Abstract
We investigated correlations of somatic BRAF V600E mutation and RET/PTC1 rearrangement with recurrent disease in Chinese patients with papillary thyroid carcinoma (ptc). This prospective study included 214 patients with ptc histologically confirmed between November 2009 and May 2011 at a single institute. We found somatic BRAF V600E mutation in 68.7% and RET/PTC1 rearrangement in 25.7% of the patients. Although BRAF mutation was not significantly associated with clinicopathologic features such as patient sex or age, multicentric disease, thyroid capsule invasion, tumour stage, or nodal metastasis, it was significantly associated with recurrent disease. Multivariate analysis revealed that BRAF mutation and tumour size were independent risk factors associated with recurrent disease, with odds ratios of 9.072 and 2.387 respectively. The area under the receiver operating characteristic curve increased 8.3% when BRAF mutation was added to the traditional prognostic factors, but that effect was statistically nonsignificant (0.663 vs. 0.746, p = 0.124). RET/PTC1 rearrangement and nodal metastasis were significantly associated in all patients (p = 0.042), marginally associated in ptc patients (p = 0.051), but not associated in microptc patients (p = 0.700). RET/PTC1 rearrangement was not significantly associated with recurrent disease. BRAF positivity is an independent predictor of recurrent disease in ptc.
Highlights
The prevalence of thyroid cancer has been increasing worldwide[1], including in China[2]
We found somatic BRAF V600E mutation in 68.7% and RET/PTC1 rearrangement in 25.7% of the patients
BRAF mutation was not significantly associated with clinicopathologic features such as patient sex or age, multicentric disease, thyroid capsule invasion, tumour stage, or nodal metastasis, it was significantly associated with recurrent disease
Summary
The prevalence of thyroid cancer has been increasing worldwide[1], including in China[2]. The prognosis of differentiated thyroid cancer is benign, with a survival rate of 96.4% after 30 years followup[5]. With the emerging understanding of molecular genetics in thyroid cancer, several specific mutations in ptc have been determined[8]. The BRAF V600E mutation has been associated with worse prognostic features (such as extrathyroidal extension, lymph node metastasis or advanced tumour stage), poor clinical outcome, and mortality[9,10,11,12,13]. In contrast to BRAF mutation, RET/PTC rearrangement has been associated with better prognosis[15]. Despite those findings, controversy remains[16,17,18,19,20,21]. Questions about the clinical significance of these mutations in the management of microptc are ongoing[22]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
