贝塞斯达III-VI结节携带孤立RAS突变的组织病理学和临床特征
Young-Ji Seo1, Hattie H Huston-Paterson2, Max A Schumm1
1Section of Endocrine Surgery, Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
概括
带有孤立RAS突变的甲状腺结节很少具有侵略性,不太可能复发. 甲状腺叶切除术对于这些瘤可能是足够的治疗方法,与BRAF突变癌症不同.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 分子诊断学 分子诊断
背景情况:
- 有着孤立RAS突变的甲状腺瘤通常被认为是惰性的.
- 对这些瘤的瘤结果的综合分子测试数据有限.
研究的目的:
- 为了描述甲状腺结节的瘤结果与孤立的RAS突变.
- 为了将结果与孤立的BRAF V600E突变甲状腺癌进行比较.
主要方法:
- 对368名患有贝塞斯达III-VI甲状腺结节的患者进行了回顾性队列研究,这些患者接受了ThyroSeq v3分子测试.
- 鉴定具有孤立RAS突变的患者,并与孤立的BRAF V600E突变癌症进行比较.
- 对恶性瘤发病率,高风险特征和结构性疾病复发的分析.
主要成果:
- 在孤立的RAS突变结节中,恶性瘤发生率为46%;在BRAF突变癌症中,百分之百.
- 淋巴结转移率较低在RAS突变的癌症中 (11%) 与BRAF突变的癌症 (39%).
- 在RAS突变组没有结构性复发,而BRAF突变组在5年内只有6%.
结论:
- 贝塞斯达III-VI甲状腺结节与孤立的RAS突变显示出较低的攻击性特征和复发率.
- 甲状腺叶切除术可能是孤立的RAS突变瘤的适当治疗方法.
- 与BRAF V600E.相比,RAS突变表明甲状腺癌的攻击性较小.
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