Associations between pathological features and radioactive iodine-refractory recurrent papillary thyroid carcinoma:...

Area of Science:

• Oncology
• Genetics
• Pathology

Background:

• Papillary thyroid carcinoma (PTC) is typically indolent, but metastatic forms often become radioactive iodine-refractory (RAI-R).
• Understanding factors predicting RAI-R in recurrent PTC is crucial for treatment strategies.

Purpose of the Study:

• To investigate the role of pathological features, BRAF^V600E, and TERT promoter (TERT-p) mutations in Vietnamese patients with RAI-R recurrent PTC.
• To identify predictors of RAI-R in recurrent PTC.

Main Methods:

• A cross-sectional study of 174 recurrent PTC cases (135 RAI-R, 39 RAI-avid).
• Logistic regression analyses were employed to assess associations between pathological features, mutations (BRAF^V600E, TERT-p), and RAI-R status.

Main Results:

• Loss of polarity/cell cohesiveness (LOP/LCC) was observed exclusively in RAI-R recurrent cancers.
• BRAF^V600E mutation and double mutations (Dmut) of BRAF^V600E/TERT-p were independent predictors of RAI-R.
• Dmut showed a significantly stronger association with RAI-R (OR=6.64) than single mutations (Smut, OR=2.75).
• The combination of BRAF^V600E and tall cell component was the strongest predictor of RAI-R.

Conclusions:

• RAI-R PTC is independently associated with BRAF^V600E and Dmut.
• The association between Dmut and RAI-R PTC is stronger than with Smut.
• Further research is needed on the role of mitotic count and LOP/LCC in RAI-R PTC.