Value of BrafV600E gene detection with SWE in differentiating benign and malignant thyroid nodules and predicting the invasiveness of malignant nodules

YANG Tonghui; WU Chuanmei; HU Bin; LIU Qiping

doi:10.20258/j.cnki.1006-9011.2025.11.008

Abstract：Objective To explore the value of BrafV600E gene detection combined with shear wave elastography(SWE)in dif-ferentiating benign and malignant thyroid nodules and predicting the invasiveness of malignant nodules.Methods A total of 120 patients with thyroid nodules who underwent thyroidectomy were selected.Braf V600E gene detection combined with SWE ex-amination was performed before the operation.According to the postoperative pathological examination results,among the 120 pa-tients,64 cases were malignant nodules and 56 cases were benign nodules.According to the metastasis of cervical lymph nodes,patients with malignant nodules were divided into the metastasis group(n=35)and the non-metastasis group(n=29).Logistic re-gression was used to analyze the relationship between the BrafV600E gene and SWE parameters and cervical lymph node metastasis of malignant thyroid nodules.Then,we calculated the area under the receiver operating characteristic curve(AUC),sensitivity and specificity,and evaluated the discriminatory value of BrafV600E gene combined with SWE for benign and malignant thyroid nodules and the predictive value for cervical lymph node metastasis of malignant nodules.Results The positive rate of Braf V600E gene mutation in the malignant group was 68.75%,significantly higher than 1.79%in the benign group,and the difference was statistically significant(P<0.05).The maximum Young's modulus(Emax)and average value(Emean)of nodules in the region of interest in the malignant group,as well as the elastic ratio(Eratio)of thyroid nodules to surrounding normal thyroid tissue were sig-nificantly higher than those in the benign group,and the differences were statistically significant(P<0.05).The sensitivity and AUC of BrafV600E gene combined with SWE in diagnosing malignant thyroid nodules were significantly higher than those of indi-vidual indicators(P<0.05).The positive rate of BrafV600E gene mutation and the Young's modulus Emax,minimum value(Emin),Emean and Eratio values of nodules in the region of interest in the metastasis group were significantly higher than those in the non-metastasis group,and the difference was statistically significant(P<0.05).BrafV600E gene,Emax and Eratio were independent risk factors for cervical lymph node metastasis of malignant thyroid nodules(P<0.05).The sensitivity and AUC of BrafV600E gene com-bined with SWE in diagnosing cervical lymph node metastasis of malignant thyroid nodules were significantly higher than those of individual indicators(P<0.05).Conclusion The BrafV600E gene detection combined with SWE has a relatively high value in differentiating benign and malignant thyroid nodules,and has a certain predictive value for the invasiveness of malignant nod-ules,which can provide a reference basis for clinical diagnosis and treatment.