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| Correlation between CT diagnosis and BRAF gene in benign and malignant thyroid nodules |
| HUANG Jun YANG Shuohui YANG Xuerong YANG Yuchan CHENG Jianming ZHAN Songhua |
| Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China |
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Abstract Objective To explore the correlation between CT diagnostic characteristics and BRAF gene in benign and malignant thyroid nodules. Methods A total of 87 patients with pathologic and CT data were collected from January 2015 to December 2017 in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine. CT features of benign and malignant nodules were recorded and univariate analysis was performed. The mutation of BRAF V600E gene was detected simultaneously. Results In 87 cases of thyroid nodules, 103 nodules were found, including 62 benign nodules and 41 malignant nodules. The CT features of benign group were nodular morphology, clear edges, and cystic degeneration can be seen in thyroid nodules. Benign nodules showed uneven enhancement and clear relationship with surrounding tissues after enhanced scanning. The CT features of malignant group were blurred nodules with irregular shape and granular calcification. Enhanced scan of malignant nodules showed enlargement of the volume of the lesion, some of them showed “peritumoral enhancement residual circle” or “peninsular enhancement”, and enlarged lymph nodes. Compared with benign nodules, malignant nodules had significant differences in number, shape, border, enhancement and enlarged lymph nodules (P < 0.05). The mutation rate of exon 15 of BRAF gene V600E in malignant nodules was significantly higher than that in benign nodules (P < 0.05). Conclusion The CT feature of thyroid nodule has certain characteristics. Combined with the mutation detection of BRAF V600E gene, CT images have some reference value for reducing missed diagnosis and misdiagnosis.
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[1] Paschke R，Hegedus L，Alexander E，et al. Thyroid nodule guidelines：agreement，disagreement and need for future research [J]. Nat Rev Endocrinol，2011，7（6）：354-361.
[2] Malandrino P，Pellegriti G，Attard M，et al. Papillary thyroid microcarcinomas：a comparative study of the characteristics and risk factors at presentation in two cancer registries [J]. J Clin Endocrinol Metab，2013，98（4）：1427-1434.
[3] Ahn H，Kim H，Welch H. Korea′s thyroid-cancer epidemic-screening and over diagnosis [J]. New Engl J Med，2014，371（19）：1765-1767.
[4] Lu J，Gao J，Zhang J，et al. Association between BRAF V600E mutation and regional lymph node metastasis in papillary thyroid carcinoma [J]. Int J Clin Exp Pathol，2015， 8（21）：793-799.
[5] Guth S，Theune U，Aberle J，et al. Very high prevalence of thyroid nodules detected by high frequency（13 MHz) ultrasound examination [J]. Eur J Clin Invest，2009，39（8）：699-706.
[6] Ahmed S，Horton K，Jeffrey R，et al. Incidental thyroid nodules on chest CT：review of the literature and management suggestions [J]. AJR Am J Roentgenol，2010，195（5）：1066-1071.
[7] 杜诗霖，董志辉，徐凌燕.甲状腺结节CT特点的相关因素研究[J].中国CT和MRI杂志，2018，16（2）：143-145.
[8] 窦益腾，朱新进，夏俊.甲状腺良恶性结节的影像学诊断研究进展[J].中国CT和MRI杂志，2018，16（2）：146-148.
[9] 卢绍辉，吴颋，吴迪，等.甲状腺常见单发结节CT多征象联合鉴别诊断[J].临床放射学杂志，2016，35（7）：1018-1022.
[10] 贾红明，傅俊明，黄惠填，等.低剂量多层螺旋CT灌注成像对甲状腺结节鉴别诊断的价值[J].广东医学，2017， 38（8）：1200-1203.
[11] Moon WJ，June SL，Lee JH，et al. Benign and malignant thyroid nodules ：US differentiation-multicenter retrospective study [J]. Radiology，2008，247（3）：762-770.
[12] Hoang JK ，Lee WK，Lee M，et al. US features of thyroid malignancy：pearls and pitfalls [J]. Radiographics，2007， 27（3）：847-860.
[13] 卢定友，陈望.甲状腺病变的CT诊断和鉴别诊断[J].中外医疗，2016，1（23）：188-190.
[14] 成建明，詹松华，周俊，等.甲状腺微小乳头状癌的CT诊断价值分析[J].医学影像学杂志，2017，27（8）：1447-1450.
[15] 韩志江，项晶晶，包凌云，等.甲状腺钙化性病变的超声和CT联合诊断[J].国际医学放射学杂志，2016，39（4）：416-421.
[16] 何俊林，王永胜，蔡剑波，等.甲状腺结节CT征象分析及诊断价值研究[J].医药论坛杂志，2018，39（7）：17-20.
[17] 徐列印，邱维加，何敏丽.结节性甲状腺肿合并甲状腺癌的CT诊断[J].临床放射学杂志，2015，34（1）：28-31.
[18] Kim DW. Computed tomography features of papillary thyroid carcinomas [J]. J Comput Assist Tomogr，2014，38（6）：936-940.
[19] 黄雅元，包凌云，韩志江，等.CT和超声的联合应用在良性甲状腺环状钙化诊断中的价值[J].中国临床医学影像杂志，2014，25（6）：385-389.
[20] 韩志江，陈文辉，舒艳艳，等.乳头状甲状腺微小癌与微小结节性甲状腺肿的CT鉴别诊断[J].中国临床医学影像杂志，2013，24（2）：88-92.
[21] 许定华，夏俊，陈金凤，等.甲状腺结节CT及病理分析[J].现代医用影像学，2016，25（6）：996-999.
[22] Tessler FN，Middleton WD，Grant EG，et al. ACR thyroid imaging，reporting and data system（TI-RADS）：white paper of the ACR TI-RADS committee [J]. J Am Coll Radiol，2017，14（5）：587-595.
[23] 巩雷，陈萍，刘宪军，等.甲状腺乳头状癌中的BRAF基因突变与相关蛋白表达的相关性[J].诊断病理学杂志，2017，24（4）：270-273.
[24] Zhang YZ，Xu T，Cui D，et al. Value of TIRADS，BSRTC and FNA-BRAF（V600E) mutation analysis in differentiating highrisk thyroid nodules [J]. Sci Rep，2015，5（5）：16927. |
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