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目的探讨鼠类肉瘤滤过性毒素菌致癌同源体B1(V-raf murine sarcoma viral oncogene homolog B1,BRAF)V600E突变与甲状腺乳头状癌颈部淋巴结转移及超声造影增强模式的相关性。方法甲状腺超声造影后经手术组织病理检查诊断为甲状腺乳头状癌患者235例(甲状腺癌组),甲状腺良性肿瘤85例为对照组,采用实时荧光定量PCR法检测2组新鲜组织病理标本中BRAFV600E突变情况,分析甲状腺癌组患者BRAFV600E突变与其颈部淋巴结转移及不同造影增强模式(高增强、等增强、低增强)间的关系。结果甲状腺癌组BRAFV600E突变率(78.3%)高于对照组(0),差异有统计学意义(P<0.05);BRAFV600E突变组患者颈部淋巴结转移率(64.7%)高于未突变组(21.6%)(P<0.05),均以中央区淋巴结转移为主;BRAFV600E突变组造影增强模式与未突变组比较差异无统计学意义(P>0.05),甲状腺癌组患者中造影模式弱增强组颈部淋巴结转移率(49.7%)低于等增强组(72.7%)和高增强组(76.2%)(P<0.05),等增强组与高增强组比较差异无统计学意义(P>0.05)。结论 BRAFV600E突变与甲状腺乳头状癌的发生及其颈部中央区淋巴结转移密切相关,有可能成为甲状腺乳头状癌侵袭性的预测因子;超声造影不能预测甲状腺乳头状癌中BRAFV600E突变的存在,但不同造影模式对颈部淋巴结转移有一定提示作用。
Objective To investigate the relationship between the V600E mutation of the murine sarcoma viral oncogene homolog B1 (BRAF) and cervical lymph node metastasis and contrast-enhanced ultrasound in papillary thyroid carcinoma. Methods 235 cases of thyroid papillary carcinoma (thyroid cancer group) and 85 cases of thyroid benign tumor were diagnosed by thyroidectomy after histopathological examination. The BRAFV600E mutation was detected by real-time fluorescence quantitative PCR in 2 groups of fresh histopathological specimens The relationship between BRAFV600E mutation and cervical lymph node metastasis and different contrast enhancement modes (high enhancement, equal enhancement, low enhancement) in thyroid cancer patients was analyzed. Results The mutation rate of BRAFV600E in thyroid cancer group was significantly higher than that in control group (78.3%) (P <0.05). The rate of cervical lymph node metastasis (64.7%) in BRAFV600E mutation group was higher than that in non-mutation group %) (P <0.05), all of which were mainly lymph node metastasis in the central region. There was no significant difference between the BRAFV600E mutation group and the unmutated group (P> 0.05). In the thyroid cancer group, The rate of lymph node metastasis (49.7%) was lower than that of the other two groups (72.7% vs 76.2%, P <0.05). There was no significant difference between the two groups (P> 0.05). Conclusions The BRAFV600E mutation is closely related to the occurrence of papillary thyroid carcinoma and lymph node metastasis in the central region of neck. It may be a predictor of the invasiveness of papillary thyroid carcinoma. Contrast ultrasound can not predict the presence of BRAFV600E mutation in papillary thyroid carcinoma. Contrast mode of cervical lymph node metastasis have some tips.