BRAFV600E突变比值在合并桥本甲状腺炎甲状腺乳头状癌中的初步研究

目的 探索桥本甲状腺炎(HT)对甲状腺乳头状癌(PTC)中BRAF^V600E突变比值(the ratio of BRAF^V600E alleles)的影响。 方法 收集242例PTC患者临床资料,其中PTC合并HT 63例,PTC不合并HT 179例,采用微滴数字PCR(ddPCR)法检测PTC中BRAF^V600E状况。利用倾向性评分匹配法(PSM),以性别、年龄、多灶性、腺外侵犯、肿瘤直径为控制变量按1∶1比例构成63对配对,比较匹配后两组BRAF^V600E阳性率和突变比值。 结果 倾向性评分匹配前,PTC合并HT组和PTC不合并HT组BRAF^V600E阳性率分别为87.3%和92.7%,两组间差异无统计学意义(P>0.05),而PTC合并HT组BRAF^V600E突变比值(3.20%)显著低于PTC不合并HT组(8.80%)(P<0.001)。经过倾向性评分匹配,两组基线水平保持一致,PTC合并HT组BRAF^V600E突变比值(3.20%)仍显著低于PTC不合并HT组(9.00%),两组间差异有统计学意义(P=0.001)。 结论 在合并HT的PTC中,BRAF^V600E突变的发生未受影响,但是BRAF^V600E突变比值明显降低,说明HT对PTC发展过程中BRAF^V600E突变存在一定影响,从而影响PTC发展及其预后。

Clinical effect of Hashimoto thyroiditis on the ratio of BRAFV600E alleles in papillary thyroid carcinoma

Objective To evaluate the clinical effect of Hashimoto thyroiditis(HT)on the ratio of BRAF^V600E alleles in papillary thyroid carcinoma(PTC). Methods Two hundred and forty-two patients who underwent surgery at our hospital between December 2017 and December 2019 were enrolled in this study. The ratio of BRAF^V600E alleles was measured using droplet digital PCR and formalin-fixed paraffin-embedded tissues, and its correlation with HT was analyzed. Using propensity score matching and based on the 63 patients with HT(1∶1), 179 PTC patients without HT during the same period were retrospectively enrolled as controls. Results There was a significant difference between the ratio of BRAF^V600E alleles(P<0.001)of the two groups(PTC patients with HT versus those without HT); the rates of positive-BRAF^V600E were not significantly different(87.3% vs 92.7%, P>0.05). After propensity score matching, the significant difference between the two groups at baseline was no longer observed. The ratio of BRAF^V600E alleles was still significantly lower in patients with HT(median 3.20%)than in those without HT(median 9.00%, P=0.001). Conclusion HT can significantly reduce the ratio of BRAF^V600E alleles in PTC, and this has an important effect on PTC progression and prognosis.