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Abstract:

Objective To investigate the values of ultrasound（US），fine ⁃ needle aspiration cytology （FNAC）and BRAFV600E mutation detection alone or combined in the diagnosis of thyroid nodules. Methods A total of 512 cases of thyroid nodules in the first affiliated hospital of Nanjing Medical University from January 2015 to December 2018 were reviewed and all the cases were received US，FNAC and BRAFV600E mutation detection and pathological diagnosis after surgery. The receiver operating characteristic curve（ROC）was draw with pathological diagnosis after surgery being the gold standard. The sensitivity，specificity，positive predictive values，negative predictive values，the optimum cutoff values and the area under curve（AUC）of each diagnostic method were calculated and compared. The diagnostic values of each method alone or combined were analyzed. Results Among the 512 cases of thyroid nodules，61 were confirmed benign nodules after surgery and 451 malignant. The sensitivity and specificity of US were 83.59% and 80.33%. The corresponding data for FNAC were 91.13% and 98.36%. The corresponding data for BRAFV600E were 95.79% and 96.72% . The corresponding data for FNAC combined with BRAFV600E were 98.45% and 96.72%. FNAC combined with BRAFV600E had a statistically different diagnostic efficiency from that of both US（χ2 = 21.081，P＜0.001）and FNAC（χ2 = 8.311，P = 0.004）alone. Conclusion FNAC com⁃ bined with BRAFV600E mutation detection can improve the diagnosis of thyroid nodules before surgery.

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