甲状腺乳头状癌BRAF^V600E突变和钠／碘转运体表达的研究  

BRAF^V600E mutation and NIS expression in papillary thyroid carcinomas

作　　者：高卫利[1] 王伟斌[2] 王浩浩[2] 滕理送[2] 

机构地区：[1]湖州市中心医院普外科,浙江省313000 [2]浙江大学医学院附属第一医院肿瘤外科

出　　处：《中华普通外科杂志》2013年第5期378-381,共4页Chinese Journal of General Surgery

摘　　要：目的研究甲状腺乳头状癌（PTC）中BRAF^V600E。突变及钠／碘转运体（NIS）的表达，并分析其临床意义。方法对40例PTC标本行BRAF^V600E。直接测序，检测其突变率；运用免疫组化检测NIS的表达情况。分析BRAF^V600E突变与PTC临床病理特征的相关性及NIS的表达与BRAF^V600E突变的相关性。结果BRAF^V600E突变率为57．5％；NIS阳性表达率为12．5％。BRAF””“突变与甲状腺包膜侵犯及肿瘤的复发明显相关（P〈0．05）。在BRAF““突变的PTC中只有1例NIS阳性表达（4．3％），NIS阳性表达在BRAF^V600E突变的PTC中显著降低（P=0．011）。结论BRAF^V600E突变的PTC更具侵袭性、复发率较高及预后差；NIS阳性表达降低．可能是PTC摄碘降低的主要原因。Objective To investigate BRAF^V600E mutation and sodium iodide symporter （NIS） expression and its clinical significance in papillary thyroid carcinomas （PTC）. Methods BRAF^V600E mutation was evaluated by direct sequencing and BRAF^V600E mutation was determined in 40 cases of PTC. NIS expression was examined by means of immuuohistochemistry. The relationship between BRAF^V600E mutation and the clinicopathologie features of PTC was analyzed. The relationship between NIS expression and BRAF^V600E mutation in PTC was analyzed. Results Positive BRAF^V600E mutation was determined in 23 of 40 cases of PTC （57.5%）, whereas positive NIS expression was showed in 7 of 40 cases （12. 5% ）. BRAF^V600E mutation was associated with extrathyroid invasion and a high risk of disease recurrence in PTC （ P 〈 0. 05 ）. Positive NIS expression was found in only one of 23 cases of PTC with BRAF^V600E mutation, and positive NIS expression was associated with a statistically significant lower BRAF^V600E mutation in PTC （P = 0. 011 ）. Conclusions BRAF^V600E mutation might be associated with higher aggressiveness, higher disease recurrence and a poorer prognosis. Lower NIS expression may be responsible for poor ^131Ⅰ uptake in PTC.

关 键 词：甲状腺肿瘤 癌 乳头状 原癌基因蛋白质B—raf 突变 

分 类 号：R736.1[医药卫生—肿瘤]