Clin Exp Otorhinolaryngol.  2017 Jun;10(2):174-180. 10.21053/ceo.2015.01655.

Predicting Extrathyroidal Extension in Patients With Papillary Thyroid Microcarcinoma According to a BRAF Mutation

• Lee DY
• Hwang SM
• An JH
• Son KR
• Baek SK
• Kim SG
• Chae YS
• Jung KY

• KMID: 2380437
• DOI: http://doi.org/10.21053/ceo.2015.01655

Abstract

OBJECTIVES
The aim of this study was to evaluate the association between preoperative parameters and extrathyroidal extension (ETE) of papillary thyroid microcarcinoma (PTMC) according to the BRAF mutation and to evaluate the preoperative predictability of ETE.
METHODS
We analyzed the medical records of 332 patients with PTMC (140 in the BRAF- group and 192 in the BRAF+ group). The presence of ETE was subjected to a correlation analysis with age, sex, tumor size, clinical nodal status, and ultrasonography (US) findings. Among the US findings, the correlation between tumors and the thyroid capsule was categorized into four groups; US group A, intraparechymal; US group B, tumor abutting the capsule <50% of diameter; US group C, tumor abutting >50% of diameter; and US group D, tumor destroyed the capsule. The predictive value of ETE, including sensitivity, specificity, and positive and negative predictive values were evaluated.
RESULTS
Tumor size and US group were significantly correlated with gross ETE in the BRAF- and BRAF+ groups. Tumor size of 0.5 cm and US groups B and C in the BRAF- group were cutoff values for gross ETE, with a negative predictive value of 100%, whereas tumor size of 0.7 cm and US groups A and B in the BRAF+ group had negative predictive values of 92.4% and 100%, respectively.
CONCLUSION
Excluding of ETE by US was categorized according to tumor size and US findings. A different categorization to exclude ETE is needed according to the BRAF mutation.

Keyword

Papillary Thyroid Microcarcinoma; BRAF Mutation; Extrathyroidal Extension; Capsules; Size

MeSH Terms

Capsules
Humans
Medical Records
Sensitivity and Specificity
Thyroid Gland*
Ultrasonography
Capsules

Figure

• 

  Fig. 1. Categorizing tumors according to their relationship with the thyroid capsule on preoperative ultrasonography. (A) Intraparechymal (arrow, thyroid parenchym between capsule and tumor), (B) abutting <50% of tumor diameter (lower arrow, tumor size; upper arrow, abutting length), (C) abutting >50% of tumor diameter (lower arrow, tumor size; upper arrow, abutting length), and (D) tumor destroying the capsule (arrows).

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