title: Diagnostic and prognostic value of immunocytochemistry and BRAF mutation analysis on liquid-based biopsies of thyroid neoplasms suspicious for carcinoma.
abstract: OBJECTIVE
  In the field of fine-needle aspiration cytology, the category of suspicious for malignancy (SM) thyroid lesions, that bears 55-85% risk of malignant histology, is a challenging topic in which morphology alone is not always able to make a correct diagnosis. Recently, immunocytochemistry (ICC) has been referred to as helpful in differentiating low- and high-malignant risk lesions and BRAF activating mutations have been identified in a significant amount of papillary thyroid carcinomas (PTC). The introduction of the liquid-based cytology (LBC) may simplify the application of these techniques to thyroid cytology.
  
  
  METHODS
  Our aim is to evaluate the diagnostic and prognostic role of both ICC and BRAF mutation for the SM category on LBC.
  
  
  METHODS
  From October 2010 through June 2011, 113 LBC cytological cases (including 37 SM and 76 PTC) underwent surgery. All cases were studied for BRAF mutation and ICC.
  
  
  RESULTS
  ICC resulted positive in 26 (86.6%) histologically malignant SM with 15 of which (40.5%) expressing a BRAF mutation. Overall, 63 cases showed a BRAF mutation resulting in PTC. Concerning the prognostic role of BRAF mutation for the two categories, we reported a significant correlation with multifocality, nodal involvement and extra-capsular invasion (P<0.0001).
  
  
  CONCLUSIONS
  Special techniques such as ICC and molecular markers might be successfully carried out on LBC-processed material. For both categories, ICC is more sensitive whereas BRAF analysis is an interesting support due to its high specificity adding a prognostic value in both SM and PTCs.
authors.affiliation: Division of Anatomic Pathology and Histology, Agostino Gemelli School of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy. esther.rossi@rm.unicatt.it
authors.forename: Esther Diana
authors.initials: ED
authors.lastname: Rossi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Martini
authors.forename: Sara
authors.initials: S
authors.lastname: Capodimonti
authors.forename: Patrizia
authors.initials: P
authors.lastname: Straccia
authors.forename: Tonia
authors.initials: T
authors.lastname: Cenci
authors.forename: Celestino Pio
authors.initials: CP
authors.lastname: Lombardi
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pontecorvi
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Larocca
authors.forename: Guido
authors.initials: G
authors.lastname: Fadda
mesh_terms: D002277:Carcinoma / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism; D002291:Carcinoma, Papillary; D004252:DNA Mutational Analysis / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D009154:Mutation; D011446:Prospective Studies; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf