Department of Surgery, Hospital Pathology, Catholic University of Korea, Seoul, Korea.
Am J Surg. 2012 Apr;203(4):436-41. doi: 10.1016/j.amjsurg.2011.02.013. Epub 2011 Jul 30.
Recent studies have shown that a BRAF(V600E) reflects poor prognosis, mainly in Western countries. However, some clinicians in Japan have suggested that the BRAF(V600E) mutation is not associated with a poor prognosis. Therefore, we investigated a relationship between BRAF(V600E) mutation and clinicopathologic factors.
From September 2008 to December 2009, we performed routine analysis of the BRAF(V600E) mutation using thyroid cancer tissue from 424 patients who underwent thyroidectomy with cervical lymph node dissection.
The BRAF(V600E) mutation 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 BRAF(V600E) mutation 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 BRAF(V600E) mutation. Multivariate analysis showed that extrathyroidal extension is independently associated with the BRAF(V600E) mutation (relative ratio: 2.466; 95% confidence interval, 1.213-5.011; P < .013).
It is not clear that the BRAF(V600E) mutation is useful for prediction of poor prognosis of PTC.
最近的研究表明，BRAF(V600E)突变主要在西方国家反映预后不良。然而，日本的一些临床医生认为 BRAF(V600E)突变与不良预后无关。因此，我们研究了 BRAF(V600E)突变与临床病理因素之间的关系。
我们使用 424 例接受甲状腺切除术和颈部淋巴结清扫术的甲状腺癌患者的组织，于 2008 年 9 月至 2009 年 12 月进行了常规的 BRAF(V600E)突变分析。
在 424 例病例中，有 335 例（79%）发现 BRAF(V600E)突变，经典型甲状腺乳头状癌（PTC）（79.7%）高于滤泡型 PTC（62.5%）（P=0.019）。单因素分析显示，BRAF(V600E)突变与甲状腺外侵犯（P=0.009）和 PTC 变体（P=0.019）有关，但高风险转移、患者年龄、切除完整性、局部侵犯和肿瘤大小（MACIS）评分（≥6）（P=0.146）和淋巴结转移（P=0.628）与 BRAF(V600E)突变无显著相关性。多因素分析显示，甲状腺外侵犯与 BRAF(V600E)突变独立相关（相对比：2.466；95%置信区间，1.213-5.011；P<0.013）。
BRAF(V600E)突变是否对 PTC 的不良预后有预测价值尚不清楚。
