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目的探讨野生型RET(WTRET)及RET/PTC1、3融合基因在成人散发性甲状腺乳头状癌(PTC)中的表达及其与临床病理学指标的关系和意义。方法用逆转录聚合酶链反应(RTPCR)检测102例石蜡与新鲜(43例)甲状腺病变组织(PTC66例,对照组各种良恶性肿瘤及良性病变共36例)中WTRET和RET/PTC1、3融合基因的表达并结合临床资料进行分析。结果(1)62%(41/66)PTC患者≥40岁。38%(25/66)PTC伴淋巴细胞性甲状腺炎,59%(39/66)伴淋巴结转移,5例(7.6%)有远处转移。(2)RET原癌基因的酪氨酸激酶区(RETTK)检出率为68.1%(45/66)。RET原癌基因断裂点(BP)与TK的同时检出率在PTC中28.8%(19/66),腺瘤中12.5%(1/8),表明存在WTRET转录物。(3)RET/PTC检出率21.2%(14/66),其中5例RET/PTC1阳性(7.6%),9例RET/PTC3阳性(13.6%)。6例(9%)PTC同时表达RET/PTC和WTRET。36例对照组病例中未检测到RET/PTC融合基因。(4)统计学分析,PTC病例中WTRET与RET/PTC1融合基因的表达与性别、年龄、肿瘤大小、多灶性、伴淋巴细胞浸润及淋巴结转移等临床病理学指标无关(P>0.05)。结论RET/PTC融合基因在散发性成人PTC中表达率低,其诊断和判断预后的价值不大。WTRET在甲状腺肿瘤的滤泡形成过程中起一定作用。
Objective To investigate the expression of wild-type RET (WTRET) and RET / PTC1,3 fusion gene in adult sporadic thyroid papillary carcinoma (PTC) and its relationship with clinicopathological parameters. Methods Totally 102 patients with rheumatoid arthritis (PTCET) and RET / PTC1,3 (control group) underwent reverse transcription polymerase chain reaction (RTPCR) in 102 cases of paraffin and fresh thyroid tissue (PTC66, control group, benign and malignant tumors, 36 cases) Fusion gene expression and clinical data analysis. Results (1) 62% (41/66) patients with PTC ≥40 years. Thirty-eight percent (25/66) PTC with lymphocytic thyroiditis, 59% (39/66) with lymph node metastases, and 5 (7.6%) distant metastases. (2) The RETTK detection rate of RET proto-oncogene was 68.1% (45/66). The simultaneous detection rate of RET proto-oncogene breakpoint (TK) and PT was 28.8% (19/66) in PTC and 12.5% (1/8) in adenoma, suggesting the presence of WTRET transcripts. (3) The detection rate of RET / PTC was 21.2% (14/66), of which 5 cases were RET / PTC1 positive (7.6%) and 9 cases RET / PTC3 positive (13.6%). 6 (9%) PTCs expressed both RET / PTC and WTRET. No RET / PTC fusion gene was detected in 36 controls. (4) Statistical analysis showed that there was no correlation between the expression of WTRET and RET / PTC1 fusion gene in clinicopathological parameters such as gender, age, tumor size, multifocality, lymphocytic infiltration and lymph node metastasis (P> 0.05). Conclusion The expression of RET / PTC fusion gene in sporadic adult PTC is low, and the value of RET / PTC fusion gene in diagnosis and prognosis is not significant. WTRET plays a role in follicular formation in thyroid tumors.