Relationship Between BRAF^V600E Gene And TERT Promoter Mutations And Cervical Lymph Node Metastasis In Papillary Thyroid Carcinoma

BackgroundThyroid cancer has become one of the most common malignancies in the endocrine system.The global incidence rate has rapidly increased in recent decades.The most common thyroid malignancy is papillary thyroid carcinoma（PTC）.With the continuous increase in the detection rate of thyroid nodules and thyroid cancer,significant progress has been made in the study of thyroid diseases.However,surgical treatment is still the main treatment method for thyroid papillary carcinoma due to differences in guidelines at home and abroad.The level of thyroid surgery is uneven,and overtreatment and undertreatment of papillary thyroid cancer are still prevalent in different regions.In addition,although most PTC patients generally have a good prognosis after systemic treatment,some clinicians suggest that PTC be converted to a more conservative treatment strategy,but about 15-20%of patients still have the risk of relapse or progressive metastasis..Therefore,in order to confirm the diagnosis and predict prognosis,determine the risk stratification of PTC,and strengthen the understanding of the molecular mechanism of PTC,it is the focus of PTC’s future research.ObjectiveTo clarify the role of BRAF ^V600E gene and TERT promoter mutations in cervical lymph node metastasis of thyroid papillary carcinoma.MethodsThe data of 432 patients with thyroid papillary carcinoma underwent surgery from February 2017 to September 2017 at the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.The mutations of BRAF ^V600E and TERT promoter were detected by PCR Fluorescence quantification and Sanger sequencing。SPSS 22.0 was used for statistical analysis of the correlation between BRAF ^V600E and TERT promoters and central and lateral lymph node metastases,the comparison between the two groups using Chi-square test,P<0.05 for the difference was statistically significant analysis of two effects of genes on cervical lymph node metastasis in patients with Thyroid Papillary.ResultsAmong the 432 patients with thyroid papillary carcinoma who met the inclusion criteria,the mutation rates of the BRAF^V600E and TERT promoters were 77.8%（336/432）and 5.3%（23/432）.In patients with BRAF ^V600E mutation,the probability of cervical lymph node metastasis was significantly higher than that in non-mutated patients（P<0.05）.In patients with TERT promoter mutations,the probability of cervical lymph node metastasis was significantly higher than that in non-mutated patients（P<0.05）.Patients with simultaneous BRAF^V600E and TERT promoters had a significantly increased probability of cervical lymph node metastases compared with patients treated with the BRAF^V600E mutation alone（P<0.05）.ConclusionMutations in BRAF^V600E and/or TERT promoter are closely related to cervical lymph node metastasis in papillary thyroid carcinoma.Preoperative fine-needle aspiration cytology and postoperative routine pathological molecular diagnosis of the two can help clinicians to develop a more rational treatment strategy,and patients with a more accurate assessment of the risk of relapse.