Nidhi Anand
Dr. Ram Manohar Lohia Institute of Medical Science, India
Title: DIAGNOSTIC VALUE OF BRAFV600E IMMUNOCYTOCHEMISTRY IN THYROID ASPIRATES IN BETHESDA CATEGORY IV AND PAPILLARY CARCINOMA THYROID.
Biography
Biography: Nidhi Anand
Abstract
AFFILIATION: 1.Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow UP, India, 2. Department of Endocrine Surgery, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, UP, India.
INTRODUCTION AND OBJECTIVE: The BRAFV600E is a common mutation in papillary thyroid carcinoma (PTC) associated with aggressive behaviour. In Bethesda category III, IV and V of thyroid cytology, the use of immunocytochemistry (ICC) and molecular testing is recommended to refine the diagnosis. The present study aimed to assess BRAFV600Eexpression in thyroid aspirates and corresponding histology specimens and to evaluate the diagnostic efficacy of conventional FNAC vs FNAC with BRAFV600E testing in Bethesda category IV and V, VI of PTC.
METHODOLOGY: This study prospectively enrolled 40 cases with thyroid aspirate of Bethesda category IV and V, IV of PTC. IHC for BRAFV600E was performed on cell blocks and corresponding histology sections. The diagnostic efficacy in the diagnosis of these lesions was assessed.
RESULTS: Our results included 25 lesions in category IV and 15 in category V &VI. The diagnostic sensitivity of ICC in thyroid aspirates was 81.82%, specificity 100%, positive predictive value 100%, negative predictive value 93.55% and accuracy 95%.
DISCUSSION & CONCLUSION: In category III, IV and V BRAFV600Emutation analysis is needed to better define the extent the initial surgery. BRAFV600Emutation can be druggable using BRAFV600E inhibitor molecules in some selected patients that improves disease free and overall survival in BRAFV600E positive cases. All BRAFV600E negative cases on cytology with Bethesda category IV, V and VI; BRAFV600E testing should be repeated on corresponding histology samples to ensure accurate mutation status.
ACKNOWLEDGEMENT: Financial assistance to intramural research grant IEC 3/16
KEYWORDS: BRAFV600Emutation, Cyto-diagnosis, Diagnostic efficacy, Bethesda category