BRAF^V600E突变与甲状腺微小乳头状癌生物学行为关联的Meta分析  

BRAF^V600E mutation is correlated with the biological behaviors of papillary thyroid microcarcinoma：a Meta-analysis

作　　者：张晶晶 赵艳萍[1] 肖雄[1] 王新华[1] 董占飞[1] 

机构地区：[1]新疆医科大学附属肿瘤医院核医学科,乌鲁木齐830011

出　　处：《中华核医学与分子影像杂志》2018年第3期199-204,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨V-raf鼠肉瘤滤过性病毒致癌基因同源体B1（BRAF）V600E突变与甲状腺微小乳头状癌（PTMC）生物学行为的关联。方法根据检索主题词，检索中文数据库（万方数据知识服务平台、维普和中国知网）及英文数据库（PubMed、Embase、Cochrane Library）中发表于2011年1月至2016年1月的相关文献；中文以＂甲状腺＂＂乳头状＂＂微小癌＂＂BRAF＂组合进行检索；英文检索主题词为＂PTMC＂＂papillary thyroid microcarcinoma＂＂thyroid microcarcinoma＂＂micropapillary thyroid carcinoma＂＂BRAF＂。采用RevMan 5.3软件进行Meta分析。结果共纳入18篇文献，累计PTMC患者2 938例，其中BRAFV600E基因突变阳性者1 536例，野生型者1 402例。BRAFV600E平均突变率约为52.3%。PTMC患者的BRAFV600E突变与多灶性[比值比（OR）=1.37，95% CI： 1.11-1.67）、甲状腺外浸润（OR=2.25，95% CI： 1.31-3.86）、淋巴结转移（OR=3.05, 95% CI： 1.60-5.79）、高TNM分期（Ⅲ期＋Ⅳ期；OR=1.99，95% CI： 1.54-2.57）、复发（OR=2.92, 95% CI： 1.84-4.65）、男性患者（OR=1.70，95% CI： 1.35-2.14）及原发灶直径大于5 mm（OR=1.62, 95% CI：1.29-2.04）有较强的关联性。结论BRAFV600E突变是PTMC高侵袭性行为的危险因素。Objective To evaluate the association between V-raf murine sarcoma viral oncogene homolog B1 （BRAF）V600E mutation and biological behaviors of papillary thyroid microcarcinoma （PTMC）.Methods Published papers about the association between BRAFV600E mutation and aggressiveness of PTMC from January 2011 to January 2016 were collected using databases of Wanfang, VIP, China National Knowledge Infrastructure （CNKI）, PubMed, Embase and Cochrane library. The key words were ＂ PTMC＂ , ＂ papillary thyroid microcarcinoma＂ , ＂ thyroid microcarcinoma＂ , ＂ micropapillary thyroid carcinoma＂ , ＂ BRAF＂ . The languages were restricted to English and Chinese. Meta-analysis was performed with RevMan 5.3 software.Results Eighteen studies involving 2 938 patients were included. A total of 1 536 patients showed BRAFV600E mutation-positive results, and 1 402 patients were with wild type. The average prevalence of the BRAFV600E mutation was 52.3%. The BRAFV600E mutation was associated with the multifocality （odds ratio （OR）=1.37, 95% CI： 1.11-1.67）, extrathyroid extension（OR=2.25, 95% CI： 1.31-3.86）, lymph node metastases（OR=3.05, 95% CI： 1.60-5.79）, advanced stage （TNM Ⅲ＋ Ⅳ; OR=1.99, 95% CI： 1.54-2.57）, recurrence（OR=2.92, 95% CI： 1.84-4.65）, male patients（OR=1.70, 95% CI： 1.35-2.14） and tumor diameter 〉5 mm（OR=1.62, 95% CI： 1.29-2.04）of PTMC. There was no significant association between BRAFV600E mutation and age or distant metastases.Conclusion BRAFV600E mutation is a risk factor for aggressive behaviors of PTMC.

关 键 词：甲状腺肿瘤 原癌基因蛋白质B-raf 突变 META分析 

分 类 号：R736.1[医药卫生—肿瘤]