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The BRAF mutation is useful for prediction of clinical recurrence in low‐risk patients with conventional papillary thyroid carcinoma
Author(s) -
Kim Tae Yong,
Kim Won Bae,
Rhee Yoon Soo,
Song Ja Young,
Kim Jung Min,
Gong Gyungyub,
Lee Seungkoo,
Kim Sang Yoon,
Kim Seong Chul,
Hong Suck Joon,
Shong Young Kee
Publication year - 2006
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2006.02605.x
Subject(s) - thyroid carcinoma , mutation , medicine , v600e , thyroidectomy , univariate analysis , oncology , carcinoma , gastroenterology , pathology , thyroid , multivariate analysis , biology , gene , genetics
Summary Background The activating BRAF V600E mutation is the most common genetic alteration reported in papillary thyroid carcinoma (PTC). While some reports suggest the BRAF V600E mutation is associated with factors predicting a poor prognosis and recurrence, this remains a controversial issue. Aim To determine whether the presence of the BRAF V600E mutation is a prognostic indicator for clinical recurrence in low‐risk patients with conventional PTC. Patients and methods The study involved 203 conventional PTC patients who underwent total or near‐total thyroidectomy followed by immediate 131 I ablation of the remnants. Patients with antithyroglobulin antibodies and those with extracervical metastases at presentation were excluded. DNA was extracted from paraffin‐embedded tumour specimens, and the presence of the BRAF V600E mutation was evaluated using PCR amplification and direct sequencing. Results The BRAF V600E mutation was found to be present in 149 (73·4%) of 203 patients. The BRAF V600E mutation was correlated with male gender ( P = 0·006) and with tumour size ( P = 0·005). While there appeared to be an association between the BRAF V600E mutation and extrathyroid extension, this did not reach statistical significance ( P = 0·062). During follow‐up of the 203 patients (median 7·3 years; range 0·7–10·0 years), 36 (18%) patients experienced recurrence. While univariate analysis showed the BRAF V600E mutation was associated with tumour recurrence (21% with mutation vs 7% without mutation; P = 0·037), this association was not shown following multivariate analyses adjusting for the clinicopathological prognostic factors of age, gender, tumour size, extrathyroid extension, multifocality and lymph node metastasis. Conclusions Although the BRAF V600E mutation was found to be associated with a higher clinical recurrence of disease in low‐risk conventional PTC patients, it was not an independent predictor.