| Objective:1.To investigate the relationship and significance between syndrome differentiation and BRAF V600 E mutation and expression of TTF-1 and Ki-67 in papillary thyroid carcinoma;2.To analyze the relationship between syndrome differentiation and lymph node metastasis of papillary thyroid carcinoma and its significance;3.To explore the relationship between BRAF V600 E mutation,TTF-1,Ki-67 expression and lymph node metastasis and its significance.Methods:Screening in November 2019 to November 2020 mammary gland thyroid surgery in affiliated hospital of shandong university of TCM diagnosis of thyroid papillary carcinoma patients by surgery,in accord with a standard 88 example,fill in the thyroid papillary carcinoma syndrome type of traditional Chinese medicine questionnaire,collecting clinical basic information,four diagnostic information and colour to exceed,postoperative pathologic information,such as dialectical classification,at the same time for the thyroid papillary carcinoma tissues BRAF gene V600 E using reverse transcriptase polymerase chain reaction(rt-pcr),immunohistochemical method to detect the vera.TTF-1,expression of Ki-67.Excel database was established,and SPSS 22.0 statistical software was used for statistical analysis of the data.Results:1.Among the included patients with thyroid breast cancer,24 cases were male(27%)and 64 cases were female(73%).The male-female incidence rate was1:2.67,54 cases were younger than 45 years old(61.4%),and 34 cases were older than 45 years old(38.6%).There were 66 cases(75%)with single lesions,22 cases(25%)with multiple lesions.There were 48 cases(54.5%)with lymph node metastasis confirmed by postoperative pathology,of which 26 cases(54.17%)had 1-5 lymph nodes,and 22 cases(45.83%)had more than 5 lymph nodes.There were 79 cases of PT1(89.8%),3 cases of PT2(3.4%),and 6 cases of PT3(6.8%)in tumor size.2.Traditional Chinese medicine classification of thyroid papillary carcinoma showed 42 cases of qi stagnation and blood stasis,accounting for47.7%;32 cases of liver stagnation and spittoon constipation,accounting for36.4%;14 cases of qi and Yin deficiency,accounting for 15.9%.There was no correlation between syndrome differentiation and lymph node metastasis(P>0.05).3.BRAF V600 E was positive in 59 cases(67.1%)and negative in 29 cases(32.9%).30 cases(34.1%)had negative TTF-1 expression(<25%),and 58 cases(65.9%)had positive TTF-1 expression(≥25%).There were 58 cases(65.9%)with negative expression of Ki-67(<10%),and 30 cases(34.1%)with positive expression of Ki-67(≥10%).4.There was a correlation between the expression of Ki-67 and the deficiency of both qi and Yin in thyroid papillary carcinoma(P<0.05) There was no correlation between BRAF V600 E mutation,low expression of TTF-1 and high expression of Ki-67 and other syndrome types of head carcinoma(P > 0.05).5.There were 70 cases with no lymph node metastasis(CN0)found in preoperative thyroid color ultrasound,among which 31 cases(44.29% of the total number of CN0)were found with lymph node metastasis(PN1)by postoperative pathology,and 39 cases(55.71%)had no lymph node metastasis after surgery.Among the patients transferred from CN0 to PN1,there were 14 cases of qi stagnation and blood stasis,accounting for 45.2% of the total number of patients transferred from CN0 to PN1,and the average expression of Ki-67 was 3.5%;there were 13 cases of liver stagnation and spittoon coagulation,accounting for 41.9%;the average expression of Ki-67 was 8.37%;there were 4 cases of qi and Yin deficiency,accounting for 12.9%;and the average expression of Ki-67 was 9.5%.BRAF V600 E mutation was associated with negative TTF-1 expression and CN0 to PN1.6.BRAF V600 E mutation was correlated with lymph node metastasis of papillary thyroid carcinoma(P<0.05),high expression of Ki-67 was positively correlated with lymph node metastasis,and negatively correlated with the number of lymph node metastasis,while TTF-1 expression was not correlated with lymph node metastasis of papillary thyroid carcinoma(P>0.05).Conclusion:1.Thyroid papillary carcinoma with deficiency of both qi and Yin was characterized by high expression of Ki-67.There was no significant correlation between qi stagnation and blood stasis and liver stagnation and spittoon constipation and cell proliferation activity.2.There is no correlation between TCM syndrome differentiation and BRAF V600 E mutation,TTF-1 expression and lymph node metastasis.Therefore,a large number of samples are still needed for the diagnosis and further discussion of TCM dialectical problems.3.BRAF V600 E mutation and high expression of Ki-67 are correlated with lymph node metastasis of papillary thyroid cancer,and the combination of the two tests may provide reference for the treatment and prognosis of papillary thyroid cancer.High expression of Ki-67 may be helpful in predicting lymph node metastasis,but not in predicting the number of lymph node metastasis. |
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