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The thyroid imaging reporting and data system on US, but not the BRAFV600E mutation in fine-needle aspirates, is associated with lateral lymph node metastasis in PTC

Authors
 Vivian Y. Park  ;  Eun-Kyung Kim  ;  Hee Jung Moon  ;  Jung Hyun Yoon  ;  Jin Young Kwak 
Citation
 Medicine, Vol.95(29) : 4292, 2016 
Journal Title
 Medicine 
ISSN
 0025-7974 
Issue Date
2016
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alleles ; Biopsy, Fine-Needle ; Carcinoma, Papillary/diagnostic imaging* ; Carcinoma, Papillary/genetics* ; Carcinoma, Papillary/pathology ; DNA Mutational Analysis* ; Female ; Humans ; Lymph Nodes/pathology ; Lymphatic Metastasis/genetics* ; Lymphatic Metastasis/pathology* ; Male ; Middle Aged ; Mutation/genetics* ; Neoplasms, Multiple Primary/diagnostic imaging ; Neoplasms, Multiple Primary/genetics ; Neoplasms, Multiple Primary/pathology ; Prognosis ; Proto-Oncogene Proteins B-raf/genetics* ; Retrospective Studies ; Statistics as Topic ; Thyroid Gland/diagnostic imaging ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Neoplasms/genetics* ; Thyroid Neoplasms/pathology ; Ultrasonography, Interventional ; Young Adult
Keywords
BRAFV600E mutation ; lateral lymph node metastasis ; papillary thyroid carcinoma ; thyroid imaging reporting and data system ; ultrasound
Abstract
The majority of patients with papillary thyroid carcinoma (PTC) have an excellent prognosis, but some show poorer outcomes and would benefit from adjunctive prognostic tools. The B-Raf proto-oncogene, serine/threonine kinase (BRAF) mutation, either based on both its presence or its quantitative measurement, and ultrasound (US) features may serve as a prognostic marker. The aim of this study was to investigate (1) the association between clinical-pathologic prognostic factors and the BRAF mutation found in fine-needle aspirates, based on both its presence and its corresponding cycle threshold (Ct) value, and (2) the association between prognostic factors and suspicious US features classified by the thyroid imaging reporting and data system (TIRADS) in PTC.Two-hundred fifty-eight consecutive patients with PTC > 1?cm and who underwent preoperative US-guided fine-needle aspiration were included in this retrospective study. Clinical-pathologic variables were compared between patients with and without the BRAF mutation. Multivariate analyses were performed to investigate (1) the association between clinical-pathologic prognostic factors and the BRAF mutation found in fine-needle aspirates, based on both its presence and corresponding Ct values, and (2) the association between prognostic factors and suspicious TIRADS US features.BRAF-positive patients had a higher proportion of multiple tumors (P?=?0.017). The number of suspicious US features classified by the TIRADS was an independent factor for predicting lateral lymph node metastasis, both in all 258 patients (odds ratio [OR]?=?1.902, P?=?0.005) and in 214 BRAF-positive patients (OR?=?1.686, P?=?0.037). The BRAF mutation status or BRAFCt values were not associated with any of the clinical-pathologic prognostic factors.In conclusion, a higher number of suspicious US features classified by the TIRADS, but not the BRAF mutation, are associated with lateral lymph node metastasis in patients with PTC, and can aid in the preoperative identification of patients at increased risk of lateral lymph node metastasis.
DOI
10.1097/MD.0000000000004292
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
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
Park, Vivian Youngjean(박영진) ORCID logo https://orcid.org/0000-0002-5135-4058
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151731
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