Conventional Ultrasound, Immunohistochemical Factors and BRAFV600E Mutation in Predicting Central Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma

Chen, Jie; Li, Xiaolong; Zhao, Chong‐Ke; Wang, Dan; Wang, Qiao; Li, Mingxu; Wei, Qing; Ji, Guo; Xu, Hui‐Xiong

doi:10.1016/j.ultrasmedbio.2018.06.020

Cited by 41 publications

(50 citation statements)

References 58 publications

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“…Emerging evidence has shown a potential value of BRAF V600E mutation in predicting central cervical lymph node metastasis of PTC. 12,13 Given these data, in this retrospective study, we tested our hypothesis that BRAF V600E mutation might constitute a genetic background conferring LNM and that BRAF status could thus differentiate the prognostic risk of level V LNM in PTC.…”

Section: Introductionmentioning

confidence: 99%

Predictive Factors for Level V Lymph Node Metastases in Papillary Thyroid Carcinoma with BRAFV600E Mutation and Clinicopathological Features

Li¹,

Tan²,

Chen³

et al. 2020

CMAR

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Background: Therapeutic lateral neck dissection (LND) is recommended in papillary thyroid carcinoma (PTC) patients with clinically lateral lymph node metastasis (LLNM), whether underwent level V LND remains controversial for lacking of sensitive predicting system. BRAF V600E mutation is associated with aggressive tumor behavior, recurrence, and disease-specific mortality of PTC. However, the relationship between BRAF V600E mutation and level V LNM is unclear. Methods: Univariate and multivariate analyses were retrospectively conducted on the potential predictive factors of 252 PTC patients who underwent initial treatment of neck lymph node dissection from September 2015 to October 2018 in our institute. BRAF V600E mutation and the clinicopathological characteristics of the two groups were compared. Results: LLNM was presented in 208 (82.5%) patients and level II-V LNM was present in 42.8%, 71.2%, 85.1%, 17.8% patients, respectively. BRAF V600E mutation was observed in 188 (74.6%) patients and was significantly associated with patients' age, lymphocytic thyroiditis, capsule invasion, bilateral central lymph node metastasis (CLNM) and level V LNM in PTC. Univariate analysis revealed that lymphocytic thyroiditis, tumor size, number of CLNM, Level II LNM, Level III LNM, simultaneous Level II+III, simultaneous Level III+IV and simultaneous Level II+III+IV were significantly correlated with Level V LNM. In addition, multivariate analysis revealed that tumor size ≥2.5 cm, number of CLNM≥3, level II metastases and BRAF V600E mutation were independent Level V LNM predictors (odds ratio 3.910, 3.660, 8.410, 0.439; 95% CI 1.737-10.135, 1.054-12.713, 1.233-57.355, 0.280-0.827, respectively). Conclusion: In summary, we presented several independent predictive factors for level V LNM in PTC patients. We constructed a risk prediction model consisting of tumor size ≥2.5 cm, number of CLNM≥3 and level II metastases and BRAF V600E mutation that may guide surgeons to evaluate the nodal status in PTC and perform tailored therapeutic LND.

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Section: Introductionmentioning

confidence: 99%

Predictive Factors for Level V Lymph Node Metastases in Papillary Thyroid Carcinoma with BRAFV600E Mutation and Clinicopathological Features

Li¹,

Tan²,

Chen³

et al. 2020

CMAR

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“…Recently, the amplification refractory mutation system‐quantitative real‐time PCR (ARMS‐qPCR) method is developed to specifically detect the BRAF V600E mutation with high sensitivity (0.1%‐1% of total cells), which can provide quantitative and rapid (<4 hour) result. And, it has been commercially used at a low cost of $87/test in clinical practice . However, there has been no report evaluating the false‐positive and false‐negative mutation results of BRAF V600E analysis in thyroid FNAC specimens before surgery using ARMS‐qPCR until now, which may cause uncertainty in interpreting the BRAF V600E analysis and the following management.…”

Section: Introductionmentioning

confidence: 99%

“…10 Some authors advocated preoperative BRAF V600E mutation analysis as an aid for improving risk stratification of PTC patients in order to define a more individualized treatment plan. [11][12][13] Therefore, it is very important to evaluate the accuracy of BRAF V600E mutation analysis in preoperative FNAC specimens.…”

Section: Introductionmentioning

confidence: 99%

“…And, it has been commercially used at a low cost of $87/test in clinical practice. 13,[20][21][22] However, there has been no report evaluating the false-positive and false-negative mutation results of BRAF V600E analysis in thyroid FNAC specimens before surgery using ARMS-qPCR until now, which may cause uncertainty in interpreting the BRAF V600E analysis and the following management. Thus, the purpose of this study was to assess the false-positive and false-negative BRAF V600E mutation results using ARMS-qPCR in preoperative thyroid FNAC specimens, with reference to the BRAF V600E mutation results using ARMS-qPCR in formalin-fixed, paraffin-embedded (FFPE) tissue samples after surgery.…”

Section: Introductionmentioning

confidence: 99%

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BRAF^V600E mutation analysis in fine‐needle aspiration cytology specimens for diagnosis of thyroid nodules: The influence of false‐positive and false‐negative results

et al. 2019

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Background The accurate evaluation of BRAFV600E mutation in preoperative fine‐needle aspiration cytology (FNAC) specimens is important for making management decisions in thyroid nodules (TNs). The aim of this study was to assess the false‐positive and false‐negative BRAFV600E mutations in thyroid FNAC specimens and their influence on diagnosis of TN. Methods This prospective study enrolled 292 nodules in 269 patients who underwent BRAFV600E mutation analysis using amplification refractory mutation system‐quantitative real‐time polymerase chain reaction (ARMS‐qPCR) both in FNAC specimens and formalin‐fixed, paraffin‐embedded (FFPE) tissue samples after surgery. The false‐positive and false‐negative mutations for BRAFV600E analysis using ARMS‐qPCR in FNAC specimens were recorded, with reference to the results of BRAFV600E mutation analysis using ARMS‐qPCR in FFPE tissue sample. Diagnostic performances of FNAC, BRAFV600E mutation analysis in FNAC specimens, BRAFV600E mutation analysis in FFPE tissue sample, and the combination of FNAC and BRAFV600E mutation analysis for predicting thyroid malignancy were assessed. Results The false‐positive and false‐negative mutations for BRAFV600E analysis using ARMS‐qPCR in FNAC specimens were 10.1% (19/189) and 7.1% (7/98), respectively. FNAC combined with preoperative BRAFV600E mutation analysis significantly increased the diagnostic sensitivity from 75.7% to 92.3%, and accuracy from 78.7% to 90.6% in comparison with FNAC alone (both P < .001). No significant differences were found between the combination of FNAC and BRAFV600E mutation analysis in FNAC specimens and the combination of FNAC and BRAFV600E mutation analysis in FFPE tissue sample (sensitivity: 92.3% vs 91.9%; accuracy: 90.6% vs 91.3%; both P > .05). Conclusions FNAC combined with preoperative BRAFV600E mutation analysis can significantly increase the diagnostic performance in comparison with FNAC alone. False‐positive and false‐negative BRAFV600E mutation results are found in preoperative FNAC specimens, whereas it does not affect the overall auxiliary diagnosis of TNs.

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“…The thyroid nodules were imaged with a Siemens Acuson S3000 US scanner equipped with a 9L4 linear array transducer (Siemens Medical Solutions, Mountain View, CA, USA; transducer frequency: 4-9 MHz) and/or an 18L6 linear array transducer (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Petal-like calcifications appeared as scattered hyperechogenic spots < 2 mm in diameter around solid thyroid nodules with the appearance of flower petals and had a cystic-like dark area ahead of each hyperechogenic spot.…”

Section: Ultrasound Examinationmentioning

confidence: 99%

Petal-Like Calcifications in Thyroid Nodules on Ultrasonography: A Rare Morphologic Characteristic of Calcification Associated With Aggressive Biological Behavior

et al. 2020

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This study investigated a rare ultrasonographically detected thyroid petal-like calcification and its relationship with thyroid carcinoma and biological behavior. We described the clinical and ultrasonographical features of thyroid nodules with petal-like calcifications in 18 patients undergoing thyroid surgery and cervical lymph node dissection. All of the thyroid nodules with petal-like calcifications were papillary thyroid carcinomas (PTCs). Of the 18 patients, 13 (72.2%) had cervical central lymph node metastasis, and five (27.8%) had cervical lateral lymph node metastasis. Petal-like calcifications occurred in malignant thyroid nodules with a high incidence of lymph node metastasis, which may be a specific ultrasonographic feature associated with the aggressive biological behavior of PTC.

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Conventional Ultrasound, Immunohistochemical Factors and BRAFV600E Mutation in Predicting Central Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma

Cited by 41 publications

References 58 publications

<p>Predictive Factors for Level V Lymph Node Metastases in Papillary Thyroid Carcinoma with <em>BRAF</em><sup>V600E</sup> Mutation and Clinicopathological Features</p>

<p>Predictive Factors for Level V Lymph Node Metastases in Papillary Thyroid Carcinoma with <em>BRAF</em><sup>V600E</sup> Mutation and Clinicopathological Features</p>

BRAF^V600E mutation analysis in fine‐needle aspiration cytology specimens for diagnosis of thyroid nodules: The influence of false‐positive and false‐negative results

Petal-Like Calcifications in Thyroid Nodules on Ultrasonography: A Rare Morphologic Characteristic of Calcification Associated With Aggressive Biological Behavior

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Conventional Ultrasound, Immunohistochemical Factors and BRAFV600E Mutation in Predicting Central Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma

Cited by 41 publications

References 58 publications

<p>Predictive Factors for Level V Lymph Node Metastases in Papillary Thyroid Carcinoma with <em>BRAF</em><sup>V600E</sup> Mutation and Clinicopathological Features</p>

<p>Predictive Factors for Level V Lymph Node Metastases in Papillary Thyroid Carcinoma with <em>BRAF</em><sup>V600E</sup> Mutation and Clinicopathological Features</p>

BRAFV600E mutation analysis in fine‐needle aspiration cytology specimens for diagnosis of thyroid nodules: The influence of false‐positive and false‐negative results

Petal-Like Calcifications in Thyroid Nodules on Ultrasonography: A Rare Morphologic Characteristic of Calcification Associated With Aggressive Biological Behavior

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BRAF^V600E mutation analysis in fine‐needle aspiration cytology specimens for diagnosis of thyroid nodules: The influence of false‐positive and false‐negative results