754 Impact of BRAFV600E Mutation on Clinicopathological Features in Patients with Concomitant Hashimoto Thyroiditis and Papillary Thyroid Carcinoma: A Meta-Analysis
L Janicki, A Patel, A Hellmann, J Kobiela- Surgery
Abstract
Aim
The aim of this meta-analysis is to identify the rate of BRAFV600E mutation among Hashimoto thyroiditis (HT) concomitant with papillary thyroid carcinoma (PTC) versus PTC patients alone. The secondary aim is to evaluate the impact of BRAFV600E mutation on clinicopathological features in both cohorts.
Method
Using a predefined search strategy, Medline, Cochrane Library, Scopus, and Web of Science were searched from inception till 16.09.2022. A total of 227 unique articles were found, of which nine studies met the inclusion criteria. Of those, six were retrospective and three prospective cohort studies. Data on patient demographics, BRAFV600E mutation and clinicopathological features was collected. Summary estimates using fixed or random effects models were generated with Review Manager 5.0.
Results
6395 patients were included in this review. The weighted arithmetic mean for BRAF mutation was 71.6% and 82.8% in HT-PTC and PTC patients, respectively. HT-PTC patients had significantly less BRAFV600E mutation than PTC patients (Odds Ratio (OR) = 0.45, 95% Confidence Interval (CI): 0.35 to 0.58). In addition, BRAFV600E positive HT-PTC patients were more likely to have multifocality (OR = 0.71 95% CI: 0.53 to 0.95), lymph node metastasis (OR = 0.59 95% CI: 0.44 to 0.78) or extrathyroidal extension (OR = 0.72 95% CI: 0.56 to 0.92) compared to BRAFV600E negative HT-PTC patients.
Conclusions
Patients with concomitant HT and PTC have less BRAFV600E mutation, which may be one of the factors responsible for less aggressive course of PTC in this cohort.