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  • Title: BRAFv600e mutation combined with thyroglobulin and fine-needle aspiration in diagnosis of lymph node metastasis of papillary thyroid carcinoma.
    Author: Li J, Liu J, Yu X, Bao X, Qian L.
    Journal: Pathol Res Pract; 2018 Nov; 214(11):1892-1897. PubMed ID: 30270103.
    Abstract:
    BACKGROUND: 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 BRAFv600e mutation (BRAFMUT) testing, FNAC and FNA-Tg are unclear. METHODS: 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 BRAFMUT tests. Diagnostic efficacy was calculated by diagnostic and chi-square tests. RESULTS: 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 BRAFMUT+ 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 BRAFMUT- group. CONCLUSION: 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.
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