影响甲状腺乳头状癌临床病理特征的相关因素分析  

Analysis of the factors associated with clinicopathological characteristics of papillary thyroid carcinoma

作　　者：刘淑[1] 高爱博[1] 赵艳茹[1] 祭美菊[1] 侯鹏[1] 施秉银[1] 

机构地区：[1]西安交通大学第一附属医院内分泌科,710061

出　　处：《中华内分泌代谢杂志》2015年第11期941-945,共5页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的 分析BRAFV600E基因突变、RET/PTC基因重排以及是否合并桥本甲状腺炎（HT）3种因素在甲状腺乳头状癌（PTC）患者中的分布,并分析其与临床病理资料的关系.方法 收集本院122例经典型PTC患者甲状腺细针穿刺样本用于基因分析,并收集所有患者手术时临床病理资料.采用焦磷酸测序法检测BRAFV600E基因突变和Taqman-qPCR检测RET/ PTC基因重排.结果 BRA FV600E基因突变的PTC患者年龄较大,不易合并HT,而RET/PTC基因重排的PTC患者的年龄较小,容易合并HT（均P＜0.05）.在≥20岁且＜45岁年龄组,BRAFV600E基因突变患者容易发生PTC的包膜外浸润（P＜0.05）,与其他的病理特征无统计学差异.RET/PTC基因重排阳性的PTC患者容易发生双侧的淋巴结转移,并且淋巴结转移的数目较多（P＜0.05）.结论 在分析某个因素与PTC患者临床病理特征的关系时,不仅要考虑到年龄因素,还应综合考虑其他因素对PTC患者临床病理特征的影响.Objective BRAFV600E mutation, RET/PTC rearrangement, and the concomitant of Hashimoto＆#39;s thyroiditis（HT） could influence clinicopathological features of papillary thyroid carcinoma （PTC）.This study is to investigate the distribution of three factors in PTC and to analyze their associations with clinicopathological characteristics.Methods Fine-needle aspiration samples were collected in a total of 122 conventional PTC patients, who were confirmed by surgery.The clinicopathological features were collected to analyze its association with different factors.BRAFV600E mutation and RET/PTC rearrangement were detected by pyrosequencing and Taqman-qPCR, respectively.Results BRAFV600E mutation was significantly correlated with an older age and a less coexistence with HT（P〈0.05）.In contrast, RET/PTC rearrangement was more prevalent in young patients and was associated with the concomitant of HT（P〈0.05）.In the age of ≥20 year and〈45 year groups, BRAFV600E mutation was significantly associated with extrathyroidal invasiveness.RET/PTC rearrangement was significantly associated with bilateral lymph node metastasis and the number of metastatic lymph node.Conclusions The distribution of three factors were different in PTC patients.In addition to the age at diagnosis, all of three factors should also be considered together to analyze the association of clinicopathological features of PTC.

关 键 词：BRAFV600E基因突变 RET/PTC基因重排 桥本甲状腺炎 甲状腺乳头状癌 

分 类 号：R736.1[医药卫生—肿瘤]