甲状腺乳头状癌中BRAF基因突变与相关蛋白表达的相关性

Relationship between BRAF gene mutation and related proteins expression in papillary thyroid carcinoma

目的研究甲状腺乳头状癌(PTC)中BRAF基因突变和D2-40、CK19、cyclinD 1蛋白表达的临床意义。方法应用扩增阻碍突变系统(ARMS法)检测63例PTC和34例甲状腺乳头状增生组织中BRAF基因突变情况;应用免疫组化SP法检测上述组织中D2-40,CK19,cyclinD 1蛋白表达水平,分析其相关性。结果BRAF基因突变率和D2-40、CK19和cyclinD 1蛋白阳性率在甲状腺乳头状癌组中显著高于乳头状增生组(P<0.05);在甲状腺乳头状癌组中,BRAF基因突变率和D2-40、cyclinD 1蛋白阳性率在淋巴结转移组高于无淋巴结转移组(P<0.05);CK19蛋白阳性率在甲状腺乳头状癌中有、无淋巴结转移组之间差异不显著(P>0.05)。结论BRAF基因突变和D2-40、CK19,cyclinD 1蛋白表达的联合检测有助于甲状腺乳头状癌与甲状腺乳头状增生的诊断与鉴别诊断,同时可作为预测甲状腺乳头状癌预后的重要指标。

Purpose To study the clinical significance of BRAF gene mutation and D2-40, CK19 and cyclinD1 protein expression in papillary thyroid carcinoma. Method BRAF gene mutation was detected in 63 specimens of papillary thyroid carcinoma and 34 samples of thyroid papillary hyperplasia tissues by amplification refractory mutation system. The protein expression level of D2-40, CK19 and cyclinD1 was determined in the tissues by immunohistochemical staining. Their correlation was analyzed. Result BRAF gene mutation rate and D2-40, CK19 and cyclinD1 protein positive expression rate in papillary thyroid carcinoma were significantly higher than thyroid papillary hyperplasia tissues （ P 〈0.05）. In the tissues of papillary thyroid carcinoma, BRAF gene mutation rate and D2-40 and cyclinD1 protein positive expression rate with lymph node metastasis were significantly higher than those without lymph node metastasis （P 〈 0. 05）. And there was no significant difference of CK19 protein expression between the lymph node metastasis group and non- metastasized group in papillary thyroid carcinoma （ P 〉 0.05 ）. Conclusion The joint detection of BRAF gene mutation and D2-40, CK19 and CyclinD1 protein expression contributes to the diagnosis and the differentiation of papillary thyroid carcinoma and thyroid papillary hyperplasia. It may also function as an important indicator for prognosis prediction of papillary thyroid carcinoma.