| 高 萍,王萍萍,张立平,等.BRAF（VE1）免疫组化联合细针穿刺细胞学在桥本甲状腺炎合并甲状腺结节诊断价值分析[J].肿瘤学杂志,2025,31(7):621-626. |
| BRAF（VE1）免疫组化联合细针穿刺细胞学在桥本甲状腺炎合并甲状腺结节诊断价值分析 |
| Fine Needle Aspiration Cytology Combined with BRAF(VE1) Immunohistochemistry in the Diagnosis of Hashimoto’s Thyroiditis with Thyroid Nodules |
| 投稿时间：2025-04-13 |
| DOI：10.11735/j.issn.1671-170X.2025.07.B008 |
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| 中文关键词: 甲状腺结节 桥本甲状腺炎 ：细针穿刺细胞学 BRAF（VE1） 诊断 |
| 英文关键词:thyroid nodules Hashimoto’s thyroiditis fine needle aspiration cytology BRAF(VE1) diagnosis |
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| 中文摘要: |
| 摘 要：［目的］ 探讨BRAF（VE1）免疫组化联合细针穿刺细胞学（fine needle aspiration cytology，FNAC）检查在桥本甲状腺炎合并甲状腺结节诊断中的价值。［方法］ 选取2021年1月至2023年12月于日照市中心医院行FNAC检查并手术切除的伴桥本甲状腺炎的甲状腺结节患者226例，按照Bethesda报告系统进行分类，利用剩余液基保存液制作细胞块，进行BRAF（VE1）免疫组化染色。依据组织病理结果，将选取病例分为甲状腺乳头状癌组和桥本甲状腺炎合并甲状腺结节组，观察两组中BRAF（VE1）免疫组化染色的表达情况，并分析BRAF（VE1）免疫组化联合FNAC在桥本甲状腺炎合并甲状腺结节诊断中的应用价值。［结果］ 术后病理证实164例为甲状腺乳头状癌，62例为桥本甲状腺炎合并甲状腺结节。穿刺细胞学Bethesda报告系统分类：Ⅱ类23例（10.2％），Ⅲ类67例（29.6％），Ⅳ类2例（0.9％），Ⅴ类48例（21.2％），Ⅵ类86例（38.1％）。164例甲状腺乳头状癌结节组穿刺液基细胞块中，BRAF（VE1）免疫组化染色阳性113例（68.9%），阴性51例（31.1%）。62例桥本甲状腺炎合并甲状腺结节组穿刺液基细胞块中，BRAF（VE1）免疫组化染色阳性0例，阴性62例（100%）。FNAC组、BRAF（VE1）免疫组化组和联合检测组的灵敏度分别为78.0%、68.9%、90.9%；特异度分别为90.3%、100%、90.3%；准确率分别为81.4%、77.4%、90.7%。联合检测组的灵敏度和准确率均高于单独检测组，差异均具有统计学意义（P均<0.05）。 ［结论］ 细胞块BRAF（VE1）免疫组化联合FNAC检查在桥本甲状腺炎合并甲状腺结节诊断中能提高细胞学诊断的灵敏度和准确率。 |
| 英文摘要: |
| Abstract：［Objective］ To investigate the value of fine needle aspiration cytology (FNAC) combined with BRAF(VE1) immunohistochemistry in the diagnosis of Hashimoto’s thyroiditis with thyroid nodules. ［Methods］ A total of 226 cases of thyroid nodules with Hashimoto’s thyroiditis undergoing FNAC examination and surgical resection at Rizhao Central Hospital from January 2021 to December 2023 were selected and classified according to the Bethesda reporting system. Cell blocks were prepared using residual liquid based preservation solution and subjected to BRAF(VE1) immunohistochemical staining. Based on the histopathological results， the cases were divided into papillary thyroid carcinoma group and Hashimoto’s thyroiditis with thyroid nodules group. The diagnostic value of FNAC alone and FNAC with BRAF (VE1) immunohistochemistry for Hashimoto’s thyroiditis with thyroid nodules was assessed. ［Results］ According to postoperative pathology results， there were 164 cases of papillary thyroid carcinoma and 62 cases of Hashimoto’s thyroiditis with thyroid nodules. And based on classification of Bethesda reporting system， there were 23 cases (10.2%) of Bethesda class Ⅱ， 67 cases (29.6%) of class Ⅲ， 2 cases (0.9%) of Class Ⅳ， 48 cases (21.2%) of Class Ⅴ， and 86 cases (38.1%) of Class Ⅵ. In 164 papillary thyroid carcinoma nodules， 113 cases (68.9%) were positive for BRAF (VE1) immunohistochemi-cal staining， while 51 cases (31.1%) were negative. In 62 Hashimoto’s thyroiditis with thyroid nodules， there were 62 cases (100.0%) of negative BRAF (VE1) and no positive case. The sensitivity of FNAC， BRAF (VE1) immunohistochemistry and combination of two method were 78.0%， 68.9% and 90.9%； the specificity were 90.3%， 100.0% and 90.3%; the accuracy rates were 81.4%， 77.4% and 90.7%， respectively. The sensitivity and accuracy of the combined detection were higher than those of FNAC and BRAF(VE1) alone(P all <0.05). ［Conclusion］ FNAC combined with BRAF(VE1) immunohistochemistry can significantly improve the sensitivity and accuracy in diagnostic of Hashimoto’s thyroiditis with thyroid nodules. |
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