食管癌组织、近癌组织和远癌组织中BRAF基因突变与BRAF蛋白质表达情况及其对早期诊断食管癌的价值

BRAF gene mutation and BRAF protein expression in esophageal cancer tissue,near cancer tissue and distant cancer tissue and value in early diagnosis of esophageal cancer

目的分析食管癌组织、近癌组织和远癌组织中鼠类肉瘤滤过性毒菌致癌同源体B1(BRAF)基因突变与BRAF蛋白质表达情况及其对早期诊断食管癌的价值。方法将2014年1月至2017年12月收治90例经手术治疗的食管癌患者作为研究对象进行回顾性分析,并检测其癌组织、近癌组织和远癌组织中BRAF基因突变与BRAF蛋白质表达情况。结果 90例癌组织中,8例患者Ⅲb期标本第11外显子增多一个碱基T或C,均未检测到BRAF基因第11、15外显子发生突变,BRAF蛋白质表达阳性率为61.11%(55/90)。90例近癌组织中BRAF蛋白质表达阳性率为14.45%(13/90)。90例远癌组织中BRAF蛋白质表达阳性率为6.67%(6/90),三组间互相比较提示差异具有统计学意义(P<0.05)。TNM Ⅲ期食管癌患者BRAF蛋白质表达阳性率显著高于Ⅱ期和Ⅰ期(P<0.05),Ⅱ期显著高于Ⅰ期(P<0.05)。有淋巴转移食管癌患者BRAF蛋白质表达阳性率显著高于无淋巴转移食管癌患者(P<0.05)。结论虽然食管癌患者癌组织BRAF基因第11外显子增多一个碱基T或C,但是尚未发现突变。食管癌患者BRAF蛋白质高表达阳性率与有无淋巴结转移及TNM分期密切相关,临床上可将BRAF蛋白质表达水平作为评估食管癌预后或恶性程度的一个重要指标。

Objective To analyze the mutation of BRAF gene and the expression of BRAF protein in the tissues of esophageal cancer,near and far cancer and value of the early diagnosis of esophageal cancer. Methods From January 2014 to December 2017,90 cases of esophageal cancer treated by operation were selected as the study subjects. The mutation of BRAF gene and the expression of BRAF protein in the cancer tissue,near and far cancer tissues were detected. Results In 90 cases,the eleventh exon T or C were increased in 8 cases of stage Ⅲ B,and no mutations in exon eleventh,fifteenth of BRAF gene were detected,and the positive rate of BRAF protein expression was 61. 11%（ 55/90）. The positive rate of BRAF protein expression in 90 cases of near cancer tissues was 14. 45%（ 13/90）. The positive rate of BRAF protein expression in 90 distant cancer tissues was 6. 67 %（ 6/90）. The difference between the three groups suggested that the difference was statistically significant（ P〈0. 05）. The positive rate of BRAF protein expression in patients with stage TNM esophageal cancer was significantly higher than that in stage Ⅱ and stage Ⅰ（ P〈0. 05）,and that in phase Ⅱ was significantly higher than that in stage Ⅰ（ P〈0. 05）. The positive rate of BRAF protein expression in esophageal cancer patients with lymph node metastasis was significantly higher than that in patients without lymph node metastasis（ P〈0. 05）. Conclusion Although the exon eleventh of BRAF gene in esophageal cancer patients is increased by one base T or C,no mutation has been found. The positive rate of BRAF protein expression is closely related to lymph node metastasis and TNM staging. The expression level of BRAF protein can be used as an important index to evaluate the prognosis and malignancy of esophageal cancer.