TERT promoter mutations and Ki-67 labeling index as a prognostic marker of papillary thyroid carcinomas: combination of two independent factors.
TERT promoter mutations and Ki-67 labeling index as a prognostic marker of papillary thyroid carcinomas: combination of two independent factors.
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DOI：
10.1038/srep41752
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发表时间：
2017-02-02
影响因子：
4.6
通讯作者：
Mitsutake N
中科院分区：
文献类型：
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作者：
Matsuse M;Yabuta T;Saenko V;Hirokawa M;Nishihara E;Suzuki K;Yamashita S;Miyauchi A;Mitsutake N
虽然大多数乳头状甲状腺癌(PTCs)预后良好，但也有一小部分表现出侵袭性行为。因此，需要一种新型的、性能良好的分子标记。在本研究中，我们评估了TERT启动子/BRAF突变和Ki-67标记指数(LI)作为PTC患者预后标志物的影响。在400例PTC标本中，354例成功进行了TERT启动子/BRAF基因分型和Ki-67 LI分析。根据突变状态和Ki-67LI的组合，将病例分为三组：高、中、低危。低、中、高危组的复发率分别为1.9%(6/323)、18.2%(4/22)和44.4%(4/9)。Kaplan-Meier曲线和对数秩次分析表明，任意两组之间均有统计学差异。在调整了年龄、性别、肿瘤大小和甲状腺外侵犯后，复发风险比仍然显著(低与中：8.8，95%CI：2.35-32.92，p = 0.001；中与高：6.255，95%CI：1.13-34.51，p = 0.035)。结论：联合检测TERT启动子/BRAFV600E突变和Ki-67LI对预测PTC复发有较好的临床应用价值。
Although most papillary thyroid carcinomas (PTCs) have a good prognosis, a small but certain fraction shows aggressive behavior. Therefore, a novel and well-performing molecular marker is needed. In the present study, we assessed the impact of the combination of the TERT promoter/BRAF mutations and Ki-67 labeling index (LI) as a prognostic marker in PTC patients. Of 400 PTC samples, 354 were successfully genotyped for both TERT promoter/BRAF and analyzed for Ki-67 LI. Based on the combination of the mutational status and Ki-67 LI, the cases were categorized into three groups: high-, middle-, and low-risk. The recurrence rates of low-, middle-, and high-risk group were 1.9% (6 of 323), 18.2% (4 of 22), and 44.4% (4 of 9), respectively. The Kaplan-Meier curve and log-rank analyses demonstrated that there were statistical differences between any two groups. The hazard ratios for recurrence remained significant after adjustment for age, sex, tumor size, and extrathyroidal extension (low vs. middle: 8.80, 95% CI: 2.35–32.92, p = 0.001; middle vs. high: 6.255, 95% CI: 1.13–34.51, p = 0.035). In conclusion, the combination of the TERT promoter/BRAFV600E mutations and Ki-67 LI performed excellent in predicting PTC recurrence and may be clinically useful.