BRAF^(V600E)突变蛋白及β-catenin、cyclin D1在cN0期甲状腺微小乳头状癌中的表达及意义  

Expressions of BRAF^(V600E)mutant protein,β-catenin and cyclin D1 in cN0 papillary thyroid microcarcinoma and the significance

作　　者：宋创业[1] 孟艳林[2] 刘冰[1] 刘攀云 李伟[4] 严丽[5] 李晓武[1] 苗建军[1] 尚培中[1] SONG Chuangye;MENG Yanlin;LIU Bing;LIU Panyun;LIWei;YAN Li;LI Xiaowu;MIAO Jianjun;SHANG Peizhong(Department of General Surgery,the 81st Group Military Hospital of the Chinese People's Liberation Army,Zhangjiakou,075000,China;Department of Disease Prevention and Control,the 81st Group Military Hospital of the Chinese People's Liberation Army,Zhangjiakou,075000,China;Department of Endocrinology,the 81st Group Military Hospital of the Chinese People's Liberation Army,Zhangjiakou,075000,China;Department of Pathology,the 81st Group Military Hospital of the Chinese People's Liberation Army,Zhangjiakou,075000,China;Department of Gland Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang,050000,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]中国人民解放军陆军第八十一集团军医院内分泌科,河北张家口075000 [4]中国人民解放军陆军第八十一集团军医院病理科,河北张家口075000 [5]河北医科大学第二医院腺体外科,河北石家庄050000

出　　处：《中国普通外科杂志》2022年第11期1462-1470,共9页China Journal of General Surgery

基　　金：河北省张家口市科学技术局重点研发计划资助项目(1921125H)。

摘　　要：背景与目的:虽然甲状腺微小乳头状癌(PTMC)进展缓慢,但仍常伴有颈部淋巴结转移。有研究提示,BRAF^(V600E)突变及Wnt/β-catenin信号通路中相关蛋白表达异常,可能与PTMC发生发展、颈部淋巴结转移有关。因此,本研究进一步探讨临床淋巴结阴性(cN0)PTMC病变组织中BRAF^(V600E)突变及β-catenin、cyclin D1表达及意义。方法:收集2018年3月—2021年9月120例确诊为cN0期PTMC患者的手术标本及临床病理资料,用免疫组化法检测BRAF^(V600E)突变及β-catenin、cyclin D1蛋白在标本中的表达,并分析其与患者临床病理特征的关系。结果:BRAF^(V600E)突变蛋白、β-catenin、cyclin D1蛋白表达阳性率在PTMC组织中阳性表达均明显高于癌旁组织(70%vs.31.7%、35.8%vs.20.8%、57.5%vs.34.2%,均P<0.05)。cyclin D1蛋白阳性表达与肿瘤直径有关,BRAF^(V600E)突变蛋白阳性表达与病灶数目有关,BRAF^(V600E)、β-catenin、cyclin D1蛋白阳性表达均与中央区淋巴结转移有关(均P<0.05)。结论:cN0期PTMC组织中BRAF^(V600E)突变及β-catenin、cyclin D1蛋白表达明显增强,它们的表达可能是PTMC进展及中央区淋巴结转移的重要原因。Background and Aims:Although the progression of papillary thyroid microcarcinoma(PTMC)is relatively slow,cervical lymph node metastasis is still present.The previous study suggested that the BRAF^(V600E)mutation and the abnormal expressions of relevant proteins of the Wnt/β-catenin signaling pathway may be associated with the occurrence and development and cervical lymph node metastasis of PTMC.Therefore,this study was conducted to investigate further the BRAF^(V600E)mutation and the expressions ofβ-catenin and cyclin D1 in the clinically node-negative(cN0)PTMC tissue and the significance.Methods:The surgical specimens and clinicopathologic data of 120 patients with confirmed cN0 PTMC from March 2018 to September 2021 were collected.The BRAF^(V600E)mutation and expression levels ofβ-catenin and cyclin D1 in the tissue samples were determined by immunohistochemical staining,and their relations with the clinicopathologic characteristics of patients were analyzed.Results:The favorable expression rates of BRAF^(V600E)mutant protein,β-catenin,and cyclin D1 in PTMC tissue were significantly higher than those in tumor-adjacent tissue(70%vs.31.7%,35.8%vs.20.8%,57.5%vs.34.2%,all P<0.05).Positive expression of cyclin D1 protein was significantly related to tumor diameter,positive expression of BRAF^(V600E)mutant protein was significantly associated with the number of lesions,and positive expressions of BRAF^(V600E)mutant protein,β-catenin,and cyclin D1 were all mainly related to central lymph node metastasis(all P<0.05).Conclusion:BRAF^(V600E)mutation,β-catenin,and cyclin D1 expressions are significantly enhanced in cN0 PTMC tissue.Their expressions may be the essential reason for the progression and central lymph node metastasis of PTMC.

关 键 词：甲状腺肿瘤 癌 乳头状 淋巴转移 

分 类 号：R736.1[医药卫生—肿瘤]