Clinical significance of BRAFV600E and TERT promoter mutation in papillary thyroid microcarcinoma*

Abstract

Abstract Objective The objective of this study was to analyze the correlation between BRAFV600E and TERT promoter mutations and papillary thyroid microcarcinoma (PTMC) risk factors, and their importance in the risk assessment of papillary thyroid microcarcinoma. Methods This study retrospectively analyzed 107 cases of PTMC, which were diagnosed after the surgery in the department of head and neck surgery in Gansu Province Tumor Hospital from October 2014 to June 2016. The mutations of BRAFV 600E and TERT promoter were detected by PCR direct sequencing. We analyzed the data using χ2 test and binary Logistic regression analysis. Results Among 107 patients with PTMC, the BRAFV 600E and TERT promoter mutation rates were 68.2% and 11.2%, respectively. Single factor analysis showed that there was a significant difference between the presence of membrane invasion, lymph node metastasis, and BRAFV 600E mutations (P < 0.01). The age, gender, thyroid capsular invasion, poor pathologic subtype, and lymph node metastasis of patients, was significantly associated with the TERT promoter mutation (P < 0.05) and the coexistence of the BRAFV600E and TERT promotor mutations; although, there was a difference between the association of these factors with the TERT promoter mutation and the association of these factors with the coexistence of the BRAFV600E and TERT promotor mutations. The multifactorial analysis showed that the factors closely related to the BRAF V600E mutation included capsular invasion (P = 0.012) and lymph node metastasis (P = 0.000). The following factors were closely associated with the TERT promoter mutant: male (P = 0.004), aged < 45 years (P = 0.026), capsular invasion (P = 0.004), pathological subtype (P = 0.030), and lymph node metastasis (P = 0.043). The following factors were closely related to the simultaneous mutation of BRAF V600E and TERT: male (P = 0.022), capsular invasion (P = 0.023), poor pathological subtype (P = 0.041), and lymph node metastasis (P = 0.030). Conclusion The risk of recurrence increases significantly when mutations in BRAF V600E and TERT promoters occur simultaneously in PTMC and may have adverse outcomes. Combined detection of BRAFV 600E and TERT promoter mutations is of great value in risk assessment of PTMC.