BRAF：是否进行择区性颈清扫术的决策工具？
BRAF: a tool in the decision to perform elective neck dissection?
机构信息
1 Institute of Cancer of the State of Sao Paulo (ICESP) , Sao Paulo, Brazil .
出版信息
Thyroid. 2013 Dec;23(12):1541-6. doi: 10.1089/thy.2012.0304. Epub 2013 Nov 12.
BACKGROUND
Some studies have demonstrated a correlation between the presence of a BRAF mutation and aggressive characteristics, including lymph node metastasis in papillary thyroid carcinoma (PTC). Prophylactic central neck dissection (CND) has been proposed for treatment of PTC. Given the potential complications of CND, we undertook a prospective study to determine the correlation between the BRAF mutation and lymph node metastasis.
METHODS
A total of 51 patients with PTC underwent total thyroidectomy and routine prophylactic CND. All patients were tested for the BRAF mutation.
RESULTS
Positive lymph nodes were found in 54.9% of patients. The BRAF mutation was found in 15 patients (29%). BRAF was not correlated with lymph node metastases. Lymph node metastases were correlated with multifocality (p=0.005) and angiolymphatic invasion (p=0.003) in univariate analysis. Age was also significant in multivariate analysis.
CONCLUSIONS
Testing for the BRAF mutation does not help in deciding whether or not to perform CND.
背景
一些研究表明，BRAF 突变的存在与侵袭性特征之间存在相关性，包括甲状腺乳头状癌（PTC）中的淋巴结转移。预防性中央颈部清扫术（CND）已被提议用于治疗 PTC。鉴于 CND 的潜在并发症，我们进行了一项前瞻性研究，以确定 BRAF 突变与淋巴结转移之间的相关性。
方法
共 51 例 PTC 患者接受甲状腺全切除术和常规预防性 CND。所有患者均进行 BRAF 突变检测。
结果
54.9%的患者发现阳性淋巴结。15 例（29%）患者存在 BRAF 突变。BRAF 与淋巴结转移无关。单因素分析显示，淋巴结转移与多灶性（p=0.005）和血管淋巴管侵犯（p=0.003）相关。年龄在多因素分析中也有意义。
结论
检测 BRAF 突变无助于决定是否进行 CND。
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