BRAFV600E基因突变检测在甲状腺乳头状癌诊断中的应用价值

Application value of BRAFV600E gene mutation detection in the diagnosis of papillary thyroid cancer

  • 摘要: 目的 分析鼠类肉瘤滤过性毒素菌致癌同源体B1(BRAF)基因V600E(BRAFV600E)突变检测在甲状腺乳头状癌(PTC)诊断中的应用价值。 方法 选择82例PTC患者为研究组,另选取同期80例甲状腺良性结节患者为对照组。采用实时荧光定量聚合酶链式反应(qRT-PCR)检测2组患者术前穿刺活检组织中的BRAFV600E基因突变情况。分析研究组患者的年龄、性别、甲状腺微小乳头状癌(PTMC)情况、病灶数、甲状腺外浸润、淋巴结转移、TNM分期等临床病理特征。 结果 研究组和对照组分别有57例和4例患者的活检组织中检出BRAFV600E基因突变,阳性率分别为69.51%和5.00%, 差异有统计学意义(P<0.01)。研究组中, BRAFV600E基因突变阳性患者PTMC比率、出现N3淋巴结转移比率、TMN Ⅱ~Ⅳ期比率显著高于BRAFV600E基因突变阴性患者(P<0.05)。术前穿刺活检组织BRAFV600E基因突变检测在PTC与良性结节的鉴别诊断、PTMC诊断及PTC临床分期诊断中的曲线下面积(AUC)分别为0.823、0.797、0.759, 差异均有统计学意义(P<0.05)。 结论 PTC组织具有较高的BRAFV600E基因突变阳性率,术前通过穿刺活检对病灶组织中BRAFV600E基因突变进行检测,在PTC的鉴别诊断、临床分期诊断、病理诊断等方面具有一定的应用价值,可用于PTC的辅助诊断和病情评价。

     

    Abstract: Objective To analyze the clinical application value of V-raf murine sarcoma viral oncogene homolog B1(BRAF)gene V600E(BRAFV600E)mutation detection in the diagnosis of papillary thyroid cancer(PTC). Methods Totally 82 patients with PTC were selected as study group, and 80 patients with benign thyroid nodules were selected as control group. The mutation of BRAFV600E gene in the preoperative biopsy tissue was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)in both groups. The clinicopathological characteristics such as age, gender, status of papillary thyroid microcarcinoma(PTMC), number of lesions, extrathyroid infiltration, lymph node metastasis and TNM staging were analyzed in the study group. Results BRAFV600E gene mutation was detected in 57 cases in the study group and 4 cases in the control group, the positive rates were 69.51% and 5.00% respectively, and there was significant difference between two groups(P<0.01). In the study group, the ratios of PTMC, N3 lymph node metastasis and TNM Ⅱ to Ⅳ in patients with positive mutation of BRAFV600E gene were significantly higher than those in patients with negative mutation of BRAFV600E gene(P<0.05). The area under curve(AUC)of BRAFV600E mutation detection in the differential diagnosis of PTC and benign nodules, the diagnosis of PTMC and the clinical stage diagnosis of PTC were 0.823, 0.797 and 0.759 respectively, and the differences were statistically significant(P<0.05). Conclusion The positive rate of BRAFV600E gene mutation is high in PTC tissue. The detection of BRAFV600E gene mutation in lesion tissue by puncture biopsy before operation has - a certain application value in differential diagnosis, clinical stage diagnosis and pathological diagnosis of PTC, which can be used for auxiliary diagnosis and disease evaluation.

     

/

返回文章
返回