甲状腺乳头状癌18 F-FDG PET/CT显像葡萄糖代谢与BRAF突变的相关性研究

摘要

Objective The objective of this study was to evaluate the correlation between maximum standard uptake values( SUVmax ) of 18 F-FDG PET/CT and BRAF mutation in patients with papillary thyroid car-cinoma(PTC).Methods Atotalof51patients(meanageof49.3±12.9years)whounderwent18F-FDGPET/CT imaging and biopsy before thyroidectomy were retrospectively analyzed. Based on the pathological results, there were 48 patients with PTC and 3 patients with follicular thyroid carcinoma(FTC). The SUVmax of thyroid nodule was measured by semi-quantitative analysis. The correlation between clinical data( gender,age,tumor size and thyroglobulin concentration) and SUVmax was also analyzed. The difference of SUVmax between the two groups was analyzed by comparing the BRAF V600E mutation group and the non-mutation group. Results In patients with PTC,27 patients had BRAF V600E mutations and 11 patients had no tumor mutation. The SUVmax of BRAF V600E mutation group was significantly higher than that in the non-mutated group(5. 5 ± 3. 9 vs. 2. 2 ± 1. 2,P=0. 002). The SUVmax of patients with tumor diameter≥1 cm was significantly higher than that in patients with tumor <1 cm(P<0. 05). The SUVmax of patients with elevated thyroglobulin concentration was higher than that in normal patients(P<0. 05). No BRAF V600E mutation was observed in the FTC group. Conclusion The BRAF V600E mutant gene has a high SUVmax value in patients with PTC. There were significant difference in SUVmax among different tumor size and serum thyroglobulin concentration.%目的 评估甲状腺乳头状癌(Papillary thyroid carcinoma,PTC)患者18 F-FDG PET/CT的最大标准摄取值(SUVmax)与BRAF突变的相关性.方法 回顾性分析我院在甲状腺切除术前接受18 F-FDG PET/CT显像和活检的患者51例(平均年龄为49.3±12.9岁),病理诊断为PTC 48例,甲状腺滤泡状癌(Follicular thyroid carcinoma,FTC)3例.采用基因检测法检测BRAF V600E突变状态,半定量分析法测定甲状腺结节灶的SUVmax,分析患者临床资料包括性别、年龄、肿瘤大小和甲状腺球蛋白浓度与SUVmax之间的相关性;将患者分为BRAF V600E突变组和未突变组,分析比较两组间SUVmax值的差异.结果 在PTC患者中,33例患者肿瘤发生BRAF V600E突变,15例患者肿瘤未发生突变,BRAF V600E突变组的SUVmax显著高于未突变组(5.5±3.9 vs.2.2±1.2,P=0.002);肿瘤直径≥1 cm的患者的SUVmax明显高于肿瘤<1 cm(P<0.05);甲状腺球蛋白浓度升高患者的SUVmax高于正常甲状腺球蛋白浓度的患者(P<0.05);FTC组中未观察到BRAF V600E突变.结论 PTC患者携带BRAF V600E突变基因相对于未携带者具有更高的SUVmax值,不同肿瘤大小、血清甲状腺球蛋浓度的PTC患者SUVmax值存在统计学差异.