新疆医科大学学报

目的探讨鼠类肉瘤滤过性病毒致癌基因同源体B1(v-raf murine sarcoma viral oncogene homolog B1,BRAF V600E)突变体蛋白在锯齿状腺瘤(serrated adenomas,SA)患者中的意义。方法选择新疆医科大学附属肿瘤医院消化肿瘤科2017年5月—2020年4月确诊的80例SA患者,分析BRAF V600E蛋白在结直肠SA中的表达特点。结果 BRAF V600E蛋白在结直肠癌(CRC)、SA和增生性息肉(HP)中均有不同比例的表达,三者BRAF V600E阳性率差异均有统计学意义(P<0.05),其中HP明显低于SA,而CRC明显高于SA,免疫组织化学结果显示,BRAF V600E蛋白在HP组织中表达不明显,在SA组织的胞浆中呈阳性表达,在CRC组织的胞浆中则呈强阳性表达;随着SA异型增生程度的加重,BRAF V600E蛋白基因表达水平也随之增加(P<0.05);BRAF V600E表达水平在淋巴结转移的CRC患者中表达水平明显增加,差异有统计学意义(P<0.05)。结论 BRAF V600E蛋白在结直肠SA中的表达量对SA进展趋势及癌变不良预后具有一定预测价值,有望成为早期诊断及预后判断的重要分子。

Objective To investigate the significance of BRAF V600E in patients with serrated adenoma(SA). Methods A total of 80 patients with SA diagnosed in Department of Digestive Oncology in the hospital from May 2017 to April 2020 were selected, and the expression characteristics of BRAF V600E protein in colorectal SA were analyzed.Results BRAF V600E protein was expressed in different proportions in colorectal cancer(CRC), SA and hyperplastic polyp(HP). There was significant difference in the positive rate of BRAF V600E among the three groups(P<0.05). HP was significantly lower than SA, while CRC was significantly higher than SA. The results of immunohistochemistry showed that the expression of BRAF V600E protein was not obvious in HP tissue, but positive in the cytoplasm of SA tissue and strongly positive in the cytoplasm of CRC tissue; with the aggravation of SA dysplasia, the expression level of BRAF V600E protein gene also increased(P<0.05). The expression level of BRAF V600E in CRC patients with lymph node metastasis was significantly higher than that in patients with lymph node metastasis(P<0.05). Conclusion The expression of BRAF V600E protein has a certain predictive value for the progression of SA and poor prognosis,and is expected to become an important molecule in early diagnosis and prognosis.