@article{WU2026, 
author = {Shuang WU and Xin LI and Chunlin TANG and Ping CHEN and Jun ZHANG and Haiyun HUANG and Yanli GUO},
title = {Diagnostic performance of combining sonographic features with BRAFV600E mutation for differentiating benign and malignant Bethesda category Ⅲ thyroid nodules},
year = {2026},
journal = {Journal of Army Medical University},
volume = {48},
number = {4},
pages = {453-460},
keywords = {thyroid nodule, ultrasonography, atypia of undetermined significance, BRAF},
url = {https://www.sciopen.com/article/10.16016/j.2097-0927.202510066},
doi = {10.16016/j.2097-0927.202510066},
abstract = {ObjectiveTo evaluate the diagnostic performance of combining sonographic features with BRAFV600E mutation for differentiating benign and malignant Bethesda category Ⅲ thyroid nodules.MethodsThis retrospective cohort study included 275 patients (278 nodules) diagnosed as Bethesda category Ⅲ by ultrasound-guided fine needle aspiration cytology (US-FNAC) at First Affiliated Hospital of Army Medical University between January 2020 and December 2024, with final confirmation via surgical pathology or repeated US-FNAC. Nodules were classified as benign or malignant based on pathological results. Diagnostic efficacy of age, sex, 9 sonographic features, ACR TI -RADS score, US-FNAC nuclear morphology, and BRAFV600E mutation was analyzed using multivariate logistic regression.ResultsSignificant differences existed in age, nodule margin, aspect ratio, maximum diameter, echogenicity, Adler blood flow grading, ACR TI-RADS classification, US-FNAC nuclear morphology, and BRAFV600E status between benign and malignant nodules (all P<0.05). Independent risk factors for malignancy included age≤52 years (OR=7.444), BRAFV600E mutation (OR =108.218), ground-glass nuclei (OR =5.389), and abnormal cervical lymph nodes (OR=13.351, P<0.05). The combined model demonstrated accuracy was 0.823, sensitivity was 0.863, specificity was 0.925, positive predictive value was 0.977, negative predictive value was 0.649, and AUC was 0.955.ConclusionIntegration of sonographic features and BRAFV600E mutation provides high diagnostic performance for Bethesda category Ⅲ thyroid nodules.}
}