Can Different Thyroid Tumor Types Be Distinguished by Polymerase Chain Reaction-Based K-ras Mutation Detection?

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Background: Thyroid tumors have mutations of the ras oncogenes, although the prognostic and diagnostic significance of this remains unclear. Usually, thyroid follicular adenoma, follicular carcinoma, and papillary carcinoma are easy to differentiate histologically. Occasionally, follicular carcinoma may be difficult to separate from the follicular variant of papillary carcinoma, and a molecular test to help differentiate the two would be critical, as their behavior and clinical management differ. In earlier reports, K- ras mutations have been suggested as such a marker. Methods and Results: To study genetic differences between thyroid tumors, the authors examined 79 cases (58 papillary carcinomas, 12 follicular carcinomas, and 9 adenomas) for the presence of a K-ras mutation in codon 12 by polymerase chain reaction and restriction endonuclease digestion. Only six papillary carcinomas (12%) showed a K-ras mutation; no mutations were detectable in the other thyroid tumors. Conclusion: K-ras mutation analysis does not help differentiate thyroid tumor types.