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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Pre-operative role of BRAF in the guidance of the surgical approach and prognosis of differentiated thyroid carcinoma

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Author(s):
Danilovic, Debora L. S. [1, 2] ; Lima, Erika U. [1] ; Domingues, Regina B. [3] ; Brandao, Lenine G. [4] ; Hoff, Ana O. [2] ; Marui, Suemi [1]
Total Authors: 6
Affiliation:
[1] Univ Sao Paulo, Fac Med, Unidade Tireoide, Lab Endocrinol Celular & Mol LIM25, BR-01246903 Sao Paulo - Brazil
[2] Inst Canc Estado Sao Paulo, Serv Endocrinol, Sao Paulo - Brazil
[3] Univ Sao Paulo, Fac Med, Hosp Clin, Serv Anat Patol, BR-01246903 Sao Paulo - Brazil
[4] Univ Sao Paulo, Fac Med, Hosp Clin, Serv Cirurgia Cabeca & Pescoco, BR-01246903 Sao Paulo - Brazil
Total Affiliations: 4
Document type: Journal article
Source: EUROPEAN JOURNAL OF ENDOCRINOLOGY; v. 170, n. 4, p. 619-625, APR 2014.
Web of Science Citations: 16
Abstract

Objective: The p. V600E BRAF and RAS mutations are found in 30-80% of differentiated thyroid carcinoma (DTC). BRAF mutation has been associated with poor prognosis. This study investigated the role of molecular studies in preoperative diagnosis of DTC and the association of p. V600E mutation with prognostic factors. Design: Prospective study. Methods: A total of 202 patients with cytological diagnosis of Bethesda III-VI underwent preoperative molecular studies and subsequent thyroidectomy. p. V600E and RAS mutations were studied in the cytology smears, using real-time PCR genotyping technique. The BRAF mutation (BRAF(+) or BRAF(-)) was correlated with histological and clinical findings. Results: Molecular study of 172 nodules with Bethesda III-V cytology improved negative predictive value and accuracy of Bethesda III and IV diagnosis. BRAF mutation was present in 65% of 94 DTC and p. Q61R NRAS in one. Except for age, BRAF C and BRAF(1) did not differ in sex, tumor size, histological subtype, multifocality, vascular invasion, extrathyroidal extension, or prognostic staging. Among papillary carcinomas, lymph node (LN) metastasis was diagnosed in 23% BRAF C and 37% BRAF K. Distant metastasis occurred in four BRAF(-) . Recurrent or persistent disease was more frequent in BRAF K (26.7 vs 3.3% BRAF(+), P=0.002) along follow-up of 29.8 +/- 10 months. BRAF(+) patients without LN metastasis by pre-operative evaluation submitted to thyroidectomy with central neck dissection ( CND) had more frequent LN metastasis ( 45 vs 5% no CND, P=0.002), but no difference in clinical outcome was observed. Conclusions: Pre-operative identification of BRAF mutation improved cytological diagnosis of DTC, but it was not associated with poor prognostic factors. Prophylactic CND did not guarantee better outcome in BRAF C patients. (AU)

FAPESP's process: 10/12883-6 - Detection of RAS mutations in follicular thyroid cells obtained from fine needle aspiration biopsy
Grantee:Suemi Marui
Support Opportunities: Regular Research Grants
FAPESP's process: 09/07544-0 - Analysis of V600E BRAF mutation in fine needle aspiration from thyroid nodule with suspicious or papillary carcinoma diagnosis
Grantee:Suemi Marui
Support Opportunities: Regular Research Grants