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BRAF V600E突变作为皮肤黑色素瘤患者的一个预后因素。

BRAF V600E mutation as a prognostic factor in cutaneous melanoma patients.

作者信息

Tas Faruk, Erturk Kayhan

机构信息

Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey.

出版信息

Dermatol Ther. 2020 Mar;33(2):e13270. doi: 10.1111/dth.13270. Epub 2020 Feb 19.

Abstract

The prognostic significance of BRAF mutations in the natural course of melanoma is controversial. The aim of study was to assess the prognostic significance of BRAF V600E mutation in cutaneous melanoma patients. A total of 151 melanomas were included in the study. BRAF V600E mutation was detected using the real-time PCR. BRAF V600E mutation rate was 51%. BRAF mutation rate was higher for young patients (61.4%) and upper limbs (63.2%), trunk (59.3%) and head and neck (59.2%) were the most frequently afflicted sites in BRAF-mutant patients, whereas lower limbs were mostly affected in BRAF-wild patients (77.8%). Likewise, acral melanomas rarely harbored BRAF mutation (17.1%). The disease-free survivals regarding the entire and Stage III cohorts were longer in the BRAF-mutant group than in the BRAF-wild group (p = .006 and p = .004, respectively), whereas Stage I-II patients had no survival differences between BRAF statuses (p = .2). Likewise, BRAF-mutant patients had better overall survival (OS) time compared to BRAF-wild patients in all stages (p = .01), in Stage III (p = .01), and in Stage IV patients (p = .001). However, no differences between BRAF statuses were observed in Stage I-II melanomas (p = .3). In conclusion, BRAF V600E-mutant melanomas show favorable prognostic impact on both disease-free and OSs in all staged melanomas except local disease.

摘要

BRAF突变在黑色素瘤自然病程中的预后意义存在争议。本研究的目的是评估BRAF V600E突变在皮肤黑色素瘤患者中的预后意义。共有151例黑色素瘤纳入本研究。采用实时PCR检测BRAF V600E突变。BRAF V600E突变率为51%。年轻患者的BRAF突变率更高(61.4%),上肢(63.2%)、躯干(59.3%)和头颈部(59.2%)是BRAF突变患者中最常受累的部位,而BRAF野生型患者中下肢受累最多(77.8%)。同样,肢端黑色素瘤很少有BRAF突变(17.1%)。BRAF突变组的整个队列和III期队列的无病生存期比BRAF野生型组长(分别为p = 0.006和p = 0.004),而I-II期患者在BRAF状态之间没有生存差异(p = 0.2)。同样,在所有分期中,BRAF突变患者的总生存期(OS)时间均优于BRAF野生型患者(p = 0.01),在III期(p = 0.01)和IV期患者中(p = 0.001)。然而,在I-II期黑色素瘤中未观察到BRAF状态之间的差异(p = 0.3)。总之,BRAF V600E突变的黑色素瘤对除局部疾病外的所有分期黑色素瘤的无病生存期和总生存期均显示出良好的预后影响。

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