Application value of ultrasound-guided repeated fine needle aspiration biopsy in Bethesda category Ⅲ thyroid nodules

TAN Bixing; LI Li; CHEN Xiao; LI Peipei; ZANG Jiawei

Abstract：Objective To evaluate the diagnostic value of repeated ultrasound-guided fine needle aspiration biopsy(US-FNAB)combined detection of BRAFV600E gene mutation in Bethesda category Ⅲ thyroid nodules,and to analyze the effect of re-peated US-FNAB interval on diagnostic efficiency.Methods A total of 108 patients with Bethesda category Ⅲ thyroid nodules underwent repeated US-FNAB at the Department of Hospital.With postoperative pathology as the gold standard,the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of repeated US-FNAB combined with BRAFV600E gene mutation detection in Bethesda category Ⅲ thyroid nodules were compared and analyzed retrospectively;and according to the interval of repeated US-FNAB,the patients were divided into 3 groups:group A(3-6 months),group B(6-12 months)and group C(>12 months),and the diagnostic accuracy and malignant rate of each group were compared.Results The diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of repeated US-FNAB combined with BRAFV600E gene mutation detection in Bethesda category Ⅲ thyroid nodules were 95.4％,93.1％,96.2％,90.0％and 97.4％,the accuracy(95.4％vs 88.0％)and sensitivity(93.1％vs 69.0％)of repeated US-FNAB combined with BRAFV600E gene mutation de-tection were significantly higher than those of repeated US-FNAB alone,the difference was statistically significant(P<0.05).The difference was statistically significant(P<0.05).The diagnostic accuracy rates of group A,B and C were 74.4％,72.2％and 75.8％,respectively,and the diagnostic malignant rates were 23.1％,22.2％and 21.2％,respectively,there was no significant difference among the groups(P>0.05).Conclusion Thyroid nodules whose first US-FNAB cytopathological findings are Bethesda category Ⅲ should be diagnosed by repeated US-FNAB as early as 3 months later,at the same time,combined with the detection of BRAFV600E gene mutation will further improve the diagnostic efficiency and be beneficial to the reasonable man-agement of such nodules in clinic.