Multivariate logistic regression analysis showed focal strong echogenicity (microcalcifications, OR = 3.04, 95% CI = 1.41–6.58, p = 0.005), hypoechogenicity (OR = 3.8, 95% CI = 1.14–12.61, p = 0.029), lymph node metastasis (OR = 3.54, 95% CI = 1.43–8.75, p = 0.006), margin (lobulated, OR = 3.7, 95% CI = 1.66–8.23, p = 0.001; extrathyroidal invasion, OR = 2.81, 95% CI = 1.11–7.06, p = 0.029), and shape (vertical position, OR = 2.7, 95% CI = 1.11–6.59, p = 0.029) were independent risk factors for BRAF mutations (Table 1). The gene discussed is BRAF; the disease is metastatic malignant neoplasm in the lymph nodes.