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Capezzone M, Rossi M, Macerola E, Cantara S, Pepe F, Morabito EM, Dalmazio G, Bardi S, Ognibene A, Alessandri M, Materazzi G, De Napoli L, Cirianni M, Torregrossa L. Identification of a Novel Non-V600E BRAF Mutation in Papillary Thyroid Cancer. Case Rep Endocrinol 2024; 2024:6621510. [PMID: 38532782 PMCID: PMC10965284 DOI: 10.1155/2024/6621510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/12/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
Papillary thyroid cancer (PTC) is a common endocrine malignancy, and its incidence is reported to be constantly increasing. BRAF mutation is detected in approximately 44% of PTCs, and the most common BRAF mutation is thymine (T) to adenine (A) missense mutation in nucleotide 1796 (T1796A, V600E). Although BRAFV600E represents 95% of all BRAF mutations, uncommon BRAF mutations have been reported in thyroid carcinomas and represent an alternative mechanism of BRAF activation with unclear clinical significance. We report a novel non-V600E mutation (c.1799_1812delinsAT, p.V600_W604delinsD), identified preoperatively with next-generation sequencing (NGS) on the material obtained with fine-needle aspiration cytology (FNAC) performed on a thyroid nodule cytologically suspicious for malignancy in a 35-year-old male patient. The presence of this new variant of BRAF mutation was subsequently confirmed in the postoperative phase by direct Sanger sequencing. In conclusion, we report a new non-V600E variant previously undetected in papillary thyroid cancer. In addition, this case report shows that the NGS technique on cytological tissue allows to detect the presence of rare mutations, thus increasing the diagnostic specificity of molecular analysis.
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Affiliation(s)
- Marco Capezzone
- UOSD of Endocrinology, Misericordia Hospital, Grosseto 58100, Italy
| | - Maja Rossi
- UOS Molecular Pathology, Hospital Misericordia, Grosseto 58100, Italy
| | - Elisabetta Macerola
- Department of Surgical, Medical and Molecular Pathology, University Hospital of Pisa, Pisa 56124, Italy
| | - Silvia Cantara
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena 53100, Italy
| | - Francesco Pepe
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Gilda Dalmazio
- UOSD of Endocrinology, Misericordia Hospital, Grosseto 58100, Italy
| | - Sara Bardi
- UOS Molecular Pathology, Hospital Misericordia, Grosseto 58100, Italy
| | - Agostino Ognibene
- UOS Molecular Pathology, Hospital Misericordia, Grosseto 58100, Italy
| | | | - Gabriele Materazzi
- Division of Endocrine Surgery, Department of Surgical Pathology, University Hospital of Pisa, Pisa 56124, Italy
| | - Luigi De Napoli
- Division of Endocrine Surgery, Department of Surgical Pathology, University Hospital of Pisa, Pisa 56124, Italy
| | - Michele Cirianni
- UOS Molecular Pathology, Hospital Misericordia, Grosseto 58100, Italy
| | - Liborio Torregrossa
- Department of Surgical, Medical and Molecular Pathology, University Hospital of Pisa, Pisa 56124, Italy
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Kim MK, Park H, Oh YL, Shin JH, Kim TH, Hahn SY. Association of Ultrasonography Features of Follicular Thyroid Carcinoma With Tumor Invasiveness and Prognosis Based on WHO Classification and TERT Promoter Mutation. Korean J Radiol 2024; 25:103-112. [PMID: 38184773 PMCID: PMC10788599 DOI: 10.3348/kjr.2023.0461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/20/2023] [Accepted: 11/02/2023] [Indexed: 01/08/2024] Open
Abstract
OBJECTIVE To investigate the association of ultrasound (US) features of follicular thyroid carcinoma (FTC) with tumor invasiveness and prognosis based on the World Health Organization (WHO) classification and telomerase reverse transcriptase (TERT) promoter mutations. MATERIALS AND METHODS This retrospective study included 54 surgically confirmed FTC patients with US images and TERT promoter mutations (41 females and 13 males; median age [interquartile range], 40 years [30-51 years]). The WHO classification consisted of minimally invasive (MI), encapsulated angioinvasive (EA), and widely invasive (WI) FTCs. Alternative classifications included Group 1 (MI-FTC and EA-FTC with wild type TERT), Group 2 (WI-FTC with wild type TERT), and Group 3 (EA-FTC and WI-FTC with mutant TERT). Each nodule was categorized according to the US patterns of the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and American College of Radiology-TIRADS (ACR-TIRADS). The Jonckheere-Terpstra and Cochran-Armitage tests were used for statistical analysis. RESULTS Among 54 patients, 29 (53.7%) had MI-FTC, 16 (29.6%) had EA-FTC, and nine (16.7%) had WI-FTC. In both the classifications, lobulation, irregular margins, and final assessment categories showed significant differences (all Ps ≤ 0.04). Furthermore, the incidences of lobulation, irregular margin, and high suspicion category tended to increase with increasing tumor invasiveness and worse prognosis (all Ps for trend ≤ 0.006). In the WHO groups, hypoechogenicity differed significantly among the groups (P = 0.01) and tended to increase in proportion as tumor invasiveness increased (P for trend = 0.02). In the alternative group, punctate echogenic foci were associated with prognosis (P = 0.03, P for trend = 0.03). CONCLUSION Increasing tumor invasiveness and worsening prognosis in FTC based on the WHO classification and TERT promoter mutation results were positively correlated with US features that indicate malignant probability according to both K-TIRADS and ACR-TIRADS.
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Affiliation(s)
- Myoung Kyoung Kim
- Department of Radiology and Center for Imaging Science, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyunju Park
- Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Lyun Oh
- Department of Pathology, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Hee Shin
- Department of Radiology and Center for Imaging Science, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae Hyuk Kim
- Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Soo Yeon Hahn
- Department of Radiology and Center for Imaging Science, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Matrone A, Citro F, Gambale C, Prete A, Minaldi E, Ciampi R, Ramone T, Materazzi G, Torregrossa L, Elisei R. BRAF K601E Mutation in Oncocytic Carcinoma of the Thyroid: A Case Report and Literature Review. J Clin Med 2023; 12:6970. [PMID: 38002585 PMCID: PMC10672186 DOI: 10.3390/jcm12226970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/23/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Thyroid carcinoma (TC) is the most common endocrine cancer, with papillary thyroid carcinoma (PTC) being the most common subtype. BRAF and RAS oncogene were characterized as the most frequently altered genes in PTC, with a strong association between genotype and histotype. The most common mutation in BRAF gene is V600E and is prevalent in classic and aggressive variants of PTC, while BRAF K601E mutation is the most common among the other rare BRAF mutations. BRAF K601E mutated thyroid carcinomas are usually characterized by low aggressiveness, except for anecdotal cases of poorly differentiated TC. CASE PRESENTATION We described a case of oncocytic carcinoma of the thyroid (OCA) with an aggressive clinical course, including widespread metastasis and resistance to radioiodine treatment. Molecular analysis revealed the exclusive presence of the BRAF K601E mutation in both primary tumor and metastatic lesions. Accordingly, a revision of the literature about aggressive TC cases carrying BRAF K601E mutation was performed. CONCLUSION Although rare, this case emphasizes the relevance of considering BRAF K601E mutation in advanced non-PTC thyroid carcinomas, since it can be considered an actionable mutation for target therapies.
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Affiliation(s)
- Antonio Matrone
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, Pisa University Hospital, 56124 Pisa, Italy; (F.C.); (C.G.); (A.P.); (E.M.); (R.C.); (T.R.); (R.E.)
| | - Fabrizia Citro
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, Pisa University Hospital, 56124 Pisa, Italy; (F.C.); (C.G.); (A.P.); (E.M.); (R.C.); (T.R.); (R.E.)
| | - Carla Gambale
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, Pisa University Hospital, 56124 Pisa, Italy; (F.C.); (C.G.); (A.P.); (E.M.); (R.C.); (T.R.); (R.E.)
| | - Alessandro Prete
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, Pisa University Hospital, 56124 Pisa, Italy; (F.C.); (C.G.); (A.P.); (E.M.); (R.C.); (T.R.); (R.E.)
| | - Elisa Minaldi
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, Pisa University Hospital, 56124 Pisa, Italy; (F.C.); (C.G.); (A.P.); (E.M.); (R.C.); (T.R.); (R.E.)
| | - Raffaele Ciampi
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, Pisa University Hospital, 56124 Pisa, Italy; (F.C.); (C.G.); (A.P.); (E.M.); (R.C.); (T.R.); (R.E.)
| | - Teresa Ramone
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, Pisa University Hospital, 56124 Pisa, Italy; (F.C.); (C.G.); (A.P.); (E.M.); (R.C.); (T.R.); (R.E.)
| | - Gabriele Materazzi
- Endocrine Surgery Unit, Department of Surgical, Medical, Molecular Pathology and Critical Area, Pisa University Hospital, 56126 Pisa, Italy;
| | - Liborio Torregrossa
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Anatomic Pathology Section, Pisa University Hospital, 56126 Pisa, Italy;
| | - Rossella Elisei
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, Pisa University Hospital, 56124 Pisa, Italy; (F.C.); (C.G.); (A.P.); (E.M.); (R.C.); (T.R.); (R.E.)
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4
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Expanding the Spectrum of BRAF Non-V600E Mutations in Thyroid Nodules: Evidence-Based Data from a Tertiary Referral Centre. Int J Mol Sci 2023; 24:ijms24044057. [PMID: 36835466 PMCID: PMC9958561 DOI: 10.3390/ijms24044057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/04/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
The BRAF p.V600E mutation represents the most specific marker for papillary thyroid carcinoma and is potentially related to aggressive behavior and persistent disease. BRAF alterations other than the p.V600E are less common in thyroid carcinoma and represent an alternative mechanism of BRAF activation with unclear clinical significance. The study aims to describe the frequency and clinicopathologic characteristics of BRAF non-V600E mutations in a large cohort (1654 samples) of thyroid lesions characterized by next-generation sequencing. BRAF mutations have been found in 20.3% (337/1654) of thyroid nodules, including classic (p.V600E) mutation in 19.2% (317/1654) of samples and non-V600E variants in 1.1% of cases (19/1654). BRAF non-V600E alterations include 5 cases harboring p.K601E, 2 harboring p.V600K substitutions, 2 with a p.K601G variant, and 10 cases with other BRAF non-V600E alterations. BRAF non-V600E mutations have been reported in one case of follicular adenoma, three cases of conventional papillary thyroid carcinoma, eight cases of follicular variant of papillary carcinomas, one case of columnar cell variant papillary thyroid carcinoma, one case of oncocytic follicular carcinoma, and two bone metastasis of follicular thyroid carcinoma. We confirm that BRAF non-V600E mutations are uncommon and typically found in indolent follicular-patterned tumors. Indeed, we show that BRAF non-V600E mutations can be found in tumors with metastatic potential. However, in both aggressive cases, the BRAF mutations were concomitant with other molecular alterations, such as TERT promoter mutation.
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Yang H, Yuan R, Alex D, Hughesman C, Liu S, Lee U, Zhou C, Wang G. Metastatic Small Bowel Adenocarcinoma Mimicking a Primary Ovarian Mucinous Tumour - Clinical, Radiologic, Pathologic and Molecular Correlation. Int J Surg Pathol 2023; 31:110-118. [PMID: 35477328 DOI: 10.1177/10668969221098083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We describe an interesting case of a patient who presented with a large adnexal mass, first favored to be mucinous carcinoma of the gynecologic origin. The primary tumour site was ascertained after the patient's small bowel was resected by identifying an adenomatous component evolving into an invasive adenocarcinoma identical in morphology and immunophenotype to the ovarian tumour. Notably, both tumours were found to harbor a BRAF K601E mutation, which is extremely rare for a primary of the ovary. BRAF mutations are present in a subset of large bowel and small bowel adenocarcinoma, but our case shows the first instance of a BRAF K601E mutation being present in a small bowel adenocarcinoma, to the best of our knowledge. This case serves as a great illustration of the pivotal role of molecular diagnostics in modern pathology in arriving at the correct diagnosis. Additionally, it is an excellent example of how clinical-radiologic-pathologic-molecular correlation plays into the landscape of molecular pathology to deliver optimal care for the patient.
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Affiliation(s)
- Hang Yang
- Department of Pathology and Laboratory Medicine, BC Cancer, 8144University of British Columbia, Vancouver, V6 T 2B5, Canada
| | - Ren Yuan
- Department of Radiology, BC Cancer, 8144University of British Columbia, Vancouver, V6 T 2B5, Canada
| | - Deepu Alex
- Department of Pathology and Laboratory Medicine, BC Cancer, 8144University of British Columbia, Vancouver, V6 T 2B5, Canada
| | - Curtis Hughesman
- Department of Pathology and Laboratory Medicine, BC Cancer, 8144University of British Columbia, Vancouver, V6 T 2B5, Canada
| | - Shiru Liu
- Department of Oncology, BC Cancer, 8144University of British Columbia, Vancouver, V6 T 2B5, Canada
| | - Ursula Lee
- Department of Oncology, BC Cancer, 8144University of British Columbia, Vancouver, V6 T 2B5, Canada
| | - Chen Zhou
- Department of Pathology and Laboratory Medicine, BC Cancer, 8144University of British Columbia, Vancouver, V6 T 2B5, Canada
| | - Gang Wang
- Department of Pathology and Laboratory Medicine, BC Cancer, 8144University of British Columbia, Vancouver, V6 T 2B5, Canada
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Repaci A, Salituro N, Vicennati V, Monari F, Cavicchi O, de Biase D, Ciarrocchi A, Acquaviva G, De Leo A, Gruppioni E, Pagotto U, Tallini G. Unexpected Widespread Bone Metastases from a BRAF K601N Mutated Follicular Thyroid Carcinoma within a Previously Resected Multinodular Goiter. Endocr Pathol 2022; 33:519-524. [PMID: 34843063 DOI: 10.1007/s12022-021-09698-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2021] [Indexed: 02/05/2023]
Abstract
Follicular thyroid carcinoma (FTC) represents the second most common malignant thyroid neoplasm after papillary carcinoma (PTC). FTC is characterized by the tendency to metastasize to distant sites such as bone and lung. In the last 20 years, the understanding of the molecular pathology of thyroid tumors has greatly improved. Uncommon BRAF non-V600E mutations have been identified and are generally believed to associate with follicular patterned tumors of low malignant potential, particularly non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTPs) (i.e., non-invasive encapsulated follicular variant PTC). We here report for the first time widespread bone metastases from a BRAF K601N mutated follicular tumor.
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Affiliation(s)
- Andrea Repaci
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
| | - Nicola Salituro
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Valentina Vicennati
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Fabio Monari
- Radiotherapy Unit, Policlinico Di Sant'Orsola, University of Bologna, Bologna, Italy
| | - Ottavio Cavicchi
- Department of Otolaryngology, Policlinico Di Sant'Orsola, University of Bologna, Bologna, Italy
| | - Dario de Biase
- Department of Pharmacy and Biotechnology (FaBit), Molecular Diagnostic Unit, University of Bologna, Azienda USL Di Bologna, Bologna, Italy
| | - Alessia Ciarrocchi
- Laboratory of Translational Research, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Giorgia Acquaviva
- Department of Experimental, Diagnostic and Specialty Medicine, Anatomic Pathology - Molecular Diagnostic Unit, University of Bologna, Azienda USL Di Bologna, Bologna, Italy
| | - Antonio De Leo
- Department of Experimental, Diagnostic and Specialty Medicine, Anatomic Pathology - Molecular Diagnostic Unit, University of Bologna, Azienda USL Di Bologna, Bologna, Italy
| | - Elisa Gruppioni
- Department of Pathology, Azienda Ospedaliero-Universitaria Di Bologna IRCCS Policlinico S.Orsola-Malpighi, Bologna, Italy
| | - Uberto Pagotto
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Giovanni Tallini
- Department of Experimental, Diagnostic and Specialty Medicine, Anatomic Pathology - Molecular Diagnostic Unit, University of Bologna, Azienda USL Di Bologna, Bologna, Italy
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Caterino M, Pirozzi M, Facchini S, Zotta A, Sica A, Lo Giudice G, Rauso R, Varriale E, Ciardiello F, Fasano M. Sorafenib in Metastatic Papillary Thyroid Carcinoma with BRAF K601E Mutation on Liquid Biopsy: A Case Report and Literature Review. Medicina (B Aires) 2022; 58:medicina58050666. [PMID: 35630083 PMCID: PMC9144761 DOI: 10.3390/medicina58050666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 11/16/2022] Open
Abstract
Differentiated thyroid cancer (DTC) includes papillary and follicular carcinomas and is the most common type of thyroid cancer. The incidence of this cancer has increased in the last few years, and even if its prognosis is generally good for a subset of patients that does not respond to radioactive iodine (RAI) therapy, the prognosis is much worse: the median overall survival (OS) from discovery of metastasis is 3–5 years and the 10-year survival rate is only 10%. Several mutations, including RAS or RET, as well as BRAF signaling, are associated with thyroid cancer. Liquid biopsy may be useful in selected patient to identify genomic alterations and thus allowing for a precision medicine approach with target therapy. Sorafenib, an oral multi-kinase inhibitor, can be used in the treatment of DTC. Case presentation: A 77 years old. man with diagnosis of metastatic DTC and evidence of presence of mutation of BRAF K601E on liquid biopsy was treated with sorafenib, showing a good response to the treatment and an improvement in the quality of life (QoL). Currently, this patient is still on treatment with sorafenib, gaining control of a multi-metastatic disease, generally characterized by a very poor prognosis. In conclusion, sorafenib has an active role in the treatment of DTC. It also has been considered the standard of care for patients with advanced unresectable hepatocellular carcinoma (HCC) and renal cell carcinoma (RCC). In our case we observe the efficacy of using sorafenib in Papillary thyroid carcinoma (PTC) such as confirming both stable disease (SD) in the CT scan as clinical benefit with an increase in QoL. Therefore, use of sorafenib remains an important treatment option, even in case of BRAF mutation, despite a rapidly evolving treatment landscape. It also seems important to perform liquid biopsies, especially in patients in whom it is not possible to repeat a new tissue biopsy. Ongoing clinical trials continue to evaluate sorafenib in different settings, and in combination with other therapies in DTC and HCC.
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Affiliation(s)
- Marianna Caterino
- Division of Oncology, Department of Precision Medicine, University of Campania, 80010 Naples, Italy
| | - Mario Pirozzi
- Division of Oncology, Department of Precision Medicine, University of Campania, 80010 Naples, Italy
| | - Sergio Facchini
- Division of Oncology, Department of Precision Medicine, University of Campania, 80010 Naples, Italy
| | - Alessia Zotta
- Division of Oncology, Department of Precision Medicine, University of Campania, 80010 Naples, Italy
| | - Antonello Sica
- Division of Oncology, Department of Precision Medicine, University of Campania, 80010 Naples, Italy
| | - Giorgio Lo Giudice
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Pansini, 5, 80131 Naples, Italy
| | - Raffaele Rauso
- Head and Neck Unit, Clinica Cobellis, 84078 Vallo della Lucania, Italy
| | - Elisa Varriale
- Division of Oncology, Fatebenefratelli Hospital, 80123 Naples, Italy
| | - Fortunato Ciardiello
- Division of Oncology, Department of Precision Medicine, University of Campania, 80010 Naples, Italy
| | - Morena Fasano
- Division of Oncology, Department of Precision Medicine, University of Campania, 80010 Naples, Italy
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8
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Hu C, Jing W, Chang Q, Zhang Z, Liu Z, Cao J, Zhao L, Sun Y, Wang C, Zhao H, Xiao T, Huiqin G. Risk stratification of indeterminate thyroid nodules by novel multigene testing: a study of Asians with a high risk of malignancy. Mol Oncol 2022; 16:1680-1693. [PMID: 35247035 PMCID: PMC9019878 DOI: 10.1002/1878-0261.13205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/01/2022] [Accepted: 03/03/2022] [Indexed: 11/06/2022] Open
Abstract
Molecular testing of indeterminate thyroid nodules informs about the presence of point mutations, insertions/deletions, copy number variants, RNA fusions, transcript alterations and miRNA expression. American Thyroid Association (ATA) guidelines suggest molecular testing of indeterminate thyroid nodules may be considered to supplement risk of malignancy (ROM). Although these recommendations have been incorporated in clinical practices in the US, molecular testing of indeterminate thyroid nodules isn't common practice in Asia. Here, we performed molecular testing of 140 indeterminate nodules from Chinese patients using a novel molecular platform composed of RNA and DNA-RNA classifiers, which is similar to Afirma GEC and ThyroSeq v3. Compared with reports from North America, the new RNA and DNA-RNA classifiers had a higher positive predictive value (p1=0.000, p2=0.020) but a lower negative predictive value (p1=0.004, p2=0.098), with no significant differences in sensitivity (p1=0.625, p2=0.179) or specificity (p1=0.391, p2=0.264). Out of 58 resected nodules, 10 were borderline and 33 malignant, indicating a 74.1% ROM, which was higher than reports in North America (10-40% ROM). Our findings emphasize molecular testing with the newly-reported RNA and DNA-RNA classifiers can be used as a "rule-in" test when ROM is high.
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Affiliation(s)
- Chunfang Hu
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Weiwei Jing
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Qing Chang
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Zhihui Zhang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Zhenrong Liu
- State Key Laboratory of Molecular Oncology, Department of Etiology and Carcinogenesis, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Jian Cao
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Linlin Zhao
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Yue Sun
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Cong Wang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Huan Zhao
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Ting Xiao
- State Key Laboratory of Molecular Oncology, Department of Etiology and Carcinogenesis, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Guo Huiqin
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
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9
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Park H, Shin HC, Yang H, Heo J, Ki CS, Kim HS, Kim JH, Hahn SY, Chung YJ, Kim SW, Chung JH, Oh YL, Kim TH. Molecular classification of follicular thyroid carcinoma based on TERT promoter mutations. Mod Pathol 2022; 35:186-192. [PMID: 34497362 PMCID: PMC8786663 DOI: 10.1038/s41379-021-00907-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 12/23/2022]
Abstract
Follicular thyroid carcinoma (FTC) has different clinicopathological characteristics than papillary thyroid carcinoma. However, there are no independent systems to predict cancer-specific survival (CSS) in FTC. Telomerase reverse transcriptase (TERT) promoter mutations are associated with tumor aggressiveness. Thus, it could be a potential prognostic marker. The aim of this study was to refine the CSS risk prediction using TERT promoter mutations in combination with the fourth edition of World Health Organization (WHO 2017) morphological classification. We investigated 77 FTC patients between August 1995 and November 2020. Cox regression was used to calculate hazard ratios to derive alternative groups. Disease-free survival (DFS) and CSS predictability were compared using Proportion of variation explained (PVE) and C-index. CSS was significantly different in encapsulated angioinvasive (EA)-FTC patients stratified by TERT promoter mutations [wild-type (WT-TERT) vs. mutant (M-TERT); P < 0.001] but not in minimally invasive (MI)-FTC and widely invasive (WI)-FTC patients (P = 0.691 and 0.176, respectively). We defined alternative groups as follows: Group 1 (MI-FTC with WT-TERT and M-TERT; EA-FTC with WT-TERT), Group 2 (WI-FTC with WT-TERT), and Group 3 (EA-FTC with M-TERT; WI-FTC with M-TERT). Both PVE (22.44 vs. 9.63, respectively) and C-index (0.831 vs. 0.731, respectively) for CSS were higher in the alternative groups than in the WHO 2017 groups. Likewise, both PVE (27.1 vs. 14.9, respectively) and C-index (0.846 vs. 0.794, respectively) for DFS were also higher in the alternative groups than in the WHO 2017 groups. Alternative group harmonizing of the WHO 2017 classification and TERT promoter mutations is effective in predicting CSS in FTC patients, thereby improving DFS predictability.
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Affiliation(s)
- Hyunju Park
- grid.264381.a0000 0001 2181 989XDepartment of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyeong Chan Shin
- grid.412091.f0000 0001 0669 3109Department of Pathology, Keimyung University School of Medicine, Daegu, Korea
| | - Heera Yang
- grid.264381.a0000 0001 2181 989XDepartment of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Heo
- grid.264381.a0000 0001 2181 989XDepartment of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang-Seok Ki
- grid.452575.40000 0004 4657 6187Green Cross Genome, Yongin, Korea
| | - Hye Seung Kim
- grid.264381.a0000 0001 2181 989XStatistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung-Han Kim
- grid.264381.a0000 0001 2181 989XDivision of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo Yeon Hahn
- grid.264381.a0000 0001 2181 989XDepartment of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yun Jae Chung
- grid.254224.70000 0001 0789 9563Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sun Wook Kim
- grid.264381.a0000 0001 2181 989XDepartment of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- grid.264381.a0000 0001 2181 989XDepartment of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Lyun Oh
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Tae Hyuk Kim
- Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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10
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Chen H, Song A, Wang Y, He Y, Tong J, Di J, Li C, Zhou Z, Cai X, Zhong D, Da J. BRAF V600E mutation test on fine-needle aspiration specimens of thyroid nodules: Clinical correlations for 4600 patients. Cancer Med 2021; 11:40-49. [PMID: 34851044 PMCID: PMC8704181 DOI: 10.1002/cam4.4419] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/08/2021] [Accepted: 10/23/2021] [Indexed: 12/17/2022] Open
Abstract
Background The BRAFV600E mutation is valuable for the diagnosis, prognosis, and therapy of papillary thyroid cancer (PTC). However, studies related to this mutation have involved only a small number of patients. Therefore, we performed a large‐scale analysis from a single institute to evaluate the accuracy of combined fine‐needle aspiration (FNA) and BRAFV600E mutation tests for PTC diagnosis. Methods A total of 4600 patients with thyroid nodules who underwent both FNA cytology and BRAFV600E mutation analysis on FNA specimens were enrolled. The association between the BRAFV600E mutation and clinicopathological features was analyzed. A separate analysis was performed for the 311 patients who underwent repeated FNA for comparison of cytological evaluation and BRAFV600E mutation results. The diagnostic efficacy of the BRAFV600E mutation test and cytologic diagnoses was evaluated for 516 patients who underwent preoperative FNA tests in comparison with conclusive postoperative histopathologic results. Results The cytology results of all 4600 FNA samples were categorized according to The Bethesda System for Reporting Thyroid Cytology (TBSRTC) stages I–VI, which accounted for 11.76%, 60.02%, 6.46%, 3.61%, 6.71%, and 11.43% of the samples, respectively. The BRAFV600E mutation was detected in 762 (16.57%) FNA samples, with rates of 1.48%, 0.87%, 20.20%, 3.01%, 66.02%, and 87.81% for TBSRTC I–VI lesions, respectively. Among the 311 repeat FNA cases, 81.0% of the BRAFV600E‐positive and 4.3% of the BRAFV600E‐negative specimens with an initial indication of cytological non‐malignancy were ultimately diagnosed as malignant by repeat FNA (p < 0.001). Among the 516 patients who underwent thyroidectomy, the sensitivity and specificity of the BRAFV600E mutation test alone for PTC diagnosis were 76.71% and 100.0%, respectively, which increased to 96.62% and 88.03%, respectively, when combining the BRAFV600E mutation test with cytology. BRAFV600E mutation was significantly associated with lymph node metastasis (p < 0.001), but not with age, gender, or tumor size. Conclusions The BRAFV600E mutation test in FNA samples has potential to reduce false negatives in PTC diagnosis, and therefore plays an important role in the diagnosis of thyroid nodules, especially those with an indeterminate or nondiagnostic cytology, which should be considered for repeat FNA.
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Affiliation(s)
- Huang Chen
- Department of Pathology, The China-Japan Friendship Hospital, Beijing, China
| | - Aiping Song
- Department of Pathology, The China-Japan Friendship Hospital, Beijing, China
| | - Ye Wang
- Department of Pathology, The China-Japan Friendship Hospital, Beijing, China
| | - Yifan He
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Jie Tong
- Department of Pathology, The China-Japan Friendship Hospital, Beijing, China
| | - Jinxi Di
- Department of Pathology, The China-Japan Friendship Hospital, Beijing, China
| | - Chun Li
- Department of Pathology, The China-Japan Friendship Hospital, Beijing, China
| | - Zhongren Zhou
- Department of Endocrinology, The China-Japan Friendship Hospital, Beijing, China
| | - Xiaopin Cai
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Dingrong Zhong
- Department of Pathology, The China-Japan Friendship Hospital, Beijing, China
| | - Jiping Da
- Department of Pathology, The China-Japan Friendship Hospital, Beijing, China.,Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hosptial, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
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11
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Vianello F, Censi S, Watutantrige-Fernando S, Barollo S, Zhu YH, Albiger N, Bertazza L, Manso J, Carducci S, Benna C, Iacobone M, Galuppini F, Pennelli G, Mian C. The role of the size in thyroid cancer risk stratification. Sci Rep 2021; 11:7303. [PMID: 33790328 PMCID: PMC8012699 DOI: 10.1038/s41598-021-86611-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 03/08/2021] [Indexed: 11/18/2022] Open
Abstract
Only a minority of cases of differentiated thyroid carcinoma (DTC) have a poor clinical outcome. Clinical outcomes and molecular aspects were assessed in: 144 DTC ≤ 40 mm without distant metastases (group 1); 50 DTC > 40 mm without distant metastases (group 2); and 46 DTC with distant metastases (group 3). Group 3 had a worse outcome than the other two groups: during the follow-up, patients more frequently had persistent disease, died, or underwent further treatment. The outcomes did not differ between groups 1 and 2. Group 3 had a higher prevalence of TERT promoter mutations than group 2 (32.6% vs 14%). Group 1 had a higher frequency of BRAF mutations than groups 2 or 3 (61.1% vs 16.0% and 26.1%, respectively), while RAS mutations were more common in group 2 than in groups 1 and 3 (16.0% vs 2.1% and 6.5%, respectively). Groups 1 and 2 shared the same outcome, but were genetically distinct. Only lymph node involvement, distant metastases, older age and (among the molecular markers) TERT promoter mutations were independent predictors of a worse outcome. Metastatic DTC had the worst outcome, while the outcome was identical for large and small non-metastatic DTC, although they showed different molecular patterns. TERT promoter mutations emerged as an independent factor pointing to a poor prognosis.
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Affiliation(s)
- Federica Vianello
- Department of Radiotherapy, Istituto Oncologico Veneto-IRCCS, Padua, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | | | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Yi Hang Zhu
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Nora Albiger
- Department of Radiotherapy, Istituto Oncologico Veneto-IRCCS, Padua, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Sofia Carducci
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Clara Benna
- Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Francesca Galuppini
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Gianmaria Pennelli
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy.
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12
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Preoperative Role of RAS or BRAF K601E in the Guidance of Surgery for Indeterminate Thyroid Nodules. World J Surg 2021; 44:2264-2271. [PMID: 32227276 DOI: 10.1007/s00268-020-05487-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND RAS and K601E BRAF mutations are not a reliable indicator of malignancy in fine-needle aspirations (FNA) of thyroid indeterminate cytologic nodules. We aimed to evaluate the histologic characteristics, the risk of malignancy associated with such mutations in FNA and their potential interest for preoperative clinical management of nodules. METHODS We evaluated 69 indeterminate thyroid nodules with RAS or K601E BRAF mutations with available histopathologic follow-up. All FNA specimens were indeterminate according to the thyroid Bethesda system. Diagnosis of malignant, benign or indolent neoplasms was classified according to 2017 WHO classification. Carcinoma, NIFTP (noninvasive follicular thyroid neoplasm with papillary-like features) and WDTUMP (well-differentiated tumor of uncertain malignant potential) were considered "surgical," as they require surgical excision. Adenoma was considered "non-surgical." The risk of malignancy and the risk of "surgical disease" were evaluated. RESULTS Pathologic evaluation of the 69 mutated nodules demonstrated benign, indolent and malignant histology in 17 cases (25%), 21 cases (30%) and 31 cases (45%), respectively. The risk of malignancy was 45%, and the risk of surgical disease was 75%. The majority of carcinomas were a follicular variant of papillary thyroid carcinoma. On follow-up, there have been no recurrences to date. CONCLUSION Preoperative RAS or BRAF K601E mutations detection in cytologic indeterminate thyroid nodules carries a high risk of surgical disease and may benefit from surgical management. Most surgical lesions harboring those mutations are low-risk tumors, which may be in favor of an initial lobectomy.
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13
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Censi S, Bertazza L, Piva I, Manso J, Benna C, Iacobone M, Mondin A, Plebani M, Faggian D, Galuppini F, Pennelli G, Barollo S, Mian C. Serum miR-375 for Diagnostic and Prognostic Purposes in Medullary Thyroid Carcinoma. Front Endocrinol (Lausanne) 2021; 12:647369. [PMID: 33854485 PMCID: PMC8039521 DOI: 10.3389/fendo.2021.647369] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/01/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Having previously demonstrated that tissue miR-375 expression in medullary thyroid carcinoma (MTC) tissues is linked to prognosis, the aim of this study was to assess the diagnostic and prognostic value of circulating miR-375 levels in MTC patients. METHODS A series of 68 patients with MTC was retrospectively retrieved and assessed in terms of their clinicopathological characteristics. MiR-375 levels were measured in all patients' presurgical blood samples. Both serum and tissue levels were tested prior to surgery in a subgroup of 57 patients. Serum miR-375 levels were also measured in serum from 49 patients with non-C-cell thyroid nodular diseases (non-CTN), 14 patients with pheochromocytoma, and 19 healthy controls. RESULTS Circulating miR-375 levels were 101 times higher in the serum of patients with MTC than in all other patients and controls, with no overlap (P < 0.01). No correlation emerged between serum and tissue miR-375 levels. Serum miR-375 levels were higher in MTC patients with N0 than in those with N1 disease (P = 0.01), and also in patients who were biochemically cured than in those who were not (P = 0.02). In the whole series of patients and controls, calcitonin (CT) and serum miR-375 levels were correlated at diagnosis (R2 = 0.40, P < 0.01), but in a U-shaped manner: a positive correlation was found with low CT levels, then the correlation turns negative as CT rises (in MTC patients). A negative correlation was indeed found in MTC patients between serum miR-375 and CT (R2 = -0.10, P = 0.01). On ROC curve analysis, a cut-off of 2.1 for serum miR-375 proved capable of distinguishing between MTC patients and the other patients and controls with a 92.6% sensitivity and a 97.6% specificity (AUC: 0.978, P < 0.01). CONCLUSIONS Serum miR-375 levels can serve as a marker in the diagnosis of MTC, with a remarkable specificity. Serum miR-375 also proved a novel marker of prognosis in this disease. Further in vitro experiments to corroborate our results are currently underway.
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Affiliation(s)
- Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Ilaria Piva
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Clara Benna
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Alberto Mondin
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Mario Plebani
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Diego Faggian
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Francesca Galuppini
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Gianmaria Pennelli
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- *Correspondence: Caterina Mian,
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14
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Kaabouch M, Chahdi H, Azouzi N, Oukabli M, Rharrassi I, Boudhas A, Jaddi H, Ababou M, Dakka N, Boichard A, Bakri Y, Dupuy C, Al Bouzidi A, El Hassani RA. BRAF V600E hot spot mutation in thyroid carcinomas: first Moroccan experience from a single-institution retrospective study. Afr Health Sci 2020; 20:1849-1856. [PMID: 34394248 PMCID: PMC8351865 DOI: 10.4314/ahs.v20i4.40] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The incidence of thyroid cancer is increasing worldwide at an alarming rate. BRAFV600E mutation is described to be associated with a worse prognostic of thyroid carcinomas, as well as extrathyroidal invasion and increased mortality. OBJECTIVE To our knowledge, there are no reported studies neither from Morocco nor from other Maghreb countries regarding the prevalence of BRAFV600E mutation in thyroid carcinomas. Here we aim to evaluate the frequency of BRAFV600E oncogene in Moroccan thyroid carcinomas. METHODS In this Single-Institution retrospective study realized in the Anatomic Pathology and Histology Service in the Military Hospital of Instruction Mohammed V 'HMIMV' in Rabat, we report, using direct genomic sequencing, the assessment of BRAFV600E in 37 thyroid tumors. RESULTS We detected BRAFV600E mutation exclusively in Papillary Thyroid Carcinomas 'PTC' with a prevalence of 28% (8 PTC out 29 PTC). Like international trends, Papillary Thyroid Carcinomas 'PTC' is more frequent than Follicular Thyroid Carcinomas 'FTC' and Anaplastic Thyroid Carcinomas 'ATC' (29 PTC, 7 FTC and 1 ATC). CONCLUSION Our finding gives to the international community the first estimated incidence of this oncogene in Morocco showing that this prevalence falls within the range of international trends (30% to 90%) reported in distinct worldwide geographic regions.
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Affiliation(s)
- Meryem Kaabouch
- Laboratory of Biology of Human Pathologies "BioPatH", Center for Genomics of Human Pathologies "GenoPatH". Faculty of Science in Rabat. Mohammed V University in Rabat, Morocco
- Anatomic Pathology and Histology Service, Military Hospital Mohammed V of Rabat, Morocco. Equipe de Recherche en PathologieTumorale. Faculty of Medicine and Pharmacy of Rabat, University Mohammed V of Rabat
- Faculty of Sciences in Rabat. Centre National de l'Energie, des Sciences et Techniques Nucléaires, Rabat, Morocco
| | - Hafsa Chahdi
- Anatomic Pathology and Histology Service, Military Hospital Mohammed V of Rabat, Morocco. Equipe de Recherche en PathologieTumorale. Faculty of Medicine and Pharmacy of Rabat, University Mohammed V of Rabat
| | - Naima Azouzi
- UMR 8200 CNRS, Institut Gustave Roussy, Villejuif, France
| | - Mohammed Oukabli
- Anatomic Pathology and Histology Service, Military Hospital Mohammed V of Rabat, Morocco. Equipe de Recherche en PathologieTumorale. Faculty of Medicine and Pharmacy of Rabat, University Mohammed V of Rabat
| | - Issam Rharrassi
- Anatomic Pathology and Histology Service, Military Hospital Mohammed V of Rabat, Morocco. Equipe de Recherche en PathologieTumorale. Faculty of Medicine and Pharmacy of Rabat, University Mohammed V of Rabat
| | - Adil Boudhas
- Anatomic Pathology and Histology Service, Military Hospital Mohammed V of Rabat, Morocco. Equipe de Recherche en PathologieTumorale. Faculty of Medicine and Pharmacy of Rabat, University Mohammed V of Rabat
| | - Hassan Jaddi
- Faculty of Sciences in Rabat. Centre National de l'Energie, des Sciences et Techniques Nucléaires, Rabat, Morocco
| | - Mouna Ababou
- Laboratory of Biology of Human Pathologies "BioPatH", Center for Genomics of Human Pathologies "GenoPatH". Faculty of Science in Rabat. Mohammed V University in Rabat, Morocco
| | - Nadia Dakka
- Laboratory of Biology of Human Pathologies "BioPatH", Center for Genomics of Human Pathologies "GenoPatH". Faculty of Science in Rabat. Mohammed V University in Rabat, Morocco
| | - Amélie Boichard
- UMR 8200 CNRS, Institut Gustave Roussy, Villejuif, France
- Center for Personalized Cancer Therapy. UCSD Moores Cancer Center. 3855 Health Sciences Drive. La Jolla, CA 92093
| | - Youssef Bakri
- Laboratory of Biology of Human Pathologies "BioPatH", Center for Genomics of Human Pathologies "GenoPatH". Faculty of Science in Rabat. Mohammed V University in Rabat, Morocco
| | - Corinne Dupuy
- UMR 8200 CNRS, Institut Gustave Roussy, Villejuif, France
| | - Abderrahmane Al Bouzidi
- Anatomic Pathology and Histology Service, Military Hospital Mohammed V of Rabat, Morocco. Equipe de Recherche en PathologieTumorale. Faculty of Medicine and Pharmacy of Rabat, University Mohammed V of Rabat
| | - Rabii Ameziane El Hassani
- Laboratory of Biology of Human Pathologies "BioPatH", Center for Genomics of Human Pathologies "GenoPatH". Faculty of Science in Rabat. Mohammed V University in Rabat, Morocco
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15
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Attia D, Lurie A, Zhai Q, Mesko T, Smallridge R. Case of aggressive metastatic follicular variant papillary thyroid carcinoma with BRAF K601E and BCORL1 mutations. BMJ Case Rep 2020; 13:13/6/e234208. [PMID: 32606114 DOI: 10.1136/bcr-2019-234208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BCL6 corepressor like-1 (BCORL1) mutation has rarely been described in thyroid cancer or in association with BRAF mutations in any malignancy. However, we report a 49-year-old woman who had aggressive follicular variant papillary thyroid carcinoma (FV-PTC) with both the BRAF K601E and BCORL1 mutations. The patient underwent a total thyroidectomy for a 3.6 cm right thyroid nodule and a smaller lesion in the left lobe in 2007; both were FV-PTCs with no lymphovascular invasion or metastases. In 2015, a positron emission tomography-CT scan showed a small defect in the left posterior lateral fifth rib with mild increased hypermetabolic activity with standardised uptake value of 3.9 and another lesion in the right hip at the junction of the femoral neck and trochanter. Tumour biopsy and genetic analysis revealed an uncommon BRAF K601E and a rare BCORL1 mutation. While rare, we report a case of aggressive FV-PTC with both the BRAF K601E and BCORL1 mutations.
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Affiliation(s)
- Doaa Attia
- Internal Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Alexander Lurie
- Department of Endocrinology, Diabetes, and Metabolism, Femwell Health Group, Miami Beach, Florida, USA
| | - Qihui Zhai
- Department of Laboratory Medicine and Pathology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | | | - Robert Smallridge
- Department of Endocrinology, Diabetes, and Metabolism, Mayo Clinic Florida, Jacksonville, Florida, USA
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16
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Abstract
Given the long-term survival of most patients with thyroid cancer, it is very important to distinguish patients who need aggressive treatment from those who do not. Conventional clinicopathological prognostic parameters could not completely predict the final outcome of each patient. Recently, molecular marker-based risk stratification of thyroid cancer has been proposed to better estimate the cancer risk. Although BRAF mutation has drawn much attention based on its high prevalence, its association with recurrence or mortality is not clear. Recently, telomerase reverse transcriptase (TERT) promoter mutation has been identified in thyroid cancer. It increases telomerase activity, which allows cancer cells to immortalize. It was found in 10 to 20% of differentiated thyroid carcinoma and 40% of dedifferentiated thyroid carcinoma. It is highly prevalent in old age, large tumor, aggressive histology, advanced stages, and distant metastasis. It is associated with increased recurrence and mortality. Concomitant BRAF and TERT promoter mutations worsen the survival rate. Inclusion of TERT promoter mutation analysis with conventional clinicopathological evaluation can lead to better prognostication and management for individual patients.
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Affiliation(s)
- Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine and Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
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17
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Paniza ACDJ, Mendes TB, Viana MDB, Thomaz DMD, Chiappini PBO, Colozza-Gama GA, Lindsey SC, de Carvalho MB, Alves VAF, Curioni O, Bastos AU, Cerutti JM. Revised criteria for diagnosis of NIFTP reveals a better correlation with tumor biological behavior. Endocr Connect 2019; 8:1529-1538. [PMID: 31671409 PMCID: PMC6893310 DOI: 10.1530/ec-19-0459] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 10/31/2019] [Indexed: 12/20/2022]
Abstract
The recent reclassification of a follicular variant of papillary thyroid carcinoma (FVPTC), subset as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), aims to avoid overtreatment of patients with an indolent lesion. The diagnosis of NIFTP has recently been revisited using more rigid criteria. This study presents histological and molecular findings and a long clinical follow-up of 94 FVPTC, 40 cases of follicular adenoma (FTA) and 22 cases of follicular carcinoma (FTC) that were classified before the advent of the NIFTP reclassification. All slides were reviewed using these rigid criteria and analysis of numerous sections of paraffin blocks and reclassified as 7 NIFTPs, 2 EFVPTCs, 29 infiltrative FVPTC (IFVPTCs), 57 invasive EFVPTC (I-EFVPTCs), 39 FTAs and 22 FTCs. Remarkably, EFVPTC and NIFTP patients were all free of disease at the end of follow-up and showed no BRAF mutation. Only one NIFTP sample harbored mutations, an NRAS Q61R. PAX8/PPARG fusion was found in I-EFVPTCs and FTC. Although additional studies are needed to identify a specific molecular profile to aid in the diagnosis of lesions with borderline morphological characteristics, we confirmed that the BRAF V600E mutation is an important tool to exclude the diagnosis of NIFTP. We also show that rigorous histopathological criteria should be strongly followed to avoid missing lesions in which more aggressive behavior is present, mainly via the analysis of capsule or vascular invasion and the presence of papillary structures.
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Affiliation(s)
- Ana Carolina de Jesus Paniza
- Division of Genetics, Department of Morphology and Genetics, Genetic Bases of Thyroid Tumors Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Thais Biude Mendes
- Division of Genetics, Department of Morphology and Genetics, Genetic Bases of Thyroid Tumors Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Matheus Duarte Borges Viana
- Division of Genetics, Department of Morphology and Genetics, Genetic Bases of Thyroid Tumors Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Débora Mota Dias Thomaz
- Division of Genetics, Department of Morphology and Genetics, Genetic Bases of Thyroid Tumors Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Gabriel A Colozza-Gama
- Division of Genetics, Department of Morphology and Genetics, Genetic Bases of Thyroid Tumors Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Susan Chow Lindsey
- Division of Endocrinology, Department of Medicine, Laboratory of Molecular and Translational Endocrinology, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | - Otavio Curioni
- Department of Head and Neck Surgery and Otorhinolaryngology, Hospital Heliópolis, São Paulo, Brazil
| | - André Uchimura Bastos
- Division of Genetics, Department of Morphology and Genetics, Genetic Bases of Thyroid Tumors Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Microbiology, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Janete Maria Cerutti
- Division of Genetics, Department of Morphology and Genetics, Genetic Bases of Thyroid Tumors Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil
- Correspondence should be addressed to J M Cerutti:
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18
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Galuppini F, Vianello F, Censi S, Barollo S, Bertazza L, Carducci S, Colato C, Manso J, Rugge M, Iacobone M, Watutantrige Fernando S, Pennelli G, Mian C. Differentiated Thyroid Carcinoma in Pediatric Age: Genetic and Clinical Scenario. Front Endocrinol (Lausanne) 2019; 10:552. [PMID: 31456750 PMCID: PMC6698790 DOI: 10.3389/fendo.2019.00552] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 07/25/2019] [Indexed: 12/04/2022] Open
Abstract
Introduction: Follicular-derived differentiated thyroid carcinoma (DTC) is the most common endocrine and epithelial malignancy in children. The differences in the clinical and pathological features of pediatric vs. adult DTC could relate to a different genetic profile. Few studies are currently available in this issue, however, and most of them involved a limited number of patients and focused mainly on radiation-exposed populations. Materials and Methods: We considered 59 pediatric patients who underwent surgery for DTC between 2000 and 2017. RET/PTC rearrangement was investigated with fluorescent in situ hybridization and real-time polymerase chain reaction. Sequencing was used to analyze mutations in the BRAF, NRAS, PTEN, PIK3CA genes, and the TERT promoter. The pediatric patients' clinical and molecular features were compared with those of 178 adult patients. Results: In our pediatric sample, male gender and age <15 years coincided with more extensive disease and more frequent lymph node and distant metastases. Compared with adults, the pediatric patients were more likely to have lymph node and distant metastasis, and to need second treatments (p < 0.01). In all, 44% of the pediatric patients were found to carry molecular alterations. RET/PTC rearrangement was confirmed as the most frequent genetic alteration in childhood DTC (24.6%) and correlated with aggressive features. BRAFV600E was only identified in 16% of the pediatric DTCs, while NRASQ61R, NRASQ61K, and TERTC250T mutations were very rare. Conclusions: Pediatric DTC is more aggressive at diagnosis and more likely to recur than its adult counterpart. Unlike the adult disease, point mutations have no key genetic role.
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Affiliation(s)
- Francesca Galuppini
- Pathology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
- Department of Women's and Children's Health, Padova University Hospital, Padova, Italy
| | - Federica Vianello
- Department of Radiotherapy, Istituto Oncologico del Veneto, IOV-IRCCS, Padova, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Sofia Carducci
- Endocrinology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Chiara Colato
- Pathology Section, Department of Pathology and Diagnostics, University of Verona, Verona, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Massimo Rugge
- Pathology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), Padova University Hospital, Padova, Italy
| | | | - Gianmaria Pennelli
- Pathology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
- *Correspondence: Caterina Mian
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Ahmad F, Nathani R, Venkat J, Bharda A, Vanere V, Bhatia S, Das BR. Molecular evaluation of BRAF gene mutation in thyroid tumors: Significant association with papillary tumors and extra thyroidal extension indicating its role as a biomarker of aggressive disease. Exp Mol Pathol 2018; 105:380-386. [DOI: 10.1016/j.yexmp.2018.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/29/2018] [Accepted: 11/06/2018] [Indexed: 01/08/2023]
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Feng Y, Feng G, Lu X, Qian W, Ye J, Manrique CA, Ma C, Lu Y. Exploratory analysis of introducing next-generation sequencing-based method to treatment-naive lung cancer patients. J Thorac Dis 2018; 10:5904-5912. [PMID: 30505499 DOI: 10.21037/jtd.2018.09.108] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background The utilization of cancer-linked genetic alterations for categorizing patients against optimal treatment is becoming increasingly popular, especially in non-small cell lung cancer (NSCLC). However, disadvantages of the conventional techniques, such as the low throughput and limited detectable alteration types, lead to the demand of large-scale parallel sequencing for different forms of genetic variants. Methods We evaluated the potential of performing next-generation sequencing (NGS)-based methods in a cohort of 61 treatment-naive NSCLC patients to profile their driver mutations, using a panel consisting of 8 well-established driver genes of lung cancer. Results Our data revealed that 80% of patients harbored driver mutations. Moreover, our data revealed a few rare mutations, such as BRAF K601E and EGFR exon 20 insertion, which cannot be detected using commercially available single gene testing kits of conventional methods. We detected one patient with dual driver mutations. Next, correlations between driver mutations and clinical characteristics were interrogated in this cohort. Our results revealed that EGFR alterations were positively correlated with early stage, adenocarcinoma, alveolar and papillary component, TTF1 expression, and negatively correlated with P40 and Ki67 expression. ERBB2 alterations were associated with younger age and micro-invasive feature of tumor. Rearrangements of ALK indicated tumor relapse. Conclusions Our study highlights the potential of NGS-based methods in treatment-naive patients, thus paving its way for routine clinical use. Investigation of clinical correlation of driver mutations might be helpful for clinicians in cancer diagnosis and has implications for seeking patients with specific gene alteration in clinical studies.
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Affiliation(s)
- Yufang Feng
- Department of Pathology, Zhangjiagang First Peoples Hospital, Suzhou 215000, China
| | - Gaohua Feng
- Department of Respiratory Medicine, Zhangjiagang Hospital of Traditional Chinese Medicine, Suzhou 215000, China
| | - Xiaoling Lu
- Department of Oncology, Zhangjiagang First Peoples Hospital, Suzhou 215000, China
| | - Wenxia Qian
- Department of Respiratory Medicine, Zhangjiagang First Peoples Hospital, Suzhou 215000, China
| | - Junyi Ye
- Burning Rock Biotech, Guangzhou 510000, China
| | - Carmen Areses Manrique
- Complexo Hospitalario Universitario de Ourense, Calle Ramon Puga Noguerol, Ourense, Spain
| | - Chunping Ma
- Department of Thoracic Surgery, Zhangjiagang First Peoples Hospital, Suzhou 215000, China
| | - Yadong Lu
- Department of Thoracic Surgery, Zhangjiagang First Peoples Hospital, Suzhou 215000, China
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Bertazza L, Sensi F, Cavedon E, Watutantrige-Fernando S, Censi S, Manso J, Vianello F, Casal Ide E, Iacobone M, Pezzani R, Mian C, Barollo S. EF24 (a Curcumin Analog) and ZSTK474 Emphasize the Effect of Cabozantinib in Medullary Thyroid Cancer. Endocrinology 2018; 159:2348-2360. [PMID: 29688429 DOI: 10.1210/en.2018-00124] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/18/2018] [Indexed: 12/11/2022]
Abstract
XL184 is a small-molecule kinase inhibitor recently included in first-line systemic therapy for patients with advanced, progressive medullary thyroid cancer (MTC). EF24 is a curcumin analog with a high bioavailability, and ZSTK474 is an inhibitor of the phosphatidylinositol 3-kinase signaling pathway. We investigated the effect of these compounds, alone and in combination, in two rearranged during transfection (RET)-mutated TT and MZ-CRC-1 MTC cell lines and in six mostly RET wild-type human MTC primary cultures. Low IC50 values demonstrated the efficacy of the drugs, whereas the combination index revealed an important synergistic effect of combinations of XL184 + ZSTK474 and XL184 + EF24. Cell-cycle changes and the induction of apoptosis or necrosis were modulated by single compounds or combinations thereof. Both XL184 and EF24, alone or combined, were effective in reducing calcitonin secretion. Western blot and in-cell Western analysis showed that the compounds prompted a decrease in general reactivity to phosphorylated antibodies. Our data confirm XL184 alone as the reference drug for RET-mutated MTC, but we also demonstrated that EF24 alone is effective in inhibiting MTC cell viability. We tested the combinations XL184 + ZSTK474 and XL184 + EF24 too, finding that they act synergistically, irrespective of RET mutation status.
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Affiliation(s)
- Loris Bertazza
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
| | - Francesca Sensi
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
| | - Elisabetta Cavedon
- Department of Radiotherapy, Istituto Oncologico Veneto-Istituto Di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - Sara Watutantrige-Fernando
- Department of Radiotherapy, Istituto Oncologico Veneto-Istituto Di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
| | - Federica Vianello
- Department of Radiotherapy, Istituto Oncologico Veneto-Istituto Di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - Eric Casal Ide
- Surgical Pathology Unit, Department of Surgical, Oncological and Gastroenterological Sciences, Padua University Hospital, Padova, Italy
| | - Maurizio Iacobone
- Surgical Pathology Unit, Department of Surgical, Oncological and Gastroenterological Sciences, Padua University Hospital, Padova, Italy
| | - Raffaele Pezzani
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
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MiR-375 and YAP1 expression profiling in medullary thyroid carcinoma and their correlation with clinical-pathological features and outcome. Virchows Arch 2017; 471:651-658. [PMID: 28861609 DOI: 10.1007/s00428-017-2227-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 07/31/2017] [Accepted: 08/23/2017] [Indexed: 12/12/2022]
Abstract
Medullary thyroid cancer (MTC) is a tumor marked by an indolent growth for which few prognostic factors and therapeutic strategies are actually available. Different studies have recently appraised well-differentiated thyroid cancers are characterized by a dysregulation in different microRNA sets; however, only few of them investigated the role of miRNA expression in MTCs. In this study, we have assessed the miR-375 expression in a series of 130 MTCs (104 are sporadic and 26 familial) with a median follow-up of 39 months (range 1-138) and then we have correlated our results with the clinical-pathological features and the patients' outcome.Moreover, we have appraised YAP1 (Yes-associated protein 1) immunohistochemical expression in the same MTC series and in 5 C-cells hyperplasia (CCH) samples as well. We observed a significant upregulation of miR-375 in all MTCs, when compared to the normal thyroid tissues. Besides, miR-375 expression was found to be closely linked to neoplastic size, a chance of thyroid capsule infiltration, the risk of lymph node metastasis, and the staging of the tumor. At the end of follow-up, only 10% (13/130) showed a tumor progression and a higher miR-375 expression was found to be closely linked to a worst patient' outcome. On the contrary, YAP1 immunohistochemical expression was sharply downregulated in tumors, whereas it was weakly expressed in CCHs. Our results suggest miR-375 plays a central role in MTC progression and, therefore, we seek following the idea that miR-375 pathway may be an effective target in novel MTC therapeutic strategies.
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Comparison Between Real-Time PCR and Pyrosequencing for Detection of BRAF V600E Mutation in Thyroid Fine-Needle Aspirates. Appl Immunohistochem Mol Morphol 2017; 25:358-365. [DOI: 10.1097/pai.0000000000000308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Macerola E, Torregrossa L, Ugolini C, Bakkar S, Vitti P, Fadda G, Basolo F. BRAF K601E Mutation in a Follicular Thyroid Adenoma: A Case Report. Int J Surg Pathol 2017; 25:348-351. [PMID: 28112041 DOI: 10.1177/1066896916688083] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BRAF mutations represent the most common genetic alteration in papillary thyroid carcinoma (PTC). The p.V600E mutation is specific for the classic and tall-cell variants of PTC and has been associated with a more aggressive biologic behavior. On the other hand, the p.K601E mutation is peculiar to the follicular variant of PTC, and seems to be a favorable prognostic indicator. A 12-year-old boy presented with a 10-mm left-sided thyroid nodule. Fine-needle aspiration cytology reported the lesion as suspicious for a follicular neoplasm (Bethesda category IV). The patient underwent lobectomy, and histopathology revealed a follicular adenoma with normal surrounding tissue. The cytological smear was found to be positive for BRAF p.K601E mutation, and this was later confirmed on the corresponding paraffin block. This case was independently revised by 4 expert pathologists, all of whom confirmed the benign nature of the thyroid lesion. This article describes the presence of a BRAF mutation in a benign thyroid lesion. To the authors' knowledge, this is the fourth case of follicular adenoma carrying BRAFK601E reported in literature to date. BRAFK601E mutation can occur in benign thyroid lesions. This finding, in the context of the current literature and the recently proposed reclassification of the noninvasive encapsulated follicular variant of papillary thyroid carcinoma into a benign lesion, confirms the importance of preoperative BRAF p.K601E testing in offering patients a tailored treatment plan and avoiding overtreatment.
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Affiliation(s)
| | | | | | | | | | - Guido Fadda
- 3 Catholic University, Foundation Agostino Gemelli University Hospital, Rome, Italy
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25
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Censi S, Cavedon E, Bertazza L, Galuppini F, Watutantrige-Fernando S, De Lazzari P, Nacamulli D, Pennelli G, Fassina A, Iacobone M, Casal Ide E, Vianello F, Barollo S, Mian C. Frequency and Significance of Ras, Tert Promoter, and Braf Mutations in Cytologically Indeterminate Thyroid Nodules: A Monocentric Case Series at a Tertiary-Level Endocrinology Unit. Front Endocrinol (Lausanne) 2017; 8:273. [PMID: 29085338 PMCID: PMC5650698 DOI: 10.3389/fendo.2017.00273] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 09/27/2017] [Indexed: 01/21/2023] Open
Abstract
PURPOSE The management of thyroid nodules of indeterminate cytology is controversial. Our study aimed to establish the frequency and significance of H-,K-,N-RAS, TERT promoter, and BRAF gene mutations in thyroid nodes of indeterminate cytology and to assess their potential usefulness in clinical practice. METHODS H-,K-,N-RAS, TERT promoter and BRAF gene mutations were examined in a series of 199 consecutive nodes of indeterminate cytology referred for surgical excision. RESULTS 69/199 (35%) were malignant on histopathological review. RAS mutations were detected in 36/199 (18%), and 19/36 cases (53%) were malignant on histological diagnosis. TERT promoter mutations were detected in 7/199 (4%) nodules, which were all malignant lesions. BRAF mutations were detected in 15/199 (8%), and a BRAF K601E mutation was identified in 2 follicular adenomas and 1 noninvasive follicular thyroid neoplasm with papillary-like nuclear features. Altogether, this panel was able to identify 48% of the malignant lesions, achieving a specificity, positive predictive value, and negative predictive value for malignancy of 85, 62, and 75%, respectively. CONCLUSION The residual malignancy risk in mutation-negative nodes is 25%. These nodes still need to be resected, but mutation analysis could help to orient the appropriate surgical strategy.
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Affiliation(s)
- Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Elisabetta Cavedon
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Francesca Galuppini
- Surgical Pathology and Cytopathology Unit, Pathology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | | | - Paola De Lazzari
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Davide Nacamulli
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Gianmaria Pennelli
- Surgical Pathology and Cytopathology Unit, Pathology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Ambrogio Fassina
- Surgical Pathology and Cytopathology Unit, Pathology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padova, Padova, Italy
| | - Eric Casal Ide
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padova, Padova, Italy
| | - Federica Vianello
- Department of Radiotherapy, Istituto Oncologico Veneto-IRCCS, Padova, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
- *Correspondence: Caterina Mian,
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Computerized cytometry and wavelet analysis of follicular lesions for detecting malignancy: A pilot study in thyroid cytology. Surgery 2017; 161:212-219. [DOI: 10.1016/j.surg.2016.06.078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/29/2016] [Accepted: 06/24/2016] [Indexed: 11/23/2022]
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27
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Cavedon E, Barollo S, Bertazza L, Pennelli G, Galuppini F, Watutantrige-Fernando S, Censi S, Iacobone M, Benna C, Vianello F, Zovato S, Nacamulli D, Mian C. Prognostic Impact of miR-224 and RAS Mutations in Medullary Thyroid Carcinoma. Int J Endocrinol 2017; 2017:4915736. [PMID: 28676824 PMCID: PMC5476902 DOI: 10.1155/2017/4915736] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/17/2017] [Accepted: 04/11/2017] [Indexed: 02/06/2023] Open
Abstract
Little is known about the function of microRNA-224 (miR-224) in medullary thyroid cancer (MTC). This study investigated the role of miR-224 expression in MTC and correlated it with mutation status in sporadic MTCs. A consecutive series of 134 MTCs were considered. Patients had a sporadic form in 80% of cases (107/134). In this group, REarranged during transfection (RET) and rat sarcoma (RAS) mutation status were assessed by direct sequencing in the tumor tissues. Quantitative real-time polymerase chain reaction was used to quantify mature hsa-miR-224 in tumor tissue. RAS (10/107 cases, 9%) and RET (39/107 cases, 36%) mutations were mutually exclusive in sporadic cases. miR-224 expression was significantly downregulated in patients with the following: high calcitonin levels at diagnosis (p = 0.03, r = -0.3); advanced stage (p = 0.001); persistent disease (p = 0.001); progressive disease (p = 0.002); and disease-related death (p = 0.0001). We found a significant positive correlation between miR-224 expression and somatic RAS mutations (p = 0.007). Patients whose MTCs had a low miR-224 expression tended to have a shorter overall survival (log-rank test p = 0.005). On multivariate analysis, miR-224 represented an independent prognostic marker. Our data indicate that miR-224 is upregulated in RAS-mutated MTCs and in patients with a better prognosis and could represent an independent prognostic marker in MTC patients.
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Affiliation(s)
- Elisabetta Cavedon
- Familial Tumor Unit, Veneto Institute of Oncology, (IOV)-IRCCS, Padova, Italy
- *Elisabetta Cavedon:
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Gianmaria Pennelli
- Surgical Pathology & Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Francesca Galuppini
- Surgical Pathology & Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | | | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Maurizio Iacobone
- Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DISCOG), University of Padua, Padua, Italy
| | - Clara Benna
- Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DISCOG), University of Padua, Padua, Italy
| | - Federica Vianello
- Department of Radiotherapy, Veneto Institute of Oncology (IOV)-IRCCS, Padova, Italy
| | - Stefania Zovato
- Familial Tumor Unit, Veneto Institute of Oncology, (IOV)-IRCCS, Padova, Italy
| | - Davide Nacamulli
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Lee MY, Ku BM, Kim HS, Lee JY, Lim SH, Sun JM, Lee SH, Park K, Oh YL, Hong M, Jeong HS, Son YI, Baek CH, Ahn MJ. Genetic Alterations and Their Clinical Implications in High-Recurrence Risk Papillary Thyroid Cancer. Cancer Res Treat 2016; 49:906-914. [PMID: 28052655 PMCID: PMC5654158 DOI: 10.4143/crt.2016.424] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 12/09/2016] [Indexed: 12/17/2022] Open
Abstract
Purpose
Papillary thyroid carcinomas (PTCs) frequently involve genetic alterations. The objective of this study was to investigate genetic alterations and further explore the relationships between these genetic alterations and clinicopathological characteristics in a high-recurrence risk (node positive, N1) PTC group.
Materials and Methods
Tumor tissue blocks were obtained from 240 surgically resected patients with histologically confirmed stage III/IV (pT3/4 or N1) PTCs. We screened gene fusions using NanoString’s nCounter technology and mutational analysis was performed by direct DNA sequencing. Data describing the clinicopathological characteristics and clinical courses were retrospectively collected.
Results
Of the 240 PTC patients, 207 (86.3%) had at least one genetic alteration, including BRAF mutation in 190 patients (79.2%), PIK3CA mutation in 25 patients (10.4%), NTRK1/3 fusion in six patients (2.5%), and RET fusion in 24 patients (10.0%). Concomitant presence of more than two genetic alterations was seen in 36 patients (15%). PTCs harboring BRAF mutation were associated with RET wild-type expression (p=0.001). RET fusion genes have been found to occur with significantly higher frequency in N1b stage patients (p=0.003) or groups of patients aged 45 years or older (p=0.031); however, no significant correlation was found between other genetic alterations. There was no trend toward favorable recurrence-free survival or overall survival among patients lacking genetic alterations. Conclusion
In the selected high-recurrence risk PTC group, most patients had more than one genetic alteration. However, these known alterations could not entirely account for clinicopathological features of high-recurrence risk PTC.
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Affiliation(s)
- Min-Young Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Bo Mi Ku
- Samsung Biomedical Research Institute, Seoul, Korea
| | - Hae Su Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Yun Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Hee Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong-Mu Sun
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se-Hoon Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keunchil Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Mineui Hong
- Department of Pathology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Han-Sin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Ik Son
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chung-Hwan Baek
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung-Ju Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Rossi ED, Bizzarro T, Longatto-Filho A, Gerhard R, Schmitt F. The diagnostic and prognostic role of liquid-based cytology: are we ready to monitor therapy and resistance? Expert Rev Anticancer Ther 2016. [PMID: 26204907 DOI: 10.1586/14737140.2015.1053874] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Here, we evaluate the diagnostic and prognostic role of liquid-based cytology (LBC) in different body lesions, including thyroid, lung, effusions and malignant breast lesions. LBC has gained consensus after being applied to both non-gynecologic and fine-needle aspiration cytology. Although some remain sceptical regarding the diagnostic efficacy of LBC, mainly when used alone, in recent years, good results have been obtained as long as it showed a high diagnostic accuracy. Here, we discuss the additional possibility of storing material for the application of ancillary techniques (immunocytochemistry-molecular analysis) with several diagnostic and prognostic advantages, which may pave the way for the challenging evaluation of both monitoring responses to treatment and resistance to targeted therapies in thyroid, lung, breast carcinoma or malignant effusions. Furthermore, it provides the use of several molecular spots as specific targets for personalized therapy.
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Affiliation(s)
- Esther Diana Rossi
- Division of Anatomic Pathology and Histology - Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
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Afkhami M, Karunamurthy A, Chiosea S, Nikiforova MN, Seethala R, Nikiforov YE, Coyne C. Histopathologic and Clinical Characterization of Thyroid Tumors Carrying the BRAF(K601E) Mutation. Thyroid 2016; 26:242-7. [PMID: 26422023 DOI: 10.1089/thy.2015.0227] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND While the association of the BRAF(V600E) mutation with aggressive histopathological tumor features and clinical behavior has been extensively studied in papillary thyroid carcinoma (PTC), the BRAF(K601E) mutation has not been well characterized. This study reports what is currently the largest series of BRAF(K601E) mutated thyroid nodules. METHODS Histopathologic, cytologic, and molecular reports over a period of seven years (June 2007 to June 2014) were reviewed to identify thyroid cases with various types of BRAF mutations. All cases positive for the BRAF(K601E) mutation were reviewed to confirm histopathologic diagnosis and establish tumor variant, and clinical charts were reviewed to obtain clinical characteristics and follow-up information. RESULTS The BRAF(K601E) mutation was identified in 39 patients and comprised 5.3% of all BRAF mutations noted in thyroidectomy specimens. Twenty-seven out of 29 nodules (93%) with BRAF(K601E) mutated tumors with surgical pathology results available for review were PTC, one (3.4%) was a follicular thyroid carcinoma, and one (3.4%) was a follicular adenoma. The majority of K601E-mutant PTCs (20 cases) were follicular variant PTC. Encapsulation was present in all but one case, and one case showed capsular invasion. Coexisting mutations overall were not identified in BRAF(K601E) mutated thyroid nodules except in a case that exhibited a complex K601E + T599I mutation and had a classic PTC phenotype. The majority of K601E mutant nodules were T1 lesions (69%) and T2 lesions (28%) by TNM staging. With a median follow-up of 19.6 months, no structural or biochemical recurrence or metastases were found in patients with an isolated BRAF(K601E) mutation. CONCLUSIONS The BRAF(K601E) mutation is the second most common BRAF mutation found in thyroid nodules. Unlike BRAF(V600E), the most common mutation, K601E is strongly associated with follicular-patterned cancer, particularly with the encapsulated follicular variant of PTC, and may also be found in follicular thyroid carcinomas. Overall, BRAF(K601E) mutant tumors show better clinical outcomes than BRAF(V600E) positive tumors, and preoperative BRAF(K601E) analysis may provide important prognostic information for use in clinical management.
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Affiliation(s)
- Michelle Afkhami
- Department of Medicine, Division of Endocrinology, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - Arivarasan Karunamurthy
- Department of Medicine, Division of Endocrinology, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - Simion Chiosea
- Department of Medicine, Division of Endocrinology, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - Marina N Nikiforova
- Department of Medicine, Division of Endocrinology, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - Raja Seethala
- Department of Medicine, Division of Endocrinology, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - Yuri E Nikiforov
- Department of Medicine, Division of Endocrinology, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - Christopher Coyne
- Department of Medicine, Division of Endocrinology, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
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Rubin B, Monticelli H, Redaelli M, Mucignat C, Barollo S, Bertazza L, Mian C, Betterle C, Iacobone M, Fassina A, Boscaro M, Pezzani R, Mantero F. Mitogen-Activated Protein Kinase Pathway: Genetic Analysis of 95 Adrenocortical Tumors. Cancer Invest 2015; 33:526-31. [DOI: 10.3109/07357907.2015.1080832] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Cribriform-morular variant of papillary thyroid carcinoma: a study of 3 cases featuring the PIK3CA mutation. Hum Pathol 2015; 46:1180-8. [DOI: 10.1016/j.humpath.2015.04.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/23/2015] [Accepted: 04/24/2015] [Indexed: 02/06/2023]
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Rossi ED, Martini M, Bizzarro T, Capodimonti S, Cenci T, Lombardi CP, Pontecorvi A, Fadda G, Larocca LM. UncommonBRAFmutations in the follicular variant of thyroid papillary carcinoma: New insights. Cancer Cytopathol 2015; 123:593-602. [DOI: 10.1002/cncy.21586] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 06/23/2015] [Accepted: 06/23/2015] [Indexed: 01/21/2023]
Affiliation(s)
- Esther Diana Rossi
- Division of Anatomic Pathology and Histology, “Agostino Gemelli” School of Medicine; Catholic University of the Sacred Heart; Rome Italy
| | - Maurizio Martini
- Division of Anatomic Pathology and Histology, “Agostino Gemelli” School of Medicine; Catholic University of the Sacred Heart; Rome Italy
| | - Tommaso Bizzarro
- Division of Anatomic Pathology and Histology, “Agostino Gemelli” School of Medicine; Catholic University of the Sacred Heart; Rome Italy
| | - Sara Capodimonti
- Division of Anatomic Pathology and Histology, “Agostino Gemelli” School of Medicine; Catholic University of the Sacred Heart; Rome Italy
| | - Tonia Cenci
- Division of Anatomic Pathology and Histology, “Agostino Gemelli” School of Medicine; Catholic University of the Sacred Heart; Rome Italy
| | - Celestino Pio Lombardi
- Division of Endocrine Surgery, “Agostino Gemelli” School of Medicine; Catholic University of the Sacred Heart; Rome Italy
| | - Alfredo Pontecorvi
- Division of Endocrinology, “Agostino Gemelli” School of Medicine; Catholic University of the Sacred Heart; Rome Italy
| | - Guido Fadda
- Division of Anatomic Pathology and Histology, “Agostino Gemelli” School of Medicine; Catholic University of the Sacred Heart; Rome Italy
| | - Luigi Maria Larocca
- Division of Anatomic Pathology and Histology, “Agostino Gemelli” School of Medicine; Catholic University of the Sacred Heart; Rome Italy
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Marino M, Monzani ML, Brigante G, Cioni K, Madeo B, Santi D, Maiorana A, Bettelli S, Moriondo V, Pignatti E, Bonacini L, Carani C, Rochira V, Simoni M. High-Resolution Melting Is a Sensitive, Cost-Effective, Time-Saving Technique for BRAF V600E Detection in Thyroid FNAB Washing Liquid: A Prospective Cohort Study. Eur Thyroid J 2015; 4:73-81. [PMID: 26279992 PMCID: PMC4521072 DOI: 10.1159/000430092] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 04/09/2015] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE The diagnostic accuracy of thyroid fine needle aspiration biopsy (FNAB) can be improved by the combination of cytological and molecular analysis. In this study, washing liquids of FNAB (wFNAB) were tested for the BRAF V600E mutation, using the sensitive and cost-effective technique called high-resolution melting (HRM). The aim was to demonstrate the feasibility of BRAF analysis in wFNAB and its diagnostic utility, combined with cytology. DESIGN Prospective cohort study. METHODS 481 patients, corresponding to 648 FNAB samples, were subjected to both cytological (on cells smeared onto a glass slide) and molecular analysis (on fluids obtained washing the FNAB needle with 1 ml of saline) of the same aspiration. BRAF V600E analysis was performed by HRM after methodological validation for application to wFNAB (technique sensitivity: 5.4%). RESULTS The cytological results of the FNAB were: 136 (21%) nondiagnostic (THY1); 415 (64%) benign (THY2); 80 (12.4%) indeterminate (THY3); 9 (1.4%) suspicious for malignancy (THY4); 8 (1.2%) diagnostic of malignancy (THY5). The BRAF V600E mutation was found in 5 THY2, 2 THY3, 6 THY4 and 6 THY5 samples. Papillary carcinoma diagnosis was histologically confirmed in all BRAF+ thyroidectomized patients. BRAF combined with cytology improved the diagnostic value compared to cytology alone in a subgroup of 74 operated patients. CONCLUSIONS HRM was demonstrated to be a feasible method for BRAF analysis in wFNAB. Thanks to its sensitivity and cost-effectiveness, it might be routinely used on a large scale in clinical practice. In perspective, standby wFNAB samples could be analyzed a posteriori in case of indeterminate cytology and/or suspicious findings on ultrasound.
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Affiliation(s)
- Marco Marino
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
- Center for Genomic Research, University of Modena and Reggio Emilia, Italy
| | - Maria Laura Monzani
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
- Azienda USL of Modena, Modena, Italy
| | - Giulia Brigante
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
- Azienda USL of Modena, Modena, Italy
| | - Katia Cioni
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
- Azienda USL of Modena, Modena, Italy
| | - Bruno Madeo
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
- Azienda USL of Modena, Modena, Italy
| | - Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
- Azienda USL of Modena, Modena, Italy
| | - Antonino Maiorana
- Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Italy
| | - Stefania Bettelli
- Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Italy
| | - Valeria Moriondo
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
- Center for Genomic Research, University of Modena and Reggio Emilia, Italy
| | - Elisa Pignatti
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
- Center for Genomic Research, University of Modena and Reggio Emilia, Italy
| | - Lara Bonacini
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
- Azienda USL of Modena, Modena, Italy
| | - Cesare Carani
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
| | - Vincenzo Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
- Azienda USL of Modena, Modena, Italy
- *Vincenzo Rochira, MD, PhD, Unit of Endocrinology, NOCSAE, Via Giardini 1355, IT-41126 Modena (Italy), E-Mail
| | - Manuela Simoni
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
- Center for Genomic Research, University of Modena and Reggio Emilia, Italy
- Azienda USL of Modena, Modena, Italy
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Yu L, Ma L, Tu Q, Zhang YI, Chen Y, Yu D, Yang S. Clinical significance of BRAF V600E mutation in 154 patients with thyroid nodules. Oncol Lett 2015; 9:2633-2638. [PMID: 26137119 DOI: 10.3892/ol.2015.3119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 02/27/2015] [Indexed: 01/21/2023] Open
Abstract
The aim of the present study was to investigate the prevalence of the BRAF V600E mutation in papillary thyroid carcinoma (PTC) patients from eastern coastal China and to determine whether it is correlated with the clinicopathological features of PTCs with or without current Hashimoto thyroiditis (HT). The BRAF V600E mutation status was analyzed in 206 thyroid nodules of 154 patients undergoing thyroidectomy using polymerase chain reaction and bi-directional sequencing. Multivariate analysis was performed to investigate the association of the BRAF V600E mutation with clinicopathological features. Thyroid nodules were classified as PTC, nodular goiter (NG), adenomatoid nodule, adenoma and HT. The BRAF V600E mutation was observed in 61.5% of PTCs analyzed; it was also detected in one normal tissue adjacent to PTC and one NG. One patient exhibited double mutations in the BRAF gene; the BRAF V600E mutation in the PTC lesion and the BRAF K601E mutation in the contralateral NG lesion. Patients harboring the BRAF V600E mutation had higher thyroid stimulating hormone levels (2.453±1.464 vs. 1.966±1.296 mIU/l), a reduced occurrence of papillary thyroid microcarcinoma (55.0 vs. 88%), and a higher occurrence of lymph node metastasis (LNM; 42.5 vs. 16.0%) compared with those with wild-type BRAF (all P<0.05). Binary logistic regression analysis revealed that the BRAF V600E mutation was associated with LNM of PTC (hazard ratio, 5.051; 95% confidence interval, 1.068-23.893; P=0.041). Conversely, no association was identified between the BRAF V600E mutation and HT (38.5 vs. 67.3%, χ2=3.656, P=0.056). Thus, in regional PTCs, the BRAF V600E mutation was prevalent, suggesting that it may be an early and phenotypically defining molecular event in PTC, and may represent an independent factor that predicts LNM.
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Affiliation(s)
- Lingying Yu
- Department of Endocrinology, Nanjing Medical University, Affiliated Hangzhou Hospital (Hangzhou First People's Hospital), Hangzhou, Zhejiang 310006, P.R. China
| | - Lizhen Ma
- Department of Endocrinology, Nanjing Medical University, Affiliated Hangzhou Hospital (Hangzhou First People's Hospital), Hangzhou, Zhejiang 310006, P.R. China
| | - Qiaofeng Tu
- Department of Endocrinology, Nanjing Medical University, Affiliated Hangzhou Hospital (Hangzhou First People's Hospital), Hangzhou, Zhejiang 310006, P.R. China
| | - Y I Zhang
- Department of Endocrinology, Nanjing Medical University, Affiliated Hangzhou Hospital (Hangzhou First People's Hospital), Hangzhou, Zhejiang 310006, P.R. China
| | - Yueming Chen
- Department of Endocrinology, Nanjing Medical University, Affiliated Hangzhou Hospital (Hangzhou First People's Hospital), Hangzhou, Zhejiang 310006, P.R. China
| | - Daojun Yu
- Department of Endocrinology, Nanjing Medical University, Affiliated Hangzhou Hospital (Hangzhou First People's Hospital), Hangzhou, Zhejiang 310006, P.R. China
| | - Shaoyu Yang
- Department of Endocrinology, Nanjing Medical University, Affiliated Hangzhou Hospital (Hangzhou First People's Hospital), Hangzhou, Zhejiang 310006, P.R. China
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Pennelli G, Galuppini F, Barollo S, Cavedon E, Bertazza L, Fassan M, Guzzardo V, Pelizzo MR, Rugge M, Mian C. The PDCD4/miR-21 pathway in medullary thyroid carcinoma. Hum Pathol 2014; 46:50-7. [PMID: 25316501 DOI: 10.1016/j.humpath.2014.09.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 09/05/2014] [Accepted: 09/15/2014] [Indexed: 01/09/2023]
Abstract
Programmed cell death 4 (PDCD4) is a tumor suppressor gene involved in tumorogenesis. MicroRNA-21 (miR-21) specifically targets PDCD4, and recent studies suggest that PDCD4 is also regulated by Akt (antiapoptotic regulator within phosphatidylinositol 3-kinase). Medullary thyroid carcinoma (MTC) is a rare neuroendocrine cancer, and disease stage at diagnosis represents the main prognostic indicator. A consecutive series of 64 MTCs was considered. REarranged during Transfection (RET) and rat sarcoma (RAS) mutation status was assessed by direct sequencing. Quantitative real-time polymerase chain reaction was used to quantify mature hsa-miR-21. PDCD4 and Ki-67 immunostaining was performed with an automated platform. Immunoblot analysis of PI3K/Akt pathway was done on thyroid tissues. MTCs were consistently associated with miR-21 up-regulation (P < .0016) and featured significant PDCD4 nuclear down-regulation. An inverse correlation emerged between miR-21 overexpression and PDCD4 down-regulation (P = .0013). At enrollment, high miR-21 levels were associated with high calcitonin levels (P = .0003), lymph node metastases (P = .001), and advanced stages (P = .0003). At the end of follow-up, high miR-21 levels were associated with biochemically persistent disease (P = .0076). At enrollment, instead, PDCD4 nuclear down-regulation was associated with high calcitonin levels (P = .04), more advanced stages of disease (P < .01), and persistent disease after the follow-up (P = .02). p-Akt was more expressed in RAS-mutated MTC than in nonmutated cancers and normal tissue. This study showed, in MTCs, that miR-21 regulates PDCD4 expression and also that the miR-21/PDCD4 pathway correlates with clinicopathological variables and prognosis. Further studies should investigate the role of miR-21 as a prognostic biomarker and the feasibility of using PDCD4-restoring strategies as a therapeutic approach to MTC.
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Affiliation(s)
- Gianmaria Pennelli
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padua 35121, Italy.
| | - Francesca Galuppini
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padua 35121, Italy
| | - Susi Barollo
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua 35128, Italy
| | - Elisabetta Cavedon
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua 35128, Italy
| | - Loris Bertazza
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua 35128, Italy
| | - Matteo Fassan
- ARC-Net Research Centre, University of Verona, Verona 37134, Italy
| | - Vincenza Guzzardo
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padua 35121, Italy
| | - Maria Rosa Pelizzo
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), Surgery Unit, University of Padua, Padua 35128, Italy
| | - Massimo Rugge
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padua 35121, Italy; Istituto Oncologico del Veneto, IOV-IRCCS, Padua 35128, Italy
| | - Caterina Mian
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua 35128, Italy
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Cho U, Oh WJ, Bae JS, Lee S, Lee YS, Park GS, Lee YS, Jung CK. Clinicopathological features of rare BRAF mutations in Korean thyroid cancer patients. J Korean Med Sci 2014; 29:1054-60. [PMID: 25120313 PMCID: PMC4129195 DOI: 10.3346/jkms.2014.29.8.1054] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 05/14/2014] [Indexed: 11/20/2022] Open
Abstract
The most common BRAF mutation in thyroid cancer is c.1799T>A (p.Val600Glu), and other BRAF mutations are rarely reported. We investigated the clinicopathological features of thyroid cancer with rare BRAF mutations. A total of 2,763 patients with thyroid cancer underwent molecular testing by direct DNA sequencing for mutations in BRAF exon 15. Among them, 2,110 (76.4%) had BRAF mutations. The c.1799T>A mutation was found in 2,093 (76.9%) of 2,722 papillary carcinomas and in one of 7 medullary carcinomas. Sixteen cases (0.76%) harbored rare mutation types. Five cases had single-nucleotide substitutions, 5 cases had small in-frame deletion or insertion, and one harbored a two-nucleotide substitution. Of these mutations, 2 were novel (c.1797_1798insGAGACTACA, c.[1799T>A; 1801_1812del]). The c.1801A>G mutation was identified in 4 follicular variant papillary carcinomas and one follicular carcinoma. None of the patients with the c.1801A>G mutation showed extrathyroidal extension or lymph node metastasis. The prevalence of rare BRAF mutations was 0.76% of all BRAF-positive thyroid cancers, and the rare mutations were associated with less aggressive pathologic features. Although BRAF mutations are detected exclusively in papillary carcinoma, they are also found in medullary carcinoma and follicular carcinoma. [Corrected]
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Affiliation(s)
- Uiju Cho
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Woo Jin Oh
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ja Seong Bae
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sohee Lee
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Sub Lee
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Gyeong Sin Park
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youn Soo Lee
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chan Kwon Jung
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Mian C, Ceccato F, Barollo S, Watutantrige-Fernando S, Albiger N, Regazzo D, de Lazzari P, Pennelli G, Rotondi S, Nacamulli D, Pelizzo MR, Jaffrain-Rea ML, Grimaldi F, Occhi G, Scaroni C. AHR over-expression in papillary thyroid carcinoma: clinical and molecular assessments in a series of Italian acromegalic patients with a long-term follow-up. PLoS One 2014; 9:e101560. [PMID: 25019383 PMCID: PMC4096503 DOI: 10.1371/journal.pone.0101560] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 06/07/2014] [Indexed: 02/03/2023] Open
Abstract
AIM Acromegaly reportedly carries an increased risk of malignant and benign thyroid tumors, with a prevalence of thyroid cancer of around 3-7%. Germline mutations in the aryl-hydrocarbon receptor (AHR) interacting protein (AIP) have been identified in familial forms of acromegaly. The molecular and endocrine relationships between follicular thyroid growth and GH-secreting pituitary adenoma have yet to be fully established. Our aim was to study the prevalence of differentiated thyroid cancer (DTC) in acromegaly, focusing on the role of genetic events responsible for the onset of thyroid cancer. METHODS Germline mutations in the AIP gene were assessed in all patients; BRAF and H-N-K RAS status was analyzed by direct sequencing in thyroid specimens, while immunohistochemistry was used to analyze the protein expression of AIP and AHR. A set of PTCs unrelated to acromegaly was also studied. RESULTS 12 DTCs (10 papillary and 2 follicular carcinomas) were identified in a cohort of 113 acromegalic patients. No differences in GH/IGF-1 levels or disease activity emerged between patients with and without DTC, but the former were older and more often female. BRAF V600E was found in 70% of the papillary thyroid cancers; there were no RAS mutations. AIP protein expression was similar in neoplastic and normal cells, while AHR protein was expressed more in PTCs carrying BRAF mutations than in normal tissue, irrespective of acromegaly status. CONCLUSIONS The prevalence of DTC in acromegaly is around 11% and endocrinologists should bear this in mind, especially when examining elderly female patients with uninodular goiter. The DTC risk does not seem to correlate with GH/IGF-1 levels, while it may be associated with BRAF mutations and AHR over-expression. Genetic or epigenetic events probably play a part in promoting thyroid carcinoma.
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Affiliation(s)
- Caterina Mian
- Endocrinology Unit, Department of Medicine, University-Hospital of Padua, Padua, Italy
| | - Filippo Ceccato
- Endocrinology Unit, Department of Medicine, University-Hospital of Padua, Padua, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine, University-Hospital of Padua, Padua, Italy
| | | | - Nora Albiger
- Endocrinology Unit, Department of Medicine, University-Hospital of Padua, Padua, Italy
| | - Daniela Regazzo
- Endocrinology Unit, Department of Medicine, University-Hospital of Padua, Padua, Italy
| | - Paola de Lazzari
- Endocrinology Unit, Department of Medicine, University-Hospital of Padua, Padua, Italy
| | - Gianmaria Pennelli
- II Pathology Unit, Department of Medicine, University-Hospital of Padua, Padua, Italy
| | - Sandra Rotondi
- Department of Clinical and Biotechnological Sciences, University of L'Aquila, L'Aquila, Italy
| | - Davide Nacamulli
- Endocrinology Unit, Department of Medicine, University-Hospital of Padua, Padua, Italy
| | - Maria Rosa Pelizzo
- Surgical Pathology Unit, Department of Surgery, University-Hospital of Padua, Padua, Italy
| | - Marie-Lise Jaffrain-Rea
- Department of Clinical and Biotechnological Sciences, University of L'Aquila, L'Aquila, Italy
- Neuromed Institute, Department of Neurological Sciences, University of L'Aquila, L'Aquila, Italy
| | - Franco Grimaldi
- Endocrinology and Metabolism Unit, University-Hospital “Santa Maria della Misericordia,” Udine, Italy
| | - Gianluca Occhi
- Endocrinology Unit, Department of Medicine, University-Hospital of Padua, Padua, Italy
| | - Carla Scaroni
- Endocrinology Unit, Department of Medicine, University-Hospital of Padua, Padua, Italy
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Barollo S, Pezzani R, Cristiani A, Redaelli M, Zambonin L, Rubin B, Bertazza L, Zane M, Mucignat-Caretta C, Bulfone A, Pennelli G, Casal Ide E, Pelizzo MR, Mantero F, Moro S, Mian C. Prevalence, tumorigenic role, and biochemical implications of rare BRAF alterations. Thyroid 2014; 24:809-19. [PMID: 24295088 DOI: 10.1089/thy.2013.0403] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Papillary thyroid carcinoma (PTC) is the most common malignant tumor of the thyroid gland, accounting for 74-80% of all thyroid cancers. The 1799T>A transversion is an activating mutation of the BRAF oncogene that is common in and specific to conventional PTC. We studied the prevalence, tumorigenic role, and biochemical implications of rare BRAF variants in a large cohort of patients. METHODS A total of 2131 fine-needle aspiration biopsy samples were collected and subjected to BRAF mutation analysis. BRAF genetic variants were analyzed by Western blot, immunofluorescence, and in silico analysis. RESULTS BRAF mutations were found in 50% (347/700) of thyroid cancers (644 PTCs, 22 anaplastic thyroid carcinomas, 34 follicular thyroid carcinomas). They were the classic (c.1799T>A, p.V600E) mutation in 96.8% (336/347) and rare genetic variants in 3.2% (11/347). In all, five infrequent BRAF alterations were detected: (i) c.1795_1797dupACA (p.T599dup); (ii) c.1801A>G (p.K601E); (iii) c.1799_1801delTGA (p.V600_K601>E); (iv) c.1799_1814>A (p.V600_S605>D); and (v) c.1798_1810delinsA (p.V600_W604>R). The last BRAF variant has never been described in the literature. Western blot analysis and immunofluorescence both revealed a variegated reactivity pattern, again emphasizing the peculiar role of every specific BRAF genetic alteration. In silico analysis of the samples studied revealed a stabilization of the "active" geometrical conformation of the B-raf enzyme associated with the activated and productive state of the kinase domain. CONCLUSIONS Rare BRAF variants were found in 1.6% of all thyroid malignancies, all clustered around the codon V600, in the binding pocket named A-loop, confirming its crucial role in the enzymatic activation of the B-Raf protein. These mutations were associated mainly with the activation of key effectors in the mitogen-activated protein kinase pathway, but a simultaneous stimulation of the PI3k/Akt cascade was demonstrated in some cases. The rare BRAF variants were not generally associated with an aggressive behavior of the PTC. To our knowledge, this is the largest series of thyroid cancers analyzed to identify and functionally characterize rare BRAF variants.
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Affiliation(s)
- Susi Barollo
- 1 Endocrinology Unit, Department of Medicine, University of Padua , Padua, Italy
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Ohori NP, Schoedel KE. Ancillary Studies in Thyroid Cytopathology. Surg Pathol Clin 2014; 7:47-60. [PMID: 26839268 DOI: 10.1016/j.path.2013.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Recent advances in thyroid imaging, clinical evaluation, cytopathology, surgical pathology, and molecular diagnostics have contributed toward greater understanding of thyroid nodules. In particular, the development of the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) has brought standardization to the field and the system dovetails well with the implementation of immunohistochemistry and molecular testing to diagnostic practice. Among the molecular strategies available, the application of the molecular panel of common genetic alterations can stratify indeterminate BSRTC diagnoses into low-risk and high-risk groups. The molecular panel markers have a high positive predictive value and therefore, the panel is considered to be a "rule-in" test. In contrast, the Afirma gene expression classifier by Veracyte Corporation is a test that has been reported to have a high negative predictive value, and therefore, considered to be a "rule-out" test. With further advances, refinements are expected to be made. In particular, the application of next-generation sequencing technology holds promise in bringing thyroid cytopathology to the next level.
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Affiliation(s)
- N Paul Ohori
- Department of Pathology, University of Pittsburgh Medical Center-Presbyterian, A610, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
| | - Karen E Schoedel
- Department of Pathology, University of Pittsburgh Medical Center-Presbyterian, A610, 200 Lothrop Street, Pittsburgh, PA 15213, USA
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An L, Jia W, Yu Y, Zou N, Liang L, Zhao Y, Fan Y, Cheng J, Shi Z, Xu G, Li G, Yang J, Zhang H. Lys63-linked polyubiquitination of BRAF at lysine 578 is required for BRAF-mediated signaling. Sci Rep 2014; 3:2344. [PMID: 23907581 PMCID: PMC3731650 DOI: 10.1038/srep02344] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 07/15/2013] [Indexed: 01/13/2023] Open
Abstract
The RAF kinase family is essential in mediating signal transduction from RAS to ERK. BRAF constitutively active mutations correlate with human cancer development. However, the precise molecular regulation of BRAF activation is not fully understood. Here we report that BRAF is modified by Lys63-linked polyubiquitination at lysine 578 within its kinase domain once it is activated by gain of constitutively active mutation or epidermal growth factor (EGF) stimulation. Substitution of BRAF lysine 578 with arginine (K578R) inhibited BRAF-mediated ERK activation. Furthermore, ectopic expression of BRAF K578R mutant inhibited anchorage-independent colony formation of MCF7 breast cancer cell line. Our studies have identified a previously unrecognized regulatory role of Lys63-linked polyubiquitination in BRAF-mediated normal and oncogenic signalings.
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Affiliation(s)
- Lei An
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Dettmer M, Perren A, Moch H, Komminoth P, Nikiforov YE, Nikiforova MN. Comprehensive MicroRNA expression profiling identifies novel markers in follicular variant of papillary thyroid carcinoma. Thyroid 2013; 23:1383-9. [PMID: 23427895 PMCID: PMC3822383 DOI: 10.1089/thy.2012.0632] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Follicular variant of papillary thyroid carcinoma (FVPTC) shares features of papillary (PTC) and follicular (FTC) thyroid carcinomas on a clinical, morphological, and genetic level. MicroRNA (miRNA) deregulation was extensively studied in PTCs and FTCs. However, very limited information is available for FVPTC. The aim of this study was to assess miRNA expression in FVPTC with the most comprehensive miRNA array panel and to correlate it with the clinicopathological data. METHODS Forty-four papillary thyroid carcinomas (17 FVPTC, 27 classic PTC) and eight normal thyroid tissue samples were analyzed for expression of 748 miRNAs using Human Microarray Assays on the ABI 7900 platform (Life Technologies, Carlsbad, CA). In addition, an independent set of 61 tumor and normal samples was studied for expression of novel miRNA markers detected in this study. RESULTS Overall, the miRNA expression profile demonstrated similar trends between FVPTC and classic PTC. Fourteen miRNAs were deregulated in FVPTC with a fold change of more than five (up/down), including miRNAs known to be upregulated in PTC (miR-146b-3p, -146-5p, -221, -222 and miR-222-5p) and novel miRNAs (miR-375, -551b, 181-2-3p, 99b-3p). However, the levels of miRNA expression were different between these tumor types and some miRNAs were uniquely dysregulated in FVPTC allowing separation of these tumors on the unsupervised hierarchical clustering analysis. Upregulation of novel miR-375 was confirmed in a large independent set of follicular cell derived neoplasms and benign nodules and demonstrated specific upregulation for PTC. Two miRNAs (miR-181a-2-3p, miR-99b-3p) were associated with an adverse outcome in FVPTC patients by a Kaplan-Meier (p < 0.05) and multivariate Cox regression analysis (p < 0.05). CONCLUSIONS Despite high similarity in miRNA expression between FVPTC and classic PTC, several miRNAs were uniquely expressed in each tumor type, supporting their histopathologic differences. Highly upregulated miRNA identified in this study (miR-375) can serve as a novel marker of papillary thyroid carcinoma, and miR-181a-2-3p and miR-99b-3p can predict relapse-free survival in patients with FVPTC thus potentially providing important diagnostic and predictive value.
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Affiliation(s)
- Matthias Dettmer
- 1 Department of Pathology and Laboratory Medicine, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
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Kim WY, Ko YS, Hwang TS, Han HS, Lim SD, Kim WS, Oh SY. A Case of Multifocal Papillary Thyroid Carcinoma Consisting of One Encapsulated Follicular Variant with BRAF K601E Mutation and Three Conventional Types with BRAF V600E Mutation. KOREAN JOURNAL OF PATHOLOGY 2013; 47:293-8. [PMID: 23837025 PMCID: PMC3701828 DOI: 10.4132/koreanjpathol.2013.47.3.293] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 09/27/2012] [Accepted: 10/04/2012] [Indexed: 01/09/2023]
Abstract
Multifocal papillary thyroid carcinoma (mPTC) comprises about 20-30% of PTC. In mPTC, individual tumor foci can be identical or frequently composed of different histological types including follicular, solid, tall-cell or conventional patterns. We report a case of mPTC consisting of one encapsulated follicular variant of papillary thyroid carcinoma (FVPTC) and three conventional PTCs in a 44-year-old woman. This case genetically demonstrates unique features including the simultaneous presence of the BRAF V600E (T1799A) mutation and the BRAF K601E (A1801G) mutation in conventional PTC and FVPTC, respectively.
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Affiliation(s)
- Wook Youn Kim
- Department of Pathology, Konkuk University School of Medicine, Seoul, Korea
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Mian C, Pennelli G, Fassan M, Balistreri M, Barollo S, Cavedon E, Galuppini F, Pizzi M, Vianello F, Pelizzo MR, Girelli ME, Rugge M, Opocher G. MicroRNA profiles in familial and sporadic medullary thyroid carcinoma: preliminary relationships with RET status and outcome. Thyroid 2012; 22:890-6. [PMID: 22747440 PMCID: PMC3429275 DOI: 10.1089/thy.2012.0045] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND MicroRNAs (miRNAs) are involved in the pathogenesis of human cancers, including medullary thyroid carcinoma (MTC). The aim of this study was to test the hypothesis that different miRNA profiles are related to RET status and prognosis in patients with hereditary MTC (hMTC) and sporadic MTC (sMTC). METHODS We analyzed the expression of nine miRNAs (miR-21, miR-127, miR-154, miR-224, miR-323, miR-370, miR-9*, miR-183, and miR-375) by quantitative real-time-polymerase chain reaction in 34 cases of sMTC, 6 cases of hMTC, and 2 cases of C-cell hyperplasia (CCH). We also analyzed the immunohistochemical expression of PDCD4, an miR-21 gene target. sMTC (n=34) was genotyped for somatic RET and RAS mutations. Disease status was defined on the basis of the concentration of serum calcitonin at the latest follow-up and other parameters as indicated in the results. RESULTS MTC and CCH were both characterized by a significant overexpression of the whole set of miRNAs (the increase being 4.2-fold for miR-21, 6.7-fold for miR-127, 8.8-fold for miR-154, 6.6-fold for miR-224, 5.8-fold for miR-323, 6.1-fold for miR-370, 13-fold for miR-9*, 6.7-fold for miR-183, and 10.1 for miR-375, p<0.0001). PDCD4 expression was significantly downregulated in MTC samples, consistent with miR-21 upregulation. Significantly lower miR-127 levels were observed in sMTC carrying somatic RET mutations in comparison to sMTC carrying a wild-type RET. In sMTC and familial MTC, the miR-224 upregulation correlated with the absence of node metastases, lower stages at diagnosis, and with biochemical cure during follow-up. CONCLUSIONS miRNAs are significantly dysregulated in MTC, and this dysregulation is probably an early event in C-cell carcinogenesis. miR-224 upregulation could represent a prognostic biomarker associated with a better outcome in MTC patients.
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Affiliation(s)
- Caterina Mian
- Endocrinology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Gianmaria Pennelli
- Surgical Pathology & Cytopathology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Matteo Fassan
- Surgical Pathology & Cytopathology Unit, Department of Medicine, University of Padua, Padua, Italy
- General Oncology Unit, Department of Surgical Oncology and Gastroenterology Sciences, University of Padua, Padua, Italy
| | - Mariangela Balistreri
- Surgical Pathology & Cytopathology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Susi Barollo
- Veneto Institute of Oncology–IRCCS, Padua, Italy
| | - Elisabetta Cavedon
- Endocrinology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Francesca Galuppini
- Surgical Pathology & Cytopathology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Marco Pizzi
- Surgical Pathology & Cytopathology Unit, Department of Medicine, University of Padua, Padua, Italy
| | | | - Maria Rosa Pelizzo
- Surgery Unit, Department of Surgical Oncology and Gastroenterology Sciences, University of Padua, Padua, Italy
| | - Maria Elisa Girelli
- Endocrinology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Massimo Rugge
- Surgical Pathology & Cytopathology Unit, Department of Medicine, University of Padua, Padua, Italy
- Veneto Institute of Oncology–IRCCS, Padua, Italy
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