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Published on: September 8, 2021
Preoperative BRAF mutation has different predictive values for lymph node metastasis according to tumor size
Yoon Kyoung So1, Young-Ik Son, Joo Yeon Park
1Department of Otorhinolaryngology-Head and Neck Surgery, Inje University College of Medicine, Haeundae Paik Hospital, Pusan, South Korea.
Summary
BRAF mutation predicts lymph node metastasis in papillary thyroid cancer (PTC), but its predictive value varies with tumor size. The mutation was only significant for predicting metastasis in tumors between 0.5 cm and 1 cm.
Area of Science:
- Oncology
- Genetics
- Surgical Pathology
Background:
- Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy.
- BRAF mutations are frequently found in PTC and are associated with aggressive disease features.
- The predictive role of BRAF mutations for lymph node (LN) metastasis in PTC requires further clarification, especially concerning tumor size.
Purpose of the Study:
- To determine if the BRAF mutation in papillary thyroid carcinoma has varying predictive significance for regional lymph node metastasis based on primary tumor size.
- To analyze the association between BRAF mutation status and lymph node metastasis across different tumor size categories in PTC patients.
Main Methods:
- A prospective cohort study involving 102 patients with unifocal PTC was conducted at a tertiary hospital.
- BRAF mutation was assessed preoperatively via fine-needle aspiration biopsy (FNAB).
- Tumors were categorized into three size groups (≤0.5 cm, >0.5-1 cm, >1 cm), and lymph node metastasis was evaluated in surgical specimens.
Main Results:
- BRAF mutation was an overall significant predictor of lymph node metastasis (P = .045).
- Lymph node metastasis rates increased significantly with tumor size (4.8% to 66.7%, P < .001).
- BRAF mutation specifically predicted lymph node metastasis only in the intermediate tumor size group (0.5-1 cm, P = .026).
Conclusions:
- The predictive value of BRAF mutation for lymph node metastasis in papillary thyroid carcinoma is dependent on tumor size.
- BRAF mutation status should be interpreted in the context of tumor size when assessing the risk of lymph node metastasis in PTC.
