甲状腺乳头状癌超声表现及BRAF^V600E基因突变与颈部淋巴结转移的相关性

Correlation of Ultrasound Characteristics and BRAF^V600E Gene Mutation with Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma

目的探讨甲状腺乳头状癌(PTC)超声声像图特征及BRAF^V600E基因突变与颈部淋巴结转移(CLNM)的相关性。方法选取行甲状腺切除术、颈部淋巴结清扫术及BRAF^V600E基因检测,病理证实为PTC并术前超声检查资料完整的患者112例,分为颈部淋巴结转移组67例与未转移组45例,分析两组超声特征及BRAF^V600E基因突变与CLNM之间的关系。结果结节大小、是否多灶、位置、ACR TI-RADS分类与CLNM显著相关(P<0.05)。经Logistic回归分析结节最大径>1 cm、是多灶及ACR TI-RADS 5类是CLNM的独立危险因素(P<0.05)。其余超声特征及BRAF^V600E基因突变与CLNM无相关性(P>0.05)。结论术前使用高频超声对患者进行检查可预测颈部淋巴结转移情况,辅助临床医生完善对患者的术前评估,为临床手术方式的选择与术后随访提供依据;BRAF^V600E基因突变与CLNM无相关性。

Objective To investigate the correlation of ultrasound features and BRAF^V600E gene mutation with cervical lymph node metastasis in papillary thyroid carcinoma.Methods A total of 112 patients who underwent thyroidectomy,cervical lymph node dissection and BRAF^V600E gene testing,whose pathology confirmed PTC and had complete ultrasound data were divided into cervical lymph node metastasis group 67 cases and non-metastatic group 45 cases.To investigate the correlation of ultrasound features and BRAF^V600E gene mutation with cervical lymph node metastasis in papillary thyroid carcinoma.Results Nodule size,multifoci,location,ACR TI-RADS classification were significantly related to CLNM(P<0.05).Logistic regression analysis showed that the largest diameter of nodules was more than 1 cm,multifocal and ACR TI-RADS Category 5 was an independent risk factor for CLNM(P<0.05).There was no correlation between other ultrasound features and BRAF^V600E gene mutations with CLNM(P>0.05).Conclusion Examination of patients with high-frequency ultrasound before surgery can predict cervical lymph node metastasis,help clinicians to improve the preoperative evaluation of patients,and then provide a basis for clinical surgery and postoperative treatment.BRAF^V600E mutation has no predictive value for CLNM.