| Objective: To investigate the significance of BRAFV600 E mutation and expression of BRAF and TERT protein in papillary thyroid microcarcinoma.Measurements: Fluorescent quantitative PCR was used to detect the mutation of BRAFV600 E in papillary thyroid microcarcinoma.Specific BRAF and TERT monoclonal antibodies were also been used simultaneously.Envision two-step immunohistochemistry was used to detect the expression of BRAF and TERT protein in PTMC.To compare the expression of BRAFV600 E between normal thyroid tissue and PTMC,and the relativity of BRAFV600 E mutation and BRAF protein expression.To understand the relationship between different groups of BRAF and TERT protein expression and each clinical pathological parameter of PTMC.Results: A total of 164 PTMCs were tested for BRAFV600 E mutations.122 were positive and 42 were wild-type mutations for BRAFV600 E mutations.In this study,12 cases of normal thyroid tissue around the tumor as a control group all had no expression of BRAFV600 E.In the meantime,BRAF protein was detected.And there were 110 cases with positive expression and 54 cases with negative.The coincidence coefficient of the two detection methods was K = 0.78,and the degree of agreement between the two test methods was statistically significant(P =0.001).The number of primary tumors,tumor size,extratumoral infiltration,lymph node metastasis,places of lymph node metastasis,metastasis size,number of metastases,pathological stage III-IV were related to BRAFV600 E mutations and PTMC.The difference was statistically significant(P<0.05).164 cases of PTMC patients were divided into four subgroups based on the expression of protein of BRAF and TERT.Protein expression was double negative in 20 cases(12.1%)and double positive in 64 cases(39%),and only BRAF protein expression in 56 cases(34%),only TERT protein expression in 24 cases(14.6%).Compared with double-negative group of protein expression,BRAF protein and TERT protein double expression has correlation with the number of primary tumors,extra-invasion,tumor size,lymph node metastasis,lymph node metastasis,lymph node metastasis and pathological stage III-IV phase.The difference was statistically significant(P<0.05).There was a significant difference in the expression of BRAF protein expression only between patients with gender,lymph node metastasis,mean lymph node metastasis,number of lymph node metastases,and clinical stage(P<0.05).This result is similar to that of BRAFV600 E mutation and PTMC clinical pathology.TERT protein expression only was related to PMTC cervical lymph node.The difference was statistically significant(P<0.05).Conclusion: BRAFV600 E mutation is a common molecular type change in PTMC and has high specificity.It is helpful for the identification and diagnosis of PTMC.The expression of BRAFV600 E was related to the number of primary tumors,primary tumor size,extra-membrane infiltration,lymph node metastasis,places of lymph node metastasis,lymph node metastasis size,number of lymph node metastasis and pathological stage III-IV in PTMC.The coexistence of BRAF and TERT mutations forms a new genetic background with poor clinical pathological results in such PTMCs.TERT and BRAF proteins can provide high guiding value for the preoperative diagnosis and surgical treatment of papillary thyroid microcarcinoma,and can predict it with higher risk of recurrence and metastasis. |
