甲状腺乳头状癌BRAF^(V600E)突变表达及其与临床病理特征的相关性研究

Detection of the BRAF^(V600E) mutation and clinicalpathological characteristics in Papillary thyroid carcinoma

目的:检测BRAFV600E突变在甲状腺乳头状癌(PTC)中的表达,分析BRAFV600E突变与PTC临床病理特征的关系,为临床预测局部转移及治疗提供有效的途径。方法:选取2003年1月~2005年8月于中山大学附属第一医院行手术切除的PTC石蜡包埋切片140例,提取石蜡切片的DNA采用Taqman荧光定量PCR检测方法检测BRAFV600E突变表达,与文献已知的PTC细胞WRO和KAT-5细胞中提取的DNA作为对照。对其中120例进行96.3~120.1个月随访。结果:140例PTC中,BRAFV600E突变率为53.6%。BRAFV600E突变与患者的性别、年龄、肿瘤大小和腺外浸润无相关,与甲状腺癌的淋巴结转移和临床分期显著相关,差异有统计学意义(P<0.01)。在120例随访病例中,发现BRAFV600E阳性的病例有较高的复发、死亡率。结论:BRAFV600E突变率与PTC的淋巴结转移和临床分期具有一定的相关性;BRAFV600E突变在临床上可以成为预测局部转移及治疗的新途径。

Objective To detect BRAF^V600E mutation in papillary thyroid carcinoma（ PTC ）. To analysis the relationship between BRAF^V600E and clinicopathologic parameters in PTC. Method In the First Affiliated Hospital,Sun Yat -sen university, for operation resection of PTC in paraffin embedded sectionsof 140 cases. The DNA extracted from paraffin sections using the Taqman method for the detection of fluorescence quantitative PCRdetection of BRAF^V600E expression of mutant, and extraction of PTC cells WRO and KAT -5 cells in the DNAdocument known as the control. 120 eases of them were performed 96.3 ~ 120. 1 months follow - up. Results In 140 cases of PTC ,BRAF^V600E mutation rate was 53.6%. BRAF^V600E mutation and the patient＇s gender, age, tumor size and infiltrating no relevant outside gland, thyroid carcinoma with lymph node metastasis and significantly associated with clinical stage （P 〈0. 01 ）. Found in 120 cases were followed up for BRAF^V600E positive cases had a higher recurrence and mortality. Conclusion The mutation rate of BRAF^V600E with lymph node metastasis and clinical staging and papil- lary thyroid carcinoma constitutes a certain correlation. BRAF^V600E mutation can provide new way to predict local metastatic therapy in clinic.