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The BRAFT1799A Mutation is not Associated with Occult Contralateral Carcinoma in Patients with Unilateral Papillary Thyroid Microcarcinoma

  • Wan, Han-Feng (Department of Otorhinolaryngology, Renji Hospistal, School of Medicine, Shanghai Jiao Tong University) ;
  • Zhang, Bin (Department of Head and Neck Surgery, Cancer Institute& Hospital, Chinese Academy of Medical Science, Peking Union Medical College) ;
  • Yan, Dan-Gui (Department of Head and Neck Surgery, Cancer Institute& Hospital, Chinese Academy of Medical Science, Peking Union Medical College) ;
  • Xu, Zhen-Gang (Department of Head and Neck Surgery, Cancer Institute& Hospital, Chinese Academy of Medical Science, Peking Union Medical College)
  • 발행 : 2015.04.14

초록

Background: The phenomenon of occult carcinoma maybe observed in patients with clinically unilateral papillary thyroid microcarcinoma (PTMC). Although many studies have reported that the $BRAF^{T1799A}$ mutation is associated with aggressive PTMC, the relationship between $BRAF^{T1799A}$ mutation and occult carcinoma is unclear. The aim of this study was to investigate the risk factors, including $BRAF^{T1799A}$ mutation, for occult contralateral carcinoma in clinically unilateral PTMC accompanied by benign nodules in the contralateral lobe. Materials and Methods: From January 2011 to December 2013, we prospectively enrolled 89 consecutive PTMC patients with clinically unilateral carcinoma accompanied by benign nodules in the contralateral lobe who received a total thyroidectomy and cervical lymph node dissection. $BRAF^{T1799A}$ mutation was tested by pyrosequencing on postoperative paraffin specimens. The frequency and predictive factors for occult contralateral carcinoma were analyzed with respect to the following variables: age, gender, family history, tumor size, presence of Hashimoto thyroiditis, extrathyroidal extension, central lymph node metastasis, multifocality of primary tumor, or $BRAF^{T1799A}$ mutation. Results: A total of 36 patients (40.4%) had occult PTMC in the contralateral lobe. The median diameter of the occult tumors was $0.33{\pm}0.21cm$. The $BRAF^{T1799A}$ mutation was found in 38 cases (42.7%). According to the univariate analysis, there were no significant differences between the presence of occult contralateral carcinoma and age, gender, family history, tumor size, presence of Hashimoto thyroiditis, extrathyroidal extension, central lymph node metastasis, multifocality of primary tumor, or $BRAF^{T1799A}$ mutation. Conclusions: Using current methods, it is difficult to preoperatively identify patients with PTMC, and further research is needed to determine predictive factors for the presence of occult contralateral carcinoma in patients with unilateral PTMC.

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참고문헌

  1. Chow SM, Law SC, Chan JK, et al (2003). Papillary microcarcinoma of the thyroid-Prognostic significance of lymph node metastasis and multifocality. Cancer, 98, 31-40. https://doi.org/10.1002/cncr.11442
  2. Cooper DS, Doherty GM, Haugen BR, et al (2009). American thyroid association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer revised American thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid, 19, 1167-214. https://doi.org/10.1089/thy.2009.0110
  3. Hay ID, Grant CS, Taylor WF, et al (1987). Ipsilateral lobectomy versus bilateral lobar resection in papillary thyroid carcinoma: a retrospective analysis of surgical outcome using a novel prognostic scoring system. Surgery, 102, 1088-95.
  4. Ito Y, Tomoda C, Uruno T, et al (2004). Papillary microcarcinoma of the thyroid: how should it be treated? World J Surg, 28, 1115-21. https://doi.org/10.1007/s00268-004-7644-5
  5. Kebebew E, Weng J, Bauer J, et al (2007). The prevalence and prognostic value of BRAF mutation in thyroid cancer. Ann Surg, 246, 466-70; discussion 470-1. https://doi.org/10.1097/SLA.0b013e318148563d
  6. Koo BS, Lim HS, Lim YC, et al (2010). Occult contralateral carcinoma in patients with unilateral papillary thyroid microcarcinoma. Ann Surg Oncol, 17, 1101-5. https://doi.org/10.1245/s10434-009-0906-6
  7. Melck AL, Yip L, Carty SE (2010). The utility of BRAF testing in the management of papillary thyroid cancer. Oncologist, 15, 1285-93. https://doi.org/10.1634/theoncologist.2010-0156
  8. Moon WJ, Jung SL, Lee JH, et al (2008). Thyroid study group, Korean society of neuro- and head and neck radiology. benign and malignant thyroid nodules: US differentiationmulticenter retrospective study. Radiology, 247, 762-70. https://doi.org/10.1148/radiol.2473070944
  9. Niu LJ, Hao YZ, Zhou CW (2006). Diagnostic value of ultrasonography in thyroid lesions. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 41, 415-18.
  10. Park SY, Park YJ, Lee YJ, et al (2006). Analysis of differential BRAF (V600E) mutational status in multifocal papillary thyroid carcinoma: evidence of independent clonal origin in distinct tumor foci. Cancer, 107, 1831-8. https://doi.org/10.1002/cncr.22218
  11. Pelizzo MR, Boschin IM, Toniato A, et al (2006). Papillary thyroid microcarcinoma (PTMC): prognostic factors, management and outcome in 403 patients. Eur J Surg Oncol, 32, 1144-8. https://doi.org/10.1016/j.ejso.2006.07.001
  12. Rossi ED, Martini M, Capodimonti S, et al (2013). BRAF (V600E) mutation analysis on liquid-based cytologyprocessed aspiration biopsies predicts bilaterality and lymph node involvement in papillary thyroid microcarcinoma. Cancer Cytopathol, 121, 291-7. https://doi.org/10.1002/cncy.21258
  13. Zhou YL, Zhang W, Gao EL, et al (2012). Preoperative BRAF mutation is predictive of occult contralateral carcinoma in patients with unilateral papillary thyroid microcarcinoma. Asian Pac J Cancer Prev, 13, 1267-72. https://doi.org/10.7314/APJCP.2012.13.4.1267