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目的分析甲状腺乳头状癌(PTC)组织中BRAFV600E基因突变及VEGF-C表达情况与其临床病理特征及中央区淋巴结转移的关系,寻找能预测PTC局部侵袭性和转移潜能的指标,为中央区淋巴结清扫寻找依据,从而选择合理的手术方式。方法运用PCR技术将PTC组织扩增后行基因测序,观察是否存在BRAFV600E基因突变;运用免疫组织化学染色方法观察PTC组织是否存在VEGF-C表达及其表达程度;分析BRAFV600E基因突变及VEGF-C表达情况与PTC临床病理特征及其中央区淋巴结转移的关系。结果 50例PTC患者中有30例(60.0%)存在BRAFV600E基因突变,其突变与VEGF-C的高表达相关(87.5%比34.6%,P=0.000)。PTC组织中VEGF-C高表达预示存在更高的中央区淋巴结转移率(87.5%比57.7%,P=0.019)。多因素分析结果表明,肿瘤侵及周围组织(P=0.009,OR=9.082,95%可信区间为1.748~47.185)和VEGF-C的高表达(P=0.009,OR=9.082,95%可信区间为1.748~47.185)是中央区淋巴结转移的独立因素。结论 1 BRAFV600E基因突变与中央区淋巴结转移无关,而其突变与VEGF-C的高表达相关。2 VEGF-C在PTC中的高表达预示更高的中央区淋巴结转移率。3肿瘤侵及甲状腺被膜特别是侵及周围组织与中央区淋巴结转移相关。
OBJECTIVE: To analyze the relationship between BRAFV600E gene mutation and VEGF-C expression in papillary thyroid carcinoma (PTC) with its clinicopathological characteristics and lymph node metastasis in central region, and to find the index that can predict the local invasion and metastatic potential of PTC for the central lymph node dissection Find the basis, to choose a reasonable surgical approach. Methods PCR was used to amplify the gene of PTC tissues and observe the existence of BRAFV600E gene mutation. The expression of VEGF-C and its expression in PTC tissues were observed by immunohistochemical staining. The expression of VEGF-C and BRAFV600E gene mutation Relationship between PTC and clinicopathological characteristics and lymph node metastasis in central area. Results The mutation of BRAFV600E gene was found in 30 (60.0%) of 50 patients with PTC. The mutation was associated with the high expression of VEGF-C (87.5% vs. 34.6%, P = 0.000). High VEGF-C expression in PTC tissues predicted a higher central lymph node metastasis (87.5% vs. 57.7%, P = 0.019). Multivariate analysis showed that the tumor invasion of surrounding tissues (P = 0.009, OR = 9.082, 95% confidence interval 1.748 ~ 47.185) and VEGF-C high expression (P = 0.009, OR = 9.082, 95% The range of 1.748 ~ 47.185) is an independent factor of central lymph node metastasis. Conclusion 1 BRAFV600E gene mutation has nothing to do with the central lymph node metastasis, and its mutation is associated with the high expression of VEGF-C. 2 The high expression of VEGF-C in PTC predicts a higher central lymph node metastasis rate. Invasion of the tumor and the thyroid capsule 3 especially the invasion of the surrounding tissue and the central lymph node metastasis.