甲状腺乳头状癌合并桥本氏甲状腺炎的BRAF基因表达及侵袭性

目的:比较甲状腺乳头状癌合并桥本氏甲状腺炎与不合并桥本氏甲状腺炎的BRAFV600E基因表达以及侵袭性的区别。方法:2011年9月到2013年9月四川大学华西医院手术治疗并有BRAFV600E基因测定的甲状腺乳头状癌患者226名,均有病理证实。其中合并桥本氏甲状腺炎者50例为研究组,同期随机抽取50例不合并桥本氏甲状腺炎者作为对照组。比较两组性别、年龄、肿瘤大小、数量、BRAFV600E基因表达以及甲状腺外侵犯和淋巴结转移与侵袭性相关的因素的区别。结果:甲状腺乳头状癌合并桥本氏甲状腺炎在男女性别,发病年龄、肿瘤大小上和对照组相比无差异(P0.05);BRAFV600E突变率、甲状腺外侵犯和淋巴结转移都较对照组更低(P0.05)。BRAF基因突变阳性组甲状腺外侵犯和淋巴结转移率较BRAFV600E基因突变阴性组更高(P0.05)。结论:BRAFV600E基因突变的甲状腺乳头状癌患者有更高的甲状腺腺外侵犯和淋巴结转移。甲状腺乳头状癌合并桥本氏甲状腺炎较不合并桥本氏甲状腺炎有着更低的BRAFV600E突变率,更低的甲状腺外侵犯和淋巴结转移。

Expression and Invasion of BRAF Gene in Papillary Thyroid Carcinoma withHashimoto's Thyroiditis

Objective:To compare difference of BRAFV600E gene expression and invasion in the papillary thyroid carcinomawith or without Hashimoto''s thyroiditis.Methods:226 patients with papillary thyroid carcinoma, diagnosed by pathology withBRAFV600E gene assay were selected from surgery department of West China Hospital, Sichuan University from September 2011 toSeptember 2013. 50 cases combined with Hashimoto''s thyroiditis were considered as study group, 50 cases that did not combine withHashimoto''s thyroiditis were as the control group. The gender, age, tumor size, number, BRAFV600E gene expression, invasion, lymphnode metastasis, and the factors associated with invasion was compared between two groups.Results:There was no difference in the gender,age, tumor size between two groups (P> 0.05); BRAFV600E mutation rate, invasion and lymph node metastasis in study group waslower than that of the control group (P <0.05). The invasion and the rate of lymph node metastasis in BRAF mutation-positive group washigher than BRAFV600E mutation-negative group (P<0.05).Conclusion:The patients of papillary thyroid cancer with BRAFV600Emutation have higher foreign invasion and lymph node metastasis. The patients of papillary thyroid carcinoma with Hashimoto''s thyroiditishave lower mutation rate of BRAFV600E, less thyroid foreign invasion and lymph node metastasis.