Braf Mutation Correlates with Ptc Recurrence

The prevalence of thyroid cancer has been increasing worldwide1, including in China2. The disease has become the fastest-increasing cancer, and it ranks 5th among the most common cancers in women3. Notably, the current increase is almost entirely attributable to papillary thyroid carcinoma (ptc)4. The prognosis of differentiated thyroid cancer is benign, with a survival rate of 96.4% after 30 years followup5. However, a significant percentage of ptc patients experience recurrent disease or distant metastasis, reducing the survival rate to 40%6. Several staging systems have been applied to stratify the risk of a poor outcome with ptc. However, all are based on histopathologic parameters after surgery7. They therefore cannot be used before an operation to determine the extent of surgery. With the emerging understanding of molecular genetics in thyroid cancer, several specific mutations in ptc have been determined8. The BRAF V600E mutation has been associated with worse prognostic features (such as extrathyroidal extension, lymph node metastasis or advanced tumour stage), poor clinical outcome, and mortality9–13. The RET/PTC oncogenes are believed to play an important role in radiation-induced ptc14. In contrast to BRAF mutation, RET/PTC rearrangement has been associated with better prognosis15. Yet despite those findings, controversy remains16–21. In addition, questions about the clinical significance of these mutations in the management of microptc are ongoing22. ABSTRACT