BRAF v600e mutation combined with thyroglobulin and fine-needle aspiration in diagnosis of lymph node metastasis of papillary thyroid carcinoma

Papillary thyroid carcinoma (PTC) is often associated with cervical lymph node metastasis (LNM), which may cause poor prognosis. Both fine-needle aspiration cytology (FNAC) and thyroglobulin measurement with fine-needle aspiration (Tg-FNA) have high diagnostic efficacy, but the diagnostic values and...

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Published inPathology, research and practice Vol. 214; no. 11; p. 1892
Main Authors Li, Jianming, Liu, Jibin, Yu, Xiaomeng, Bao, Xiaoli, Qian, Linxue
Format Journal Article
LanguageEnglish
Published Germany 01.11.2018
Subjects
Adult
Area Under Curve
Biopsy, Fine-Needle - methods
Cytodiagnosis - methods
DNA Mutational Analysis
Female
Humans
Lymphatic Metastasis - diagnosis
Lymphatic Metastasis - genetics
Male
Middle Aged
Mutation
Proto-Oncogene Proteins B-raf - genetics
ROC Curve
Sensitivity and Specificity
Thyroglobulin - analysis
Thyroid Cancer, Papillary - diagnosis
Thyroid Cancer, Papillary - genetics
Lymph node metastasis
FNAC
BRAFv600e test
FNA-Tg
Papillary thyroid carcinoma
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Summary:Papillary thyroid carcinoma (PTC) is often associated with cervical lymph node metastasis (LNM), which may cause poor prognosis. Both fine-needle aspiration cytology (FNAC) and thyroglobulin measurement with fine-needle aspiration (Tg-FNA) have high diagnostic efficacy, but the diagnostic values and relationships among BRAF mutation (BRAF ) testing, FNAC and FNA-Tg are unclear. We enrolled 145 patients with confirmed PTC and lymph nodes (LNs) that were suspected to be metastatic based on ultrasound findings, who were treated from May 2017 to April 2018, and underwent FNAC, Tg-FNA and BRAF tests. Diagnostic efficacy was calculated by diagnostic and chi-square tests. Diagnostic values were FNAC-sensitivity: 67%, specificity: 100%, PPV: 100%, NPV: 66%, accuracy: 80%; and FNA-Tg (at a cut-off of 2.23 ng/mL)-sensitivity: 97.3%, specificity: 87.8%, PPV: 87.8%, NPV: 97.3%, accuracy: 92.3%. In the BRAF group, sensitivities and specificities were FNAC: 68.6% and 100%, Tg-FNA: 94.4% and 85.7%; compared with FNAC: 75% and 90.9%, Tg-FNA: 80% and 100% in the BRAF group. The combination of Tg-FNA + FNAC is useful in diagnosing metastatic PTC. BRAF mutational status does not affect the diagnostic performance of FNAC or Tg-FNA.
ISSN:1618-0631