甲状腺乳头状癌BRAF突变与初始治疗疗效的关系  

The correlation between BRAF mutation and the initial treatment outcome of papillary thyroid cancer

作　　者：代文莉[1,2] 崔邦平[1,2] 胡涛[2] 严凯[2] 胡伟[2] 

机构地区：[1]三峡大学第一临床医学院核医学教研室,湖北宜昌443003 [2]宜昌市中心人民医院核医学科,湖北宜昌443003

出　　处：《现代肿瘤医学》2013年第3期504-506,共3页Journal of Modern Oncology

基　　金：教育部科学技术研究重点项目(编号:210269);湖北省教育厅科研项目(编号:B20101206);宜昌市科技计划项目(编号:A01301-08)

摘　　要：目的:探讨甲状腺乳头状癌BRAF突变与初始治疗疗效的关系。方法:收集我院甲状腺乳头状癌根治手术患者60例临床资料,患者均进行131I清甲治疗和甲状腺激素抑制治疗。所有患者随访过程中进行甲状腺球蛋白、甲状腺球蛋白抗体测定,131I全身扫描以及其他常规检查。应用Pyrosequencing焦磷酸测序技术对患者石蜡标本进行BRAF突变分析。对BRAF突变情况与患者疾病缓解程度进行卡方检验,并对两组患者Tg水平进行秩和检验。结果:60例甲状腺乳头状癌患者BRAF突变阳性47例(78.3%),完全缓解患者占48.3%(29/60),其中131I全身及常规影像检查阴性但Tg升高患者12例。BRAF突变阳性患者初始治疗完全缓解率仅40.4%,显著低于未发生突变的患者(76.9%)(P=0.020);两组患者的Tg水平差异有统计学意义(P=0.046)。131I全身阴性但Tg升高的12例患者中BRAF突变阳性11例,阴性1例,OR值为3.04。结论:BRAF突变阳性的患者初始治疗完全缓解率低,更容易出现不摄碘的隐匿病灶。Objective：BRAF mutation was the most frequent gene event in papillary thyroid cancer, this research was to explore the correlation between the existence of BRAF mutation and the initial treatment outcome of papillary thyroid cancer. Methods：All 60 papillary thyroid cancer patients undergoing surgery and radioiodine therapy were re- viewed in this study. The paraffin - embedded tissues of the patients were selected for DNA extraction and BRAF mu- tation analysis. The clinic pathological features and initial treatment outcome including： sex, age, neck lymph node me- tastasis, distant metastasis, free of disease ,were analyzed also the correlation between the existence of BRAF mutation and clinic pathological features and outcome of the initial treatment. Results：78.3 % （47/60） patients were confirmed BRAF mutation,and 48.3% （29/60） were observed complete remission. BRAF mutation was not correlated with age, neck lymph node metastasis, distant metastasis, but lower complete remission rate was observed in the BRAF mu- tation group, comparing to the wild type BRAF group. 11/12 patients with high thyroglobulin level and no imaging evi- dence of tumor was with BRAF mutation, the OR value was 3.04. Conclusion： Papillary thyroid cancer patients withBRAF mutation was with lower complete remission rate after the initial treatment and 3.04 times iodine - refractory disease than wild type BRAF patients.

关 键 词：甲状腺乳头状癌 BRAF突变 初始治疗 

分 类 号：R736.1[医药卫生—肿瘤]