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中华医学超声杂志(电子版) ›› 2017, Vol. 14 ›› Issue (12) : 914 -918. doi: 10.3877/cma.j.issn.1672-6448.2017.12.008

所属专题: 文献

浅表器官超声影像学

甲状腺结节声像图特征与BRAFV600E基因突变的相关性研究
杨明1, 罗渝昆1,(), 张艳1, 张明博1, 武荣1, 文晶1, 谢芳1, 张颖1, 李杰1   
  1. 1. 100853 北京,解放军总医院超声科
  • 收稿日期:2017-03-14 出版日期:2017-12-01
  • 通信作者: 罗渝昆
  • 基金资助:
    国家自然科学基金(81471681); 解放军总医院临床扶持基金(2015FC-TSYS-1030)

Correlation between ultrasonographic features of thyroid nodules and BRAFV600E mutation

Ming Yang1, Yukun Luo1,(), Yan Zhang1, Mingbo Zhang1, Rong Wu1, Jing Wen1, Fang Xie1, Ying Zhang1, Jie Li1   

  1. 1. Department of Ultrasound, Chinese PLA General Hospital, Beijing 100853, China
  • Received:2017-03-14 Published:2017-12-01
  • Corresponding author: Yukun Luo
  • About author:
    Corresponding author: Luo Yukun, Email:
引用本文:

杨明, 罗渝昆, 张艳, 张明博, 武荣, 文晶, 谢芳, 张颖, 李杰. 甲状腺结节声像图特征与BRAFV600E基因突变的相关性研究[J/OL]. 中华医学超声杂志(电子版), 2017, 14(12): 914-918.

Ming Yang, Yukun Luo, Yan Zhang, Mingbo Zhang, Rong Wu, Jing Wen, Fang Xie, Ying Zhang, Jie Li. Correlation between ultrasonographic features of thyroid nodules and BRAFV600E mutation[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(12): 914-918.

目的

研究甲状腺结节声像图特征与BRAFV600E基因突变的相关性。

方法

选取2015年10月至2016年2月因甲状腺超声发现可疑结节在解放军总医院行穿刺活检的患者179例,共194个结节。结节最大径为(1.1±0.8)cm。记录结节的大小、回声、边界、形态、纵横比、钙化、包膜连续性,同时行穿刺活检获取组织,行常规病理及BRAFV600E基因检测。BRAFV600E基因突变组与BRAFV600E基因未突变组BRAFV600E基因检测与常规超声表现比较采用χ2检验,以有统计学意义的资料为自变量,BRAFV600E基因检测结果为应变量进行Logistic回归分析。

结果

BRAFV600E基因突变组与BRAFV600E基因未突变组结节的纵横比、边界、包膜连续性比较,差异均有统计学意义(χ2=11.174、45.517、11.046,P均<0.05)。经Logistic回归分析结节的纵横比、边界、包膜连续性是BRAFV600E基因突变的独立危险因素(OR=2.276,95%CI:1.117~4.638,P<0.05;OR=8.412,95%CI:3.836~18.448,P<0.001;OR=2.582,95%CI:1.138~5.860,P<0.05)。

结论

甲状腺结节纵横比、边界、包膜连续性等可作为预测结节BRAFV600E基因突变与否的征象,为临床进一步处理提供依据。

Objective

To study the correlation between ultrasonographic features of thyroid nodule and BRAFV600E mutation.

Methods

A total of 179 patients with 194 suspicious throid nodules were included in this study. They underwent ultrasound, biopsy, pathology and BRAFV600E mutation examination between October 2015 and February 2016 at Chinese PLA General Hospital. The size of nodules were (1.1±0.8) cm. The size, echo, boundary, shape aspect ratio, calcification and capsular invasion of nodules were investigated. The correlation between ultrasonographic features of thyroid nodule and BRAFV600E mutation analyzed by chis-square test and Logistic Regression analysis using statistical data as independent variable, BRAFV600E mutation as dependent variable.

Results

There were significant different in nodule′s ratio, boundary, capsular invasion characteristic between the BRAFV600E positive group and the BRAFV600E negative group (χ2=11.174, 45.517, 11.046, all P<0.05), and these signs are possibly associated with BRAFV600E mutation by logistic regression model analysis (OR=2.276, 95%CI: 1.117-4.638, P<0.05; OR=8.412, 95%CI: 3.836-18.448, P<0.001; OR=2.582, 95%CI: 1.138-5.860, P<0.05).

Conclusions

The ratio, boundary, capsular invasion characteristic of thyroid nodules are possibly associated with BRAFV600E mutation. These signs can be used to predict BRAFV600E mutation and facilitate subsequent treatment for such nodules.

图2 女性患者,35岁,BRAFV600E基因突变结节,病理为甲状腺乳头状癌,结节位于右叶中部,为低回声,边界不清,形态不规则,纵横比=1,有包膜侵犯,内回声不均匀,未见钙化
表1 BRAFV600E基因突变组与BRAFV600E基因未突变组结节声像图特征比较(个)
表2 声像图特征性表现与BRAFV600E基因突变的Logistic回归分析
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