Relationship between lymphovascular invasion and clinicopathological features of papillary thyroid carcinoma

Abstract

Lymphovascular invasion (LVI) is an important prognostic factor in various solid tumors, however, data on the association between LVI and thyroid carcinomas are limited. In this study, we evaluated the relationship between LVI and clinicopathological features of papillary thyroid carcinoma (PTC). Six hundred seventy-eight patients diagnosed with PTC between 2012 and 2015 were included into the study. Patients were classified based on the presence or absence of LVI. Gender, age, ultrasonography (US), tumor size and multifocality, BRAFV600E mutation, perineural and capsular invasion, extrathyroid extension (ETE), nodal metastasis, and recurrences were evaluated, and risk analysis was performed for each parameter. The number of patients with LVI [LVI (+)] was 63, while the number of patients without LVI [LVI (-)] was 615. The female/male ratio was 564/114. LVI was present in 18.4% of male patients and in 7.4 % of female patients. In the age group between 17-25 years LVI was detected in 6/13 patients, and this result was statistically significant compared to other age groups (p = 0.004). Suspicious lymph nodes upon US, perineural or capsular invasion, ETE, tumor size, and nodal metastasis were significantly more frequent in LVI (+) group (p < 0.001). The frequency of BRAFV600E mutation was also significantly higher in LVI (+) group (p < 0.001). Overall, the presence of LVI was associated with gender, tumor size, age, lymph node metastasis, pathological lymph nodes, perineural and capsular invasion, ETE, and BRAFV600E mutation. These results suggest that in PTC patients undergoing thyroidectomy, the presence of LVI should be considered as an indicator of aggressive clinicopathological features and those patients should be followed up carefully for recurrences and metastasis.

BRAF and KRAS mutations in papillary thyroid carcinoma in the United Arab Emirates

“…We have shown a significant correlation between lymph node metastasis and BRAF V600E mutation, this finding supported by Carol et al study [52] Lymphovascular invasion (LVI) is an important prognostic factor in in PTC and significantly associated with BRAF V600E mutation suggesting the presence of LVI should be considered as an indicator of aggressive clinicopathological features and patients with positive LVI should be followed up carefully for possible recurrence or metastasis [53]. In addition, BRAF V600E mutation is an independent predictor of lymph node metastasis in PTC [54,55].…”

Role of ultrasonographic features and quantified BRAFV600E mutation in lymph node metastasis in Chinese patients with papillary thyroid carcinoma

“…Sezer et al . suggested that the lymphovascular invasion was significantly associated with an increased risk of cervical lymph node metastasis (OR = 30.61;95CI:14.99–62.49) 19 . Our results also showed that the optimal cut-off value of the tumor size for predicting the risk of cervical LNM was 0.95 cm, in proximity to 1 cm which is one of the diagnostic criteria of PTMC 20 .…”

Prediction of cervical lymph node metastasis with contrast-enhanced ultrasound and association between presence of BRAFV600E and extrathyroidal extension in papillary thyroid carcinoma

“… 8 Previous studies 9 , 10 have reported a strong association between BRAF V600E and the poor clinicopathological outcome of PTCs; however, a paradox has been observed between the high frequency of BRAF V600E mutations in PTCs and the low prevalence of CLNM. 11 – 13 Hence, controversy remains concerning the value and accuracy of BRAF in predicting CLNM.…”