA P P, OMAR M, BUTI Y, et al.Hashimoto's thyroiditis minimizes lymph node metastasis in BRAF mutant papillary thyroid carcinomas[J].Biomedicines, 2022, 10(8):2051-2063.
[20] CHEN H, SONG A, WANG Y, et al.BRAFV600E mutation test on fine-needle aspiration specimens of thyroid nodules:Clinical correlations for 4600 patients[J].Cancer Med, 2022, 11(1):40-49.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录