Correlation between the preoperative abundance of fine-needle aspiration (FNA)-BRAFV600E mutations and clinicopathological features of papillary thyroid carcinoma

Abstract:

Objective To investigate the relationship between the preoperative abundance of fine-needle aspiration（FNA）-BRAF^V600E mutations and clinicopathological features of papillary thyroid cancer（PTC）.Methods Retrospective analysis was performed on the clinical data of 301 patients who underwent radical thyroidectomy in Affiliated Hospital of Integrated Traditional Chinese and Western Medicine of Nanjing University of Chinese Medicine from January 30，2021 to February 28，2022. Preoperative FNA of all patients showed BRAF^V600E mutation. All patients underwent preoperative mutant abundance detection， and PTC was confirmed by postoperative pathology analysis. The relationship between BRAF^V600E mutant abundance and clinicopathological features was analyzed.Results A total of 301 patients were enrolled，including 91 males and 210 females. The median age of the patients was 42（33-51） years old， ranging from 18 to 69 years old. The abundance of BRAF^V600E mutation in patients with tumor diameter more than 1 cm was higher than that in patients with tumor diameter no more than 1 cm［29.05（18.03-37.56） vs. 18.35（6.74-29.61），P<0.001］. The abundance of BRAF^V600E mutation in patients with cervical lymph node metastasis was higher than that in patients without cervical lymph node metastasis［24.72（8.08-34.32） vs. 18（8.68-28.54），P=0.040］. The abundance of BRAF^V600E mutation in female patients with cervical lymph node metastasis was higher than that in patients without cervical lymph node metastasis［25.75（9.62-34.30） vs. 17.47（7.27-26.86），P=0.007］，but there was no statistical significance among male patients（P=0.654）. The receiver operating characteristic（ROC） curve for predicting cervical lymph node metastasis in female PTC patients was constructed with the abundance of BRAF^V600E mutation（AUC=0.609，95%CI=0.532-0.686），and the cutoff value was 25.65%. Multivariate analysis showed that the following aspects had a significant correlation with cervical lymph node metastasis in female PTC patients（P<0.05），such as less than 55 years old（OR=0.138-0.735，P=0.007），BRAF^V600E mutant abundance no less than 25.68%（OR=1.271-4.65，P=0.007），multifocality（OR=1.282-4.623，P=0.007） and tumor diameter more than 1 cm（OR=2.257-11.927，P<0.001）.Conclusion The abundance of BRAF^V600E mutation was significantly correlated with tumor diameter and cervical lymph node metastasis in PTC patients. The rate of cervical lymph node metastasis of female PTC patients with BRAF^V600E mutant abundance of no less than 25.68% has been significantly increased.