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Endocrine

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24-09-2022 | Ultrasound | Original Article

The combination of BRAF^V600E mutation and Chinese Thyroid Imaging Reporting and Data System is helpful in the management of AUS/FLUS thyroid nodules

Authors: Qiang Li, Lu Yang, Jianghong Lv, Lilong Xu, Murui Zhang, Shiyan Li

Published in: Endocrine | Issue 3/2022

Abstract

Purpose

To explore the utility of the BRAF^V600E mutation in combination with the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) in the management of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) thyroid nodule (TN).

Methods

138 AUS/FLUS TNs in 129 patients were included. Each TN underwent preoperative BRAF^V600E mutation analysis and was classified using the C-TIRADS. Histopathologic diagnosis served as reference standard.

Results

46 benign TNs and 92 malignant TNs were identified. The C-TIRADS 4C and 5 (OR = 10.409, P = 0.000), BRAF^V600E mutation (OR = 36.493, P = 0.000) were independent predictors of malignant nodules. There were significant differences in malignancy rate among the different C-TIRADS TNs (P = 0.000), and these TNs with higher C-TIRADS were associated with increased malignancy rate (P for trend = 0.000). The rate of the nodule with BRAF^V600E mutation increased with the increase of C-TIRADS (P for trend = 0.001). For AUS/FLUS TNs without BRAF^V600E mutation, the malignancy rates of the C-TIRADS 3, 4A, 4B, 4C, and 5 were 0%, 21.4%, 20.8%, 70.8%, and 100%, respectively (P = 0.000), and the malignancy rate increased from C-TIRADS 3 to C-TIRADS 5 (P for trend = 0.000). C-TIRADS and BRAF^V600E mutation had similar diagnostic efficacy (P > 0.05), and the sensitivity, negative predictive value, and accuracy of the combination were significantly higher than BRAF^V600E gene or C-TIRADS alone (P < 0.05).

Conclusions

C-TIRADS can effectively provide risk stratification for AUS/FLUS nodules. The combination is helpful in selecting appropriate management for AUS/FLUS patients.

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Title: The combination of BRAFV600E mutation and Chinese Thyroid Imaging Reporting and Data System is helpful in the management of AUS/FLUS thyroid nodules
Authors: Qiang Li
Lu Yang
Jianghong Lv
Lilong Xu
Murui Zhang
Shiyan Li
Publication date: 24-09-2022
Publisher: Springer US
Keywords: Ultrasound
Goiter
Ultrasound
Published in: Endocrine / Issue 3/2022
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-022-03176-8

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The combination of BRAF^V600E mutation and Chinese Thyroid Imaging Reporting and Data System is helpful in the management of AUS/FLUS thyroid nodules

Abstract

Purpose

Methods

Results

Conclusions

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