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Association between diffuse lymphocytic infiltration and papillary thyroid cancer aggressiveness according to the presence of thyroid peroxidase antibody and BRAFV600E mutation

Authors
 Young Ki Lee  ;  Kyeong Hye Park  ;  Se Hee Park  ;  Kwang Joon Kim  ;  Dong Yeob Shin  ;  Kee Hyun Nam  ;  Woong Youn Chung  ;  Eun Jig Lee 
Citation
 HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, Vol.40(10) : 2271-2279, 2018 
Journal Title
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
ISSN
 1043-3074 
Issue Date
2018
Keywords
B-type Raf (BRAF) ; Hashimoto's thyroiditis ; diffuse lymphocytic infiltration ; papillary thyroid carcinoma ; thyroid peroxidase antibody
Abstract
BACKGROUND: Diffuse lymphocytic infiltration (DLI) is frequently found with papillary thyroid cancer (PTC), so there has been long interest in how it affects the characteristics of PTC. This purpose of this study was to define the association between DLI and PTC aggressiveness according to thyroperoxidase antibody (TPOAb) and B-type Raf (BRAF)V600E mutation positivity.

METHODS: There were 1879 patients with PTC who underwent surgery and were enrolled in this study. Clinicopathologic characteristics were compared between groups according to the presence of DLI and TPOAb. Multiple logistic regression analysis was conducted to assess odds ratio (OR) for each dependent variable (BRAFV600E mutation, tumor size >1.0 cm, multifocality, extrathyroidal extension, and lymph node metastasis) of each group according to the presence of DLI and TPOAb, with the group with neither DLI or TPOAb (DLI-negative TPOAb-negative PTC) as the reference.

RESULTS: The DLI-positive PTC showed more frequent multifocality and less frequent BRAFV600E mutation than DLI-negative PTC. Among patients with DLI-positive PTC, extrathyroidal extension and BRAFV600E mutation was less frequent when serum TPOAb was positive. In multiple logistic regressions, DLI-positive TPOAb-positive PTC showed a high OR for multifocality (1.410; P = .017), but low ORs for BRAFV600E mutation (0.521; P < .001) and extrathyroidal extension (0.691; P = .008). The patients with DLI-positive TPOAb-positive PTCs showed a high OR for multifocality (1.588; P = .002), and high ORs for tumor size >1.0 cm (2.205; P = .019) and lymph node metastasis (2.005; P = .032) in subgroup analyses of PTC with wild-type BRAF. The DLI-negative TPOAb-positive group was not associated with any tumor aggressiveness-related variables.

CONCLUSION: Although DLI was associated with multifocality regardless of TPOAb positivity, it was associated with an indolent feature when TPOAb was positive but with aggressive features in PTC with wild-type BRAF when TPOAb was negative. The TPOAb and BRAF status may help to define the clinical implication of lymphocytic infiltration found with PTC.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1002/hed.25327
DOI
10.1002/hed.25327
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kwang Joon(김광준) ORCID logo https://orcid.org/0000-0002-5554-8255
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Shin, Dong Yeob(신동엽) ORCID logo https://orcid.org/0000-0003-1048-7978
Lee, Eun Jig(이은직) ORCID logo https://orcid.org/0000-0002-9876-8370
Chung, Woong Youn(정웅윤)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167308
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