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The role of BRAFV600E mutation and ultrasonography for the surgical management of a thyroid nodule suspicious for papillary thyroid carcinoma on cytology

 Hee Jung Moon  ;  Jin Young Kwak  ;  Eun-Kyung Kim  ;  Jong Rak Choi  ;  Soon Won Hong  ;  Min Jung Kim  ;  Eun Ju Son 
 ANNALS OF SURGICAL ONCOLOGY, Vol.16(11) : 3125-3131, 2009 
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Adult ; Aged ; Carcinoma, Papillary/diagnostic imaging ; Carcinoma, Papillary/genetics ; Carcinoma, Papillary/surgery ; DNA Primers/chemistry ; Female ; Humans ; Male ; Middle Aged ; Mutation/genetics* ; Neoplasm Staging ; Prognosis ; Prospective Studies ; Proto-Oncogene Proteins B-raf/genetics* ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Neoplasms/genetics* ; Thyroid Neoplasms/surgery ; Thyroid Nodule/diagnostic imaging* ; Thyroid Nodule/genetics* ; Thyroid Nodule/surgery ; Ultrasonography
BACKGROUND: This study was designed to investigate the role of BRAFV600E mutation status in cytology specimens and ultrasonography (US) when planning surgery for thyroid nodules with cytologic results suspicious for papillary thyroid carcinoma (PTC). METHODS: From July 2008 to November 2008, 91 consecutive patients with cytologic results of suspicious for PTC underwent thyroidectomy. Before surgery, all patients received US-guided fine needle aspiration biopsy (US-FNAB) solely for the purpose of BRAFV600E mutation analysis of thyroid nodules suspicious for PTC on cytology. BRAFV600E mutations were tested by direct sequencing. We investigated the role of BRAFV600E mutation and US in planning the thyroid surgery. RESULTS: Of 91 nodules suspicious for PTC, 42 (46.2%) were positive for the BRAFV600E mutation and confirmed to be PTC by histopathology. The positive predictive values of BRAFV600E mutation was 100%. Of the 49 nodules without the BRAFV600E mutation, 42 (85.7%) proved to be PTC. Thirty-nine of 42 (92.9%) PTCs were suspicious for malignant features on US. Two of seven (28.6%) benign lesions showed probably benign features. The sensitivity, positive predictive value, and accuracy of US in thyroid nodules without BRAFV600E mutations was 92.9% (39/42), 88.6% (39/44), and 83.7% (41/49), respectively. CONCLUSIONS: The BRAFV600E mutation is a useful molecular marker for preoperative diagnosis of PTC and an indicator for therapeutic thyroid surgery in the nodule with cytologic results suspicious for PTC. In thyroid nodules without the BRAFV600E mutation, suspicious malignant features on US may help in planning the extent of thyroid surgery.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Choi, Jong Rak(최종락) ORCID logo https://orcid.org/0000-0002-0608-2989
Hong, Soon Won(홍순원) ORCID logo https://orcid.org/0000-0002-0324-2414
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