摘要
目的 探讨超声引导下细针穿刺活检(US-FNAB)联合鼠类肉瘤病毒癌基因同源物B(BRAF)基因检测对甲状腺乳头状癌(PTC)患者颈部淋巴结转移的诊断价值。方法 选取行甲状腺切除手术和淋巴结清扫的122例PTC患者,均进行US-FNAB及BRAF基因检测。比较颈部淋巴结转移和未转移PTC患者的临床特征。以病理检查结果为金标准,分析US-FNAB、BRAF基因检测及二者联合对PTC患者颈部淋巴结转移的诊断效能。结果 颈部淋巴结转移和未转移PTC患者的肿瘤多灶性、被膜外侵犯情况、回声强度及边界情况比较,差异均有统计学意义(P﹤0.05)。US-FNAB联合BRAF基因检测诊断PTC患者颈部淋巴结转移的灵敏度、特异度、准确度均高于US-FNAB或BRAF基因检测,且与术后病理检查结果的一致性良好(Kappa=0.835)。受试者工作特征(ROC)曲线显示,US-FNAB联合BRAF基因检测诊断PTC患者颈部淋巴结转移的曲线下面积(AUC)为0.915(95%CI:0.857~0.974),高于US-FNAB、BRAF基因检测的0.806(95%CI:0.723~0.888)和0.699%(0.604~0.794)。结论 US-FNAB联合BRAF基因检测对PTC患者颈部淋巴结转移具有较高的诊断价值,可为临床诊断PTC患者颈部淋巴结转移提供参考依据。
Objective To investigate the diagnostic value of ultrasound-guided fine-needle aspiration biopsy(US-FNAB)combined with v-raf murine sarcoma viral oncogene homolog B(BRAF)gene test for cervical lymph node metastasis of papillary thyroid carcinoma(PTC).Method A total of 122 PTC patients who underwent thyroidectomy and lymph node dissection were selected and received US-FNAB and BRAF gene test.The clinical characteristics of PTC patients with cervical lymph node metastasis and without cervical lymph node metastasis were compared.The diagnostic value of single and combined detection of US-FNAB and BRAF gene test for cervical lymph node metastasis in PTC pa-tients was analyzed by using pathological result as gold standard.Result There were significant differences in tumor mu-lifocality,extracapsular invasion,echo intensity and boundary between PTC patients with cervical lymph node metastasis and without cervical lymph node metastasis(P<0.05).The sensitivity,specificity and accuracy of US-FNAB combined with BRAF gene test in the diagnosis of cervical lymph node metastasis in PTC patients were higher than those of US-FNAB or BRAF gene test alone,and with good consistency with postoperative pathological results(Kappa=0.835).The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of US-FNAB combined with BRAF gene test was 0.915(95%CI:0.857-0.974),which was higher than 0.806(95%CI:0.723-0.888)of US-FNAB and 0.699%(95%CI:0.604-0.794)of BRAF gene test.Conclusion US-FNAB combined with BRAF gene test has high diagnostic efficiency for cervical lymph node metastasis in PTC patients,which can provide reference for clinical diagno-sis of cervical lymph node metastasis of PTC patients.
作者
姚晶晶
郑兰兰
杨爽灵
王飞亚
YAO Jingjing;ZHENG Lanlan;YANG Shuangling;WANG Feiya(Department of Ultrasound Diagnosis,General Hospital of Pingmei Shenma Medical Group,Pingdingshan 467000,He’nan,China;Department of Pathology,General Hospital of Pingmei Shenma Medical Group,Pingdingshan 467000,He’nan,China)
出处
《癌症进展》
2023年第12期1373-1376,共4页
Oncology Progress
关键词
甲状腺乳头状癌
颈部淋巴结转移
超声引导下细针穿刺活检
鼠类肉瘤病毒癌基因同源物B
诊断价值
papillary thyroid carcinoma
cervical lymph node metastasis
ultrasound-guided fine-needle aspiration bi-opsy
v-raf murine sarcoma viral oncogene homolog B
diagnostic value
