甲状腺乳头状癌中BRAFV600E突变蛋白表达的意义

Clinical Significance of BRAFV600E Mutation in Papillary Thyroid Carcinoma

目的探讨甲状腺乳头状癌中BRAF^V600E突变蛋白的表达情况,分析其与临床病理特征的关系。方法应用免疫组织化学检测244例手术切除甲状腺乳头状癌组织和癌旁组织的BRAF^V600E突变蛋白表达情况,结合临床病理学资料,分析BRAF^V600E突变与临床病理参数之间的关系。结果BRAF^V600E突变蛋白仅在甲状腺乳头状癌组织中表达,表达率为86.48%,癌旁非肿瘤组织不表达;经典型乳头状癌的突变阳性率为88.89%,高于滤泡型的78.18%(X^2=4.176,P=0.041);有淋巴结转移患者(85%)的突变率高于无转移患者(68.42%)(X^2=4.526,P=0.033);有被膜侵犯患者(94.64%)的突变率高于无被膜侵犯者(84.04%)(X^2=4.145,P=0.042);差异均有统计学意义。而与不同肿瘤直径、年龄、性别和病灶数量之间的差异均无统计学意义(P>0.05)。结论BRAF^V600E突变蛋白在甲状腺乳头状癌中呈高表达,其表达与淋巴结转移和被膜侵犯有显著相关,提示BRAF^V600E突变可能与肿瘤侵袭性相关,可作为甲状腺乳头状癌预后的预测因子。

Objective To investigate the expression of BRAF^V600E mutation in papillary thyroid carcinoma and analyze its relationship with clinicopathological features.Methods Immunohistochemistry was used to detect the expression of BRAF^V600E mutant protein in 244 patients with papillary thyroid carcinoma and adjacent tissues.The relationship between BRAF^V600E mutation and clinicopathological parameters was analyzed with clinical pathological data.Results BRAF^V600E mutant protein was expressed only in papillary thyroid carcinoma,and the expression rate was 86.48%.The non⁃tumor tissue adjacent to the tumor was not expressed.The expression rate was 88.89%in classic papillary thyroid carcinoma,85%in lymph node metastasis group,and 94.64%in capsule invasion group,which were higher than follicular type(78.18%)(X^2=4.176,P=0.041),non⁃lymph node metastasis group(68.42%)(X^2=4.526,P=0.033)and non⁃capsule invasion group(84.04%)(X^2=4.145,P=0.042),respectively,and corresponding comparison have significant statistical difference(P<0.05).There were no significant differences between the different tumor diameters,ages,genders and lesions number(P>0.05).Conclusion BRAF^V600E mutant protein is highly expressed in papillary thyroid carcinoma,and its expression is significantly associated with lymph node metastasis and capsular invasion.It suggests that BRAF^V600E mutation may be associated with tumor invasion and may be a predictor of papillary thyroid carcinoma prognosis.