甲状腺乳头状癌患者临床病理特征和BRAF V600E基因突变对其颈部淋巴结转移的影响

doi:10.13481/j.1671-587X.20220420

Abstract

Abstract:

Objective： To investigate the correlations of cervical lymph node metastasis with the chinicopathological characteristics and BRAF V600E gene mutation in the patients with papillary thyroid cancer （PTC）， and to clarify the influencing factors of cervical lymph nodes metastasis in the patients with PTC.

Methods

The PTC patients underwent surgical therapy in our hospital were selected；the patients’ clinical data were retrospectively analyzed， including age， sex， side， number， metastatic lymph nodes and location of the PTC patients， and the pathologic data were also analyzed， including location， diameter， number， capsular invasion， peri-tumor fibrosis， psammoma bodies， vascular and nervous invasion. The BRAF V600E mutation detection was performed in PTC tissue， the correlation of cervical lymph node metastasis with the clinical characteristics，pothological feateres and BRAF V600E gene mutation of the PTC patients were analyzed，and Logistic regression analysis was performed to analyze the influencing factors of cervical lymph node metastasis in the PTC patients.

Results

In the 321 PTC patients， 129 patients （40.2%） were found with cervical lymph node metastatasis. BRAF V600E gene mutation were found in 279 （86.9%） patients； there was no correlation of BRAF V600E gene mutation with cervical lymph node metastasis in the PTC patients（P>0.05）.Cervical lymph node metastasis had correlations with age， maximal diameter， multiple tumors in bilateral sides， psammoma bodies and vascular invasion（P<0.05 or P<0.01）. The results of Logistic regression analysis demonstrated that age （OR=0.729，95%CI：0.600－0.885）， maximal tumor diameter （OR=1.796，95%CI：1.326－2.433）， tumor number（OR=1.947，95%CI：1.225－3.096），psammoma bodies （OR=2.578，95%CI：1.037－6.409）， and vascular invasions （OR=8.856，95%CI：1.929－40.656） were the influencing factors of cervical lymph node metastasis in the PTC patients.

Conclusion

The cervical lymph node metastasis of the PTC patients shows the correlations with age， maximal tumor diameter， tumor number， psammoma bodies and vascular invasion， and shows no correlation with BRAF V600E gene mutation.

Key words: Papillary thyroid cancer, BRAF V600E, Lymph node, Metastasis

CLC Number:

R736.1

Wei JI,Jian DONG,Hong CHANG,Xuemei DU,Hong PENG,Hong XIE,Aimin ZHAO,Wei YAN,Juan BAI,Zhenxing PENG,Jinshu YIN. Influence of chinicopathological characteristics and BRAF V600E gene mutation in cervical lymph node metastasis in patients with papillary thyroid cancer[J].Journal of Jilin University(Medicine Edition), 2022, 48(4): 995-1002.

Figures/Tables 4

Tab.1

Tab. 2

Tab.3

Tab.4

References 31

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Variable	Total (Constituent ratio )	Lymph node metastasis（n=129）	No lymph node metastasis（n=192）	χ2	P
Age (year)				9.834	0.002
<40	150 (46.7)	74 （57.4）	76 （39.6）
≥40	171 (53.3)	55 （42.6）	116 （60.4）
Gender				0.362	0.547
Female	225 (70.1)	88 (68.2)	137 (71.4)
Male	96 (29.9)	41 (31.8)	55 (28.6)
Maximal diameter				15.412	<0.001
<0.5 cm	75 (23.4)	20 （15.5）	55 （28.6）
0.5－1.0 cm	117 (36.4)	41 （31.8）	76 （39.6）
>1.0 cm	129 (40.2)	68 （52.7）	61 （31.8）
Tumor location				8.470	0.014
Single tumor in unilateral lobe	204 (63.6)	70 (54.3)	134 (69.8)
Multiple tumors in unilateral lobe	41 (12.8)	19 (14.7)	22 (11.4)
Multiple tumors in both lobes	76 (23.6)	40 (31.0)	36（18.8）
Capsular invasion				1.479	0.224
Positive	137 (42.7)	54 (41.9)	83 (43.2)
Negative	184 (57.3)	75 (58.1)	109 (56.8)
Psammoma bodies				4.409	0.036
Positive	21 (6.5)	13 (10.1)	8 (4.2)
Negative	300 (93.5)	116 (89.9)	184 (95.8)
Lymph-plasma cells				0.079	0.778
Positive	77 (24.0)	32 (24.8)	45 (23.4)
Negative	244 (76.0)	97 (75.2)	147 (76.6)
Fiber wrapped				1.523	0.217
Positive	114 (35.5)	51 (39.5)	63 (32.8)
Negative	207 (64.5)	78 (60.5)	129 (67.2)
Vascular invasion				11.126	0.001
Positive	13 (4.0)	11 (8.5)	2 (1.0)
Negative	298 (96.0)	118 (91.5)	190 (99.0)
Nerve invasion				0.787	0.375
Positive	8 (2.5)	2 (1.6)	6 (3.1)
Negative	313 (97.5)	127 (98.4)	186 (96.9)
BRAF V600E				0.002	0.967
Positive	279 (86.9)	112 (86.8)	167 (87.0)
Negative	42 (13.1)	17 (13.2)	25 (13.0)

Variable	Total (Constituent ratio)	Single tumor in one lobe	Multiple tumors in one lobe	Multiple tumors in both lobes	χ2	P
Lymph node number					2.782	0.249
<5	82 （63.6）	49 (70.0)	11 (57.9)	22 (55.0)
≥5	47 （36.4）	21 (30.0)	8 (42.1)	18 (45.0)
Lymph node location					16.141	<0.01
One side	104 (80.6)	62 (88.6)	18 (94.7)	24 (60.0)
Both sides	25 (19.4)	8 (11.4)	1 (5.3)	16 (40.0)
Lymph node zone					7.148	0.128
Central zone	76 (58.9)	47 (67.1)	8 (42.1)	21 (52.5)
Lateral zone	11 (8.5)	3 (4.3)	2 (10.5)	6 (15.0)
Both zones	42 (32.6)	20 (28.6)	9 (47.4)	13 (32.5)

Variable		Value
Lymph node metastasis	Y	0=No,1=Yes
Age	X1	1=<30 years，2=30－39 years,3=40－49 years,4=50－59 years,5=>60 years
Multiple tumors in bilateral lobes	X2	0=No,1=yes
Maximal diameter	X3	1=≤0.5 cm,2=0.6－1.0 cm,3=>1.0 cm
Number	X4	1=Single，2=Multiple
Psammoma bodies	X5	0=Negative，1=Positive
Vascular invasion	X6	0=Negative，1=Positive

Variable	β	SE	Wald χ²	P	OR	95%CI
Age	－0.316	0.099	10.152	0.001	0.729	0.600－0.885
Maximal diameter	0.586	0.155	14.325	0.000	1.796	1.326－2.433
Number	0.666	0.237	7.940	0.005	1.947	1.225－3.096
Psammoma bodies	0.947	0.465	4.151	0.042	2.578	1.037－6.409
Vascular invasion	2.181	0.778	7.868	0.005	8.856	1.929－40.656

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Influence of chinicopathological characteristics and BRAF V600E gene mutation in cervical lymph node metastasis in patients with papillary thyroid cancer

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