title: Clinical significance of preoperative detection of serum p53 antibodies and BRAF(V600E) mutation in patients with papillary thyroid carcinoma.
abstract: The goal of the present study was to evaluate the clinical and diagnostic value of both serum p53-antibodies (Abs) and preoperative fine needle aspiration cytology (FNAC) for BRAF mutation in patients with papillary thyroid carcinoma (PTC). A total of 312 patients, including thyroid adenoma (85) and PTC (227) were enrolled in this study. Two types of enzyme-linked immunosorbent assays (ELISA), phage-ELISA and p53-ELISA, were used to measure serum p53-Ab levels. Sanger sequencing was used to determine BRAF gene mutation in FNA samples. Phage-ELISA was more efficient than conventional p53-ELISA in measuring serum p53-Abs in PTC patients. BRAF mutation analysis with FNAC significantly improved PTC diagnostic sensitivity from 80.18% to 93.83% (P=0.001) and accuracy from 82.31% to 92.37% (P=0.005). Bothp53-Abs and BRAF mutation were positively associated with lymphatic metastasis and advanced TNM stages. Particularly, serum p53-Abs positively associated with multifocality (P=0.02), while BRAF mutation associated with extrathyoidal extension (P=0.01). Furthermore, PTC patients with both elevated serum p53-Abs and BRAF mutation had a higher prevalence of extrathyoidal extension (P=0.003), lymphnode metastasis (P=0.00), multifocality (P=0.04), and advanced TNM stages (P=0.004). Our results indicate that serum p53-Abs alone might not be a reliable biomarker for PTC diagnosis, but the combined analysis of serum p53-Abs and BRAF mutation in FNAC may be useful for optimizing surgical treatment and prognostic prediction of unfavorable clinicopathologic outcomes.
authors.affiliation: Jilin Provincial Key Laboratory of Surgical Translational Medicine, Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University Changchun, China.
authors.forename: Qing-Feng
authors.initials: QF
authors.lastname: Fu
authors.affiliation: Institute of Genetics and Cytology, School of Life Sciences, Northeast Normal University Changchun, China.
authors.forename: Peng-Tao
authors.initials: PT
authors.lastname: Pan
authors.affiliation: Jilin Provincial Key Laboratory of Surgical Translational Medicine, Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University Changchun, China.
authors.forename: Le
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Jilin Provincial Key Laboratory of Surgical Translational Medicine, Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University Changchun, China.
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Liu
authors.affiliation: Department of Ultrasonics, China-Japan Union Hospital of Jilin University Changchun, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Guo
authors.affiliation: Institute of Genetics and Cytology, School of Life Sciences, Northeast Normal University Changchun, China.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Jilin Provincial Key Laboratory of Surgical Translational Medicine, Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University Changchun, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Sun
keywords: BRAF mutation; fine needle aspiration cytology; p53 antibodies; papillary thyroid carcinoma