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

Maria Rosa Pelizzo, Isabella Merante Boschin, Susi Barollo, Gianmaria Pennelli, Antonio Toniato, Laura Zambonin, Federica Vianello, Andrea Piotto, Eric Casal Ide, Costantino Pagetta, Nadia Sorgato, Francesca Torresan, Elisa Girelli Maria Elisa Girelli, Nacamulli Davide Nacamulli, Mantero Franco Mantero, Mian Caterina Mian

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)325-329
Number of pages5
JournalClinical Chemistry and Laboratory Medicine
Volume49
Issue number2
DOIs
Publication statusPublished - Feb 1 2011

Keywords

  • BRAF
  • cytology
  • papillary thyroid cancer

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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