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BRAF mutation associated with other genetic events identifies a subset of aggressive papillary thyroid carcinoma.
Clin Endocrinol (Oxf). 2008 Apr; 68(4):618-34.CE

Abstract

PURPOSE

BRAF(V600E) mutation represents the most common oncogenic event in sporadic papillary thyroid cancer (PTC). There are, however, significant discrepancies regarding the overall frequency, its prevalence in PTC-variants, and its relationship with clinico-pathological parameters of poor outcome. Moreover, the impact of BRAF(V600E) mutants on tumour-related patient's death has not been evaluated.

DESIGN

We analysed, by PCR-SSCP and/or PCR-direct sequencing, exons 8, 10, 11 and 15 of BRAF in 113 tumour samples from 49 PTC-patients. Matched lymph node metastases and/or distant metastases (DMs) were screened in 35 patients. Focal changes in the growth pattern or microscopic grade within the primary tumour (Pt) or the metastases were separately genotyped. Mutations at H-, K-, N-ras and PIK3CA exons 9 and 20 were also investigated. For comparison with PTC cases, the BRAF and Ras mutational status was evaluated in 89 specimens obtained from 24 poorly differentiated thyroid carcinomas (PDCs) and 36 anaplastic thyroid carcinomas (ATCs).

RESULTS

BRAF(V600E) was found in 13/16 classical PTCs (CL-PTCs), 6/17 follicular variant PTCs (FV-PTCs) and 8/16 mixed (papillary/follicular) PTCs (Mx-PTCs), being significantly associated with CL-PTCs (P = 0.015). BRAF(V600E) segregated with metastatic PTC-cells in 43% of the patients, but only one DM disclosed the mutation. PTC-tumours featuring concurrent less-differentiated foci were BRAF wild-type in both components. Noteworthy, the frequency of BRAF mutations among PDCs and ATCs resulted considerably lower (16.6% and 25%, respectively) than in PTCs (55%). The prevalence of Ras mutations among PDCs and ATCs (46% and 36%, respectively) was, however, much higher than in PTCs (14%). Five (71%) of the patients who died of PTC displayed somatic mutations. Four of them had other gene alteration associated with BRAF(V600E) and the only one that did not, BRAF(V600E) was restricted to the Pt. The occurrence of BRAF(V600E) associated with other genetic events was an independent predictor of DMs during follow-up, recurrence and tumour-related death. Remarkably, two PDCs (8.3%) and five ATCs (14%) revealed concurrent BRAF and Ras mutations.

CONCLUSION

BRAF(V600E)'alone' does not represent a marker for poor outcome, however, when associated with alterations in other genes identifies a subset of PTCs with increased risk of recurrence and decreased survival.

Authors+Show Affiliations

Institute of Molecular Pathology and Immunology of Porto University, Porto, Portugal.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18070147

Citation

Costa, Angela M., et al. "BRAF Mutation Associated With Other Genetic Events Identifies a Subset of Aggressive Papillary Thyroid Carcinoma." Clinical Endocrinology, vol. 68, no. 4, 2008, pp. 618-34.
Costa AM, Herrero A, Fresno MF, et al. BRAF mutation associated with other genetic events identifies a subset of aggressive papillary thyroid carcinoma. Clin Endocrinol (Oxf). 2008;68(4):618-34.
Costa, A. M., Herrero, A., Fresno, M. F., Heymann, J., Alvarez, J. A., Cameselle-Teijeiro, J., & García-Rostán, G. (2008). BRAF mutation associated with other genetic events identifies a subset of aggressive papillary thyroid carcinoma. Clinical Endocrinology, 68(4), 618-34.
Costa AM, et al. BRAF Mutation Associated With Other Genetic Events Identifies a Subset of Aggressive Papillary Thyroid Carcinoma. Clin Endocrinol (Oxf). 2008;68(4):618-34. PubMed PMID: 18070147.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - BRAF mutation associated with other genetic events identifies a subset of aggressive papillary thyroid carcinoma. AU - Costa,Angela M, AU - Herrero,Agustín, AU - Fresno,Manuel F, AU - Heymann,Jonas, AU - Alvarez,José Antonio, AU - Cameselle-Teijeiro,Jose, AU - García-Rostán,Ginesa, Y1 - 2007/12/05/ PY - 2007/12/12/pubmed PY - 2009/9/1/medline PY - 2007/12/12/entrez SP - 618 EP - 34 JF - Clinical endocrinology JO - Clin. Endocrinol. (Oxf) VL - 68 IS - 4 N2 - PURPOSE: BRAF(V600E) mutation represents the most common oncogenic event in sporadic papillary thyroid cancer (PTC). There are, however, significant discrepancies regarding the overall frequency, its prevalence in PTC-variants, and its relationship with clinico-pathological parameters of poor outcome. Moreover, the impact of BRAF(V600E) mutants on tumour-related patient's death has not been evaluated. DESIGN: We analysed, by PCR-SSCP and/or PCR-direct sequencing, exons 8, 10, 11 and 15 of BRAF in 113 tumour samples from 49 PTC-patients. Matched lymph node metastases and/or distant metastases (DMs) were screened in 35 patients. Focal changes in the growth pattern or microscopic grade within the primary tumour (Pt) or the metastases were separately genotyped. Mutations at H-, K-, N-ras and PIK3CA exons 9 and 20 were also investigated. For comparison with PTC cases, the BRAF and Ras mutational status was evaluated in 89 specimens obtained from 24 poorly differentiated thyroid carcinomas (PDCs) and 36 anaplastic thyroid carcinomas (ATCs). RESULTS: BRAF(V600E) was found in 13/16 classical PTCs (CL-PTCs), 6/17 follicular variant PTCs (FV-PTCs) and 8/16 mixed (papillary/follicular) PTCs (Mx-PTCs), being significantly associated with CL-PTCs (P = 0.015). BRAF(V600E) segregated with metastatic PTC-cells in 43% of the patients, but only one DM disclosed the mutation. PTC-tumours featuring concurrent less-differentiated foci were BRAF wild-type in both components. Noteworthy, the frequency of BRAF mutations among PDCs and ATCs resulted considerably lower (16.6% and 25%, respectively) than in PTCs (55%). The prevalence of Ras mutations among PDCs and ATCs (46% and 36%, respectively) was, however, much higher than in PTCs (14%). Five (71%) of the patients who died of PTC displayed somatic mutations. Four of them had other gene alteration associated with BRAF(V600E) and the only one that did not, BRAF(V600E) was restricted to the Pt. The occurrence of BRAF(V600E) associated with other genetic events was an independent predictor of DMs during follow-up, recurrence and tumour-related death. Remarkably, two PDCs (8.3%) and five ATCs (14%) revealed concurrent BRAF and Ras mutations. CONCLUSION: BRAF(V600E)'alone' does not represent a marker for poor outcome, however, when associated with alterations in other genes identifies a subset of PTCs with increased risk of recurrence and decreased survival. SN - 1365-2265 UR - https://www.unboundmedicine.com/medline/citation/18070147/BRAF_mutation_associated_with_other_genetic_events_identifies_a_subset_of_aggressive_papillary_thyroid_carcinoma_ L2 - https://doi.org/10.1111/j.1365-2265.2007.03077.x DB - PRIME DP - Unbound Medicine ER -