Value of TI-RADS, <em>BRAF</em> V600E mutation analysis and BSRTC in differential diagnosis of thyroid nodules

JI Xiangpeng; GUO Man; WEN Baojie; ZHANG Jie; JIN Zhibin; YU Pengli; WU Min; KONG Wentao

doi:10.19732/j.cnki.2096-6210.2023.02.008

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Value of TI-RADS, BRAF V600E mutation analysis and BSRTC in differential diagnosis of thyroid nodules

更新时间：2025-12-15

- Value of TI-RADS, BRAF V600E mutation analysis and BSRTC in differential diagnosis of thyroid nodules
- Vol. 32, Issue 2, Pages: 156-162(2023)
- 作者机构：
  
  南京大学医学院附属鼓楼医院超声诊断科,江苏,南京,210009
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2023.02.008
  CLC：
- Published Online：28 April 2023，
  
  Published：28 April 2023
- 稿件说明：
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姬祥鹏,郭曼,闻宝杰,等. TI-RADS、BRAF V600E突变分析与BSRTC在甲状腺结节鉴别诊断中的价值[J]. 肿瘤影像学, 2023, 32(2): 156-162 https://doi.

org/10.19732/j.cnki.2096-6210.2023.02.008
姬祥鹏,郭曼,闻宝杰,等. TI-RADS、BRAF V600E突变分析与BSRTC在甲状腺结节鉴别诊断中的价值[J]. 肿瘤影像学, 2023, 32(2): 156-162 https://doi. DOI： 10.19732/j.cnki.2096-6210.2023.02.008.

org/10.19732/j.cnki.2096-6210.2023.02.008 DOI：

摘要

目的：

探讨超声甲状腺影像报告和数据系统（Thyroid Imaging Report and Data System，TI-RADS）、甲状腺细胞病理学Bethesda报告系统（The Bethesda System for Reporting Thyroid Cytopathology，BSRTC）与

BRAF

V600E突变分析在甲状腺良恶性结节鉴别诊断中的价值。

方法：

回顾并分析行手术切除的1 093个甲状腺结节的术前超声检查、超声引导下细针穿刺活检（fine-needle aspiration biopsy，FNAB）与

BRAF

V600E突变分析结果。依据TI-RADS分类标准对结节进行分类，采用BSRTC对结节进行细胞学诊断。分别计算3种方法的灵敏度、特异度及曲线下面积（area under curve，AUC）。

结果：

单独应用时，TI-RADS诊断甲状腺良恶性结节的灵敏度、阴性预测值和准确度最高，分别为99.21%、84.00%和95.97%；BSRTC诊断阳性预测值和约登指数最高，分别为99.22%和78.52%；

BRAF

V600E突变分析的AUC最高，为0.893；

BRAF

V600E突变分析和BSRTC特异度最高，均为91.03%。联合应用时，BSRTC联合

BRAF

V600E突变分析的诊断特异度、阳性预测值、约登指数、准确度和AUC最高，分别为84.62%、98.77%、79.60%、98.90%和0.898；三者联合诊断的灵敏度、阴性预测值最高，分别为99.61%、91.11%。对于BSRTC Ⅰ、Ⅲ、Ⅳ类结节，联合TI-RADS、

BRAF

V600E突变分析可以减少误诊，提高恶性结节检出率。

结论：

BSRTC、TI-RADS与

BRAF

V600E突变分析与在甲状腺结节诊断中均有较高的价值，三者联合有助于进一步提高甲状腺结节诊断的准确度，减少误判。

Abstract

Objective:

To explore the value of the Thyroid Imaging Reporting and Data System (TI-RADS)

The Bethesda

System for Reporting Thyroid Cytopathology (BSRTC) and

BRAF

V600E mutation analysis in the differential diagnosis of thyroid nodules.

Methods:

The preoperative ultrasonography

ultrasound-guided fine-needle aspiration biopsy (FNAB)

and

BRAF

V600E mutation analysis results of 1 093 thyroid nodules that underwent surgery resection were analyzed. TI-RADS classification criteria was used to classify the nodules

and BSRTC was used to undergo cytological diagnosis of the nodules. The sensitivity

specificity

and area under curve (AUC) of the three methods were calculated and compared.

Results:

When applied individually

the sensitivity

negative predictive value

and accuracy of TI-RADS were the highest among the three methods

and they were 99.21%

84.00%

and 95.97%

respectively. BSRTC had the highest positive predictive value

Youden index

and the values were 99.22%

and 78.52%

respectively.

BRAF

V600E mutation analysis had the highest AUC (0.893). Both

BRAF

V600E mutation analysis and BSRTC had the highest specialty (91.93%). When applied in combination

the combination of BSRTC and

BRAF

V600E mutation analysis had thehighest specialty (84.62%)

positive predictive value (98.77%)

Youden index (79.60%)

accuracy (98.90%) and AUC (0.898). The highest sensitivity (99.61%)

and negative predictive value (91.11%) were achieved when all three methods were combined. For the Ⅰ

Ⅲ

and Ⅳ nodules

BSRTC combined with TI-RADS and/or

BRAF

V600E mutation analysis reduced misdiagnosis and improved diagnostic accuracy. For the Ⅰ

Ⅲ

and Ⅳ nodules

BSRTC combined with TI-RADS and

BRAF

V600E mutation analysis reduced misdiagnosis and improved diagnostic accuracy.

Conclusion:

BSRTC

TI-RADS

and

BRAF

V600E mutation analysis all have high value in the diagnosis of thyroid nodules

and the combination of three methods could improve diagnostic efficiency and reduce misdiagnosis.

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Value of TI-RADS, BRAF V600E mutation analysis and BSRTC in differential diagnosis of thyroid nodules

DOI：10.19732/j.cnki.2096-6210.2023.02.008

摘要

Abstract

关键词

Keywords

references