甲状腺乳头状癌HRAS和TERT启动子突变与临床及超声特征的相关性研究  

Correlation Analysis of HRAS and TERT Promoter Mutations with Clinical and Ultrasound Features in Papillary Thyroid Carcinoma

作　　者：杨艳丽 周祖邦[2] 马欢 代九菊 李振珺 Yang Yanli;Zhou Zubang;Ma Huan;Dai Jiuju;Li Zhenjun(Gansu University of Traditional Chinese Medicine,Lanzhou 730000,China;Department of Ultrasound,Gansu Provincial People's Hospital,Lanzhou 730000,China;Department of Pathology,Gansu Provincial People's Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学,兰州市730000 [2]甘肃省人民医院超声科,兰州市730000 [3]甘肃省人民医院病理科,兰州市730000

出　　处：《中国超声医学杂志》2024年第3期249-252,共4页Chinese Journal of Ultrasound in Medicine

基　　金：甘肃省重点研发计划项目(No.22YF7FA098)。

摘　　要：目的 探讨甲状腺乳头状癌(PTC)HRAS和TERT启动子突变与临床及超声特征的相关性。方法 回顾性分析术后病理证实为PTC的186例患者的临床及超声特征,分析与HRAS和TERT启动子突变之间的关系。结果 186例PTC患者中,TERT启动子突变18例(9.68%),HRAS基因突变9例(4.84%),TERT和HRAS基因共突变4例(2.15%)。TERT启动子的突变与年龄(P=0.048)、直径大小(P=0.030)、腺外侵犯(P=0.041)、淋巴结转移(P=0.013)临床病理特征有关。HRAS基因突变的超声图像表现为结节边界清(P=0.041),不靠近被膜生长(P=0.029)。TERT和HRAS基因共突变4例,3例发生淋巴结转移,1例表现为腺外侵犯。结论 对PTC患者从分子水平检测可显著提高对结节的恶性程度和侵袭性发生的预测价值,对此类结节患者尽早手术治疗及术后随访观察提供临床依据。Objective To explore the association between HRAS and TERT promoter mutation with clinical and ultrasound characteristics in papillary thyroid carcinoma(PTC).Methods Clinical and ultrasonic features of 186 patients pathologically confirmed PTC were included in this retrospective study,in order to analyze the correlation between HRAS and TERT promoter mutation status and clinical and ultrasonic features.Results In 186 patients with PTC,TERT promoter mutations were found in 9.68%(18 of 186),HRAS mutations were found in 4.84%(9 of 186),and HRAS and TERT promoter co-mutations were found in 2.15%(4 of 186).TERT promoter mutation was significantly associated with age(P=0.048),tumor size(P=0.030),extrathyroidal invasion(P=0.041),lymph node metastasis(P=0.013).The ultrasonographic characteristics of HRAS mutation were more likely to had clear boundaries(P=0.041) and not close to the membrane(P=0.029).HRAS and TERT gene co-mutations were found in 4 cases,3 cases showed lymph node metastasis and 1 case showed extrglandular invasion.Conclusions Detection of PTC at molecular level can significantly improve the predictive value of malignancy and invasiveness of nodules,and provide clinical basis for early surgical treatment and postoperative follow-up.

关 键 词：甲状腺乳头状癌 HRAS TERT 超声特征 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]