中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2013年
11期
931-934
,共4页
桥本甲状腺炎%甲状腺乳头状癌%BRAF
橋本甲狀腺炎%甲狀腺乳頭狀癌%BRAF
교본갑상선염%갑상선유두상암%BRAF
Hashimoto's thyroiditis%Papillary thyroid carcinoma%BRAF
目的 总结甲状腺乳头状癌(PTC)合并桥本甲状腺炎(HT)的辅助检查、诊断等临床特征,分析BRAFV600E基因突变与PTC合并HT的相关性.方法 回顾性分析201 1年3月至2012年3月期间收治的合并HT的PTC患者(研究组50例)和未合并HT的PFC患者(对照组150例)的临床特征,并比较了两组患者的差异,对其BRAFV600E基因突变情况进行了对照分析.结果 研究组中颈部超声检查对颈部淋巴结转移判断的敏感度为88.9％,特异度为50.0％;研究组中TSH、甲状腺球蛋白抗体及甲状腺过氧化物酶抗体水平均高于对照组(均P＜0.01),二者淋巴结转移率(36.0％对54.0％)及侧颈转移率(22.2％对63.0％)差异均有统计学意义(P=0.041,P=0.004);BRAFN600E基因突变率在研究组及对照组中分别为34.0％和70.7％(P＜0.01);研究组中BRAF基因突变与淋巴结转移有显著相关性(P＜0.01).结论 超声检查对于判断HT合并PTC患者颈部淋巴结转移情况的敏感性较好,特异性较差,需与术中快速冰冻病理结合以评估颈部淋巴结清扫范围;BRAFV600E基因突变在PTC合并HT中有所减少,使其淋巴结转移率有所降低,总体预后好.
目的 總結甲狀腺乳頭狀癌(PTC)閤併橋本甲狀腺炎(HT)的輔助檢查、診斷等臨床特徵,分析BRAFV600E基因突變與PTC閤併HT的相關性.方法 迴顧性分析201 1年3月至2012年3月期間收治的閤併HT的PTC患者(研究組50例)和未閤併HT的PFC患者(對照組150例)的臨床特徵,併比較瞭兩組患者的差異,對其BRAFV600E基因突變情況進行瞭對照分析.結果 研究組中頸部超聲檢查對頸部淋巴結轉移判斷的敏感度為88.9％,特異度為50.0％;研究組中TSH、甲狀腺毬蛋白抗體及甲狀腺過氧化物酶抗體水平均高于對照組(均P＜0.01),二者淋巴結轉移率(36.0％對54.0％)及側頸轉移率(22.2％對63.0％)差異均有統計學意義(P=0.041,P=0.004);BRAFN600E基因突變率在研究組及對照組中分彆為34.0％和70.7％(P＜0.01);研究組中BRAF基因突變與淋巴結轉移有顯著相關性(P＜0.01).結論 超聲檢查對于判斷HT閤併PTC患者頸部淋巴結轉移情況的敏感性較好,特異性較差,需與術中快速冰凍病理結閤以評估頸部淋巴結清掃範圍;BRAFV600E基因突變在PTC閤併HT中有所減少,使其淋巴結轉移率有所降低,總體預後好.
목적 총결갑상선유두상암(PTC)합병교본갑상선염(HT)적보조검사、진단등림상특정,분석BRAFV600E기인돌변여PTC합병HT적상관성.방법 회고성분석201 1년3월지2012년3월기간수치적합병HT적PTC환자(연구조50례)화미합병HT적PFC환자(대조조150례)적림상특정,병비교료량조환자적차이,대기BRAFV600E기인돌변정황진행료대조분석.결과 연구조중경부초성검사대경부림파결전이판단적민감도위88.9％,특이도위50.0％;연구조중TSH、갑상선구단백항체급갑상선과양화물매항체수평균고우대조조(균P＜0.01),이자림파결전이솔(36.0％대54.0％)급측경전이솔(22.2％대63.0％)차이균유통계학의의(P=0.041,P=0.004);BRAFN600E기인돌변솔재연구조급대조조중분별위34.0％화70.7％(P＜0.01);연구조중BRAF기인돌변여림파결전이유현저상관성(P＜0.01).결론 초성검사대우판단HT합병PTC환자경부림파결전이정황적민감성교호,특이성교차,수여술중쾌속빙동병리결합이평고경부림파결청소범위;BRAFV600E기인돌변재PTC합병HT중유소감소,사기림파결전이솔유소강저,총체예후호.
Objective To investigate the correlation of BRAFV600E mutation with papillary thyroid carcinoma and coexisting Hashimoto's thyroiditis.Methods A retrospective analysis of clinical characteristics was made in 50 patients with PTC and coexisting HT(research group) and 150 PTC patients(control group) from March,2011 to March,2012,regarding the difference in BRAFV600E mutation.Results In research group,the sensitivity of ultrasound in detecting lymphatic metastasis was 88.9％,while the specificity was 50.0％ ; the levels ofTSH,thyroid globulin antibody,and thyroid peroxidase antibody in research group were higher than those in control group (all P＜ 0.01).Rates of lymphatic metastasis (36.0％ vs 54.0％) and metastasis in Ⅱ-V area(22.2％ vs 63.0％) showed statistically significant differences between research group and control group(P=0.041,P=0.004).The respective rates of mutation of BRAFV600Ein two groups were 34.0％ and 70.7％,showing significant difference (P＜0.01).There was a significant correlation between BRAFV600E mutation and lymphatic metastasis in research group (P ＜ 0.01).Conclusions The sensitivity of ultrasound in detecting lymphatic metastasis of PTC is quite satisfactory while with its poor specificity.Combination of ultrasound with the fast frozen section pathology may help assess the scope of surgery.Reduced BRAF V600Emutation in PTC with coexisting HT results in reduction of lymphatic metastasis and may help to improve the prognosis of patients.
