Pathology and Pathological Disorders

Biography

Biography: Nidhi Anand

Abstract

INTRODUCTION AND OBJECTIVE: The BRAF^V600E 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 BRAF^V600Eexpression in thyroid aspirates and corresponding histology specimens and to evaluate the diagnostic efficacy of conventional FNAC vs FNAC with BRAF^V600E 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 BRAF^V600E 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  BRAF^V600Emutation analysis is needed to better define the extent the initial surgery. BRAF^V600Emutation can be druggable using BRAF^V600E inhibitor molecules in some selected patients that improves disease free and overall survival in BRAF^V600E positive cases. All BRAF^V600E negative cases on cytology with Bethesda category IV, V and VI; BRAF^V600E testing should be repeated on corresponding histology samples to ensure accurate mutation status.