孙鑫,张巍,程令刚,广旸,张雨康.甲状腺乳头状癌临床、多模态超声及病理学特征与BRAF V600E突变的相关性[J].中国医学影像技术,2024,40(5):730~734
甲状腺乳头状癌临床、多模态超声及病理学特征与BRAF V600E突变的相关性
Correlations of clinical, multi-modal ultrasonic and pathological features of papillary thyroid carcinoma with BRAF V600E mutation
投稿时间:2024-01-08  修订日期:2024-02-27
DOI:10.13929/j.issn.1003-3289.2024.05.021
中文关键词:  癌,乳头状  甲状腺肿瘤  超声检查  BRAF V600E基因  前瞻性研究
英文关键词:carcinoma, papillary  thyroid neoplasms  ultrasonography  BRAF V600E gene  prospective studies
基金项目:
作者单位E-mail
孙鑫 首都医科大学附属北京天坛医院超声科, 北京 100070  
张巍 首都医科大学附属北京天坛医院超声科, 北京 100070 ultrazw@sina.com 
程令刚 首都医科大学附属北京天坛医院超声科, 北京 100070  
广旸 首都医科大学附属北京天坛医院超声科, 北京 100070  
张雨康 首都医科大学附属北京天坛医院超声科, 北京 100070  
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中文摘要:
      目的 观察甲状腺乳头状癌(PTC)临床、多模态超声及病理学特征与BRAF V600E突变的相关性。方法 前瞻性收集临床疑诊甲状腺恶性病变患者,获取病理学及基因检测结果后,根据BRAF V600E基因检测结果将PTC分为BRAF V600E突变(+)(突变组)和BRAF V600E突变(-)(野生型组);以单因素分析及多因素logistic回归分析组间临床、常规超声、超声造影(CEUS)及病理学表现,筛选PTC BRAF V600E基因突变的独立预测因素。结果 共纳入116例PTC患者(116个病灶),包括突变组77例、野生型组39例。组间甲状腺过氧化物酶抗体(TPO-Ab)水平,常规超声所示病灶大小、方位、边缘、微钙化,CEUS显示增强后病灶大小变化、平均通过时间(MTT),以及病理学显示被膜外侵犯、颈部中央区淋巴结转移及合并良性结节占比差异均有统计学意义(P均<0.05);其中,TPO-Ab、多模态超声所示病灶方位及增强后病灶大小变化、病理学颈部中央区淋巴结转移均为PTC BRAF V600E基因突变的独立预测因素(OR=0.175、3.868、5.769、6.943,P均<0.05)。结论 患者TPO-Ab水平,多模态超声所示病灶方位、增强后病灶大小变化及病理学显示颈部中央区淋巴结转移均与PTC BRAF V600E基因突变独立相关。
英文摘要:
      Objective To observe the correlations of clinical, multi-modal ultrasonic and pathological features of papillary thyroid carcinoma (PTC) with BRAF V600E mutation. Methods Patients with clinically suspected malignant thyroid lesions were prospectively collected. After the results of pathology and gene test were obtained, PTC patients were divided into BRAF V600E mutation (+) (mutant group) and BRAF V600E mutation (-) (wild-type group) according to BRAF V600E gene test. Univariate analysis and multivariate logistic regression were used to compare clinical, conventional ultrasound, contrast-enhanced ultrasound (CEUS) and pathological manifestations between groups, so as to screen the independent risk factors of PTC BRAF V600E gene mutation. Results A total of 116 PTC patients (116 lesions) were enrolled, including 77 in mutant group and 39 in wild-type group. Statistical differences of thyroid peroxidase antibody (TPO-Ab) level, lesion size, orientation, margin and microcalcification observed on conventional ultrasound, changes of lesion size and the mean transit time (MTT) shown on CEUS, as well as of extramembranous invasion, cervical central lymph node metastasis, complicated with benign nodules shown by pathology were found between groups (all P<0.05). TPO-Ab level, lesion orientation and changes of lesion size after enhancement shown by multi-modal ultrasound, and pathological cervical central lymph node metastasis were all independent predictive factors for PTC BRAF V600E gene mutation (OR=0.175, 3.868, 5.769, 6.943, all P<0.05). Conclusion Patients’ TPO-Ab level, lesion orientation, changes of lesion size after enhancement shown by multi-modal ultrasound and pathological cervical central lymph node metastasis were all independently associated with PTC BRAF V600E gene mutation.
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