Poorer Prognosis and Higher Prevalence of BRAF V600E Mutation in Synchronous Bilateral Papillary Thyroid Carcinoma

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• 作者：Weibin Wang MD ; PhD (1)
  Wenhe Zhao MD (1)
  Haiyong Wang MD ; PhD (1)
  Xiaodong Teng MD (2)
  Haohao Wang MD ; PhD (1)
  Xiangheng Chen MD (1)
  Zhongqi Li MD (1)
  Xiongfei Yu MD (1)
  Thomas J. Fahey III MD (3)
  Lisong Teng MD ; PhD (1)
  
• 刊名：Annals of Surgical Oncology
• 出版年：2012
• 出版时间：January 2012
• 年：2012
• 卷：19
• 期：1
• 页码：31-36
• 全文大小：259KB
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• 作者单位：Weibin Wang MD, PhD (1)
  Wenhe Zhao MD (1)
  Haiyong Wang MD, PhD (1)
  Xiaodong Teng MD (2)
  Haohao Wang MD, PhD (1)
  Xiangheng Chen MD (1)
  Zhongqi Li MD (1)
  Xiongfei Yu MD (1)
  Thomas J. Fahey III MD (3)
  Lisong Teng MD, PhD (1)
  
  1. Cancer Center, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
  2. Department of Pathology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
  3. Department of Surgery, New York Presbyterian Hospital, and Weill Medical College of Cornell University, New York, USA
  

文摘

Background The clinical significance of synchronous bilateral papillary thyroid carcinoma (SBiPTC) has not been fully defined, and the prevalence of BRAF V600E mutation in SBiPTC remains unknown. The purpose of this study is to compare the clinical outcomes and BRAF V600E mutation incidence of SBiPTC patients with those of unilateral papillary thyroid carcinoma (UiPTC) patients. Methods From 1997 to 2008, a total of 903 patients with papillary thyroid cancer were treated at a single institution. Of 891 studied patients, 177 (19.9%) had SBiPTC and 714 had UiPTC. SBiPTC was defined as cancer diagnosed in both thyroid lobes at the same time or within a period of 3?months. The mean follow-up time was 6?years, ranging from 2.5 to 13.5?years. Rates of disease-free survival (DFS) and overall survival (OS) were calculated and compared. BRAF V600E mutation was determined by polymerase chain reaction (PCR) amplification and DNA sequencing. Results Compared with UiPTC patients, patients with SBiPTC were more likely to have larger tumor size, extrathyroidal invasion, lymph node metastasis, and more advanced stage. The 5-year DFS rate was 86.0% for SBiPTC patients and 94.0% for UiPTC patients (p?=?0.013). The prevalence of BRAF V600E mutation in the SBiPTC group was significantly higher than that in the UiPTC group (65.7% vs. 50.4%; p?=?0.038). Conclusions Patients with SBiPTC present with more advanced tumor stage and have shorter disease-free survival than UiPTC patients. Poorer outcomes of these patients may be at least partially explained by the high incidence of BRAF V600E mutation.