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 BRAFV600E 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 BRAFV600E 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), BRAFV600E 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 BRAFV600E mutation increased with the increase of C-TIRADS (P for trend = 0.001). For AUS/FLUS TNs without BRAFV600E 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 BRAFV600E mutation had similar diagnostic efficacy (P > 0.05), and the sensitivity, negative predictive value, and accuracy of the combination were significantly higher than BRAFV600E 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.

• Authors: Qiang Li, Lu Yang, Jianghong Lv, Lilong Xu, Murui Zhang, Shiyan Li
• Journal: Endocrine (Endocrine) Vol. 78 Issue 3 Pg. 507-516 (Dec 2022) ISSN: 1559-0100 [Electronic] United States
• PMID: 36152114 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Chemical References

• BRAF protein, human
• Proto-Oncogene Proteins B-raf

Topics

• Humans
• Adenocarcinoma, Follicular (pathology)
• China
• Mutation
• Proto-Oncogene Proteins B-raf (genetics)
• Retrospective Studies
• Thyroid Neoplasms (diagnostic imaging, genetics)
• Thyroid Nodule (diagnostic imaging, genetics, pathology)