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Cytojournal. 2006 Apr 10;3:10. doi: 10.1186/1742-6413-3-10.

Utility of BRAF V600E mutation detection in cytologically indeterminate thyroid nodules.

CytoJournal

Leslie R Rowe, Brandon G Bentz, Joel S Bentz

Affiliations

  1. Institute for Clinical and Experimental Pathology, Associated Regional and University Pathologists (ARUP) Laboratories, Salt Lake City, UT, USA. [email protected]

PMID: 16606457 PMCID: PMC1481512 DOI: 10.1186/1742-6413-3-10

Abstract

BACKGROUND: Fine needle aspiration (FNA) is widely utilized for evaluation of patients with thyroid nodules. However, approximately 30% are indeterminate for malignancy. Recently, a mutation in the BRAF gene has been reported to be the most common genetic event in papillary thyroid carcinoma (PTC). In this retrospective study, we assessed the utility of BRAF V600E mutation detection for refining indeterminate preoperative cytologic diagnoses in patients with PTC.

METHODS: Archival indeterminate thyroid FNAs and corresponding formalin-fixed, paraffin-embedded (FFPE) surgical samples with PTC were identified in our patient files. DNA extracted from slide scape lysates and 5 mum FFPE sections were evaluated for the BRAF V600E mutation using LightCycler PCR and fluorescent melting curve analysis (LCPCR). Amplification products that showed deviation from the wild-type genomic DNA melting peak, discordant FNA and FFPE matched pairs, and all benign control samples, underwent direct DNA sequencing.

RESULTS: A total of 19 indeterminate thyroid FNAs demonstrating PTC on FFPE surgical samples were included in the study. Using BRAF mutation analysis, the preoperative diagnosis of PTC was confirmed in 3/19 (15.8%) FNA samples that could not be conclusively diagnosed on cytology alone. However, 9/19 (47.4%) FFPE tissue samples were positive for the V600E mutation. Of the discordant pairs, 5/6 FNAs contained less than 50% tumor cells.

CONCLUSION: When used with indeterminate FNA samples, BRAF mutation analysis may be a useful adjunct technique for confirming the diagnosis of malignancy in an otherwise equivocal case. However, overall tumor cell content of some archival FNA smear slides is a limiting factor for mutation detection.

References

  1. J Pathol. 2001 Jun;194(2):183-93 - PubMed
  2. Clin Endocrinol (Oxf). 2002 Mar;56(3):281-90 - PubMed
  3. Expert Rev Mol Diagn. 2001 May;1(1):92-101 - PubMed
  4. J Clin Endocrinol Metab. 2004 Oct;89(10):5175-80 - PubMed
  5. Cancer. 2000 Dec 25;90(6):335-41 - PubMed
  6. J Clin Endocrinol Metab. 2004 Mar;89(3):1365-8 - PubMed
  7. Am J Surg. 1983 Jul;146(1):72-8 - PubMed
  8. Ann Intern Med. 1993 Feb 15;118(4):282-9 - PubMed
  9. Ann Surg. 2002 May;235(5):656-62; discussion 662-4 - PubMed
  10. J Pathol. 2004 Feb;202(2):247-51 - PubMed
  11. Thyroid. 1998 Jul;8(7):565-9 - PubMed
  12. J Natl Cancer Inst. 2003 Apr 16;95(8):625-7 - PubMed
  13. J Clin Endocrinol Metab. 2003 Nov;88(11):5399-404 - PubMed
  14. Virchows Arch. 1996 Nov;429(4-5):213-9 - PubMed
  15. Acta Endocrinol (Copenh). 1989 Aug;121(2):197-202 - PubMed
  16. CA Cancer J Clin. 2004 Jan-Feb;54(1):8-29 - PubMed
  17. Adv Surg. 1999;33:1-27 - PubMed
  18. N Engl J Med. 2005 Jun 9;352(23):2406-12 - PubMed
  19. World J Surg. 2000 Aug;24(8):923-33 - PubMed
  20. Mod Pathol. 1997 Jul;10(7):668-74 - PubMed
  21. Mayo Clin Proc. 1997 Oct;72(10):913-6 - PubMed
  22. Thyroid. 2001 Sep;11(9):877-81 - PubMed
  23. J Clin Endocrinol Metab. 2002 Sep;87(9):4411-5 - PubMed
  24. Yonsei Med J. 2004 Oct 31;45(5):818-21 - PubMed
  25. Arch Intern Med. 1984 Mar;144(3):474-6 - PubMed
  26. Ann Surg Oncol. 2000 Jun;7(5):376-98 - PubMed
  27. Cancer Res. 2003 Apr 1;63(7):1454-7 - PubMed
  28. Cancer. 1970 Apr;25(4):792-802 - PubMed
  29. Cancer Res. 2003 Aug 1;63(15):4561-7 - PubMed
  30. Clin Cancer Res. 2004 Apr 15;10(8):2761-5 - PubMed
  31. J Am Coll Surg. 1998 Nov;187(5):494-502 - PubMed
  32. Oncogene. 2003 Jul 17;22(29):4578-80 - PubMed
  33. Mod Pathol. 2001 Apr;14(4):338-42 - PubMed
  34. Nature. 2002 Jun 27;417(6892):949-54 - PubMed
  35. Virchows Arch. 2005 Jun;446(6):589-95 - PubMed
  36. Cancer Genet Cytogenet. 2004 Feb;149(1):68-71 - PubMed
  37. Laryngoscope. 2002 Jul;112(7 Pt 1):1209-12 - PubMed
  38. Surgery. 1994 Dec;116(6):1054-60 - PubMed
  39. Oncogene. 2003 Sep 25;22(41):6455-7 - PubMed
  40. Am J Surg. 1983 Sep;146(3):349-54 - PubMed
  41. Cancer Control. 2000 May-Jun;7(3):240-5 - PubMed
  42. J Clin Endocrinol Metab. 2003 Sep;88(9):4393-7 - PubMed
  43. Eur J Surg Oncol. 2003 Nov;29(9):747-9 - PubMed
  44. Endocr Pathol. 2001 Fall;12(3):275-9 - PubMed
  45. Int J Oncol. 2002 Aug;21(2):265-72 - PubMed
  46. Am J Clin Pathol. 2001 Nov;116(5):696-702 - PubMed
  47. Am J Pathol. 1933;9(Suppl):801-812.3 - PubMed
  48. Acta Cytol. 2001 May-Jun;45(3):347-52 - PubMed
  49. Ann Surg. 1930 Aug;92(2):169-81 - PubMed
  50. Clin Chem. 2000 Feb;46(2):147-8 - PubMed
  51. Am J Surg. 2004 Nov;188(5):459-62 - PubMed
  52. Ann Intern Med. 1968 Sep;69(3):537-40 - PubMed
  53. J Clin Endocrinol Metab. 2001 Jul;86(7):3211-6 - PubMed
  54. J Clin Endocrinol Metab. 2004 Jun;89(6):2867-72 - PubMed
  55. Arch Pathol Lab Med. 2003 May;127(5):579-83 - PubMed
  56. Acta Cytol. 2003 Sep-Oct;47(5):709-22 - PubMed

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