PURPOSE: It is unclear whether if BRAFV600E mutation analysis should routinely accompany ultrasound-guided fine-needle aspiration in the diagnosis of malignancy in patients with thyroid nodules considering its cost-effectiveness. The aim of this study was to evaluate the proper indication of adjunctive BRAFV600E mutation analysis at the time of ultrasound-guided fine-needle aspiration in the diagnosis of thyroid nodules.
MATERIALS AND METHODS: This study included 518 nodules in 479 patients who underwent ultrasound-guided fine-needle aspiration with BRAFV600E mutation analysis using dual priming oligonucleotide-based multiplex polymerase chain reaction. We calculated and compared the diagnostic performances of cytology and cytology with BRAFV600E mutation analysis to detect malignancy among thyroid nodules according to ultrasound features and size.
RESULTS: Sensitivity, negative predictive value, and accuracy of cytology with BRAFV600E mutation analysis were significantly higher than those of cytology alone in thyroid nodules with suspicious ultrasound features in nodules regardless of size. Diagnostic performances did not show significant differences between cytology and cytology with BRAFV600E mutation analysis in nodules without any suspicious ultrasound features, regardless of size. CONCLUSION: The BRAFV600E mutation analysis was a useful adjunctive diagnostic tool in the diagnosis of thyroid nodules with suspicious ultrasound features regardless of size.
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