Pre-operative role of BRAF in the guidance of the surgical approach and prognosis of differentiated thyroid carcinoma

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorDANILOVIC, Debora L. S.
dc.contributor.authorLIMA, Erika U.
dc.contributor.authorDOMINGUES, Regina B.
dc.contributor.authorBRANDAO, Lenine G.
dc.contributor.authorHOFF, Ana O.
dc.contributor.authorMARUI, Suemi
dc.date.accessioned2014-09-30T14:36:52Z
dc.date.available2014-09-30T14:36:52Z
dc.date.issued2014
dc.description.abstractObjective: The p. V600E BRAF and RAS mutations are found in 30-80% of differentiated thyroid carcinoma (DTC). BRAF mutation has been associated with poor prognosis. This study investigated the role of molecular studies in preoperative diagnosis of DTC and the association of p. V600E mutation with prognostic factors. Design: Prospective study. Methods: A total of 202 patients with cytological diagnosis of Bethesda III-VI underwent preoperative molecular studies and subsequent thyroidectomy. p. V600E and RAS mutations were studied in the cytology smears, using real-time PCR genotyping technique. The BRAF mutation (BRAF(+) or BRAF(-)) was correlated with histological and clinical findings. Results: Molecular study of 172 nodules with Bethesda III-V cytology improved negative predictive value and accuracy of Bethesda III and IV diagnosis. BRAF mutation was present in 65% of 94 DTC and p. Q61R NRAS in one. Except for age, BRAF C and BRAF(1) did not differ in sex, tumor size, histological subtype, multifocality, vascular invasion, extrathyroidal extension, or prognostic staging. Among papillary carcinomas, lymph node (LN) metastasis was diagnosed in 23% BRAF C and 37% BRAF K. Distant metastasis occurred in four BRAF(-) . Recurrent or persistent disease was more frequent in BRAF K (26.7 vs 3.3% BRAF(+), P=0.002) along follow-up of 29.8 +/- 10 months. BRAF(+) patients without LN metastasis by pre-operative evaluation submitted to thyroidectomy with central neck dissection ( CND) had more frequent LN metastasis ( 45 vs 5% no CND, P=0.002), but no difference in clinical outcome was observed. Conclusions: Pre-operative identification of BRAF mutation improved cytological diagnosis of DTC, but it was not associated with poor prognostic factors. Prophylactic CND did not guarantee better outcome in BRAF C patients.
dc.description.indexMEDLINE
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [09/07544-0, 10/12883-6]
dc.identifier.citationEUROPEAN JOURNAL OF ENDOCRINOLOGY, v.170, n.4, p.619-625, 2014
dc.identifier.doi10.1530/EJE-13-0944
dc.identifier.eissn1479-683X
dc.identifier.issn0804-4643
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/7307
dc.language.isoeng
dc.publisherBIOSCIENTIFICA LTD
dc.relation.ispartofEuropean Journal of Endocrinology
dc.rightsrestrictedAccess
dc.rights.holderCopyright BIOSCIENTIFICA LTD
dc.subject.otherlymph-node metastasis
dc.subject.otherclinicopathological features
dc.subject.otherbraf(v600e) mutation
dc.subject.otherv600e mutation
dc.subject.otherdiagnostic-accuracy
dc.subject.otherhigh prevalence
dc.subject.othercancer
dc.subject.othernodules
dc.subject.otherspecimens
dc.subject.othercytology
dc.subject.wosEndocrinology & Metabolism
dc.titlePre-operative role of BRAF in the guidance of the surgical approach and prognosis of differentiated thyroid carcinoma
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalDOMINGUES, Regina B.:Univ Sao Paulo, Fac Med, Hosp Clin, Serv Anat Patol, BR-01246903 Sao Paulo, Brazil
hcfmusp.citation.scopus26
hcfmusp.contributor.author-fmusphcDEBORA LUCIA SEGURO DANILOVIC
hcfmusp.contributor.author-fmusphcERIKA URBANO DE LIMA
hcfmusp.contributor.author-fmusphcLENINE GARCIA BRANDAO
hcfmusp.contributor.author-fmusphcANA AMELIA FIALHO DE OLIVEIRA HOFF
hcfmusp.contributor.author-fmusphcSUEMI MARUI
hcfmusp.description.beginpage619
hcfmusp.description.endpage625
hcfmusp.description.issue4
hcfmusp.description.volume170
hcfmusp.origemWOS
hcfmusp.origem.pubmed24468978
hcfmusp.origem.scopus2-s2.0-84899493011
hcfmusp.origem.wosWOS:000334351800023
hcfmusp.publisher.cityBRISTOL
hcfmusp.publisher.countryENGLAND
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hcfmusp.remissive.sponsorshipFAPESP
hcfmusp.scopus.lastupdate2024-05-17
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