BRAF analysis by fine needle aspiration biopsy of thyroid nodules improves preoperative identification of papillary thyroid carcinoma and represents a prognostic factor. A mono-institutional experience
BRAF analysis by fine needle aspiration biopsy of thyroid nodules improves preoperative identification of papillary thyroid carcinoma and represents a prognostic factor. A mono-institutional experience
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DOI：
10.1515/cclm.2011.031
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发表时间：
2011-02-01
影响因子：
6.8
通讯作者：
Mian, Caterina
中科院分区：
文献类型：
--
作者：
Pelizzo, Maria Rosa;Boschin, Isabella Merante;Mian, Caterina
背景资料：目前，甲状腺肿块的术前诊断依赖于细针穿刺活检（FNAB）获得的甲状腺细胞的显微镜评价。最近，FNAB已与分子分析相结合，以提高细胞学评价的准确性。在这项单机构前瞻性研究中，我们评估了在甲状腺FNAB中常规引入BRAF检测是否有助于改善甲状腺乳头状癌（PTC）在“暂停”或恶性细胞学类别中的术前识别。此外，我们研究了BRAFV 600 E突变在PTC.Methods的预后作用：BRAFV 600 E分析进行甲状腺FNAB从270例患者分为五个细胞学类别之一，THY 1，THY 2，THY 3，THY 4，THY 5。所有患者随后于2008年10月至2009年9月在我科接受甲状腺切除术+/-淋巴结清扫术。对于每个细胞学分类，我们考虑PTC的明确组织学诊断和BRAFV 600 E突变的存在。在141例PTC的最终组织诊断，我们相关的BRAFV 600 E的存在与性别，年龄，组织型，TNM分期，病变大小，囊外扩展，淋巴结转移和multifocality.Results：BRAFV 600 E突变的患病率，PTCs在最终组织诊断，为69%。FNAB诊断准确率从88%提高到91%。BRAFV 600 E突变与年龄较大、PTC经典变异、> 45岁患者的晚期相关。结论：BRAFV 600 E检测可提高FNAB对PTC的诊断准确性，是一种有用的辅助工具，可用于特定病例甲状腺结节的术前诊断。BRAFV 600 E突变与PTC的一些临床病理特征相关。
Background: The current preoperative diagnosis of a thyroid mass relies on microscopic evaluation of thyroid cells obtained by fine needle aspiration biopsy (FNAB). More recently, FNAB has been combined with molecular analysis to increase the accuracy of the cytological evaluation. In this mono-institutional prospective study, we evaluated whether the routine introduction of BRAF testing in thyroid FNAB could help ameliorate the preoperative recognition of papillary thyroid carcinoma (PTC) in "suspended" or malignant cytological categories. Moreover, we investigated the prognostic role of the BRAFV600E mutation in PTC.Methods: BRAFV600E analysis was performed in thyroid FNAB from 270 patients classified into one of five cytological categories THY1, THY2, THY3, THY4, THY5. All subsequently underwent thyroidectomy +/- node dissection, from October 2008 to September 2009 in our Department. For each cytological category, we considered the definitive histological diagnosis of PTC and the presence of the BRAFV600E mutation. In 141 patients with a final tissue diagnosis of PTC, we correlated the presence of BRAFV600E with gender, age, histotype, TNM, size of the lesion, extracapsular extension, node metastases and multifocality.Results: The prevalence of the BRAFV600E mutation, among PTCs at final tissue diagnosis, was 69%. It improved the FNAB diagnostic accuracy from 88% to 91%. The BRAFV600E mutation was correlated with older age, classical variant of PTC, advanced stages in patients > 45 years.Conclusions: BRAFV600E testing could play a role in improving the diagnostic accuracy of FNAB for PTC, representing a useful adjuvant tool in presurgical characterization of thyroid nodes in particular cases. There is an association between the BRAFV600E mutation and some clinico-pathological characteristics of PTC.