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BRAF V600E as an accurate marker to complement fine needle aspiration (FNA) cytology in the guidance of thyroid surgery in the Chinese population: evidence from over 1000 consecutive FNAs with follow-up.

BRAF V600E作为中国人群甲状腺手术指导中补充细针穿刺 (FNA) 细胞学的准确标志物: 来自超过1000个连续FNA随访的证据。

  • 影响因子:2.04
  • DOI:10.1093/jjco/hyaa209
  • 作者列表:"Zhao Q","Wang Y","Ye Q","Wang P","Rao J
  • 发表时间:2021-04-01
Abstract

BACKGROUND:Currently, several commercial molecular tests have been developed for reclassifying thyroid nodules with indeterminate fine needle aspiration cytology. These tests are quite expensive and not available in China. Previous studies demonstrated a very high prevalence of the BRAF V600E mutation in Asian people. A high incidence may result in a robust sensitivity. We conducted this study to determine the prevalence of BRAF V600E mutation and its ability to reclassify cytologically indeterminate thyroid nodules in the Chinese population. METHODS:Between January 2016 and October 2018, consecutive patients who underwent a fine needle aspiration procedure and agreed to provide materials for molecular analysis in our hospital were recruited in this study. All were followed up until they had a thyroidectomy and a final pathological diagnosis or until January 2019 (those did not have surgery). RESULTS:A total of 1960 patients were included in this study. Until January 2019, 1240 patients underwent surgery. Using histopathological diagnosis as a gold standard, the overall sensitivity and specificity of the BRAF V600E mutational analysis for the discrimination of benign nodules from cancer in thyroid fine needle aspiration samples were 83.3% (81.0-85.3%) and 96.0% (77.7-99.8%), respectively, with an area under the ROC curve of 0.90 (95% CI 0.85-0.95, P < 0.001). Among cases with indeterminate cytology, BRAF-positive cases were showing malignancy in the final pathology, and BRAF-negative cases were showing safer to be followed up. CONCLUSION:The BRAF V600E mutation is highly prevalent in the Chinese population and can accurately complement cytopathology in the guidance of thyroid surgery.Mini-abstract: The BRAF V600E mutation has both high specificity and sensitivity to predict thyroid malignancy in the Chinese population. It can accurately complement cytopathology in the guidance of thyroid surgery.

摘要

背景: 目前,已经开发了几种商业分子检测方法,用不确定的细针穿刺细胞学对甲状腺结节进行重新分类。这些测试相当昂贵,在中国还没有。以前的研究表明,在亚洲人中BRAF V600E突变的患病率非常高。高发病率可能导致稳健的灵敏度。我们进行了这项研究,以确定中国人群中BRAF V600E突变的患病率及其重新分类细胞学不确定甲状腺结节的能力。 方法: 在2016年1月至2018年10月期间,在本研究中招募接受细针穿刺术并同意为我们医院的分子分析提供材料的连续患者。所有患者均接受随访,直到他们接受了甲状腺切除术和最终病理诊断,或直到2019年1月 (那些没有接受手术的患者)。 结果: 本研究共纳入1960例患者。至2019年1月,1240例患者接受了手术治疗。以组织病理学诊断为金标准,BRAF V600E突变分析对甲状腺细针穿刺标本中良性结节与癌鉴别的总体敏感性和特异性分别为83.3% (81.0-85.3%) 和96.0% (77.7-99.8%),ROC曲线下面积为0.90 (95% CI 0.85-0.95,P <0.001)。在细胞学不确定的病例中,BRAF阳性病例在最终病理中显示恶性,BRAF阴性病例显示随访更安全。 结论: BRAF V600E突变在中国人群中高度流行,在甲状腺手术指导中可准确补充细胞病理学。在甲状腺手术的指导下,能准确地补充细胞病理学。

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