RAS基因在甲状腺滤泡状癌中的表达及其临床意义  

Expression of RAS gene in follicular thyroid carcinoma and its clinic significance

作　　者：付云平 叶晖 FU Yunping;YE Hui(Department of Surgery,School of Clinical Medicine,Guizhou Medical University,Guiyang 550004,Guizhou,China;Department of Thyroid Surgery,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China;Department of Thyroid and Breast Surgery,Jinyang Hospital Affiliated to Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学临床医学院外科教研室,贵州贵阳550004 [2]贵州医科大学附属医院甲状腺外科,贵州贵阳550004 [3]贵州医科大学附属金阳医院甲乳外科,贵州贵阳550004

出　　处：《贵州医科大学学报》2024年第4期553-560,共8页Journal of Guizhou Medical University

基　　金：贵州省卫健委科学技术基金项目(gzwkj2022-80)。

摘　　要：目的探讨RAS基因在甲状腺滤泡状癌(FTC)中的表达与FTC患者临床特征的相关性。方法收集34例甲状腺滤泡状癌患者年龄、性别、结节纵横比、结节回声、结节钙化、甲状腺影像报告和数据系统的分级(TI-RADS)分类、肿瘤大小、淋巴结转移情况、体质量指数(BMI)及临床分期资料,检测术前甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、促甲状腺激素(TSH)及甲状腺激素(TH)水平,采用扩增阻滞突变系统多聚酶链式扩增(ARMS-PCR)技术检测RAS(KRAS/HRAS/NRAS)的突变状态,实时荧光定量PCR技术(qPCR)检测KRAS、NRAS、HRAS基因突变情况,采用单因素分析基因突变与临床特征的相关性。结果15例发生RAS基因突变(NRAS、KRAS、HRAS),突变率为44.1%,其中NRAS突变10例(29.4%)、KRAS突变4例(11.8%)、HRAS突变1例(3.0%);<55岁患者有18例、≥55岁有16例,且与RAS基因突变有关(P<0.05),TI-RADS分类4类及以上25例;肿瘤<1 cm患者有11例、1~4 cm 10例,>4 cm 13例,均与RAS基因突变有关(P<0.05)。结论RAS的突变状态与患者年龄及肿瘤大小相关,与其他临床特征无相关性。Objective To investigate the correlation of RAS expression in follicular thyroid carcinoma(FTC)with clinical characteristics of FTC patients.Methods The clinical data of 34 patients confirmed as FTC were collected:age,gender,nodule aspect ratio,nodule echo,nodule calcification,thyroid imaging reporting and data system(TI-RADS)classification,tumor size,lymph node metastasis,clinical staging,preoperative TPO-Ab,preoperative TGAb,TSH,TH,and BMI.The mutation status of the RAS(KRAS/HRAS/NRAS)was detected by the PCR(ARMS-PCR),and the real-time gene amplification fluorescence detection system(qPCR)for the mutation of KRAS,NRAS;univariate analysis was adopted to analyze the correlation between gene mutations and clinical characteristics.Result Fifteen cases had RAS gene mutation(NRAS,KRAS,HRAS)with a mutation rate of 44.1%;of which 10 NRAS mutations(29.4%),4 KRAS mutations(11.8%)and 1 HRAS mutation(3%).There were 18 patients<55 years old,16 patients≥55 years old,and were correlated with RAS gene mutation(P<0.05),25 cases as TI-RADS category 4 and above;11 patients with tumor size<1 cm,10 patients with the tumor size between 1to 4 cm,13 patients'tumor size>4 cm,all were correlated with RAS gene mutation(P<0.05).Conclusions Mutation status of RAS is correlated with patient age and tumor size and no correlation with other clinical features.

关 键 词：甲状腺滤泡状癌 KRAS NRAS HRAS 超声 血清学 

分 类 号：R736.1[医药卫生—肿瘤]