BRAF^V600E突变比值在合并桥本甲状腺炎甲状腺乳头状癌中的初步研究  

Clinical effect of Hashimoto thyroiditis on the ratio of BRAF^V600E alleles in papillary thyroid carcinoma

作　　者：倪烨钦 吴凡 荀延萍 赵盼 张仕蓉 周天晗 孙思涵 陆凯宁 罗定存 NI Yeqin;WU Fan;XUN Yanping;ZHAO Pan;ZHANG Shirong;ZHOU Tianhan;SUN Sihan;LU Kaining;LUO Dingcun(The Fourth Clinical Medical College,Zhejiang Chinese Medical University,Hangzhou 310006,Zhejiang,China;Centre of Translational Medicine,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,Zhejiang,China;Department of Pathology,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,Zhejiang China;Nanjing Medical University Nanjing 210000,Jiangsu,China;Department of Surgical Oncology,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,Zhejiang,China)

机构地区：[1]浙江中医药大学第四临床医学院,浙江杭州310006 [2]浙江大学医学院附属杭州市第一人民医院转化医学研究中心,浙江杭州310006 [3]浙江大学医学院附属杭州市第一人民医院病理科,浙江杭州310006 [4]南京医科大学,江苏南京210000 [5]浙江大学医学院附属杭州市第一人民医院肿瘤外科,浙江杭州310006

出　　处：《山东大学耳鼻喉眼学报》2020年第3期75-80,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：杭州市重大科技创新专项项目(20131813A08);杭州市卫生科技计划项目(OO20190490、OO20190151)。

摘　　要：目的探索桥本甲状腺炎(HT)对甲状腺乳头状癌(PTC)中BRAF^V600E突变比值(the ratio of BRAF^V600E alleles)的影响。方法收集242例PTC患者临床资料,其中PTC合并HT 63例,PTC不合并HT 179例,采用微滴数字PCR(ddPCR)法检测PTC中BRAF^V600E状况。利用倾向性评分匹配法(PSM),以性别、年龄、多灶性、腺外侵犯、肿瘤直径为控制变量按1∶1比例构成63对配对,比较匹配后两组BRAF^V600E阳性率和突变比值。结果倾向性评分匹配前,PTC合并HT组和PTC不合并HT组BRAF^V600E阳性率分别为87.3%和92.7%,两组间差异无统计学意义(P>0.05),而PTC合并HT组BRAF^V600E突变比值(3.20%)显著低于PTC不合并HT组(8.80%)(P<0.001)。经过倾向性评分匹配,两组基线水平保持一致,PTC合并HT组BRAF^V600E突变比值(3.20%)仍显著低于PTC不合并HT组(9.00%),两组间差异有统计学意义(P=0.001)。结论在合并HT的PTC中,BRAF^V600E突变的发生未受影响,但是BRAF^V600E突变比值明显降低,说明HT对PTC发展过程中BRAF^V600E突变存在一定影响,从而影响PTC发展及其预后。Objective To evaluate the clinical effect of Hashimoto thyroiditis(HT)on the ratio of BRAF^V600E alleles in papillary thyroid carcinoma(PTC). Methods Two hundred and forty-two patients who underwent surgery at our hospital between December 2017 and December 2019 were enrolled in this study. The ratio of BRAF^V600E alleles was measured using droplet digital PCR and formalin-fixed paraffin-embedded tissues, and its correlation with HT was analyzed. Using propensity score matching and based on the 63 patients with HT(1∶1), 179 PTC patients without HT during the same period were retrospectively enrolled as controls. Results There was a significant difference between the ratio of BRAF^V600E alleles(P<0.001)of the two groups(PTC patients with HT versus those without HT);the rates of positive-BRAF^V600E were not significantly different(87.3% vs 92.7%, P>0.05). After propensity score matching, the significant difference between the two groups at baseline was no longer observed. The ratio of BRAF^V600E alleles was still significantly lower in patients with HT(median 3.20%)than in those without HT(median 9.00%, P=0.001). Conclusion HT can significantly reduce the ratio of BRAF^V600E alleles in PTC, and this has an important effect on PTC progression and prognosis.

关 键 词：甲状腺肿瘤 倾向性评分匹配 桥本甲状腺炎 BRAF^V600E突变比值 

分 类 号：R604[医药卫生—外科学] R736[医药卫生—临床医学]