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Huang J, Wang J, Xv J, Wang J, Wang G, Zhao Y. Genetic alterations and allele frequency of BRAF V600E and TERT mutation in papillary thyroid carcinoma with intermediate-to-high recurrence risk: a retrospective study. Clin Exp Med 2024; 24:76. [PMID: 38607456 PMCID: PMC11014806 DOI: 10.1007/s10238-024-01320-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 03/02/2024] [Indexed: 04/13/2024]
Abstract
The predictive value of allele frequency (AF) of BRAF V600E and TERT mutations in papillary thyroid carcinoma (PTC) remains controversial. We aimed to investigate the AF of BRAF V600E and TERT mutations in intermediate-to-high risk PTC and their association between tumor invasiveness, prognosis, and other mutations. Probe hybridization capture and high-throughput sequencing were used to quantitatively test 40 gene loci in 94 intermediate-to-high recurrence risk PTC patients, combined with clinical characteristics and follow-up for retrospective analysis. BRAF V600E mutation AF was linked to a increased risk of thyroid capsule penetration, recurrence, and concurrent mutations. Concurrent mutations could lead to a worse prognosis and increased invasiveness. TERT promoter mutation frequently accompanied other mutations and resulted in a poorer prognosis. However, there was no clear association between the TERT mutation AF and tumor invasiveness or recurrence. The sensitivity and specificity of predicting recurrence in intermediate-to-high risk PTC with BRAF V600E mutation AF > 28.2% were 60 and 80%. Although genetic alterations in PTC can differ among different ethnicities, the AF of BRAF V600E and TERT mutations may be similar. The AF of BRAF V600E has the potential to be a novel indicator in predicting PTC invasiveness and prognosis.
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Affiliation(s)
- Jiayu Huang
- Department of Thyroid Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Jiazhi Wang
- Department of Thyroid Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Jingchao Xv
- Department of Thyroid Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Jingran Wang
- Department of Thyroid Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Guangzhi Wang
- Department of Thyroid Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China.
| | - Yongfu Zhao
- Department of Thyroid Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China.
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Janicki L, Patel A, Jendrzejewski J, Hellmann A. Prevalence and Impact of BRAF mutation in patients with concomitant papillary thyroid carcinoma and Hashimoto's thyroiditis: a systematic review with meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1273498. [PMID: 38047109 PMCID: PMC10691376 DOI: 10.3389/fendo.2023.1273498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/25/2023] [Indexed: 12/05/2023] Open
Abstract
Background Evidence suggests that patients with Hashimoto thyroiditis (HT) are at significantly higher risk of developing papillary thyroid cancer (PTC). However, the course of PTC in patients with both diseases concomitantly has been found to be more indolent than conventional PTC. Additionally, it has been well proven that BRAF mutation results in an aggressive course of PTC. The aims of this meta-analysis were to identify prevalence of BRAF mutation and its impact on clinicopathological features in patients with concomitant PTC-HT. Methods Medline, Cochrane Library, Scopus, and Web of Science were searched until 16.09.2022, resulting in 227 articles, of which nine studies were included. Summary estimates, comparing patients with (A) BRAF (+) PTC-HT versus BRAF (+) PTC, and (B) BRAF (+) PTC-HT versus BRAF (-) PTC-HT, were generated with Review Manager 5.0. Results In total, 6395 patients were included in this review. PTC-HT patients had significantly less BRAF mutation than PTC patients (Odds Ratio (OR) (95% Confidence Interval (CI))=0.45 (0.35-0.58), P<0.001). BRAF (+) PTC-HT patients were significantly more likely to have multifocal lesions (OR (95% CI)=1.22 (1.04-1.44), P=0.01) but less likely to have lymph node metastasis (OR (95% CI)=0.65 (0.46-0.91), P=0.01) and extrathyroidal extension (OR (95% CI)=0.55 (0.32-0.96), P=0.03) compared to BRAF (+) PTC patients. BRAF (+) PTC-HT patients were more likely to have multifocal lesions (OR (95% CI)=0.71 (0.53-0.95), P=0.02), lymph node metastasis (OR (95% CI)=0.59 (0.44-0.78), P<0.001) and extrathyroidal extension (OR (95% CI)=0.72 (0.56-0.92), P=0.01) compared to BRAF (-) PTC-HT patients. Conclusion This meta-analysis highlights that the lower prevalence of BRAF mutation in patients with PTC-HT than conventional PTC may explain the indolent clinicopathological course in this cohort.
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Affiliation(s)
- Lukasz Janicki
- Department of Surgical Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Agastya Patel
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
- Regional Hepato-Pancreato-Biliary Surgical Unit, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Jarosław Jendrzejewski
- Department of Endocrinology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Andrzej Hellmann
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
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Lin Y, Wu ZR, Shi YP, Ding M, Tang XY, He Y, Zhai B, Li P. Radiofrequency Ablation of Unifocal Papillary Thyroid Microcarcinoma With BRAF V600E Mutation. J Clin Endocrinol Metab 2023; 108:e1298-e1305. [PMID: 37220176 DOI: 10.1210/clinem/dgad269] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Indexed: 05/25/2023]
Abstract
CONTEXT To date there is no study on the feasibility of radiofrequency ablation (RFA) for papillary thyroid microcarcinomas (PTMCs) with BRAF V600E mutation. OBJECTIVE This study was designed to evaluate the efficiency, safety, and prognosis of ultrasound (US)-guided percutaneous RFA for unifocal PTMCs with BRAF V600E mutation. MATERIALS AND METHODS Sixty patients with 60 unifocal BRAF V600E mutation-positive PTMCs who received US-guided RFA between January 2020 and December 2021 were retrospectively analyzed. The mean maximum PTMC tumor diameter was 5.8 ± 1.7 mm (range, 2.5-10.0 mm). All PTMCs were pathologically confirmed by fine needle aspiration or core needle biopsy, and BRAF V600E mutation was confirmed to be positive by real-time fluorescent quantitative polymerase chain reaction. Contrast-enhanced ultrasound (CEUS) was performed immediately after RFA to evaluate whether PTMCs were extendedly ablated. Ultrasound was performed 1, 3, 6, and 12 months after RFA and every 6 months thereafter to evaluate the changes in the ablation zone, local recurrence, and cervical lymph node metastasis (LNM). The complications were recorded and evaluated. RESULTS Extended ablation was achieved in all enrolled patients. The ablation zone sizes increased immediately after RFA compared with those of tumors before treatment. One month later, the ablation zone sizes were smaller than immediately after RFA. At the last follow-up assessment, 42 nodules (70.0%) completely disappeared and the ablation zones of 18 nodules (30.0%) showed fissure-like changes. No local recurrence or cervical LNM was detected. Voice change (1.7%) was the only major complication. CONCLUSION RFA is effective and safe in treating unifocal PTMCs with BRAF V600E mutation, especially when surgery is not feasible or refused by patients who are unwilling to continue active surveillance.
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Affiliation(s)
- Yan Lin
- Department of Interventional Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People's Republic of China
| | - Zhao-Rong Wu
- Department of Interventional Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People's Republic of China
| | - Yao-Ping Shi
- Department of Interventional Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People's Republic of China
| | - Min Ding
- Department of Interventional Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People's Republic of China
| | - Xiao-Yin Tang
- Department of Interventional Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People's Republic of China
| | - Yi He
- Department of Interventional Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People's Republic of China
| | - Bo Zhai
- Department of Interventional Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People's Republic of China
| | - Ping Li
- Department of Interventional Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People's Republic of China
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Seo GT, Minkowitz J, Kapustin DA, Fan J, Minkowitz G, Minkowitz M, Dowling E, Matloob A, Asti D, Dhar M, Shutty C, Brickman A, Urken ML, Brandwein-Weber M, Finkelstein SD. Synchronous thyroid cancer and malignant struma ovarii: concordant mutations and microRNA profile, discordant loss of heterozygosity loci. Diagn Pathol 2023; 18:47. [PMID: 37072862 PMCID: PMC10111709 DOI: 10.1186/s13000-023-01336-6] [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: 01/17/2023] [Accepted: 04/03/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Struma ovarii is an unusual ovarian teratoma containing predominantly thyroid tissue. Less than 10% of cases undergo malignant transformation in the thyroid tissue and are considered malignant struma ovarii (MSO). MSO have been reported with concurrent thyroid lesions, but molecular data is lacking. CASE PRESENTATION A 42-year-old female developed MSO and synchronous multifocal subcentimeter papillary thyroid carcinoma (PTC). The patient underwent a salpingo-oophrectomy, thyroidectomy, and low-dose radioactive iodine ablation. Both the thyroid subcentimeter PTC and MSO were positive for BRAF V600E mutation, and microRNA expression profiles were similar across all tumor deposits. However, only the malignant component demonstrated extensive loss of heterozygosity (LOH) involving multiple tumor suppressor gene (TSG) chromosomal loci. CONCLUSIONS We present the first reported case of MSO with synchronous multifocal subcentimeter PTC in the thyroid containing concordant BRAF V600E mutations and resulting with discordant LOH findings. This data suggests that loss of expression in tumor suppressor gene(s) may be an important contributor to phenotypic expression of malignancy.
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Affiliation(s)
- Gabriella T Seo
- Thyroid, Head and Neck Cancer (THANC) Foundation, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
| | - Jeremy Minkowitz
- Minkowitz Pathology, 904 49th Street, Brooklyn, NY, 11219, USA
- SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | - Danielle A Kapustin
- Thyroid, Head and Neck Cancer (THANC) Foundation, 10 Union Square East, Suite 5B, New York, NY, 10003, USA.
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 5B, New York, NY, 10003, USA.
| | - Jun Fan
- Department of Pathology, Mount Sinai West Medical Center, 1000 10th Avenue, New York, NY, 10019, USA
| | | | | | - Eric Dowling
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
| | - Ammar Matloob
- Department of Pathology, Mount Sinai West Medical Center, 1000 10th Avenue, New York, NY, 10019, USA
| | - Divya Asti
- Department of Hematology and Medical Oncology, Northwell Health Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY, 10305, USA
| | - Meekoo Dhar
- Department of Hematology and Medical Oncology, Northwell Health Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY, 10305, USA
| | | | - Alan Brickman
- ParCare Community Health Network, 6010 Bay Parkway, Brooklyn, NY, 11204, USA
| | - Mark L Urken
- Thyroid, Head and Neck Cancer (THANC) Foundation, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
| | - Margaret Brandwein-Weber
- Department of Pathology, Mount Sinai West Medical Center, 1000 10th Avenue, New York, NY, 10019, USA
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A New Indicator to Differentiate Thyroid Follicular Inclusions in Cervical Lymph Nodes from Patients with Thyroid Cancer. Int J Mol Sci 2022; 24:ijms24010490. [PMID: 36613940 PMCID: PMC9820803 DOI: 10.3390/ijms24010490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/05/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
Nodal metastasis is crucial for determining the stage of well-differentiated thyroid cancer (WTC) in patients older than 55. Well-formed thyroid follicular inclusions (TFIs) are occasionally encountered in the cervical lymph nodes (LNs) of patients with papillary thyroid carcinoma (PTC), and it is difficult to determine whether they are true nodal metastases or ectopic thyroid tissues (ETT). This study aimed to elucidate the impact of the expression of the DNA damage response molecule TP53-binding protein 1 (53BP1) using immunofluorescence (IF) as a biomarker to differentiate TFIs in cervical LN by comparing the mutation analyses of primary thyroid cancers. The data demonstrated the necessity for the differential diagnosis of true metastases from ETT among TFIs in cervical LNs. PTC-like nuclear features using hematoxylin-eosin staining combined with immunohistochemistry for conventional biomarkers of PTC, including BRAFV600E protein, were most helpful in identifying metastatic follicular-patterned carcinomas. In conclusion, IF analysis of 53BP1 expression could be an excellent ancillary technique to distinguish metastatic carcinoma or ETT from TFIs in LNs, particularly in cases other than BRAFV600E-mutated PTC.
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Swan KZ, Madsen SH, Bonnema SJ, Nielsen VE, Jespersen ML. Preoperative BRAF V600E mutation detection in thyroid carcinoma by immunocytochemistry. APMIS 2022; 130:627-636. [PMID: 35951496 PMCID: PMC9804421 DOI: 10.1111/apm.13267] [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: 06/26/2022] [Accepted: 08/09/2022] [Indexed: 01/05/2023]
Abstract
The BRAFV600E (BRAF) mutation is present in 40-50% of papillary thyroid carcinomas (PTC) and has been associated with more aggressive clinicopathological characteristics of PTC. The aim of this study was to evaluate different methods for preoperative identification of the BRAF mutation in PTC using cytological and histological specimens. Prospectively collected preoperative cytological clots from patients with suspected PTC were tested with BRAF immunocytochemistry (ICC) and the Cobas Test (PCR). In addition, histological specimens were tested with BRAF immunohistochemistry (IHC) and the Cobas Test. All nodules were histologically examined. Fifty-three patients were included in the study. Complete mutation testing was available in 32 patients. The main reason for exclusion was insufficient cell content in the cytological specimen. Twenty-seven nodules were histologically diagnosed as PTC, and 41% (n = 11) of PTCs were BRAF ICC positive. All non-PTC nodules were negative by BRAF ICC. In 26 nodules, all four BRAF tests were concordant, while discordant test results were found in six nodules. ICC was in accordance with the consensus BRAF status in five of these nodules, while BRAF status was undetermined in one nodule. BRAF ICC showed high concordance with the Cobas Test and a low rate of false negative stain. These results indicate that BRAF ICC may be a feasible method for preoperative detection of the BRAFV600E mutation in patients with PTC.
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Affiliation(s)
- Kristine Zøylner Swan
- Department of Otorhinolaryngology Head & Neck SurgeryAarhus University HospitalAarhusDenmark
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7
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Wang Z, Tang P, Hua S, Gao J, Zhang B, Wan H, Wu Q, Zhang J, Chen G. Genetic and Clinicopathologic Characteristics of Papillary Thyroid Carcinoma in the Chinese Population: High BRAF Mutation Allele Frequency, Multiple Driver Gene Mutations, and RET Fusion May Indicate More Advanced TN Stage. Onco Targets Ther 2022; 15:147-157. [PMID: 35173448 PMCID: PMC8841610 DOI: 10.2147/ott.s339114] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/02/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Zhihong Wang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Peng Tang
- Department of Breast and Thyroid Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China
| | - Surong Hua
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Junyi Gao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Bin Zhang
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
| | - Hua Wan
- Research and Development Department, Beijing USCI Medical Laboratory, Beijing, People’s Republic of China
| | - Qixi Wu
- Research and Development Department, Beijing USCI Medical Laboratory, Beijing, People’s Republic of China
| | - Jiaxin Zhang
- Department of Thyroid and Breast Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of China
- Correspondence: Ge Chen, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan Hu Tong, Beijing, 100730, People’s Republic of China, Tel +86 156 1123 3738, Fax +86 156 69152600, Email ; Jiaxin Zhang, Department of Thyroid and Breast Surgery, Affiliated Hospital of Xuzhou Medical University, No. 99, Huaihai West Road, Xuzhou, 221004, People’s Republic of China, Tel +86 180 5226 8693, Fax +86 180 85802306, Email
| | - Ge Chen
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
- Correspondence: Ge Chen, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan Hu Tong, Beijing, 100730, People’s Republic of China, Tel +86 156 1123 3738, Fax +86 156 69152600, Email ; Jiaxin Zhang, Department of Thyroid and Breast Surgery, Affiliated Hospital of Xuzhou Medical University, No. 99, Huaihai West Road, Xuzhou, 221004, People’s Republic of China, Tel +86 180 5226 8693, Fax +86 180 85802306, Email
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8
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Zurnadzhy L, Bogdanova T, Rogounovitch TI, Ito M, Tronko M, Yamashita S, Mitsutake N, Chernyshov S, Masiuk S, Saenko VA. The BRAFV600E Mutation Is Not a Risk Factor for More Aggressive Tumor Behavior in Radiogenic and Sporadic Papillary Thyroid Carcinoma at a Young Age. Cancers (Basel) 2021; 13:cancers13236038. [PMID: 34885148 PMCID: PMC8656579 DOI: 10.3390/cancers13236038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Analysis of the groups of young Ukrainian patients (aged ≤28 years) with radiogenic and sporadic papillary thyroid carcinomas (PTCs) showed that the frequency of BRAFV600E was increasing with patient age, consistently remaining lower in radiogenic PTCs. In both etiopathogenic groups, the BRAFV600E-positive PTCs more frequently had a dominant papillary growth pattern, smaller tumor size, higher Ki67 labeling index, and a frequency of the major indicators of tumor invasiveness that is lower than or equal to that of the BRAFV600E-negative tumors. Comparison of the BRAFV600E-positive PTCs across the groups found a virtual absence of differences, while the BRAFV600E-negative tumors differed markedly and displayed a higher frequency of invasive tumor features in the radiogenic PTCs. Hence, there is evidence that BRAFV600E does not confer a more aggressive course of PTC in young patients regardless of tumor etiology. Abstract Histopathological changes in the fusion oncogene-driven papillary thyroid carcinomas (PTCs) from children and adolescents exposed to Chernobyl fallout have been extensively studied. However, characteristics of the radiogenic BRAFV600E-positive PTCs, whose proportion is growing with time, are not well described yet. We analyzed the relationship between the BRAFV600E status (determined immunohistochemically with the VE1 antibody) and the clinicopathological features of 247 radiogenic and 138 sporadic PTCs from young Ukrainian patients aged ≤28 years. The frequency of BRAFV600E was increasing with patient age, consistently remaining lower in radiogenic PTCs. In both etiopathogenic groups, the BRAFV600E-positive PTCs more frequently had a dominant papillary growth pattern, smaller tumor size, higher Ki67 labeling index, and a frequency of the major indicators of tumor invasiveness that is lower than or equal to that of the BRAFV600E-negative tumors. Comparison of the BRAFV600E-positive PTCs across the groups found a virtual absence of differences. In contrast, the BRAFV600E-negative radiogenic PTCs displayed less frequent dominant papillary and more frequent solid growth patterns, lower Ki67 labeling index, and higher invasiveness than the BRAFV600E-negative sporadic tumors. Thus, BRAFV600E is not associated with a more aggressive course of PTC in young patients regardless of etiology. The major clinicopathological differences between the radiogenic and sporadic PTCs are observed among the BRAFV600E-negative tumors.
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Affiliation(s)
- Liudmyla Zurnadzhy
- State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, 69 Vyshgorodska Str., 04114 Kyiv, Ukraine; (L.Z.); (T.B.); (M.T.); (S.C.)
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan;
| | - Tetiana Bogdanova
- State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, 69 Vyshgorodska Str., 04114 Kyiv, Ukraine; (L.Z.); (T.B.); (M.T.); (S.C.)
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan;
| | - Tatiana I. Rogounovitch
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan;
- Correspondence: ; Tel.: +81-(0)95-819-7116
| | - Masahiro Ito
- Nagasaki Medical Center, 2-1001-1 Kubara, Omura 856-8562, Japan;
| | - Mykola Tronko
- State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, 69 Vyshgorodska Str., 04114 Kyiv, Ukraine; (L.Z.); (T.B.); (M.T.); (S.C.)
| | - Shunichi Yamashita
- Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan;
- National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Chiba 263-8555, Japan
| | - Norisato Mitsutake
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan;
| | - Serhii Chernyshov
- State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, 69 Vyshgorodska Str., 04114 Kyiv, Ukraine; (L.Z.); (T.B.); (M.T.); (S.C.)
| | - Sergii Masiuk
- State Institution “National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine”, 53 Illienka Str., 04050 Kyiv, Ukraine;
| | - Vladimir A. Saenko
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan;
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Al-Masri M, Al-Shobaki T, Al-Najjar H, Iskanderian R, Younis E, Abdallah N, Tbakhi A, Haddad H, Al-Masri M, Obeid Z, Jarrar A. BRAF V600E mutation in papillary thyroid carcinoma: it's relation to clinical features and oncologic outcomes in a single cancer centre experience. Endocr Connect 2021; 10:1531-1537. [PMID: 34734568 PMCID: PMC8679880 DOI: 10.1530/ec-21-0410] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/03/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE This study focuses on the oncologic influence of BRAF V600E mutations in a cohort of Middle Eastern papillary thyroid carcinoma (PTC) patients treated at a single centre. We tested the association of BRAF V600E mutation with papillary thyroid carcinoma at King Hussein Cancer Center. METHODS Patients with histologically confirmed PTC who underwent surgical treatment between 2006 and 2015 were included in this study. Oncological outcomes, both short- and long-termed, were collected. RESULTS A total of 128 patients (68% females) were included in this study with a mean age of 38 years (±13.8). The median follow-up period was 50 months. The BRAF V600E mutation was found in 71% of patients. The tumour size for patients with a negative BRAF V600E mutation was significantly larger in comparison to patients who tested positive for the mutation (3.47 cm vs 2.31 cm, respectively, P = 0.009). The two groups showed similar disease-free survival (DFS) rates; positive = 75% (median 43 months (0-168)) compared to 78% for the negative BRAF V600E mutation (median 38 months (3-142)) (P = 0.162, HR = 0.731) Furthermore, both groups showed similar overall survival rates, positive = 94.5% (median 56 months (0-228)) compared to 94.6% for the negative BRAF V600E mutation (median 43 months (3-157)) (P = 0.941, HR = 0.940). CONCLUSION BRAF V600E mutation had no effect on loco-regional recurrence, distant metastasis, overall survival, or DFS. These findings may be attributed to geographic variations or reflect that BRAF V600E may only serve as an indicator of poor prognosis in high-risk group as such.
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Affiliation(s)
- Mahmoud Al-Masri
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
- Correspondence should be addressed to M Al-Masri:
| | | | - Hani Al-Najjar
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
| | | | - Enas Younis
- Department of Internal Medicine, Endocrine, King Hussein Cancer Center, Amman, Jordan
| | - Niveen Abdallah
- Department of Cell Therapy & Applied Genomics, King Hussein Cancer Center, Amman, Jordan
| | - Abdelghani Tbakhi
- Department of Cell Therapy & Applied Genomics, King Hussein Cancer Center, Amman, Jordan
| | - Hussam Haddad
- Department of Pathology & Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
| | | | - Zeinab Obeid
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
| | - Awad Jarrar
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
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10
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Giani C, Torregrossa L, Ramone T, Romei C, Matrone A, Molinaro E, Agate L, Materazzi G, Piaggi P, Ugolini C, Basolo F, Ciampi R, Elisei R. Whole Tumor Capsule Is Prognostic of Very Good Outcome in the Classical Variant of Papillary Thyroid Cancer. J Clin Endocrinol Metab 2021; 106:e4072-e4083. [PMID: 34231847 DOI: 10.1210/clinem/dgab396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Tumor capsule integrity is becoming a relevant issue to predict the biological behavior of human tumors, including thyroid cancer. OBJECTIVE This work aims to verify whether a whole tumor capsule in the classical variant of papillary thyroid carcinoma (CVPTC) could have as a predictive role of a good outcome as for follicular variant (FVPTC). METHODS FVPTC (n = 600) and CVPTC (n = 554) cases were analyzed. We distinguished between encapsulated-FVPTC (E-FVPTC) and encapsulated-CVPTC (E-CVPTC) and, thereafter, invasive (Ei-FVPTC and Ei-CVPTC) and noninvasive (En-FVPTC and En-CVPTC) tumors, according to the invasion or integrity of the tumor capsule, respectively. Cases without a tumor capsule were indicated as invasive-FVPTC (I-FVPTC) and invasive-CVPTC (I-CVPTC). The subgroup of each variant was evaluated for BRAF mutations. RESULTS E-FVPTC was more frequent than E-CVPTC (P < .001). No differences were found between En-FVPTC and En-CVPTC or between Ei-FVPTC and Ei-CVPTC. After 18 years of follow-up, a greater number of not-cured cases were observed in Ei-CVPTC with respect to Ei-FVPTC, but not in En-CVPTC to En-FVPTC. Multivariate clustering analysis showed that En-FVPTC, En-CVPTC, and Ei-FVPTC have similar features but different from I-FVPTC and I-CVPTC and, to a lesser extent, from Ei-CVPTC. A total of 177 of 614 (28.8%) cases were BRAFV600E mutated, and 10 of 614 (1.6%) carried BRAF-rare alterations. A significantly higher rate of En-CVPTC (22/49, 44.9%) than En-FVPTC (15/195, 7.7%) (P < .0001) were BRAFV600E mutated. CONCLUSION En-CVPTC is less prevalent than En-FVPTC. However, it has good clinical/ pathological behavior comparable to En-FVPTC. This finding confirms the good prognostic role of a whole tumor capsule in CVPTC as well. New nomenclature for En-CVPTC, similar to that introduced for En-FVPTC (ie, noninvasive follicular thyroid neoplasm with papillary-like nuclear features; NIFTP) could be envisaged.
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Affiliation(s)
- Carlotta Giani
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, Italy
| | - Liborio Torregrossa
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Pathology Unit, University Hospital of Pisa, Pisa, Italy
| | - Teresa Ramone
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, Italy
| | - Cristina Romei
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, Italy
| | - Antonio Matrone
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, Italy
| | - Eleonora Molinaro
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, Italy
| | - Laura Agate
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, Italy
| | - Gabriele Materazzi
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Surgery Unit, University Hospital of Pisa, Pisa, Italy
| | - Paolo Piaggi
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Clara Ugolini
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Pathology Unit, University Hospital of Pisa, Pisa, Italy
| | - Fulvio Basolo
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Pathology Unit, University Hospital of Pisa, Pisa, Italy
| | - Raffaele Ciampi
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, Italy
| | - Rossella Elisei
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, Italy
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11
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Suzuki M, Moriya S, Kobayashi S, Nishijima Y, Fujii T, Ikota H, Yokoo H, Saio M. Computer-assisted image analysis of cytological specimens clarify the correlation between nuclear size and intranuclear cytoplasmic inclusions regardless of BRAFV600E mutation in papillary thyroid carcinoma. Cytopathology 2021; 32:718-731. [PMID: 34159645 DOI: 10.1111/cyt.13022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/29/2021] [Accepted: 06/08/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The morphological features of nuclei in cytological and histological specimens were compared and examined for the presence of BRAFV600E mutation and the appearance rate of intranuclear cytoplasmic inclusions (NI). METHODS BRAFV600E mutation was identified using a mutation-specific antibody (clone; VE1) in 103 thyroid papillary carcinoma cases at Gunma University Hospital. The nuclear area, perimeter, and roundness of the corresponding cytological specimens and haematoxylin and eosin-stained specimens were analysed using image analysis software, and the appearance rate of NI was calculated and compared. RESULTS BRAFV600E mutation was detected in 71 (69%) cases. The appearance rate of NI was significantly higher in the BRAFV600E mutation-positive group in cytological and histological specimens (P = .0070 and .0184, respectively). Significant differences were observed between the BRAFV600E mutation-negative and -positive groups in the average nuclear area and average nuclear perimeter in cytological specimens (P = .0137 and .0152, respectively). In addition, nuclear enlargement was correlated with the appearance rate of NI regardless of the presence of BRAFV600E mutation in cytological specimens. In the BRAFV600E mutation-negative group, the nuclear area and perimeter were significantly smaller in the lymph node metastasis-positive cases (P = .0182 and .0260, respectively). CONCLUSION This study found that the appearance rate of NI was positively correlated with the nuclear area and perimeter and negatively correlated with nuclear roundness in cytological specimens. Furthermore, these results were observed regardless of the existence of BRAFV600E mutation. These results have never been previously reported and clearly demonstrate the usefulness of cytological specimens in computer-assisted image analysis.
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Affiliation(s)
- Midori Suzuki
- Laboratory of Histopathology and Cytopathology, Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma, Japan
| | - Shunichi Moriya
- Laboratory of Histopathology and Cytopathology, Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma, Japan
| | - Sayaka Kobayashi
- Laboratory of Histopathology and Cytopathology, Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma, Japan
| | - Yoshimi Nishijima
- Laboratory of Histopathology and Cytopathology, Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma, Japan
| | - Takaaki Fujii
- Division of Breast and Endocrine Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hayato Ikota
- Clinical Department of Pathology, Gunma University Hospital, Gunma, Japan
| | - Hideaki Yokoo
- Department of Human Pathology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Masanao Saio
- Laboratory of Histopathology and Cytopathology, Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma, Japan
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12
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Abi-Raad R, Prasad ML, Zheng J, Hui P, Ustun B, Schofield K, Cai G, Adeniran AJ. Prognostic Assessment of BRAF Mutation in Preoperative Thyroid Fine-Needle Aspiration Specimens. Am J Clin Pathol 2021; 156:100-108. [PMID: 33527115 DOI: 10.1093/ajcp/aqaa213] [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: 11/12/2022] Open
Abstract
OBJECTIVES We investigate the potential role of BRAF testing in guiding surgical intervention in papillary thyroid carcinoma (PTC). METHODS Thyroid fine-needle aspiration (FNA) cases with available BRAF result and follow-up thyroidectomy for PTC were included in the study. Cytology and surgical diagnoses were correlated with BRAF status. RESULTS There were 151 cases of thyroid FNA specimens with BRAF testing (70 mutant and 81 wild-type BRAF) and histologically confirmed unilateral, unifocal PTCs. There were no differences in age, sex, tumor size, or lymphovascular invasion on thyroidectomy specimens between mutant and wild-type BRAF cases. BRAF mutation was significantly associated with cytology diagnosis (P < .001), PTC subtype (P < .001), extrathyroidal extension (ETE) (P = .006), and higher tumor (T) stage (P = .04). However, an analysis within the histologic subtypes of PTC revealed no significant association between BRAF mutation and ETE or higher T stage. There was also no difference in central (P = .847) or lateral (p = 1) neck lymph node (LN) metastasis. CONCLUSIONS BRAF mutation identified in thyroid FNA specimens correlates with histologic subtypes but is not an independent factor for predicting PTC biological behavior and should not be used to guide the extent of LN dissection.
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Affiliation(s)
- Rita Abi-Raad
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Manju L Prasad
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Jingwei Zheng
- Clinical Research Center, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Pei Hui
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Berrin Ustun
- Department of Pathology, Montefiore Medical Center, New York, NY, USA
| | - Kevin Schofield
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Guoping Cai
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
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13
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Dell'Aquila M, Fiorentino V, Martini M, Capodimonti S, Cenci T, Lombardi CP, Raffaelli M, Pontecorvi A, Fadda G, Pantanowitz L, Larocca LM, Rossi ED. How limited molecular testing can also offer diagnostic and prognostic evaluation of thyroid nodules processed with liquid-based cytology: Role of TERT promoter and BRAF V600E mutation analysis. Cancer Cytopathol 2021; 129:819-829. [PMID: 34076961 DOI: 10.1002/cncy.22454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Mutational analysis contributes to the diagnosis and prognosis of thyroid nodules analyzed with fine-needle aspiration cytology (FNAC). Although several advanced molecular tests based on multiple molecular markers are available for clinical use and have increased their impact on clinical management of patients, they are not widely available. Among them is BRAF V600E, one of the most studied mutations. Other genetic alterations, such as TERT promoter mutations, may coexist in thyroid carcinomas. Previous studies have demonstrated that this duet might be involved in the aggressiveness of thyroid cancer, although its prognostic value related to mortality remains undefined. The detection of such genetic alterations in thyroid liquid-based cytology (LBC) thus may assist with patient management. METHODS From January 2013 to June 2014, 356 thyroid FNAC samples were processed by LBC, including 174 surgical follow-up samples. BRAF V600E and TERT mutation analyses were performed on both LBC and histopathology. RESULTS The study included 119 samples categorized as atypia of undetermined significance, 42 categorized as follicular neoplasms, 61 categorized as suspicious for malignancy, and 34 categorized as positive for malignancy. BRAF V600E mutation was detected in 10.4% of all cases, whereas TERT promoter mutations were identified in 1.1%. TERT-mutated cases belonged to the positive for malignancy category, with a histologic diagnosis of tall cell variant of papillary thyroid carcinoma. These genetic alterations correlated with lymph node metastases (P = .0349) and higher disease stage. CONCLUSIONS BRAF V600E and TERT analysis can be performed on LBC. TERT mutations are rarely identified in well differentiated thyroid carcinoma but are associated with higher stage. Although a larger molecular panel may offer more information, analyzing these few point mutations is still likely to be useful for managing potentially more aggressive thyroid carcinomas.
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Affiliation(s)
- Marco Dell'Aquila
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
| | - Vincenzo Fiorentino
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
| | - Maurizio Martini
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
| | - Sara Capodimonti
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
| | - Tonia Cenci
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
| | - Celestino Pio Lombardi
- Division of Endocrine Surgery, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
| | - Marco Raffaelli
- Division of Endocrine Surgery, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
| | - Alfredo Pontecorvi
- Division of Endocrinology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
| | - Guido Fadda
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
| | - Liron Pantanowitz
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Luigi Maria Larocca
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
| | - Esther Diana Rossi
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
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14
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Jaffar S, Jayasekara J, Aniss AM, Tsang VHM, Learoyd DL, Clifton-Bligh R, Gill AJ, Glover AR, Sidhu SB, Robinson B, Sywak M. Predicting distant metastatic disease in differentiated thyroid cancer: a matched case-control study. ANZ J Surg 2021; 91:716-723. [PMID: 33590959 DOI: 10.1111/ans.16652] [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: 11/28/2020] [Revised: 01/17/2021] [Accepted: 01/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The occurrence of distant metastasis (DM) is the most important prognostic factor influencing survival outcomes in differentiated thyroid cancer (DTC). Identifying patients who are likely to develop DM and offering these cases more aggressive surgical approaches and I-131 therapy, is paramount to achieving the best possible outcomes. DM on presentation in DTC are uncommon, with an incidence of 1-9%. However, the incidence of DTC is rising and the disease affects a relatively young cohort of patients. The aims of this study were to investigate predictive factors in the development of DM by comparing a homogenous group of DTC patients with and without DM, and to illustrate the overall and disease-specific survival (DSS) rates of DTC patients presenting with DM. METHODS A matched case-control study of patients with DTC and DM was undertaken. The study group comprised a consecutive series of cases with DM treated in the period 1968-2014. Patients with DM at initial presentation were identified (DTC-DM group). A control group of patients without DM were matched based on age, gender, tumour size and histological subtype. The primary outcome measures were overall and disease-free survival. Secondary outcome measures were lymph node involvement (LNI), extra-thyroidal extension (ETE) of tumour and presence of BRAFV600E mutation identified on immunohistochemistry. RESULTS A total of 2547 patients with DTC were reviewed and of these 83 (3.26%) had DM at initial presentation. At 5 and 10 years, the overall survival rates for DTC-DM patients were 89.6% and 64%, respectively. The 5 and 10 year DSS rates for DTC-DM cases were 90.2% and 67.3%, respectively. When compared to the DTC group, the DTC-DM group had significantly higher rates of ETE (63% vs. 29.5%, P < 0.0001) and LNI (32.5% vs. 18.8%, P = 0.044). Among patients with papillary thyroid cancer (PTC), the presence of BRAFV600E mutation was significantly associated with DM (62.2% vs. 36.8%, P = 0.028). CONCLUSION ETE, LNI and BRAFV600E mutation in PTC are significant predictors for the development of distant metastatic disease.
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Affiliation(s)
- Sukaina Jaffar
- Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jayani Jayasekara
- Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Ahmad M Aniss
- Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Venessa H M Tsang
- Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Endocrinology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Diana L Learoyd
- Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Endocrinology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Roderick Clifton-Bligh
- Department of Endocrinology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Cancer Genetics Laboratory, Kolling Institute of Medical Research, Univerisity of Sydney and Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Anthony J Gill
- NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, University of Sydney and Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Anothony R Glover
- Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Stan B Sidhu
- Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Bruce Robinson
- Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Endocrinology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Mark Sywak
- Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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15
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Tabriz N, Grone J, Uslar V, Tannapfel A, Weyhe D. BRAF V600E mutation correlates with aggressive clinico-pathological features but does not influence tumor recurrence in papillary thyroid carcinoma-10-year single-center results. Gland Surg 2020; 9:1902-1913. [PMID: 33447541 DOI: 10.21037/gs-20-244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background BRAF V600E mutation is common in papillary thyroid carcinoma (PTC) but its prognostic value and influence on tumor recurrence is controversial. We investigated if BRAF V600E mutation influences tumor behavior and recurrence, and if it can be used as surrogate parameter in PTC. Methods In a single center retrospective study with a median follow-up of 5 years, incidence of BRAF V600E mutation in 186 PTC specimens from 2007-2016 was investigated. Tumor outcome parameters including TNM status, multifocal and invasive growth and tumor recurrence rate were examined. Results In 98 specimens (52.7%) a BRAF V600E mutation (BRAF+), and in 88 specimens (47.3%) no mutation (BRAF-) was detected. There was no gender specific difference. BRAF+ patients were significantly older (mean 5.6 years; P=0.011). BRAF+ tumors were significantly smaller (14.4 vs. 18.3 mm; P=0.018), and more often showed a multifocal (30.6% vs. 17%; P=0.031) and extracapsular tumor growth pattern (pT3b and pT4a; BRAF+ 22.4% vs. BRAF- 10.2%; P=0.026). Although lymph node-status did not differ in both groups, BRAF+ showed a higher infiltration rate of the lateral lymph node compartment (12.2% vs. 5.7%; P=n.s.). Distant metastases occurred only in BRAF+ (3.1% vs. 0%). There was no significant difference in terms of tumor recurrence rate. Conclusions Results regarding the incidence of malignant lymph nodes, tumor growth pattern and tumor multifocality suggest a more aggressive tumor behavior in BRAF+ PTC but this fact does not affect tumor recurrence rate in a five year follow up period. Therefore, the postoperative role of BRAF V600E mutation remains unclear, and a general change of operative procedure and radicality cannot be recommended based on BRAF status alone.
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Affiliation(s)
- Navid Tabriz
- University Hospital for Visceral Surgery, Pius Hospital Oldenburg, Medical Campus University of Oldenburg, Oldenburg, Germany
| | - Johannes Grone
- University Hospital for Visceral Surgery, Pius Hospital Oldenburg, Medical Campus University of Oldenburg, Oldenburg, Germany
| | - Verena Uslar
- University Hospital for Visceral Surgery, Pius Hospital Oldenburg, Medical Campus University of Oldenburg, Oldenburg, Germany
| | | | - Dirk Weyhe
- University Hospital for Visceral Surgery, Pius Hospital Oldenburg, Medical Campus University of Oldenburg, Oldenburg, Germany
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16
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Chakraborty D, Shakya S, Ballal S, Agarwal S, Bal C. BRAF V600E and TERT promoter mutations in paediatric and young adult papillary thyroid cancer and clinicopathological correlation. J Pediatr Endocrinol Metab 2020; 33:1465-1474. [PMID: 33027050 DOI: 10.1515/jpem-2020-0174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 09/13/2020] [Indexed: 12/12/2022]
Abstract
Objectives The primary objective of this study was to determine the prevalence of BRAF V600E and TERTpromoter mutations in paediatric and young adult patients with papillary thyroid carcinoma (PTC) and the secondary objective, to assess their association with clinicopathological features. Methods Patients ≤20 years who underwent surgery for differentiated thyroid cancer (DTC) from 2005 to 2018 were consecutively enrolled for BRAF V600E and TERTpromoter mutations analysis and records analysed for the association of aggressive features. Univariate analysis and multivariate logistic regression were used to identify the independent predictors of BRAF V600E mutations. Results Among 100 patients with DTC, 68 patients were ≤18 years and the remaining 30 patients were >18 years of age with a median age of 17 years (IQR 14-19 years) 98 patients had PTC and 2 had FTC. BRAF V600E mutation was present in 14/98 (14.3%) PTC and TERTpromoter mutation noted in none. Multivariate analysis identified RAI refractoriness (OR:10.57, 95% CI: 2.6 to 41.6, P-0.0008) as an independent factor associated with BRAF V600E mutation. 17 patients with distant metastases were negative for both BRAF V600E or TERTpromoter mutation. No significant association was observed between age, gender, PTC variants, extra-thyroidal extension, lymphovascular invasion, multifocality, RAI administration and event rate with BRAF V600E mutation. Irrespective of BRAF V600E mutation, radioiodine refractory status (p-0.0001) had a reduced EFS probability. Conclusion In paediatric & young adult PTC, TERTpromoter mutation is absent and BRAFV600E mutation is not associated with distant metastasis. The prevalence rate of the BRAF V600E mutation is much lower compared to adult PTC patients.
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Affiliation(s)
- Dhritiman Chakraborty
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sunil Shakya
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjana Ballal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shipra Agarwal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Chandrasekhar Bal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
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17
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Abi-Raad R, Prasad ML, Adeniran AJ, Cai G. Fine-needle aspiration cytomorphology of papillary thyroid carcinoma with NTRK gene rearrangement from a case series with predominantly indeterminate cytology. Cancer Cytopathol 2020; 128:803-811. [PMID: 32931153 DOI: 10.1002/cncy.22353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Neurotrophic tyrosine kinase receptor (NTRK) rearrangement has been reported in a subset of papillary thyroid carcinoma (PTC) cases. Little is known about the cytomorphologic features of NTRK-rearranged PTC. METHODS We report an institutional series of 13 fine-needle aspiration (FNA) specimens of NTRK-rearranged PTC with a predominantly indeterminate cytology diagnosis. NTRK3 or NTRK1 rearrangements were detected on FNA or surgical specimens by next-generation sequencing. RESULTS The 13 patients had a median age of 18 years; 10 patients were female and 3 patients were male. In 10 (77%) cases, cytology was indeterminate, and histopathologic follow-up was predominantly the follicular variant of PTC (n = 8 [62%]), mostly infiltrative subtype. Of 12 FNA specimens available for review, a predominant loosely cohesive group pattern was the most commonly encountered architectural pattern (n = 5 [41%]), followed by single cell (n = 3 [25%]), thick cord (n = 2 [17%]), and microfollicular pattern (n = 2 [17%]). Background lymphocytic thyroiditis was observed in 9 cases. At the cellular level, the cytoplasm was moderate and granular, occasionally vacuolated. Classic PTC nuclear features (eg, nuclear enlargement, elongation, grooves, and nuclear membrane irregularity) were present but were often focal and subtle. Chromatin was often granular. Intranuclear pseudoinclusions were absent or rare. CONCLUSION Our study demonstrates that most cases of NTRK rearrangement lack classic PTC cytomorphologic characteristics. Loosely cohesive groups and single cells with granular, sometimes vacuolated cytoplasm and subtle nuclear features are often seen on FNA specimens. Recognizing these characteristics may be helpful to preoperatively prompt molecular testing, including NTRK rearrangement analysis.
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Affiliation(s)
- Rita Abi-Raad
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Manju L Prasad
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Adebowale J Adeniran
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Guoping Cai
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
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18
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Barreno LRQ, Mello JBHD, Barros-Filho MC, Francisco AL, Chulam TC, Pinto CAL, Gonçalves-Filho J, Kowalski LP. Characterization of BRAF mutation in patients older than 45 years with well-differentiated thyroid carcinoma. Braz J Otorhinolaryngol 2020; 88:523-528. [PMID: 32972866 PMCID: PMC9422592 DOI: 10.1016/j.bjorl.2020.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/12/2020] [Indexed: 11/15/2022] Open
Abstract
Introduction Papillary thyroid carcinoma is the most frequent endocrine neoplasia and its incidence has tripled over the past 35 years. Although papillary thyroid carcinoma carries a good prognosis, 10%−30% of patients still develop recurrence and metastasis. Some clinical and genetic features are associated with worse prognosis. The most frequent mutation is the BRAF p.V600E, which has been associated with many clinical features of poor prognosis. However, many studies have produced controversial results without any association between BRAF mutation and clinicopathological features of poor prognosis. Objective Since the prognostic value of BRAF mutations remains controversial, this study aims to investigate the importance of this mutation in therapeutic decisions for papillary thyroid carcinoma. Methods Therefore, we evaluated whether the presence of BRAF mutation is associated with features of poor prognosis in 85 patients with papillary thyroid carcinoma older than 45 years treated at A.C. Camargo Cancer Center, from 1980 to 2007. BRAF mutation was evaluated by pyrosequencing. Statistical analysis was performed using SPSS. Results The mean age of patients was 54 years (range: 45 − 77 years), 73 were women (85.8%) and 12 were men (14.2%). Among them, 39 cases (45.9%) presented extrathyroidal extension and 11 cases had recurrent disease. BRAF mutation was detected in 57 (67%) patients. No significant association was observed between BRAF mutation and gender (p = 0.743), age (p = 0.236), N-stage (p = 0.423), vascular and perineural infiltration (p = 0.085 or multifocality (p = 1.0). Although not statistically significant, the majority of patients with recurrent disease were BRAF positive (9 out of 11) (p = 0.325). Patients affected by BRAF mutation are associated with tumors larger than 1 cm (p = 0.034) and with extrathyroidal extension (p = 0.033). Conclusion Although BRAF testing is widely available, there are no consistent data to support improvement in outcomes from incorporating it into therapeutic decision for thyroid cancer.
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Ebina A, Togashi Y, Baba S, Sato Y, Sakata S, Ishikawa M, Mitani H, Takeuchi K, Sugitani I. TERT Promoter Mutation and Extent of Thyroidectomy in Patients with 1-4 cm Intrathyroidal Papillary Carcinoma. Cancers (Basel) 2020; 12:cancers12082115. [PMID: 32751594 PMCID: PMC7464551 DOI: 10.3390/cancers12082115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/19/2022] Open
Abstract
There are concerns regarding overtreatment in papillary thyroid carcinoma (PTC). BRAF V600E and TERT promoter mutations play important roles in the development of PTC. However, initial surgical approaches for PTC based on genetic characteristics remain unclear. The present study aimed to identify genetic mutations as predictors of prognosis and to establish proper indications for lobectomy (LT) in patients with 1–4 cm intrathyroidal PTC. Prospectively accumulated data from 685 consecutive patients with PTC who underwent primary thyroid surgery at the Cancer Institute Hospital, Tokyo, Japan, between 2001 and 2012 were retrospectively reviewed. Of the 685 patients examined, 538 (78.5%) had BRAF V600E mutation and 133 (19.4%) had TERT promoter mutations. Patients with TERT promoter mutations displayed significantly worse outcomes than those without mutations (10-year cause-specific survival (CSS): 73.7% vs. 98.1%, p < 0.001; 10-year disease-free survival (DFS): 53.7% vs. 93.3%, p < 0.001). As for extent of thyroidectomy among TERT mutation-negative patients with 1–4 cm intrathyroidal PTC, patients who underwent LT showed no significant differences in 10-year CSS and 10-year DFS compared to patients who had total thyroidectomy (TT) under propensity score-matching. Avoiding TT for those patients indicates a possible pathway to prevent overtreatment and reduce postoperative complications.
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Affiliation(s)
- Aya Ebina
- Department of Endocrine Surgery, Nippon Medical School, Tokyo 113-8603, Japan;
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan; (Y.T.); (S.B.); (Y.S.); (S.S.); (K.T.)
- Correspondence: ; Tel.: +81-3-3822-2131
| | - Yuki Togashi
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan; (Y.T.); (S.B.); (Y.S.); (S.S.); (K.T.)
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
| | - Satoko Baba
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan; (Y.T.); (S.B.); (Y.S.); (S.S.); (K.T.)
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
| | - Yukiko Sato
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan; (Y.T.); (S.B.); (Y.S.); (S.S.); (K.T.)
| | - Seiji Sakata
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan; (Y.T.); (S.B.); (Y.S.); (S.S.); (K.T.)
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
| | - Masashi Ishikawa
- Department of Anesthesiology, Nippon Medical School, Tokyo 113-8603, Japan;
| | - Hiroki Mitani
- Division of Head and Neck, Cancer Institute Hospital, Tokyo 135-8550, Japan;
| | - Kengo Takeuchi
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan; (Y.T.); (S.B.); (Y.S.); (S.S.); (K.T.)
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
- Clinical Pathology Center, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
| | - Iwao Sugitani
- Department of Endocrine Surgery, Nippon Medical School, Tokyo 113-8603, Japan;
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Liu R, Li Y, Chen W, Cong J, Zhang Z, Ma L, Chu L, Xiao H, Zhang Y, Liu Y, Xu Y, Yu Q, Yang X, Sun C. Mutations of the TERT promoter are associated with aggressiveness and recurrence/distant metastasis of papillary thyroid carcinoma. Oncol Lett 2020; 20:50. [PMID: 32802170 DOI: 10.3892/ol.2020.11904] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 06/23/2020] [Indexed: 12/22/2022] Open
Abstract
Several previous studies have shown that mutations in B-Raf proto-oncogene (BRAF) and telomerase reverse transcriptase (TERT) can be used for the diagnosis and prognosis of papillary thyroid carcinoma (PTC). However, whether mutations in BRAF and the TERT promoter may improve the accurate identification and risk stratification of high-risk patients in the early stage of PTC remains unclear and requires further investigation. In the present study, mutations in BRAF and the TERT promoter were examined in 205 patients using PCR and Sanger DNA sequencing. The potential association between mutations in these two genes and the clinicopathological characteristics of patients with PTC was then analyzed. BRAF mutations were identified in 169/205 (82.4%) patients, whereas only 8/205 (3.9%) patients presented mutations in the TERT promoter, seven patients exhibited a C228T mutation, and the remaining one had a C250T mutation. There were 6/205 (2.9%) patients with mutations in both BRAF and the TERT promoter. Importantly, compared with patients with no mutations, patients with mutations in BRAF were more likely to exhibit mutations in the TERT promoter. A significant difference in lymph node metastasis was found between the BRAF V600E mutation group and the group without mutations in BRAF. Mutations in the TERT promoter were significantly correlated with older age, extrathyroidal invasion, tumor multifocality and advanced tumor/node/metastasis stage, which are associated with the aggressiveness of PTC. Moreover, compared with patients exhibiting mutations in BRAF, mutations in the TERT promoter were found to be significantly associated with aggressive clinicopathological features and higher risk of recurrence or distant metastasis. Collectively, mutations in the TERT promoter were not frequent, but were significantly correlated with more aggressive clinicopathological features of PTC. Therefore, mutations in the TERT promoter may be an important factor in the genetic background of PTC, and detection of such mutations may help the accurate identification and management of high-risk patients with recurrent or distant metastasis.
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Affiliation(s)
- Riming Liu
- Center for Laboratory Diagnosis, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
| | - Yulan Li
- Center for Laboratory Diagnosis, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
| | - Weixin Chen
- Department of General Surgery, Zhongshan Hospital of Fudan University, Qingpu, Shanghai 201700, P.R. China
| | - Jianglin Cong
- Department of Gynaecology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
| | - Zhengfang Zhang
- Center for Laboratory Diagnosis, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
| | - Li Ma
- Center for Laboratory Diagnosis, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
| | - Lina Chu
- Center for Laboratory Diagnosis, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
| | - Hui Xiao
- Center for Laboratory Diagnosis, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
| | - Yanhong Zhang
- Center for Laboratory Diagnosis, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
| | - Yongming Liu
- Center for Laboratory Diagnosis, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
| | - Yimin Xu
- Center for Laboratory Diagnosis, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
| | - Qin Yu
- Center for Laboratory Diagnosis, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
| | - Xin Yang
- Center for Laboratory Diagnosis, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
| | - Chengming Sun
- Center for Laboratory Diagnosis, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 370600, P.R. China
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21
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Szpak-Ulczok S, Pfeifer A, Rusinek D, Oczko-Wojciechowska M, Kowalska M, Tyszkiewicz T, Cieslicka M, Handkiewicz-Junak D, Fujarewicz K, Lange D, Chmielik E, Zembala-Nozynska E, Student S, Kotecka-Blicharz A, Kluczewska-Galka A, Jarzab B, Czarniecka A, Jarzab M, Krajewska J. Differences in Gene Expression Profile of Primary Tumors in Metastatic and Non-Metastatic Papillary Thyroid Carcinoma-Do They Exist? Int J Mol Sci 2020; 21:E4629. [PMID: 32610693 PMCID: PMC7369779 DOI: 10.3390/ijms21134629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/22/2020] [Accepted: 06/26/2020] [Indexed: 12/14/2022] Open
Abstract
Molecular mechanisms of distant metastases (M1) in papillary thyroid cancer (PTC) are poorly understood. We attempted to analyze the gene expression profile in PTC primary tumors to seek the genes associated with M1 status and characterize their molecular function. One hundred and twenty-three patients, including 36 M1 cases, were subjected to transcriptome oligonucleotide microarray analyses: (set A-U133, set B-HG 1.0 ST) at transcript and gene group level (limma, gene set enrichment analysis (GSEA)). An additional independent set of 63 PTCs, including 9 M1 cases, was used to validate results by qPCR. The analysis on dataset A detected eleven transcripts showing significant differences in expression between metastatic and non-metastatic PTC. These genes were validated on microarray dataset B. The differential expression was positively confirmed for only two genes: IGFBP3, (most significant) and ECM1. However, when analyzed on an independent dataset by qPCR, the IGFBP3 gene showed no differences in expression. Gene group analysis showed differences mainly among immune-related transcripts, indicating the potential influence of tumor immune infiltration or signal within the primary tumor. The differences in gene expression profile between metastatic and non-metastatic PTC, if they exist, are subtle and potentially detectable only in large datasets.
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Affiliation(s)
- Sylwia Szpak-Ulczok
- Nuclear Medicine and Endocrine Oncology Department; Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (S.S.-U.); (D.H.-J.); (A.K.-B.); (A.K.-G.); (B.J.)
| | - Aleksandra Pfeifer
- Department of Genetic and Molecular Diagnostics of Cancer, Maria Sklodowska, Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (A.P.); (D.R.); (M.O.-W.); (M.K.); (T.T.); (M.C.)
| | - Dagmara Rusinek
- Department of Genetic and Molecular Diagnostics of Cancer, Maria Sklodowska, Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (A.P.); (D.R.); (M.O.-W.); (M.K.); (T.T.); (M.C.)
| | - Malgorzata Oczko-Wojciechowska
- Department of Genetic and Molecular Diagnostics of Cancer, Maria Sklodowska, Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (A.P.); (D.R.); (M.O.-W.); (M.K.); (T.T.); (M.C.)
| | - Malgorzata Kowalska
- Department of Genetic and Molecular Diagnostics of Cancer, Maria Sklodowska, Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (A.P.); (D.R.); (M.O.-W.); (M.K.); (T.T.); (M.C.)
| | - Tomasz Tyszkiewicz
- Department of Genetic and Molecular Diagnostics of Cancer, Maria Sklodowska, Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (A.P.); (D.R.); (M.O.-W.); (M.K.); (T.T.); (M.C.)
| | - Marta Cieslicka
- Department of Genetic and Molecular Diagnostics of Cancer, Maria Sklodowska, Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (A.P.); (D.R.); (M.O.-W.); (M.K.); (T.T.); (M.C.)
| | - Daria Handkiewicz-Junak
- Nuclear Medicine and Endocrine Oncology Department; Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (S.S.-U.); (D.H.-J.); (A.K.-B.); (A.K.-G.); (B.J.)
| | - Krzysztof Fujarewicz
- Institute of Automatic Control, Silesian University of Technology, 44-100 Gliwice, Poland; (K.F.); (S.S.)
| | - Dariusz Lange
- Tumor Pathology Department; Maria Sklodowska, Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (D.L.); (E.C.); (E.Z.-N.)
| | - Ewa Chmielik
- Tumor Pathology Department; Maria Sklodowska, Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (D.L.); (E.C.); (E.Z.-N.)
| | - Ewa Zembala-Nozynska
- Tumor Pathology Department; Maria Sklodowska, Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (D.L.); (E.C.); (E.Z.-N.)
| | - Sebastian Student
- Institute of Automatic Control, Silesian University of Technology, 44-100 Gliwice, Poland; (K.F.); (S.S.)
| | - Agnieszka Kotecka-Blicharz
- Nuclear Medicine and Endocrine Oncology Department; Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (S.S.-U.); (D.H.-J.); (A.K.-B.); (A.K.-G.); (B.J.)
| | - Aneta Kluczewska-Galka
- Nuclear Medicine and Endocrine Oncology Department; Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (S.S.-U.); (D.H.-J.); (A.K.-B.); (A.K.-G.); (B.J.)
| | - Barbara Jarzab
- Nuclear Medicine and Endocrine Oncology Department; Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (S.S.-U.); (D.H.-J.); (A.K.-B.); (A.K.-G.); (B.J.)
| | - Agnieszka Czarniecka
- The Oncologic and Reconstructive Surgery Clinic; Maria Sklodowska, Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland;
| | - Michal Jarzab
- Breast Unit; Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland;
| | - Jolanta Krajewska
- Nuclear Medicine and Endocrine Oncology Department; Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland; (S.S.-U.); (D.H.-J.); (A.K.-B.); (A.K.-G.); (B.J.)
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Correlation between F18-FDG PET/CT Imaging and BRAF V600E Genetic Mutation for the Early Assessment of Treatment Response in Papillary Thyroid Cancers. J Pers Med 2020; 10:jpm10020052. [PMID: 32575591 PMCID: PMC7354584 DOI: 10.3390/jpm10020052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/11/2020] [Accepted: 06/18/2020] [Indexed: 11/25/2022] Open
Abstract
In thyroid neoplastic pathology, the BRAF V600E mutation is shown to be involved in the oncogenesis of papillary thyroid cancer and its subtypes. The purpose of this study is to evaluate the correlation between the mutation of the BRAF V600E oncogene and the pathological standardized uptake values (SUV) at the F18-fluorodeoxyglucose (F18-FDG) positron emission tomography/computed tomography (PET/CT) evaluation, for a group of 20 patients with radically treated (total thyroidectomy and radioiodine therapy) papillary thyroid cancer, with subclinical persistent disease, at 6 months after the initial treatment. We analyzed the correlations between the values of SUV and the presence of the BRAF mutation as well with other prognostic factors such as stage, age, specific tumor markers (thyroglobulin and anti-thyroglobulin), extrathyroid extension, the presence of metastatic lymph nodes or distant metastasis. The value of SUV in the case of BRAF+ (positive) patients was higher than in the negative ones, but without statistical significance, thus, the values of the SUV cannot be a predictable factor for the presence of the genetic mutation. There was a statistically significant correlation in BRAF+ subgroup between the SUV values and the positive resection limit following surgery, showing a higher SUV value in the PET/CT evaluation. No correlation was observed between the aforementioned prognostic factors involved in papillary thyroid cancer and the BRAF V600E mutation.
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Marina M, Serra MF, Aldigeri R, Ceresini G. Incidental versus clinically diagnosed differentiated thyroid cancer in both adult and elderly subjects: histological characteristics and follow-up in a retrospective analysis from a single institution. Endocrine 2020; 68:584-591. [PMID: 31970586 DOI: 10.1007/s12020-020-02200-z] [Citation(s) in RCA: 2] [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] [Received: 09/16/2019] [Accepted: 01/13/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Most thyroid cancer are incidentally diagnosed. However, little is known on the different modalities of incidental diagnosis in adult versus older patients. METHODS We retrospectively analyzed data from 440 patients consecutively diagnosed with differentiated thyroid cancer (DTC) in a single institution. Modalities of diagnosis were categorized as follows: (A) clinically diagnosed, nonincidental cases; (B) incidental during carotid power-duplex (CPD); (C) incidental during neck imaging other than carotid power-duplex; (D) incidental during imaging workup of thyroid dysfunction or at histological examination after thyroidectomy for benign lesions. Demographics, histology and follow-up were compared between adult (<65 years) and older (≥65 years) patients according to the different modalities of diagnosis. RESULTS A total of 363 and 67 cases were recorded in adult and older patients, respectively with incidental proportions of 79% and 85%, respectively. A P < 0.001 significant difference in the modality of diagnosis was found between adult and older subjects, the latter presenting with a higher prevalence of Group B. In the nonincidental group, papillary histotype, larger size, and extrathyroidal invasion were more frequently observed in older subjects. Disease-free survival was comparable between adult and older subjects in the incidental cases, whereas it was reduced, though not significantly, in older subjects. CONCLUSION Incidental cases of DTC are more frequently diagnosed in the old subjects and are mainly due to CPD. Disease-free survival is comparable between adult and older subjects in both incidental and nonincidental cases, although it may be slightly reduced in nonincidentally diagnosed older patients.
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Affiliation(s)
- Michela Marina
- Unit of Internal Medicine and Oncological Endocrinology, Department of Medicine and Surgery, University Hospital of Parma, University of Parma, Parma, Italy
| | - Maria Francesca Serra
- Unit of Internal Medicine and Oncological Endocrinology, Department of Medicine and Surgery, University Hospital of Parma, University of Parma, Parma, Italy
| | - Raffaella Aldigeri
- Unit of Internal Medicine and Oncological Endocrinology, Department of Medicine and Surgery, University Hospital of Parma, University of Parma, Parma, Italy
| | - Graziano Ceresini
- Unit of Internal Medicine and Oncological Endocrinology, Department of Medicine and Surgery, University Hospital of Parma, University of Parma, Parma, Italy.
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Koelsch B, Theurer S, Staniszewska M, Heupel J, Koch A, Mergener S, Walk F, Fischer C, Kutritz A, Schmid KW, Kindler-Röhrborn A. An Animal Model Further Uncovers the Role of Mutant Braf V600E during Papillary Thyroid Cancer Development. THE AMERICAN JOURNAL OF PATHOLOGY 2020; 190:702-710. [PMID: 31953036 DOI: 10.1016/j.ajpath.2019.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/14/2019] [Accepted: 11/19/2019] [Indexed: 12/15/2022]
Abstract
Papillary thyroid carcinomas (PTCs) account for 90% of human thyroid cancer cases, which represent 1% of all cancer cases. They are likely to develop from papillary thyroid microcarcinomas (PTMCs), found in up to 36% of healthy individuals, due to rare progression events (0.01%). Although the prognosis of PTCs is excellent, 5% to 10% of tumors display an unfavorable outcome. About 45% of PTCs exhibit activating BRAFV600E mutations. Rats of the inbred BD strains postnatally exposed to the carcinogen N-ethyl-N-nitrosourea developed PTMCs, which closely resembled their human counterparts judging from their histology, size, and marginal tendency to progress. DNA sequencing revealed mutations in exon 15 of the Braf gene identical to the human BRAFV600E mutation in 82% of the cases. Predominantly a 50:50 ratio of wild-type to mutant Braf alleles was seen regardless of tumor size or animal age, indicating that the Braf mutation is an early, if not the initial, event in rat PTMC development. Surprisingly, most PTMCs carrying a confirmed BrafV600E mutation did not display BrafV600E protein expression. As the BrafV600Egene is supposed to be the driver in PTC development, down-regulation of expression should contribute to the low risk for progression of PTMC. This model system will enable further insights into the molecular mechanisms of PTMC initiation and progression to PTC, further translating into targeted tumor prevention strategies/therapies.
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Affiliation(s)
- Bernd Koelsch
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Sarah Theurer
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Magdalena Staniszewska
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Jacqueline Heupel
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Amelie Koch
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Svenja Mergener
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Franziska Walk
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Christine Fischer
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - Andrea Kutritz
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Kurt W Schmid
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Andrea Kindler-Röhrborn
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany.
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25
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Zarkesh M, Zadeh-Vakili A, Akbarzadeh M, Nozhat Z, Fanaei SA, Hedayati M, Azizi F. BRAF V600E mutation and microRNAs are helpful in distinguishing papillary thyroid malignant lesions: Tissues and fine needle aspiration cytology cases. Life Sci 2019; 223:166-173. [PMID: 30890403 DOI: 10.1016/j.lfs.2019.03.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 03/04/2019] [Accepted: 03/15/2019] [Indexed: 01/08/2023]
Abstract
AIMS Mutations of BRAF oncogene are considered to contribute in the invasiveness and poor clinicopathologic features of papillary thyroid cancer (PTC). As a step towards understanding the underlying molecular mechanisms of this contribution, we aimed to examine the association of four microRNAs' (miR-222, -137, -214, -181b) levels with BRAFV600E and clinicopathological features in PTC tissues and fine needle aspiration (FNA) specimens. METHODS In total, 56 PTC and 27 benign with multinodular goiter tissue samples, 95 FNA samples, and B-CPAP and HEK293 cell lines were examined. BRAFV600E mutation was examined in PTC tissues and FNA samples. Expression of microRNAs was assessed by real-time quantitative reverse transcription-PCR. KEY FINDINGS The frequency of BRAFV600E in PTC tissues and FNA samples "suspicious for PTC" was 41.1 and 36.8%, respectively. MiR-222, -137, -214, and -181b were significantly upregulated in PTC tumors (P < 0.05) and in B-CPAP cell line (P < 0.001). In FNA, the expressions of miR-222, -181b and -214 were significantly elevated in patients suspected for PTC (P < 0.05), while there was no significant difference in miR-137. After adjustment for age and sex, miR-181b was associated with an increased risk of bearing BRAFV600E mutation (OR: 1.27; 95% CI: 1.01-1.61; P = 0.045) and risk of lymphovascular invasion (OR: 1.66; 95% CI: 1.01-2.72; P = 0.045); miR-137 was associated with the risk of larger tumor size (OR: 1.31; 95% CI: 1.04-1.65; P = 0.022); miR-222 was related to increase in extracapsular invasion (OR: 1.28; 95% CI: 1.04-1.57; P = 0.018). SIGNIFICANCE Upregulation of miR-222, -214 and -181b has been confirmed in PTC tumors, FNA samples and cell line. MiR-137 upregulation has been confirmed in PTC tumors and cell line, but not in FNA samples. MiR-222, -137 and -181b showed an association with the degree of malignancy in PTC tumors.
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Affiliation(s)
- Maryam Zarkesh
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Azita Zadeh-Vakili
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mahdi Akbarzadeh
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Nozhat
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
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Are BRAF V600E and K-Ras Mutations Associated With Tumor Aggressiveness in Well-Differentiated Thyroid Cancer? Int Surg 2019. [DOI: 10.9738/intsurg-d-14-00145.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim:
Many clinical studies have shown an association between B-type rapidly growing fibrosarcoma kinase [BRAF(V600E)] mutation and aggressive clinicopathologic features, although some results from others are controversial. Besides, Kirsten rat sarcoma (K-Ras) mutations are more common in endemic iodine deficiency regions, as our country is. However, use of the biologic markers are questioned in clinical practice; they are beginning to be used for the management of patients with thyroid nodules and cancers. The aim of the present study was to evaluate the prevalence of the BRAF(V600E) mutation in tumor samples and its relationship to high-risk clinicopathologic features.
Methods:
From 2000 to 2007, 82 patients with well-differentiated thyroid cancer (WDTC) who underwent surgery in Ege University were enrolled retrospectively in the study. Univariate and multivariate analyses were performed to analyze associations between BRAF(V600E) and K-Ras mutations and clinicopathologic features. We identified 82 patients with WDTC (male:female = 1:3.2).
Results:
The median follow-up was 96 months. The mean age was 46.4 (16–80). None of the all analyzed prognostic factors—age; sex; lymph node metastasis; multifocality; multicentricity; invasion; tumor diameter; and tumor, node, metastasis staging—were correlated with BRAF(V600E) mutation status in the univariate analysis. Meanwhile, none of the analyzed prognostic factors were correlated with K-Ras mutation status.
Discussion:
Although many studies suggest BRAF(V600E) and K-Ras mutations as prognostic factors in WDTC, our results are controversial. BRAF(V600E) and K-Ras mutations have no significant effects on tumor aggressiveness in Turkish patients with WDTC. Our results underline that it is too early to reach a conclusion that BRAF(V600E) and K-Ras mutations are involved with poor clinical outcomes.
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Xu Y, Chen J, Yang Z, Xu L. Identification of RNA Expression Profiles in Thyroid Cancer to Construct a Competing Endogenous RNA (ceRNA) Network of mRNAs, Long Noncoding RNAs (lncRNAs), and microRNAs (miRNAs). Med Sci Monit 2019; 25:1140-1154. [PMID: 30745559 PMCID: PMC6380385 DOI: 10.12659/msm.912450] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background The aims of this study were to use RNA expression profile bioinformatics data from cases of thyroid cancer from the Cancer Genome Atlas (TCGA), the Kyoto Encyclopedia of Genes and Genomes (KEGG), and the Gene Ontology (GO) databases to construct a competing endogenous RNA (ceRNA) network of mRNAs, long noncoding RNAs (lncRNAs), and microRNAs (miRNAs). Material/Methods TCGA provided RNA profiles from 515 thyroid cancer tissues and 56 normal thyroid tissues. The DESeq R package analyzed high-throughput sequencing data on differentially expressed RNAs. GO and KEGG pathway analysis used the DAVID 6.8 and the ClusterProfile R package. Kaplan-Meier survival statistics and Cox regression analysis were performed. The thyroid cancer ceRNA network was constructed based on the miRDB, miRTarBase, and TargetScan databases. Results There were 1,098 mRNAs associated with thyroid cancer; 101 mRNAs were associated with overall survival (OS). Multivariate analysis developed a risk scoring system that identified seven signature mRNAs, with a discriminative value of 0.88, determined by receiver operating characteristic (ROC) curve analysis. A ceRNA network included 13 mRNAs, 31 lncRNAs, and seven miRNAs. Four out of the 31 lncRNAs and all miRNAs were down-regulated, and the remaining RNAs were upregulated. Two lncRNAs (MIR1281A2HG and OPCML-IT1) and one miRNA (miR-184) were significantly associated with OS in patients with thyroid cancer. Conclusions Differential RNA expression profiling in thyroid cancer was used to construct a ceRNA network of mRNAs, lncRNAs, and miRNAs that showed potential in evaluating prognosis.
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Affiliation(s)
- Yuanxin Xu
- Department of Endocrinology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Jiuwei Chen
- Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Zhihui Yang
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Lihua Xu
- Department of Nursing, The Hospital of Heilongjiang Province, Harbin, Heilongjiang, China (mainland)
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28
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Colombo C, Muzza M, Proverbio MC, Tosi D, Soranna D, Pesenti C, Rossi S, Cirello V, De Leo S, Fusco N, Miozzo M, Bulfamante G, Vicentini L, Ferrero S, Zambon A, Tabano S, Fugazzola L. Impact of Mutation Density and Heterogeneity on Papillary Thyroid Cancer Clinical Features and Remission Probability. Thyroid 2019; 29:237-251. [PMID: 30501571 DOI: 10.1089/thy.2018.0339] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The need to integrate the classification of cancer with information on the genetic pattern has emerged in recent years for several tumors. METHODS The genomic background of a large series of 208 papillary thyroid cancers (PTC) followed at a single center was analyzed by a custom MassARRAY genotyping platform, which allows the simultaneous detection of 19 common genetic alterations, including point mutations and fusions. RESULTS Of the PTCs investigated, 71% were found to have pathognomonic genetic findings, with BRAFV600E and TERT promoter mutations being the most frequent monoallelic alterations (42% and 23.5%, respectively), followed by RET/PTC fusions. In 19.2% of cases, two or more point mutations were found, and the co-occurrence of a fusion with one or more point mutation(s) was also observed. Coexisting BRAFV600E and TERT promoter mutations were detected in a subgroup of aggressive PTCs (12%). A correlation between several aggressive features and mutation density was found, regardless of the type of association (i.e., only point mutations, or point mutations and fusions). Importantly, Kaplan-Meier curves demonstrated that mutation density significantly correlated with a higher risk of persistent disease. In most cases, the evaluation of the allelic frequencies normalized for the cancer cell content indicated the presence of the monoallelic mutation in virtually all tumor cells. A minority of cases was found to harbor low allelic frequencies, consistent with the presence of the mutations in a small subset of cancer cells, thus indicating tumor heterogeneity. Consistently, the presence of coexisting genetic alterations with different allelic frequencies in some tumors suggests that PTC can be formed by clones/subclones with different mutational profiles. CONCLUSIONS A large mono-institutional series of PTCs was fully genotyped by means of a cost- and time-effective customized panel, revealing a strong impact of mutation density and genetic heterogeneity on the clinical features and on disease outcomes, indicating that an accurate risk stratification of thyroid cancer cannot rely on the analysis of a single genetic event. Finally, the heterogeneity found in some tumors warrants attention, since the occurrence of this phenomenon is likely to affect response to targeted therapies.
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Affiliation(s)
- Carla Colombo
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Marina Muzza
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 3 Endocrine Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Carla Proverbio
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Delfina Tosi
- 4 Unit of Pathology, ASST Santi Paolo e Carlo, Milan, Italy
- 5 Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Chiara Pesenti
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Rossi
- 4 Unit of Pathology, ASST Santi Paolo e Carlo, Milan, Italy
| | - Valentina Cirello
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Simone De Leo
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Nicola Fusco
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
- 9 Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Monica Miozzo
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Gaetano Bulfamante
- 4 Unit of Pathology, ASST Santi Paolo e Carlo, Milan, Italy
- 5 Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Leonardo Vicentini
- 10 Endocrine Surgery Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Stefano Ferrero
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
- 9 Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Antonella Zambon
- 7 Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Silvia Tabano
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Fugazzola
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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de Castro TP, Penha RCC, Buexm LA, de Carvalho FN, Oliveira RDVC, Agarez FV, Pinto LW, Carvalho DP. Molecular Predictors for Advanced Papillary Thyroid Carcinoma Recurrence. Front Endocrinol (Lausanne) 2019; 10:839. [PMID: 31866944 PMCID: PMC6907036 DOI: 10.3389/fendo.2019.00839] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/18/2019] [Indexed: 02/01/2023] Open
Abstract
Despite its indolent course, one-third of the papillary thyroid carcinoma (PTC) cases relapses, which directly impact on the quality of patients' lives. The molecular predictors of recurrence of PTC are poorly defined. We aimed at evaluating the long-term (10-20 years) prognostic value of aggressiveness markers in advanced PTC. To this end, immunohistochemistry for BRAFV600E, Estrogen receptor α, Progesterone receptor, Ki-67, and E-cadherin were performed in 53 primary advanced PTC from an up to 20 years follow-up patients from a well-characterized Brazilian cohort. Categorical data were summarized using frequencies and groups were compared using Chi-squared and Fisher's exact tests. The expressions of the aggressiveness markers were associated with clinical-pathological data using the single-covariate logistic regression analysis. The Kaplan-Meier method with the Log-rank and Peto tests was used to estimate the probability of PTC-free survival. Persistence and recurrence (active disease) were associated with age (≥55 years), tumor size (>2 cm), extrathyroidal extension, local aggressiveness, macroscopic lymph node metastasis, and TNM stage at initial treatment. The BRAFV600E mutation status was associated with extrathyroidal extension, local aggressiveness, and inversely associated with distant metastasis at initial treatment. All progesterone receptor-positive patients had active disease and displayed a shorter time of PTC-free survival than the negative ones using the Kaplan-Meir analysis (p = 0.001, Log Rank; p = 0.005, Peto). Loss of E-cadherin expression was associated with an increase in the probability of active disease (OR = 3.75). BRAFV600E could be useful as a biomarker of local aggressiveness, while PR positive and E-cadherin loss of expression could predict the recurrence of advanced PTC.
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Affiliation(s)
| | | | - Luisa Aguirre Buexm
- Molecular Carcinogenesis Program, Research Center, National Institute of Cancer, Rio de Janeiro, Brazil
| | | | | | | | | | - Denise P. Carvalho
- Endocrine Physiology Laboratory Doris Rosenthal, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- *Correspondence: Denise P. Carvalho
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Zarkesh M, Zadeh-Vakili A, Akbarzadeh M, Fanaei SA, Hedayati M, Azizi F. The role of matrix metalloproteinase-9 as a prognostic biomarker in papillary thyroid cancer. BMC Cancer 2018; 18:1199. [PMID: 30509240 PMCID: PMC6276227 DOI: 10.1186/s12885-018-5112-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 11/20/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The aim of the present study was to investigate the association between matrix metalloproteinase-9 (MMP-9) expression with BRAF V600E mutation and clinicopathological features, in Iranian papillary thyroid cancer (PTC) patients. METHODS In total, 90 participants including 60 PTC patients (15 males and 45 females) and 30 individuals with benign multinodular goiter (MNG) (5 males and 25 females) which were confirmed by surgical pathology, were investigated. MMP-9 was evaluated at both mRNA and protein levels, using SYBR-Green Real-Time PCR and enzyme-linked immune sorbent assay (ELISA), respectively. BRAF V600E mutation was detected by sequencing. RESULTS Mean age of PTC and MNG patients was 37.6 ± 12.6 and 48.1 ± 13.3 years, respectively (P = 0.001). BRAF V600E mutation was found in 24 of the 60 (40%) PTC cases, with mean tumor size of 1.59 ± 1.20 cm. MMP-9 mRNA levels were elevated in tumoral compared to the adjacent non-tumoral tissues (P = 0.039); moreover, this rise was also observed in PTC patients compared to MNG patients (P = 0.001). The mRNA levels of MMP-9 increased in patients aged≥45 years (P = 0.015), those with lymphovascular invasion (P = 0.003), and higher tumor stages (III and IV) (P = 0.011). The protein level of MMP-9 increased in tumoral compared to adjacent non-tumoral tissues (P < 0.001); this increase was also found in PTC patients compared to MNG participants (P = 0.004). MMP-9 protein level was higher in patients aged≥45 years (P = 0.001), those with lymphovascular invasion (P = 0.036) and higher TNM stages (III and IV) (P = 0.001). Area under the ROC curve (AUC) was 0.70 (95%CI: 0.57-0.83, P = 0.003), with 91.4% sensitivity and 51.9% specificity at the cutoff value of 0.50. CONCLUSION The mRNA and protein levels of MMP-9 had no association with BRAF V600E mutation in Iranian PTC patients. These levels were associated with age, TNM stages, and lymphovascular invasion, being defined as malignant factors. Thus, elevated levels of MMP-9 in PTC patients compared to MNG participants illustrated that it can be used as a potential biomarker to differentiate PTC patients from those with MNG.
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Affiliation(s)
- Maryam Zarkesh
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Po Box: 19395-4763, Tehran, Iran
| | - Azita Zadeh-Vakili
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Po Box: 19395-4763, Tehran, Iran.
| | - Mahdi Akbarzadeh
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Ahmad Fanaei
- Association Professor of General Surgery, Erfan Hospital, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
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Song JY, Sun SR, Dong F, Huang T, Wu B, Zhou J. Predictive Value of BRAF V600E Mutation for Lymph Node Metastasis in Papillary Thyroid Cancer: A Meta-analysis. Curr Med Sci 2018; 38:785-797. [PMID: 30341513 DOI: 10.1007/s11596-018-1945-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 06/21/2018] [Indexed: 12/11/2022]
Abstract
BRAFV600E mutation has been thought to be a valuable molecular marker that may predict a worse prognosis for papillary thyroid cancer (PTC). But whether BRAFV600E mutation is associated with lymph node metastasis (LNM) remains controversial. Different surgical strategies may bring a bias in demonsstrating the association between them. In order to delineate a risk stratification to guide a tailored initial approach to tumors that express BRAFV600E mutation, we performed this meta-analysis by using the articles in which total or near-total thyroidectomy plus bilateral central lymph node dissection was routinely performed to avoid the bias from the surgical strategy. We searched the Medline, Embase and CNKI database for eligible studies from January 2003 to May 2018. Meta-analysis was performed using the STATA 12.0 software. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated under fixed-effects or randomeffects models. Fifteen clinical studies were included with a total of 4909 PTC patients. Our meta-analysis results reported that BRAFV600E mutation was associated with LNM (OR=1.34; 95% CI: 1.09-1.65; P=0.005), as well as central LNM (OR=1.59; 95% CI: 1.35-1.88; P<0.00001). Moreover, in patients with papillary thyroid microcarcinoma, we also confirmed the predictive value of BRAFV600E mutation for LNM (OR=3.49; 95% CI: 2.02-6.02; P<0.00001). This meta-analysis demonstrates that BRAFV600E mutation is closely related to LNM in PTC patients. The results suggest that BRAFV600E mutation can be considered as a risk factor for LNM in PTC. Moreover, combining BRAFV600E mutation with other risk factors to determine the initial surgical treatment may bring benefits for PTC patients.
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Affiliation(s)
- Jing-Yong Song
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Department of Gastrointestinal Surgery, Hainan Cancer Hospital, Haikou, 570000, China
| | - Shi-Ran Sun
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Fang Dong
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Tao Huang
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Bin Wu
- Department of Orthopaedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Jing Zhou
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Li X, Li H, Zhao J, Dai Q, Huang C, Jin L, Yang F, Chen F, Wang O, Gao Y. Plasma ω-3 and ω-6 fatty acids in thyroid diseases. Oncol Lett 2018; 16:5433-5440. [PMID: 30250615 DOI: 10.3892/ol.2018.9288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 02/19/2018] [Indexed: 12/21/2022] Open
Abstract
The incidences of nodular goiter (NG), thyroid adenoma (TA), and thyroid cancer (TC) are increasing rapidly; however, the etiologies of these diseases remain unclear. The present study aimed to evaluate the differences in plasma fatty acids among these three thyroid diseases to facilitate etiological research. Four ω-3 and seven ω-6 polyunsaturated fatty acids were measured from 97 TC, 14 TA and 11 NG patient plasma samples with gas chromatography-flame ionization detector. Fatty acids levels were expressed as the percentage of each fatty acid out of the total fatty acids evaluated. The present study identified that the level of 22:6n-3 [median, interquartile range (IQR)] was significantly increased in TA (5.2%, 4.3-6.4%) compared with NG (3.6%, 3.1-4.6%) and TC patients (4.2%, 3.2-4.8%). Though not statistically significant, the levels of 20:5n-3 and 22:5n-3 demonstrated a similar pattern. The level of 22:4n-6 expressed (median, IQR) was significantly increased in NG patients (0.21%, 0.18-0.26%) compared with TA (0.16%, 0.15-0.18%) and TC (0.17%, 0.14-0.22%) patients. Furthermore the fatty acids 18:3n-6, 20:2n-6, 20:3n-6, 20:4:6, and 22:5n-6 demonstrated a similar but statistically insignificant pattern. This suggests that different fatty acids exhibit various etiological roles in NG, TA and TC and warrant further study.
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Affiliation(s)
- Xiang Li
- School of Life Sciences, Shanghai University, Shanghai 200444, P.R. China
| | - Hui Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, P.R. China
| | - Jing Zhao
- Chinese Academy of Sciences Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, P.R. China
| | - Qi Dai
- School of Life Sciences, Shanghai University, Shanghai 200444, P.R. China
| | - Chaoran Huang
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P.R. China
| | - Langping Jin
- Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Fan Yang
- Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Fuxue Chen
- School of Life Sciences, Shanghai University, Shanghai 200444, P.R. China
| | - Ouchen Wang
- Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Ying Gao
- Chinese Academy of Sciences Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, P.R. China
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Geraldo MV, Nakaya HI, Kimura ET. Down-regulation of 14q32-encoded miRNAs and tumor suppressor role for miR-654-3p in papillary thyroid cancer. Oncotarget 2018; 8:9597-9607. [PMID: 28030816 PMCID: PMC5354756 DOI: 10.18632/oncotarget.14162] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 11/26/2016] [Indexed: 11/25/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) is the most prevalent malignant neoplasia of the thyroid gland. A fraction of PTC cases show loss of differentiation and aggressive behavior, with radioiodine therapy resistance and metastasis. Although microRNAs (miRNAs) emerged as promising molecular markers for PTC, their role in the loss of differentiation observed during PTC progression remains to be fully understood. We performed the large-scale analysis of miRNA expression during PTC progression in BRAFT1799A-transgenic animals (Tg-Braf) and thyroid cancer cell lines and identified the marked downregulation of several miRNAs from the region 14q32. Data from The Cancer Genome Atlas (TCGA) confirmed the global downregulation of miRNAs from the 14q32 region in human PTC. The regulatory network potentially suppressed by these miRNAs suggests that key cancer-related biological processes such as cell proliferation, adhesion, migration and angiogenesis. Among the downregulated miRNAs, we observed that miR-654-3p levels decrease with long-term PTC progression in Tg-Braf mice and inversely correlate with EMT. The in vitro restoration of miR-654-3p decreased cell proliferation and migration and induced reprogramming of metastasis-related genes, suggesting a tumor suppressor role for this miRNA. In conclusion, we show global downregulation of 14q32-encoded miRNAs in an in vivo model of PTC progression. The potential circuitry in which these miRNAs are involved suggests that these miRNAs could play a key role in the pathophysiology of PTC and therefore be relevant for the development of new therapeutic strategies.
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Affiliation(s)
- Murilo Vieira Geraldo
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil.,Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Campinas, Brazil
| | - Helder Imoto Nakaya
- Department of Clinical Analyses and Toxicology, School of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Edna Teruko Kimura
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
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Sahli ZT, Smith PW, Umbricht CB, Zeiger MA. Preoperative Molecular Markers in Thyroid Nodules. Front Endocrinol (Lausanne) 2018; 9:179. [PMID: 29720964 PMCID: PMC5915469 DOI: 10.3389/fendo.2018.00179] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/03/2018] [Indexed: 12/12/2022] Open
Abstract
The need for distinguishing benign from malignant thyroid nodules has led to the pursuit of differentiating molecular markers. The most common molecular tests in clinical use are Afirma® Gene Expression Classifier (GEC) and Thyroseq® V2. Despite the rapidly developing field of molecular markers, several limitations exist. These challenges include the recent introduction of the histopathological diagnosis "Non-Invasive Follicular Thyroid neoplasm with Papillary-like nuclear features", the correlation of genetic mutations within both benign and malignant pathologic diagnoses, the lack of follow-up of molecular marker negative nodules, and the cost-effectiveness of molecular markers. In this manuscript, we review the current published literature surrounding the diagnostic value of Afirma® GEC and Thyroseq® V2. Among Afirma® GEC studies, sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) ranged from 75 to 100%, 5 to 53%, 13 to 100%, and 20 to 100%, respectively. Among Thyroseq® V2 studies, Se, Sp, PPV, and NPV ranged from 40 to 100%, 56 to 93%, 13 to 90%, and 48 to 97%, respectively. We also discuss current challenges to Afirma® GEC and Thyroseq® V2 utility and clinical application, and preview the future directions of these rapidly developing technologies.
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Affiliation(s)
- Zeyad T. Sahli
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Philip W. Smith
- Department of Surgery, University of Virginia, Charlottesville, VA, United States
| | - Christopher B. Umbricht
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Martha A. Zeiger
- Department of Surgery, University of Virginia, Charlottesville, VA, United States
- *Correspondence: Martha A. Zeiger,
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Ren H, Shen Y, Hu D, He W, Zhou J, Cao Y, Mao Y, Dou Y, Xiong W, Xiao Q, Zhang Y, Su X. Co-existence of BRAFV600E and TERT promoter mutations in papillary thyroid carcinoma is associated with tumor aggressiveness, but not with lymph node metastasis. Cancer Manag Res 2018; 10:1005-1013. [PMID: 29760568 PMCID: PMC5937490 DOI: 10.2147/cmar.s159583] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Mutations of BRAFV600E and TERT promoters are associated with thyroid cancer development. This study further investigated association of these mutations with clinicopathological characteristics from patients with papillary thyroid carcinoma (PTC). METHODS Tumor tissues from 342 PTC patients were obtained for DNA extraction and polymerase chain reaction amplification to detect the BRAFV600E mutation using amplification-refractory mutation system-polymerase chain reaction. TERT promoter mutations were assessed using Sanger DNA sequencing. The association of these gene mutations with clinicopathological characteristics was then statistically analyzed. RESULTS Two hundred and seventy of 342 (78.9%) PTC patients harbored the BRAFV600E mutation, which was associated with older age male patients. Moreover, TERT promoter mutations occurred in 12 of 342 (3.5 %) PTC patients, all of whom also had the BRAF mutation. One hundred thirty-three patients with papillary thyroid microcarcinoma (PTMC) had no TERT mutations. Statistically, the coexistence of BRAF and TERT promoter mutations were significantly associated with older age, larger tumor size, extrathyroidal extension, and advanced tumor stage, but not with central lymph node metastasis, lateral lymph node metastasis, numbers of lymph node metastasis >5, and numbers of involved/harvested lymph nodes (No. of LNs involved or harvested). The multivariate analyses showed older age (odds ratio [OR], 2.194; 95% CI: 1.117-4.311; p=0.023), larger tumor size (OR, 4.100; 95% CI: 2.257-7.450; p<0.001), and multiplicity (OR, 2.240; 95% CI: 1.309-3.831; p=0.003) were all independent predictors for high prevalence of extrathyroidal extension. However, there was no statistical association with any clinicopathological characteristics except for Hashimoto thyroiditis in PTMC. CONCLUSION The current study demonstrated that the coexistence of BRAF and TERT promoter mutations were associated with the PTC aggressiveness, although these mutations were not associated with PTC lymph node metastasis or with PTMC.
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Affiliation(s)
- Haoyu Ren
- Department of Endocrine and Breast Surgery
| | - Yifan Shen
- The Center for Clinical Molecular Medical Detection, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Daixing Hu
- Department of Endocrine and Breast Surgery
| | - Wei He
- Department of Endocrine and Breast Surgery
| | - Jing Zhou
- Department of Endocrine and Breast Surgery
| | - Yijia Cao
- Department of Endocrine and Breast Surgery
| | - Yu Mao
- Department of Endocrine and Breast Surgery
| | - Yi Dou
- Department of Endocrine and Breast Surgery
| | - Wei Xiong
- Department of Endocrine and Breast Surgery
| | - Qi Xiao
- Department of Endocrine and Breast Surgery
| | - Yuhong Zhang
- The Center for Clinical Molecular Medical Detection, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Xinliang Su
- Department of Endocrine and Breast Surgery
- Correspondence: Xinliang Su, Department of Endocrine and Breast Surgery, The First Affiliated Hospital, Chongqing Medical University, 1 Friendship Road, Yuzhong District, Chongqing 400016, China, Tel +86 135 0830 9161, Fax +86 23 8901 1463, Email
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Hahn SY, Kim TH, Ki CS, Kim SW, Ahn S, Shin JH, Chung JH. Ultrasound and clinicopathological features of papillary thyroid carcinomas with BRAF and TERT promoter mutations. Oncotarget 2017; 8:108946-108957. [PMID: 29312581 PMCID: PMC5752494 DOI: 10.18632/oncotarget.22430] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 07/26/2017] [Indexed: 11/25/2022] Open
Abstract
This study is to investigate if any relationship exists between the telomerase reverse transcriptase (TERT) promoter or proto-oncogene BRAF mutation and ultrasound (US) and clinicopathological features of papillary thyroid carcinomas (PTCs). The study included 150 patients with surgically confirmed PTC from October 1994 to December 2004. According to the existence of TERT promoter or BRAF mutations, we categorized patients into three groups (no mutation, BRAF mutation alone, or TERT+BRAF mutations) and analyzed the relationships between TERT promoter or BRAF mutation and US and clinicopathological features. The rate of recurrence or death according to mutation analysis was estimated. There were 35 (23.3%) cases with no mutation, 104 (69.3%) with BRAF mutation alone, and 11 (7.3%) with TERT+BRAF mutations. As the number of genetic mutations increased from no mutation to BRAF mutation alone to both BRAF and TERT mutations, the proportions of hypoechogenicity, non-parallel orientation, spiculated/microlobulated margin, microcalcifications, and high suspicion category increased. PTCs with TERT+BRAF mutations recurred more frequently than other groups (odd ratio = 17.921 and 31.468). The intervals to recurrence and overall survival were significantly shorter in the TERT+BRAF mutation group than in the other groups (Ps <.0001). PTCs with no mutation, with BRAF mutation alone, and with both TERT and BRAF mutations linearly increase in the probability of displaying malignant US features. In PTCs, the coexistence of BRAF with TERT mutations is more strongly correlated with recurrence and mortality than BRAF mutation alone.
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Affiliation(s)
- Soo Yeon Hahn
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang Seok Ki
- Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soohyun Ahn
- Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Hee Shin
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Giordano TJ. Genomic Hallmarks of Thyroid Neoplasia. ANNUAL REVIEW OF PATHOLOGY-MECHANISMS OF DISEASE 2017; 13:141-162. [PMID: 29083981 DOI: 10.1146/annurev-pathol-121808-102139] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The genomic landscape of thyroid cancers that are derived from follicular cells has been substantially elucidated through the coordinated application of high-throughput genomic technologies. Here, I review the common genetic alterations across the spectrum of thyroid neoplasia and present the resulting model of thyroid cancer initiation and progression. This model illustrates the striking correlation between tumor differentiation and overall somatic mutational burden, which also likely explains the highly variable clinical behavior and outcome of patients with thyroid cancers. These advances are yielding critical insights into thyroid cancer pathogenesis, which are being leveraged for the development of new diagnostic tools, prognostic and predictive biomarkers, and novel therapeutic approaches.
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Affiliation(s)
- Thomas J Giordano
- Departments of Pathology and Internal Medicine, Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA;
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Gorshtein A, Benbassat C, Robenshtok E, Shimon I, Hirsch D. Response to Treatment is Highly Predictable in cN0 Patients with Papillary Thyroid Carcinoma. World J Surg 2017; 40:2123-30. [PMID: 27094559 DOI: 10.1007/s00268-016-3507-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND While involvement of macrometastatic lymph nodes is a recognized independent predictor of an adverse course in papillary thyroid cancer (PTC) patients, the clinicopathological variables associated with disease persistence/recurrence in clinically node-negative (cN0) disease are not well defined. The indications for prophylactic central neck dissection (pCND) in this patient group remain unclear as well. We aim to investigate the risk factors associated with short- and long-term persistence/recurrence of PTC in patients with cN0 disease at presentation compared to patients with PTC and cervical lymph node involvement (N1) and the response to initial treatment in these subgroups of patients. METHODS Data were collected retrospectively for 392 consecutive patients with PTC, 223 with cN0 disease and 169 with N1 disease, who were treated and followed at a single tertiary medical center in which pCND is not routinely performed for PTC. RESULTS Compared to patients with N1 disease, patients with cN0 disease had significantly smaller tumors, lower rates of multifocality, and less extrathyroidal extension. Persistency rates at 1 year were 6.7 % in the cN0 group and 47 % in the N1 group, and at last follow-up, 3.6 and 33.5 %, respectively (p = 0.001 for both time points). Within the cN0 group, those with persistent disease at 1 year (n = 15) had significantly larger tumors and higher stimulated thyroglobulin. Only six had structural residual disease, four of them lymph node metastases. All patients with persistent disease were initially treated with total thyroidectomy and radioiodine. Recurrence occurred in only three patients. After 8.3 ± 3.8 years of follow-up, eight patients with cN0 had persistent disease, three of them biochemical. Higher American Joint Committee of Cancer stage and extrathyroidal extension were the only factors that predicted disease persistence at the last follow-up in this group. CONCLUSIONS Patients with cN0 PTC and no distant metastases are usually disease free after thyroidectomy with/without radioactive iodine and do not need further interventions. The initial staging in these patients is a valid prognostic factor for disease outcomes.
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Affiliation(s)
- Alexander Gorshtein
- Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital, 49100, Petach Tikva, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel.
| | - Carlos Benbassat
- Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital, 49100, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Eyal Robenshtok
- Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital, 49100, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Ilan Shimon
- Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital, 49100, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Dania Hirsch
- Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital, 49100, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
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Vuong HG, Altibi AMA, Duong UNP, Ngo HTT, Pham TQ, Tran HM, Oishi N, Mochizuki K, Nakazawa T, Hassell L, Katoh R, Kondo T. Role of molecular markers to predict distant metastasis in papillary thyroid carcinoma: Promising value of TERT promoter mutations and insignificant role of BRAF mutations—a meta-analysis. Tumour Biol 2017; 39:1010428317713913. [DOI: 10.1177/1010428317713913] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The presence of distant metastasis is associated with an adverse outcome in papillary thyroid cancer. We performed a meta-analysis to investigate the role of molecular markers as predictors for distant metastasis in papillary thyroid cancer. Four electronic databases including PubMed, Web of Science, Scopus, and Virtual Health Library were searched, and odds ratio and its 95% confidence interval concerning the association of BRAF, RAS, and TERT promoter mutations and RET/PTC rearrangements with distant metastasis were calculated using random-effects model. In total, 42 studies with 11,109 papillary thyroid cancers were included for meta-analyses. Overall, the presence of TERT promoter (odds ratio = 5.95; 95% confidence interval = 2.95–11.99), RAS mutations (odds ratio = 2.5; 95% confidence interval = 1.00–6.22), and RET/PTC rearrangements (odds ratio = 1.92; 95% confidence interval = 1.03–3.56) were found to be associated with a significantly increased risk for distant metastasis. BRAF mutations were not associated with an elevated risk for distant metastasis (odds ratio = 0.79; 95% confidence interval = 0.54–1.16). In conclusion, our study demonstrated the promising value of few molecular biomarkers, especially TERT promoter mutations in predicting distant metastasis in papillary thyroid cancers, while BRAF mutations showed no association with distant metastasis. Our study affirms the value of selected mutations for tumor risk stratification and assessment of patients’ prognosis.
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Affiliation(s)
- Huy Gia Vuong
- Department of Pathology, University of Yamanashi, Yamanashi, Japan
- Department of Pathology, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Ahmed MA Altibi
- Faculty of Medicine, The University of Jordan, Amman, Jordan
| | - Uyen NP Duong
- Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Hanh TT Ngo
- Department of Pathology, University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thong Quang Pham
- Department of Pathology, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Hung Minh Tran
- Faculty of Medicine, University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Naoki Oishi
- Department of Pathology, University of Yamanashi, Yamanashi, Japan
| | - Kunio Mochizuki
- Department of Pathology, University of Yamanashi, Yamanashi, Japan
| | - Tadao Nakazawa
- Department of Pathology, University of Yamanashi, Yamanashi, Japan
| | - Lewis Hassell
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ryohei Katoh
- Department of Pathology, University of Yamanashi, Yamanashi, Japan
| | - Tetsuo Kondo
- Department of Pathology, University of Yamanashi, Yamanashi, Japan
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Szymonek M, Kowalik A, Kopczyński J, Gąsior-Perczak D, Pałyga I, Walczyk A, Gadawska-Juszczyk K, Płusa A, Mężyk R, Chrapek M, Góźdź S, Kowalska A. Immunohistochemistry cannot replace DNA analysis for evaluation of BRAF V600E mutations in papillary thyroid carcinoma. Oncotarget 2017; 8:74897-74909. [PMID: 29088832 PMCID: PMC5650387 DOI: 10.18632/oncotarget.20451] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/25/2017] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The BRAF V600E mutation is the most common genetic event occurring in papillary thyroid cancer (PTC). Recently, the possibility of using immunohistochemistry (IHC) to detect the BRAF V600E mutation has been reported. MATERIALS AND METHODS In 140 patients with classical PTC, the status of the BRAF V600E mutation was determined by IHC (using two alternative staining protocols, IHC-1 and IHC-2) and molecular biology methods: Sanger sequencing (SEQ) and real-time PCR (qPCR). RESULTS The BRAF V600E mutation was detected in 57.1% (80/140) patients by IHC-1 and 62.9% (88/140) patients by IHC-2. The highest correlation in detecting the BRAF V600E mutation was found between IHC-2 and qPCR (94.2%), and between IHC-1 and qPCR (83.9%). Correlations between IHC-1 and SEQ and between IHC-2 and SEQ were 71.5% and 76.2%, respectively. The IHC-2 protocol had higher sensitivity, PPV, and NPV, and Cohen's kappa than IHC- 1. The presence of BRAF V600E mutation in IHC-2 statistically correlated with age at diagnosis, histopathological stage, and extrathyroidal extension. CONCLUSIONS The results obtained in this study indicate a lack of concordance between BRAF V600E detection by IHC and molecular methods. The IHC method cannot replace molecular methods for the detection of the BRAF V600E mutation.
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Affiliation(s)
- Monika Szymonek
- Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland
| | - Artur Kowalik
- Department of Molecular Diagnostics, Holycross Cancer Center, Kielce, Poland
| | - Janusz Kopczyński
- Department of Surgical Pathology, Holycross Cancer Center, Kielce, Poland
| | | | - Iwona Pałyga
- Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland
| | | | | | - Agnieszka Płusa
- Department of Surgical Pathology, Holycross Cancer Center, Kielce, Poland
| | - Ryszard Mężyk
- Cancer Epidemiology, Holycross Cancer Center, Kielce, Poland
| | - Magdalena Chrapek
- Department of Probability Theory and Statistics Institute of Mathematics, Faculty of Mathematics and Natural Science, Jan Kochanowski University, Kielce, Poland
| | - Stanisław Góźdź
- Oncology Clinic, Holycross Cancer Center, Kielce, Poland
- The Faculty of Health Sciences, Jan Kochanowski University in Kielce, Poland
| | - Aldona Kowalska
- Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland
- The Faculty of Health Sciences, Jan Kochanowski University in Kielce, Poland
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41
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Xing W, Liu X, He Q, Zhang Z, Jiang Z. BRAF V600E mutation contributes papillary thyroid carcinoma and Hashimoto thyroiditis with resistance to thyroid hormone: A case report and literature review. Oncol Lett 2017; 14:2903-2911. [PMID: 28928829 PMCID: PMC5588167 DOI: 10.3892/ol.2017.6486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 04/04/2017] [Indexed: 01/17/2023] Open
Abstract
Resistance to thyroid hormone (RTH) is a rare autosomal hereditary disorder characterized by increased serum thyroid hormone (TH) levels with unsuppressed or increased thyrotropin concentration. It remains unknown whether the coexistence of RTH with papillary thyroid carcinoma (PTC) and Hashimoto thyroiditis (HT) is incidental or whether it possesses a genetic or pathophysiological association. In the present study, a case of RTH with PTC and HT in an 11-year-old Chinese patient was examined and the clinical presentation of RTH with PTC was discussed. In addition, the possible associations between RTH, PTC and HT were determined. HT was confirmed in the patient using an autoimmune assay and thyroid ultrasound. RTH was diagnosed on the basis of clinical manifestations, laboratory information and gene analysis, and PTC was diagnosed according to histological results. Results of BRAFV600E mutation analysis were positive. A literature review of 14 cases of RTH with PTC was included for comparison. The present case report indicates an association of RTH with PTC and HT coexistence in the patient. Close follow-up, histological evaluation and BRAFV600E mutation detection should be performed in each RTH case with HT, since a persistent increase in TSH may be a risk factor for the development of thyroid neoplasm.
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Affiliation(s)
- Wanjia Xing
- Department of Endocrinology, General Hospital of Jinan Military Command, Jinan, Shandong 250031, P.R. China
| | - Xiaohong Liu
- Department of Pathology, General Hospital of Jinan Military Command, Jinan, Shandong 250031, P.R. China
| | - Qingqing He
- Department of Thyroid and Breast Surgery, General Hospital of Jinan Military Command, Jinan, Shandong 250031, P.R. China
| | - Zongjing Zhang
- Department of Endocrinology, General Hospital of Jinan Military Command, Jinan, Shandong 250031, P.R. China
| | - Zhaoshun Jiang
- Department of Endocrinology, General Hospital of Jinan Military Command, Jinan, Shandong 250031, P.R. China
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Rusinek D, Chmielik E, Krajewska J, Jarzab M, Oczko-Wojciechowska M, Czarniecka A, Jarzab B. Current Advances in Thyroid Cancer Management. Are We Ready for the Epidemic Rise of Diagnoses? Int J Mol Sci 2017; 18:E1817. [PMID: 28829399 PMCID: PMC5578203 DOI: 10.3390/ijms18081817] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 08/16/2017] [Accepted: 08/16/2017] [Indexed: 02/07/2023] Open
Abstract
A rising incidence of thyroid cancers (TCs) mainly small tumors, observed during recent years, lead to many controversies regarding treatment strategies. TCs represent a distinct molecular background and clinical outcome. Although in most cases TCs are characterized by a good prognosis, there are some aggressive forms, which do not respond to standard treatment. There are still some questions, which have to be resolved to avoid dangerous simplifications in the clinical management. In this article, we focused on the current advantages in preoperative molecular diagnostic tests and histopathological examination including noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). We discussed the controversies regarding the extent of thyroid surgery and adjuvant radioiodine therapy, as well as new treatment modalities for radioiodine-refractory differentiated thyroid cancer (RR-DTC). Considering medullary thyroid cancer (MTC), we analyzed a clinical management based on histopathology and RET (ret proto-oncogene) mutation genotype, disease follow-up with a special attention to serum calcitonin doubling time as an important prognostic marker, and targeted therapy applied in advanced MTC. In addition, we provided some data regarding anaplastic thyroid cancer (ATC), a highly lethal neoplasm, which lead to death in nearly 100% of patients due to the lack of effective treatment options.
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Affiliation(s)
- Dagmara Rusinek
- Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie Memorial Institute-Cancer Center, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Ewa Chmielik
- Tumor Pathology Department, Maria Sklodowska-Curie Memorial Institute-Cancer Center, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Jolanta Krajewska
- Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie Memorial Institute-Cancer Center, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Michal Jarzab
- 3rd Department of Radiotherapy and Chemotherapy, Breast Unit, Maria Sklodowska-Curie Memorial Institute-Cancer Center, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Malgorzata Oczko-Wojciechowska
- Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie Memorial Institute-Cancer Center, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Agnieszka Czarniecka
- Department of Oncological and Reconstructive Surgery, Maria Sklodowska-Curie Memorial Institute-Cancer Center, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Barbara Jarzab
- Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie Memorial Institute-Cancer Center, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101 Gliwice, Poland.
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Chou CK, Liu RT, Kang HY. MicroRNA-146b: A Novel Biomarker and Therapeutic Target for Human Papillary Thyroid Cancer. Int J Mol Sci 2017; 18:ijms18030636. [PMID: 28294980 PMCID: PMC5372649 DOI: 10.3390/ijms18030636] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 03/06/2017] [Accepted: 03/08/2017] [Indexed: 12/31/2022] Open
Abstract
Papillary thyroid cancer (PTC) is the most common tumor subtype of thyroid cancer. However, not all PTCs are responsive to current surgical and radioiodine treatment. The well-established clinical prognostic factors include tumor size, lymph node/distal metastasis, and extrathyroidal invasion. The RET/PTC-RAS-BRAF linear molecular signaling cascade is known to mediate PTC pathogenesis. However, whether presence of BRAF mutation, the most common genetic alteration in PTC, can affect PTC behavior and prognosis is controversial. MicroRNAs (miRNAs) have been labeled as promising molecular prognostic markers in several tumor types. Our recent studies demonstrated that microRNA-146b (miR-146b) deregulation is associated with PTC aggressiveness and prognosis. Here we summarize the current knowledge related to the functional roles, regulated target genes, and clinical applications of miR-146b in PTC and discuss how these studies provide insights into the key role of miR-146b as an oncogenic regulator promoting cellular transformation as well as a prognosis marker for tumor recurrence in PTC. In conjunction with the current perspectives on miRNAs in a wide variety of human cancers, this review will hopefully translate these updated findings on miR-146b into more comprehensive diagnostic or prognostic information regarding treatment in PTC patients before surgical intervention and follow up strategies.
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Affiliation(s)
- Chen-Kai Chou
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan.
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kaohsiung City 833, Taiwan.
| | - Rue-Tusan Liu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan.
| | - Hong-Yo Kang
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kaohsiung City 833, Taiwan.
- Hormone Research Center and Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan.
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BRAF and TERT promoter mutations in the aggressiveness of papillary thyroid carcinoma: a study of 653 patients. Oncotarget 2017; 7:18346-55. [PMID: 26943032 PMCID: PMC4951292 DOI: 10.18632/oncotarget.7811] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/29/2016] [Indexed: 01/04/2023] Open
Abstract
The role of telomerase reverse transcriptase (TERT) gene promoter mutations in the aggressiveness of papillary thyroid cancer (PTC) remains to be further investigated. Here we examined the relationship of TERT promoter mutations and BRAF V600E with the clinicopathological features of PTC in 653 patients. Sanger sequencing of genomic DNA from primary PTC tumors was performed for mutation detection and genotype-clinicopathological correlation of the tumor was analyzed. BRAF V600E and TERT promoter mutations were found in 63.7% (416 of 653) and 4.1% (27 of 653) of patients, respectively; the latter became 9.8% when only tumors ≥ 1.5 cm were analyzed. TERT promoter mutations occurred more frequently in BRAF mutation-positive cases compared to wild-type cases, being 5.3% in the former versus 2.1% in the latter (P = 0.050). BRAF and TERT promoter mutations were each significantly associated with high-risk clinicopathological features of PTC, such as old patient age, large tumor size, extrathyroidal invasion, capsular invasion, and advanced disease stages. Coexistence of BRAF V600E and TERT promoter mutations was particularly associated with high-risk clinicopathological features, as exemplified by extrathyroidal invasion seen in 54.5% (12/22) of patients harboring both mutations versus 9.9% (23/232) of patients harboring neither mutation (P < 0.001). Thus, this study, the largest on TERT mutation so far, demonstrates a significant role of BRAF V600E and TERT promoter mutations in the aggressiveness of PTC, which is particularly robust and cooperative when the two mutations coexist. These results, together with previous studies, establish a significant role of these mutations in the aggressiveness of PTC.
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Vuong HG, Altibi AM, Abdelhamid AH, Ngoc PUD, Quan VD, Tantawi MY, Elfil M, Le Huy Vu T, Elgebaly A, Oishi N, Nakazawa T, Hirayama K, Katoh R, Huy NT, Kondo T. The changing characteristics and molecular profiles of papillary thyroid carcinoma over time: a systematic review. Oncotarget 2017; 8:10637-10649. [PMID: 27793009 PMCID: PMC5354688 DOI: 10.18632/oncotarget.12885] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 10/14/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The genetic alterations of papillary thyroid carcinoma (PTC) have been reported to change over the past few decades. We performed this systematic review to further examine the trends and modifications of patient demographic, clinicopathological features and molecular profiles of PTC over time. METHODS A literature search was performed within six electronic databases to identify relevant articles. The inclusion criteria were published studies investigating BRAF mutations, RET/PTC rearrangements or RAS mutations in PTCs or classical PTCs. Two teams of reviewers independently screened titles and abstracts of all articles. Full texts of potential articles were read and extracted data were listed and stratified into an excel file according to country, city, institution, and surgical time period. Student t test and Pearson Chi-square were used to analyze the trends of demographic and clinicopathological features of PTC patients and the prevalence of each genetic alteration in individual institutions. RESULTS From 3139 articles, we included 16 articles for final analysis. Our results showed an increasing trend of BRAF and a decreasing trend of RET/PTC prevalence over time in PTCs and classical PTCs, accompanied by an older age of PTC patients, an increase in proportion of PTMC and less aggressive behaviours of tumours. CONCLUSIONS The demographic and clinicopathological characteristics and molecular profile of PTCs have been changing over the past few decades. These modifications suggest changes in etiologies and risk factors of thyroid cancer that influence the tumorigenesis of PTCs.
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Affiliation(s)
- Huy Gia Vuong
- Department of Pathology, University of Yamanashi, Yamanashi, Japan
- Department of Pathology, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | | | | | | | - Vo Duy Quan
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | | | - Mohamed Elfil
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | | | - Naoki Oishi
- Department of Pathology, University of Yamanashi, Yamanashi, Japan
| | - Tadao Nakazawa
- Department of Pathology, University of Yamanashi, Yamanashi, Japan
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine, Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Ryohei Katoh
- Department of Pathology, University of Yamanashi, Yamanashi, Japan
| | - Nguyen Tien Huy
- Department of Clinical Product Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Tetsuo Kondo
- Department of Pathology, University of Yamanashi, Yamanashi, Japan
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Krishnamurthy A, Ramshankar V, Murherkar K, Vidyarani S, Raghunandhan GC, Das A, Desai PB, Albert K. Role and relevance of BRAF mutations in risk stratifying patients of papillary thyroid cancers along with a review of literature. Indian J Cancer 2017; 54:372-378. [DOI: 10.4103/ijc.ijc_182_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Boaventura P, Batista R, Pestana A, Reis M, Mendes A, Eloy C, Sobrinho-Simões M, Soares P. TERT promoter mutations: a genetic signature of benign and malignant thyroid tumours occurring in the context of tinea capitis irradiation. Eur J Endocrinol 2017; 176:49-55. [PMID: 27760791 DOI: 10.1530/eje-16-0740] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/15/2016] [Accepted: 10/19/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the frequency and molecular characteristics of TERTp mutations in thyroid adenomas and carcinomas occurring in the low-dose radiation exposure tinea capitis setting. DESIGN AND METHODS Twenty-seven patients with 34 well-differentiated thyroid carcinomas and 28 patients with 29 follicular adenomas diagnosed in a Portuguese tinea capitis cohort were studied. Blood samples were obtained from all the patients. Screening for TERTp mutations was performed by PCR amplification followed by Sanger sequencing. A series of 33 sporadic thyroid adenomas was used as control. RESULTS TERTp mutations were detected in six of the 28 patients with adenoma (21.4%) and in four of the 27 patients with carcinoma (14.8%). Three tumours (two carcinomas and one adenoma) had the tandem mutation -124/-125 GG>AA (30.0%), whereas the remaining seven had the -124G > A. The 20.7% frequency of TERTp mutations in adenomas contrasts with the absence of mutations in the adenomas from the control group and from most series on record, whereas the one found in carcinomas (11.8%) is similar to those reported in the literature for sporadic carcinomas. CONCLUSION TERTp mutations, including the tandem mutation -124/-125 GG>AA not described previously in thyroid tumours, appear to represent a genetic signature for thyroid tumours in patients submitted to low-dose X-ray irradiation. The high frequency of TERTp mutations in the adenomas of our cohort contrasts with their absence in sporadically occurring, as well as in adenomas of the Chernobyl series.
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Affiliation(s)
- Paula Boaventura
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of PortoPorto, Portugal
- i3S - Instituto de Investigação e Inovação em SaúdeUniversidade do Porto, Porto, Portugal
| | - Rui Batista
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of PortoPorto, Portugal
- i3S - Instituto de Investigação e Inovação em SaúdeUniversidade do Porto, Porto, Portugal
| | - Ana Pestana
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of PortoPorto, Portugal
- i3S - Instituto de Investigação e Inovação em SaúdeUniversidade do Porto, Porto, Portugal
| | - Marta Reis
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of PortoPorto, Portugal
- i3S - Instituto de Investigação e Inovação em SaúdeUniversidade do Porto, Porto, Portugal
| | - Adélia Mendes
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of PortoPorto, Portugal
- i3S - Instituto de Investigação e Inovação em SaúdeUniversidade do Porto, Porto, Portugal
| | - Catarina Eloy
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of PortoPorto, Portugal
- i3S - Instituto de Investigação e Inovação em SaúdeUniversidade do Porto, Porto, Portugal
| | - Manuel Sobrinho-Simões
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of PortoPorto, Portugal
- i3S - Instituto de Investigação e Inovação em SaúdeUniversidade do Porto, Porto, Portugal
- Faculty of MedicineUniversity of Porto, Porto, Portugal
- Department of PathologyCentro Hospitalar de S. João, Porto, Portugal
| | - Paula Soares
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of PortoPorto, Portugal
- i3S - Instituto de Investigação e Inovação em SaúdeUniversidade do Porto, Porto, Portugal
- Faculty of MedicineUniversity of Porto, Porto, Portugal
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Clinical implications of the extent of BRAF V600E alleles in patients with papillary thyroid carcinoma. Oral Oncol 2016; 62:72-77. [PMID: 27865374 DOI: 10.1016/j.oraloncology.2016.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/10/2016] [Accepted: 10/15/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVE There are many conflicting reports about the clinical implications of BRAFV600E in papillary thyroid cancer (PTC). We investigated the associations between the extent of BRAFV600E alleles and both clinico-pathological features and recurrence of PTC. MATERIALS AND METHODS Carcinoma tissues from 60 patients with PTC were genotyped for BRAFV600E using pyrosequencing, and the clinico-pathological factors and disease outcomes of the patients were examined. The associations between the extent of mutant BRAF alleles and both clinico-pathological parameters and recurrence-free survival (RFS) were analyzed. RESULTS The BRAFV600E mutation was detected in 66.7% (40/60) of our PTC patients. When we defined four groups on the basis of the extent of BRAFV600E alleles by pyrosequencing-negative (less than 5%), low (5 - less than 15%), intermediate (15 - less than 25%), and high (25% or greater)- the four groups showed statistically significant differences regarding lymph node (LN) metastasis and recurrence (P<0.05). However, age, gender, tumor size, multicentricity, capsular invasion, and lymphovascular invasion were not significantly different among the groups. The 10-year RFS rates in PTC patients with greater than 25% and less than 25% mutated BRAF alleles were 74% and 100%, respectively. This difference was significant (P=0.043). CONCLUSIONS A high extent more than 25% of BRAFV600E alleles may be associated with disease outcome in PTC patients. We need more data to verify a hypothesis that the extent of BRAF mutations may be clinically informative in the management of PTC, such as by tailoring proper surgical and radioactive iodine treatments and determining appropriate management during follow-up.
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Nasirden A, Saito T, Fukumura Y, Hara K, Akaike K, Kurisaki-Arakawa A, Asahina M, Yamashita A, Tomomasa R, Hayashi T, Arakawa A, Yao T. In Japanese patients with papillary thyroid carcinoma, TERT promoter mutation is associated with poor prognosis, in contrast to BRAF V600E mutation. Virchows Arch 2016; 469:687-696. [DOI: 10.1007/s00428-016-2027-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 09/06/2016] [Accepted: 09/21/2016] [Indexed: 10/20/2022]
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Liu C, Chen T, Liu Z. Associations between BRAF(V600E) and prognostic factors and poor outcomes in papillary thyroid carcinoma: a meta-analysis. World J Surg Oncol 2016; 14:241. [PMID: 27600854 PMCID: PMC5012084 DOI: 10.1186/s12957-016-0979-1] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 08/13/2016] [Indexed: 12/22/2022] Open
Abstract
Background The objective of this study is to perform a meta-analysis to evaluate the associations between the BRAFV600E mutation status and aggressive clinicopathological features and poor prognostic factors in papillary thyroid cancer. Methods A literature search was performed within the PubMed, MEDLINE, Web of Science databases, and EMBASE databases using the Medical Subject Headings and keywords from January 2003 to July 2015. Individual study-specific odds ratios and confidence intervals were calculated, as were the Mantel-Haenszel pooled odds ratios for the combined studies. Results Sixty-three studies of 20,764 patients were included in the final analysis. Compared with wild-type BRAF, the BRAFV600E mutation was associated with aggressive clinicopathological factors, including extrathyroidal extension, higher TNM stage, lymph node metastasis, and recurrence, and was associated with reduced overall survival; however, there was no significant association between the presence of BRAF mutation and distant metastasis. Conclusions BRAF mutations are closely associated with aggressive clinicopathological characteristics and poorer prognosis in papillary thyroid cancer. Accordingly, aggressive treatment should be considered for papillary thyroid cancer patients with BRAF mutation.
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Affiliation(s)
- Chunping Liu
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, China
| | - Tianwen Chen
- Department of Breast and Thyroid Surgery, Affiliated Nanshan Hospital, Guangdong Medical College, Number 89, Taoyuan Road, Shenzhen, China
| | - Zeming Liu
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Number 1277, Jiefang Road, Wuhan, Hubei Province, China. .,Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Number 238, Jiefanglu, Wuhan, Hubei Province, People's Republic of China.
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