甲状腺乳头状癌中氟脱氧葡萄糖摄取与BRAF突变的关系
Relationship Between F-fluorodeoxyglucose Accumulation and the BRAF Mutation in Papillary Thyroid Cancer.
作者信息
Chang Jae Won, Park Ki Wan, Heo Jae Hyung, Jung Seung-Nam, Liu Lihua, Kim Sung Min, Kwon In Sun, Koo Bon Seok
机构信息
Department of Otolaryngology-Head and Neck Surgery, Research Institute for Medical Science, College of Medicine, Chungnam National University, 640 Daesa-Dong, Chung-Gu, Daejeon, 301-721, Republic of Korea.
Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Republic of Korea.
出版信息
World J Surg. 2018 Jan;42(1):114-122. doi: 10.1007/s00268-017-4136-y.
BACKGROUND
To determine whether F-fluoro-2-deoxyglucose (F-FDG)-PET/CT is useful for predicting the BRAF mutation status of a primary papillary thyroid carcinoma (PTC).
METHODS
A retrospective analysis was performed in 108 patients who underwent F-FDG positron emission tomography-computed tomography (PET/CT) for staging before thyroidectomy and BRAF analysis in biopsy-confirmed PTC. The maximum standardized uptake value (SUV) of the primary tumor was calculated according to FDG accumulation. Univariate and multivariate analyses were performed to assess the association between the SUV and clinicopathological variables.
RESULTS
The BRAF mutation was detected in 71 of 108 (65.7%) patients. In all subjects, the tumor size and BRAF mutation were independently related to the SUV according to multivariate analyses (P = 0.002 and 0.007, respectively). The SUV was significantly higher in tumors with the BRAF mutation than in tumors with wild-type BRAF (10.24 ± 11.89 versus 4.02 ± 3.86; P = 0.007). In the tumor size >1 cm subgroup, the BRAF mutation was the only factor significantly associated with the SUV (P = 0.016). A SUV cutoff level of 4.9 was determined to be significant for predicting the BRAF mutation status (sensitivity 77.4%, specificity 100.0%, area under the curve 0.929; P < 0.0001) according to ROC curve analysis.
CONCLUSIONS
The BRAF mutation is independently associated with high F-FDG uptake in PTC, especially in those with a tumor size >1 cm.
背景
确定F-氟-2-脱氧葡萄糖（F-FDG）-PET/CT是否有助于预测原发性甲状腺乳头状癌（PTC）的BRAF突变状态。
方法
对108例因活检确诊的PTC行甲状腺切除术前分期而行F-FDG正电子发射断层扫描-计算机断层扫描（PET/CT）及BRAF分析的患者进行回顾性分析。根据FDG摄取情况计算原发肿瘤的最大标准化摄取值（SUV）。进行单因素和多因素分析以评估SUV与临床病理变量之间的关联。
结果
108例患者中有71例（65.7%）检测到BRAF突变。在所有受试者中，根据多因素分析，肿瘤大小和BRAF突变与SUV独立相关（P分别为0.002和0.007）。BRAF突变肿瘤的SUV显著高于BRAF野生型肿瘤（10.24±11.89对4.02±3.86；P = 0.007）。在肿瘤大小>1 cm亚组中，BRAF突变是与SUV显著相关的唯一因素（P = 0.016）。根据ROC曲线分析，确定SUV临界值为4.9对预测BRAF突变状态具有显著意义（敏感性77.4%，特异性100.0%，曲线下面积0.929；P < 0.0001）。
结论
BRAF突变与PTC中高F-FDG摄取独立相关，尤其是在肿瘤大小>1 cm的患者中。
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