| Abstract: | Objective In this study, the clinical, pathological and genetic data of PTC patients in The Third Affiliated Hospital of Kunming Medical University were collected, sorted out and statistically analyzed to explore the correlation between PTC gene mutations and the aggressiveness of PTC. Besides, the correlation between BRAF V600E mutation and the occult metastasis of central lymph nodes in PTC was discussed, so as to refine the precise treatment of PTC. Methods PTC patients who met the inclusion criteria and agreed to be enrolled in the Third Affiliated Hospital of Kunming Medical University from April 2018 to April 2022 were selected. The genetic, pathological and clinical data were collected and analyzed. （1） Each gene mutation group was used as the observation group and the wild-type was used as the control group to compare the difference between each gene mutation and wild type. （2） Multiple gene mutations were used as observation group and single gene mutations were used as control group to compare the difference between multiple gene mutation and single gene mutation. （3） In cN0 patients: BRAF V600E single gene mutation was used as observation group and without gene mutation was used as control group to analyse the correlation between the BRAF V600E and he occult metastasis of central lymph nodes in PTC . Results （1） BRAF V600E mutation: CLNM and N1 accounted for a large proportion and the number of central lymph node metastasis was high , TPO-Ab reduced （P < 0.05）; TERT mutant: Elderly, male, lateral neck lymph node metastasis accounted for a large proportion and the number of lateral neck lymph node metastasis was high, T stage was later （P < 0.05）. RET mutant: Lateral neck lymph node metastasis accounted for a large proportion and the number of lateral neck lymph node metastasis was high, T stage was late （P < 0.05）. NTRK3 and ETV6 were fused together, and the results were consistent: in the mutant group, the invasion of thyroid capsule accounted for more （P < 0.05）. RAS mutation: Tg-Ab was reduced （P < 0.05）; TP53、CCDC6: There was no significant difference between the mutant group and the wild-type group （P ≥ 0.05）. （2） Thyroid capsule invasion, lateral neck lymphatic metastasis accounted for a large proportion and more metastatic lymph nodes in the lateral neck, M stage was later in Multiple gene mutations group （P < 0.05）; （3） In patients with cN0: CLNM accounted for a large proportion and the number of lateral neck lymph node metastasis was high in BRAF V600E single mutation group （P < 0.05）. Conclusions （1） BRAF V600E mutation is associated with CLNM in PTC. （2） Multi-gene mutation shows stronger lateral neck lymph node and distant metastasis ability than single gene mutation. （3） BRAF V600E mutation is associated with the occult metastasis of the central lymph node in cN0 PTC patients. |
