1.南京中医药大学附属中西医结合医院,甲乳外科
2.超声科
3.内分泌科,南京 210028
Received:24 November 2022,
Revised:2023-01-15,
Accepted:12 March 2023,
Published:28 April 2023
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章双艳,黄驰,马丙娥,等.细针穿刺检测BRAFV600E突变丰度与甲状腺乳头状癌临床病理特征的相关性[J].重庆医科大学学报,2023,48(4):398-403.
Zhang Shuangyan,Huang Chi,Ma Bing’e,et al.Correlation between the preoperative abundance of fine-needle aspiration (FNA)-BRAFV600E mutations and clinicopathological features of papillary thyroid carcinoma[J].Journal of Chongqing Medical University,2023,48(4):398-403.
章双艳,黄驰,马丙娥,等.细针穿刺检测BRAFV600E突变丰度与甲状腺乳头状癌临床病理特征的相关性[J].重庆医科大学学报,2023,48(4):398-403. DOI: 10.13406/j.cnki.cyxb.003204.
Zhang Shuangyan,Huang Chi,Ma Bing’e,et al.Correlation between the preoperative abundance of fine-needle aspiration (FNA)-BRAFV600E mutations and clinicopathological features of papillary thyroid carcinoma[J].Journal of Chongqing Medical University,2023,48(4):398-403. DOI: 10.13406/j.cnki.cyxb.003204.
目的
2
探讨术前细针穿刺基因检测
BRAF
V600E
突变丰度与甲状腺乳头状癌(papillary thyroid cancer,PTC)临床病理特征的关系。
方法
2
回顾性统计2021年1月30日至2022年2月28日就诊于南京中医药大学附属中西医结合医院的301例患者临床资料,术前细针穿刺基因检测示
BRAF
V600E
突变(含突变丰度检测),所有患者完成甲状腺癌根治术,术后病理证实为甲状腺乳头状癌,分析
BRAF
V600E
基因突变丰度与临床病理特征的关系。
结果
2
纳入301例患者,男91例,女210例,年龄42(33~51)岁,范围18~69岁。肿瘤直径
>
1 cm的患者
BRAF
V600E
基因突变丰度高于肿瘤直径≤1 cm者[29.05(18.03~37.56) vs. 18.35(6.74~29.61),
P
<
0.001],颈部淋巴结转移患者
BRAF
V600E
基因突变丰度高于无颈部淋巴结转移者[24.72(8.08~34.32) vs. 18(8.68~28.54),
P
=0.040]。男女分开统计,女性颈部淋巴结转移患者
BRAF
V600E
基因突变丰度高于无颈部淋巴结转移者[25.75(9.62~34.30) vs. 17.47(7.27~26.86),
P
=0.007],男性患者
BRAF
V600E
基因突变丰度与颈部淋巴结转移无明显相关性(
P
=0.654)。通过受试者工作特征(receiver operating characteristic,ROC)曲线分析
BRAF
V600E
突变丰度诊断女性PTC患者颈部淋巴结转移的效能,曲线下面积(area under the curve,AUC)为0.609(95%CI=0.532~0.686),取截断值25.68%。多因素分析显示,年龄
<
55岁(
OR
=0.138~0.735,
P
=0.007)、
BRAF
V600E
突变丰度≥25.68%(
OR
=1.271~4.65,
P
=0.007)、多灶(
OR
=1.282~4.623,
P
=0.007)、肿瘤直径
>
1 cm(
OR
=2.257~11.927,
P
<
0.001)与女性PTC患者颈部淋巴结转移有明显相关性(
P
<
0.05)。
结论
2
BRAF
V600E
突变丰度与PTC患者肿瘤直径、颈部淋巴结转移明显相关。
BRAF
V600E
突变丰度≥25.68%的女性PTC患者颈部淋巴结转移率明显升高。
Objective
2
To investigate the relationship between the preoperative abundance of fine-needle aspiration(FNA)-
BRAF
V600E
mutations and clinicopathological features of papillary thyroid cancer(PTC).
Methods
2
Retrospective analysis was performed on the clinical data of 301 patients who underwent radical thyroidectomy in Affiliated Hospital of Integrated Traditional Chinese and Western Medicine of Nanjing University of Chinese Medicine from January 30,2021 to February 28,2022. Preoperative FNA of all patients showed
BRAF
V600E
mutation. All patients underwent preoperative mutant abundance detection, and PTC was confirmed by postoperative pathology analysis. The relationship between
BRAF
V600E
mutant abundance and clinicopathological features was analyzed.
Results
2
A total of 301 patients were enrolled,including 91 males and 210 females. The median age of the patients was 42(33-51) years old, ranging from 18 to 69 years old. The abundance of
BRAF
V600E
mutation in patients with tumor diameter more than 1 cm was higher than that in patients with tumor diameter no more than 1 cm[29.05(18.03-37.56) vs. 18.35(6.74-29.61),
P
<
0.001]. The abundance of
BRAF
V600E
mutation in patients with cervical lymph node metastasis was higher than that in patients without cervical lymph node metastasis[24.72(8.08-34.32) vs. 18(8.68-28.54),
P
=0.040]. The abundance of
BRAF
V600E
mutation in female patients with cervical lymph node metastasis was higher than that in patients without cervical lymph node metastasis[25.75(9.62-34.30) vs. 17.47(7.27-26.86),
P
=0.007],but there was no statistical significance among male patients(
P
=0.654). The receiver operating characteristic(R
OC) curve for predicting cervical lymph node metastasis in female PTC patients was constructed with the abundance of
BRAF
V600E
mutation(AUC=0.609,95%CI=0.532-0.686),and the cutoff value was 25.65%. Multivariate analysis showed that the following aspects had a significant correlation with cervical lymph node metastasis in female PTC patients(
P
<
0.05),such as less than 55 years old(
OR
=0.138-0.735,
P
=0.007),
BRAF
V600E
mutant abundance no less than 25.68%(
OR
=1.271-4.65,
P
=0.007),multifocality(
OR
=1.282-4.623,
P=
0.007) and tumor diameter more than 1 cm(
OR
=2.257-11.927,
P
<
0.001).
Conclusion
2
The abundance of
BRAF
V600E
mutation was significantly correlated with tumor diameter and cervical lymph node metastasis in PTC patients. The rate of cervical lymph node metastasis of female PTC patients with
BRAF
V600E
mutant abundance of no less than 25.68% has been significantly increased.
Sung H , Ferlay J , Siegel RL , et al . Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2021 , 71 ( 3 ): 209 - 249 .
王龙龙 , 李红强 , 苌群刚 , 等 . 甲状腺癌21 980例患者临床病理特征与发病趋势分析 [J ] . 中华医学杂志 , 2020 , 100 ( 14 ): 1072 - 1076 .
Wang LL , Li HQ , Chang QG , et al . Clinical pathology and incidence trend of thyroid cancer based on 21 980 cases [J ] . Natl Med J China , 2020 , 100 ( 14 ): 1072 - 1076 .
甲状腺结节和分化型甲状腺癌诊治指南 [J ] . 中华核医学与分子影像杂志 , 2013 , 33 ( 2 ): 96 - 115 .
Guidelines for diagnosis and treatment of thyroid nodules and differentiated thyroid cancer [J ] . Chin J Nucl Med Mol Imaging , 2013 , 33 ( 2 ): 96 - 115 .
Rashid FA , Munkhdelger J , Fukuoka J , et al . Prevalence of BRAF V600E mutation in Asian series of papillary thyroid carcinoma-a contemporary systematic review [J ] . Gland Surg , 2020 , 9 ( 5 ): 1878 - 1900 .
赫 捷 , 李 进 , 程颖 , 等 . 中国临床肿瘤学会(CSCO)分化型甲状腺癌诊疗指南2021 [J ] . 肿瘤预防与治疗 , 2021 , 34 ( 12 ): 1164 - 1201 .
He J , Li J , Chen Y , et al . Guidelines of Chinese society of clinical oncology(CSCO)differentiated thyroid cancer [J ] . J Cancer Control Treat , 2021 , 34 ( 12 ): 1164 - 1201 .
Laha D , Nilubol N , Boufraqech M . New therapies for advanced thyroid cancer [J ] . Front Endocrinol(Lausanne) , 2020 , 11 : 82 .
Lin B , Ma HQ , Ma MG , et al . The incidence and survival analysis for anaplastic thyroid cancer:a SEER database analysis [J ] . Am J Transl Res , 2019 , 11 ( 9 ): 5888 - 5896 .
高 明 , 葛明华 , 嵇庆海 , 等 . 甲状腺微小乳头状癌诊断与治疗中国专家共识(2016版) [J ] . 中国肿瘤临床 , 2016 , 43 ( 10 ): 405 - 411 .
Gao M , Ge MH , Ji QH , et al . China expert consensus on diagnosis and treatment of thyroid micropapillary carcinoma(2016 edition) [J ] . Chin J Clin Oncol , 2016 , 43 ( 10 ): 405 - 411 .
于 淏 , 王 强 , 查斯洛 , 等 . 5 mm及以下cN0甲状腺乳头状微小癌中央区淋巴结转移规律及危险因素分析 [J ] . 第二军医大学学报 , 2018 , 39 ( 1 ): 101 - 104 .
Yu H , Wang Q , Zha SL , et al . Patterns and risk factors of central lymph node metastasis in cN0 papillary thyroid microcarcinoma with tumor maximum diameter of 5 mm or below [J ] . Acad J Second Mil Med Univ , 2018 , 39 ( 1 ): 101 - 104 .
潘 勐 , 黄 勇 , 汪汉华 , 等 . CT征象联合临床病理特征对甲状腺微小乳头状癌中央组淋巴结转移的预测价值 [J ] . 中国普外基础与临床杂志 , 2022 , 29 ( 6 ): 738 - 742 .
Pan M , Huang Y , Wang HH , et al . Prediction of lymph node metastasis in central group of thyroid papillary microcarcinoma by CT signs combined with clinicopathological features [J ] . Chin J Bases Clin Gen Surg , 2022 , 29 ( 6 ): 738 - 742 .
闫 雪 , 段宇龙 , 徐建林 , 等 . 甲状腺乳头状癌彩超血流参数及临床病理与颈部淋巴结转移的关系 [J ] . 实用癌症杂志 , 2021 , 36 ( 11 ): 1795 - 1798 .
Yan X , Duan YL , Xu JL , et al . Relationship between blood flow parameters of color Doppler ultrasound,clinicopathology and cervical lymph node metastasis in papillary thyroid carcinoma [J ] . Pract J Cancer , 2021 , 36 ( 11 ): 1795 - 1798 .
江晶晶 , 王建华 , 丁文波 , 等 . FNAC联合 BRAF V600E 基因检测对甲状腺癌颈部淋巴结转移的诊断价值 [J ] . 中国普外基础与临床杂志 , 2018 , 25 ( 9 ): 1083 - 1086 .
Jiang JJ , Wang JH , Ding WB , et al . Diagnostic significance of fine needle aspiration cytology combined with BRAF V600E gene detection in cervical lymph node metastasis of thyroid cancer [J ] . Chin J Bases Clin Gen Surg , 2018 , 25 ( 9 ): 1083 - 1086 .
罗定远 , 欧阳能太 . 甲状腺癌分子诊断的现状与展望 [J ] . 临床外科杂志 , 2020 , 28 ( 3 ): 285 - 288 .
Luo DY , Ouyang NT . The status and trends of molecular diagnosis in thyroid cancer [J ] . J Clin Surg , 2020 , 28 ( 3 ): 285 - 288 .
Xing MZ . Genetic-guided risk assessment and management of thyroid cancer [J ] . Endocrinol Metab Clin North Am , 2019 , 48 ( 1 ): 109 - 124 .
Heidorn SJ , Milagre C , Whittaker S , et al . Kinase-dead BRAF and oncogenic RAS cooperate to drive tumor progression through CRAF [J ] . Cell , 2010 , 140 ( 2 ): 209 - 221 .
Moulana FI , Priyani AAH , de Silva MVC , et al . BRAF-oncogene-induced senescence and the role of thyroid-stimulating hormone signaling in the progression of papillary thyroid carcinoma [J ] . Horm Cancer , 2018 , 9 ( 1 ): 1 - 11 .
Givens DJ , Buchmann LO , Agarwal AM , et al . BRAF V600E does not predict aggressive features of pediatric papillary thyroid carcinoma [J ] . Laryngoscope , 2014 , 124 ( 9 ): E389 - E393 .
朱长雨 , 顾 梅 , 党受涛 , 等 . 甲状腺乳头状癌临床病理学特征与 BRAF V600E 基因突变相关性研究 [J ] . 中国实用外科杂志 , 2019 , 39 ( 3 ): 237 - 239 .
Zhu CY , Gu M , Dang ST , et al . Correlation between clinicopathological features and BRAF V600E gene mutation in papillary thyroid carcinoma [J ] . Chin J Pract Surg , 2019 , 39 ( 3 ): 237 - 239 .
Zhang XC , Liang ZY , Wang SY , et al . Application of next-generation sequencing technology to precision medicine in cancer:joint consensus of the Tumor Biomarker Committee of the Chinese Society of Clinical Oncology [J ] . Cancer Biol Med , 2019 , 16 ( 1 ): 189 - 204 .
邵 岚 , 王文娴 , 石志永 , 等 . EGFR T790M突变丰度对奥希替尼治疗晚期非小细胞肺癌疗效的影响 [J ] . 肿瘤学杂志 , 2020 , 26 ( 7 ): 575 - 581 .
Shao L , Wang WX , Shi ZY , et al . Relationship between abundance of EGFR T790M mutation and efficacy of osimertinib in treatment of advanced non-small cell lung cancer patients [J ] . J Chin Oncol , 2020 , 26 ( 7 ): 575 - 581 .
徐含烟 , 赖茜茜 , 苏珊珊 , 等 . 晚期肺腺癌患者血浆表皮生长因子受体突变丰度与表皮生长因子受体酪氨酸激酶抑制剂疗效的相关性研究 [J ] . 中华内科杂志 , 2019 , 58 ( 1 ): 49 - 55 .
Xu HY , Lai QQ , Su SS , et al . Plasma relative abundance of epidermal growth factor receptor mutations predicts clinical response to epidermal growth factor receptor-tyrosine kinase inhibitors in patients with advanced lung adenocarcinoma [J ] . Chin J Intern Med , 2019 , 58 ( 1 ): 49 - 55 .
骆鹏飞 , 穆夏黎 , 焦大海 , 等 . 甲状腺结节细针穿刺细胞学检查标本充分性的影响因素 [J ] . 中华医学杂志 , 2020 , 100 ( 24 ): 1913 - 1916 .
Luo PF , Mu XL , Jiao DH , et al . Influencing factors of adequacy of fine needle aspiration cytological examination specimens for thyroid nodules [J ] . Natl Med J China , 2020 , 100 ( 24 ): 1913 - 1916 .
贺青卿 , 于 芳 , 范子义 , 等 . 单中心2038例甲状腺癌20年随访及危险因素分析 [J ] . 中华内分泌外科杂志 , 2022 , 16 ( 1 ): 18 - 22 .
He QQ , Yu F , Fan ZY , et al . Risk factor analysis of 20-year follow-up of 2038 cases of thyroid cancer:a single center study [J ] . Chin J Endocr Surg , 2022 , 16 ( 1 ): 18 - 22 .
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