超声及BRAF^(V600E)基因对甲状腺乳头状癌颈部淋巴结转移的预测因素

Predictor research 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)超声征象及BRAF^(V600E)基因与颈部淋巴结转移的相关性。方法回顾性分析病理诊断为甲状腺乳头状癌136例患者,178个甲状腺癌结节,83枚颈部淋巴结的超声影像学资料和BRAF^(V600E)基因结果,分析BRAF^(V600E)基因、各超声特征与颈部淋巴结转移的相关因素。结果单因素分析结果显示:多发病灶、年龄<40岁、结节最大径≥1.5 cm、微钙化、甲状腺包膜侵犯、BRAF^(V600E)基因突变与甲状腺乳头状癌颈部淋巴结转移的发生有关(P<0.05);多变量分析结果显示:甲状腺包膜侵犯、BRAF^(V600E)基因突变是颈部淋巴结转移的危险因素(OR=2.701、3.282,均P<0.05)。结论甲状腺包膜侵犯、BRAF^(V600E)基因突变的甲状腺乳头状癌患者,更易发生颈部淋巴结转移。

Objective To investigate the correlations of ultrasound characteristics and BRAF^(V600E)gene with cervical lymph node metastasis(CLNM)in papillary thyroid carcinoma(PTC).Methods The ultrasound data of 136 cases of PTC,including 178 thyroid nodules,83 cervical lymph nodes and BRAF^(V600E)gene from November 2018 to July 2019 in our hospital were retrospectively collected.To investigate the correlation of ultrasound characteristics and BRAF^(V600E)gene with CLNM in PTC.Results Single factor analysis results showed that multifocality,age<40 years,nodule diameter≥1.5 cm,microcalcification,invasion outside the thyroid capsule and BRAF^(V600E)gene mutation were significantly correlated to CLNM(P<0.05).Multivariate analysis showed that invasion outside the thyroid capsule and BRAF^(V600E)gene mutation were independent risk factor for CLNM(OR=2.701 and 3.282,respectively,P<0.05).Conclusion The PTC patients with invasion outside the thyroid capsule and BRAF^(V600E)gene mutation are more likely to develop CLNM.