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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2021.1
- 수록면
- 123 - 133 (11page)
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Background: Assessing nuclear features is diagnostically challenging in the aspect of thyroid pathology. The aim of this study was to determine whether pathologists could distinguish BRAF-like and RAS-like nuclear features morphologically and identify morphological features to differentiate thyroid tumors with RAS-like mutations from encapsulated papillary thyroid carcinoma (PTC) with predominant follicular growth and BRAFV600E mutation. Methods: Representative whole slide images of 16 encapsulated thyroid tumors with predominant follicular growth were reviewed by 12 thyroid pathologists using a web browser-based image viewer. Total nuclear score was calculated from semi-quantitatively scored eight nuclear features. The molecular profile of RAS and BRAF genes was determined by Sanger sequencing. Results: Total nuclear score ranging 0 to 24 could differentiate BRAF-like tumors from RAS-like tumors with a cut-off value of score 14. The interobserver agreement was the highest for the assessment of nuclear pseudoinclusions (NPIs) but the lowest for nuclearelongation and sickle-shaped nuclei. NPIs were found in tumors with BRAFV600E mutation, but not in tumors with RAS-like mutations. Total nuclear scores were significantly higher for tumors with BRAFV600E than for those with RAS-like mutations (P<0.001). Conclusion: Our results suggest that NPIs and high nuclear scores have diagnostic utility as rule-in markers for differentiating PTC with BRAFV600E mutation from benign or borderline follicular tumors with RAS-like mutations. Relaxation of rigid criteria for nuclear features resulted in an overdiagnosis of PTC. Immunostaining or molecular testing for BRAFV600E mutation is a useful adjunct for cases with high nuclear scores to identify true PTC.
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참고문헌 (35)
참고문헌 신청
Lloyd RV / 2017 / WHO classification of tumors of endocrine organs / International Agency for Research on Cancer (IARC) :65~91
Zhu Y / 2020 / Histopathologic assessment of capsular invasion in follicular thyroid neoplasms-an observer variation study / Endocr Pathol 31:132~140
Liu Z / 2019 / Interobserver and intraobserver variation in the morphological evaluation of noninvasive follicular thyroid neoplasm with papillary-like nuclear features in Asian practice / Pathol Int 69:202~210
Nikiforov YE / 2016 / Nomenclature revision for encapsulated follicular variant of papillary thyroid carcinoma : a paradigm shift to reduce overtreatment of indolent tumors / JAMA Oncol 2:1023~1029
Nikiforov YE / 2018 / Change in diagnostic criteria for noninvasive follicular thyroid neoplasm with papillarylike nuclear features / JAMA Oncol 4:1125~1126
Zhu Y / 2020 / Histopathologic assessment of capsular invasion in follicular thyroid neoplasms-an observer variation study / Endocr Pathol 31:132~140
Liu Z / 2019 / Interobserver and intraobserver variation in the morphological evaluation of noninvasive follicular thyroid neoplasm with papillary-like nuclear features in Asian practice / Pathol Int 69:202~210
Nikiforov YE / 2016 / Nomenclature revision for encapsulated follicular variant of papillary thyroid carcinoma : a paradigm shift to reduce overtreatment of indolent tumors / JAMA Oncol 2:1023~1029
Nikiforov YE / 2018 / Change in diagnostic criteria for noninvasive follicular thyroid neoplasm with papillarylike nuclear features / JAMA Oncol 4:1125~1126
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Update from the 2022 World Health Organization Classification of Thyroid Tumors: A Standardized Diagnostic Approach
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Expression of NF2 Modulates the Progression of BRAFV600E Mutated Thyroid Cancer Cells
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Thyroid Cancer, Iodine, and Gene Mutation
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