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V600E突变对甲状腺乳头状癌患者无事件生存期的影响:罗马尼亚人群的回顾性研究

Impact of V600E Mutation on Event-Free Survival in Patients with Papillary Thyroid Carcinoma: A Retrospective Study in a Romanian Population.

作者信息

Nechifor-Boilă Adela, Zahan Ancuţa, Bănescu Claudia, Moldovan Valeriu, Piciu Doina, Voidăzan Septimiu, Borda Angela

机构信息

Department of Histology, Center for Advanced Medical and Pharmaceutical Research, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu-Mureș, 38th Gh. Marinescu Street, 540139 Targu Mures, Romania.

Department of Pathology, Targu-Mures Clinical County Hospital, 28 First December 1918 Street, 540061 Targu Mures, Romania.

出版信息

Cancers (Basel). 2023 Aug 11;15(16):4053. doi: 10.3390/cancers15164053.

Abstract

We aimed to evaluate the prognostic value of V600E mutation in a series of 127 papillary thyroid carcinoma (PTC) cases as a single factor, and in synergic interaction with other standard risk factors. V600E mutation was assessed by real-time PCR. Event-free survival (EFS) was calculated between the date of the first evaluation and the date of occurrence of an adverse event or the date of the last known status. The prevalence of V600E mutation was 57.2%. The Kaplan-Meier analysis showed a significant reduction of EFS among cases harboring V600E mutation compared to non-mutated cases ( = 0.010). In addition, V600E mutation was found to better predict adverse outcomes when associated with the following risk factors: age ≥ 55 years old ( < 0.001), male gender ( < 0.001), conventional ( = 0.005) and tall cell ( = 0.014) histology, tumor size > 40 mm ( = 0.001), extrathyroidal extension ( = 0.001), multifocality ( = 0.001) and lymph node metastasis ( < 0.001). In univariate analysis, a 3.74-fold increased risk for a reduced EFS ( = 0.018) was found for V600E-mutated cases, but no increased risk was further confirmed by multivariate analysis. Our results highlight that V600E mutation cannot be used alone as an independent predictive factor in PTC patients, but is prognostically valuable if integrated in the context of other clinicopathological risk factors.

摘要

我们旨在评估127例乳头状甲状腺癌(PTC)患者中V600E突变作为单一因素以及与其他标准风险因素协同作用时的预后价值。通过实时PCR评估V600E突变。计算从首次评估日期至不良事件发生日期或最后已知状态日期之间的无事件生存期(EFS)。V600E突变的发生率为57.2%。Kaplan-Meier分析显示,与未发生V600E突变的病例相比,发生该突变的病例的EFS显著降低(P = 0.010)。此外,发现V600E突变与以下风险因素相关时能更好地预测不良结局:年龄≥55岁(P < 0.001)、男性(P < 0.001)、传统型(P = 0.005)和高细胞型(P = 0.014)组织学类型、肿瘤大小>40 mm(P = 0.001)、甲状腺外侵犯(P = 0.001)、多灶性(P = 0.001)和淋巴结转移(P < 0.001)。单因素分析发现,V600E突变的病例EFS降低的风险增加3.74倍(P = 0.018),但多因素分析未进一步证实风险增加。我们的结果强调,V600E突变不能单独作为PTC患者的独立预测因素,但如果结合其他临床病理风险因素则具有预后价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/805a/10452493/23e967cba18f/cancers-15-04053-g001.jpg

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