CAJ | 학술논문

目的观察甲状腺乳头状癌中RAS基因突变的情况,分析其突变对患者临床特点及预后的影响.方法选取经病理证实为甲状腺乳头状癌的患者354例,对患者病情、治疗方式、病理特点、预后等情况进行详细研究.依RAS突变与否将患者分为两组.比较两组间病理类型、病情进展、复发情况及生存时间等方面的差异,通过多元回归分析评估RAS突变与不同变量间的相关性.结果 354例患者中86例有RAS突变.突变阳性与阴性者对比,两者原发灶状态(P=0.004)、远处转移(P=0.027)、病情分期(P=0.004)及ATA危险分层(P =0.000)间差异有统计学意义.RAS突变阳性者复发率较高,无复发生存时间较短(P ＜0.005).RAS突变与ATA危险分层存在明显相关性.结论 RAS突变增加了甲状腺癌患者术后复发的危险性,RAS突变和ATA危险分层是预测甲状腺乳头状癌预后的重要指标.
목적 관찰갑상선유두상암중RAS기인돌변적정황,분석기돌변대환자림상특점급예후적영향.방법 선취경병리증실위갑상선유두상암적환자354례,대환자병정、치료방식、병리특점、예후등정황진행상세연구.의RAS돌변여부장환자분위량조.비교량조간병리류형、병정진전、복발정황급생존시간등방면적차이,통과다원회귀분석평고RAS돌변여불동변량간적상관성.결과 354례환자중86례유RAS돌변.돌변양성여음성자대비,량자원발조상태(P=0.004)、원처전이(P=0.027)、병정분기(P=0.004)급ATA위험분층(P =0.000)간차이유통계학의의.RAS돌변양성자복발솔교고,무복발생존시간교단(P ＜0.005).RAS돌변여ATA위험분층존재명현상관성.결론 RAS돌변증가료갑상선암환자술후복발적위험성,RAS돌변화ATA위험분층시예측갑상선유두상암예후적중요지표.
Objective To observe the RAS gene mutations in papillary thyroid carcinoma,and to analyse the effects of mutation on clinical characteristics and prognosis.Methods In this study,354 papillary thyroid carcinoma patients were divided into 2 groups according to RAS mutation by DNA sequence analysis.The pathological type,disease progression,recurrence and prognostic difference between the two groups were compared,and regression analysis was performed to evaluate the relationship between different variables and RAS mutation.Results There were 86 patients with RAS positive mutation.A significant difference was found with primary sites (P =0.004),distant metastasis (P =0.027),AJCC stage (P =0.004) and ATA risk stratification (P =0.000) between two groups.RAS positive patients have higher recurrence rate and shorter recurrence-free survival time (P ＜ 0.005) than the negative patients.Furthermore,in the multivariate analysis,the RAS mutation was significantly associated only with the ATA stratification.Conclusions RAS mutation increases risk of recurrence,RAS mutation and ATA stratification might be a valuable diagnostic and prognostic marker of papillary thyroid carcinoma.