甲状腺乳头状癌BRAF、RET表达与地域关系的Meta分析

忻 莹，仲妙春，管丹丹，郭海巍

(浙江省人民医院，浙江 杭州 310014)

·基础与临床研究·

甲状腺乳头状癌BRAF、RET表达与地域关系的Meta分析

忻 莹，仲妙春，管丹丹，郭海巍

(浙江省人民医院，浙江 杭州 310014)

目的：通过荟萃分析对甲状腺乳头状癌的常见基因突变或重排与地域分布的关系进行初步的探究。方法在Pubmed中筛选2016年3月前发表的相关英文文献，并分析甲状腺乳头状癌BRAF、RET、RAS基因突变或重排与肿瘤大小、淋巴结转移、远处转移等指标在地域上的分布特点。结果BRAF突变在美洲、亚洲、澳洲、欧洲地区都与甲状腺乳头状癌的分期、复发、腺外侵犯、淋巴结转移等多个指标相关；RET重排仅在美洲地区甲状腺乳头状癌的发生性别、肿瘤大小、腺外侵犯、淋巴结转移有关。结论甲状腺乳头状癌BRAF突变和RET重排对肿瘤大小、分期、淋巴结转移等临床生物学行为可能因地区差异而有不同影响。

甲状腺乳头癌；BRAF；RET；基因突变

Abstract：[Objective]The relationship between the common gene mutation or rearrangement and geographical distribution of papillary thyroid carcinoma was explored by meta-analysis.[Method] We reviewed the related publications within Pubmed before March 2016. Clinico-pathological parameters such as gender, age, recurrence, extra-thyroidal extension, lymph node metastasis (LNM), distant metastasis, tumor size and stage were analyzed in the study.[Result] In this study, we included 101 studies assessing BRAF mutation, 9 studies about RET mutation and 4 studies covering BRAF, RET and RAS in the same study. BRAF mutation seemed to be more likely related to male gender, older age, higher tumor stage, recurrence, LNM and multifocality. RETrearrangement correlated with a higher rate of LNM，but the result was equivocal. Significant associations were found between RAS mutation and male gender, tumor size, tumor stage and extra-thyroidal extension in PTC.[Conclusion]Our study demonstrated that BRAF mutation was associated with a poor prognosis in PTC. However, RAS mutation might yield a better prognosis of PTC which required further confirmation. The role of RET arrangement was still equivocal in PTC.

Keywords: papillary thyroid cancer; BRAF; RET；gene mutation

甲状腺癌是全世界常见的肿瘤之一。甲状腺乳头状癌(Papillary Thyroid Cancer，PTC)占甲状腺肿瘤的88%，是最常见的临床病理类型。尽管大多数PTC的预后良好，约10%病例可能发生局部复发或转移，10年生存率约40%。一些基因的突变或重排可能通过MAPK和PI3K-Akt信号通路，导致PTC预后不良，如BRAF点突变、RAS点突变、RET/PTC重排等。本研究中，将对PTC常见基因突变或重排与肿瘤大小、分期、淋巴结转移等临床指标的关系在不同地域间进行Meta分析，以探究对PTC预后最有预测意义的基因改变。

1 资料与方法

1.1 数据收集和选择

我们在Pubmed中搜寻2016年3月前发表的相关文……