The fuse of 70% of thyroid cancer is it

BRAF is a star gene in the field of thyroid cancer.

gene detection is indispensable.

has detected the mutation of and .

What is the significance of the mutation found? Does the

mutation affect the treatment of the protocol ?

Today we will talk about the

BRAF gene

BRAF gene and cell proliferation and differentiation Melanoma, bowel cancer, thyroid cancer

But these changes exist only in tumor cells

are not passed on to the next generation

BRAF genes associated with thyroid cancer are V600E and K601E mutations It is present in 60-70% of papillary carcinomas

and 40% of poorly differentiated and undifferentiated carcinomas

If the BRAFV600E mutation is found

diagnosis of thyroid cancer ,How can assessment and treatment help?

BRAF mutation role

Used to diagnose

Everyone may know

If thyroid nodule biopsy (cytology)cannot diagnose good and evil

But genetic testing finds BRAF mutation Additional diagnostic value is limited

361 cytologically undiagnosed nodules in the above table

BRAF mutations were found in only 43 cases

BRAF mutations generally exist in papillary carcinomas with nuclear features typical of the classic type or high cell subtype

cells Diagnosis is not difficult

Cytological diagnosis is difficult in RAS-mutated follicular tumors

Used to evaluate

Some early studies have shown that

BRAF-positive papillary carcinoma has a slightly higher recurrence rate and mortality rate

slightly higher than negative papillary carcinomas papillary carcinomas

Papillary carcinomas with mutations may be more aggressive

but more evidence now suggests that

BRAF mutations have a very weak effect on prognosis

only when combined with more dangerous mutations such as TERT or TP53

has a prognostic effect Only has a more obvious impact

BRAF mutation predicts likelihood of benefit from iodine therapy

By type of genetic alteration

Papillary carcinoma includes BRAF mutation, RAS mutation,Three types of RTK fusions

RAS-mutated tumors retain a good iodine uptake ability

RTK (RET/NTRK/ALK) fusion tumors have the second highest impact on iodine uptake

BRAF gene has the greatest effect on iodine uptake

Therefore, BRAF-mutated tumors have no effect on iodine treatment Good

3 For routine treatment

Some people suggest that BRAF-mutated thyroid cancer should be treated more aggressively

For example, micro-cancers with mutations are not suitable for observation The positive rate among cancers

For tiny cancers that almost never lead to death

If such harsh observation conditions are given,

will definitely lead to overtreatment of

In addition, even if the BRAF gene has no mutation Department found that large-scale metastasis

or tumor metastasis to distant

full resection is still the most appropriate way The treatment plan

is still based on pathology, Tumor marker and low-dose iodine scan

Of course, you drink iodine once and it will not work.

If you know that the BRAF gene has a mutation

, you will understand the reason why the metastases do not take iodine.

Iodine treatment ends here.

4 Used for Drug treatment

Very few thyroid cancers develop to an uncontrolled stage

Need to be controlled by targeted drugs

If a BRAF mutation is found in the tumor gene

A BRAF inhibitor can be used

Both papillary or undifferentiated cancer

Use a BRAF inhibitor alone The effect is not good

The effect is doubled when combined with the drug

This also reminds us that some thyroid cancers are refractory

BRAF mutation is just a trigger There must be no mutation in

There is no mutation in the diagnosis and treatment plan.

is by no means detected a BRAF gene.

We immediately enter the era of precision medicine