The Association of the BRAFV600E Mutation With Prognostic Factors and Poor Clinical Outcome in Papillary Thyroid Cancer
The Association of the BRAFV600E Mutation With Prognostic Factors and Poor Clinical Outcome in Papillary Thyroid Cancer
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DOI：
10.1002/cncr.26500
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发表时间：
2012-04-01
期刊：
影响因子：
6.2
通讯作者：
Park, Do Joon
中科院分区：
文献类型：
--
作者：
Kim, Tae Hyuk;Park, Young Joo;Park, Do Joon
背景：BRAF（V600E）突变对乳头状甲状腺癌（PTC）预后因素和不良临床结局的影响尚未完全量化。作者进行了全面的荟萃分析，以评估这些疾病与BRAF（V600E）突变之间的关联强度。方法：作者利用Medline数据库，对2003年1月至2010年10月手术标本中BRAF（V600E）突变与临床病理结果相关性的临床研究进行了鉴定。手工检索了131项相关研究。作者选择了27项研究，包括5655名PTC患者。他们使用随机效应模型计算了每项研究的合并优势比（ORs）或95%置信区间（CIs）的风险比。结果：BRAF（V600E）突变的平均患病率为49.4%。在26项研究中，与携带野生型BRAF基因的患者相比，携带BRAF（V600E）突变的PTC患者甲状腺外侵袭（OR, 2.14; 95% CI, 1.68-2.73）、淋巴结转移（OR, 1.54; 95% CI, 1.21-1.97）和晚期TNM （OR, 2.00; 95% CI, 1.61-2.49）的OR增加。在8项研究中，突变患者复发和持续性疾病的风险增加了2.14倍（95% CI, 1.67-2.74）。在不同的研究人群中，这种关联大体上是一致的。结论：本荟萃分析表明，BRAF（V600E）突变与PTC的高危临床病理因素和预后较差密切相关。本研究的结果表明，BRAF（V600E）突变应被视为PTC的不良预后标志物，并可能为个体患者提供更好的治疗。癌症2012;118:1764 - 73。(C) 2011年美国癌症协会。
BACKGROUND: The effects of the BRAF(V600E) mutation on prognostic factors and poor clinical outcomes in papillary thyroid cancer (PTC) have not been fully quantified. The authors performed comprehensive meta-analysis to assess the strength of associations between these conditions and the BRAF(V600E) mutation. METHODS: The authors identified the clinical studies that examined the association of the BRAF(V600E) mutation in surgical specimens with clinicopathologic outcomes between January 2003 and October 2010 using the Medline database. One hundred thirty-one relevant studies were hand-searched. The authors selected 27 studies that included 5655 PTC patients. They calculated the pooled odds ratios (ORs) or risk ratios with 95% confidence intervals (CIs) for each study using a random effect model. RESULTS: The average prevalence rate of the BRAF(V600E) mutation was 49.4%. In 26 studies, compared with the patients who had the wild-type BRAF genes, the PTC patients with the BRAF(V600E) mutation had increased ORs of an extrathyroidal invasion (OR, 2.14; 95% CI, 1.68-2.73), a lymph node metastasis (OR, 1.54; 95% CI, 1.21-1.97), and an advanced TNM stage (OR, 2.00; 95% CI, 1.61-2.49). In 8 studies, patients with the mutation had 2.14-fold increased risk of recurrent and persistent disease (95% CI, 1.67-2.74). The associations were generally consistent across the different study populations. CONCLUSIONS: This meta-analysis demonstrates that the BRAF(V600E) mutation is closely related to the high-risk clinicopathological factors and poorer outcome of PTC. The results obtained here suggest that the BRAF(V600E) mutation should be considered as a poor prognostic marker in PTC and may lead to better management for individual patients. Cancer 2012;118:1764-73. (C) 2011 American Cancer Society.