Prognostic implication of BRAF and TERT promoter mutation combination in papillary thyroid carcinoma—A meta‐analysis

• Published in: Clinical endocrinology (Oxford) Vol. 87; no. 5; pp. 411 - 417
• Main Authors: Vuong, Huy Gia, Altibi, Ahmed M.A., Duong, Uyen N.P., Hassell, Lewis
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.11.2017
• Subjects: BRAF mutation; BRAF V600E; Carcinoma, Papillary - diagnosis; Carcinoma, Papillary - genetics; Genotypes; Humans; Meta-analysis; Mutation; Papillary thyroid carcinoma; Prognosis; Promoter Regions, Genetic - genetics; Proto-Oncogene Proteins B-raf - genetics; review; Risk Assessment - methods; Risk groups; Telomerase - genetics; TERT promoter; Thyroid; Thyroid cancer; Thyroid Cancer, Papillary; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - genetics; Tumors; meta-analysis; BRAF V600E; papillary thyroid carcinoma; review; BRAF mutation; TERT promoter
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/cen.13413

Introduction The use of molecular markers, especially BRAF and TERT promoter mutations, for risk stratification in papillary thyroid carcinoma (PTC) is subject to continuing debate. In this study, we aimed to investigate the clinicopathological implication of each genotype when combining BRAF and TERT promoter mutations in PTCs. Methods We searched four electronic databases including PubMed, Scopus, Web of Science and Virtual Health Library for relevant studies. Pooled estimates of odds ratios and corresponding 95% confidence intervals were calculated using random‐effect model. Results From 111 results, we finally included 11 studies with 3911 PTC patients for meta‐analyses. Our results demonstrated that PTCs with concurrent BRAF and TERT promoter mutations were associated with increased tumour aggressiveness in comparison with PTCs harbouring BRAF or TERT promoter mutation alone. The combination of BRAF and TERT promoter mutations could classify PTCs into four distinct risk groups with decreasing aggressiveness as follows: coexisting BRAF and TERT > TERT alone=BRAF alone > no mutations. Conclusion The risk stratification of PTC based on these four genotypes can help improve the clinical management of PTCs by identifying the group of PTCs with the highest aggressiveness.