BRAF mutation in papillary thyroid microcarcinoma – additional marker of risk stratification
https://doi.org/10.14341/ket2014336-40
Abstract
Background
Papillary thyroid microcarcinoma (PTMC) is heterogeneous group of tumor less than 1 cm in the diameter. The volume of surgical treatment stay unstable because unclear biological potential of PTMC.
Aim
The aim of our study was to assess the utility of BRAF gene mutation as preoperative additional marker of risk stratification.
Materials and methods
We include 44 patient who were operated in general surgery department Pavlov State Medical University from 2001 to 2013. In all 44 cases BRAF gene mutation was detected and compared with clinic-morphological features (multifocality, invasive growth, lymph node metastasis, recurrence) retrospectively
Results
In our study the frequency of BRAF gene mutation was 68.2%. On multivariate regression analysis the presence of bilateral tumoural foci, lymph node metastasis and the presence of capsular invasion were significantly related to BRAF positive gene status.
Conclusions
Thus, appropriate volume for the BRAF positive PTMC is thyroidectomy with central compartment lymph node dissection.
About the Authors
Dmitriy Yuriyevich Semyonov
First Pavlov State Medical University of St. Peterburg;
Federal Almazov Medical Research Centre, Saint-Petersburg
Russian Federation
MD, PhD, Professor, Head of the General Surgery Chair of First Pavlov State Medical University of St. Peterburg, Head of the Endocrine Surgery department of Federal Almazov Medical Research Centre
Russian Federation
MD, PhD, Professor, Head of the General Surgery Chair of First Pavlov State Medical University of St. Peterburg, Head of the Endocrine Surgery department of Federal Almazov Medical Research Centre
Marina Evgenyevna Boriskova
First Pavlov State Medical University of St. Peterburg;
Federal Almazov Medical Research Centre, Saint-Petersburg
Russian Federation
MD, PhD, Assistence professor of the general surgery chair of First Pavlov State Medical University of St. Peterburg, Chief Researcher of the Endocrine Surgery department in Federal Almazov Medical Research Centre
Russian Federation
MD, PhD, Assistence professor of the general surgery chair of First Pavlov State Medical University of St. Peterburg, Chief Researcher of the Endocrine Surgery department in Federal Almazov Medical Research Centre
Mikhail Igorevich Zaraisky
First Pavlov State Medical University of St. Peterburg
Russian Federation
MD, PhD, Professor of the clinical and laboratory diagnostic chair in First Pavlov State Medical University of St. Peterburg
Russian Federation
MD, PhD, Professor of the clinical and laboratory diagnostic chair in First Pavlov State Medical University of St. Peterburg
Ul'yana Valentinovna Farafonova
First Pavlov State Medical University of St. Peterburg
Russian Federation
MD, PhD-student
Russian Federation
MD, PhD-student
Mikhail Andrianovich Bikov
First Pavlov State Medical University of St. Peterburg;
Federal Almazov Medical Research Centre, Saint-Petersburg
Russian Federation
MD
Russian Federation
MD
References
1. De Lellis RA, LloydRV, Heitz PU, Eng C. World Health Organization Classification of Tumors. Pathology and genetics of tumors of endocrine organs. Lyon: IARC Press; 2004. pp. 54-55.
2. Baloch ZW, LiVolsi VA. Microcarcinoma of the thyroid. Advances in Anatomic Pathology. 2006;13(2):69-75. doi: 10.1097/01.pap.0000213006.10362.17
3. Pazaitou-Panayiotou K, Capezzone M, Pacini F. Clinical features and therapeutic implication of papillary thyroid microcarcinoma. Thyroid. 2007;17(11):1085-1092. doi: 10.1089/thy.2007.0005
4. Ito Y, Uruno T, Nakano K, Takamura Y, Miya A, Kobayashi K, et al. An observation trial without surgical treatment in patients with papillary microcarcinoma of the thyroid. Thyroid. 2003;13(4): 381-387. doi: 10.1089/105072503321669875
5. Giordano D, Gradoni P, Oretti G, Molina E, Ferri T. Treatment and prognostic factors of papillary thyroid microcarcinoma. Clinical Otolaryngology. 2010;35(2):118-124. doi: 10.1111/ j.1749-4486.2010.02085.x
6. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167-1214. doi: 10.1089/thy.2009.0110
7. Ланцов Д.С. Морфология и пролиферативная активность микрокарциномы щитовидной железы: Дисс. ... канд.мед. наук. – Обнинск; 2007. [Lantsov DS. Morfologiya i prolifera-tivnaya aktivnost' mikrokartsinomy shchitovidnoy zhelezy [Dissertation]. Obninsk; 2007.]
8. Xing M. BRAF Mutation in papillary thyroid microcarcinoma: The promise of better risk management. Annals of Surgical Oncology. 2009;16(4):801-803. doi: 10.1245/s10434-008-0298-z
9. Virk RK, Van Dyke AL, Finkelstein A, Prasad A, Gibson J, Hui P, et al. BRAFV600E mutation in papillary thyroid microcarcinoma: a genotype–phenotype correlation. Modern Pathology. 2012;26(1): 62-70. doi: 10.1038/modpathol.2012.152
10. NiemeierLA, KuffnerAkatsu H, Song C, Carty SE, HodakSP, Yip L, et al. A combined molecular-pathologic score improves risk stratification of thyroid papillary microcarcinoma. Cancer. 2012;118(8):2069-2077. doi: 10.1002/cncr.26425
11. Zheng X, Wei S, Han Y, Li Y, Yu Y, Yun X, et al. Papillary microcar-cinoma of the thyroid: Clinical characteristics and BRAFV600E mutational status of 977 cases. Annals of Surgical Oncology. 2013;20(7):2266-2273. doi: 10.1245/s10434-012-2851-z
12. Диагностика и лечение дифференцированного рака щитовидной железы. Национальные клинические рекомендации, принятые на IX Российском онкологическом конгрессе и IV Всероссийском тиреоидологическом конгрессе. // Эндокринная хирургия. – 2008. – №1. – С. 3-5. [Diagnostika i lechenie differentsirovannogo raka shchitovidnoy zhelezy. Natsional'nye klinicheskie rekomendatsii, prinyatye na XI Rossiyskom onkologicheskom kongresse i IV Vserossiyskom tireoidologicheskom kongresse. Endocrine Surgery. 2008;(1):3-5.] doi: 10.14341/2306-3513-2008-1-3-5
13. Zhou Y-L, Zhang W, Gao E-L, Dai X-X, Yang H, Zhang X-H, et al. Preoperative BRAF mutation is predictive of occult contralateral carcinoma in patients with unilateral papillary thyroid microcarci-noma. Asian Pacific Journal of Cancer Prevention. 2012;13(4):1267-1272. doi: 10.7314/apjcp.2012.13.4.1267
Supplementary files
Review
For citations:
Semyonov D.Yu., Boriskova M.E., Zaraisky M.I., Farafonova U.V., Bikov M.A. BRAF mutation in papillary thyroid microcarcinoma – additional marker of risk stratification. Clinical and experimental thyroidology. 2014;10(3):36-40. (In Russ.) https://doi.org/10.14341/ket2014336-40
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