甲状腺乳头状癌RAS基因突变与临床预后的关系  

Relationship between the RAS mutation and clinical prognosis in papillary thyroid carcinoma

作　　者：沈棵 张帅[1] 古维立[1] 黄迪[1] 陈绵龄[1] 梁柳森[1] 

机构地区：[1]广州市第一人民医院普外科二区,510180

出　　处：《中华普通外科杂志》2014年第1期44-48,共5页Chinese Journal of General Surgery

摘　　要：目的观察甲状腺乳头状癌中RAS基因突变的情况，分析其突变对患者临床特点及预后的影响。方法选取经病理证实为甲状腺乳头状癌的患者354例，对患者病情、治疗方式、病理特点、预后等情况进行详细研究。依RAS突变与否将患者分为两组。比较两组间病理类型、病情进展、复发情况及生存时间等方面的差异，通过多元回归分析评估RAS突变与不同变量间的相关性。结果354例患者中86例有RAS突变。突变阳性与阴性者对比，两者原发灶状态（P=0．004）、远处转移（P=0．027）、病情分期（P=0．004）及ATA危险分层（P=0．ooo）间差异有统计学意义。RAS突变阳性者复发率较高，无复发生存时间较短（P〈0．005）。RAS突变与ATA危险分层存在明显相关性。结论RAS突变增加了甲状腺癌患者术后复发的危险性，RAS突变和A1IA危险分层是预测甲状腺乳头状癌预后的重要指标。Objective To observe the RAS gene mutations in papillary thyroid carcinoma, and to analyse the effects of mutation on clinical characteristics and prognosis. Methods In this study, 354 papillary thyroid carcinoma patients were divided into 2 groups according to RAS mutation by DNA sequence analysis. The pathological type, disease progression, recurrence and prognostic difference between the two groups were compared, and regression analysis was performed to evaluate the relationship between different variables and RAS mutation. Results There were 86 patients with RAS positive mutation. A significant difference was found with primary sites （ P = 0. 004 ）, distant metastasis （ P = 0. 027 ）, AJCC stage （ P = 0. 004） and ATA risk stratification （ P = O. 000 ） between two groups. RAS positive patients have higher recurrence rate and shorter recurrence-free survival time （P 〈 0. 005 ） than the negative patients. Furthermore, in the multivariate analysis, the RAS mutation was significantly associated only with the ATA stratification. Conclusions RAS mutation increases risk of recurrence, RAS mutation and ATA stratification might be a valuable diagnostic and prognostic marker of papillary thyroid carcinoma.

关 键 词：甲状腺肿瘤 癌 乳头状 预后 点突变 

分 类 号：R734.340.4[医药卫生—肿瘤]