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BRAFV600E突变在韩国乳头状甲状腺癌患者中并非预后因素。

BRAFV600E mutation does not serve as a prognostic factor in Korean patients with papillary thyroid carcinoma.

作者信息

Ahn Dongbin, Park June Sik, Sohn Jin Ho, Kim Jae Hyug, Park Sun-Kyun, Seo An Na, Park Ji Young

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.

出版信息

Auris Nasus Larynx. 2012 Apr;39(2):198-203. doi: 10.1016/j.anl.2011.07.011. Epub 2011 Aug 20.

Abstract

OBJECTIVES

In recent years, BRAF(V600E) mutation has emerged as a promising prognostic marker for risk stratification of patients with papillary thyroid carcinoma (PTC). However, routine use of this marker has been questioned. In some parts of the world, particularly in Korea, the incidence of BRAF(V600E) mutation is too high to have true prognostic value. The relatively low number of tumors without BRAF(V600E) mutation would prejudice the efficient use of this marker in the Korean population.

METHODS

The study involved 107 patients with histologically confirmed conventional PTC after surgical management for thyroid cancer from April 2010 to December 2010. BRAF(V600E) mutation analysis was performed by polymerase chain reaction (PCR)-based amplification of DNA extracted from paraffin-embedded tumor specimens, and the relationship between BRAF(V600E) mutation and various prognostic factors was investigated.

RESULTS

BRAF(V600E) mutation was found to be present in 85 (79.4%) of 107 patients with conventional PTC. Analysis of the clinical characteristics as function of the presence or absence of BRAF(V600E) mutation revealed no differences between the BRAF(V600E)-positive and BRAF(V600E)-negative patients. Moreover, BRAF(V600E) mutation was not correlated with any of the prognostic factors including age ≥45 years, male gender, tumor size ≥1cm, multifocality, extra-thyroidal extension, concurrent Hashimoto's thyroiditis, and lymph node metastasis neither in the univariate nor in the multivariate analysis.

CONCLUSIONS

BRAF(V600E) mutation does not significantly reflect tumor aggressiveness in Korean patients with conventional PTC. We consider that BRAF(V600E) mutation does not possess prognostic value in Korea, where it is prevalent, and where most of the PTC types are conventional.

摘要

目的

近年来,BRAF(V600E)突变已成为甲状腺乳头状癌(PTC)患者风险分层的一个有前景的预后标志物。然而,该标志物的常规使用受到了质疑。在世界上的一些地区,尤其是韩国,BRAF(V600E)突变的发生率过高,以至于没有真正的预后价值。BRAF(V600E)未突变肿瘤的数量相对较少,这会影响该标志物在韩国人群中的有效应用。

方法

本研究纳入了2010年4月至2010年12月期间因甲状腺癌接受手术治疗且经组织学确诊为传统PTC的107例患者。通过基于聚合酶链反应(PCR)的方法对石蜡包埋肿瘤标本中提取的DNA进行扩增,以分析BRAF(V600E)突变情况,并研究BRAF(V600E)突变与各种预后因素之间的关系。

结果

在107例传统PTC患者中,有85例(79.4%)检测到BRAF(V600E)突变。根据BRAF(V600E)突变情况分析临床特征发现,BRAF(V600E)阳性和阴性患者之间无差异。此外,在单因素和多因素分析中,BRAF(V600E)突变均与任何预后因素无关,这些预后因素包括年龄≥45岁、男性、肿瘤大小≥1cm、多灶性、甲状腺外侵犯、合并桥本甲状腺炎以及淋巴结转移。

结论

BRAF(V600E)突变在韩国传统PTC患者中不能显著反映肿瘤的侵袭性。我们认为,在BRAF(V600E)突变普遍存在且大多数PTC类型为传统型的韩国,BRAF(V600E)突变不具有预后价值。

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