Study On The Correlation Between BRAF V600E Mutation And Clinicopathological Characteristics Of Papillary Thyroid Cancer And Establishment Of Prediction Model

Background:BRAF(V-raf murine sarcoma viral oncogene homolog Bl)V600E mutation is very common in papillary thyroid cancer,but the relationship between BRAF V600E mutation and papillary thyroid cancer-related indicators is still controversial.Studies have shown that BRAF V600E gene mutation is related to the invasiveness of papillary thyroid cancer,and BRAF V600E gene mutation is a poor prognostic factor of papillary thyroid cancer.Study on the correlation between BRAF V600E mutation and clinicopathological characteristics of papillary thyroid cancer and establishment of prediction model have important clinical value.Objective:To analyze the relationship between BRAF V600E mutation and clinicopathological characteristics of papillary thyroid cancer,and establish a prediction model of BRAF V600E mutation,and provide reference for the treatment of papillary thyroid cancer.Methods:A retrospective analysis of the medical records of 206 papillary thyroid cancer patients admitted to the first affiliated hospital of soochow university from July 2018 to December 2019 was performed.At the same time,a meta-analysis was performed to verify the results.Finally,the BRAF V600E gene mutation prediction model was established by independent risk factors.Results:BRAF V600E gene mutation was detected in 175 patients(85%).Univariate analysis manifested that BRAF V600E gene mutation was related to tumor's location,Hashimoto's thyroiditis,and central lymph node metastasis(P<0.05),but wasn't related to gender,age,BMI(Body Mass Index),tumor diameter,extrathyroidal extension,the number of lesions and lateral lymph node metastasis(P>0.05).TSH(Thyroid stimulating hormone)levels were higher in the group without BRAF V600E mutation than in the group with BRAF V600E mutation(P<0.05),and the difference of NLR(Neutrophil to lymphocyte ratio)value between the two groups wasn't statistically significant(P>0.05).Multivariate analysis indicated that tumor located in the lower third,with central lymph node metastasis and without Hashimoto's thyroiditis were independent risk factors of BRAF V600E mutation(P<0.05).Meta-analysis showed that BRAF V600E gene mutation was associated with gender,Hashimoto's thyroiditis,central lymph node metastasis,extrathyroidal extension,number of lesions(P<0.05),but had no significant correlation with age,tumor diameter,and lateral lymph node metastasis(P>0.05).The area under the ROC curve of the prediction model was 0.775,the prediction accuracy of the model was moderate.Conclusions:Tumors located in the lower third of the thyroid,with central lymph node metastasis and without Hashimoto's thyroiditis were independent risk factors of BRAF V600E mutation.The prediction model of BRAF V600E gene mutation in this study had certain clinical reference value,for patients with high risk of BRAF V600E mutation,more rigorous TSH inhibition strategies and shorter review cycles should be implemented postoperatively.