老年甲状腺乳头状癌超声表现与 BRAF 基因突变及临床病理特征的相关性 ^*

To investigate the correlation between ultrasonographic findings of papillary thyroid carcinoma and BRAF gene mutation and clinicopathological features in elderly patients

摘要

目的 分析老年甲状腺乳头状癌超声表现与 BRAF 基因突变及临床病理特征的相关性。方法 选取 2022 年 3 月—2024 年 4 月南通大学附属肿瘤医院收治的 121 例老年甲状腺乳头状癌患者进行回顾性分析。入组患者均行超声检查, 并采用聚合酶链反应检测 BRAF 基因, 采集患者临床病理特征、超声表现等资料, 依据 BRAF 基因检测结果将患者分为突变组 [BRAF 突变 (+)] 和野生型组 [BRAF 突变 (-)], 采用多因素 logistic 回归模型分析 BRAF 基因突变的独立预测因素。结果 BRAF 基因检测结果显示, 突变组 80 例, 野生型组 41 例。突变组甲状腺球蛋白抗体 (TG-Ab) 异常、被膜外侵犯、颈部中央区淋巴结转移、合并良性结节、病灶方位垂直位、边缘不规则、微钙化占比均高于野生型组 (P<0.05), 肿瘤最大直径长于野生型组 (P<0.05); 两组在性别、年龄、促甲状腺激素异常、甲状腺球蛋白异常、甲状腺过氧化物酶抗体异常、病灶数量、合并桥本甲状腺炎、病灶位置、低回声晕、实性成分回声、甲状腺背景、血流 Rago 分型方面比较, 差异均无统计学意义 (P>0.05)。多因素 logistic 回归分析结果显示, TG-Ab 异常、被膜外侵犯、肿瘤最大直径、颈部中央区淋巴结转移、病灶方位为垂直位均为 BRAF 基因突变的独立预测因素 (P<0.05)。结论 老年甲状腺乳头状癌患者 TG-Ab 异常、被膜外侵犯、肿瘤最大直径、颈部中央区淋巴结转移和病灶呈垂直位等特征与 BRAF 基因突变密切相关。

Abstract

Objective To analyze the correlation between ultrasonographic findings of papillary thyroid carcinoma and BRAF gene mutation and clinicopathological features in the elderly. Methods A retrospective analysis was conducted on 121 elderly patients with papillary thyroid carcinoma admitted to the Affiliated Cancer Hospital of Nantong University from March 2022 to April 2024. All patients underwent ultrasound examination, and polymerase chain reaction technology was used to detect the BRAF gene. The clinicopathological characteristics and ultrasound manifestations of the patients were collected. According to the results of BRAF gene detection, the patients were divided into BRAF mutation (+) (mutant group) and BRAF mutation (-) (wild type group). Multivariate logistic regression analysis was used to analyze the independent predictive factors of BRAF gene mutation. Results The BRAF gene test results showed that there were 80 cases in the mutant group and 41 cases in the wild-type group. The abnormal thyroid globulin antibody (TG-Ab), extracapsular invasion, lymph node metastasis in the central cervical region, combined benign nodules, vertical lesion location, irregular margin, and the proportion of microcalcification in the mutant group were all higher than those in the wild-type group (P<0.05), and the maximum diameter of the tumor was longer than that in the wild-type group (P<0.05). There were no statistically significant differences between the two groups in terms of gender, age, abnormal thyroid stimulating hormone, abnormal thyroglobulin, abnormal thyroid peroxidase antibody, number of lesions, combined Hashimoto's thyroiditis, lesion location, hypoechoic halo, solid component echo, thyroid background, and blood flow Rago classification (P>0.05). Multivariate logistic regression analysis showed that TG-Ab abnormality, extracapsular invasion, maximum tumor diameter, central cervical lymph node metastasis, and vertical position of the lesion were independent predictors of BRAF mutation (P<0.05). Conclusion The characteristics such as abnormal TG-Ab, extracapsular invasion, the maximum diameter of the tumor, lymph node metastasis in the central cervical region and vertical lesion in elderly patients with papillary thyroid carcinoma are closely related to BRAF gene mutations.

关键词

甲状腺乳头状癌 / BRAF 基因 / 超声检查

Key words

Papillary thyroid carcinoma / BRAF gene / Ultrasound examination

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基金资助

^*国家自然科学基金面上项目(82373387)