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The BRAFT1799A Mutation is not Associated with Occult Contralateral Carcinoma in Patients with Unilateral Papillary Thyroid Microcarcinoma

  • Wan, Han-Feng (Department of Otorhinolaryngology, Renji Hospistal, School of Medicine, Shanghai Jiao Tong University) ;
  • Zhang, Bin (Department of Head and Neck Surgery, Cancer Institute& Hospital, Chinese Academy of Medical Science, Peking Union Medical College) ;
  • Yan, Dan-Gui (Department of Head and Neck Surgery, Cancer Institute& Hospital, Chinese Academy of Medical Science, Peking Union Medical College) ;
  • Xu, Zhen-Gang (Department of Head and Neck Surgery, Cancer Institute& Hospital, Chinese Academy of Medical Science, Peking Union Medical College)
  • Published : 2015.04.14

Abstract

Background: The phenomenon of occult carcinoma maybe observed in patients with clinically unilateral papillary thyroid microcarcinoma (PTMC). Although many studies have reported that the $BRAF^{T1799A}$ mutation is associated with aggressive PTMC, the relationship between $BRAF^{T1799A}$ mutation and occult carcinoma is unclear. The aim of this study was to investigate the risk factors, including $BRAF^{T1799A}$ mutation, for occult contralateral carcinoma in clinically unilateral PTMC accompanied by benign nodules in the contralateral lobe. Materials and Methods: From January 2011 to December 2013, we prospectively enrolled 89 consecutive PTMC patients with clinically unilateral carcinoma accompanied by benign nodules in the contralateral lobe who received a total thyroidectomy and cervical lymph node dissection. $BRAF^{T1799A}$ mutation was tested by pyrosequencing on postoperative paraffin specimens. The frequency and predictive factors for occult contralateral carcinoma were analyzed with respect to the following variables: age, gender, family history, tumor size, presence of Hashimoto thyroiditis, extrathyroidal extension, central lymph node metastasis, multifocality of primary tumor, or $BRAF^{T1799A}$ mutation. Results: A total of 36 patients (40.4%) had occult PTMC in the contralateral lobe. The median diameter of the occult tumors was $0.33{\pm}0.21cm$. The $BRAF^{T1799A}$ mutation was found in 38 cases (42.7%). According to the univariate analysis, there were no significant differences between the presence of occult contralateral carcinoma and age, gender, family history, tumor size, presence of Hashimoto thyroiditis, extrathyroidal extension, central lymph node metastasis, multifocality of primary tumor, or $BRAF^{T1799A}$ mutation. Conclusions: Using current methods, it is difficult to preoperatively identify patients with PTMC, and further research is needed to determine predictive factors for the presence of occult contralateral carcinoma in patients with unilateral PTMC.

Keywords

Thyroid neoplasm;carcinoma;papillary;gene;BRAF

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