青岛地区BRAF^(V600E)基因突变型甲状腺乳头状癌的临床病理特点

CLINICOPATHOLOGICAL FEATURES OF PAPILLARY TYROID CARCINOMA WITH BRAF^(V600E) MUTATION IN QINGDAO,CHINA

目的探讨青岛地区BRAF^(V600E)突变型甲状腺乳头状癌(PTC)的侵袭性及碘相关激素特点。方法采用突变扩增阻滞系统(ARMS)对连续收治的175例青岛地区的PTC病人的BRAF基因的第600位密码子(BRAF^(V600E))突变情况进行检测,观察BRAF^(V600E)基因突变型与野生型PTC病人在肿瘤侵袭性和术前甲状腺相关激素上的差异。结果 BRAF^(V600E)突变型PTC病人129例,BRAF^(V600E)野生型PTC病人46例,BRAF^(V600E)基因突变型与野生型PTC病人在侵犯包膜及周围组织、淋巴结转移、癌肿长径≤1cm所占比例间的差异均无统计学意义(χ~2=0.051～0.521,P>0.05),在肿瘤多灶性间的差异具有统计学意义(χ~2=4.075,P<0.05);在碘代谢相关激素血清游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)表达间的差异无统计学意义(t=0.046～0.618,P>0.05)。结论青岛地区BRAF^(V600E)突变型PTC病人较野生型PTC病人肿瘤多灶性的比例更大,可为BRAF^(V600E)突变型PTC病人诊疗提供参考。

Objective To investigate the invasiveness and iodine-related hormone characteristics of papillary thyroid carcinoma （PTC） with BRAF^V600E （the V600E codon of the BRAF gene） mutation in Qingdao, China. Methods The amplification refractory mutation system was used to detect the mutation of BRAF^V600E which encodes BRAF protein in 175 consecutive patients with PTC in Qingdao, China. The tumor invasiveness and preoperative levels of thyroid-related hormones were compared between the PTC patients with BRAF^V600E mutation and those with wild-type （WT） BRAF^V600E . Results There were 129 patients with BRAF^V600E mutation and 46 patients with WT BRAF^V600E . There were no significant differences in the proportions of patients with invasion of the capsule and surrounding tissues, lymph node metastasis, and tumor diameter ≤1 cm between the PTC patients with BRAF^V600E mutation and those with WT BRAF^V600E （ χ ^2=0.051-0.521, P 〉0.05）, while there was a significant difference in the rate of tumor multifocality between them （ χ^2=4.075, P 〈0.05）. There were no significant differences in the serum levels of free triiodothyronine, free thyroxine, and thyroid-stimulating hormone between them （ t =0.046-0.618, P 〉 0.05 ）. Conclusion The PTC patients with BRAF^V600E mutation have a significantly higher rate of tumor multifocality than those with WT BRAF^V600E in Qingdao, China, which can provide a reference for the diagnosis and treatment of PTC patients with BRAF^V600E mutation.