Background/Objectives: Papillary thyroid microcarcinoma (MPTC), a subset of papillary thyroid carcinoma (PTC), is increasingly detected with advanced imaging. While most MPTCs are indolent, some exhibit aggressive behavior, complicating clinical management. TheBRAF V600Emutation, common in PTC, is linked to aggressive features, and its allele frequency (AF) may serve as a biomarker for tumor aggressiveness. This study explored the association betweenBRAF V600EAF and aggressive histopathological features in MPTC.Methods: Data from 1 January 2016 to 23 December 2023 were retrieved from two McGill University teaching hospitals. Inclusion criteria comprised patients aged ≥ 18 years with thyroid nodules ≤ 1 cm, documentedBRAF V600Emutation and AF results, and available surgical pathology reports. Tumor aggressiveness was defined as the presence of lymph node metastasis, aggressive histological subtype (tall cell, hobnail, columnar, solid/trabecular or diffuse sclerosing), extra thyroidal extension, or extensive lymphovascular extension. Associations were explored usingt-tests.Results: Among 1564 records, 34 met the inclusion criteria and were included in analyses. The meanBRAF V600EAF was significantly higher in aggressive tumors (23.58) compared to non-aggressive tumors (13.73) (95% CI: −18.53 to −1.16,p= 0.03). Although not statistically significant, trends were observed for higherBRAF V600EAF in tumors with lymph node metastasis (mean AF: 25.4) compared to those without (mean AF: 16.67,p= 0.08). No significant difference was noted inBRAF V600EAF by histological subtype (mean AF for aggressive: 19.57; non-aggressive: 19.15,p= 0.94).Conclusions: ElevatedBRAF V600EAF is associated with aggressive behavior in MPTC, highlighting its potential as a biomarker to inform treatment strategies. Larger studies are warranted to validate these findings and enhance clinical management of MPTC patients.
背景/目的：甲状腺微小乳头状癌（MPTC）作为甲状腺乳头状癌（PTC）的一个亚型，随着影像技术的进步其检出率日益增高。虽然多数MPTC呈惰性表现，但部分病例具有侵袭性行为，使临床决策复杂化。BRAF V600E突变在PTC中常见，与侵袭性特征相关，其等位基因频率（AF）可能作为肿瘤侵袭性的生物标志物。本研究旨在探讨MPTC中BRAF V600E AF与侵袭性组织病理学特征之间的关联。 方法：研究数据取自麦吉尔大学两所教学医院2016年1月1日至2023年12月23日的病历资料。纳入标准包括：年龄≥18岁、甲状腺结节≤1 cm、具有BRAF V600E突变及AF检测结果、可获得手术病理报告的患者。肿瘤侵袭性定义为存在淋巴结转移、侵袭性组织学亚型（高细胞型、鞋钉样、柱状细胞型、实性/梁状型或弥漫硬化型）、甲状腺外侵犯或广泛淋巴血管侵犯。采用t检验进行关联性分析。 结果：在1564份记录中，34例符合纳入标准并进入分析。侵袭性肿瘤的平均BRAF V600E AF（23.58）显著高于非侵袭性肿瘤（13.73）（95% CI：-18.53至-1.16，p=0.03）。尽管未达统计学显著性，但存在淋巴结转移的肿瘤（平均AF：25.4）较无转移者（平均AF：16.67）呈现更高的BRAF V600E AF趋势（p=0.08）。不同组织学亚型间的BRAF V600E AF无显著差异（侵袭性亚型平均AF：19.57；非侵袭性亚型：19.15，p=0.94）。 结论：BRAF V600E AF升高与MPTC的侵袭性行为相关，提示其可作为指导治疗策略的生物标志物。需要更大规模的研究验证这些发现，以优化MPTC患者的临床管理。
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