Predicting Extrathyroidal Extension in Patients With Papillary Thyroid Microcarcinoma According to a BRAF Mutation

Abstract

ObjectivesThe aim of this study was to evaluate the association between preoperative parameters and extrathyroidal extension (ETE) of papillary thyroid microcarcinoma (PTMC) according to the BRAF mutation and to evaluate the preoperative predictability of ETE.MethodsWe analyzed the medical records of 332 patients with PTMC (140 in the BRAF– group and 192 in the BRAF+ group). The presence of ETE was subjected to a correlation analysis with age, sex, tumor size, clinical nodal status, and ultrasonography (US) findings. Among the US findings, the correlation between tumors and the thyroid capsule was categorized into four groups; US group A, intraparechymal; US group B, tumor abutting the capsule <50% of diameter; US group C, tumor abutting >50% of diameter; and US group D, tumor destroyed the capsule. The predictive value of ETE, including sensitivity, specificity, and positive and negative predictive values were evaluated.ResultsTumor size and US group were significantly correlated with gross ETE in the BRAF– and BRAF+ groups. Tumor size of 0.5 cm and US groups B and C in the BRAF– group were cutoff values for gross ETE, with a negative predictive value of 100%, whereas tumor size of 0.7 cm and US groups A and B in the BRAF+ group had negative predictive values of 92.4% and 100%, respectively.ConclusionExcluding of ETE by US was categorized according to tumor size and US findings. A different categorization to exclude ETE is needed according to the BRAF mutation.

BRAF and NRAS Mutations in Papillary Thyroid Carcinoma and Concordance in BRAF Mutations Between Primary and Corresponding Lymph Node Metastases

“…In addition, BRAF mutational status has been correlated with recurrence of PTMCs, suggesting its importance in stratifying patients for surgical management 28 , 29 . On the other hand, several papers concluded that BRAF positivity is not significantly associated with most clinicopathologic features redolent of aggressiveness, including tumor multicentricity, lymphovascular invasion, extranodal extension, central neck involvement, advanced stage (stage III or IV), and distant metastasis 30 , 31 .…”

Identifying the Transcriptional Regulatory Network Associated With Extrathyroidal Extension in Papillary Thyroid Carcinoma by Comprehensive Bioinformatics Analysis

“…p values were calculated using the Wilcoxon rank sum test. *p < 0.05, **p < 0.01, and ***p < 0.001. studies, Chakraborty et al (2012) and Lee et al (2017) found that B-Raf proto-oncogene mutation status was significantly related to extrathyroidal invasion and lymph node metastasis. However, no studies identifying biomarkers of ETE in PTC have been reported.…”

“…It has relatively good prognosis and a low mortality rate (Xia et al, 2018). However, its prognosis is associated with several clinicopathological factors, including age, tumor size, distant metastasis, and the development of extrathyroidal extension (ETE; Hay et al, 1993;So et al, 2015;Lee et al, 2017).…”

The Number of Central Lymph Nodes on Preoperative Ultrasound Predicts Central Neck Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Prospective Cohort Study

“…Due to time costs, labor costs, and other expense issues, doctors and patients in China may be more inclined to choose surgery. Another important reason is more than 30% cervical lymph node metastasis in CN0 PTC and extrathyroidal extension [25,26]. With the application of ACR-TIRADS and ATA guidelines in recent years, this situation has been improving [27].…”