Reduction of False-Negative Papillary Thyroid Carcinomas by the Routine Analysis of BRAFT1799A Mutation on Fine-Needle Aspiration Biopsy Specimens
| Autor: | Martín López de la Torre-Casares, Patricia Becerra-Massare, Jesús María Villar-Del Moral, Carlos García-Calvente, Marisa Cañadas-Garre, Miguel A. López-Nevot, Susana Céspedes-Mas, Teresa Muros-de Fuentes, Gonzalo Piédrola-Maroto, Jose M. Llamas-Elvira, Rosa Montes-Ramírez, Ricardo Vílchez-Joya |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Proto-Oncogene Proteins B-raf medicine.medical_specialty Pathology Adolescent endocrine system diseases Biopsy Fine-Needle Sensitivity and Specificity Thyroid carcinoma Young Adult Biopsy Carcinoma medicine Humans Prospective Studies Thyroid Neoplasms Prospective cohort study False Negative Reactions Aged Aged 80 and over medicine.diagnostic_test business.industry Thyroid DNA Neoplasm Middle Aged medicine.disease Carcinoma Papillary Fine-needle aspiration medicine.anatomical_structure Cytopathology Mutation Female Surgery Radiology business |
| Zdroj: | Annals of Surgery. 255:986-992 |
| ISSN: | 0003-4932 |
| Popis: | To evaluate prospectively the usefulness of the routine determination of BRAF(T1799A) mutation on thyroid fine-needle aspiration biopsy (FNAB) to detect cytopathology false negative papillary thyroid carcinomas (PTC) and, therefore, as a tool to improve the sensitivity of the preoperative cytopathological diagnosis of PTC in thyroid nodules.FNAB is the most reliable diagnostic test to discriminate between malignant and benign thyroid nodules, but nondiagnostic results remain a clinical management dilemma. BRAF(T1799A) mutation is the most prevalent genetic alteration in thyroid cancers and is specific for PTC, characteristics that make it the most potentially helpful genetic tool to improve the diagnostic accuracy of FNAB.An exhaustive recruitment of all patients subjected to thyroid FNAB in our institution during 4 years was performed. BRAF(T1799A) mutation was determined on thyroid FNAB specimens by PCR and restriction fragment length polymorphism, plus direct sequencing in positive samples.BRAF(T1799A) mutation on FNAB detected 47.2% (17/36) of PTC cases. It confirmed preoperatively 45.5% (5/11) of the PTC cases in the indeterminate category and decreased the rate of cytopathology false-negatives in 33.3% (6/18), improving the combined (BRAF(T1799A) mutation + cytopathological analysis) sensitivity of the detection of PTC on FNAB in 16.7%.BRAF(T1799A) mutation improves the diagnosis of PTC on FNAB, mainly because of the detection of cytopathology false-negatives, and it can be helpful in the routine analysis of thyroid nodules, especially in clinical settings with moderate sensitivity to detect PTC on FNAB. |
| Databáze: | OpenAIRE |
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