Background
Thyroid cancer is prevalent worldwide, including in China, where its incidence is on the rise. Papillary thyroid carcinoma (PTC) is the predominant subtype. Investigating the relationship between clinical data associated with PTC and gene mutations is crucial for improving detection and treatment.
Patients and Methods
We collected samples and associated clinical data from 700 PTC patients at Shanxi Provincial People’s Hospital. Using a panel of 57 genes linked to thyroid cancer, we sequenced the samples to determine the mutation frequency of thyroid cancer-associated genes in PTC. We further analyzed the correlation between gene variants and clinical information.
Results
The mean age of patients in this study was 42.5 years. Females predominated, comprising 507 of the total patient population, resulting in a female-to-male ratio of 2.63 (507:193). Tumor distribution revealed 198, 257, and 142 cases on the left, right, and both sides, respectively. Among the 57 thyroid cancer-related genes analyzed, we identified at least one driver gene in 83.6% of patients. Notably, 76.4% had
BRAF
mutations, mainly
BRAF
V600E
, which constituted 90.9% of all BRAF mutations, with 535 cases exhibiting these mutations. Other significant driver genes included
CHEK2
(
n
= 84),
RET
(
n
= 42),
PIK3CA
(
n
= 7), and
EGFR
(
n
= 7).
RET
fusions (
n
= 28) were also identified. Notably, patients under 55 years old exhibit a higher tendency towards advanced N staging, suggesting that younger individuals may be more prone to lymph node metastasis. Additionally, male patients were more likely to have advanced N stages. Importantly, a positive correlation was observed between higher
BRAF
allele frequencies and more advanced T and N stages. Similarly, correlation analysis revealed that a greater frequency of
RET
fusions correlated with later T and N stages.
Conclusion
This study uncovered several significant insights. Younger PTC patients exhibited a higher propensity for lymph node metastasis. An elevated mutation frequency of
BRAF
was correlated with a higher occurrence of
RET
fusions, predisposing individuals to lymph node metastasis and potentially indicating a poorer prognosis.
Supplementary Information
The online version contains supplementary material available at 10.1007/s40291-024-00721-1.