Relationship between BRAF V600E and clinica features in papillary thyroid carcinoma
Relationship between BRAF V600E and clinica features in papillary thyroid carcinoma
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DOI：
10.1530/ec-19-0246
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发表时间：
2019-07-01
影响因子：
2.9
通讯作者：
Ling, Rui
中科院分区：
文献类型：
--
作者：
Yan, Changjiao;Huang, Meiling;Ling, Rui
目的：在迄今为止中国最大的单机构队列研究中，研究BRAF基因突变状态，并分析其与甲状腺乳头状癌（PTC）患者流行病学危险因素和临床结局的关系。方法：对2048例PTC患者的病历进行回顾性分析。采用单因素和多因素logistic回归分析确定BRAF V600E突变的危险因素。生存结果包括远处转移性和持续性或复发性PTC，平均随访时间为23.4（5-47）个月。结果：BRAF V600E突变存在于83.7%的患者中（2048例中的1715例）。BRAF V600E突变与年龄、合并高血压和桥本甲状腺炎（HT）等流行病学特征相关。在临床病理特征方面，BRAF V600E与双侧多灶性（比值比（OR） 1.233, 95%可信区间（CI） 1.063 ~ 1.431, P < 0.01）和侧淋巴结转移较少（OR 0.496, 95% CI 0.357 ~ 0.689, P < 0.01）显著相关。在单因素分析中，较小的肿瘤大小和较晚的疾病分期具有显著性，但在多因素调整后变得不显著。BRAF V600E突变与甲状腺外侵袭、远处转移、疾病持续或复发之间未发现关联。结论：部分流行病学特征是BRAF V600E突变的独立危险因素或保护因素。BRAF V600E突变的存在并不是PTC不良临床结果的积极预后。然而，BRAF V600E的高患病率可能为复发和晚期疾病的手术策略和靶向治疗提供指导。
Objective: To investigate the mutant status of BRAF gene and analyze its relationship to epidemiological risk factors and clinical outcomes among patients with papillary thyroid cancer (PTC) in the largest, single-institution Chinese cohort to date.Methods: The medical records of 2048 PTC patients were reviewed in this retrospective study. Single-factor and multiple logistic regression analyses were applied to identify risk factors for BRAF V600E mutation. Survival outcomes including distant metastatic and persistent or recurrent PTC were examined, with a mean follow-up time of 23.4 (5-47) months.Results: The BRAF V600E mutation was present in 83.7% of patients (1715 of 2048). Correlation was found between BRAF V600E mutation and several epidemiological features, including age, concomitant hypertension and Hashimoto thyroiditis (HT). For the clinicopathological features, BRAF V600E was significantly associated with bilateral multifocality (odds ratio (OR) 1.233, 95% confidence interval (CI) 1.063-1.431, P < 0.01) and less lateral lymph node metastases (OR 0.496, 95% CI 0.357-0.689, P < 0.01). Smaller tumor size and advanced disease stage were significant in single-factor analyses but became insignificant after multivariate adjustment. No association was found between BRAF V600E mutation and extrathyroidal invasion, distant metastatic and disease persistence or recurrence.Conclusion: Part of epidemiological features are independent risk or protective factors for BRAF V600E mutation. The presence of BRAF V600E mutation is not an aggressive prognosis on poor clinical outcomes in PTC. However, the high prevalence of BRAF V600E may provide guidance for surgery strategy and opportunity for targeted treatment in recurrent and advanced stage disease.