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瘤等级和分子特征与 Sporadic Medullary 甲状腺癌的生存相关
Simona Censi1, Francesca Galuppini2, Cristina Clausi1
1Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy.
国际骨髓甲状腺癌分级系统 (IMTCGS) 独立预测骨髓甲状腺癌 (MTC) 患者的生存率. 根据IMTCGS的定义,高等级的MTC与较差的结果和特定的遗传突变有关.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 骨髓甲状腺癌 (MTC) 的分级影响患者的治疗结果.
- 国际甲状腺髓癌分级系统 (IMTCGS) 将MTC分为高级和低级瘤.
- 了解IMTCGS,临床因素和分子变化的关系对于零星的MTC至关重要.
研究的目的:
- 调查IMTCGS分级与零星MTC中的临床数据之间的关联.
- 探索IMTCGS分级与MTC的分子状态之间的联系,特别是RET和RAS基因突变.
- 为了确定IMTCGS等级对患者结果的预后价值.
主要方法:
- 141名零星MTC患者的回顾性队列研究.
- 收集了临床,病理和随访数据;瘤使用IMTCGS进行了分级.
- 分析了RET和RAS基因的体质突变;使用卡普兰-梅尔和考克斯回归的生存分析.
主要成果:
- IMTCGS分级与疾病特异性存活率 (DSS) 独立相关 (HR 8.8,p=0.005).
- 在高度MTC中,RET突变,特别是RET-M918T更频繁 (p<0.001).
- 高度MTC中没有RAS突变,但在11.8%的低度瘤中存在.
结论:
- IMTCGS分级是零星MTC中DSS的重要独立预测因素.
- MTC分级与RET和RAS突变模式相关,解释了高等级瘤的攻击性行为.
- 在临床和分子因素之外,IMTCGS提供了宝贵的预后信息.
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