| ObjectiveBRAF gene mutation has a close relationship with thyroid gland around outside invasion, lymph node metastasis and tumor stage. Cases of the clinical trials for mutated BRAF gene mutation, adopt the method of grouping antitheses, apply different surgical methods in the treatment of tumor recurrence after 1 year through statistical analysis, to explore different operative methods for patients prognosis if there is a difference. MethodsBetween December 2013 and November 2014, By grouping contrast method, we retrospectively analyzed study among 160 patients with thyroid cancer in the first affiliated hospital of Zhengzhou university thyroid surgical ward. These cases divided by genetic testing into two groups, concluding 91 cases in gene mutation group and 69 cases in not mutation group. And then,91 cases in gene mutation group randomly divided into two groups:46 cases adopt a surgery resection including unilateral thyroid lobe, thyroid isthmus and unilateral lymph nodes in central region.;45 cases in the second group adopt a different surgery resection including unilateral thyroid lobe and thyroid isthmus. After operation,a periodic review was performed.91 cases had a follow-up time in one year to compare two different operation on patient prognosis if there is a difference.91 cases need to meet the following criteria: In line with the unilateral malignant thyroid nodule, size 1.0cm or less,and without breaking thyroid capsule, preoperative diagnosis of surrounding tissues and lymph node metastasis in the distance. ResultsIn the group that 46 cases adopt a surgery resection including unilateral thyroid lobe, thyroid isthmus and unilateral lymph nodes in central region, one case appeared voice hoarse and incidence was 2% 20 cases appeared numbness around mouth and upper limb and incidence was 43%;45 cases in the other group, No one appeared voice hoarse and 12 cases appeared numbness around mouth and upper limb and incidence was 27%.The patient who appeared voice hoarse restored within half a year. 91 cases with BRAF gene mutation and 69 cases without BRAF gene mutation made up 160 cases, and the positive rate was 56.9%.In one year, the operation team among 46 cases with a bigger scope had 1 tumor recurrence cases, the other operation team among 45 cases with a relatively small scope had 6 tumor recurrence cases. Chi-square =3.989, P=0.048, the difference was statistically significant(P<0.05). Conclusion1.BRAF gene mutation have not a big impact on biochemical indicators in patients’ blood. There has no statistical differences(P>0.05)2.BRAF gene mutation is common in the cases of thyroid cancer,as a response to this, we confirm that the cases, conforming to criteria including the unilateral malignant thyroid nodule, size 1.0cm or less, and without breaking thyroid capsule, preoperative diagnosis of surrounding tissues and lymph node metastasis in the distance, should be performed a surgery resection including unilateral thyroid lobe, thyroid isthmus and unilateral lymph nodes in central region. |
