甲状腺乳头状癌中慢性淋巴细胞性甲状腺炎与BRAF突变的关系

Chronic lymphocytic thyroiditis and BRAF V600E in papillary thyroid carcinoma

目的根据甲状腺乳头状癌(PTC)的BRAF突变状态研究慢性淋巴细胞性甲状腺炎(CLT)的临床意义。方法对400例行双侧甲状腺全切手术的甲状腺乳头状癌标本采用免疫组化法检测BRAF突变。结果 BRAF突变率在伴发CLT的PTC(75.9%)中明显低于不伴发CLT的PTC(83.1%)。无论是BRAF(-)还是BRAF(+)的PTC,CLT是PTC癌甲状腺外浸润(ETE)低发病率的预示因素,也是中央淋巴结转移的预示因素。结论 BRAF突变率在伴发CLT的PTC中明显低于不伴发CLT的PTC,而且无论BRAF阴性还是阳性,CLT都是PTC低侵袭性的预示因素。

Objective To determine the clinical significance of chronic lymphocytic thyroiditis（ CLT） according to BRAF mutation status in papillary thyroid carcinoma（ PTC） patients. Methods 400 cases of specimen of PTC patients who underwent total thyroidectomy with bilateral central neck dissection were studied by useing of En Vision immunohistochemistry for BRAF mutation. Results The prevalence of BRAF mutation was significantly less frequent in conventional PTC patients with CLT（ 75. 9% vs. 83. 1%）. CLT was an predictor for low prevalence of ETE in both BRAFnegative and BRAF-positive conventional PTC patients. In addition,CLT was an independent predictor for low prevalence of CLNM in both BRAF-negative and BRAF-positive PTC patients. Conclusion BRAF mutation is significantly less frequent in PTC patients with CLT. However,CLT is a predictor for less aggressiveness in conventional PTC patients regardless of BRAF mutation status.