甲状腺乳头状癌不同临床特征和BRAFV600E突变率的对比研究
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R736.1,{R730.22}

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河北省2022年度中医药科研计划项目指令性课题 (2022218)


Comparative study on different clinical features and BRAFV600E mutation rate of papillary thyroid carcinoma
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    摘要:

    目的探讨BRAFV600E 突变率与甲状腺乳头状癌 (Papillary Thyroid Carcinoma,PTC) 不同临床特征的相关性。方法选取保定市第一中心医院 2016 年 12 月至 2019 年 12 月诊断为 PTC 的病例共 164 例,收集相关临床病理资料,检测患者 BRAFV600E 基因突变情况,分析BRAFV600E 突变率与不同临床病理特征的相关性,以期探究BRAFV600E 突变对PTC患者临床病理特征及预后的影响。结果 52 (31.7%) 例患者为甲状腺乳头状癌合并桥本氏甲状腺炎,132 (80.5%) 例患者发生颈淋巴结转移,48 (29.3%) 例患者年龄≥55 岁,108 (65.9%) 例患者检测到 BRAFV600E 基因突变。桥本氏甲状腺炎与 PTC 患者的年龄、病灶位置、肿瘤最大径及结节钙化相关,有统计学意义 (P<0.05)。颈部淋巴结转移与PTC患者的年龄、BRAFV600E 基因突变相关,有统计学意义 (P<0.05)。年龄 (<55岁,≥55岁) 与 PTC患者的病变类型、肿瘤最大径、淋巴结转移及是否合并桥本氏甲状腺炎有一定关系 (P<0.05)。结论 BRAFV600E 是 PTC患者癌变过程中重要的驱动基因,在 PTC患者中具有一定比例的突变率。无论有无BRAFV600E 突变,桥本甲状腺炎合并甲状腺乳头状癌患者预后较好。当PTC出现BRAFV600E 突变时, 颈部淋巴结转移更易出现,在淋巴结清扫术的临床决策时应更加慎重。BRAFV600E 基因结合55岁年龄分层对PTC预后影响不大。

    Abstract:

    Objective To investigate the correlation between BRAFV600E and different clinical features of Pap‐ illary Thyroid Carcinoma (PTC). Methods The clinical and pathological data of 164 patients diagnosed with PTC between December 2016 to December 2019 in Baoding First Central Hospital were selected, detecting the BRAFV600E gene mutation in patients and analyzing the correlation between BRAFV600E mutation rate and different clinicopathological characteristics in order to investigate the effect of BRAFV600E mutation on clinicopathological characteristics and prognosis of PTC patients. Results A total of 164 PTC patients were included, 52 (31.7%) pa‐ tients had papillary thyroid carcinoma combined with Hashimoto's thyroiditis, 132 (80.5%) patients developed cer‐ vical lymph node metastasis, 48 (29.3%) patients were≥55 years old, and 108 (65.9%) patients were detected BRAFV600E mutation. Hashimoto's thyroiditis was associated with the age, lesion location, maximum tumor diame‐ ter and nodular calcification in PTC patients (P<0.05) Lymph node metastasis was associated with the age and BRAFV600E gene mutation of PTC patients (P<0.05). Age (<55 years old, ≥55 years old) was associated with lesion type, maximum tumor diameter, lymph node metastasis and presence of Hashimoto's thyroiditis in PTC patients (P <0.05). Conclusion BRAFV600E is an important driver gene during carcinogenesis of PTC patients and has a certain proportion of mutation rate in PTC patients. The prognosis of Hashimoto's thyroiditis combined with PTC is better regardless of the presence or absence of BRAFV600E mutation premise. When the BRAFV600E mutation is present in PTC lymph node metastasis is more likely to occur and clinical decision-making is more cautious in lymphadenec‐ tomy. The BRAFV600E gene in combination with the cut-off of 55 years old doesn't give significance for PTC diag‐ nosis and prognosis.

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  • 在线发布日期: 2022-01-14
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