BRAF V600E Gene Mutation Is Associated With Bilateral Malignancy of Papillary Thyroid Cancer

Background: Papillary thyroid cancer (PTC) is the most prevalent type of thyroid cancer, which is the most common type of endocrine malignancy. Stratification and personalized surgical management of PTC patients are the major challenges for thyroid surgeons. Though BRAF V600E gene mutation presents in 50-70% of PTCs, it is unclear whether BRAF V600E testing could contribute to clinical practice. Therefore, this study investigated the association between BRAF V600E mutation and clinicopathologic features of PTC to evaluate the benefit of BRAF V600E testing to clinical management of PTC. Methods: In total, 145 patients with PTC who underwent bilateral thyroid surgery between July 2016 and December 2016 were included in this study. BRAF V600E mutation status and other clinicopathologic features were evaluated using the resected samples obtained during the surgery. Results: Bilateral PTC was found in 72.8% of the patients with BRAF V600E mutation, and in 42.0% of the patients without the mutation. In addition, the occurrence of BRAF V600E mutation was higher in cases with bilateral PTC (63.4%) than that in cases with unilateral PTC (42.3%). The difference observed above was statistically significant (P = 0.014 by chi-square test) and BRAF V600E mutation was significantly associated with the bilaterality of PTC (P = 0.0080 by logistic regression). Conclusions: Presence of BRAF V600E mutation has been found to be associated with bilaterality of PTC, suggesting that total or near total thyroidectomy should be considered for patients with the mutation.