Li Fei, Chen Guangqi, Sheng Chunjun, Gusdon Aaron M, Huang Yueye, Lv Zhongwei, Xu Huixiong, Xing Mingzhao, Qu Shen
Department of EndocrinologyShanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yan Chang Middle Road, Shanghai 200072, ChinaFirst Clinical Medical CollegeNanjing Medical University, Nanjing 210029, ChinaJiangsu Institute of Nuclear MedicineWuxi 214063, ChinaDepartment of CardiologyShanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, ChinaDepartment of Neurology and NeuroscienceWeill Cornell Medical College, New York, New York 10065, USADepartments of Nuclear MedicineUltrasound MedicineShanghai Tenth People's Hospital, Shanghai 200072, ChinaThyroid InstituteTongji University, Shanghai 200072, ChinaDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA Department of EndocrinologyShanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yan Chang Middle Road, Shanghai 200072, ChinaFirst Clinical Medical CollegeNanjing Medical University, Nanjing 210029, ChinaJiangsu Institute of Nuclear MedicineWuxi 214063, ChinaDepartment of CardiologyShanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, ChinaDepartment of Neurology and NeuroscienceWeill Cornell Medical College, New York, New York 10065, USADepartments of Nuclear MedicineUltrasound MedicineShanghai Tenth People's Hospital, Shanghai 200072, ChinaThyroid InstituteTongji University, Shanghai 200072, ChinaDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA Department of EndocrinologyShanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yan Chang Middle Road, Shanghai 200072, ChinaFirst Clinical Medical CollegeNanjing Medical University, Nanjing 210029, ChinaJiangsu Institute of Nuclear MedicineWuxi 214063, ChinaDepartment of CardiologyShanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, ChinaDepartment o
Department of EndocrinologyShanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yan Chang Middle Road, Shanghai 200072, ChinaFirst Clinical Medical CollegeNanjing Medical University, Nanjing 210029, ChinaJiangsu Institute of Nuclear MedicineWuxi 214063, ChinaDepartment of CardiologyShanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, ChinaDepartment of Neurology and NeuroscienceWeill Cornell Medical College, New York, New York 10065, USADepartments of Nuclear MedicineUltrasound MedicineShanghai Tenth People's Hospital, Shanghai 200072, ChinaThyroid InstituteTongji University, Shanghai 200072, ChinaDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
Endocr Relat Cancer. 2015 Apr;22(2):159-68. doi: 10.1530/ERC-14-0531. Epub 2015 Jan 15.
The prognostic value of the BRAFV600E mutation, resulting in poor clinical outcomes of papillary thyroid carcinoma, has been generally confirmed. However, the association of BRAFV600E with aggressive clinical behaviors of papillary thyroid microcarcinoma (PTMC) has not been firmly established in individual studies. We performed this meta-analysis to examine the relationship between BRAFV600E mutation and the clinicopathological features of PTMC. We conducted a systematic search in PubMed, EMBASE, and the Cochrane library for relevant studies. We selected all the studies that reported clinicopathological features of PTMC patients with information available on BRAFV600E mutation status. Nineteen studies involving a total of 3437 patients met these selection criteria and were included in the analyses. The average prevalence of the BRAFV600E mutation was 47.48%, with no significant difference with respect to patient sex (male versus female) and age (younger than 45 years versus 45 years or older). Compared with the WT BRAF gene, the BRAFV600E mutation was associated with tumor multifocality (odds ratio (OR) 1.38; 95% CI, 1.04-1.82), extrathyroidal extension (OR 3.09; 95% CI, 2.24-4.26), lymph node metastases (OR 2.43; 95% CI, 1.28-4.60), and advanced stage (OR 2.39; 95% CI, 1.38-4.15) of PTMC. Thus, our findings from this large meta-analysis definitively demonstrate that BRAFV600E-mutation-positive PTMC are more likely to manifest with aggressive clinicopathological characteristics. In appropriate clinical settings, testing for the BRAFV600E mutation is likely to be useful in assisting the risk stratification and management of PTMC.
BRAFV600E突变导致甲状腺乳头状癌临床预后不良，这一点已得到普遍证实。然而，在个别研究中，BRAFV600E与甲状腺微小乳头状癌（PTMC）侵袭性临床行为之间的关联尚未得到确凿证实。我们进行了这项荟萃分析，以研究BRAFV600E突变与PTMC临床病理特征之间的关系。我们在PubMed、EMBASE和Cochrane图书馆中进行了系统检索，以查找相关研究。我们选择了所有报告了PTMC患者临床病理特征且有BRAFV600E突变状态信息的研究。19项研究共涉及3437例患者，符合这些选择标准并纳入分析。BRAFV600E突变的平均患病率为47.48%，在患者性别（男性与女性）和年龄（45岁以下与45岁及以上）方面无显著差异。与野生型BRAF基因相比，BRAFV600E突变与PTMC的肿瘤多灶性（比值比（OR）1.38；95%置信区间，1.04 - 1.82）、甲状腺外侵犯（OR 3.09；95%置信区间，2.24 - 4.26）、淋巴结转移（OR 2.43；95%置信区间，1.28 - 4.60）和晚期（OR 2.39；95%置信区间，1.38 - 4.15）相关。因此，我们这项大型荟萃分析的结果明确表明，BRAFV600E突变阳性的PTMC更有可能表现出侵袭性的临床病理特征。在适当的临床环境中，检测BRAFV600E突变可能有助于PTMC的风险分层和管理。
