陆军军医大学学报2026，Vol.48Issue(4)：453-460,8.DOI:10.16016/j.2097-0927.202510066
超声特征联合BRAFV600E基因对Bethesda Ⅲ类甲状腺结节良恶性的诊断效能
Diagnostic performance of combining sonographic features with BRAFV600E mutation for differentiating benign and malignant Bethesda category Ⅲ thyroid nodules
摘要
Abstract
Objective To evaluate the diagnostic performance of combining sonographic features with BRAFV600E mutation for differentiating benign and malignant Bethesda category Ⅲ thyroid nodules.Methods This retrospective cohort study included 275 patients(278 nodules)diagnosed as Bethesda category Ⅲ by ultrasound-guided fine needle aspiration cytology(US-FNAC)at First Affiliated Hospital of Army Medical University between January 2020 and December 2024,with final confirmation via surgical pathology or repeated US-FNAC.Nodules were classified as benign or malignant based on pathological results.Diagnostic efficacy of age,sex,9 sonographic features,ACR TI-RADS score,US-FNAC nuclear morphology,and BRAFV600E mutation was analyzed using multivariate logistic regression.Results Significant differences existed in age,nodule margin,aspect ratio,maximum diameter,echogenicity,Adler blood flow grading,ACR TI-RADS classification,US-FNAC nuclear morphology,and BRAFV600E status between benign and malignant nodules(all P＜0.05).Independent risk factors for malignancy included age≤52 years(OR=7.444),BRAFV600E mutation(OR=108.218),ground-glass nuclei(OR=5.389),and abnormal cervical lymph nodes(OR=13.351,P＜0.05).The combined model demonstrated accuracy was 0.823,sensitivity was 0.863,specificity was 0.925,positive predictive value was 0.977,negative predictive value was 0.649,and AUC was 0.955.Conclusion Integration of sonographic features and BRAFV600E mutation provides high diagnostic performance for Bethesda category Ⅲ thyroid nodules.关键词
甲状腺结节/超声检查/意义不明确的非典型/BRAFKey words
thyroid nodule/ultrasonography/atypia of undetermined significance/BRAF分类
医药卫生引用本文复制引用
吴爽,李欣,唐春霖,陈萍,张君,黄海韵,郭燕丽..超声特征联合BRAFV600E基因对Bethesda Ⅲ类甲状腺结节良恶性的诊断效能[J].陆军军医大学学报,2026,48(4):453-460,8.基金项目
重庆市技术创新与应用发展专项重点项目(CSTB2022TIAD-KPX0153) Supported by the Chongqing Key Project of Technological Innovation and Application Development Special Program(CSTB2022TIAD-KPX0153). （CSTB2022TIAD-KPX0153）
