Association between diffuse lymphocytic infiltration and papillary thyroid cancer aggressiveness according to the presence of thyroid peroxidase antibody and BRAF V600E mutation

Young Ki Lee, Kyeong Hye Park, Se Hee Park, Kwang Joon Kim, Dong Yeob Shin, Kee Hyun Nam, Woong Youn Chung, Eunjig Lee

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Diffuse lymphocytic infiltration (DLI) is frequently found with papillary thyroid cancer (PTC), so there has been long interest in how it affects the characteristics of PTC. This purpose of this study was to define the association between DLI and PTC aggressiveness according to thyroperoxidase antibody (TPOAb) and B-type Raf (BRAF) V600E mutation positivity. Methods: There were 1879 patients with PTC who underwent surgery and were enrolled in this study. Clinicopathologic characteristics were compared between groups according to the presence of DLI and TPOAb. Multiple logistic regression analysis was conducted to assess odds ratio (OR) for each dependent variable (BRAF V600E mutation, tumor size >1.0 cm, multifocality, extrathyroidal extension, and lymph node metastasis) of each group according to the presence of DLI and TPOAb, with the group with neither DLI or TPOAb (DLI-negative TPOAb-negative PTC) as the reference. Results: The DLI-positive PTC showed more frequent multifocality and less frequent BRAF V600E mutation than DLI-negative PTC. Among patients with DLI-positive PTC, extrathyroidal extension and BRAF V600E mutation was less frequent when serum TPOAb was positive. In multiple logistic regressions, DLI-positive TPOAb-positive PTC showed a high OR for multifocality (1.410; P =.017), but low ORs for BRAF V600E mutation (0.521; P <.001) and extrathyroidal extension (0.691; P =.008). The patients with DLI-positive TPOAb-positive PTCs showed a high OR for multifocality (1.588; P =.002), and high ORs for tumor size >1.0 cm (2.205; P =.019) and lymph node metastasis (2.005; P =.032) in subgroup analyses of PTC with wild-type BRAF. The DLI-negative TPOAb-positive group was not associated with any tumor aggressiveness-related variables. Conclusion: Although DLI was associated with multifocality regardless of TPOAb positivity, it was associated with an indolent feature when TPOAb was positive but with aggressive features in PTC with wild-type BRAF when TPOAb was negative. The TPOAb and BRAF status may help to define the clinical implication of lymphocytic infiltration found with PTC.

Original languageEnglish
Pages (from-to)2271-2279
Number of pages9
JournalHead and Neck
Volume40
Issue number10
DOIs
Publication statusPublished - 2018 Oct 1

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Iodide Peroxidase
Mutation
Antibodies
Papillary Thyroid cancer
Logistic Models
Lymph Nodes
Odds Ratio
Neoplasm Metastasis
Neoplasms

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

Cite this

Lee, Young Ki ; Park, Kyeong Hye ; Park, Se Hee ; Kim, Kwang Joon ; Shin, Dong Yeob ; Nam, Kee Hyun ; Chung, Woong Youn ; Lee, Eunjig. / Association between diffuse lymphocytic infiltration and papillary thyroid cancer aggressiveness according to the presence of thyroid peroxidase antibody and BRAF V600E mutation In: Head and Neck. 2018 ; Vol. 40, No. 10. pp. 2271-2279.
@article{08eabed91f4946f88c0fd524d92d4596,
title = "Association between diffuse lymphocytic infiltration and papillary thyroid cancer aggressiveness according to the presence of thyroid peroxidase antibody and BRAF V600E mutation",
abstract = "Background: Diffuse lymphocytic infiltration (DLI) is frequently found with papillary thyroid cancer (PTC), so there has been long interest in how it affects the characteristics of PTC. This purpose of this study was to define the association between DLI and PTC aggressiveness according to thyroperoxidase antibody (TPOAb) and B-type Raf (BRAF) V600E mutation positivity. Methods: There were 1879 patients with PTC who underwent surgery and were enrolled in this study. Clinicopathologic characteristics were compared between groups according to the presence of DLI and TPOAb. Multiple logistic regression analysis was conducted to assess odds ratio (OR) for each dependent variable (BRAF V600E mutation, tumor size >1.0 cm, multifocality, extrathyroidal extension, and lymph node metastasis) of each group according to the presence of DLI and TPOAb, with the group with neither DLI or TPOAb (DLI-negative TPOAb-negative PTC) as the reference. Results: The DLI-positive PTC showed more frequent multifocality and less frequent BRAF V600E mutation than DLI-negative PTC. Among patients with DLI-positive PTC, extrathyroidal extension and BRAF V600E mutation was less frequent when serum TPOAb was positive. In multiple logistic regressions, DLI-positive TPOAb-positive PTC showed a high OR for multifocality (1.410; P =.017), but low ORs for BRAF V600E mutation (0.521; P <.001) and extrathyroidal extension (0.691; P =.008). The patients with DLI-positive TPOAb-positive PTCs showed a high OR for multifocality (1.588; P =.002), and high ORs for tumor size >1.0 cm (2.205; P =.019) and lymph node metastasis (2.005; P =.032) in subgroup analyses of PTC with wild-type BRAF. The DLI-negative TPOAb-positive group was not associated with any tumor aggressiveness-related variables. Conclusion: Although DLI was associated with multifocality regardless of TPOAb positivity, it was associated with an indolent feature when TPOAb was positive but with aggressive features in PTC with wild-type BRAF when TPOAb was negative. The TPOAb and BRAF status may help to define the clinical implication of lymphocytic infiltration found with PTC.",
author = "Lee, {Young Ki} and Park, {Kyeong Hye} and Park, {Se Hee} and Kim, {Kwang Joon} and Shin, {Dong Yeob} and Nam, {Kee Hyun} and Chung, {Woong Youn} and Eunjig Lee",
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Association between diffuse lymphocytic infiltration and papillary thyroid cancer aggressiveness according to the presence of thyroid peroxidase antibody and BRAF V600E mutation . / Lee, Young Ki; Park, Kyeong Hye; Park, Se Hee; Kim, Kwang Joon; Shin, Dong Yeob; Nam, Kee Hyun; Chung, Woong Youn; Lee, Eunjig.

In: Head and Neck, Vol. 40, No. 10, 01.10.2018, p. 2271-2279.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association between diffuse lymphocytic infiltration and papillary thyroid cancer aggressiveness according to the presence of thyroid peroxidase antibody and BRAF V600E mutation

AU - Lee, Young Ki

AU - Park, Kyeong Hye

AU - Park, Se Hee

AU - Kim, Kwang Joon

AU - Shin, Dong Yeob

AU - Nam, Kee Hyun

AU - Chung, Woong Youn

AU - Lee, Eunjig

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Background: Diffuse lymphocytic infiltration (DLI) is frequently found with papillary thyroid cancer (PTC), so there has been long interest in how it affects the characteristics of PTC. This purpose of this study was to define the association between DLI and PTC aggressiveness according to thyroperoxidase antibody (TPOAb) and B-type Raf (BRAF) V600E mutation positivity. Methods: There were 1879 patients with PTC who underwent surgery and were enrolled in this study. Clinicopathologic characteristics were compared between groups according to the presence of DLI and TPOAb. Multiple logistic regression analysis was conducted to assess odds ratio (OR) for each dependent variable (BRAF V600E mutation, tumor size >1.0 cm, multifocality, extrathyroidal extension, and lymph node metastasis) of each group according to the presence of DLI and TPOAb, with the group with neither DLI or TPOAb (DLI-negative TPOAb-negative PTC) as the reference. Results: The DLI-positive PTC showed more frequent multifocality and less frequent BRAF V600E mutation than DLI-negative PTC. Among patients with DLI-positive PTC, extrathyroidal extension and BRAF V600E mutation was less frequent when serum TPOAb was positive. In multiple logistic regressions, DLI-positive TPOAb-positive PTC showed a high OR for multifocality (1.410; P =.017), but low ORs for BRAF V600E mutation (0.521; P <.001) and extrathyroidal extension (0.691; P =.008). The patients with DLI-positive TPOAb-positive PTCs showed a high OR for multifocality (1.588; P =.002), and high ORs for tumor size >1.0 cm (2.205; P =.019) and lymph node metastasis (2.005; P =.032) in subgroup analyses of PTC with wild-type BRAF. The DLI-negative TPOAb-positive group was not associated with any tumor aggressiveness-related variables. Conclusion: Although DLI was associated with multifocality regardless of TPOAb positivity, it was associated with an indolent feature when TPOAb was positive but with aggressive features in PTC with wild-type BRAF when TPOAb was negative. The TPOAb and BRAF status may help to define the clinical implication of lymphocytic infiltration found with PTC.

AB - Background: Diffuse lymphocytic infiltration (DLI) is frequently found with papillary thyroid cancer (PTC), so there has been long interest in how it affects the characteristics of PTC. This purpose of this study was to define the association between DLI and PTC aggressiveness according to thyroperoxidase antibody (TPOAb) and B-type Raf (BRAF) V600E mutation positivity. Methods: There were 1879 patients with PTC who underwent surgery and were enrolled in this study. Clinicopathologic characteristics were compared between groups according to the presence of DLI and TPOAb. Multiple logistic regression analysis was conducted to assess odds ratio (OR) for each dependent variable (BRAF V600E mutation, tumor size >1.0 cm, multifocality, extrathyroidal extension, and lymph node metastasis) of each group according to the presence of DLI and TPOAb, with the group with neither DLI or TPOAb (DLI-negative TPOAb-negative PTC) as the reference. Results: The DLI-positive PTC showed more frequent multifocality and less frequent BRAF V600E mutation than DLI-negative PTC. Among patients with DLI-positive PTC, extrathyroidal extension and BRAF V600E mutation was less frequent when serum TPOAb was positive. In multiple logistic regressions, DLI-positive TPOAb-positive PTC showed a high OR for multifocality (1.410; P =.017), but low ORs for BRAF V600E mutation (0.521; P <.001) and extrathyroidal extension (0.691; P =.008). The patients with DLI-positive TPOAb-positive PTCs showed a high OR for multifocality (1.588; P =.002), and high ORs for tumor size >1.0 cm (2.205; P =.019) and lymph node metastasis (2.005; P =.032) in subgroup analyses of PTC with wild-type BRAF. The DLI-negative TPOAb-positive group was not associated with any tumor aggressiveness-related variables. Conclusion: Although DLI was associated with multifocality regardless of TPOAb positivity, it was associated with an indolent feature when TPOAb was positive but with aggressive features in PTC with wild-type BRAF when TPOAb was negative. The TPOAb and BRAF status may help to define the clinical implication of lymphocytic infiltration found with PTC.

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