PURPOSE: Papillary thyroid carcinoma (PTC) is the most common malignant
tumor of the
thyroid and BRAFV600E
mutation is the most frequent genetic alteration in PTC. BRAFV600E
mutation has been demonstrated as a prognostic
biomarker for prediction of poor clinicopathological outcomes, such as increased
incidence of extrathyroidal extension,
lymph node metastasis , and advanced stage. However, there is conflicting
literature regarding the
association of BRAFV600E
mutation and aggressive clinicopathological features. In this study, we investigated the
prevalence of BRAFV600E
mutation in PTC and determined the
association of BRAF
mutation with
indicators of poor
prognosis for PTC.
METHODS: We reviewed 1009
patients with PTC,
who underwent
thyroid surgery at Kyungpook National
University Hospital between January 2013 and March 2014. BRAFV600E
mutation analysis was performed using
real-time polymerase chain reaction based amplification of
DNA extracted from
paraffin -embedded
tumor specimens.
RESULTS: BRAFV600E
mutation was detected in 863 (85.5%)
patients . In univariate
analysis , histologic subtype, extrathyroidal extension, and advanced stage showed significant
association with BRAFV600E
mutation . In addition, concurrent Hashimoto's
thyroiditis showed an
association with low
prevalence of BRAFV600E
mutation . However, no statistically significant
association was observed for age,
gender , multifocal or bilateral
tumor , and
lymph node metastasis .
Multivariate analysis showed an independent
association of extrathyroidal extension with BRAFV600E
mutation .
CONCLUSION: In this study, extrathyroidal extension of PTC is an independent
prognostic factor associated with BRAFV600E
mutation status. However, conduct of further large scale studies with long term follow up is required before the BRAF
mutation can be conclusively recommended as a prognostic
biomarker .