Diagnostic value of thyroid imaging reporting and data system combined with BRAFV600E mutation analysis in Bethesda categories III–V thyroid nodules

Wu, Li-Da; Hua, Shucheng; Chen, Wenqin; Gao, Yingqian; Yuan, Yanggang; Li, Xiao; Lu, Wenjuan; Ye, Xinhua; Deng, Hongyan

doi:10.1038/s41598-022-09822-5

Cited by 5 publications

(3 citation statements)

References 35 publications

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“…Our data indicated that, compared to a single US-FNAB, its combination with BRAF V600E mutation performed a significantly higher accuracy and sensitivity, whereas a comparable specificity in predicting PTC among macro-calcified thyroid nodules. Similar results have also been reported previously in some researches involving thyroid nodules (not limited to macro-calcified nodules) [ 8 , 21 , 23 ]. However, one of the disadvantages of our study was that we did not compare the diagnostic value of US-FNAB combined BRAF V600E to CNB, which was another screening test with both high sensitivity and specificity, because some of the recent reports indicated that CNB showed greater diagnostic performance and ought to be considered first to improve diagnostic efficiency when evaluating entirely calcified types of macro-calcified nodules [ 24 , 25 ].…”

Section: Discussionsupporting

confidence: 91%

Association between macrocalcification and papillary thyroid carcinoma and corresponding valuable diagnostic tool: retrospective study

Zhou

et al. 2023

World J Surg Onc

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Background Microcalcifications are suggested to be an indicator of thyroid malignancy, especially for papillary thyroid carcinoma (PTC), nonetheless, the association between macrocalcification and PTC is underexplored. Furthermore, screening methods like ultrasonography and ultrasound-guided fine needle aspiration biopsy (US-FNAB) are limited in evaluating macro-calcified thyroid nodules. Thus, we aimed to investigate the relationship between macrocalcification and PTC. We also explored the diagnostic efficiency of US-FNAB and proto-Oncogene Proteins B-raf V600E (BRAF V600E) mutation in macro-calcified thyroid nodules evaluation. Methods A retrospective research of 2645 thyroid nodules from 2078 participants was performed and divided into three groups as non-, micro-, and macro-calcified for further PTC incidence comparison. Besides, a total of 100 macro-calcified thyroid nodules with both results of US-FNAB and BRAF V600E mutation were screened out for subsequent evaluation of diagnostic efficiency. Results Compared to non-calcification, macrocalcification showed a significantly higher incidence of PTC (31.5% vs. 23.2%, P<0.05). Additionally, when compared with a single US-FNAB, the combination of US-FNAB and BRAF V600E mutation showed better diagnostic efficiency in diagnosing macro-calcified thyroid nodule (area under the curve (AUC) 0.94 vs. 0.84, P=0.03), with a significantly higher sensitivity (100.0% vs. 67.2%, P<0.01) and a comparable standard of specificity (88.9% vs. 100.0%, P=0.13). Conclusions Occurrence of macrocalcification in thyroid nodules may suggest a high risk of PTC, and the combination of US-FNAB and BRAF V600E showed a greater value in identifying macro-calcified thyroid nodules, especially with significantly higher sensitivity. Trial registration The Ethics Committee of The First Affiliated Hospital of Wenzhou Medical University (2018-026).

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Section: Discussionsupporting

confidence: 91%

Association between macrocalcification and papillary thyroid carcinoma and corresponding valuable diagnostic tool: retrospective study

Zhou

et al. 2023

World J Surg Onc

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“…Fnais et al [46], in their meta-analysis, did not find any substantial evidence to support the implementation of BRAF mutation analysis as a single screening test for patients with indeterminate thyroid nodules (categories III-V together or separately in category III nodules). However, several authors agree that the combined assessment of the BRAF mutation and ultrasound risk can be effectively used in the diagnosis of BSRTC category III nodules [47,48]. Our analyses confirmed this opinion, but only with respect to AUS-nuclear nodules.…”

Section: Discussionsupporting

confidence: 73%

Effective Use of microRNA, BRAF and Sonographic Risk Assessment in Bethesda III Thyroid Nodules Requires a Different Approach to Nodules with Features of Nuclear Atypia and Other Types of Atypia

Słowińska-Klencka,

Popowicz,

Kulczycka-Wojdala

et al. 2023

Cancers

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The aim of the study was to analyze the diagnostic usefulness of the combined assessment of the ultrasound risk category of the nodule (evaluated with EU-TIRADS system), the presence of BRAF V600E mutation and the expression of selected microRNAs (miR-146b, miR-221 and miR-222) in Bethesda category III thyroid nodules, separately for cases with nuclear atypia (AUS-nuclear) and cases with other types of atypia (AUS-other). We evaluated 161 nodules (66 AUS-nuclear and 95 AUS-other) with known results of postoperative histopathological examination. The rate of cancer and the rate of PTC among cancers were nearly three times higher in the AUS-nuclear than the AUS-other group. For AUS-nuclear nodules, the most effective diagnostic panel included, in addition to repeat FNA, the assessment of BRAF V600E mutation and the expression of miR-146b and miR-222 (sensitivity: 93.5%, specificity: 80.0%). For AUS-other nodules, a two-step procedure was most effective: at the first stage, forgoing surgical treatment in subjects with a benign repeat FNA outcome, and, at the second stage, the assessment of miR-222 expression and the EU-TIRADS category (sensitivity: 92.3%, specificity: 76.8%). The optimal use of molecular methods in the diagnostics of category III thyroid nodules requires a separate approach for nodules with nuclear atypia and nodules with other types of atypia.

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“…It is a challenge facing clinicians to distinguish thyroid cancers from benign nodules to ensure that each patient receives timely and appropriate treatment [11]. The ne needle aspiration cytology (FNAC) has proven useful in assessing the likelihood of malignant tumors [12,13]. However, the sample collection and interpretation of thyroid smears can be intractable and require experience.…”

Section: Introductionmentioning

confidence: 99%

BRAF V600E Mutation in Thyroid Carcinoma: A Large-Scale Study in Han Chinese Population

Cong,

Ouyang,

Zhou

et al. 2024

Preprint

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Background The prevalence of genetic mutations in thyroid cancer varies significantly among different ethnic backgrounds. The present study aimed to investigate the clinical potential of BRAF V600E in a large group of homogenous Han Chinese patients. Methods From 2018 to 2021, 6232 thyroid disease patients who underwent thyroidectomy at our hospital were enrolled. We measured the diagnostic value of BRAF and plotted ROC curves. Patients with full clinical-pathological data were selected and divided into the BRAF mutation and wild type groups. We conducted univariate and multivariate analyses to quantify the differences in potential predictive factors of papillary thyroid carcinoma (PTC) patients between the groups. Kaplan-Meier survival analysis was used to estimate overall recurrence and recurrence rate. Results The prevalence of BRAF V600E mutation was 86.0% in PTCs. The sensitivity and specificity of BRAF mutation for diagnosing PTC from suspicious lesions were 85.5% and 100%, respectively. The sensitivity and specificity of BRAF analysis in the indeterminate cytology group were 72.5% and 100%, respectively. BRAF mutation showed an independent association with older age, negative HT, larger tumor size, extrathyroidal extension, and multifocality in PTCs. In micro-PTCs (tumor size ≤1), the mutation was also positively correlated with progressive phenotypes of extrathyroidal extension and multifocality. BRAF mutation was associated with poorer recurrence-free probability in Kaplan-Meier survival analysis. Conclusions This large single-center study revealed that BRAF V600E is highly prevalent in the Han Chinese population and demonstrated BRAF V600E mutation testing has high diagnostic accuracy and its strong association with the progress of aggressiveness in PTCs and a higher probability of recurrence. BRAF mutation can serve as an accurate marker for diagnosis and decision-making with great value.

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Diagnostic value of thyroid imaging reporting and data system combined with BRAFV600E mutation analysis in Bethesda categories III–V thyroid nodules

Cited by 5 publications

References 35 publications

Association between macrocalcification and papillary thyroid carcinoma and corresponding valuable diagnostic tool: retrospective study

Association between macrocalcification and papillary thyroid carcinoma and corresponding valuable diagnostic tool: retrospective study

Effective Use of microRNA, BRAF and Sonographic Risk Assessment in Bethesda III Thyroid Nodules Requires a Different Approach to Nodules with Features of Nuclear Atypia and Other Types of Atypia

BRAF V600E Mutation in Thyroid Carcinoma: A Large-Scale Study in Han Chinese Population

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