2019 年第 6 期 第 14 卷

甲状腺乳头状癌患者BRAF-V600E基因突变与促甲状腺激素水平及相关临床指标的相关性分析

Relation among BRAF-V600E gene mutation, thyroid stimulating hormone and related clinical indicators in patients with papillary thyroid carcinoma

作者：朱长雨伍冀湘顾梅赵京阳李新宇党受涛

英文作者：

单位：100730首都医科大学附属北京同仁医院肿瘤科（朱长雨、顾梅、赵京阳、李新宇、党受涛），普外科（伍冀湘）

英文单位：

关键词：甲状腺乳头状癌；促甲状腺激素；BRAF-V600E基因突变

英文关键词：

• 摘要：

• 【摘要】目的    探讨甲状腺乳头状癌患者BRAF-V600E基因突变与促甲状腺激素（TSH）水平及相关临床指标的相关性。方法    回顾性分析2016年8月至2018年5月首都医科大学附属北京同仁医院手术治疗的甲状腺乳头状癌患者290例，均术前检测TSH、甲状腺微粒体抗体（TMAb）、甲状腺球蛋白抗体、游离三碘甲状腺原氨酸、游离甲状腺素水平，术后行常规组织病理学检查并检测BRAF-V600E基因突变状态。将患者按照BRAF-V600E突变状态分为阴性组（59例）、弱阳性组（39例）及阳性组（192组）。比较组间及组内各指标的差异。结果    BRAF-V600E突变阴性组、弱阳性组、阳性组在肿瘤与被膜关系方面差异有统计学意义（χ2＝14.877，P＝0.005），其中阴性组患者更易出现被膜侵犯；各组间TSH水平差异无统计学意义（P>0.05）。在所有患者中，TSH水平在血清TMAb水平0～9 kU/L组及＞9 kU/L组间差异有统计学意义［1.60(1.11,2.40)mIU/L比1.97(1.15,3.25)mIU/L］（Z＝-1.999，P＝0.046）。结论    甲状腺乳头状癌BRAF-V600E基因突变与TSH水平无明显关联。BRAF-V600E基因阴性患者肿瘤更易侵犯被膜。

• 【Abstract】Objective    To explore the relation among BRAF-V600E gene mutation, serum thyroid stimulating hormone(TSH) and related clinical indicators in patients with papillary thyroid carcinoma. Methods    Clinical data of 290 patients with papillary thyroid carcinoma who had surgical treatment between August 2016 to May 2018 in Beijing Tongren Hospital, Capital Medical University were retrospectively analyzed. Serum levels of TSH, thyromicrosomal antibody(TMAb), thyroglobulin antibody, free triiodothyronine and free thyroxine were detected before surgery. Histopathologic features and BRAF-V600E gene mutation were tested after surgery. According to the testing results of BRAF-V600E gene mutation, the patients were divided into negative group（n＝59）, weakly positive group（n＝39） and positive group（n＝192）. Clinical data were analyzed among the three groups. Results    There was a significant difference among the negative group, weakly positive group and positive group in thyroid capsule invasion（χ2＝14.877， P＝0.005）; patients with negative BRAF-V600E gene mutation were more likely to have capsule invasion. There was no significant difference of TSH level among the three groups (P>0.05). Serum TSH level showed a significant difference between TMAb 0-9 kU/L group and ＞9 kU/L group［1.60(1.11,2.40)mIU/L vs 1.97(1.15,3.25)mIU/L］（Z＝-1.999， P＝0.046）. Conclusions    There is no significant relation between BRAF-V600E gene mutation and serum TSH level in papillary thyroid carcinoma patients. Negative BRAF-V600E gene mutation may be related with thyroid capsule invasion.