摘要
目的探讨BRAF^(V600E)基因野生型甲状腺乳头状癌(PTC)的临床病理特征。方法选取首都医科大学附属北京同仁医院2021年8月至2024年6月收治的483例经手术确诊为PTC的患者,其中54例患者经BRAF^(V600E)基因突变检测确认为BRAF^(V600E)基因野生型(BRAF^(V600E)野生型组),429例为BRAF^(V600E)基因突变型(BRAF^(V600E)突变型组)。回顾性分析两组患者的临床病理特征。结果54例PTC患者同时进行了术前细针穿刺标本和术后石蜡标本的BRAF^(V600E)基因突变检测,其中有53例两份标本检测结果一致。BRAF^(V600E)野生型组中术前细针穿刺细胞学Ⅴ类占比最高,且明显高于BRAF^(V600E)突变型组,Ⅵ类占比次之,但低于BRAF^(V600E)突变型组,差异均有统计学意义(P<0.05)。BRAF^(V600E)野生型组中合并桥本甲状腺炎的比例高于BRAF^(V600E)突变型组,差异有统计学意义(P<0.05)。两组性别、年龄、肿瘤部位、肿瘤数量(单/多灶)、肿瘤灶数、肿瘤大小、肿瘤最大径、有被膜侵犯比例、有淋巴结转移比例、淋巴结转移数量、甲状腺滤泡结节性病变比例比较差异均无统计学意义(P>0.05)。结论术前细针穿刺标本和术后石蜡标本的BRAF^(V600E)基因突变检测一致性极高,术后标本不需要重复检测。BRAF^(V600E)基因野生型PTC在细针穿刺细胞学检查中相对缺乏典型性病变,同时更易伴随桥本甲状腺炎,是值得关注的一部分PTC病例。
Objective To investigate the clinicopathological features of BRAF^(V600E) gene wild-type papillary thyroid carcinoma(PTC).Method A total of 483 patients diagnosed with PTC by surgery and admitted to Beijing Tongren Hospital Affiliated to Capital Medical University from August 2021 to June 2024 were selected.Among them,54 patients were confirmed as BRAF^(V600E) gene wild type(BRAF^(V600E) wild type group)by BRAF^(V600E) gene mutation detection.429 cases were BRAF^(V600E) gene mutation type(BRAF^(V600E) mutation type group).A retrospective analysis was conducted on the clinicopathological characteristics of the two groups of patients.Result BRAF^(V600E) gene mutation detection was simultaneously performed on preoperativefine-needle aspiration specimens and postoperative paraffin specimens in 54 patients with PTC.Among them,the test results of the two specimens were consistent in 53 cases.In the BRAF^(V600E) wild-type group,the proportion of class V in preoperativefine-needle aspiration cytology was the highest and significantly higher than that in the BRAF^(V600E) mutant group.The proportion of class VI was second but lower than that in the BRAF^(V600E) mutant group.The differences were statistically significant(P<0.05).The proportion of patients with Hashimoto’s thyroiditis in the BRAF^(V600E) wild-type group was higher than that in the BRAF^(V600E) mutant group,and the difference was statistically significant(P<0.05).There were no statistically significant differences between the two groups in terms of gender,age,tumor location,number of tumors(single/multiple),number of tumor foci,tumor size,maximum diameter of the tumor,proportion of capsule invasion,proportion of lymph node metastasis,number of lymph node metastasis,and proportion of thyroid follicular nodular lesions(P>0.05).Conclusion The consistency of BRAF^(V600E) gene mutation detection betweenfine needle aspiration specimen and paraffin specimen after operation is very high,and repeated detection is not needed for postoperative specimen.Wild-type PTC with BRAF^(V600E) gene is relatively lack of typical lesions infine needle aspiration cytology,and it is more likely to be accompanied by Hashimoto’s thyroiditis,which is a part of PTC cases worthy of attention.
作者
贾双双
马东林
朴颖实
Jia Shuangshuang;Ma Donglin;Piao Yingshi(Department of Pathology,Beijing Tongren Hospital/Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology,Capital Medical University,Beijing 100730,China)
出处
《中国医刊》
2025年第6期684-687,共4页
Chinese Journal of Medicine
