甲状腺乳头状癌BRAF^(v600E)基因突变探究  

Investigation of BRAF^(v600E) gene mutation in papillary thyroid carcinoma

作　　者：赖烨钤[1] LAI Ye-qian(Department of Thyroid Surgery, Meizhou City People’s Hospital, Meizhou 514021, China)

机构地区：[1]梅州市人民医院甲状腺外科,514021

出　　处：《中国现代药物应用》2017年第10期31-33,共3页Chinese Journal of Modern Drug Application

摘　　要：目的分析BRAF^(v600E)基因突变能否作为甲状腺乳头状癌患者临床病理学特征的预后判断。方法从各大知名数据库中筛选2014年3月前的有关检测是否发生BRAF^(v600E)基因突变的甲状腺乳头状癌患者的文献,参照纽卡斯尔-渥太华量表对文献质量进行评分,本研究选择文献质量3~5星的文献(满分9星),并提取文献中的可靠数据,采用Rev Man5.1对数据进行Meta分析。结果共筛选出23篇文献,共有2771例甲状腺乳头状癌患者(均进行过BRAF^(v600E)基因突变检测)纳入甲状腺乳头状癌临床病理学特征和BRAF^(v600E)基因突变的关系的分析。发生BRAF^(v600E)基因突变率为25%~84%,平均发生BRAF^(v600E)基因突变的比例为54.7%。经过Meta分析还显示BRAF^(v600E)基因突变与患者性别、年龄>45周岁或是平均年龄、远处转移无显著联系(P>0.05);BRAF^(v600E)基因突变与甲状腺外浸润、淋巴结转移、高TNM分期有关(OR=2.17、1.96、2.42,P<0.01)。结论根据对BRAF^(v600E)基因突变与中国甲状腺乳头状癌患者临床病例特征进行Meta分析发现,BRAF^(v600E)基因突变可以在淋巴结转移、甲状腺外浸润、高TNM分期等方面对中国患者做出预后评估。但需要说明的是,远处转移检测技术尚不成熟,没有比较简单的方法可以检测出患者是否发生远处转移,所以本研究关于BRAF^(v600E)基因突变与远处转移的观点仍然有待商榷,希望可以有更多类似的研究或更多的相关数据可以进一步验证。Objective To analyze the feasibility of BRAFv600E gene mutation as prognosis judgmentfor clinical pathological characteristics in papillary thyroid carcinoma patients.Methods Related literature ofBRAFv600E gene mutation detection in papillary thyroid carcinoma patients before March2014were screened frommajor databases,and Newcastle-Ottawa scale was applied to grade the literature.Literature selected in this studygraded3~5stars(9stars as full mark),and authentic data were taken into Meta analysis by RevMan5.1.ResultsThere were totally23selected literature,including2771patients with papillary thyroid carcinoma(all receivedBRAFv600E gene mutation detection)in analysis of relationship between clinical pathological characteristics andBRAFv600E gene mutation in papillary thyroid carcinoma.Incidence of BRAFv600E gene mutation was25%~84%,with mean incidence of BRAFv600E gene mutation as54.7%.Meta analysis showed no obvious relationship betweenBRAFv600E gene mutation and patients gender,>45years old or mean age,and distant metastasis(P>0.05).BRAFv600E gene mutation showed its relationship with exterior thyroid infiltration,lymphatic metastasis andhigh TNM staging(OR=2.17,1.96,2.42,P<0.01).Conclusion Meta analysis of BRAFv600E gene mutation andclinical pathological characteristics in Chinese papillary thyroid carcinoma patients showed prognosis evaluationby BRAFv600E gene mutation for lymphatic metastasis,exterior thyroid infiltration and high TNM staging.It’snecessary to note that due to undeveloped distant metastasis detection technique,there is no easy detection methodfor occurrence of distant metastasis in patients.Therefore,the viewpoint of relationship between BRAFv600E genemutation and distant metastasis in this study requires more discuss and further verification by more research anddata.

关 键 词：甲状腺乳头状癌 BRAFv600E META 分析 基因突变 

分 类 号：R736.1[医药卫生—肿瘤]