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.
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.
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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.	黄美玲, 李永平, 凌瑞. BRAF V600E 基因突变与乳头状甲状腺癌淋巴结转移相关性的 Meta 分析. 中国肿瘤, 2017, 26(2): 145-151.
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11.	胡洪生, 孙少华, 沈丰, 等. 以颈部淋巴结转移为首发症状的隐匿性甲状腺癌的诊治探讨. 中国普外基础与临床杂志, 2017, 24(3): 355-360.
12.	陈曦, 陈海珍. 甲状腺癌颈淋巴结转移影像学诊断方法选择及评价. 中国实用外科杂志, 2017, 37(9): 944-948.
13.	刘洁, 胡如英, 张琼敏, 等. 甲状腺乳头状癌术后超声引导下淋巴结穿刺 195 例的临床分析. 医学影像学杂志, 2016, 26(10): 1799-1802.
14.	黄煜庆, 温庆良, 葛明华. 甲状腺乳头状癌术前颈淋巴结转移评估技术研究进展. 肿瘤学杂志, 2017, 23(1): 65-70.
15.	刘晓晖, 华玺, 丁鹏, 等. 超声引导下颈淋巴结穿刺活检对甲状腺癌诊断的临床价值. 实用癌症杂志, 2016, 31(7): 1191-1193.
16.	蒋燕, 郑哲岚. 高频超声及细针穿刺对甲状腺乳头状癌颈部淋巴结转移的诊断意义. 肿瘤, 2015, 35(9): 1034-1038.
17.	章建全, 盛建国, 赵璐璐, 等. 超声引导下正常甲状旁腺细针穿刺物甲状旁腺激素含量测定及细胞学验证. 第二军医大学学报, 2013, 34(4): 357-361.
18.	周好, 陈海珍, 陈曦, 等. 细针穿刺洗脱液测定甲状腺球蛋白鉴别转移淋巴结性质. 外科理论与实践, 2012, 17(1): 17-20.
19.	谭广谋, 廖卫国, 陈伟泉, 等. 颈淋巴结穿刺细胞学检查对甲状腺癌颈淋巴结转移的诊断价值. 广东医学, 2012, 33(2): 248-249.
20.	宫宁, 刘彦强. 超声引导下细针穿刺活检术在颈部增大淋巴结诊断中的应用. 华北国防医药, 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. 黄美玲, 李永平, 凌瑞. BRAF V600E 基因突变与乳头状甲状腺癌淋巴结转移相关性的 Meta 分析. 中国肿瘤, 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, 孙少华, 沈丰, 等. 以颈部淋巴结转移为首发症状的隐匿性甲状腺癌的诊治探讨. 中国普外基础与临床杂志, 2017, 24(3): 355-360.
12. 陈曦, 陈海珍. 甲状腺癌颈淋巴结转移影像学诊断方法选择及评价. 中国实用外科杂志, 2017, 37(9): 944-948.
13. 刘洁, 胡如英, 张琼敏, 等. 甲状腺乳头状癌术后超声引导下淋巴结穿刺 195 例的临床分析. 医学影像学杂志, 2016, 26(10): 1799-1802.
14. 黄煜庆, 温庆良, 葛明华. 甲状腺乳头状癌术前颈淋巴结转移评估技术研究进展. 肿瘤学杂志, 2017, 23(1): 65-70.
15. 刘晓晖, 华玺, 丁鹏, 等. 超声引导下颈淋巴结穿刺活检对甲状腺癌诊断的临床价值. 实用癌症杂志, 2016, 31(7): 1191-1193.
16. 蒋燕, 郑哲岚. 高频超声及细针穿刺对甲状腺乳头状癌颈部淋巴结转移的诊断意义. 肿瘤, 2015, 35(9): 1034-1038.
17. 章建全, 盛建国, 赵璐璐, 等. 超声引导下正常甲状旁腺细针穿刺物甲状旁腺激素含量测定及细胞学验证. 第二军医大学学报, 2013, 34(4): 357-361.
18. 周好, 陈海珍, 陈曦, 等. 细针穿刺洗脱液测定甲状腺球蛋白鉴别转移淋巴结性质. 外科理论与实践, 2012, 17(1): 17-20.
19. 谭广谋, 廖卫国, 陈伟泉, 等. 颈淋巴结穿刺细胞学检查对甲状腺癌颈淋巴结转移的诊断价值. 广东医学, 2012, 33(2): 248-249.
20. 宫宁, 刘彦强. 超声引导下细针穿刺活检术在颈部增大淋巴结诊断中的应用. 华北国防医药, 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