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.