甲状腺癌中PTEN蛋白表达与BRAFV600E突变的相关性研究

目的：探讨PTEN蛋白在甲状腺乳头状癌（PTC）中的表达情况，并进一步分析此蛋白的表达量与BRAFV600E基因突变的相关性及临床意义，初步揭示两者在PTC发生、发展中的致癌作用。方法：采用免疫组化EnVision两步法检测70例PTC 中PTEN 蛋白的表达水平；采用 PCR法及 DNA 测序法检测上述标本中BRAFV600E突变情况，分析PTEN蛋白表达与BRAFV600E突变的相关性及其与PTC临床病理特征的关系。结果：70例PTC中PTEN阴性率为78．6％（55／70），与癌旁组织18．6％（13／70）比较，差异有统计学意义（P＜0．05）。PTEN表达下调与性别、肿瘤淋巴结转移、临床分期有关（P＜0．05）；与BRAFV600E突变、年龄、肿瘤直径无关（P＞0．05）。70例PTC中BRAFV600E突变率为60％，BRAFV600E突变与肿瘤淋巴结转移、临床分期密切相关（P＜0．05）；与患者年龄、性别、肿瘤大小无关（P＞0．05）。结论：PTEN蛋白表达与BRAFV600E突变无相关性。两者可能是PTC生物侵袭高的独立危险因素，可能作为评估PTC预后不良的不同肿瘤标记物。两者对甲状腺癌的临床个体化治疗及判定预后有指导意义。

Correlation between PTEN protein expression and BRAF V600E mutations in thyroid carcinoma

Objective:To explore the PTEN protein expression in papillary thyroid carcinoma(PTC),and further analyze the protein expression of the quantity and the correlation of BRAFV600E mutation and its clinical significance, and the development of carcinogenesis.Methods:The expressions of PTEN in 70 patients with PTC were detected by immunohistochemical EnVision two step method.The BRAFV600E mutation status was detected by PCR method and DNA sequencing method.The correlation between PTEN protein expression and mutation in BRAFV600E and clinico-pathologic features were analyzed.Results:The negative rate of PTEN was 78.6%(55/70)and 18.6%(13/70)with adjacent tissues in 70 patients with PTC,and the difference was statistically significant(P<0.05).The expression of PTEN was associated with gender,tumor lymph node metastasis and pathological staging(P<0.05 ).The BRAFV600E mutation age and tumor size were not correlated with PTEN (P>0.05).The mutation rate of BRAFV600E was 60%in 70 patients with BRAFV600E mutation,which was closely related to tumor lymph node metastasis,pathological staging(P<0.05).The age,gender and tumor size were not correlated with BRAFV600E mutation(P>0.05).Conclusion:There was no correlation between PTEN protein expression and BRAFV600E mutation.The two may be independent risk factors for adverse outcome of PTC,which may be used as a markers for evaluating the prognosis of PTC.The two have the guiding significance for the clinical treatment of thyroid cancer and the prognosis of the patients.