The Relationship Between BRAF^V600E Gene Mutation And Primary Hyperthyroidism With Papillary Thyroid Carcinoma

ObjectiveTo investigate the clinical and pathological features of patients with primary hyperthyroidism complicated with papillary thyroid carcinoma and its relationship with BRAF ^V600E600E gene mutation.Method?1?.Select primary hyperthyroidism patients who were surgically treated at the Affiliated Hospital of Qingdao University between January 2011 and December 2016 and pathologically confirmed as papillary thyroid carcinoma.?1?To collect the patient's sex,age,and preoperative ultrasound features:number of nodules,echo,calcification,border,morphology,aspect ratio,cervical lymph node metastasis,and serum TPOAb,TGAb levels.?2?The postoperative pathological features were recorded:including the longest diameter of the lesions,single and double sides,invading the capsule,lymph node metastasis and distribution area,number,and whether Hashimoto's thyroiditis and nodular goiter were involved.?3?To evaluate recurrence risk stratification,and TNM staging.?4?To analyze the clinical and pathological features of patients with hyperthyroidism and nail cancer.?2?collecting postoperative pathological wax blocks of the above patients,extracting DNA,after ordinary PCR amplification,BRAF ^V600E600E mutation was measured by simple sequencing method.To calculate the mutation rate of BRAF ^V600E600E gene in patients with hyperthyroidism combined with carcinoma,analysis the correlation between BRAF ^V600Egene mutation and the clinical and Pathological features of patients with hyperthyroidism combined with papillary thyroid carcinoma.Results?1?80 cases of hyperthyroidism combined with thyroid carcinoma,5 cases?6.25%?male,75 cases?93.75%?female;age range 24-70 years,median age 48 years;preoperative ultrasound showed hypo echoic nodule 75 Cases?93.75%?,micro-calcification were 54 cases?67.50%?,unclear borders were 70 cases?87.50%?;postoperative pathology showed that the longest diameter of the tumor ranged from 0.2cm to 2.0cm,with an average diameter of 0.790±0.062cm;Micro-carcinoma were 63 cases?78.75%?and lymph node metastasis were 33 cases?41.25%?.The risk of recurrence stratification:40 cases of low-risk group,40 cases of moderate and high-risk group,TNM staging:55 cases in phase I-II,25 in phase III-IV.?2?Micro-carcinoma?diameter?1cm?group had a lower risk of cervical lymph node metastasis and recurrence risk and a lower proportion of TNM stage III-IV compared with non micro-carcinoma group?all P=0.006?0.003?0.006?;the gender,age,nodule micro-calcification,borderline,invade the membrane has no statistically significant difference.?all P>0.05?.?3?Lymph node metastasis compared with no metastasis group:these people of the age<45 years,non micro-carcinoma,TNM stage III-IV have a big proportion,and the diameter of the tumor were larger?all P=0.009,0.006,0.000,0.000?.There was no statistically significant difference between sex,micro-calcification,borderline,and invasion of the capsule?all P>0.05?.?4?The positive rate of BRAF ^V600E600E gene mutation was 51.25%?41/80?.Between groups,BRAF ^V600E600E gene mutation rate was significantly increased in the groups of Ultrasound nodule borderline unclear,pathological encroachment capsule,lymph node metastasis,recurrence risk stratification high-risk,TNM stage III-IV?all P=0.035?0.024?0.006?0.000?0.000?.The ratio of BRAF ^V600E600E gene mutation was significantly higher in the larger diameter group?P=0.004?.Conclusions?1?Hyperthyroidism combined with PTC is dominated by women,with mostly micro-carcinoma and relatively low malignancy.Nodular ultrasound features were low echo,micro-calcification,and unclear boundaries.?2?Age<45 years,diameter>1cm and high TNM stage are risk factors for PTC lymph node metastasis.?3?The positive rate of BRAF ^V600E600E gene mutation was 51.25%,it's Similar to simple papillary thyroid carcinoma.Large diameter,capsule invasion,lymph node metastasis,high risk of recurrence,high TNM staging were associated with mutations in the BRAF ^V600E600E gene.It suggests that BRAF ^V600E600E gene mutation may be related to the occurrence of malignancy,metastasis,recurrence,malignancy,and poor prognosis.