title: Cytomorphological factors and BRAF mutation predicting risk of lymph node metastasis in preoperative liquid-based fine needle aspirations of papillary thyroid carcinoma.
abstract: OBJECTIVE
  Preoperative fine needle aspiration biopsy (FNAB) has become the initial diagnostic method for papillary thyroid carcinoma (PTC). Identification of cytomorphologic factors predicting lymph node metastasis (LNM) is clinically important for determining the appropriate treatment regimen due to the high rate of lymph node involvement in PTC at the time of diagnosis. Hobnail features (HF) have previously been described as potential histomorphologic features in the histological examination of PTC. This study evaluated the value of HF as a predictor of LNM.
  
  
  METHODS
  Histologically confirmed FNABs (n = 111) of papillary thyroid microcarcinoma prepared by the liquid-based method were enrolled. Along with other cytomorphologic parameters, HF were evaluated for their value in predicting LNM.
  
  
  RESULTS
  Although HF were closely correlated with cytoplasmic vacuoles of tumor cells and background macrophages (p < 0.05), which were considered diagnostic indicators of PTC with cystic changes, HF were only found to be significantly correlated with LNM (p = 0.008). The BRAF(V660E) mutation was not associated with LNM. All combinations including HF were revealed as stronger predictors of LNM (odds ratios: 2.254-2.524, p < 0.05).
  
  
  CONCLUSIONS
  HF, a distinctive cytomorphologic feature, may be used as a factor predicting LNM in preoperative FNAB of PTC.
authors: Department of Pathology, Cancer Center, Dongnam Institute of Radiological and Medical Sciences, Busan, South Korea.
authors: Soo Young
authors: SY
authors: Chung
authors: Jae Seok
authors: JS
authors: Lee
authors: Hyebin
authors: H
authors: Lee
authors: Sung Hee
authors: SH
authors: Park
authors: Soo Jin
authors: SJ
authors: Kim
authors: Han Suk
authors: HS
authors: Ryu
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000175:diagnosis* / Q000235:genetics / Q000556:secondary / Q000601:surgery; D002291:Carcinoma, Papillary; D016009:Chi-Square Distribution; D004252:DNA Mutational Analysis; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008264:Macrophages / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D016017:Odds Ratio; D010641:Phenotype; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D018570:Risk Assessment; D012307:Risk Factors; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D014617:Vacuoles / Q000473:pathology; D055815:Young Adult
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf