Associations of BRAF V600E, clinical pathology and imaging factors with the recurrence rate of papillary thyroid microcarcinoma

Abstract

In the present study, the recurrence rate of papillary thyroid microcarcinoma (PTMC) was assessed by analyzing postoperative follow-up data of affected patients and its associations with BRAF V600E, clinical pathology and imaging factors were explored. A total of 506 patients with PTMC were selected who underwent surgery from January 2014 to March 2016. The maximal diameter of thyroid nodules was ≤1 cm and all patients who underwent BRAF V600E testing and evaluation for lymph node metastasis. Postoperatively, each patient was regularly followed up to detect recurrence. Categorical variables were comparatively analyzed using univariate Cox linear regression analysis to screen for protective and adverse factors influencing recurrence of PTMC. A stepwise Cox proportional hazards regression model analysis was performed to explore risk factors affecting recurrence. Among the 506 patients, 477 were followed up, 29 were lost to follow-up and 26 patients experienced recurrence. The 5-year recurrent rate of PTMC was 5.45%. The univariate Cox regression analysis indicated that PTMC recurrence was influenced by BRAF V600E, sex, multifocality, capsular invasion and lateral cervical lymph node metastasis (P<0.05), but not by age, tumor location on the thyroid, size, single central lymph node metastasis, distant metastasis and operative approach (P>0.05). The significant factors associated with recurrent PTMC were subjected to stepwise multivariate Cox proportional hazards regression model analysis and the results indicated that BRAF V600E, sex, multifocality and lateral cervical lymph node metastasis were independent factors influencing recurrence in patients with PTMC, with a statistically significant difference (P<0.05). In conclusion, BRAF V600E, sex, multifocality and lateral cervical lymph node metastasis are independent risk factors for recurrent PTMC. Patients and methods Research subjects. The independent ethics committee of China Medical University (Shenyang, China) approved this study. In total, 506 patients were included who underwent

Risk Factors for Cervical Lymph Node Metastasis in Middle Eastern Papillary Thyroid Microcarcinoma

“…PTMC has become a health concern due to its increase in incidence over recent decades [ 19 , 20 ]. Although cases of PTMC usually have favorable outcomes, there is a subset of PTMC patients that present with aggressive disease and a high risk of recurrence.…”

“…Several clinico-pathological and molecular characteristics have been shown to increase the risk for LNM such as older age, gender, multifocality, bilaterality, extra-thyroidal extension, and the presence of Hashimoto’s thyroiditis [ 15 , 17 , 18 ]. In addition, the presence of BRAF mutations has been reported to be a significant risk factor for LNM [ 19 , 20 ].…”

Correlation between Ultrasonographic Appearance of Papillary Thyroid Microcarcinoma and BRAF V600E Mutation

“…After one year, the nodule increased significantly and the anteroposterior diameter exceeded 1.0 cm, accompanied by lymph node metastasis. Therefore, BRAF V600E expression was positive and tumor invasiveness could be related [ 36 , 37 ]. Further research is needed for future follow-up.…”

TERT Promoter Mutations Are an Independent Predictor of Distant Metastasis in Middle Eastern Papillary Thyroid Microcarcinoma

“…Previous studies have evaluated the mutational profile of PTMC with aggressive features with contrasting results (31)(32)(33). BRAF is the most studied gene in PTMC, being detected in about 50% of cases and was associated with aggressive clinical features and risk of recurrence (32,34,35). However, incidence of TERT promoter mutations and their clinical impact on PTMC have shown contradicting results.…”