Kosin Med J.  2018 Jun;33(1):1-11. 10.7180/kmj.2018.33.1.1.

Diagnostic value of BRAF(V600E) mutation analysis in fine needle aspiration for evaluation of thyroid nodules

• Lee HW
• Ock SY
• Kim BK
• Kwon SK
• Choi YS
• Kim JH
• Jung SB

• KMID: 2415835
• DOI: http://doi.org/10.7180/kmj.2018.33.1.1

Abstract

OBJECTIVES
Ultrasound-guided fine-needle aspiration (FNA) is routinely used in the evaluation of thyroid nodules. However, it has several pitfalls, as has been noted in nondiagnostic and indeterminate cases. This study aims to investigate the value of BRAF(V600E) mutation co-testing in FNA cytology. METHOD: A total of 310 patients underwent BRAF(V600E) mutation co-testing in FNA cytology on thyroid nodules between June 2013 and June 2014. Of the 310 patients, 69 patients who had undergone a surgery for thyroid nodules were included in this study. The presence of the BRAF(V600E) mutation was determined by allele-specific polymerase chain reaction amplification of exon 15 of the BRAF gene.
RESULTS
Of 69 cases, 33 (47.8%) were BRAF(V600E) mutation positive. The BRAF(V600E) mutation was not significantly associated with high-risk features such as tumor size, lymph node metastasis, and pathological stage. The respective diagnostic performance of FNA (P = 0.02), BRAF(V600E) mutation (P = 0.03), and ultrasonographic (P = 0.00) findings was statistically significant. The sensitivity, specificity and positive predictive value of FNA was 64.9%, 83.3%, and 94.8%. The sensitivity, specificity and positive predictive value of BRAF(V600E) mutation was 56.1%, 91.7%, and 96.9% and the US features was 91.2%, 91.7%, and 98.1% respectively. However, sensitivity of FNA with BRAF(V600E) mutation (77.2%) was lower than FNA with US (92.9%) and combination all together (92.9%).
CONCLUSION
In this study, we found that US features were the most useful in preoperative differential diagnosis of thyroid nodules. BRAF(V600E) mutation co-testing in FNA cytology was also useful for diagnosis of thyroid tumors.

Keyword

BRAF(V600E) mutation; Fine-needle aspiration; Thyroid nodules; Ultrasound features

MeSH Terms

Biopsy, Fine-Needle*
Diagnosis
Diagnosis, Differential
Exons
Humans
Lymph Nodes
Methods
Neoplasm Metastasis
Polymerase Chain Reaction
Sensitivity and Specificity
Thyroid Gland*
Thyroid Nodule*

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