ECE2015 Eposter Presentations Thyroid cancer (90 abstracts)
BRAF V600E positive papillary thyroid carcinoma is associated with suspicious ultrasound features
Julia Sastre-Marcos 1 , Florentino Del Val-Zaballos 1 , Claudia Cortes-Muñoz 1 , Yolanda Campos-Martin 1 , Sonsoles Aso-Manso 1 , Ignacio Jaen-Diaz 2 , Almudena Vicente-Delgado 1 & Jose Lopez-Lopez 1
1Complejo Hospitalario de Toledo, Toledo, Spain; 2Centro de Salud de Buenavista, Toledo, Spain.
Aims: To study if BRAF V600E mutation in thyroid fine needle aspiration (FNA) is associated with specific ultrasound (US) characteristics.
Patients and methods: From 2010 to 2014 we reviewed patients with thyroid nodules with the following inclusion criteria: US guided FNA of the nodule and molecular testing for BRAF V600E on the FNA. BRAF mutation was detected using fluorescence melting curve. An expert on US, blinded to the BRAF status reviewed US examinations and recorded the sonographic characteristics for each nodule. Six US characteristics were collected: margins, echogenicity, halo, nodular vascularization, calcifications and cystic or solid composition. US findings were classified into three categories: probably benign, indeterminate o suspicious. Demographic and clinical characteristics were also analysed. Univariate (χ2 and student’s t-test) and multivariate analysis were carried out.
Results: patients were studied (85, 6% women), mean age 52 years. 79 patients showed BRAF V600E mutations on FNA (29, 2%). BRAF-positive patients were younger (48.5±16.0 vs 53.6±16.1 years, P<0,05) and with different gender distribution (men 21.5% vs 11.5%, P<0.05). BRAF-positive nodules showed at least one malignant US characteristics in 89.9% vs 49.5% in BRAF-wild type nodules (P<0.001). BRAF-positive nodules were classified as suspicious in 63.3% and as probably benign in 10.1%. BRAF-negative nodules were classified as suspicious in 24% and probably benign in 50, 5% (P<0.001). By multivariate analysis, micro-macrocalcifications (OR 3.8 CI95% 1.8–8.0, P<0.001) and hypoechogenicity (OR 2.7 CI95% 1.2–6.2, P<0.05) were independently associated with the presence of BRAF V600E mutation.
Conclusion: Suspicious US characteristics are highly associated with BRAF positive FNA. Routine cervical US and molecular testing can contribute to improve preoperative risk classification of papillary thyroid cancer.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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