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False-negative BRAF V600E mutation results on fine-needle aspiration cytology of papillary thyroid carcinoma

Title
False-negative BRAF V600E mutation results on fine-needle aspiration cytology of papillary thyroid carcinoma
Authors
Paek S.H.Kim B.S.Kang K.H.Kim H.S.
Ewha Authors
백세현
Issue Date
2017
Journal Title
World Journal of Surgical Oncology
ISSN
1477-7819JCR Link
Citation
vol. 15, no. 1
Keywords
BRAFFalse-negative rateFine-needle aspiration cytologyPapillary thyroid carcinoma
Publisher
BioMed Central Ltd.
Indexed
SCIE; SCOPUS WOS scopus
Abstract
Background: The BRAF V600E mutation is highly specific for papillary thyroid carcinoma (PTC). A test for this mutation can increase the diagnostic accuracy of fine-needle aspiration cytology (FNAC), but a considerably high false-negative rate for the BRAF V600E mutation on FNAC has been reported. In this study, we investigated the risk factors associated with false-negative BRAF V600E mutation results on FNAC. Methods: BRAF V600E mutation results of 221 PTC nodules between December 2011 and June 2013 were retrospectively reviewed. BRAF V600E mutation results on both preoperative FNAC and postoperative formalin-fixed, paraffin-embedded (FFPE) samples were compared. We investigated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of BRAF V600E mutation results on FNAC. And, we identified the risk factors associated with false-negative results. Results: Of 221 PTC nodules, 150 (67.9%) on FNAC and 185 (83.7%) on FFPE samples were BRAF V600E mutation positive. The sensitivity, specificity, PPV, and NPV for BRAF V600E mutation testing with FNAC were 80.5, 97.2, 99.3, and 49.3%, respectively. Thirty-six (16.3%) BRAF V600E mutation-negative nodules on FNAC were mutation positive on FFPE sample analysis. Risk factors for these false-negative results were age, indeterminate FNAC results (nondiagnostic, atypia of undetermined significance (AUS), and findings suspicious for PTC), and PTC subtype. Conclusion: False-negative rate of BRAF mutation testing with FNAC for thyroid nodules is increased in cases of old age, indeterminate FNAC pathology results, and certain PTC subtypes. Therapeutic surgery can be considered for these cases. A well-designed prospective study with informed consent of patients will be essential for more informative results. © 2017 The Author(s).
DOI
10.1186/s12957-017-1266-5
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의료원 > 의료원 > Journal papers
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