title: The association of the BRAF(V600E) mutation with prognostic factors and poor clinical outcome in papillary thyroid cancer: a meta-analysis.
abstract: BACKGROUND
  The effects of the BRAF(V600E) mutation on prognostic factors and poor clinical outcomes in papillary thyroid cancer (PTC) have not been fully quantified. The authors performed comprehensive meta-analysis to assess the strength of associations between these conditions and the BRAF(V600E) mutation.
  
  
  METHODS
  The authors identified the clinical studies that examined the association of the BRAF(V600E) mutation in surgical specimens with clinicopathologic outcomes between January 2003 and October 2010 using the Medline database. One hundred thirty-one relevant studies were hand-searched. The authors selected 27 studies that included 5655 PTC patients. They calculated the pooled odds ratios (ORs) or risk ratios with 95% confidence intervals (CIs) for each study using a random effect model.
  
  
  RESULTS
  The average prevalence rate of the BRAF(V600E) mutation was 49.4%. In 26 studies, compared with the patients who had the wild-type BRAF genes, the PTC patients with the BRAF(V600E) mutation had increased ORs of an extrathyroidal invasion (OR, 2.14; 95% CI, 1.68-2.73), a lymph node metastasis (OR, 1.54; 95% CI, 1.21-1.97), and an advanced TNM stage (OR, 2.00; 95% CI, 1.61-2.49). In 8 studies, patients with the mutation had 2.14-fold increased risk of recurrent and persistent disease (95% CI, 1.67-2.74). The associations were generally consistent across the different study populations.
  
  
  CONCLUSIONS
  This meta-analysis demonstrates that the BRAF(V600E) mutation is closely related to the high-risk clinicopathological factors and poorer outcome of PTC. The results obtained here suggest that the BRAF(V600E) mutation should be considered as a poor prognostic marker in PTC and may lead to better management for individual patients.
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
authors: Tae Hyuk
authors: TH
authors: Kim
authors: Young Joo
authors: YJ
authors: Park
authors: Jung Ah
authors: JA
authors: Lim
authors: Hwa Young
authors: HY
authors: Ahn
authors: Eun Kyung
authors: EK
authors: Lee
authors: You Jin
authors: YJ
authors: Lee
authors: Kyung Won
authors: KW
authors: Kim
authors: Seo Kyung
authors: SK
authors: Hahn
authors: Yeo Kyu
authors: YK
authors: Youn
authors: Kwang Hyun
authors: KH
authors: Kim
authors: Bo Youn
authors: BY
authors: Cho
authors: Do Joon
authors: DJ
authors: Park
mesh_terms: D000328:Adult; D002277:Carcinoma; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D012008:Recurrence; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf