Dujardin Fanny, Pagès Jean-Christophe, Collin Christine, de Calan Loïc, Lecomte Pierre, Guyétant Serge
Service d'anatomie et cytologie pathologiques, hôpital Trousseau, CHRU de Tours, 37044 Tours cedex 09, France.
Ann Pathol. 2010 Aug;30(4):252-62. doi: 10.1016/j.annpat.2010.05.011. Epub 2010 Jul 29.
BRAF V600E mutation in papillary thyroid carcinoma (PTC): prevalence and detection in fine needle aspiration (FNA) specimens.
The activating mutation of the BRAF gene, T1799A, is the most common and specific genetic alteration in PTC. In the present study, our aims were to confirm these data and investigate the feasibility of BRAF mutation detection in FNA specimens.
In a retrospective study, we examined paraffin-embedded surgical samples of 57 PTC and 51 non-PTC thyroid tumors for the presence of BRAF mutation by dideoxy sequencing. We analyzed thyroid aspirates (drop and washed-out solution) and smears from 31 patients who underwent thyroidectomy, before intraoperative frozen sections, and 25 archival thyroid FNA smears.
The BRAF mutation was present in 58 % of PTC. Among non-PTC thyroid tumors, only one medullary thyroid carcinoma contained the BRAF mutation. BRAF mutation was correctly detected from the FNA-derived materials. Considering the search of BRAF mutation in preoperative FNA smears, the diagnosis of PTC would have been affirmed in 31 % (4/13) of indeterminate and suspicious FNA.
BRAF mutation detection in FNA specimens is feasible and could be used as an adjunct tool for preoperative diagnosis of PTC classified as indeterminate and suspicious with conventional cytology (categories 3, 4 and 5 according to NCI/Bethesda 2008 terminology).
甲状腺乳头状癌(PTC)中的BRAF V600E突变:细针穿刺活检(FNA)标本中的发生率及检测
BRAF基因的激活突变T1799A是PTC中最常见且特异的基因改变。在本研究中,我们旨在证实这些数据,并研究在FNA标本中检测BRAF突变的可行性。
在一项回顾性研究中,我们通过双脱氧测序检查了57例PTC和51例非PTC甲状腺肿瘤的石蜡包埋手术样本中BRAF突变的存在情况。我们分析了31例接受甲状腺切除术患者在术中冰冻切片前的甲状腺抽吸物(滴液和洗脱液)及涂片,以及25份存档的甲状腺FNA涂片。
58%的PTC存在BRAF突变。在非PTC甲状腺肿瘤中,仅1例髓样甲状腺癌含有BRAF突变。从FNA来源的材料中正确检测到了BRAF突变。考虑到在术前FNA涂片中搜索BRAF突变,在31%(4/13)的不确定和可疑FNA中可确诊为PTC。
在FNA标本中检测BRAF突变是可行的,可作为术前诊断常规细胞学分类为不确定和可疑的PTC(根据NCI/贝塞斯达2008术语,类别3、4和5)的辅助工具。