BRAFV600E突变比值在预测甲状腺乳头状癌颈部淋巴结转移中的临床价值[论著]

目的　探索BRAFV600E突变比值（The Ratio of BRAFV600E expression），在预测甲状腺乳头状癌（papillary thyroid carcinoma，PTC）颈部淋巴结转移（lymph node metastasis，LNM）中的临床价值。方法　收集于浙江大学医学院附属杭州市第一人民医院2018年1月至2019年1月间手术治疗的234例PTC患者，采用微滴数字PCR（droplet digital PCR，ddPCR）定量法检测病理石蜡标本BRAFV600E突变比值，分析突变比值与PTC患者LNM的相关性，构建受试者工作特征曲线（ROC）。结果　PTC患者伴有LNM者的BRAFV600E突变比值显著高于无LNM者（P <0.01），ROC曲线显示BRAFV600E突变比值预测LNM的敏感性、特异性、阳性预测值、阴性预测值和曲线下面积（AUC）分别为27.7%、91.0%、73.3%、58.5%、0.581。结论　利用PTC病理石蜡标本中BRAFV600E突变比值预测LNM有较高的特异性，可为PTC颈淋巴结清扫提供临床决策。

Clinical value of the ratio of BRAF^V600E expression for predicting lymph node metastasis in papillary thyroid carcinoma

Objective To investigate the clinical value of the ratio of BRAF^V600E expression for predicting lymph node metastasis(LNM)in papillary thyroid carcinoma(PTC).Methods From January 2018 to January 2019,234 patients underwent surgery in our hosptial and were enrolled in this study.The ratio of BRAFV6U0E expression was quantified by droplet digital PCR(ddPCR)in formalin-fixed paraffin-embedded tissues(FFPE)to analyze the correlation with LNM.The receiver operating characteristic curve(ROC)was constructed to evaluate the diagnostic value of the ratio of BRAF^V600E expression for LNM.Results The ratio of BRAFV600E expression with LNM is significantly higher than that of without LNM(P<0.01).The ROC show the sensitivity,specificity,positive predictive value,negative predictive value and area under the curve(AUC)are 27.7%,91.0%,73.3%,58.5%and 0.581,respectively.Conclusion The ratio of BRAF^V600E expression in FFPE is highly specific for predicting the diagnosis of LNM in PTC,which may help to provide clinical decisions for cervical lymph node dissection.