Prevalence of BRAF V600E gene mutation in patients with Indeterminate and Atypic FNA and relationship between sonographic, cytological characteristics and thyroid examination in Besat clinic in Kerman

Background: One of the most common endocrine disorders is thyroid diseases and the nodular thuroid disorders is a common clinical feature and can be existed in a thyroid withnormal feature. Since this disease can be accompanied with malignant thyroid disorder, in recent years evaluation of gene mutation BRAFV600E for patients with Indeterminate andAtypic FNA is recommended and different studies are done around incidence of this mutation in other cancers. For the reason that there is no article about the relationship between BRAFV600E with Indeterminate and Atypic FNA in Iran, this article is designed for the Prevalence of BRAF V600E gene mutation in patients with indeterminate andAtypic FNA and relationship between sonographic, Cytological characteristics and thyroid examination in Besat clinic in Kerman. Objectives: Given that the BRAFV600E gene cannot be tested in all laboratories, if this study shows that this gene is associated with any of the features of thyroid sonography,clinical examination and cytology report,it may help early diagnosis of malignant cases.in Indeterminate and Atypic FNA that have specific features mentioned and in areas where the BRAFV600E gene cannot be tested. Materials and Methods:This study is a cross sectional study that is done for 75 patients that reported Indeterminate and Atypic FNA.primerily for patients that enter thisstudy,physical exam and ultrasonography and FNA under the guide of ultrasonography is done.and then this samples evaluated for BRAFV600E.Due to the lack of cooperation ofmany patients,we had to be used the paraffin blocked samples for evaluation of this mutation in patients who were surgically treated .finally we succeeded to collect 37 FNAsamples and 38 paraffin blocked samples. Results: Frequency of BRAFV600E is evaluated in 75 patients was 18.67% and there was no meaningful difference between two groups atypia and AUS/FLUS(P=0.42). Two Atypia and AUS/FLUS groups were compared by comparing BRAF gene result with mean age,gender,mean TSH,physical examination,thyroid sonography,cytology and pathology(for surgery patients) report , there was only two meaningful difference and that was follicular cell pattern and morphology in cytology report between the two groups Atypia and AUS/FLUS in the patients with negative BRAF mutations and there was no meaningful difference in other variables in either group ..Finally according to pathology report of patients with surgery ,in PTC group 28.5% and in 18.5% of patients that their pathology reports was benign , BRAFV600E was founded.and at the end of this study ,sensitivity,specificity,PPV,NPV was estimated:28%,81%,28% and 80%.positive LR IS 1.4 and negative LR IS 0.9.Conclusion: According to results,there was no meaningful relationship between BRAFV600E and Cytology and pathology report and according to this study evaluation ofBRAFV600E for detect PTC might be not valuable in AUS/FLUS and Atypia reports.But according to specificity we can use BRAFV600E in therapeutic process.and according tono difference between atypia and AUS/FLUS in comparison with other variables ,this possibility is posed that some of patients in Atypia group can be considered as AUS/FLUS.

Keywords:

Atypia , AUS , BRAF V600E , FLUS , FNA