Kim Suk Kyeong, Song Kee-Ho, Lim So Duk, Lim Young Chang, Yoo Young Bum, Kim Ji Soo, Hwang Tae Sook
Departments of 1Internal Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Korea.
Thyroid. 2009 Feb;19(2):137-41. doi: 10.1089/thy.2008.0144.
It has been reported that patients with papillary thyroid carcinoma (PTC) have a high incidence of background Hashimoto thyroiditis (HT); however, the linkage of HT to PTC is controversial. Recent studies have shown that the prevalence of activating point mutations in BRAFV600E is much higher (73-86%) in Korea than in Western countries (29-69%), and associated with a poor prognosis in PTC. The purpose of the present study was to investigate the frequency of the BRAFV600E mutation in PTC with and without HT, and to determine clinical and pathological features that were associated with concomitant HT and PTC.
Fine-needle aspiration slides from 101 patients with surgically confirmed PTC were studied. The DNA was extracted from the atypical cells that were scraped from slides. It was then analyzed for the BRAFV600E mutation by pyrosequencing. In addition, the presence of background HT in surgical specimens and other clinical and pathological features of the patients were characterized.
HT was present in 37 (36.6%) of the patients. The BRAFV600E mutation was present in 27 (72.9%) of patients with HT but was present in 61 (95.3%) of patients without HT ( p#0.01). The inverse correlation of concurrent HT with the BRAFV600E mutation was significant for both males and females ( p < 0.01). The presence of background HT was not associated with tumor size, extrathyroidal invasion, lymph node (LN) metastasis, or tumor stage. The patients were younger in the group without background HT (44.1 +/- 13.2 vs. 49.8 +/- 13.9, p 1/40.05). The BRAFV600E mutation was present in 88 (87.1%) of the 101 patients with PTC. The presence of the BRAFV600E mutation was significantly associated with LN metastasis ( p < 0.02; odds ratio, 6.24; 95% confidence interval, 1.51-25.79).
In Korean patients with PTC, the BRAFV600E mutation is associated with a lower frequency of background HT and a high frequency of LN metastasis.
已有报道称，甲状腺乳头状癌（PTC）患者合并桥本甲状腺炎（HT）的发生率较高；然而，HT与PTC之间的联系仍存在争议。最近的研究表明，BRAFV600E激活点突变在韩国的患病率（73 - 86%）远高于西方国家（29 - 69%），并且与PTC的不良预后相关。本研究的目的是调查伴有和不伴有HT的PTC中BRAFV600E突变的频率，并确定与HT和PTC并存相关的临床和病理特征。
对101例经手术确诊为PTC患者的细针穿刺涂片进行研究。从涂片上刮取的非典型细胞中提取DNA，然后通过焦磷酸测序分析BRAFV600E突变情况。此外，对手术标本中是否存在背景HT以及患者的其他临床和病理特征进行了描述。
37例（36.6%）患者存在HT。BRAFV600E突变在伴有HT的患者中占27例（72.9%），而在不伴有HT的患者中占61例（95.3%）（p<0.01）。HT与BRAFV600E突变的负相关在男性和女性中均具有显著性（p<0.01）。背景HT的存在与肿瘤大小、甲状腺外侵犯、淋巴结（LN）转移或肿瘤分期无关。无背景HT组的患者年龄较轻（44.1±13.2岁 vs. 49.8±13.9岁，p = 0.05）。101例PTC患者中有88例（87.1%）存在BRAFV600E突变。BRAFV600E突变的存在与LN转移显著相关（p<0.02；优势比，6.24；95%置信区间，1.51 - 25.79）。
在韩国PTC患者中，BRAFV600E突变与背景HT的低频率和LN转移的高频率相关。
