BRAF analysis before surgery for papillary thyroid carcinoma: Correlation with clinicopathological features and prognosis in a single-institution prospective experience

Francesca Galuppini, Gianmaria Pennelli, Federica Vianello, Simona Censi, Laura Zambonin, Sara Watutantrige-Fernando, Jacopo Manso, Davide Nacamulli, Ornella Lora, Maria Rosa Pelizzo, Massimo Rugge, Susi Barollo, Caterina Mian

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Risk stratification in patients with papillary thyroid carcinoma (PTC) currently relies on postoperative parameters. Testing for BRAF mutations preoperatively may serve as a novel tool for identifying PTC patients at risk of persistence/recurrence after surgery. Methods: The study involved 185 consecutive patients with a histological diagnosis of PTC and BRAF analysis performed on thyroid fine-needle aspiration biopsy (FNAB). We assessed BRAF status in FNAB specimens obtained before thyroidectomy for PTC, and examined its association with the clinicopathological characteristics identified postoperatively, and with outcome after a mean 55±15 months of follow-up. Results: One hundred and fifteen of 185 (62%) PTCs carried a BRAF mutation. Univariate analysis showed that BRAF status correlated with the histological variant of PTC, cancer size, and stage at diagnosis, but not with gender, age, multifocality, or lymph node involvement. BRAF-mutated cases had a higher prevalence of persistent/recurrent disease by the end of the follow-up (11% vs. 8%), but this difference was not statistically significant. The Kaplan-Meier curve shows that among the patients with persistent/recurrent disease, BRAF-mutated patients needed a second treatment earlier than patients with BRAF wild-type, although the difference did not completely reach the statistical significance. Conclusions: Our study confirmed that preoperatively identified BRAF mutation are associated with certain pathological features of PTC that correlate with prognosis. We speculate that it has a role in identifying PTCs that would generally be considered low-risk but that may reveal an aggressive behavior during their follow-up.

Original languageEnglish
Pages (from-to)1531-1539
Number of pages9
JournalClinical Chemistry and Laboratory Medicine
Volume54
Issue number9
DOIs
Publication statusPublished - Sep 1 2016

Keywords

  • BRAF
  • FNAB
  • prognosis
  • thyroid cancer

ASJC Scopus subject areas

  • Medicine(all)
  • Clinical Biochemistry
  • Biochemistry, medical

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