甲状腺乳头状癌中BRAFV600E突变蛋白表达的意义

    Clinical Significance of BRAFV600E Mutation in Papillary Thyroid Carcinoma

    • 摘要: 目的 探讨甲状腺乳头状癌中BRAFV600E突变蛋白的表达情况,分析其与临床病理特征的关系。 方法 应用免疫组织化学检测244例手术切除甲状腺乳头状癌组织和癌旁组织的BRAFV600E突变蛋白表达情况,结合临床病理学资料,分析BRAFV600E突变与临床病理参数之间的关系。 结果 BRAFV600E突变蛋白仅在甲状腺乳头状癌组织中表达,表达率为86.48%,癌旁非肿瘤组织不表达;经典型乳头状癌的突变阳性率为88.89%,高于滤泡型的78.18%(χ2=4.176,P=0.041);有淋巴结转移患者(85%)的突变率高于无转移患者(68.42%)(χ2=4.526,P=0.033);有被膜侵犯患者(94.64%)的突变率高于无被膜侵犯者(84.04%)(χ2=4.145,P=0.042);差异均有统计学意义。而与不同肿瘤直径、年龄、性别和病灶数量之间的差异均无统计学意义(P>0.05)。 结论 BRAFV600E突变蛋白在甲状腺乳头状癌中呈高表达,其表达与淋巴结转移和被膜侵犯有显著相关,提示BRAFV600E突变可能与肿瘤侵袭性相关,可作为甲状腺乳头状癌预后的预测因子。

       

      Abstract: Objective To investigate the expression of BRAFV600E mutation in papillary thyroid carcinoma and analyze its relationship with clinicopathological features. Methods Immunohistochemistry was used to detect the expression of BRAFV600E mutant protein in 244 patients with papillary thyroid carcinoma and adjacent tissues. The relationship between BRAFV600E mutation and clinicopathological parameters was analyzed with clinical pathological data. Results BRAFV600E mutant protein was expressed only in papillary thyroid carcinoma, and the expression rate was 86.48%. The non-tumor tissue adjacent to the tumor was not expressed. The expression rate was 88.89% in classic papillary thyroid carcinoma, 85% in lymph node metastasis group, and 94.64% in capsule invasion group, which were higher than follicular type(78.18%)(χ2=4.176,P=0.041), non-lymph node metastasis group (68.42%)(χ2=4.526,P=0.033) and non-capsule invasion group (84.04%)(χ2=4.145,P=0.042), respectively, and corresponding comparison have significant statistical difference(P<0.05). There were no significant differences between the different tumor diameters, ages, genders and lesions number(P>0.05). Conclusion BRAFV600E mutant protein is highly expressed in papillary thyroid carcinoma, and its expression is significantly associated with lymph node metastasis and capsular invasion. It suggests that BRAFV600E mutation may be associated with tumor invasion and may be a predictor of papillary thyroid carcinoma prognosis.

       

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