Diagnostic significance of fine needle aspiration cytology combined with BRAF<sup>V600E</sup> gene detection in cervical lymph node metastasis of thyroid cancer _CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

JIANG Jingjing ,  WANG Jianhua , DING Wenbo , XU Shuhang , WU Xinping , LI Minghong

Department of General Surgey, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Traditional Chinese and Western Medicine, Nanjing 210028, P. R. China;

Corresponding?author：

WANG Jianhua, Email: 311w@163.com

Keywords：

cervical lymph node metastasis of thyroid cancer; fine needle aspiration; BRAF^V600E gene; diagnostic significance

DOI：

10.7507/1007-9424.201801056

Video：

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Objective To investigate the diagnostic significance of fine needle aspiration cytology (FNAC) combined with BRAF^V600E gene detection in the diagnosis of cervical lymph node metastasis of thyroid cancer. Methods Atotal of 140 patients with suspected cervical lymph node metastasis of thyroid cancer were collected as the research objects, and all patients were given ultrasound-guided FNAC and detection of BRAF^V600E gene. The significance of the diagnosis was analyzed according to the gold standard after pathological examination. Results All the 140 patients underwent surgical treatment. For FNAC, the sensitivity was 63.6% (84/132), the specificity was 100% (8/8), the accuracy was 65.7% (92/140), the positive predictive value was 100% (84/84), and the negative predictive value was 14.3% (8/56). For detection of BRAF^V600E gene, the sensitivity was 84.8% (112/132), the specificity was 100% (8/8), the accuracy was 85.7% (120/140), the positive predictive value was 100% (112/112), and the negative predictive value was 28.5% (8/28). For FNAC combined with BRAF^V600E gene detection, the sensitivity was 90.9% (120/132), the specificity was 100% (8/8), the accuracy was 91.4% (128/140), the positive predictive value was 100% (120/120), and the negative predictive value was 40.0% (8/20). The area under curve of receiver operating characteristic for FNAC, detection of BRAF^V600E gene, and FNAC combined with BRAF^V600E gene detection were 0.818, 0.924, and 0.955, respectively. Conclusion FNAC combine with BRAF^V600E gene detection improves the accuracy of neck lymph node metastasis in patients with thyroid cancer, which is worthyof performed.

Citation： JIANG Jingjing, WANG Jianhua, DING Wenbo, XU Shuhang, WU Xinping, LI Minghong. Diagnostic significance of fine needle aspiration cytology combined with BRAF^V600E gene detection in cervical lymph node metastasis of thyroid cancer . CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(9): 1083-1086. doi: 10.7507/1007-9424.201801056 Copy

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2.	Chung J, Kim EK, Lim H, et al. Optimal indication of thyroglobulin measurement in fine-needle aspiration for detecting lateral metastatic lymph nodes in patients with papillary thyroid carcinoma. Head Neck, 2014, 36(6): 795-801.
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13.	劉潔, 胡如英, 張瓊敏, 等. 甲狀腺乳頭狀癌術后超聲引導下淋巴結穿刺 195 例的臨床分析. 醫學影像學雜志, 2016, 26(10): 1799-1802.
14.	黃煜慶, 溫慶良, 葛明華. 甲狀腺乳頭狀癌術前頸淋巴結轉移評估技術研究進展. 腫瘤學雜志, 2017, 23(1): 65-70.
15.	劉曉暉, 華璽, 丁鵬, 等. 超聲引導下頸淋巴結穿刺活檢對甲狀腺癌診斷的臨床價值. 實用癌癥雜志, 2016, 31(7): 1191-1193.
16.	蔣燕, 鄭哲嵐. 高頻超聲及細針穿刺對甲狀腺乳頭狀癌頸部淋巴結轉移的診斷意義. 腫瘤, 2015, 35(9): 1034-1038.
17.	章建全, 盛建國, 趙璐璐, 等. 超聲引導下正常甲狀旁腺細針穿刺物甲狀旁腺激素含量測定及細胞學驗證. 第二軍醫大學學報, 2013, 34(4): 357-361.
18.	周好, 陳海珍, 陳曦, 等. 細針穿刺洗脫液測定甲狀腺球蛋白鑒別轉移淋巴結性質. 外科理論與實踐, 2012, 17(1): 17-20.
19.	譚廣謀, 廖衛國, 陳偉泉, 等. 頸淋巴結穿刺細胞學檢查對甲狀腺癌頸淋巴結轉移的診斷價值. 廣東醫學, 2012, 33(2): 248-249.
20.	宮寧, 劉彥強. 超聲引導下細針穿刺活檢術在頸部增大淋巴結診斷中的應用. 華北國防醫藥, 2010, 22(2): 134-135.

1. Sherman SI. Thyroid carcinoma. Lancet, 2003, 361(9356): 501-511.
2. Chung J, Kim EK, Lim H, et al. Optimal indication of thyroglobulin measurement in fine-needle aspiration for detecting lateral metastatic lymph nodes in patients with papillary thyroid carcinoma. Head Neck, 2014, 36(6): 795-801.
3. Giacomini CP, Jeffrey RB, Shin LK. Ultrasonographic evaluation of malignant and normal cervical lymph nodes. Semin Ultrasound CT MR, 2013, 34(3): 236-247.
4. Kim DW, Choo HJ, Lee YJ, et al. Sonographic features of cervical lymph nodes after thyroidectomy for papillary thyroid carcinoma. J Ultrasound Med, 2013, 32(7): 1173-1180.
5. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid, 2016, 26(1): 1-133.
6. Bahn RS, Castro MR. Approach to the patient with nontoxic multinodular goiter. J Clin Endocrinol Metab, 2011, 96(5): 1202-1212.
7. Xing M, Alzahrani AS, Carson KA, et al. Association between BRAF V600E mutation and recurrence of papillary thyroid cancer. J Clin Oncol, 2015, 33(1): 42-50.
8. Xing M, Alzahrani AS, Carson KA, et al. Association between BRAF V600E mutation and mortality in patients with papillary thyroid cancer. JAMA, 2013, 309(14): 1493-1501.
9. 黃美玲, 李永平, 凌瑞. BRAF V600E 基因突變與乳頭狀甲狀腺癌淋巴結轉移相關性的 Meta 分析. 中國腫瘤, 2017, 26(2): 145-151.
10. Lu J, Gao J, Zhang J, et al. Association between BRAF V600E mutation and regional lymph node metastasis in papillary thyroid carcinoma. Int J Clin Exp Pathol, 2015, 8(1): 793-799.
11. 胡洪生, 孫少華, 沈豐, 等. 以頸部淋巴結轉移為首發癥狀的隱匿性甲狀腺癌的診治探討. 中國普外基礎與臨床雜志, 2017, 24(3): 355-360.
12. 陳曦, 陳海珍. 甲狀腺癌頸淋巴結轉移影像學診斷方法選擇及評價. 中國實用外科雜志, 2017, 37(9): 944-948.
13. 劉潔, 胡如英, 張瓊敏, 等. 甲狀腺乳頭狀癌術后超聲引導下淋巴結穿刺 195 例的臨床分析. 醫學影像學雜志, 2016, 26(10): 1799-1802.
14. 黃煜慶, 溫慶良, 葛明華. 甲狀腺乳頭狀癌術前頸淋巴結轉移評估技術研究進展. 腫瘤學雜志, 2017, 23(1): 65-70.
15. 劉曉暉, 華璽, 丁鵬, 等. 超聲引導下頸淋巴結穿刺活檢對甲狀腺癌診斷的臨床價值. 實用癌癥雜志, 2016, 31(7): 1191-1193.
16. 蔣燕, 鄭哲嵐. 高頻超聲及細針穿刺對甲狀腺乳頭狀癌頸部淋巴結轉移的診斷意義. 腫瘤, 2015, 35(9): 1034-1038.
17. 章建全, 盛建國, 趙璐璐, 等. 超聲引導下正常甲狀旁腺細針穿刺物甲狀旁腺激素含量測定及細胞學驗證. 第二軍醫大學學報, 2013, 34(4): 357-361.
18. 周好, 陳海珍, 陳曦, 等. 細針穿刺洗脫液測定甲狀腺球蛋白鑒別轉移淋巴結性質. 外科理論與實踐, 2012, 17(1): 17-20.
19. 譚廣謀, 廖衛國, 陳偉泉, 等. 頸淋巴結穿刺細胞學檢查對甲狀腺癌頸淋巴結轉移的診斷價值. 廣東醫學, 2012, 33(2): 248-249.
20. 宮寧, 劉彥強. 超聲引導下細針穿刺活檢術在頸部增大淋巴結診斷中的應用. 華北國防醫藥, 2010, 22(2): 134-135.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnostic significance of fine needle aspiration cytology combined with BRAF^V600E gene detection in cervical lymph node metastasis of thyroid cancer

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnostic significance of fine needle aspiration cytology combined with BRAFV600E gene detection in cervical lymph node metastasis of thyroid cancer

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Diagnostic significance of fine needle aspiration cytology combined with BRAF^V600E gene detection in cervical lymph node metastasis of thyroid cancer