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目的：比较甲状腺乳头状癌合并桥本氏甲状腺炎与不合并桥本氏甲状腺炎的BRAFV600E 基因表达以及侵袭性的区别。方法：2011 年9 月到2013 年9 月四川大学华西医院手术治疗并有BRAFV600E 基因测定的甲状腺乳头状癌患者226 名，均有病理证实。其中合并桥本氏甲状腺炎者50 例为研究组，同期随机抽取50 例不合并桥本氏甲状腺炎者作为对照组。比较两组性别、年龄、肿瘤大小、数量、BRAFV600E 基因表达以及甲状腺外侵犯和淋巴结转移与侵袭性相关的因素的区别。结果：甲状腺乳头状癌合并桥本氏甲状腺炎在男女性别，发病年龄、肿瘤大小上和对照组相比无差异（P>0.05）；BRAFV600E突变率、甲状腺外侵犯和淋巴结转移都较对照组更低（P<0.05）。BRAF 基因突变阳性组甲状腺外侵犯和淋巴结转移率较BRAFV600E基因突变阴性组更高（P<0.05）。结论：BRAFV600E 基因突变的甲状腺乳头状癌患者有更高的甲状腺腺外侵犯和淋巴结转移。甲状腺乳头状癌合并桥本氏甲状腺炎较不合并桥本氏甲状腺炎有着更低的BRAFV600E突变率，更低的甲状腺外侵犯和淋巴结转移。

英文摘要:

Objective:To compare difference of BRAFV600E gene expression and invasion in the papillary thyroid carcinoma with or without Hashimoto's thyroiditis.Methods:226 patients with papillary thyroid carcinoma, diagnosed by pathology with BRAFV600E gene assay were selected from surgery department of West China Hospital, Sichuan University from September 2011 to September 2013. 50 cases combined with Hashimoto's thyroiditis were considered as study group, 50 cases that did not combine with Hashimoto's thyroiditis were as the control group. The gender, age, tumor size, number, BRAFV600E gene expression, invasion, lymph node metastasis, and the factors associated with invasion was compared between two groups.Results:There was no difference in the gender, age, tumor size between two groups (P> 0.05); BRAFV600E mutation rate, invasion and lymph node metastasis in study group was lower than that of the control group (P <0.05). The invasion and the rate of lymph node metastasis in BRAF mutation-positive group was higher than BRAFV600E mutation-negative group (P<0.05).Conclusion:The patients of papillary thyroid cancer with BRAFV600E mutation have higher foreign invasion and lymph node metastasis. The patients of papillary thyroid carcinoma with Hashimoto's thyroiditis have lower mutation rate of BRAFV600E, less thyroid foreign invasion and lymph node metastasis.

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