目的:探讨n 131I辅助治疗对B-Raf原癌基因丝/苏氨酸蛋白激酶(BRAF)n V600E突变型非远处转移性甲状腺乳头状癌(PTC)患者的长期治疗疗效反应。n 方法:回顾性分析2008年1月至2019年1月间就诊于北京协和医院仅行1次n 131I治疗且临床、随访(中位随访时间63个月)及评估资料完整的181例非远处转移性PTC患者[男65例，女116例，年龄(38.9±11.8)岁]资料。按其原发灶BRAFn V600E基因是否突变分为突变型组和野生型组；根据n 131I治疗剂量的不同，分为清除残留甲状腺组织(简称清甲)治疗组(1.1 GBq)和辅助治疗组(3.7～5.5 GBq)。采用两独立样本n t检验、Mann-Whitney n U检验和n χ2检验比较各组患者的临床、病理特征及n 131I治疗后长期治疗疗效反应。n 结果:BRAFn V600E突变型患者(n n＝150)的n 131I治疗前刺激性甲状腺球蛋白(ps-Tg)水平明显高于野生型[n n＝31；6.32(0.90，8.70)与3.92(0.40，4.40) μg/L；n z＝-2.413, n P＝0.016]，但2组的其余临床病理特征(包括年龄、性别、肿瘤大小、多灶性、被膜侵犯、N分期)差异均无统计学意义(n t＝-0.663, n z＝-1.151, n χ2值：0.003～1.491，均n P>0.05)，2组的治疗疗效反应差异也无统计学意义(n χ2＝1.094，n P＝0.778)。81例接受n 131I辅助治疗的患者中，突变型组(n n＝69)的ps-Tg水平高于野生型组[n n＝12；8.70(1.30，11.80)与3.40(0.30，4.50) μg/L；n z＝-2.194，n P＝0.028]；但2组的治疗疗效反应差异无统计学意义(n χ2＝1.792，n P＝0.617)。BRAFn V600E突变型患者中，与清甲治疗组(n n＝81)相比，辅助治疗组(n n＝69)肿瘤较大[1.52(0.95，2.00)与1.21(0.60，1.50) cm；n z＝-2.728, n P＝0.006]、N分期较晚(n χ2＝11.460, n P＝0.003)、ps-Tg水平较高[8.70(1.30，11.80)与4.34(0.50，5.30) μg/L；n z＝-3.314, n P＝0.001]，但2组的治疗疗效反应差异无统计学意义(n χ2＝6.478，n P＝0.091)。n 结论:131I辅助治疗有助于改善肿瘤较大、淋巴结分期较晚、ps-Tg水平较高的BRAFn V600E突变型非远处转移性PTC患者的较长期治疗疗效反应。n “,”Objective:To evaluate n 131I adjuvant therapy in B-Raf proto-oncogene, serine/threonine kinase (BRAF)n V600E mutant patients with non-distant metastatic papillary thyroid cancer (PTC).n Methods:From January 2008 to January 2019, a total of 181 PTC patients (65 males, 116 females, age: (38.9±11.8) years) with non-distant metastases from Peking Union Medical College Hospital were retrospectively enrolled. All patients received only one time n 131I therapy with complete clinicopathological information, data of follow-up (median time: 63 months) and assessment of response to therapy. Patients were divided into mutant and wild type group in terms of BRAFn V600E status or ablation group (1.1 GBq) and adjuvant therapy group (3.7-5.5 GBq) in terms of different n 131I dosage. Clinicopathological features and the response to therapy were compared between different groups by using independent-sample n t test, Mann-Whitney n U test and n χ2 test.n Results:The levels of preablative stimulated thyroglobulin (ps-Tg) in the BRAFn V600E mutant type group (n n=150) was significantly higher than that in the wild type group (n n=31; 6.32(0.90, 8.70) n vs 3.92(0.40, 4.40) μg/L; n z=-2.413, n P=0.016), however, there were no significant differences in other clinicopathological characteristics (including age, sex, tumor size, multifocality, capsule invasion and N staging) between the two groups (n t=-0.663, n z=-1.151, n χ2 values: 0.003-1.491, all n P>0.05) and the therapeutic response was also not different between the two groups(n χ2=1.094, n P=0.778). Of 81 patients who received n 131I adjuvant therapy, the ps-Tg level of BRAFn V600E mutant type group (n n=69) was higher than that of the wild type group(n n=12; 8.70(1.30, 11.80) n vs 3.40(0.30, 4.50) μg/L; n z=-2.194, n P=0.028), while the therapeutic response was not different between the two groups (n χ2=1.792, n P=0.617). Compared with BRAFn V600E mutant patients received n 131I ablation (n n=81), BRAFn V600E mutant patients received n 131I adjuvant therapy (n n=69) had larger tumors (1.52(0.95, 2.00) n vs 1.21(0.60, 1.50) cm; n z=-2.728, n P=0.006), more advanced N staging (n χ2=11.460, n P=0.003) and higher ps-Tg level (8.70(1.30, 11.80) n vs 4.34(0.50, 5.30) μg/L; n z=-3.314, n P=0.001), but the therapeutic response was not different between the two groups (n χ2=6.478, n P=0.091).n Conclusion:131I adjuvant therapy may improve the longer-term response to therapy in BRAFn V600E mutant PTC patients with lager tumors, more advanced N staging and higher ps-Tg level.n