Surgical Perspective of T1799A BRAF Mutation Diagnostic Value in Papillary Thyroid Carcinoma

Abstract

Background: Throughout Indonesia, thyroid cancer is one of the ten commonest malignancies, with papillary thyroid carcinoma (PTC) in our hospital accounting for about 60% of all thyroid nodules. Although fine needle aspiration biopsy (FNAB) is the most reliable diagnostic tool, some nodules are diagnosed as indeterminate and second surgery is common for PTC. The aim of this study was to establish the diagnostic value and feasibility of testing the BRAF T1799A mutation on FNA specimens for improving PTC diagnosis. Materials and Methods: This prospective study enrolled 95 patients with thyroid nodules and future surgery planned. Results of mutational status were compared with surgical pathology diagnosis. Results: Of the 70 cases included in the final analysis, 62.8% were PTC and the prevalence of BRAF mutation was 38.6%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for BRAF mutation analysis were 36%, 100%, 100% and 48%, respectively. With other data findings, nodules with "onset less than 5 year" and "hard consistency" were proven as diagnostic determinants for BRAF mutation with a probability of 62.5%. This mutation was also a significant risk factor for extra-capsular extension. Conclusions: Molecular analysis of the BRAF T1799A mutation in FNAB specimens has high specificity and positive predictive value for PTC. It could be used in the selective patients with clinical characteristics to facilitate PTC diagnosis and for guidance regarding extent of thyroidectomy.

Associations of the BRAF (V600E) mutation and p53 protein expression with clinicopathological features of papillary thyroid carcinomas patients

“…Furthermore, multiple previous studies have demonstrated a correlation between the BRAF (V600E) mutation and the high-risk clinicopathological characteristics of PTC, including older age at diagnosis, male gender, large tumor size, the presence of extrathyroidal extension, lymph node and distant metastasis and an advanced stage (9)(10)(11)13,15,16,(18)(19)(20)28,29). By contrast, certain studies were unable to identify marked associations between the BRAF (V600E) mutation and the high-risk clinicopathological characteristics of PTC (12,14).…”

“…Numerous studies have evaluated the association between the BRAF (V600E) mutation, clinicopathological features and clinical outcomes of PTC; however, controversial results have been obtained for a correlation between the BRAF (V600E) mutation and clinicopathological features (1,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Furthermore, multiple previous studies have demonstrated a correlation between the BRAF (V600E) mutation and the high-risk clinicopathological characteristics of PTC, including older age at diagnosis, male gender, large tumor size, the presence of extrathyroidal extension, lymph node and distant metastasis and an advanced stage (9)(10)(11)13,15,16,(18)(19)(20)28,29).…”

“…Numerous studies have investigated potential associations among the BRAF (V600E) mutation, clinicopathological features of PTC and the clinical outcome of patients; however, correlations between the incidence of the BRAF (V600E) mutation and clinicopathological features in PTC patients remains controversial (1,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Role of survivin in the pathogenesis of papillary thyroid carcinoma

“…Papillary carcinoma growth is stimulated by thyroidstimulating hormone and the carcinomas can be shrunk with thyroid hormones. Eighty percent of PTC patients survive approximately 10 years (Brahma et al, 2013).…”

Elevated Expression of Nuclear Protein Kinase CK2α as a Poor Prognosis Indicator in Lymph Node Cancerous Metastases of Human Thyroid Cancers

“…Medullary thyroid carcinomas (MTC) are derived from the parafollicular C-cells, they account for a minority (5%) of thyroid carcinomas. V600E mutations in papillary thyroid carcinoma occurred more than 50% in Iran and Indonesia (Brahma et al, 2013;Ranjbar et al, 2013). This spectrum of progression has been linked with a pattern of cumulative genetic defects that correlate with tumor differentiation, metastatic potential, and aggressiveness.…”