Lymphatic mapping establishes the role of BRAF gene mutation in papillary thyroid carcinoma

Joseph Kim, Armando E. Giuliano, Roderick R. Turner, Robyn E. Gaffney, Naoyuki Umetani, Minoru Kitago, David Elashoff, Dave S.B. Hoon

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Abstract

OBJECTIVE: To define the role of BRAF gene mutation in the progression of papillary thyroid carcinoma. SUMMARY BACKGROUND DATA: BRAF gene mutation is frequently detected in papillary thyroid carcinoma. Its role in pathogenesis or progression is under investigation. METHODS: Patients who underwent thyroidectomy and sentinel lymph node biopsy for papillary thyroid cancer were accrued. BRAF mutation was assessed in primary tumors and matched sentinel lymph nodes by a quantitative real-time PCR assay. RESULTS: Tissue specimens from 103 consecutive patients were evaluated. BRAF mutation of the primary tumor was detected in 34 (33%) patients. In 26 of 34 (76%) patients with BRAF mutation, concomitant lymph node metastasis was detected. On the contrary, in 69 patients with BRAF mutation-negative primary tumors, only 12 (17%) patients had lymph node metastasis (χ, P < 0.0001). BRAF mutation was detected in 20 of 26 (77%) lymph node metastases matched to BRAF mutation-positive primary tumors; it was not detected in lymph node metastases matched to BRAF mutation-negative primary tumors. Univariate analysis identified age, stage, tumor size, and BRAF mutation as prognostic factors for lymph node metastasis. In multivariate analysis, only BRAF mutation remained a significant prognostic factor for lymph node metastasis (odds ratio = 10.8, 95% confidence interval, 3.5-34.0, P < 0.0001). CONCLUSIONS: BRAF mutation may be a key genetic factor for the metastatic progression of papillary thyroid carcinoma. The study demonstrates that this gene mutation is a significant risk factor for locoregional lymph node metastasis and has potential utility as a surrogate marker.

Original languageEnglish
Pages (from-to)799-804
Number of pages6
JournalAnnals of surgery
Volume244
Issue number5
DOIs
Publication statusPublished - 2006 Nov 1

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ASJC Scopus subject areas

  • Surgery

Cite this

Kim, J., Giuliano, A. E., Turner, R. R., Gaffney, R. E., Umetani, N., Kitago, M., Elashoff, D., & Hoon, D. S. B. (2006). Lymphatic mapping establishes the role of BRAF gene mutation in papillary thyroid carcinoma. Annals of surgery, 244(5), 799-804. https://doi.org/10.1097/01.sla.0000224751.80858.13