Predicting Extrathyroidal Extension in Patients With Papillary Thyroid Microcarcinoma According to a BRAF Mutation
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives. The aim of this study was to evaluate the association between preoperative parameters and extrathyroidal extension (ETE) of papillary thyroid microcarcinoma (PTMC) according to the BRAF mutation and to evaluate the preoperative predictability of ETE. Methods. We analyzed the medical records of 332 patients with PTMC (140 in the BRAF– group and 192 in the BRAF+ group). The presence of ETE was subjected to a correlation analysis with age, sex, tumor size, clinical nodal status, and ultrasonography (US) findings. Among the US findings, the correlation between tumors and the thyroid capsule was categorized into four groups; US group A, intraparechymal; US group B, tumor abutting the capsule <50% of diameter; US group C, tumor abutting >50% of diameter; and US group D, tumor destroyed the capsule. The predictive value of ETE, including sensitivity, specificity, and positive and negative predictive values were evaluated. Results. Tumor size and US group were significantly correlated with gross ETE in the BRAF– and BRAF+ groups. Tumor size of 0.5 cm and US groups B and C in the BRAF– group were cutoff values for gross ETE, with a negative predictive value of 100%, whereas tumor size of 0.7 cm and US groups A and B in the BRAF+ group had negative predictive values of 92.4% and 100%, respectively. Conclusion. Excluding of ETE by US was categorized according to tumor size and US findings. A different categorization to exclude ETE is needed according to the BRAF mutation.
Abstract
Objectives. The aim of this study was to evaluate the association between preoperative parameters and extrathyroidal extension (ETE) of papillary thyroid microcarcinoma (PTMC) according to the BRAF mutation and to evaluate the preoperative predictability of ETE. Methods. We analyzed the medical records of 332 patients with PTMC (140 in the BRAF– group and 192 in the BRAF+ group). The presence of ETE was subjected to a correlation analysis with age, sex, tumor size, clinical nodal status, and ultrasonography (US) findings. Among the US findings, the correlation between tumors and the thyroid capsule was categorized into four groups; US group A, intraparechymal; US group B, tumor abutting the capsule <50% of diameter; US group C, tumor abutting >50% of diameter; and US group D, tumor destroyed the capsule. The predictive value of ETE, including sensitivity, specificity, and positive and negative predictive values were evaluated. Results. Tumor size and US group were significantly correlated with gross ETE in the BRAF– and BRAF+ groups. Tumor size of 0.5 cm and US groups B and C in the BRAF– group were cutoff values for gross ETE, with a negative predictive value of 100%, whereas tumor size of 0.7 cm and US groups A and B in the BRAF+ group had negative predictive values of 92.4% and 100%, respectively. Conclusion. Excluding of ETE by US was categorized according to tumor size and US findings. A different categorization to exclude ETE is needed according to the BRAF mutation.
참고문헌 (25)
- Frasca F, "BRAF(V600E) mutation and the biology of papillary thyroid cancer", Endocr Relat Cancer, 15(1), pp.191~205 (2008)
- Guan H, "Association of high iodine intake with the T1799A BRAF mutation in papillary thyroid cancer", J Clin Endocrinol Metab, 94(5), pp.1612~1617 (2009)
- Li C, "BRAF V600E mutation and its association with clinicopathological features of papillary thyroid cancer: a meta-analysis", J Clin Endocrinol Metab, 97(12), pp.4559~4570 (2012)
- Chakraborty A, "BRAF V600E mutation in papillary thyroid carcinoma: significant association with node metastases and extra thyroidal invasion", Endocr Pathol, 23(2), pp.83~93 (2012)
- Kim TH, "The association of the BRAF(V600E) mutation with prognostic factors and poor clinical outcome in papillary thyroid cancer: a meta-analysis", Cancer, 118(7), pp.1764~1773 (2012)
- Lee X, "Analysis of differential BRAF(V600E) mutational status in high aggressive papillary thyroid microcarcinoma", Ann Surg Oncol, 16(2), pp.240~245 (2009)
- Byar DP, "A prognostic index for thyroid carcinoma: a study of the E.O.R.T.C", Eur J Cancer, 15(8), pp.1033~1041 (1979)
- Hay ID, "Ipsilateral lobectomy versus bilateral lobar resection in papillary thyroid carcinoma: a retrospective analysis of surgical outcome using a novel prognostic scoring system", Surgery, 102(6), pp.1088~1095 (1987)
- Hay ID, "Predicting outcome in papillary thyroid carcinoma: development of a reliable prognostic scoring system in a cohort of 1779 patients surgically treated at one institution during 1940 through 1989", Surgery, 114(6), pp.1050~1057 (1993)
- Kim SS, "Preoperative ultrasonographic tumor characteristics as a predictive factor of tumor stage in papillary thyroid carcinoma", Head Neck, 33(12), pp.1719~1726 (2011)
- Lee DY, "Prediction of extrathyroidal extension using ultrasonography and computed tomography", Int J Endocrinol, 2014, pp.351058~ (2014)
- Kwak JY, "Association of BRAFV600E mutation with poor clinical prognostic factors and US features in Korean patients with papillary thyroid microcarcinoma", Radiology, 253(3), pp.854~860 (2009)
- Kabaker AS, "Suspicious ultrasound characteristics predict BRAF V600E-positive papillary thyroid carcinoma", Thyroid, 22(6), pp.585~589 (2012)
- Radowsky JS, "Impact of degree of extrathyroidal extension of disease on papillary thyroid cancer outcome", Thyroid, 24(2), pp.241~244 (2014)
- Ito Y, "Prognostic significance of extrathyroid extension of papillary thyroid carcinoma: massive but not minimal extension affects the relapse-free survival", World J Surg, 30(5), pp.780~786 (2006)
- Jin BJ, "Characteristics and significance of minimal and maximal extrathyroidal extension in papillary thyroid carcinoma", Oral Oncol, 51(8), pp.759~763 (2015)
- Moon HJ, "Minimal extrathyroidal extension in patients with papillary thyroid microcarcinoma: is it a real prognostic factor?", Ann Surg Oncol, 18(7), pp.1916~1923 (2011)
- Kwak JY, "Extrathyroid extension of well-differentiated papillary thyroid microcarcinoma on US", Thyroid, 18(6), pp.609~614 (2008)
- Moon HJ, "Clinical implication of elastography as a prognostic factor of papillary thyroid microcarcinoma", Ann Surg Oncol, 19(7), pp.2279~2287 (2012)
- King AD, "Staging papillary carcinoma of the thyroid: magnetic resonance imaging vs ultrasound of the neck", Clin Radiol, 55(3), pp.222~226 (2000)
- Niederer-Wust SM, "Impact of clinical risk scores and BRAF V600E mutation status on outcome in papillary thyroid cancer", Surgery, 157(1), pp.119~125 (2015)
- Lim JY, "Clinicopathologic implications of the BRAF(V600E) mutation in papillary thyroid cancer: a subgroup analysis of 3130 cases in a single center", Thyroid, 23(11), pp.1423~1430 (2013)
- Zheng X, "Papillary microcarcinoma of the thyroid: clinical characteristics and BRAF(V600E) mutational status of 977 cases", Ann Surg Oncol, 20(7), pp.2266~2273 (2013)
- Ryu J, "Extent of thyroidectomy affects vocal and throat functions: a prospective observational study of lobectomy versus total thyroidectomy", Surgery, 154(3), pp.611~620 (2013)
- Leslie C, "BRAF p.Val600Glu (V600E) mutation detection in thyroid fine needle aspiration cell block samples: a feasibility study", Pathology, 47(5), pp.432~438 (2015)
