Clinical oncology (Royal College of Radiologists (Great Britain)) · 2025
The BRAFV600E Mutation Enhances Age-Based Prognostic Stratification in Radioiodine-Treated Papillary Thyroid Cancer: A Retrospective Cohort Study.
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Cao J, Liang H, Li X, Guan X, Ma Y Z, Li J
Аннотация
AIMS: To evaluate whether BRAFV600E mutation status enhances the value of age in predicting clinical outcomes for papillary thyroid carcinoma (PTC) patients receiving radioactive iodide (RAI) therapy.
MATERIALS AND METHODS: We conducted a retrospective analysis of 1160 PTC patients treated with RAI therapy. Patients were stratified by age (≤18, 18-55, and ≥55 years) and BRAFV600E status. Clinicopathological characteristics, treatment responses, and risk factors for poor outcomes (biochemical/structural incomplete response biochemical incomplete response/structural incomplete response [BIR/SIR]) were analysed using logistic regression.
RESULTS: BRAFV600E-positive patients aged ≤18 years showed aggressive features, including larger tumour size, higher lymph node metastasis rates, elevated thyroglobulin levels (TgAb-negative), and worse 6-month/3-year outcomes (all P < .05). Multivariate analysis confirmed high-risk subtypes, distant metastasis, and elevated Tg levels as independent BIR/SIR predictors. BRAFV600E-negative patients showed no significant age-related clinical characteristics and outcomes (P > .05).
CONCLUSION: BRAFV600E mutation status significantly modifies the impact of age in PTC patients with RAI therapy. Patients aged ≤18 years with BRAFV600E-positive exhibit distinct aggressive behaviours and poorer RAI therapy responses. These findings support integrating BRAFV600E testing with age stratification to refine risk assessment and therapeutic strategies.
MATERIALS AND METHODS: We conducted a retrospective analysis of 1160 PTC patients treated with RAI therapy. Patients were stratified by age (≤18, 18-55, and ≥55 years) and BRAFV600E status. Clinicopathological characteristics, treatment responses, and risk factors for poor outcomes (biochemical/structural incomplete response biochemical incomplete response/structural incomplete response [BIR/SIR]) were analysed using logistic regression.
RESULTS: BRAFV600E-positive patients aged ≤18 years showed aggressive features, including larger tumour size, higher lymph node metastasis rates, elevated thyroglobulin levels (TgAb-negative), and worse 6-month/3-year outcomes (all P < .05). Multivariate analysis confirmed high-risk subtypes, distant metastasis, and elevated Tg levels as independent BIR/SIR predictors. BRAFV600E-negative patients showed no significant age-related clinical characteristics and outcomes (P > .05).
CONCLUSION: BRAFV600E mutation status significantly modifies the impact of age in PTC patients with RAI therapy. Patients aged ≤18 years with BRAFV600E-positive exhibit distinct aggressive behaviours and poorer RAI therapy responses. These findings support integrating BRAFV600E testing with age stratification to refine risk assessment and therapeutic strategies.