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检测甲状腺组织 BRAF V600E 突变蛋白的免疫组织化学的临床意义。

Clinical significance of immunohistochemistry to detect BRAF V600E mutant protein in thyroid tissues.

机构信息

Department of Pathology, The Second Hospital of Dalian Medical University.

The Press of Dalian Medical University.

出版信息

Medicine (Baltimore). 2021 Apr 23;100(16):e25566. doi: 10.1097/MD.0000000000025566.

Abstract

This study investigated the feasibility of using immunohistochemistry (IHC) instead of PCR to detect BRAF V600E mutant protein in papillary thyroid carcinoma (PTC), and to determine the value of using preoperative BRAF V600E mutant protein by IHC to assist in the diagnosis of thyroid nodule patients with Hashimoto's thyroiditis (HT).The expression of BRAFV600E mutant protein was measured in 23 cases of HT+PTC, 31 cases of PTC, and 28 cases of HT by IHC, followed by PCR in the same samples for validation. SPSS 19.0 software was used for statistical analysis.The sensitivity and specificity of IHC to detect BRAF V600E mutation were 100% and 42.86%, respectively. In addition, the mutation rate of BRAF V600E protein in the HT+PTC group (34.78%, 8/23) was lower than that in the PTC group (80.65%, 25/31).The application of IHC to detect BRAF V600E mutant protein has good sensitivity but not specificity to diagnose PTC. IHC can be used as a preliminary screening method to detect BRAF V600E mutation. The strongly positive (+++) staining of IHC potently indicated BRAF V600E gene mutation. For suspicious thyroid nodules combined with HT, the detection of BRAF V600E mutant protein with IHC alone is not of great significance for differentiating benign and malignant nodules.

摘要

本研究旨在探讨免疫组织化学(IHC)检测甲状腺乳头状癌(PTC)中 BRAF V600E 突变蛋白的可行性,并评估术前应用 IHC 检测 BRAF V600E 突变蛋白辅助诊断桥本甲状腺炎(HT)合并甲状腺结节患者的价值。采用 IHC 法检测 23 例 HT+PTC、31 例 PTC 和 28 例 HT 中 BRAFV600E 突变蛋白的表达,并用相同样本进行 PCR 验证。采用 SPSS 19.0 软件进行统计学分析。IHC 检测 BRAF V600E 突变的敏感性和特异性分别为 100%和 42.86%。此外,HT+PTC 组 BRAF V600E 蛋白突变率(34.78%,8/23)低于 PTC 组(80.65%,25/31)。IHC 检测 BRAF V600E 突变蛋白诊断 PTC 的敏感性较好,但特异性欠佳。IHC 可作为检测 BRAF V600E 突变的初步筛查方法,IHC 强阳性(+++)染色强烈提示 BRAF V600E 基因突变。对于可疑的 HT 合并甲状腺结节,单独应用 IHC 检测 BRAF V600E 突变蛋白对良恶性结节的鉴别诊断意义不大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6683/8078443/75463ac2fc84/medi-100-e25566-g001.jpg

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