Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.
Clinical Research Center, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Am J Clin Pathol. 2021 Jun 17;156(1):100-108. doi: 10.1093/ajcp/aqaa213.
We investigate the potential role of BRAF testing in guiding surgical intervention in papillary thyroid carcinoma (PTC).
Thyroid fine-needle aspiration (FNA) cases with available BRAF result and follow-up thyroidectomy for PTC were included in the study. Cytology and surgical diagnoses were correlated with BRAF status.
There were 151 cases of thyroid FNA specimens with BRAF testing (70 mutant and 81 wild-type BRAF) and histologically confirmed unilateral, unifocal PTCs. There were no differences in age, sex, tumor size, or lymphovascular invasion on thyroidectomy specimens between mutant and wild-type BRAF cases. BRAF mutation was significantly associated with cytology diagnosis (P < .001), PTC subtype (P < .001), extrathyroidal extension (ETE) (P = .006), and higher tumor (T) stage (P = .04). However, an analysis within the histologic subtypes of PTC revealed no significant association between BRAF mutation and ETE or higher T stage. There was also no difference in central (P = .847) or lateral (p = 1) neck lymph node (LN) metastasis.
BRAF mutation identified in thyroid FNA specimens correlates with histologic subtypes but is not an independent factor for predicting PTC biological behavior and should not be used to guide the extent of LN dissection.
我们研究 BRAF 检测在指导甲状腺乳头状癌（PTC）手术干预中的潜在作用。
本研究纳入了具有 BRAF 检测结果和接受 PTC 甲状腺切除术随访的甲状腺细针抽吸（FNA）病例。细胞学和手术诊断与 BRAF 状态相关联。
共有 151 例甲状腺 FNA 标本进行了 BRAF 检测（70 例 BRAF 突变和 81 例野生型 BRAF），并经组织学证实为单侧、单发 PTC。在 BRAF 突变型和野生型病例中，甲状腺切除标本的年龄、性别、肿瘤大小或血管淋巴管侵犯均无差异。BRAF 突变与细胞学诊断（P<0.001）、PTC 亚型（P<0.001）、甲状腺外侵犯（ETE）（P=0.006）和更高的肿瘤（T）分期（P=0.04）显著相关。然而，在 PTC 的组织学亚型中进行分析，发现 BRAF 突变与 ETE 或更高的 T 分期之间没有显著关联。中央（P=0.847）或侧方（p=1）颈部淋巴结（LN）转移也无差异。
甲状腺 FNA 标本中检测到的 BRAF 突变与组织学亚型相关，但不是预测 PTC 生物学行为的独立因素，不应用于指导 LN 清扫的范围。
