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目的探讨甲状腺微小乳头状癌(PTMC)伴和不伴桥本甲状腺炎(HT)患者临床病理学特征的差异,同时比较两者BRAF~(V600E)的表达情况。方法回顾性收集2012年12月至2015年6月期间于上海交通大学医学院附属仁济医院(南院)行手术治疗的168例PTMC患者的临床资料,其中伴发HT患者49例(伴发HT组),不伴HT患者119例(不伴HT组)。比较2组患者的临床病理学特征及其BRAF~(V600E)表达的差异。结果伴发HT组和不伴HT组患者的性别构成、年龄和肿瘤直径比较差异均有统计学意义(P<0.050),伴发HT组患者中女性、年龄<45岁及肿瘤直径≤0.5 cm患者的比例较高。伴发HT组患者中BRAF~(V600E)表达阳性32例(65.31%,32/49),不伴HT组患者中BRAF~(V600E)表达阳性84例(70.59%,84/119),两者的BRAF~(V600E)表达阳性率比较差异无统计学意义(P>0.050)。在伴发HT的患者中,BRAF~(V600E)表达程度与性别、被膜侵犯情况及淋巴结转移情况均相关,女性、无被膜侵犯及无淋巴结转移者的BRAF~(V600E)表达程度较弱(P<0.050)。在被膜外侵犯和淋巴结转移患者中,伴发HT患者的BRAF~(V600E)表达较不伴HT患者弱(P<0.050)。结论伴发HT的PTMC患者女性较多、年龄较小,肿瘤直径较小,可能是其预后较好的原因。此外,BRAF~(V600E)表达较弱可能是伴发HT、存在淋巴结转移和被膜侵犯的PTMC患者预后较好的原因。
Objective To investigate the clinicopathological features of thyroid papillary carcinoma (PTMC) with and without Hashimoto’s thyroiditis (HT) and to compare the expression of BR600 V600E. Methods The clinical data of 168 patients with PTMC who underwent surgical treatment at Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from December 2012 to June 2015 were collected retrospectively. Among them, 49 patients with HT HT group), 119 patients without HT (without HT group). The clinicopathological characteristics and the expression of BRAF ~ (V600E) in two groups were compared. Results There were significant differences in sex composition, age and tumor diameter between patients with HT and those without HT (P <0.050). Female patients with age less than 45 years and tumors with diameter less than or equal to 0.5 cm A higher proportion of patients. 32 cases (65.31%, 32/49) were positive for BRAF V600E in patients with HT, 84 cases (70.59%, 84/119) in BRAF V600E in patients without HT, The positive rate of BRAF ~ (V600E) expression was no significant difference (P> 0.050). In patients with HT, the expression level of BRAF ~ (V600E) was correlated with sex, invasion of membrane and lymph node metastasis, while the expression of BRAF ~ (V600E) in women without membrane invasion and without lymph node metastasis was weak (P <0.050). In patients with extravasaphylactic invasion and lymph node metastasis, BRAF ~ (V600E) expression in HT patients was weaker than in patients without HT (P <0.050). Conclusions There are more female patients, younger patients and smaller tumor diameter in PTMC patients with HT, which may be the reason of their better prognosis. In addition, the weak expression of BRAF ~ (V600E) may be associated with HT, there is lymph node metastasis and invasion of PTMC patients with better prognosis of the reason.