title: Clinical Manifestations and Gene Expression in Patients with Conventional Papillary Thyroid Carcinoma Carrying the BRAF(V600E) Mutation and BRAF Pseudogene.
abstract: The association of BRAF(V600E) with the clinical manifestations of papillary thyroid carcinoma (PTC) remains controversial. Recent studies have shown that the BRAF pseudogene can activate the MAPK pathway and induce tumorigenesis. This study investigated the association of BRAF(V600E), the BRAF pseudogene, and their mRNA levels with clinical features and thyroid-specific gene expression in conventional PTCs.
  
  
  
  A total of 78 specimens were collected from patients with conventional PTCs. RNA was isolated, and quantitative polymerase chain reaction was used to measure the mRNA levels of BRAF, the BRAF pseudogene, and thyroid-specific and tumor-related genes. Immunohistochemical (IHC) staining of BRAF, ERK, sodium-iodide symporter (NIS), thyrotropin receptor, glucose transporter 1, and Ki67 was also performed.
  
  
  
  BRAF(V600E) and the BRAF pseudogene were detected in 73.0% (57/78) and 91.7% (44/48), respectively, of the conventional PTCs. The presence of BRAF(V600E) was not associated with the multiple clinical features assessed or the recurrence rate during 76.9 ± 47.2 months of follow-up. Neither was it associated with IHC staining or tumor-related/thyroid-specific gene expression, except for decreased NIS gene expression. The BRAF pseudogene was not associated with clinical characteristics or thyroid-specific gene expression, except for decreased decoy receptor 3 (DCR3) expression. High BRAF mRNA levels were associated with bilateral and multifocal lesions, and BRAF-pseudogene mRNA levels were positively correlated with BRAF mRNA levels (r = 0.415, p = 0.009).
  
  
  
  These results do not support the use of the BRAF(V600E) mutation as a prognostic marker of conventional PTC. However, the association of high BRAF mRNA levels with more advanced clinical features suggests that BRAF mRNA levels might be a more useful clinical marker of PTCs, independent of the BRAF(V600E) mutation status. The correlation between BRAF-pseudogene mRNA levels and BRAF mRNA levels in PTCs is in agreement with the hypothesis that the BRAF pseudogene regulates BRAF expression during tumorigenesis by acting as competitive noncoding RNA. However, additional studies with larger sample sizes are required to confirm these findings.
authors.affiliation: 1 Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University , Taipei, Taiwan .|2 Division of Endocrinology and Metabolism, Department of Internal Medicine, Shuang Ho Hospital , Taipei Medical University, New Taipei City, Taiwan .|3 Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine; College of Medicine, Taipei Medical University , Taipei, Taiwan .
authors.forename: Jiunn-Diann
authors.initials: JD
authors.lastname: Lin
authors.affiliation: 4 Department of Medical Research and Education, Taipei Veterans General Hospital , Taipei, Taiwan .
authors.forename: Shuai-Shuai
authors.initials: SS
authors.lastname: Fu
authors.affiliation: 5 Department of Surgery, Taipei Veterans General Hospital , Taipei, Taiwan .
authors.forename: Jui-Yu
authors.initials: JY
authors.lastname: Chen
authors.affiliation: 5 Department of Surgery, Taipei Veterans General Hospital , Taipei, Taiwan .
authors.forename: Chen-Hsen
authors.initials: CH
authors.lastname: Lee
authors.affiliation: 6 Division of Hematology and Oncology, Taipei Medical University Hospital , Taipei, Taiwan .
authors.forename: Wing-Keung
authors.initials: WK
authors.lastname: Chau
authors.affiliation: 1 Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University , Taipei, Taiwan .
authors.forename: Chao-Wen
authors.initials: CW
authors.lastname: Cheng
authors.affiliation: 1 Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University , Taipei, Taiwan .|7 Department of Medical Research, Shuang Ho Hospital , Taipei Medical University, New Taipei City, Taiwan .
authors.forename: Yuan-Hung
authors.initials: YH
authors.lastname: Wang
authors.affiliation: 1 Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University , Taipei, Taiwan .|8 Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital , Taipei Medical University, New Taipei City, Taiwan .
authors.forename: Yuh-Feng
authors.initials: YF
authors.lastname: Lin
authors.affiliation: 9 Department of Family Medicine, Shuang Ho Hospital , Taipei Medical University, New Taipei City, Taiwan .
authors.forename: Wen-Fang
authors.initials: WF
authors.lastname: Fang
authors.affiliation: 10 Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Veterans General Hospital , Taipei, Taiwan .
authors.forename: Kam-Tsun
authors.initials: KT
authors.lastname: Tang
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics* / Q000378:metabolism; D011544:Pseudogenes; D053323:Receptors, Tumor Necrosis Factor, Member 6b / Q000235:genetics / Q000378:metabolism; D013961:Thyroid Gland / Q000378:metabolism* / Q000473:pathology; D013964:Thyroid Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000473:pathology
chemical_list: D053323:Receptors, Tumor Necrosis Factor, Member 6b; C505911:TNFRSF6B protein, human; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf