Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752, Korea.
Radiology. 2009 Dec;253(3):854-60. doi: 10.1148/radiol.2533090471. Epub 2009 Aug 25.
To evaluate the association of known prognostic factors with the BRAF(V600E) mutation and its association with ultrasonographic (US) features in Korean patients with papillary thyroid microcarcinoma (PTMC).
This retrospective study was institutional review board approved; informed consent was not required from patients. From July 2008 to November 2008, 339 consecutive patients underwent surgery for PTMC. US-guided fine-needle aspiration biopsy was performed to evaluate BRAF status in thyroid nodules before surgery. Logistic regression analysis was performed to assess the association between BRAF status, determined by using clinicopathologic factors, and several US features.
Univariate analysis revealed an association between the BRAF(V600E) mutation and both tumor size and extracapsular invasion. Tumor size, extracapsular invasion, and high TNM stage (III and IV) were significantly associated with BRAF(V600E) in multivariate analysis. BRAF(V600E) was not significantly associated with any US features.
The BRAF(V600E) mutation can be used as a potential prognostic factor in PTMC patients in a BRAF(V600E)-prevalent area. Future studies will be needed to determine how this information can be used to alter patient care.
评估已知预后因素与 BRAF(V600E)突变的相关性，以及其与韩国甲状腺微小乳头状癌（PTMC）患者超声（US）特征的相关性。
本回顾性研究获得机构审查委员会批准；患者无需签署知情同意书。2008 年 7 月至 2008 年 11 月，连续 339 例患者因 PTMC 接受手术治疗。在术前，通过 US 引导下的细针抽吸活检评估甲状腺结节中的 BRAF 状态。采用 logistic 回归分析评估 BRAF 状态与临床病理因素和几种 US 特征之间的相关性。
单因素分析显示，BRAF(V600E)突变与肿瘤大小和包膜外侵犯均有关。多因素分析显示，肿瘤大小、包膜外侵犯和高 TNM 分期（III 期和 IV 期）与 BRAF(V600E)显著相关。BRAF(V600E)与任何 US 特征均无显著相关性。
在 BRAF(V600E)阳性的地区，BRAF(V600E)突变可作为 PTMC 患者的潜在预后因素。需要进一步研究以确定如何利用这些信息改变患者的治疗。
