title: Surgical perspective of T1799A BRAF mutation diagnostic value in papillary thyroid carcinoma.
abstract: BACKGROUND
  Throughout Indonesia, thyroid cancer is one of the ten commonest malignancies, with papillary thyroid carcinoma (PTC) in our hospital accounting for about 60% of all thyroid nodules. Although fine needle aspiration biopsy (FNAB) is the most reliable diagnostic tool, some nodules are diagnosed as indeterminate and second surgery is common for PTC. The aim of this study was to establish the diagnostic value and feasibility of testing the BRAF T1799A mutation on FNA specimens for improving PTC diagnosis.
  
  
  METHODS
  This prospective study enrolled 95 patients with thyroid nodules and future surgery planned. Results of mutational status were compared with surgical pathology diagnosis.
  
  
  RESULTS
  Of the 70 cases included in the final analysis, 62.8% were PTC and the prevalence of BRAF mutation was 38.6%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for BRAF mutation analysis were 36%, 100%, 100% and 48%, respectively. With other data findings, nodules with "onset less than 5 year" and "hard consistency" were proven as diagnostic determinants for BRAF mutation with a probability of 62.5%. This mutation was also a significant risk factor for extra-capsular extension.
  
  
  CONCLUSIONS
  Molecular analysis of the BRAF T1799A mutation in FNAB specimens has high specificity and positive predictive value for PTC. It could be used in the selective patients with clinical characteristics to facilitate PTC diagnosis and for guidance regarding extent of thyroidectomy.
authors.affiliation: Department of Surgical Oncology, Dharmais National Cancer Center, Indonesia. bbrahma_s@yahoo.com
authors.forename: Bayu
authors.initials: B
authors.lastname: Brahma
authors.forename: Erwin Danil
authors.initials: ED
authors.lastname: Yulian
authors.forename: Muchlis
authors.initials: M
authors.lastname: Ramli
authors.forename: Iswari
authors.initials: I
authors.lastname: Setianingsih
authors.forename: Walta
authors.initials: W
authors.lastname: Gautama
authors.forename: Putri
authors.initials: P
authors.lastname: Brahma
authors.forename: Sudigdo
authors.initials: S
authors.lastname: Sastroasmoro
authors.forename: Kuntjoro
authors.initials: K
authors.lastname: Harimurti
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D002291:Carcinoma, Papillary; D004252:DNA Mutational Analysis; D005240:Feasibility Studies; D005260:Female; D005820:Genetic Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D000077273:Thyroid Cancer, Papillary; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf