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目的研究甲状腺乳头状癌(PTC)中BRAF基因突变和D2-40、CK19、cyclinD 1蛋白表达的临床意义。方法应用扩增阻碍突变系统(ARMS法)检测63例PTC和34例甲状腺乳头状增生组织中BRAF基因突变情况;应用免疫组化SP法检测上述组织中D2-40,CK19,cyclinD 1蛋白表达水平,分析其相关性。结果BRAF基因突变率和D2-40、CK19和cyclinD 1蛋白阳性率在甲状腺乳头状癌组中显著高于乳头状增生组(P<0.05);在甲状腺乳头状癌组中,BRAF基因突变率和D2-40、cyclinD 1蛋白阳性率在淋巴结转移组高于无淋巴结转移组(P<0.05);CK19蛋白阳性率在甲状腺乳头状癌中有、无淋巴结转移组之间差异不显著(P>0.05)。结论BRAF基因突变和D2-40、CK19,cyclinD 1蛋白表达的联合检测有助于甲状腺乳头状癌与甲状腺乳头状增生的诊断与鉴别诊断,同时可作为预测甲状腺乳头状癌预后的重要指标。
Objective To study the clinical significance of BRAF gene mutation and expression of D2-40, CK19 and cyclinD1 in papillary thyroid carcinoma (PTC). Methods The mutation of BRAF gene in 63 cases of PTC and 34 cases of thyroid papillary hyperplasia was detected by ARMS. The expressions of D2-40, CK19 and cyclinD 1 in the tissue were detected by immunohistochemical SP method , Analyze its relevance. Results The positive rate of BRAF gene mutation and the positive rates of D2-40, CK19 and cyclinD1 protein in papillary thyroid carcinoma group were significantly higher than that in papillary hyperplasia group (P <0.05). In thyroid papillary carcinoma group, the mutation rate of BRAF gene and The positive rates of D2-40 and cyclinD1 in lymph node metastasis group were higher than those without lymph node metastasis group (P <0.05). The positive rate of CK19 protein in papillary thyroid carcinoma was no significant difference between the two groups (P> 0.05 ). Conclusions The combined detection of BRAF gene mutations and the expression of D2-40, CK19 and cyclinD1 is helpful to the diagnosis and differential diagnosis of papillary thyroid carcinoma and papillary thyroid papillary hyperplasia. It may be used as an important index to predict the prognosis of papillary thyroid carcinoma.