甲状腺乳头状癌并发桥本氏甲状腺炎患者BRAF-V600E基因表达及T淋巴细胞亚群分析

Expression of BRAF-V600E Gene and Analysis of Lymphocyte Subgroup in Thyroid Papillary Carcinoma Combined with Hashimoto's Thyroiditis

目的探讨甲状腺乳头状癌并发桥本氏甲状腺炎BRAF-V600E基因表达及T淋巴细胞亚群的变化。方法选取2018年9月~2019年8月期间于重庆三峡中心医院就诊的单纯甲状腺乳头状癌患者(PTC组)45例、单纯桥本氏甲状腺炎(HT组)患者55例、甲状腺乳头状癌并发桥本氏甲状腺炎患者(PTC-HT组)42例,以健康体检者(NC组)50例为对照。观察三组研究对象的BRAF-V600E基因表达及CD4^+T,CD8^+T,CD4^+/CD8^+的变化。结果PTC组患者BRAF-V600E突变率48.15%,HT组1.81%,PTC-HT组66.67%,NC组未见BRAF-V600E突变;三个观察组CD8^+T均比NC组显著升高,CD4^+均比NC组显著降低,差异均有统计学意义(P<0.05),但PTC组患者CD4^+显著低于HT组和PTC-HT组,PTC-HT组CD8^+又显著低于HT组,差异均有统计学意义(均P<0.05)。三个观察组CD4^+/CD8^+均比NC组显著升高显著下降,差异均有统计学意义(P<0.05)。结论与PTC组相比,BRAF-V600E在PTC-HT组患者表达率更高,PTC,PTC-HT和HT患者T淋巴细胞亚群均分化异常,机体存在免疫功能障碍,尤以PTC为甚。

Objective To investigate the expression of BRAF-V600E gene and changes of T lymphocyte subsets in thyroid papillary carcinoma combined with Hashimoto's thyroiditis.Methods From September 2018 to August 2019 in Chongqing Three Gorges Central Hospital,45 patients with simple papillary thyroid cancer(PTC group),55 patients with Hashimoto's thyroiditis(HT group),42 patients with papillary thyroid cancer and Hashimoto's thyroiditis(PTC-HT group),and 50 healthy subjects(NC group)were selected as controls.The BRAF-V600E gene expression and the changes of CD4^+T,CD8^+T and CD4^+/CD8^+ in three groups were observed.Results The mutation rate of BRAF-V600E in the PTC group was 48.15%,HT group was 1.81%,PTC-HT group was 66.67%,and the BRAF-V600E mutation was not observed in the NC group.The three observation groups CD8^+ was all higher than the NC group,CD4^+ significanlly decreased compared with NC group,the differences were statistically significant(all P<0.05),but the PTC group patients CD4^+ were significantly lower than the HT and PTC-HT groups CD4+in PTC-HT group was significantly lower than the HT group,the differentes were statistically significant(all P<0.05).The three observation groups had a significant decrease in CD4^+/CD8^+ compared to the NC group,the differences wree statistically significant(t/χ^2 all P<0.05).Conclusion Compared with PTC,BRAF-V600E had a higher expression rate in PTC-HT patients and the difference was significant,PTC,PTC-HT and HT patients had abnormal differentiation of T lymphocyte subgroups,and the body had immune dysfunction,especially PTC.