甲状腺乳头状癌组织中CK34βE12、MC的表达和BRAF基因突变的意义  

Significance of CK34βE12,MC Expression and BRAF Gene Mutation in the Papilary Thyroid Carcinoma

作　　者：侯卫华[1] 李从洋[1] 孟祥超 于兵兵[1] 刘艳峰[1] 张萌 王建业 段尚林[1] 胡学信[1] 

机构地区：[1]中国人民解放军第152中心医院病理科,河南平顶山467000

出　　处：《肿瘤基础与临床》2017年第5期377-381,共5页journal of basic and clinical oncology

摘　　要：目的探讨高分子量角蛋白CK34βE12、间皮细胞(MC)表达和BRAF基因突变在甲状腺乳头状癌(PTC)中的临床意义。方法采用免疫组化Envision两步法检测88例PTC和88例甲状腺良性病变(BTL)中CK34βE12、MC的表达;采用PCR及DNA测序法检测36例PTC和36例BTL中BRAF基因突变状况,分析其与PTC临床病理特征的关系。结果 88例PTC组织中CK34βE12、MC阳性率分别为96.6%、95.5%,高于BTL组织中的13.6%、6.8%(P<0.05)。CK34βE12、MC在PTC组织中表达的敏感性分别为96.6%、95.5%,特异性分别为86.4%、93.2%。36例PTC组织中BRAF突变率为63.9%,高于BTL组织中的0.0%(P<0.05)。BRAF突变与肿瘤淋巴结转移密切相关(P<0.05)。结论检测CK34βE12、MC在PTC与BTL鉴别诊断中具有重要实用价值;BRAF突变对确诊PTC具有重要临床意义,且可能是预测PTC侵袭转移能力的指标。Objective To explore the significance of CK34βE12,mesothelial cell(MC) expressions and BRAF gene mutation in the papilary thyroid carcinoma.Methods The expressions of CK34βE12 and MC protein in the 88 cases of PTC tissues and the 88 cases of benign thyroid lesions(BTL) were detected by immunohistochemical Envision method;The mutation status of BRAF protein in the 36 cases of PTC tissues and the 36 cases of BTL tissues were detected by PCR and DNA sequencing,the relationship between them and the clinical pathological characteristics were analyzed.Results The positive rate of CK34βE12 and MC in the PTC was respectively 96.6% and95.5%,and was respectively 13.6% and 6.8% in the BTL,the difference was statistically significant(P<0.05).The sensitivity of MC and CK34βE12 in the PTC was 96.6% and 95.5% respectively,and the specificity was86.4% and 93.2% respectively.The BRAF mutation rate in the PTC was 63.9%,and was 0.0% in the BTL,the difference was statistically significant(P<0.05).The BRAF mutation was closely related with lymph node metastasis(P<0.05).Conclusion The detection of CK34βE12 and MC has the important practical value in the differential diagnosis of PTC and BTL;the BRAF mutations has the important clinical significance in the diagnosis of PTC,and may be a index to forecast invasion and metastasis in the PTC.

关 键 词：甲状腺肿瘤 乳头状癌 免疫组化 高分子角蛋白 间皮细胞 BRAF基因 

分 类 号：R739.5[医药卫生—肿瘤]