We aimed to evaluate the prognostic value ofBRAFV600E mutation in a series of 127 papillary thyroid carcinoma (PTC) cases as a single factor, and in synergic interaction with other standard risk factors.BRAFV600E mutation was assessed by real-time PCR. Event-free survival (EFS) was calculated between the date of the first evaluation and the date of occurrence of an adverse event or the date of the last known status. The prevalence ofBRAFV600E mutation was 57.2%. The Kaplan–Meier analysis showed a significant reduction of EFS among cases harboringBRAFV600E mutation compared to non-mutated cases (p= 0.010). In addition,BRAFV600E mutation was found to better predict adverse outcomes when associated with the following risk factors: age ≥ 55 years old (p< 0.001), male gender (p< 0.001), conventional (p= 0.005) and tall cell (p= 0.014) histology, tumor size > 40 mm (p= 0.001), extrathyroidal extension (p= 0.001), multifocality (p= 0.001) and lymph node metastasis (p< 0.001). In univariate analysis, a 3.74-fold increased risk for a reduced EFS (p= 0.018) was found forBRAFV600E-mutated cases, but no increased risk was further confirmed by multivariate analysis. Our results highlight thatBRAFV600E mutation cannot be used alone as an independent predictive factor in PTC patients, but is prognostically valuable if integrated in the context of other clinicopathological risk factors.
本研究旨在评估BRAFV600E突变对127例甲状腺乳头状癌（PTC）病例的预后价值，分别作为单一因素以及与其他标准风险因素的协同作用进行分析。BRAFV600E突变通过实时荧光定量PCR进行检测。无事件生存期（EFS）计算自首次评估日期至不良事件发生日期或末次已知状态日期。BRAFV600E突变发生率为57.2%。Kaplan-Meier分析显示，与未突变病例相比，携带BRAFV600E突变的病例EFS显著缩短（p=0.010）。此外，当BRAFV600E突变与以下风险因素结合时，能更有效预测不良结局：年龄≥55岁（p<0.001）、男性（p<0.001）、经典型（p=0.005）和高细胞型（p=0.014）组织学亚型、肿瘤大小>40毫米（p=0.001）、甲状腺外侵犯（p=0.001）、多灶性（p=0.001）及淋巴结转移（p<0.001）。单变量分析显示，BRAFV600E突变病例的EFS降低风险增加3.74倍（p=0.018），但多变量分析未进一步证实其独立风险性。我们的研究结果强调，BRAFV600E突变不能单独作为PTC患者的独立预测因子，但结合其他临床病理风险因素时具有重要预后价值。
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