BRAF Mutation Predicts a Poorer Clinical Prognosis for Papillary Thyroid Cancer

作者：Mingzhao Xing, William H. Westra, Ralph P. Tufano, Yoram Cohen, Eli Rosenbaum, Kerry J. Rhoden, Kathryn A. Carson, Vasily Vasko, О. С. Ларін, Giovanni Tallini, Sara M. Tolaney, Elizabeth H. Holt, Pei Hui, Christopher B. Umbricht, Shehzad Basaria, Marge Ewertz, Anthony P. Tufaro, Joseph A. Califano, Matthew D. Ringel, Martha A. Zeiger, David Sidransky, Paul W. Ladenson · 发表于：The Journal of Clinical Endocrinology & Metabolism · 年份：2005 · DOI：10.1210/jc.2005-0987 · 被引用次数：1002 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Thyroid and Parathyroid Surgery、Thyroid Disorders and Treatments

CONTEXT: Use of BRAF mutation in papillary thyroid cancer (PTC) has the potential to improve risk stratification of this cancer. OBJECTIVE: The objective of the study was to investigate the prognostic value of BRAF mutation in patients with PTC. DESIGN, SETTING, AND SUBJECTS: In a multicenter study of 219 PTC patients, data on their clinicopathological characteristics and clinical courses between 1990 and 2004 were retrospectively collected, and their tumor BRAF mutation status was determined. Associations of BRAF mutation with initial tumor characteristics and subsequent recurrence were analyzed. MAIN OUTCOME MEASURE: Relationships between the BRAF mutation status and clinicopathological outcomes, including recurrence, were measured. RESULTS: We found a significant association between BRAF mutation and extrathyroidal invasion (P < 0.001), lymph node metastasis (P < 0.001), and advanced tumor stage III/IV (P = 0.007) at initial surgery. This association remained significant on multivariate analysis, adjusting for conventional clinicopathological predictors of recurrence excluding the histological PTC subtype, but was lost when the tumor subtype was included in the model. BRAF mutation was also significantly associated with tumor recurrence, 25 vs. 9% with and without mutation, respectively (P = 0.004), during a median of 15 (interquartile range, 3-29) months of follow-up. This association remained significant on multivariate analysis adjusting for conventional clinicopatholog...