BRAF^(V600E)突变与NLR相关性及其对cN0期PTMC患者CLNM影响的临床研究  

Clinical Study on the Correlation between BRAF^(V600E) Mutation and NLR and Its Effect on CLNM in CN0 Stage PTMC Patients

作　　者：宋创业[1] 孟艳林[2] 严丽[3] 孟繁玉 卜晓沛 冯帆 SONG Chuang-ye;MENG Yan-lin;YAN Li;MENG Fan-yu;BU Xiao-pei;FENG Fan(Department of General Surgery,The 81 st Group Army Hospital of PLA Army,Zhangjiakou,Hebei 075000,China;Department of Disease Control and Prevention,The 81 st Group Army Hospital of PLA Army,Zhangjiakou,Hebei 075000,China;Department of Glandular Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050005,China;Medical Insurance Center of Zhuolu Medical Security Bureau,Zhuolu,Hebei 075600,China;The 4 th Brigade of Basic Medical College,Air Force Military Medical University,Xi’an,Shaanxi 710038,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]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 [3]河北医科大学第二医院腺体外科,河北石家庄050005 [4]涿鹿县医疗保障局医保中心,河北涿鹿075600 [5]空军军医大学基础医学院学员四大队,陕西西安710038

出　　处：《河北北方学院学报（自然科学版）》2021年第10期12-16,共5页Journal of Hebei North University:Natural Science Edition

基　　金：张家口市重点研发计划项目(No.1921125H)。

摘　　要：目的研究BRAF ^(V600E)突变与中性粒细胞/淋巴细胞计数比值(NLR)的相关性及其对甲状腺微小乳头状癌(PTMC)中央区淋巴结转移(CLNM)的影响。方法150例cN0期PTMC患者术中均行预防性中央区淋巴结清扫术;根据术前外周静脉血血常规计算NLR,Ventana免疫组化检测术后病理标本BRAF ^(V600E)突变情况;采用交互作用相对超额危险度、归因比以及协同指数分析BRAF ^(V600E)突变和炎症指标间的交互作用。结果不存在BRAF ^(V600E)突变且NLR<2.5的PTMC患者CLNM转移比例最低(P<0.05);而存在BRAF ^(V600E)突变且NLR≥2.5的PTMC患者CLNM比例明显高于仅存在BRAF ^(V600E)突变或NLR≥2.5及不存在BRAF V600E突变且NLR<2.5的患者(P<0.05)。BRAF V600E和NLR交互作用分析显示RERI=4.987(0.159~11.011),AP=0.497(0.199~0.802),SI=2.313(1.502~4.605)。结论BRAF V600E突变和NLR具有明显交互作用,两者具有协同作用,促进了PTMC患者CLNM。Objective To study the correlation between BRAF^(V600E)mutation and neutrophil/lymphocyte ratio(NLR)and its effect on central lymph node metastasis(CLNM)of papillary thyroid microcarcinoma(PTMC).Methods A total of 150 patients with cN0 PTMC underwent intraoperative prophylactic central lymph node dissection.NLR was calculated according to preoperative peripheral venous blood routine,and BRAF^(V600E)mutation was detected by Ventana immunohistochemistry test.Relatively excessive risk,attribution ratio,and synergistic index were used to analyse interactions between BRAF^(V600E)mutations and inflammatory indicators.Results PTMC patients without BRAF^(V600E)mutation and with NLR<2.5 had the lowest CLNM metastasis rate(P<0.05);CLNM metastasis rate in PTMC patients with BRAF^(V600E)mutation and NLR≥2.5 was significantly higher than that of PTMC patients with only BRAF^(V600E)mutation or NLR≥2.5,as well as that of PTMC patients without BRAF^(V600E)mutation and NLR<2.5(P<0.05).Interaction analysis between BRAF^(V600E)and NLR showed RERI=4.987(0.159~11.011),AP=0.497(0.199~0.802),and SI=2.313(1.502~4.605).Conclusion BRAF^(V600E)mutation and NLR had significant interaction,and they had synergistic effect,which promoted CLNM in PTMC patients.

关 键 词：甲状腺微小乳头状癌 中央区淋巴结转移 中性粒细胞/淋巴细胞计数比值 BRAF V600E 

分 类 号：R736.1[医药卫生—肿瘤]