BRAFV600E status and clinical characteristics in solitary and multiple papillary thyroid carcinoma: experience of 512 cases at a clinical center in China

Abstract

BackgroundPapillary thyroid carcinoma (PTC) is one of the most frequent endocrine malignancies. In most cases, it often presents as multifocal tumor. It has been reported that multifocal tumors are associated with elevated risk of lymph node and distant metastases. Multifocality is also one of the factors predicting prognosis. Recent studies show that BRAFV600E mutation occurs more frequently in aggressive PTC. The purpose of this study was to evaluate BRAFV600E status and clinicopathological features in multiple and solitary PTC.MethodsWe performed a retrospective study to analyze 512 PTC cases who received surgery, including 376 solitary PTCs and 136 multiple PTCs.ResultsMultiple PTC is more related to lymph node metastasis and vascular invasion than solitary PTC. However, the distant metastasis rate and 10-year survival rate showed no difference between these two groups. BRAFV600E mutation status was more frequent in multiple PTC patients with lymph node metastasis and late stage at diagnosis.ConclusionBRAFV600E mutation is most commonly associated with extra-thyroidal extension and lymph node metastasis in PTC. Multiple PTC patients with young age, large tumors and BRAFV600E mutation should be followed carefully. Our study provides useful information for PTC patients’ followup and treatment.

Clinical impact of BRAF mutation on the diagnosis and prognosis of papillary thyroid carcinoma: a systematic review and meta‐analysis

“…), repetitive publication, unreliable reference standard and confounding result data (the data could not be extracted for statistical analysis). At last, 67 (18 diagnostic studies and 49 prognostic studies) studies were considered eligible for inclusion . The study selection process was summarized in Fig.…”

“…A total of 46 studies (9704 patients) were eligible for analysing the relationship of BRAF V600E and the gender of patients with PTC [10,14,15,33,36,37,[39][40][41][42][43][46][47][48][49][50][51][52][54][55][56][57][58][59][60][61][62][63][64][65][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82]. The pooled of RR was 1Á11 (95% CI: 0Á98-1Á25, random-effect model, Fig.…”

Comparison of the clinicopathologic features of solitary and multifocal papillary thyroid carcinoma and the utility of testing an additional tumor nodule for BRAFV600E in multifocal cases

“…The number of tumor nodules usually ranges from two to six with a mean size of about 1 cm [16,24]. This study reports a rate of 47% for multifocal cases.…”

“…BRAF V600E is the most common genetic mutation in PTC and many studies have found association with adverse prognostic features including more aggressive subtypes, extrathyroidal extension, lymph node and distant metastasis, as well as increased recurrence and mortality [16,17]. Melck and colleagues also demonstrated that cases of PTC with BRAF V600E mutation were more likely to require cervical reoperation compared to those without mutation [18].…”

“…Most studies report a rate of mPTC's in the range of 20-27% but has been reported to be present in up to 78.1% of patients, usually with a dominant tumor nodule and multiple microcarcinomas [7,8,16,22,23]. The number of tumor nodules usually ranges from two to six with a mean size of about 1 cm [16,24].…”