摘要
目的探讨甲状腺癌超声表现与颈部淋巴结转移以及BRAF V600E突变的关系。方法选取70例行甲状腺癌根治术及颈部淋巴结清扫的甲状腺癌患者,收集术前超声检查结果,术后行BRAF V600E基因突变检测。结果 70例患者中,颈部淋巴结转移率为30.00%,BRAF V600E突变率为71.43%;男性患者颈部淋巴结转移率明显高于女性患者,且超声表现为病灶多发、病灶直径﹥10 mm、边缘不规则、可接触被膜、血流丰富、钙化、病灶纵横比≥1患者的颈部淋巴结转移率均高于超声表现为病灶单发、病灶直径≤10 mm、边缘规则、不可接触被膜、血流不丰富、无钙化、病灶纵横比﹤1的患者,差异均有统计学意义(P﹤0.05);超声表现为病灶多发、边缘不规则、可接触被膜、血流丰富、钙化患者的BRAF V600E突变率均明显高于超声表现为病灶单发、边缘规则、不可接触被膜、血流不丰富、无钙化的患者,差异均有统计学意义(P﹤0.01)。Logistic回归分析结果显示,病灶多发、可接触被膜、血流丰富、钙化是发生颈部淋巴结转移的危险因素(OR=3.071、6.253、2.575、2.502,P﹤0.01);病灶多发是发生BRAF V600E突变的危险因素(OR=3.333,P﹤0.01)。结论甲状腺癌超声表现与颈部淋巴结转移、BRAF V600E突变有一定关系,值得进一步研究。
Objective To investigate the relationship between ultrasound manifestations of thyroid carcinoma and cervical lymph node metastasis and BRAF V600E mutation.Method The research included 70 patients with thyroid cancer who underwent radical thyroidectomy and neck lymph node dissection,the results of preoperative ultrasonography were collected and BRAF V600E gene mutation was detected after operation.Result Among the 70 patients,the metastasis rate of cervical lymph nodes was 30.00%,and the mutation rate of BRAF V600E was 71.43%;the rate of cervical lymph node metastasis in male patients was significantly higher than that in female patients,and the rate of cervical lymph node metastasis in patients with multiple lesions,diameter of lesions >10 mm,irregular margins,contactable capsule,rich blood flow,calcification,aspect ratio of lesions≥1 were higher than that in patients with single lesion,diameter of lesions≤10 mm,regular margin,non-contactable capsules,insufficient blood flow,absence of calcification and aspect ratio of lesion<1,the differences were statistically significant(P<0.05);the mutation rate of BRAF V600E in patients with multiple lesions,irregular margins,contactable capsules,abundant blood flow and calcification was significantly higher than that in patients with single lesion,regular margins,non-contactable capsules,insufficient blood flow and no calcification,showing statistically significant differences(P<0.01).Logistics regression analysis showed that,multiple lesions,contactable capsules,abundant blood flow and calcification were the risk factors for predicting cervical lymph node metastasis(OR=3.071,6.253,2.575 and 2.502,P<0.01);moreover,presence of multiple lesions was a risk factor for predicting BRAF V600 mutation(OR=3.333,P<0.01).Conclusion The ultrasound features of thyroid carcinoma are related to cervical lymph node metastasis and BRAF V600E mutation,further study is warranted.
作者
孔繁云
符尚宏
唐昌明
KONG Fanyun;FU Shanghong;TANG Changming(Department of Ultrasonography,Haikou Third People’s Hospital,Haikou 571100,Hainan,China;Department of General Surgery,Haikou Third People’s Hospital,Haikou 571100,Hainan,China)
出处
《癌症进展》
2019年第2期158-161,共4页
Oncology Progress
