The synergic effect of BRAFV600E mutation and multifocality on central lymph node metastasis in unilateral papillary thyroid carcinoma

Endocrine journal

Zhuo Tan¹  Yan Lin²  Jun-Rong Wang³  Chang-Fu Zheng⁴  Xue-Yan Qu⁵  Ze Hu⁶  Hai-Jiang Qu⁶ 

[1] Department of Head and Neck Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China;Department of Laboratory Medicine, Taizhou Cancer Hospital, Wenling, Zhejiang, China;Department of Laboratory Medicine, Wenling Women’s and Children’s Hospital, Wenling, Zhejiang, China;Department of Ultrasound, Taizhou Cancer Hospital, Wenling, Zhejiang, China;Nursing Department, The First People’s Hospital of Wenling, Wenling City, Zhejiang, China;The Department of Thyroid and Breast, Taizhou Cancer Hospital, Wenling, Zhejiang, China

关键词: Papillary thyroid carcinoma;    BRAFV600E mutation;    Multifocality;    Central lymph node metastasis;    Prophylactic lymph node dissection;   

DOI  :  10.1507/endocrj.EJ17-0110

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

The purpose of this study is to evaluate the potential synergic effect of BRAFV600E mutation and multifocality on central lymph nodes metastasis (CLNM) in the patients with unilateral papillary thyroid carcinoma (PTC). We enrolled 413 patients with unilateral PTCs who accepted prophylactic unilateral or bilateral central lymph node dissection (LND). Univariate and multivariate analyses were made to determine the association between related factors and CLNM. Then, all patients were divided into 4 groups based on their status of BRAFV600E mutation and multifocality. Relative excess risk of interaction (RERI), attributable proportion (AP) of interaction and synergy index (SI) were applied to evaluate the interactive effect of these two factors on CLNM. Results showed that BRAFV600E mutation and multifocality were independent risk factors for CLNM. A further study revealed that unilateral PTCs accompanying multifocality with BRAFV600E mutation had the highest incidence of CLNM compared with other subgroups. Besides, RERI was 4.323 (95% CI = 1.276–7.369), AP was 0.523 (95% CI = 0.364–0.682) and SI was 2.469 (95% CI = 1.607 to 3.794), indicating a significant additive interaction of BRAFV600E mutation and multifocality on CLNM. The present study has confirmed that BRAFV600E mutation and multifocality are risk factors for CLNM in unilateral PTC. Additionally, unilateral PTC patients accompanying multifocality with BRAFV600E mutation may have an increased risk of CLNM in clinically negative CLNM.

【 授权许可】

Unknown