Park Ah Young, Son Eun Ju, Kim Jeong-Ah, Youk Ji Hyun, Park Yun Joo, Park Cheong Soo, Chang Hang Seok
Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea; Department of Radiology, Soonchunghyang University Hospital, Soonchunghyang University College of Medicine, Seoul, Republic of Korea.
PLoS One. 2014 Oct 22;9(10):e110868. doi: 10.1371/journal.pone.0110868. eCollection 2014.
To evaluate the association of the BRAF(V600E) mutation with sonographic features and clinicopathologic characteristics in a large population with conventional papillary thyroid carcinoma (PTC).
We retrospectively reviewed the sonographic features, clinicopathologic characteristics, and presence of the BRAF(V600E) mutation in 688 patients who underwent thyroidectomy for conventional PTC between January and July 2010 at a single institution. The incidence of the BRAF(V600E) mutation was calculated. The sonographic features and clinicopathologic characteristics were compared between BRAF-positive and BRAF-negative patients. BRAF-positive patients were subdivided into those with papillary thyroid microcarcinoma (the PTMC group) and those with PTC larger than 10 mm (the PTC>10 mm group), and their sonographic features were compared.
The BRAF(V600E) mutation was detected in 69.2% of patients (476 of 688). Sonographic features were not significantly different between BRAF-positive and BRAF-negative PTC, nor between PTMC and PTC>10 mm groups. The BRAF(V600E) mutation was associated with male sex (P = 0.028), large tumor size, extrathyroidal extension, central and lateral lymph node metastasis, and advanced tumor stage (P<0.0001).
The BRAF(V600E)mutation was significantly associated with several poor clinicopathologic characteristics, but was not associated with sonographic features, regardless of tumor size. We recommend that patients with a thyroid nodule with any suspicious sonographic feature undergo preoperative BRAF(V600E) testing for risk stratification and to guide the initial surgical approach in PTC.
在一大群患有传统型甲状腺乳头状癌（PTC）的患者中，评估BRAF（V600E）突变与超声特征及临床病理特征之间的关联。
我们回顾性分析了2010年1月至7月在某单一机构因传统型PTC接受甲状腺切除术的688例患者的超声特征、临床病理特征以及BRAF（V600E）突变情况。计算BRAF（V600E）突变的发生率。比较BRAF阳性和BRAF阴性患者的超声特征及临床病理特征。将BRAF阳性患者分为甲状腺微小乳头状癌患者（PTMC组）和肿瘤直径大于10mm的PTC患者（PTC>10mm组），并比较两组的超声特征。
688例患者中有476例（69.2%）检测到BRAF（V600E）突变。BRAF阳性和BRAF阴性的PTC患者之间，以及PTMC组和PTC>10mm组之间的超声特征无显著差异。BRAF（V600E）突变与男性（P = 0.028）、肿瘤体积大、甲状腺外侵犯、中央和侧方淋巴结转移以及肿瘤晚期（P<0.0001）相关。
BRAF（V600E）突变与若干不良临床病理特征显著相关，但与超声特征无关，无论肿瘤大小如何。我们建议，对于任何具有可疑超声特征的甲状腺结节患者，应进行术前BRAF（V600E）检测，以进行风险分层并指导PTC的初始手术方式。
