Correlation Between Molecular Characteristics And Clinicopathological Features Of Papillary Thyroid Carcinom

Background:The incidence of papillary thyroid carcinoma(PTC)is increasing year by year,and the patients of which are younger and younger.The prognosis of PTC patients is well,the ten-year survival rate of which is 90%.But some PTC patients have poor prognosis with distant metastasis.Differences of PTC prognosis and aggressiveness are mainly related to tumor heterogeneity,which is determined by molecular characteristics of tumors.Therefore,in order to better assess the prognosis of patients and the risk of disease,it is necessary to analyze the aggressiveness of PTC at the molecular level.At present,BRAF gene,RET gene and TERT promoter have become the main research targets,however,there are still some controversies.Although the American Thyroid Association(ATA)includes BRAF mutations in its risk stratification system and most studies have shown that BRAF mutations are associated with the aggressiveness and poor prognosis of PTC,there are still some studies that suggest that BRAF mutations are not associated with the aggressiveness of PTC.Some studies have shown that RET gene rearrangement is associated with PTC invasiveness,but other studies have suggested that RET gene rearrangement does not lead to PTC invasiveness.The TERT promoter would increase the distant metastasis of PTC,which usually happens with BRAF mutation.There are few studies on the relation between PTEN and TC,and related studies have shown that PTEN deficiency in TC can increase tumor invasiveness and the recurrence of PTC,but there is no report on PTEN.y65 x.Objective:In this study,patients with PTC who underwent surgical treatment for the first time and can provide genetic testing information were selected as the research objects.We analyzed the correlation of BRAF gene,TERT promoter,RET gene and PTEN gene with the epidemiological such as gender and age and clinicopathological characteristics of PTC,so as to provide more precise and individualized treatment plan for PTC patients.Method:This study collected 260 PTC patients in laparoscopic surgery department admitted to the First Affiliated Hospital of Dalian Medical University from May 2018 to February2022.Whether it invaded the capsule,the lymph nodes in the central group,the lymph nodes in the lateral neck region,and the results of genetic testing are collected.Among them,260 patients underwent BRAF,RET,KRAS,NRAS,HRAS gene and TERT gene promoter sequence detection,and 237 patients underwent gene detection including PTEN.The correlation of these genes and the clinical characteristics of PTC patients was analyzed.Statistical analysis was performed using SPSS 25.0 software.For measurement data,t test and nonparametric test were used according to the data type;for count data,c2 test,corrected c2 test and Fisher’s exact probability method were used according to the data.According to the specific situation of the data,linear correlation analysis or rank correlation analysis was adopted.All statistical tests were two-sided,and the test level was α=0.05,and P<0.05 was considered statistically significant.Results:BRAF gene mutation was associated with the gender of PTC and central group lymph node metastasis(P<0.05),that is,BRAF gene mutation was more likely to occur in male PTC patients and BRAF gene mutation was more likely to be accompanied by central group lymph node metastasis.The frequency of BRAF gene mutation was correlated with the maximum diameter(cm)of tumor foci(r=0.399,P<0.001).BRAF mutation was not associated with age,unilateral and bilateral,multifocal,lateral neck lymph node metastasis and capsule invasion(P>0.05).RET gene rearrangement was not associated with any clinicopathological features of PTC,but was associated with BRAF gene mutation(P<0.05).When BRAF gene mutation happened,the occurrence rate of RET gene rearrangement would reduce.The TERT promoter was associated with lateral cervical lymph node metastasis in PTC(P<0.05),but not with other clinical features.As a new detection site,PTEN.y65 x is related to the unilateral and multifocal predisposition of PTC(P<0.05),that is,the mutation of this gene makes PTC more likely to have bilateral and multiple tumor foci;but it has nothing to do with other clinical features.