Clinical significance of multi-genic assay in identifying aggressive papillary thyroid carcinoma

A minority of papillary thyroid carcinoma (PTC) is highly aggressive, with rapid progression and a poor prognosis. This study investigated the ability of multi-genic assay to identify patients with aggressive PTC.

A total of 117 PTC patients treated at The First Affiliated Hospital of Chongqing Medical University with clinicopathological data and multi-genic assay results and 389 patients with complete data from The Cancer Genome Atlas (TCGA) database were included. The chi-square test was used to analyze the relationship between the multi-genic assay results and clinicopathological characteristics. Univariate and multivariate regression analyses were used to analyze the impact of various factors on prognosis.

The median follow-up times of the local and TCGA cohorts were 30 months and 34 months, respectively. The results showed that central lymph node metastasis (P = 0.036), lateral lymph node metastasis (P = 0.003) and mutations in genes other than BRAF^V600E (P = 0.002) were significantly associated with disease-free survival (DFS) in the local cohort, while the analysis of TCGA data showed that mutations in genes other than BRAF^V600E were significantly related to poor prognosis (P = 0.029). According to univariate and multivariate analyses, mutations in genes other than BRAF^V600E (P = 0.021) and lateral lymph node metastasis (P = 0.022) were independent factors for postoperative recurrence, as well as, mutations in genes other than BRAF^V600E were an independent factor of survival (P = 0.047).

The multi-genic assay was able to identify aggressive PTC, providing an effective biological basis for surgical management and postoperative treatment.