Is the BRAFV600Emutation useful as a predictor of preoperative risk in papillary thyroid cancer?

Objective Recent studies have shown that a BRAFV600Ereflects poor prognosis, mainly in Western countries. However, some clinicians in Japan have suggested that the BRAFV600Emutation is not associated with a poor prognosis. Therefore, we investigated a relationship between BRAFV600Emutation and clini...

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Published in:The American journal of surgery 2012-04, Vol.203 (4), p.436
Main Authors: Jung Kwang Nam, Chan Kwon Jung, Song, Byung Joo, Lim, Dong Jun, Chae, Byung Joo, Lee, Nam Seop, Woo Chan Park, Kim, Jeong Soo, Sang Seol Jung, Bae, Ja Seong
Format: Article
Language:English
Subjects:
Cancer
Cervix
Classification
Confidence intervals
Deoxyribonucleic acid
Dissection
DNA
Genetic testing
Health risks
Lymph
Lymph nodes
Lymphatic system
Medical prognosis
Metastases
Metastasis
Multivariate analysis
Mutation
Papillary thyroid cancer
Papillary thyroid carcinoma
Polymerase chain reaction
Prognosis
Risk groups
Surgery
Thyroid
Thyroid cancer
Thyroidectomy
Tumors
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Summary:Objective Recent studies have shown that a BRAFV600Ereflects poor prognosis, mainly in Western countries. However, some clinicians in Japan have suggested that the BRAFV600Emutation is not associated with a poor prognosis. Therefore, we investigated a relationship between BRAFV600Emutation and clinicopathologic factors. Methods From September 2008 to December 2009, we performed routine analysis of the BRAFV600Emutation using thyroid cancer tissue from 424 patients who underwent thyroidectomy with cervical lymph node dissection. Results The BRAFV600Emutation was found in 335 of 424 cases (79%) and was higher in classic papillary thyroid carcinoma (PTC) (79.7%) than in the follicular variant of PTC (62.5%) (P= .019). On univariate analysis, the BRAFV600Emutation was associated with extrathyroidal extension (P= .009) and variants of PTC (P= .019), but a high-risk Metastasis, Patient Age, Completeness of resection, local Invasion and Tumor Size (MACIS) score (>= 6) (P= .146) and lymph node metastasis (P= .628) were not significantly associated with the BRAFV600Emutation. Multivariate analysis showed that extrathyroidal extension is independently associated with the BRAFV600Emutation (relative ratio: 2.466; 95% confidence interval, 1.213-5.011;P< .013). Conclusion It is not clear that the BRAFV600Emutation is useful for prediction of poor prognosis of PTC.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2011.02.013