与分化型甲状腺癌分子亚型相关的病理特征。
Pathologic Features Associated With Molecular Subtypes of Well-Differentiated Thyroid Cancer.
机构信息
Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati, College of Medicine, Cincinnati, Ohio.
Medical Affairs, Veracyte, Inc, South San Francisco, California.
出版信息
Endocr Pract. 2021 Mar;27(3):206-211. doi: 10.1016/j.eprac.2020.09.003. Epub 2020 Dec 14.
OBJECTIVE
To determine the association between pathologic features and molecular classes (BRAF-like, RAS-like, and non-BRAF-like non-RAS-like [NBNR]).
METHODS
Retrospective review of a merged database containing 676 patients, 84% (571/676) were assigned to a molecular class from publicly accessible sequenced data of thyroid neoplasms.
RESULTS
The merged cohort included 571 neoplasms: 353 (62%) BRAF-like, 172 (30%) RAS-like, and 46 (8.1%) NBNR. Lymph node metastasis (any N1 disease) was present in 166/337 (49%) of BRAF-like, 23/164 (14%) of RAS-like, and 0/46 (0%) of NBNR and are significantly different (P < .001). Gross extra-thyroidal extension was observed in 27 patients, including 24/331 (7%) of BRAF-like, 2/160 (1%) of RAS-like, and 1/46 (2%) of NBNR (P = .01). N1B lymph node metastases or T4 disease was present in 74/333 (22%) of BRAF-like, 10/160 (6%) of RAS-like, and 1/46 (2%) of NBNR (P < .0001). Distant metastasis was present in 4/151 (2.6%) of BRAF-like, 2/50 (4%) of RAS-like and 0/46 for NBNR (P = .627). Angioinvasion was present in 0/81 (0%) of BRAF-like, 3/53 (6%) of RAS-like, and 3/46 (7%) of NBNR (P = .08); and multifocality was present in 27/81 (33%) of BRAF-like, 9/53 (17%) of RAS-like, and 1/46 (2%) for NBNR (P = .0001).
CONCLUSION
Pathological features of metastasis, gross extra-thyroidal extension, and multifocality were more prevalent in BRAF-like samples compared to RAS-like and NBNR. A trend towards increased frequency of angioinvasion in RAS-like and NBNR cancers compared to BRAF-like samples was observed. Further studies are needed to evaluate if preoperative knowledge of molecular mutations in thyroid tumors aids in decision-making regarding extent of surgery.
目的
确定病理特征与分子类型（BRAF 样、RAS 样和非 BRAF 样非 RAS 样[NBNR]）之间的关联。
方法
回顾性合并数据库中包含 676 例患者的数据库，其中 84%（571/676）根据甲状腺肿瘤公开可获得的测序数据被分配到一个分子类别。
结果
合并队列包括 571 个肿瘤：353 个（62%）为 BRAF 样，172 个（30%）为 RAS 样，46 个（8.1%）为 NBNR。337 例 BRAF 样中有 166 例（49%）存在淋巴结转移（任何 N1 疾病），164 例 RAS 样中有 23 例（14%），46 例 NBNR 中无一例（0%），差异有统计学意义（P<.001）。27 例存在大体甲状腺外延伸，其中 331 例 BRAF 样中有 24 例（7%），160 例 RAS 样中有 2 例（1%），46 例 NBNR 中有 1 例（2%）（P=.01）。333 例 BRAF 样中有 74 例（22%）、160 例 RAS 样中有 10 例（6%）、46 例 NBNR 中有 1 例（2%）存在 N1B 淋巴结转移或 T4 疾病（P<.0001）。151 例 BRAF 样中有 4 例（2.6%）、50 例 RAS 样中有 2 例（4%）和 46 例 NBNR 中有 0 例（0%）发生远处转移（P=.627）。81 例 BRAF 样中有 0 例（0%）、53 例 RAS 样中有 3 例（6%）和 46 例 NBNR 中有 3 例（7%）发生血管侵犯（P=.08）；81 例 BRAF 样中有 27 例（33%）、53 例 RAS 样中有 9 例（17%）和 46 例 NBNR 中有 1 例（2%）存在多灶性（P=0.0001）。
结论
与 RAS 样和 NBNR 相比，BRAF 样样本的转移、大体甲状腺外延伸和多灶性等病理特征更为常见。与 BRAF 样样本相比，RAS 样和 NBNR 样癌症中血管侵犯的频率呈增加趋势。需要进一步研究来评估术前了解甲状腺肿瘤的分子突变是否有助于决策手术范围。
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