Lu Hai-Zhen, Qiu Tian, Ying Jian-Ming, Lyn Ning
Department of Pathology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, P.R. China.
Oncol Lett. 2017 Mar;13(3):1595-1600. doi: 10.3892/ol.2017.5661. Epub 2017 Feb 1.
The B-Raf proto-oncogene serine/threonine kinase (BRAF) mutation is an important oncogene in the development of papillary thyroid carcinoma (PTC) and has been identified as a risk factor for poor prognosis in patients with PTC. However, whether the BRAF mutation is a prognostic marker in patients with solitary papillary thyroid microcarcinoma (sPTMC) has not yet been established. The present study aimed to identify the association between BRAF mutation and the clinicopathological features of patients with sPTMC. A total of 108 patients with sPTMC who underwent surgery at the Cancer Institute and Hospital of the Chinese Academy of Medical Sciences between December 2010 and December 2012 were analyzed retrospectively. Exon 15 of the BRAF gene was amplified using the polymerase chain reaction and direct sequencing was performed to detect the BRAF mutation. Statistical analysis was subsequently performed using SPSS software (version 16.0). The association between BRAF mutation and clinicopathological features of sPTMC was tested with the χ test or Fisher's exact test, as appropriate. There were 27 males and 81 females in the cohort, who were aged between 22 and 66 years old, with an average age of 42 years. The BRAF mutation was found in 59 out of 108 (54.6%) patients with sPTMC. The presence of the BRAF mutation was demonstrated to be significantly associated with extrathyroidal extension (P=0.019), advanced Tumor-Node-Metastasis stage (P=0.007) and the presence of autoimmune thyroiditis (P=0.010). The BRAF mutation was not significantly associated with gender, anatomic location or subtype of sPTMC (P>0.05). In addition, the BRAF mutation indicated poor prognosis in patients with sPTMC. These results suggest that the BRAF mutation is a risk factor for poor prognosis in patients with sPTMC. This knowledge will aid in the risk stratification and post-operative management of patients with sPTMC.
B-Raf原癌基因丝氨酸/苏氨酸激酶（BRAF）突变是甲状腺乳头状癌（PTC）发生发展过程中的一种重要致癌基因，并且已被确定为PTC患者预后不良的一个危险因素。然而，BRAF突变是否为孤立性甲状腺微小乳头状癌（sPTMC）患者的预后标志物尚未明确。本研究旨在确定BRAF突变与sPTMC患者临床病理特征之间的关联。对2010年12月至2012年12月期间在中国医学科学院肿瘤医院接受手术的108例sPTMC患者进行回顾性分析。采用聚合酶链反应扩增BRAF基因的第15外显子，并进行直接测序以检测BRAF突变。随后使用SPSS软件（版本16.0）进行统计分析。根据情况，采用χ检验或Fisher精确检验来检测BRAF突变与sPTMC临床病理特征之间的关联。该队列中有27例男性和81例女性，年龄在22至66岁之间，平均年龄为42岁。在108例sPTMC患者中，有59例（54.6%）检测到BRAF突变。结果表明，BRAF突变的存在与甲状腺外侵犯（P=0.019）、高级别肿瘤-淋巴结-转移分期（P=0.007）以及自身免疫性甲状腺炎的存在（P=0.010）显著相关。BRAF突变与sPTMC的性别、解剖位置或亚型无显著关联（P>0.05）。此外，BRAF突变表明sPTMC患者预后不良。这些结果提示，BRAF突变是sPTMC患者预后不良的一个危险因素。这一认识将有助于sPTMC患者的风险分层和术后管理。
