BRAF^V600E突变在cN0期PTMC颈中央区淋巴结转移中的预测价值  

The predictive value of BRAF^V600E mutation for central lymph node metastasis(CLNM)in patients with cN0 papillary thyroid microcarcinoma(PTMC)

作　　者：宋创业[1] 严丽[2] 孟艳林[3] 刘冰[1] 尚培中[1] 南润玲 吕瑞昌 张江华[1] 张克俭 Song Chuangye;Yan Li;Meng Yanlin;Liu Bing;Shang Peizhong;Nan Runling;Lyv Ruichang;Zhang Jianghua;Zhang Kejian(Department of General Surgery,the 81st Liberation Army Hospital,Hebei 075000,China;Department of Glandular Surgery,the Second Hospital of Hebei Medical University,Hebei 050005,China;Department of Infection control division,the 81st Liberation Army Hospital,Hebei 075000,China)

机构地区：[1]中国人民解放军陆军第八十一集团军医院普通外科,河北张家口075000 [2]河北医科大学第二医院腺体外科,石家庄050005 [3]中国人民解放军陆军第八十一集团军医院疾病预防控制科,河北张家口075000

出　　处：《中华普外科手术学杂志（电子版）》2020年第6期631-634,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨BRAF^V600E突变在cN0期甲状腺微小乳头状癌(PTMC)颈中央区淋巴结转移(CLNM)的临床意义及预测价值。方法回顾性分析2017年1月至2020年1月经手术治疗、病理证实的222例cN0期PTMC患者的临床资料,分析BRAF^V600E突变阳性与PTMC患者CLNM的相关性。应用SPSS 23.0统计软件分析数据,单因素分析采用χ^2检验分析,多因素分析采用Logistic回归分析;P<0.05为差异有统计学意义。结果222例PTMC患者94例(42.3%)存在CLNM;肿瘤大小、肿瘤多灶性、包膜侵犯、BRAF^V600E突变是CLNM的独立危险因素(P<0.05),发生CLNM的风险更高;BRAF^V600E突变(OR=2.445,95%CI:1.557~3.840)是影响CLNM最重要的独立危险因素。结论PTMC具有较高的CLNM,BRAF^V600E突变阳性时应常规行预防性中央区淋巴结清扫术;BRAF^V600E突变可有效预测cN0期PTMC患者是否存在CLNM。Objective To investigate the clinical significance and predictive value of BRAF^V600E mutation for central lymph node metastasis(CLNM)in patients with cN0 papillary thyroid microcarcinoma(PTMC).Methods A retrospective analysis was performed in 222 patients with pathologically confirmed cN0 PTMC from January 2017 to January 2020.The correlation between BRAF^V600E mutation and CLNM of PTMC was analyzed.Statistical analysis was performed by using SPSS 23.0 software.Theχ^2 test was used for univariate analysis and Logistic regression was used for multivariate analysis.A P value of<0.05 were considered as statistically significant difference.Results Among 222 patients,there were 94 cases(42.3%)of CLNM.Tumor size,multifocality,capsular invasion and BRAF^V600E mutation were independent risk factors for CLNM(P<0.05),however BRAF^V600E mutation(OR=2.445,95%CI:1.557~3.840)was the most important independent risk factor for CLNM.Conclusion PTMC patients had a high rate of CLNM,and prophylactic central lymph node clearance should be routinely performed in patients with BRAF^V600E mutation.BRAF^V600E mutation could effectively predict CLNM in patients with cN0 PTMC.

关 键 词：甲状腺肿瘤 腺癌 乳头状 淋巴转移 BRAF^V600E 

分 类 号：R73[医药卫生—肿瘤]