年龄小于55岁和V600E突变是直径≤1.0 cm的乳头状甲状腺癌发生淋巴结转移的危险因素，但在直径>1.0 cm的乳头状甲状腺癌中并非如此。

Younger Than 55 Years Old and V600E Mutation are Risk Factors for Lymph Node Metastasis in Papillary Thyroid Carcinomas ≤1.0 cm but Not in >1.0 cm.

作者信息

Lai Yeqian, Gu Yihua, Yu Ming, Deng Jiaqin

机构信息

Department of Thyroid Surgery, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China.

Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China.

出版信息

Int J Gen Med. 2023 Apr 19;16:1403-1414. doi: 10.2147/IJGM.S408588. eCollection 2023.

DOI:10.2147/IJGM.S408588

PMID:37155469

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10122992/

Abstract

BACKGROUND

Studies on the relationship between V600E mutation and the clinicopathologic features of papillary thyroid carcinoma (PTC), risk of lymph node metastasis in papillary thyroid microcarcinoma (PTMC) have shown inconsistent results.

METHODS

In this retrospective analysis, clinicopathological data of the patients were collected, and molecular testing was done for V600E mutation. PTC patients are divided into PTC≤1.0cm (PTMC) and PTC>1.0cm, and the relationship between V600E mutation and clinicopathologic features was analyzed respectively.

RESULTS

Of the 520 PTC patients, 432 (83.1%) were female and 416 (80.0%) were <55 years old. V600E mutation was detected in 422 (81.2%) tumour samples of PTC. There was no significant difference in the frequency of V600E mutation between different age groups. There were 250 (48.1%) patients with PTMC and 270 (51.9%) patients with PTC>1.0cm. V600E mutation was significantly associated with bilateral cancer (23.0% vs 4.9%, =0.005) and lymph node metastasis (61.7% vs 39.0%, =0.009) in PTMC patients, while V600E mutation was significantly associated with bilateral cancer (24.9% vs 12.3%, =0.048) in PTC>1.0cm patients. Logistic regression analysis showed that, after adjusting for gender, Hashimoto's thyroiditis and calcification, we found that younger age (<55 years old) (OR: 2.384, 95% CI: 1.241-4.579, =0.009) and V600E mutation (OR: 2.213, 95% CI: 1.085-4.512, =0.029) were significantly associated with lymph node metastasis in PTMC, similar results were not obtained in PTC>1.0cm.

CONCLUSION

Younger age (<55 years old) and V600E mutation was independent risk factor for lymph node metastasis in PTMC.

摘要

背景

关于V600E突变与甲状腺乳头状癌（PTC）临床病理特征、甲状腺微小乳头状癌（PTMC）淋巴结转移风险之间关系的研究结果并不一致。

方法

在这项回顾性分析中，收集患者的临床病理数据，并进行V600E突变的分子检测。将PTC患者分为PTC≤1.0cm（PTMC）和PTC>1.0cm两组，分别分析V600E突变与临床病理特征之间的关系。

结果

520例PTC患者中，女性432例（83.1%），年龄<55岁者416例（80.0%）。422例（81.2%）PTC肿瘤样本检测到V600E突变。不同年龄组V600E突变频率无显著差异。PTMC患者250例（48.1%），PTC>1.0cm患者270例（51.9%）。PTMC患者中，V600E突变与双侧癌（23.0% vs 4.9%，P = 0.005）及淋巴结转移（61.7% vs 39.0%，P = 0.009）显著相关；PTC>1.0cm患者中，V600E突变与双侧癌（24.9% vs 12.3%）显著相关（P = 0.048）。Logistic回归分析显示，校正性别、桥本甲状腺炎和钙化因素后，发现年龄较小（<55岁）（OR：2.384，95%CI：1.241 - 4.579，P = 0.009）和V600E突变（OR：2.213，95%CI：1.085 - 4.512，P = 0.029）与PTMC淋巴结转移显著相关，PTC>1.0cm患者未得到类似结果。