Association of BRAF mutation with higher lymph node ratio: a potential independent prognostic factor in papillary thyroid carcinoma — ASN Events
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Association of BRAF mutation with higher lymph node ratio: a potential independent prognostic factor in papillary thyroid carcinoma (#345)

Colin Moncrieff 1 2 , Catherine Woolnough 1 2 , Michael S Elliott 1 3 , Ruta Gupta 4 , Jessie A Tubb 2 , Ash Gargya 2 , Jonathon Clarke 3 , Susan V McLennan 1 2 , Elizabeth Chua 1 2
  1. Sydney Medical School, University of Sydney, Sydney , NSW, Australia
  2. Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
  3. Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital , Sydney, NSW, Australia
  4. Department of Diagnostic Oncology and Tissue Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia

Introduction: Our previous studies have shown that lymph node ratio (LNR) can predict higher risk of recurrence in papillary thyroid cancer (PTC)1. Whether a higher LNR is associated with V600E BRAF mutation (BRAF+ve) is not known. In this study, we investigated the incidence of BRAF+ve in PTC tissue and the corresponding lymph node metastases (LNM). The association between BRAF+ve, LNR, lymphovascular invasion (LVI) and recurrence was also examined. 

Methods: PTC tissue and LNM were obtained from 13 histologically confirmed PTC patients who had thyroidectomies performed with lymph node dissection at Royal Prince Alfred Hospital since 2000. DNA was extracted from formalin-fixed paraffin-embedded micro-dissected PTC and LNM. The BRAF+ve mutation was detected by melt curve analysis and confirmed by DNA sequencing. 

Results: The BRAF+ve mutation was detected in both PTC and LNM in 8/13 of cases. There were no discordant results.  Of the 8 BRAF+ve matched PTC and LNM cases, 2 had recurrence and 4 had LVI. The majority (7/8) had LNR > 0.3.

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Conclusions: In this small series, the presence of  BRAF+ve mutation in PTC is associated with  BRAF+ve mutation in the LNM. BRAF+ve is also associated with a higher LNR which we have previously shown as an independent prognostic factor in PTC. 

1 

  1. 1.Prognostic Implications of Lymph Node Yield and Lymph Node Ratio in Papillary Thyroid Carcinoma. J.H. Vas Nunes, J.R. Clark, K. Gao, E. Chua, P. Campbell, N. Niles, A. Gargya, M.S. Elliott . Thyroid. February 2013.
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