To Investigate The Clinical Significance Of BRAF^V600E Mutation In Cervical Lymph Node Metastasis Of PTC

Objective:To investigate the clinical significance of BRAF^V600E mutation in cervical lymph node metastasis of Papillary Thyroid Carcinoma（PTC）,and to provide a basis for individualized diagnosis and treatment of PTC patients.Methods:The data of patients with PTC who were newly diagnosed and treated at Department of Head and Neck Surgery,Sichuan Cancer Hospital from July 2020 to October 2022 were retrospectively analyzed.The clinicopathological characteristics of PTC patients were compared by chi-square test,and the risk factors of cervical lymph node metastasis of PTC patients were analyzed by multivariate analysis.Results:1.Among 1107 PTC patients,there were 895 cases with BRAF^V600E mutation and 212 cases without mutation;590 cases with cervical lymph node metastasis and 517 cases without cervical lymph node metastasis.2.Univariate analysis showed that BRAF^V600E mutation was significantly associated with gender,BMI,number of cancer foci,location of cancer foci,extrathyroidal extension and cervical lymph node metastasis（P<0.05）.3.Statistical analysis of cervical lymph node metastasis in PTC patients showed that:PTC patients with male,younger than 55 years old,BRAF^V600E mutation,multifocality,maximum diameter of tumor>10mm,bilateral tumor foci and extrathyroidal extension are more likely to have cervical lymph node metastasis.The risk of cervical lymph node metastasis in PTC patients with BRAF^V600E mutation is 1.604 times higher than that in patients without BRAF^V600Emutation.4.In male PTC patients,the risk of cervical lymph node metastasis in BRAF^V600E mutation group was 4.536 times higher than that in non-mutation group.5.In PTC patients younger than 55 years old,the risk of cervical lymph node metastasis in patients with BRAF^V600E mutation was 1.788 times that in patients without BRAF^V600E mutation.6.In overweight/obese PTC patients,the risk of cervical lymph node metastasis in BRAF^V600E mutation group was 2.141 times higher than that in non-mutation group.7.The rate of cervical lymph node metastasis in patients with BRAF^V600E mutation is higher than that in patients without BRAF^V600E mutation in both single and multiple PTC lesions;8.In PTC patients with tumor diameter>10mm,the risk of cervical lymph node metastasis in patients with BRAF^V600Emutation was 3.086times that in patients without BRAF^V600E mutation.9.The risk of cervical lymph node metastasis in patients with unilateral lobar cancer in BRAF^V600E mutation group was1.490 times higher than that in patients without BRAF^V600E mutation,and the risk of cervical lymph node metastasis in patients with bilateral lobar cancer in BRAF^V600Emutation group was 2.772 times higher than that in patients without BRAF^V600E mutation.10.In PTC patients with extrathyroidal extension,the risk of cervical lymph node metastasis in BRAF^V600E mutation group was 1.622 times higher than that in unmutated group.Conclusions:1.BRAF^V600E mutation is more likely to occur in PTC patients with male,overweight/obesity,multiple cancer foci,bilateral lobe cancer foci,extrathyroidal extension and cervical lymph node metastasis.2.BRAF^V600E mutation is an independent risk factor for cervical lymph node metastasis in PTC patients.The risk of cervical lymph node metastasis in PTC patients with BRAF^V600Emutation is increased.Preoperative BRAF^V600E gene detection can be considered for PTC patients to guide the choice of surgical methods;3.BRAF^V600E mutation increases the risk of cervical lymph node metastasis in PTC patients with male,<55 years old,overweight/obesity,maximum tumor diameter>10mm,bilateral tumor foci and extrathyroidal extension.PTC patients with BRAF^V600E mutation with the above characteristics may be treated more actively.