The Clinical Significance of the BRAF Mutation in Patients with Papillary Thyroid Cancer
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Purpose: Papillary thyroid cancer (PTC) is the most frequent subtype among thyroid cancers. B-type Raf kinase (BRAF) mutation can be found in approximately 80% of patients with PTC in Korea. However, there is ongoing debate whether BRAF mutation is clinically significant or not in PTC. Therefore, we investigated the clinical significance of BRAF mutation. Methods: We retrospectively enrolled 1,503 PTC patients (1,170 who were BRAF positive) among the registered from January in 2009 to October in 2013. The mean follow-up period was 53.0 months (max 173 months). BRAF mutation analysis was performed by restriction fragment length polymorphism-polymerase chain reaction. Results: In the group with the BRAF mutation, male gender (P=0.003), the capsular invasion (P<0.001), and N1 stage (P<0.001) were more frequent features and there were more central lymph node metastases than in those without the mutation. The frequencies of total thyroidectomy and radioactive iodine (RAI) therapy were not different between the 2 groups (P=0.753 and P=0.139, respectively) and the BRAF mutation was not a prognostic factor for recurrence (P=0.823). The significant prognostic factor for recurrence was the post-RAI therapy stimulated thyroglobulin, only which reflected the response of treatment. It did not differ between the 2 groups in this study. Conclusion: Although the BRAF mutation was not a prognostic factor for the recurrence, but was correlated with the aggressive behavior in this study. Therefore, to determine whether the early surgical treatment is possible in this group is important and it may be a useful preoperative modulator to determine whether early surgical treatment is necessary or not.
Abstract
Purpose: Papillary thyroid cancer (PTC) is the most frequent subtype among thyroid cancers. B-type Raf kinase (BRAF) mutation can be found in approximately 80% of patients with PTC in Korea. However, there is ongoing debate whether BRAF mutation is clinically significant or not in PTC. Therefore, we investigated the clinical significance of BRAF mutation. Methods: We retrospectively enrolled 1,503 PTC patients (1,170 who were BRAF positive) among the registered from January in 2009 to October in 2013. The mean follow-up period was 53.0 months (max 173 months). BRAF mutation analysis was performed by restriction fragment length polymorphism-polymerase chain reaction. Results: In the group with the BRAF mutation, male gender (P=0.003), the capsular invasion (P<0.001), and N1 stage (P<0.001) were more frequent features and there were more central lymph node metastases than in those without the mutation. The frequencies of total thyroidectomy and radioactive iodine (RAI) therapy were not different between the 2 groups (P=0.753 and P=0.139, respectively) and the BRAF mutation was not a prognostic factor for recurrence (P=0.823). The significant prognostic factor for recurrence was the post-RAI therapy stimulated thyroglobulin, only which reflected the response of treatment. It did not differ between the 2 groups in this study. Conclusion: Although the BRAF mutation was not a prognostic factor for the recurrence, but was correlated with the aggressive behavior in this study. Therefore, to determine whether the early surgical treatment is possible in this group is important and it may be a useful preoperative modulator to determine whether early surgical treatment is necessary or not.
참고문헌 (23)
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