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Clinical Routine TE...
Clinical Routine TERT Promoter Mutational Screening of Follicular Thyroid Tumors of Uncertain Malignant Potential (FT-UMPs): A Useful Predictor of Metastatic Disease
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- Hysek, M (författare)
- Karolinska Institutet
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- Paulsson, JO (författare)
- Karolinska Institutet
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- Jatta, K (författare)
- Karolinska Institutet
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- Shabo, I (författare)
- Karolinska Institutet
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- Stenman, A (författare)
- Karolinska Institutet
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- Hoog, A (författare)
- Karolinska Institutet
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- Larsson, C (författare)
- Karolinska Institutet
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- Zedenius, J (författare)
- Karolinska Institutet
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- Juhlin, CC (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2019-09-26
- 2019
- Engelska.
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Ingår i: Cancers. - : MDPI AG. - 2072-6694. ; 11:10
- Relaterad länk:
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https://www.mdpi.com...
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http://kipublication...
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https://doi.org/10.3...
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Abstract
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- Mutations of the Telomerase reverse transcriptase (TERT) gene promoter are recurrently found in follicular thyroid carcinoma (FTC) and follicular tumors of uncertain malignant potential (FT-UMP), but nearly never in follicular thyroid adenoma (FTA). We, therefore, believe these mutations could signify malignant potential. At our department, postoperative TERT promoter mutational testing of FT-UMPs was implemented in 2014, with a positive mutation screening leading to vigilant follow-up and sometimes adjuvant treatment. To date, we screened 51 FT-UMPs and compared outcomes to 40 minimally invasive FTCs (miFTCs) with known TERT genotypes. Eight FT-UMPs (16%) displayed TERT promoter mutations, of which four cases underwent a completion lobectomy at the discretion of the patient, and a single patient also opted in for radioiodine (RAI) treatment. Three mutation-positive patients developed distant metastases, registered in one patient receiving a completion lobectomy and in two patients with no additional treatment. Three out of four patients who received additional surgery, including the RAI-treated patient, are still without metastatic disease. We conclude that FT-UMPs with TERT promoter mutations harbor malignant potential and exhibit at least similar recurrence rates to TERT-promoter-mutated miFTCs. Mutational screening should constitute a cornerstone analysis in the histopathological work-up of FT-UMPs.
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