BRAF V600E mutation and Its Association with Clinicopathological Features of Papillary Thyroid Cancer: A Meta-Analysis
BRAF V600E mutation and Its Association with Clinicopathological Features of Papillary Thyroid Cancer: A Meta-Analysis
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DOI：
10.1210/jc.2012-2104
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发表时间：
2012-12-01
影响因子：
5.8
通讯作者：
Zeiger, Martha A.
中科院分区：
文献类型：
--
作者：
Li, Carol;Lee, Kathleen C.;Zeiger, Martha A.
背景：关于BRAF V600E突变与甲状腺乳头状癌（PTC）侵袭性临床病理特征的关系，文献存在矛盾。然而，一些人建议将BRAF状态纳入PTC患者的管理中，特别是淋巴结清扫。因此，我们进行了一项荟萃分析，以检查BRAF与PTC临床病理特征之间的关系。方法：在PubMed和EMBASE数据库中使用以下医学主题标题（MeSH）和关键词进行文献检索：“braf”、“突变”、“甲状腺”、“肿瘤”、“癌症”和“癌”。计算了个别研究特定的优势比和置信区间，以及联合研究的Mantel-Haenszel合并优势比。结果：共纳入32项研究，包括6372例患者。BRAF突变与淋巴结转移（LNM）、晚期、甲状腺外扩展、肿瘤大小、男性、多灶性、包膜缺失、典型PTC和高细胞变异型PTC相关。与年龄或血管浸润无关。只有两项研究是前瞻性的；其中9个包括连续患者，1个包括随机选择的患者；只有两例患者接受了常规的中央淋巴结清扫，因此可以评估LNM的存在。结论：meta分析发现BRAF突变与LNM、分期、甲状腺外扩展、肿瘤大小、男性、多灶性、无包膜、典型PTC和PTC中的高细胞变异型PTC相关。然而，几乎所有的研究都是回顾性的，32个研究中只有两个纳入了常规中央淋巴结清扫的患者，这强调了在做出重要的临床决策之前，需要精心设计的研究来适当地检查这种关联。[J] .中华内分泌杂志，2012,31(5):559- 557。
Background: There is conflicting literature regarding the association of the BRAF V600E mutation and aggressive clinicopathological features of papillary thyroid cancer (PTC). Nevertheless, some propose that BRAF status be incorporated into the management of patients with PTC, specifically recommendations regarding lymph node dissection. We therefore performed a meta-analysis to examine the relationship between BRAF and clinicopathological features of PTC.Methods: A literature search was performed within PubMed and EMBASE databases using the following Medical Subject Headings (MeSH) and keywords: "braf," "mutation," "thyroid," "neoplasm(s)," "tumor," "cancer," and "carcinoma." Individual study-specific odds ratios and confidence intervals were calculated, as were Mantel-Haenszel pooled odds ratios for the combined studies.Results: Thirty-two studies including 6372 patients were reviewed. BRAF mutation was associated with lymph node metastases (LNM), advanced stage, extrathyroidal extension, tumor size, male gender, multifocality, absence of capsule, classic PTC, and tall-cell variant PTC. There was no association with age or vascular invasion. Only two studies were prospective; nine included consecutive patients, whereas one included randomly selected patients; and only two included patients who had undergone routine central lymph node dissection and were thus evaluable for the presence of LNM.Conclusion: Meta-analysis found that BRAF mutation is associated with LNM, stage, extrathyroidal extension, tumor size, male gender, multifocality, absence of capsule, classic PTC, and tall-cell variant PTC in PTC. However, almost all studies were retrospective and only two of 32 included patients who had undergone routine central lymph node dissection, emphasizing the need for well-designed studies to appropriately examine this association before making important clinical decisions. (J Clin Endocrinol Metab 97: 4559-4570, 2012)