CAJ | 학술논문

目的：探讨鼠类肉瘤滤过性毒菌致癌同源体B1（BRAF）V600E基因突变与甲状腺乳头状癌（ PTC）中央区淋巴结转移的关系。方法回顾性分析126例PTC患者的临床病理资料，采用荧光定量PCR检测BRAF V600E基因的突变情况。结果126例PTC患者中，BRAF V600E基因突变发生率为69．0％（87／126）。单因素分析显示，中央区淋巴结转移与BRAF V600E基因突变有关（P＜0．05），而患者性别、年龄、多发病灶、肿瘤大小、腺外侵及、桥本氏甲状腺炎和肿瘤分期与 BRAF V600E基因突变无关（P＞0．05）。多因素分析显示，只有中央区淋巴结转移与BRAF V600E基因突变有关（P＜0．05）。当肿瘤直径≤10 mm时，BRAF V600E基因突变对中央区淋巴结转移无影响（P＞0．05）；当肿瘤直径＞10 mm时，BRAF V600E基因突变阳性患者的中央区淋巴结转移率显著高于BRAF V600E基因突变阴性患者，差异有统计学意义（P＜0．05）。结论 BRAF V600E基因突变是PTC中央区淋巴结转移风险的独立预测因素。对于术前检测BRAF V600E基因突变阳性的患者，肿瘤直径越大越应该重视中央区淋巴结清扫的重要性，且应该常规清扫该区域淋巴脂肪组织。但当BRAF V600E基因突变阴性患者的肿瘤直径≤5 mm时，应该重新审视中央区淋巴结清扫的必要性。
목적：탐토서류육류려과성독균치암동원체B1（BRAF）V600E기인돌변여갑상선유두상암（ PTC）중앙구림파결전이적관계。방법회고성분석126례PTC환자적림상병리자료，채용형광정량PCR검측BRAF V600E기인적돌변정황。결과126례PTC환자중，BRAF V600E기인돌변발생솔위69．0％（87／126）。단인소분석현시，중앙구림파결전이여BRAF V600E기인돌변유관（P＜0．05），이환자성별、년령、다발병조、종류대소、선외침급、교본씨갑상선염화종류분기여 BRAF V600E기인돌변무관（P＞0．05）。다인소분석현시，지유중앙구림파결전이여BRAF V600E기인돌변유관（P＜0．05）。당종류직경≤10 mm시，BRAF V600E기인돌변대중앙구림파결전이무영향（P＞0．05）；당종류직경＞10 mm시，BRAF V600E기인돌변양성환자적중앙구림파결전이솔현저고우BRAF V600E기인돌변음성환자，차이유통계학의의（P＜0．05）。결론 BRAF V600E기인돌변시PTC중앙구림파결전이풍험적독립예측인소。대우술전검측BRAF V600E기인돌변양성적환자，종류직경월대월응해중시중앙구림파결청소적중요성，차응해상규청소해구역림파지방조직。단당BRAF V600E기인돌변음성환자적종류직경≤5 mm시，응해중신심시중앙구림파결청소적필요성。
Objective To investigate the association of concomitant BRAFV600E mutation with central lymph node metastases in papillary thyroid carcinoma ( PTC ) . Methods The clinicopathological data of 126 PTC patients who underwent surgical treatment within a period of 2 years were retrospectively analyzed. The BRAF V600E gene mutation was detected by quantitative fluorescence PCR. Results The BRAF mutation rate was 69. 0% (87/126). The univariate analysis showed that BRAF mutation status was significantly associated with central lymph node metastasis (P<0. 05), while the gender, multiple lesions, tumor size, extra?thyroidal invasion, Hashimoto′s thyroiditis and tumor stage were not significantly associated with the BRAF mutation (P>0. 05 for all). The multivariate analysis showed that only central lymph node metastasis was significantly correlated with BRAF mutation (P<0. 05). When the diameter of tumor was≤10 mm, BRAF mutation was statistically not significantly correlated to central lymph node metastasis ( P>0. 05). When the diameter of tumor was >10 mm, the central lymph node metastasis rate was significantly higher in patients with positive BRAF mutation than that in patients with a negative BRAF mutation ( P<0. 05). Conclusions The presence of BRAF mutation is an independent predictive factor for central lymph node metastasis. When PTC is with preoperative positive BRAF mutation, the cervical dissection should be routinely performed. The larger the tumor diameter is, the more important is the central lymph node dissection. There should be re?evaluated the necessity of preventative central lymph node dissection when the tumor diameter was ≤5 mm in patients with negative BRAF mutation.