Is BRAF mutation associated with lymph node metastasis in patients with papillary thyroid cancer

摘要: Many researchers have investigated the clinical role of V600E BRAF mutation in patients with papillary thyroid cancer (PTC). The constitutively activates RAS/RAF/mitogen-activated protein kinase signal transduction pathway and results malignant transformation cells. This is found ≤70% PTCs, highly specific, easily detected fine-needle aspirate biopsy samples.1 In recent years, there has been an increased focus literature on prognostic value potential PTC.2,3 However, true association poor clinicopathologic features, particularly, lymph node metastasis (LNM) that could affect surgical approach to these patients, remains controversial. With exception 2 studies,4-6 remaining studies, including one we co-authored, examining LNM do not include who undergone routine central dissection (CLND).1,7 largest study, by Basolo et al,8 as example, examined 1,060 PTC correlation LMN. this only tumors <2 cm were included underwent CLND if intraoperative abnormalities identified.8 By likely more advanced disease known status and, excluding those CLND, may exist bias larger, aggressive and/or clinically evident at presentation. Additionally, many studies evaluate presence overall, rather than LNM. also report a significant between univariate analysis only.4,9,10 significance lost few perform multivariate analysis, adjusting for all variables be associated (age, gender, extrathyroidal extension, multifocality, variants size). Studies maintaining either adjust age gender or specify adjusted variables. Table I includes majority features none demonstrated LMN.3,6,11 Table I Multivariable logistic regressions predictor metastases, cancer Despite controversy exists conflicting reports, some proposed should incorporated into algorithmic management respect extent surgery, specifically, whether patient undergo CLND.12 Additional multi-institutional which surgeons therefore evaluable are needed determine measurement does independently predict nodal metastases. small chose examine retrospectively consecutive part endocrine surgery practice, confounding factors age, tumor size, variant, extension.