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Predictive Value of BRAFV600E Mutation for Lymph Node Metastasis in Papillary Thyroid Cancer: A Meta-analysis

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Abstract

BRAFV600E mutation has been thought to be a valuable molecular marker that may predict a worse prognosis for papillary thyroid cancer (PTC). But whether BRAFV600E mutation is associated with lymph node metastasis (LNM) remains controversial. Different surgical strategies may bring a bias in demonsstrating the association between them. In order to delineate a risk stratification to guide a tailored initial approach to tumors that express BRAFV600E mutation, we performed this meta-analysis by using the articles in which total or near-total thyroidectomy plus bilateral central lymph node dissection was routinely performed to avoid the bias from the surgical strategy. We searched the Medline, Embase and CNKI database for eligible studies from January 2003 to May 2018. Meta-analysis was performed using the STATA 12.0 software. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated under fixed-effects or randomeffects models. Fifteen clinical studies were included with a total of 4909 PTC patients. Our meta-analysis results reported that BRAFV600E mutation was associated with LNM (OR=1.34; 95% CI: 1.09–1.65; P=0.005), as well as central LNM (OR=1.59; 95% CI: 1.35–1.88; P<0.00001). Moreover, in patients with papillary thyroid microcarcinoma, we also confirmed the predictive value of BRAFV600E mutation for LNM (OR=3.49; 95% CI: 2.02–6.02; P<0.00001). This meta-analysis demonstrates that BRAFV600E mutation is closely related to LNM in PTC patients. The results suggest that BRAFV600E mutation can be considered as a risk factor for LNM in PTC. Moreover, combining BRAFV600E mutation with other risk factors to determine the initial surgical treatment may bring benefits for PTC patients.

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Author notes

  1. These authors contributed equally to this study.

Authors and Affiliations

  1. Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Jing-yong Song, Fang Dong, Tao Huang & Jing Zhou

  2. Department of Gastrointestinal Surgery, Hainan Cancer Hospital, Haikou, 570000, China

    Jing-yong Song

  3. Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Shi-ran Sun

  4. Department of Orthopaedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Bin Wu

Authors
  1. Jing-yong Song
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  2. Shi-ran Sun
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  3. Fang Dong
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  4. Tao Huang
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  5. Bin Wu
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  6. Jing Zhou
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Corresponding authors

Correspondence to Bin Wu or Jing Zhou.

Additional information

This study was supported by National Natural Science Foundation of China (No. 81702650), Natural Science Foundation of Hubei Province (No. 2016CFB323) and Innovation Foundation of Huazhong University of Science and Technology (No. 2016YXMS229).

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Song, Jy., Sun, Sr., Dong, F. et al. Predictive Value of BRAFV600E Mutation for Lymph Node Metastasis in Papillary Thyroid Cancer: A Meta-analysis. CURR MED SCI 38, 785–797 (2018). https://doi.org/10.1007/s11596-018-1945-7

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  • DOI: https://doi.org/10.1007/s11596-018-1945-7

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