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Martins-de-Barros AV, Dos Anjos RS, Silva CCG, de Oliveira E Silva ED, da Costa Araújo FA, de Vasconcelos Carvalho M. Diagnostic accuracy of immunohistochemistry compared with molecular tests for detection of BRAF V600E mutation in ameloblastomas: systematic review and meta-analysis. J Oral Pathol Med 2022; 51:223-230. [PMID: 35090195 DOI: 10.1111/jop.13278] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The objective of this systematic review with meta-analysis was to critically evaluate the available data on sensitivity and specificity of IHC compared with molecular tests in the detection of BRAF V600E mutation in ameloblastomas. MATERIALS AND METHODS This systematic review was performed based on the PRISMA statement and registered in Prospero (CRD42021259117). PubMed, Web of Science, Scopus and Cochrane Library databases were searched for observational studies to answer the question "What is the diagnostic accuracy of immunohistochemistry compared with molecular tests for the diagnosis of BRAF V600E mutation in ameloblastomas?". Methodological quality and risk of bias assessment of the selected studies were based on the QUADAS-2. Meta-analysis based on hierarchical SROC curve model and summary measures for sensitivity and specificity were computed. RESULTS A total of 226 records were found, but only 05 articles met the inclusion criteria, with 277 FFPE specimens of ameloblastoma included in the quantitative analysis. The sensitivity of the IHC compared to molecular tests ranged from 0.71 to 1.00, while all of the included studies showed perfect specificity (1.00). Pooled measures for sensitivity and specificity were 0.95 [95% CI 0.89, 1.00] and 1.00 [95% CI 0.95, 1.00], respectively. The Diagnostic Odds Ratio was 4.05 and the AUC for SROC curve was calculated as 0.979. CONCLUSIONS BRAF V600E-specific IHC using VE1 antibody showed extremely high sensitivity and specificity when compared with molecular tests in the detection of the mutation in ameloblastomas.
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Affiliation(s)
- Allan Vinícius Martins-de-Barros
- University of Pernambuco (UPE), School of Dentistry, Post-Graduation Program in Dentistry. Recife, Pernambuco, Brazil.,Hospital Universitário Oswaldo Cruz (HUOC/UPE), Centro Integrado de Anatomia Patológica (CIAP), Recife, Pernambuco, Brazil.,Hospital Universitário Oswaldo Cruz (HUOC/UPE, Department of Oral and Maxillofacial Surgery, Recife, Pernambuco, Brazil
| | - Raíssa Soares Dos Anjos
- University of Pernambuco (UPE), School of Dentistry, Post-Graduation Program in Dentistry. Recife, Pernambuco, Brazil.,Hospital Universitário Oswaldo Cruz (HUOC/UPE), Centro Integrado de Anatomia Patológica (CIAP), Recife, Pernambuco, Brazil
| | - Caio César Gonçalves Silva
- University of Pernambuco (UPE), School of Dentistry, Post-Graduation Program in Dentistry. Recife, Pernambuco, Brazil.,Hospital Universitário Oswaldo Cruz (HUOC/UPE, Department of Oral and Maxillofacial Surgery, Recife, Pernambuco, Brazil
| | - Emanuel Dias de Oliveira E Silva
- University of Pernambuco (UPE), School of Dentistry, Post-Graduation Program in Dentistry. Recife, Pernambuco, Brazil.,Hospital Universitário Oswaldo Cruz (HUOC/UPE, Department of Oral and Maxillofacial Surgery, Recife, Pernambuco, Brazil
| | - Fábio Andrey da Costa Araújo
- University of Pernambuco (UPE), School of Dentistry, Post-Graduation Program in Dentistry. Recife, Pernambuco, Brazil.,Hospital Universitário Oswaldo Cruz (HUOC/UPE, Department of Oral and Maxillofacial Surgery, Recife, Pernambuco, Brazil
| | - Marianne de Vasconcelos Carvalho
- University of Pernambuco (UPE), School of Dentistry, Post-Graduation Program in Dentistry. Recife, Pernambuco, Brazil.,Hospital Universitário Oswaldo Cruz (HUOC/UPE), Centro Integrado de Anatomia Patológica (CIAP), Recife, Pernambuco, Brazil
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2
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Anand N, Agrawal T, Gupta A, Shukla S, Pradhan R, Husain N. Diagnostic Efficacy of BRAFV600E Immunocytochemistry in Thyroid Aspirates in Bethesda Category IV and Papillary Thyroid Carcinoma. J Cytol 2021; 38:113-119. [PMID: 34703086 PMCID: PMC8489694 DOI: 10.4103/joc.joc_248_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 04/01/2021] [Accepted: 07/29/2021] [Indexed: 11/04/2022] Open
Abstract
Background In papillary thyroid carcinoma (PTC), BRAFV600E is a common mutation and is associated with aggressive clinical behaviour. Immunocytochemistry (ICC) and molecular testing are recommended in the Bethesda System for Reporting Thyroid Cytopathology 2017 (TBSRTC) category III, IV and V. Aims The current study aimed to evaluate the diagnostic efficacy of conventional FNAC versus FNAC with BRAFV600E immunostaining in cases of TBSRTC category IV, cases of suspicious for PTC and cases of PTC. Methods and Material The study included a prospective case series of 45 patients with clinically palpable thyroid nodules with TBSRTC category IV, category V (suspicious for PTC) and PTC. The corresponding histology specimens of all the 45 cases were also analyzed. Immunostaining for BRAFV600E was performed on FNAC cell blocks and their corresponding histology sections using anti-BRAF (VE1) clone (Ventana). The diagnostic efficacy of the BRAFV600E immunostaining was compared on cytological specimens with histological specimens. Results BRAFV600E immunostaining helped to improve the sensitivity of the cytology to confirm the PTC as a diagnostic aid for thyroid FNAs. Cytology alone had a sensitivity of 62.96% and a lower specificity of 60.70%. The combination of both the tests together provided 84.62% sensitivity and much higher specificity of 100%. PPV was also increased to 100% and NPV was raised 94.12%. Conclusions The performance of BRAFV600E immunostaining on the cytological specimen is a rapid, simple and cost-effective test and could be considered in TBSRTC category IV and suspicious and malignant cases of PTC.
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Affiliation(s)
- Nidhi Anand
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Tushar Agrawal
- Department of Pathology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Anurag Gupta
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Saumya Shukla
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Roma Pradhan
- Department of Endocrine Surgery, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Nuzhat Husain
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Suzuki M, Moriya S, Kobayashi S, Nishijima Y, Fujii T, Ikota H, Yokoo H, Saio M. Computer-assisted image analysis of cytological specimens clarify the correlation between nuclear size and intranuclear cytoplasmic inclusions regardless of BRAFV600E mutation in papillary thyroid carcinoma. Cytopathology 2021; 32:718-731. [PMID: 34159645 DOI: 10.1111/cyt.13022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/29/2021] [Accepted: 06/08/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The morphological features of nuclei in cytological and histological specimens were compared and examined for the presence of BRAFV600E mutation and the appearance rate of intranuclear cytoplasmic inclusions (NI). METHODS BRAFV600E mutation was identified using a mutation-specific antibody (clone; VE1) in 103 thyroid papillary carcinoma cases at Gunma University Hospital. The nuclear area, perimeter, and roundness of the corresponding cytological specimens and haematoxylin and eosin-stained specimens were analysed using image analysis software, and the appearance rate of NI was calculated and compared. RESULTS BRAFV600E mutation was detected in 71 (69%) cases. The appearance rate of NI was significantly higher in the BRAFV600E mutation-positive group in cytological and histological specimens (P = .0070 and .0184, respectively). Significant differences were observed between the BRAFV600E mutation-negative and -positive groups in the average nuclear area and average nuclear perimeter in cytological specimens (P = .0137 and .0152, respectively). In addition, nuclear enlargement was correlated with the appearance rate of NI regardless of the presence of BRAFV600E mutation in cytological specimens. In the BRAFV600E mutation-negative group, the nuclear area and perimeter were significantly smaller in the lymph node metastasis-positive cases (P = .0182 and .0260, respectively). CONCLUSION This study found that the appearance rate of NI was positively correlated with the nuclear area and perimeter and negatively correlated with nuclear roundness in cytological specimens. Furthermore, these results were observed regardless of the existence of BRAFV600E mutation. These results have never been previously reported and clearly demonstrate the usefulness of cytological specimens in computer-assisted image analysis.
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Affiliation(s)
- Midori Suzuki
- Laboratory of Histopathology and Cytopathology, Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma, Japan
| | - Shunichi Moriya
- Laboratory of Histopathology and Cytopathology, Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma, Japan
| | - Sayaka Kobayashi
- Laboratory of Histopathology and Cytopathology, Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma, Japan
| | - Yoshimi Nishijima
- Laboratory of Histopathology and Cytopathology, Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma, Japan
| | - Takaaki Fujii
- Division of Breast and Endocrine Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hayato Ikota
- Clinical Department of Pathology, Gunma University Hospital, Gunma, Japan
| | - Hideaki Yokoo
- Department of Human Pathology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Masanao Saio
- Laboratory of Histopathology and Cytopathology, Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma, Japan
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Parker KG, White MG, Cipriani NA. Comparison of Molecular Methods and BRAF Immunohistochemistry (VE1 Clone) for the Detection of BRAF V600E Mutation in Papillary Thyroid Carcinoma: A Meta-Analysis. Head Neck Pathol 2020; 14:1067-1079. [PMID: 32358715 PMCID: PMC7669962 DOI: 10.1007/s12105-020-01166-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
The evaluation of surgically resected papillary thyroid carcinomas (PTC) by immunohistochemistry (IHC) for BRAF mutation has diagnostic, prognostic and therapeutic implications. The goal of this meta-analysis was to perform a systematic review of studies using the VE1 clone (specific for detection of the BRAF V600E mutation) on formalin-fixed paraffin embedded (FFPE) thyroid surgical resection specimens for primary papillary thyroid carcinoma. The authors' molecular techniques, immunohistochemistry protocols, and scoring methods for VE1 immunostaining were also evaluated. This study included 4079 PTCs representing data from 23 studies. The results extracted from each study were split into two different groups, direct sequencing group or PCR group, based on the molecular "gold standard" method used to compare VE1 IHC staining. In the direct sequencing group, the IHC sensitivity was 100% (95% CI 0.97-1.00) and specificity 84% (95% 0.72-0.91). In the PCR group the sensitivity was 98% (95% CI 0.96-0.99) and specificity 89% (95% CI 0.82-0.94). Although immunohistochemical procedures varied by author, the overall performance of the VE1 clone shows that it is highly sensitive and relatively specific for detecting the BRAF V600E mutation in surgical resection specimens. However, standardization of immunohistochemical procedural method and scoring/interpretation criteria may improve the reliability and reproducibility for the use of VE1 clone for future practice.
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Affiliation(s)
- Kyle G Parker
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, USA.
| | - Michael G White
- Department of General Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nicole A Cipriani
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, USA
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5
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VE1 Immunohistochemistry Improves the Limit of Genotyping for Detecting BRAFV600E Mutation in Papillary Thyroid Cancer. Cancers (Basel) 2020; 12:cancers12030596. [PMID: 32150939 PMCID: PMC7139976 DOI: 10.3390/cancers12030596] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/29/2020] [Accepted: 03/04/2020] [Indexed: 02/07/2023] Open
Abstract
Detection of BRAFV600E is useful for making diagnosis and risk stratification of papillary thyroid carcinoma (PTC). Molecular testing, however, is not always available for routine clinical use. To assess the clinical utility and reliability of VE1 immunohistochemistry (IHC) for detecting BRAFV600E mutation in PTC, VE1 IHC was performed on the tissue microarrays of 514 patients with PTC and was compared with Sanger sequencing results. Of 514 PTC cases, 433 (84.2%) were positive for VE1 expression. Among 6 discordant cases between VE1 IHC and Sanger sequencing, 3 initial VE1-false negative cases turned out to be true false negative on repeat testing, and 3 VE1-false positive cases showed BRAFV600E mutation using digital PCR analysis. PTCs with low variant allele fraction were positive for VE1 IHC but were not detected using sequencing. VE1 IHC showed 99.3% sensitivity, 100% specificity, 100% positive predictive value, and 96.4% negative predictive value. The BRAFV600E mutation was significantly associated with older age, multifocality, extrathyroidal extension, lymph node metastasis, and advanced tumor stage. In conclusion, VE1 IHC is a reliable method for detecting BRAFV600E mutation in PTC specimens.
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6
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Abstract
Differentiated thyroid carcinomas make up most thyroid malignancies. The AJCC staging system and the ATA risk prediction system are the best predictors of mortality and recurrence, respectively. Key factors to be identified and reported by pathologists are reviewed in this article and include: (1) aggressive histologic variants of papillary thyroid carcinoma (including tall cell, columnar cell, and hobnail variants); (2) presence of gross extrathyroidal extension (into skeletal muscle or adjacent organs); (3) angioinvasion (including number of foci); (4) number, anatomic level, and size of lymph node metastases; (4) extranodal extension; (5) genetics (especially BRAF V600E or TERT promoter mutation).
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Affiliation(s)
- Nicole A Cipriani
- Department of Pathology, The University of Chicago, 5841 South Maryland Avenue, MC 6101, Chicago, IL 60637, USA.
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8
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Singarayer R, Mete O, Perrier L, Thabane L, Asa SL, Van Uum S, Ezzat S, Goldstein DP, Sawka AM. A Systematic Review and Meta-Analysis of the Diagnostic Performance of BRAF V600E Immunohistochemistry in Thyroid Histopathology. Endocr Pathol 2019; 30:201-218. [PMID: 31300997 DOI: 10.1007/s12022-019-09585-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Immunohistochemistry (IHC) in evaluating thyroid surgical specimens may facilitate diagnostic and prognostic evaluation, with potential therapeutic implications. We performed a systematic review and meta-analysis examining the analytic validity of IHC in detecting BRAFV600E mutations in thyroid cancer (primary or metastatic). We screened citations from three electronic databases (until December 20, 2018), supplemented by a hand search of authors' files and cross-references of reviews. Citations and full-text papers were independently reviewed in duplicate, and consensus was achieved on inclusion of papers. Two reviewers independently critically appraised and abstracted data from included papers. Random-effect meta-analyses were conducted for sensitivity and specificity estimates. We reviewed 1499 unique citations and 93 full-text articles. We included 1 systematic review and 30 original articles. The published review (from 2015) needed to be updated as there were multiple subsequent original studies. The pooled sensitivity of IHC in detecting a BRAFV600E mutation was 96.8% (95% confidence interval [CI] at 94.1%, 98.3%) (29 studies, including 2659 BRAFV600E mutant tumors). The IHC pooled specificity was 86.3% (95% CI 80.7%, 90.4%) (28 studies, including 1107 BRAFV600E wild-type specimens). These meta-analyses were subject to statistically significant heterogeneity, partly explained by antibody type (sensitivity and specificity) and tissue/tumor type (specificity). In conclusion, BRAF IHC is highly sensitive and reasonably specific in detecting the BRAFV600E mutation; however, there is some variability in analytic performance.
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Affiliation(s)
- Ranjit Singarayer
- Thyroid Fellow, University of Toronto, Toronto, Canada
- Toronto General Hospital, 200 Elizabeth Street, 12 EN-212, Toronto, Ontario, M5G 2C, Canada
| | - Ozgur Mete
- Department of Pathology, University Health Network and University of Toronto, Toronto, Canada
- Toronto General Hospital, 200 Elizabeth Street, 11 EN-422, Toronto, Ontario, M5G 2C4, Canada
| | - Laure Perrier
- University of Toronto Libraries, University of Toronto, 130 St. George St, Toronto, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Biostatistics Unit, 3rd Floor, Martha Wing, Room H-325, 50 Charlton Avenue East, Hamilton, Ontario, L8N 4A6, Canada
| | - Sylvia L Asa
- Department of Pathology, University Health Network and University of Toronto, Toronto, Canada
- Toronto General Hospital, 200 Elizabeth Street, 11 EN-422, Toronto, Ontario, M5G 2C4, Canada
| | - Stan Van Uum
- Division of Endocrinology, Western University, London, Ontario, Canada
- Division of Endocrinology & Metabolism, St Joseph's Health Care London, Room B5-130, 268 Grosvenor Street, London, Ontario, Canada
| | - Shereen Ezzat
- Department of Endocrine Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Toronto General Hospital, 585 University Avenue, 9NU-986, Toronto, Ontario, M5G 2N2, Canada
| | - David P Goldstein
- Department of Otolaryngology, Head and Neck Surgery, University Health Network and University of Toronto, Toronto, Canada
- Princess Margaret Cancer Centre, 610 University Avenue, Suite 3-950, Toronto, Ontario, M5G 2M9, Canada
| | - Anna M Sawka
- Division of Endocrinology, University Health Network and University of Toronto, Toronto, Canada.
- Toronto General Hospital, 200 Elizabeth Street, 12 EN-212, Toronto, Ontario, M5G 2C4, Canada.
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9
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Chen D, Qi W, Zhang P, Zhang Y, Liu Y, Guan H, Wang L. Investigation of BRAF V600E detection approaches in papillary thyroid carcinoma. Pathol Res Pract 2018; 214:303-307. [DOI: 10.1016/j.prp.2017.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 08/04/2017] [Accepted: 09/05/2017] [Indexed: 11/24/2022]
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Martinuzzi C, Pastorino L, Andreotti V, Garuti A, Minuto M, Fiocca R, Bianchi-Scarrà G, Ghiorzo P, Grillo F, Mastracci L. A combination of immunohistochemistry and molecular approaches improves highly sensitive detection of BRAF mutations in papillary thyroid cancer. Endocrine 2016; 53:672-80. [PMID: 26296380 DOI: 10.1007/s12020-015-0720-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/08/2015] [Indexed: 12/19/2022]
Abstract
The optimal method for BRAF mutation detection remains to be determined despite advances in molecular detection techniques. The aim of this study was to compare, against classical Sanger sequencing, the diagnostic performance of two of the most recently developed, highly sensitive methods: BRAF V600E immunohistochemistry (IHC) and peptide nucleic-acid (PNA)-clamp qPCR. BRAF exon 15 mutations were searched in formalin-fixed paraffin-embedded tissues from 86 papillary thyroid carcinoma using the three methods. The limits of detection of Sanger sequencing in borderline or discordant cases were quantified by next generation sequencing. BRAF mutations were found in 74.4 % of cases by PNA, in 71 % of cases by IHC, and in 64 % of cases by Sanger sequencing. Complete concordance for the three methods was observed in 80 % of samples. Better concordance was observed with the combination of two methods, particularly PNA and IHC (59/64) (92 %), while the combination of PNA and Sanger was concordant in 55 cases (86 %). Sensitivity of the three methods was 99 % for PNA, 94.2 % for IHC, and 89.5 % for Sanger. Our data show that IHC could be used as a cost-effective, first-line method for BRAF V600E detection in daily practice, followed by PNA analysis in negative or uninterpretable cases, as the most efficient method. PNA-clamp quantitative PCR is highly sensitive and complementary to IHC as it also recognizes other mutations besides V600E and it is suitable for diagnostic purposes.
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Affiliation(s)
- Claudia Martinuzzi
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - Lorenza Pastorino
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - Virginia Andreotti
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - Anna Garuti
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - Michele Minuto
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
- Surgery 1 Unit, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Roberto Fiocca
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
- Pathology Unit, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Giovanna Bianchi-Scarrà
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
- Genetics of Rare Tumors, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
| | - Paola Ghiorzo
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy.
- Genetics of Rare Tumors, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy.
| | - Federica Grillo
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
- Pathology Unit, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Luca Mastracci
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
- Pathology Unit, IRCCS AOU San Martino-IST, Genoa, Italy
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Pyo JS, Sohn JH, Kang G. Diagnostic Accuracy of BRAF Immunohistochemistry in Colorectal Cancer: a Meta-Analysis and Diagnostic Test Accuracy Review. Pathol Oncol Res 2016; 22:831-7. [DOI: 10.1007/s12253-016-0077-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 05/16/2016] [Indexed: 11/29/2022]
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12
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Moghaddam PA, Virk R, Sakhdari A, Prasad ML, Cosar EF, Khan A. Five Top Stories in Thyroid Pathology. Arch Pathol Lab Med 2016; 140:158-70. [PMID: 26910221 DOI: 10.5858/arpa.2014-0468-ra] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Thyroid carcinoma is the most common malignant tumor of endocrine organs, yet it only accounts for approximately 1% of all cancers in the United States with more than 35,000 new cases diagnosed each year and more than 450,000 people living with this disease. While most tumors can be diagnosed without much difficulty, a few tumor types, especially tumors with follicular pattern, sometimes pose a diagnostic challenge. OBJECTIVE To discuss morphologic, immunohistochemical, and molecular features of thyroid tumors. We also explore the clinicopathologic features of papillary microcarcinoma and medullary microcarcinoma and how the latter is related and differentiated from C-cell hyperplasia. Finally with the ever-growing list of organ systems involved in immunoglobulin (Ig) G4-related diseases, we discuss the still not completely explored IgG-4-related thyroid disease. DATA SOURCES Data were obtained from review of the pertinent peer-reviewed literature and institutional experience. CONCLUSIONS Histomorphologic evaluation still remains the gold standard for diagnosis in most cases of thyroid diseases. The application of ancillary studies such as immunohistochemistry and molecular diagnosis, including next-generation sequencing, is becoming more common.
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Affiliation(s)
- Parnian Ahmadi Moghaddam
- From the Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester (Drs Moghaddam, Sakhdari, Cosar, and Khan)
| | - Renu Virk
- and the Department of Pathology, Yale School of Medicine, New Haven, Connecticut (Drs Virk and Prasad)
| | - Ali Sakhdari
- From the Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester (Drs Moghaddam, Sakhdari, Cosar, and Khan)
| | - Manju L Prasad
- and the Department of Pathology, Yale School of Medicine, New Haven, Connecticut (Drs Virk and Prasad)
| | - Ediz F Cosar
- From the Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester (Drs Moghaddam, Sakhdari, Cosar, and Khan)
| | - Ashraf Khan
- From the Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester (Drs Moghaddam, Sakhdari, Cosar, and Khan)
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Kim YH, Yim H, Lee YH, Han JH, Lee KB, Lee J, Soh EY, Jeong SY, Kim JH. Evaluation of the VE1 Antibody in Thyroid Cytology Using Ex Vivo Papillary Thyroid Carcinoma Specimens. J Pathol Transl Med 2015; 50:58-66. [PMID: 26657312 PMCID: PMC4734968 DOI: 10.4132/jptm.2015.10.10] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 10/08/2015] [Accepted: 10/10/2015] [Indexed: 11/29/2022] Open
Abstract
Background: Recently, VE1, a monoclonal antibody against the BRAFV600E mutant protein, has been investigated in terms of its detection of the BRAFV600E mutation. Although VE1 immunostaining and molecular methods used to assess papillary thyroid carcinoma in surgical specimens are in good agreement, evaluation of VE1 in thyroid cytology samples is rarely performed, and its diagnostic value in cytology has not been well established. In present study, we explored VE1 immunoexpression in cytology samples from ex vivo papillary thyroid carcinoma specimens in order to minimize limitations of low cellularity and sampling/targeting errors originated from thyroid fineneedle aspiration and compared our results with those obtained using the corresponding papillary thyroid carcinoma tissues. Methods: The VE1 antibody was evaluated in 21 cases of thyroid cytology obtained directly from ex vivo thyroid specimens. VE1 immunostaining was performed using liquid-based cytology, and the results were compared with those obtained using the corresponding tissues. Results: Of 21 cases, 19 classic papillary thyroid carcinomas had BRAFV600E mutations, whereas two follicular variants expressed wild-type BRAF. VE1 immunoexpression varied according to specimen type. In detection of the BRAFV600E mutation, VE1 immunostaining of the surgical specimen exhibited 100% sensitivity and 100% specificity, whereas VE1 immunostaining of the cytology specimen exhibited only 94.7% sensitivity and 0% specificity. Conclusions: Our data suggest that VE1 immunostaining of a cytology specimen is less specific than that of a surgical specimen for detection of the BRAFV600E mutation, and that VE1 immunostaining of a cytology specimen should be further evaluated and optimized for clinical use.
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Affiliation(s)
- Yon Hee Kim
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Hyunee Yim
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Yong-Hee Lee
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Jae Ho Han
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Kyi Beom Lee
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Jeonghun Lee
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Euy Young Soh
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Seon-Yong Jeong
- Department of Medical Genetics, Ajou University School of Medicine, Suwon, Korea
| | - Jang-Hee Kim
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
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Pyo JS, Sohn JH, Kang G. BRAF Immunohistochemistry Using Clone VE1 is Strongly Concordant with BRAF(V600E) Mutation Test in Papillary Thyroid Carcinoma. Endocr Pathol 2015; 26:211-7. [PMID: 25957797 DOI: 10.1007/s12022-015-9374-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The aim of this study was to investigate the concordance between BRAF(V600E) mutation test and immunohistochemistry (IHC) and determine the diagnostic accuracy of IHC for papillary thyroid carcinoma (PTC) through a systematic review, meta-analysis, and diagnostic test accuracy review. The current systematic review and meta-analysis included 1141 PTCs in 11 eligible studies. We investigated the concordance rate and performed subgroup analysis using tissue and cytologic samples. Diagnostic test accuracy review was conducted and calculated using the value of area under curve (AUC) on the summary receiver operating characteristic (SROC) curve. The positive rate of BRAF IHC was 79.1% (903 of 1141 cases), and the BRAF(V600E) mutation was found in 76.6% (874 of 1141 cases). The concordance rates were 0.921 (95% confidence interval (CI) 0.877-0.950) and 0.894 (95% CI 0.801-0.946) in IHC positive and negative subgroups, respectively. In the diagnostic test accuracy review, the pooled sensitivity and specificity were 0.97 (95% CI 0.95-0.98) and 0.78 (95% CI 0.72-0.83). The value of AUC on SROC curve was 0.983, and diagnostic odds ratio was 164.28 (95% CI 57.69-467.80). Our results showed that BRAF IHC was strongly concordant with BRAF mutation test and had high diagnostic accuracy in BRAF mutation analysis of PTC.
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Affiliation(s)
- Jung-Soo Pyo
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 78 Saemunan-gil, Jongno-gu, Seoul, 110-746, South Korea
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Na JI, Kim JH, Kim HJ, Kim HK, Moon KS, Lee JS, Lee JH, Lee KH, Park JT. VE1 immunohistochemical detection of the BRAF V600E mutation in thyroid carcinoma: a review of its usefulness and limitations. Virchows Arch 2015; 467:155-68. [PMID: 25894433 DOI: 10.1007/s00428-015-1773-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 03/23/2015] [Accepted: 04/08/2015] [Indexed: 01/17/2023]
Abstract
The BRAF V600E mutation is a valuable prognostic factor in thyroid carcinoma despite lingering debate. Successful immunohistochemical (IHC) detection of the BRAF V600E mutation using a VE1 antibody was introduced recently. The objective of this study was to verify the usefulness of IHC detection of the BRAF V600E mutation in thyroid carcinoma using the VE1 antibody. IHC detection of BRAF V600E was performed on various thyroid carcinoma subtypes. IHC results were compared with those obtained from real-time polymerase chain reaction (PCR) detection. Discordant cases were re-examined using a direct sequencing method following nested PCR amplification. The BRAF V600E mutation was detected in 68 % (71/104) of papillary carcinoma cases and 78 % (7/9) of anaplastic carcinoma cases. The mutation was not detected in patients with follicular carcinoma (0/18) or in medullary carcinoma (0/21). The overall sensitivity and specificity of IHC using the VE1 antibody were 100 and 94 %, respectively, suggesting that molecular-based results were indeterminable in four VE1-positive cases. IHC using the VE1 antibody is a highly sensitive and specific method for BRAF V600E mutation detection and may represent a future replacement for DNA-based molecular tests.
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Affiliation(s)
- Jong-In Na
- Department of Pathology, Chonnam National University Medical School, #5 Hak-dong, Dong-gu, Gwang-ju, 501-746, South Korea
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16
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Abstract
The significance of BRAF mutations in neoplasia was first recognized in 2002 when mutations were discovered in a broad range of cancers. Numerous subsequent studies expanded our understanding of BRAF V600E as a critical diagnostic, prognostic, and predictive biomarker in many cancers. Additionally, the advent of small-molecule inhibitors of BRAF V600E rendered assessment of BRAF mutation status essential in tumors such as melanoma. In clinical practice, evaluation of BRAF mutation status has routinely been performed by DNA-based assays utilizing polymerase chain reaction (PCR). However, molecular testing is not available at many hospitals since it is time-consuming, expensive, and requires expertise in molecular techniques. The first BRAF V600E-specific antibody was reported in 2011 (clone VE1). A purified version of this antibody as well as a second monoclonal antibody targeted to BRAF V600E is now commercially available. In this review, clinicopathologic characteristics associated with BRAF-mutant tumors will be highlighted, and the prognostic and predictive implications of a BRAF V600E mutation will be discussed with a focus on melanoma, thyroid carcinoma and colorectal carcinoma. Additionally, we will review the correlation between immunohistochemistry and molecular results and deliberate how BRAF immunohistochemistry might be utilized in the evaluation of these tumors.
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Affiliation(s)
- Lauren L Ritterhouse
- Department of Pathology, Brigham and Women׳s Hospital, Harvard Medical School, 75 Francis St, Boston, Massachusetts 02115
| | - Justine A Barletta
- Department of Pathology, Brigham and Women׳s Hospital, Harvard Medical School, 75 Francis St, Boston, Massachusetts 02115.
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