갑상선 미세침흡인세포검사 슬라이드에서 BRAF Mutation 검출을 통한 갑상선 유두암의 진단

• 영문명: Diagnosis of Papillary Thyroid Cancer via Detection of BRAF Mutation on Fine Needle Aspiration Cytology Slides
• 발행기관: 대한내분비외과학회
• 저자명: 박원서¹ 이규언² 송정윤¹ 정유승³ 김훈엽⁴ 고석환¹ 윤여규^2,5 Won Seo Park M.D.¹ Kyu Eun Lee M.D.² Jeong Yoon Song M.D. Ph.D.¹ Yoo Seung Chung M.D.³ Hoon Yub Kim M.D.⁴ Suck Hwan Koh M.D. Ph.D.¹ and Yeo-Kyu Youn M.D. Ph.D.² 5
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』10권1호, 12~18쪽, 전체 7쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2010.03.30

영문 초록

Purpose: The prevalence rate of the BRAF mutation in papillary thyroid cancer (PTC) is as high as about 52 to 83% in Korea. Preoperative detection of BRAF mutation on fine needle aspiration cytology (FNAC) slides may help the surgeon make better therapeutic decisions. The present study aims to assess the feasibility of the mutant allele specific amplification (MASA) and restriction fragment length polymorphism (RFLP) method with using conventional FNAC slides and we also wanted to evaluate the clinical role of preoperatively detecting BRAF mutation. Methods: We extracted the genomic DNA from 59 FNAC slides and performed direct sequencing (DS) for detecting BRAF mutation. We could use only 17 slides for the MASA method and 6 slides for the RFLP method due to the shortage of extracted DNA. Additionally, we retrospectively analyzed the cases for which a histological diagnosis could be made. Results: Genomic DNA was extracted from 23 out of the 59 FNAC slides. The BRAF mutation status could be assessed via DS in 33 out of the 59 FNAC slides. The concordance between the MASA method and DS and the RFLP method and DS was 36.3% and 66.7% respectively. The positive and negative predictive value of the 13 indeterminate nodules was 87.5% and 20%, respectively. We could not find any association between the BRAF mutations and the alleged risk factors of PTC. Conclusion: We believe that the purity and the amount of the DNA template must be increased to detect BRAF mutation with using a FNAC slide. Preoperative detection of the BRAF mutation on a FNAC slide may refine the cytological diagnosis, but the application of assessing BRAF mutation as a prognostic marker is debatable. (Korean J Endocrine Surg 2010;10:12-18)

키워드

갑상선 유두암, BRAF 돌연변이, 미세침흡인세포검사,Papillary thyroid cancer, BRAF mutation, Fine needle aspiration cytology