The combination of BRAFV600E mutation and Chinese Thyroid Imaging Reporting and Data System is helpful in the management of AUS/FLUS thyroid nodules

Abstract

Purpose To explore the utility of the BRAF V600E mutation in combination with Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) in the management of atypia of undetermined signi cance/follicular lesion of undetermined signi cance (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 classi ed using the C-TIRADS. Histopathologic diagnosis served as reference standard.Results 46 benign TNs and 92 malignant TNs were identi ed. Malignant TNs were more commonly observed in TNs with a size less than 10mm (P = 0.033). There were signi cant 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 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). The diagnostic performance of C-TIRADS was similar to the BRAF V600E mutation (P > 0.05), and the sensitivity, negative predictive value, and accuracy of the combination were signi cantly higher than BRAF V600E gene or C-TIRADS alone (P < 0.05).Conclusions C-TIRADS can effectively provide risk strati cation for AUS/FLUS TNs. The combination can be helpful in selecting appropriate management for AUS/FLUS patients.

An economically efficient strategy for diagnosing atypia of undetermined significance or follicular lesion of undetermined significance thyroid nodules with ultrasound-based risk stratification systems and BRAFV600E testing

“…Studies have shown that the BRAF V600E gene mutation exhibits high specificity and general sensitivity for diagnosing PTC ( 13 , 14 ). In some studies, the combination of BRAF V600E and RSSs was used for the diagnosis of thyroid nodules ( 15 , 16 ). The general approach involved performing a BRAF V600E test on all thyroid nodules and diagnosing those with positive BRAF V600E or RSSs results as positive while diagnosing those with negative results for both markers as negative.…”

The Diagnostic Value of BRAF V600E Gene Detection Combined with DNA Ploidy Analysis in Thyroid Cancer

“…A study reported that the diagnostic accuracy of BRAF V600E gene mutation combined with enhanced computed tomography (CT) was significantly improved relative to enhanced CT alone [21]. In addition, compared with only TI-RADS, the combination of TI-RADS and BRAF V600E gene mutation detection contributed to select the more appropriate management for the patients with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) thyroid nodule [22].…”