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- Title
BRAFStatus of Follicular Variant of Papillary Thyroid Carcinoma and its Relationship to Its Clinical and Cytological Features.
- Authors
Agnese Proietti; Riccardo Giannini; Clara Ugolini; Mario Miccoli; Gabriella Fontanini; Giancarlo Di Coscio; Rossana Romani; Piero Berti; Paolo Miccoli; Fulvio Basolo
- Abstract
Background:The cytological discrimination between benign and malignant follicular-patterned lesions of the thyroid can represent a diagnostic challenge, even for experienced pathologists. To attempt to clarify this diagnostic problem, we analyzed the BRAFstatus of thyroid tumors in a group of patients with follicular variant of papillary thyroid carcinoma (FVPTC) and its correlation with cytomorphological features.Methods:The BRAFstatus was evaluated in a total of 187 patients in whom FVPTC was consecutively diagnosed by histology between January 2006 and January 2009. Each case had a previous fine-needle aspiration diagnosis classified according to the British Thyroid Association Guidelines categorized as inadequate (Thy1) (n= 19), benign (Thy2) (n= 19), follicular lesion and follicular lesion with atypia (Thy3) (n= 109), suspicious of PTC (Thy4) (n= 29), or malignant (Thy5) (n= 11). The first 68 cases were selected for a morphological study by a quantitative analysis of four cytological features (grooves, intranuclear cytoplasmatic inclusions, number of cells per high power field (400 ×), and mean nuclear diameter) of the carcinomas.Results:The BRAFstatus of each tumor was correlated with the cytological classes. 54.5% and 27.6% of Thy5and Thy4, respectively, were BRAF-mutated, against 12.1% of follicular lesions and 9.3% of follicular lesion with atypia (Thy3). This comparison was statistically significative (p= 0.0017). Among the 68 cases selected for the cyto-morphological study, the BRAFstatus frequency was similar to that of the total case series. No significant differences were found correlating the cytological classes with the number of cells, the number of grooves, and the mean cell diameters. Only the number of intranuclear cytoplasmatic inclusions were associated (p< 0.05) with the Thy5cytological class.Conclusions:BRAFis mutated in a low percentage of FVPTC, and most of these mutated cases are suspicious or positive on fine-needle aspiration. BRAFanalysis is of limited value in the preoperative diagnosis of FVPTC.
- Subjects
PAPILLARY carcinoma; NEEDLE biopsy; HISTOPATHOLOGY; CANCER cells; CYTOLOGY; QUANTITATIVE research; MEDICAL care
- Publication
Thyroid, 2010, Vol 20, Issue 11, p1263
- ISSN
1050-7256
- Publication type
Article
- DOI
10.1089/thy.2009.0283