Clinical significance of telomerase reverse transcriptase promoter mutation in radioactive iodine refractory papillary thyroid cancer
10.3760/cma.j.cn321828-20210427-00137
- VernacularTitle:端粒酶反转录酶启动子突变在放射性碘难治性甲状腺乳头状癌中的意义
- Author:
Tingting WANG
1
;
Gangming CAI
;
Yi PAN
;
Heming GUO
;
Sicheng LI
;
Qi MA
;
Zhixue YANG
;
Longjiang XU
;
Ji HU
;
Chen FANG
Author Information
1. 江苏省原子医学研究所附属江原医院内分泌科，无锡 214063
- Keywords:
Thyroid neoplasms;
Carcinoma, papillary;
Mutation;
Transcription initiation site;
Telomerase;
Proto-oncogene proteins B-raf;
Brachytherapy;
Iodine radioisoto
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2022;42(2):90-95
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the influence of telomerase reverse transcriptase (TERT) promoter mutation on radioiodine uptake status of radioactive iodine refractory papillary thyroid cancer (RAIR-PTC) and radioiodine therapy response by analyzing the mutation frequency of TERT promoter in RAIR-PTC.Methods:A total of 37 patients with RAIR-PTC (15 males, 22 females, age (49.8±16.1) years) and 40 PTC patients with effective radioiodine therapy (13 males, 27 females, age (39.8±10.9) years) between January 2005 and June 2020 in JiangYuan Hospital Affiliated to Jiangsu Institute of Nuclear Medicine were retrospectively analyzed. TERT promoter mutation and B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation of patients were observed. The differences across genotype patterns on radioiodine uptake status and therapy response were compared. The Fisher′s exact test and independent-sample t test were used for data analysis. Results:The incidence rate of TERT promoter mutation in the RAIR-PTC group was 40.54% (15/37, all C228T), which was significantly higher than that in the effective radioiodine therapy group (0, 0/40; P<0.001). No statistically significant difference was found for the mutation rate of BRAF V600E between the RAIR group (64.86%, 24/37) and the effective radioiodine therapy group (72.50%, 29/40; P=0.858). Patients with TERT promoter mutation were older ( t=3.76, P=0.001) and the non-intake rate of radioiodine in distant metastases of those patients was higher ( P=0.037). Furthermore, 2/3 of patients who received targeted therapies and 3/4 deaths had TERT promoter mutation. Among 35 patients with negative thyroglobulin antibody (TgAb), 11/14 of patients with TERT mutation had a rising stimulated thyroglobulin (sTg), while the percentage of the non-TERT mutation group was 57.1% (12/21; P=0.357). Conclusion:The TERT promoter mutation rate is significantly increased in RAIR-PTC patients and can serve as a prognostic predictor in RAIR.
