超声引导细针穿刺标本BRAF V600E及CyclinD1联合检测对于甲状腺癌患者颈部淋巴结转移的预测价值

Predictive value of combined detection of BRAF V600E and CyclinD1 by ultrasound-guided fine needle aspiration for cervical lymph node metastasis in patients with thyroid carcinoma

目的探讨利用超声引导细针抽吸标本进行BRAF V600E与CyclinD1联合检测对于甲状腺癌患者颈部淋巴结转移的预测价值。方法我院2015-08~2016-12收治的经超声引导细针抽吸细胞学检查确诊的甲状腺癌患者56例,所获得标本检测BRAF V600E和CyclinD1。对BRAF V600E和CyclinD1检测结果与随访结果进行回顾性分析。结果本组病例穿刺取材成功率为100%。56例患者中,39例检出BRAF V600E突变,突变检出率为69.6%;40例CyclinD1阳性表达,阳性表达率为71.4%。在30例既检测出BRAF V600E突变又发生CyclinD1阳性表达的病例中,手术病理发现颈部淋巴结转移18例,发生率为60%。其余26例病例中,手术病理发现颈部淋巴结转移5例,发生率为19.2%(5/26),既检测出BRAF V600E突变又发生CyclinD1阳性表达的病例颈部淋巴结转移发生率明显高于其余病例。结论利用超声引导细针抽吸标本进行BRAF V600E与CyclinD1联合检测对于甲状腺癌患者颈部淋巴结转移有一定的预测价值。

Objective To investigate the predictive value of combined detection of BRAF V600E and CyclinD1 in specimens by ultra- sound-guided fine-needle aspiration from metastatic cervical lymph nodes in patients with thyroid carcinoma. Methods Fifty-six patients with thyroid carcinoma diagnosed by ultrasound-guided fine-needle aspiration cytology admitted to our hospital from August 2015 to De- cember 2016 were enrolled in this study. The obtained samples were used for combined detection of BRAF V600E and CyclinD1. The re- suits and the follow-up data were retrospectively analyzed and compared. Results The success rate of puncture was 100% （56/56）. A- mong 56 cases,39 cases had BRAF V6OOE mutation,and the mutation detection rate was 69. 6%. CyclinD1 positive expression was detec- ted in 40 cases ,and the positive expression rate was 71.4% （40/56）. Among 30 cases of both the detection of BRAF V600E mutation and CyclinD1 positive expression, 18 cases（60. 0% ） of cervical lymph node metastasis were found according to surgical pathology. Among the other 26 cases,cervical lymph node metastasis was found in 5 cases, and the incidence was 19. 2% （5/26）. The incidence of cervical lymph node metastasis with both BRAF V6OOE mutation and CyclinD1 positive expression was significantly higher than that of the other patients. Conclusion The combined detection of BRAF V600E and CyclinD1 in specimen by ultrasound-guided fine-needle aspiration in patients with thyroid carcinoma can be useful in predicting the cervical lymph node metastasis.