braf-v600e基因检测在甲状腺微小乳头状癌诊治中的临床及病理意义

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1、授予单位代码10089学号或申请号20153279中国图书分类号R736.1HebeiMedicalUniversity硕士学位论文专业学位BRAF-V600E基因检测在甲状腺微小乳头状癌诊治中的临床及病理意义研究生：陈红导师：廖海鹰教授专业：外科学二级学院：河北医科大学第二医院2018年3月目录中文摘要··········································································································1英文摘要································

2、··········································································2综述BRAF-V600E基因检测在甲状腺微小乳头状癌诊治中的临床及病理意义··········································································································4致谢···········································································

3、·······································19个人简历··········································································································20中文摘要BRAF-V600E基因检测在甲状腺微小乳头状癌诊治中的临床及病理意义摘要甲状腺癌是目前发现的人体内分泌系统最常见的恶性肿瘤，甲状腺乳头状癌(papillarythyroidcarcinoma，PTC)在甲状腺癌众多病理类型中最为常见，近年来发病率呈明显上升趋势，其中甲状腺微小

4、乳头状癌（papillarythyroidmicrocarcinoma，PTMC）占据乳头状癌的主要部分。甲状腺微小乳头状癌检出率的增加与人们健康意识的增加及检查手段的提高相关。超声是目前诊断甲状腺结节首选的影像学检查方法，大大提高了甲状腺结节的检出率，但对于良恶性的鉴别，尤其是直径小于10mm的结节，存在一定的局限性。超声引导下细针穿刺细胞学（ultrasoundguidedfine-needleaspirationcytology，US-FNAC）弥补了超声的不足之处，提高了甲状腺微小结节术前诊断的准确率，其作为术前鉴别甲状腺良恶性结节的检查手段，在临床中得到广泛应用，但仍存在不足

5、之处。研究发现BRAF-V600E基因突变与甲状腺癌变过程相关，是PTC最常见遗传学事件。本文从PTMC的研究背景，到超声在甲状腺微小结节的检出率及鉴别良恶性中发挥的作用，到US-FNAC作为术前甄别甲状腺微小结节良恶性的有效手段，到BRAF-V600E基因突变在PTMC的发生、发展过程中的作用机制，与PTMC临床病理学特征的关系及临床诊治中的指导意义；总结阐述了近年来BRAF-V600E在术前甄别高侵袭性PTMC中的意义和临床应用前景。BRAF-V600E基因有望成为有效的PTMC分子标志物，更好的指导PTMC的诊疗，达到基础医学与临床医学的相关结合、相互反馈，达到个体化精准治疗标准

6、。关键词：甲状腺微小乳头状癌,超声,超声引导下细针穿刺细胞学，BRAF-V600E,基因检测1英文摘要TheclinicalandpathologicalsignificanceofBRAF-V600Egenetictestinginthediagnosisandtreatmentofpapillarythyroidmicrocarcinoma(PTMC)ABSTRACTThyroidcarcinomaisthemostcommonendocrinemalignancy.Ofallthetypesofthyroidcarcinoma,papillarythyroidcarcinomai

7、sthemostcommonone,anditsmorbidityisincreasingforthepastfewyears.Papillarythyroidmicrocarcinoma(PTMC)accountsforthemajorincidenceofPTC.Theincreaseinthedetectionrateofthyroidmicropapillarycarcinomaisinconnectionwiththepeople’s