Associations between pathological features and radioactive iodine-refractory recurrent papillary thyroid carcinoma: with mutation analysis using recurrent samples
Nguyen T.N. Mussazhanova Z. Kurohama H. Hoang V.D. Le N.H. Ngo T.M.H. Nguyen V.P.T. Matsuda K. Matsuoka Y. Tratsiakova K. Nguyen T.N.A. Sailaubekova Y. Nguyen T.P. Le M.S. Nakashima M.
December 2025BioMed Central Ltd
BMC Endocrine Disorders
2025#25Issue 1
Background: Although papillary thyroid carcinomas (PTC) are usually indolent in nature and clinically controllable, two-thirds of metastatic diseases become radioactive iodine-refractory (RAI-R). This study aimed to determine the role of pathological features, BRAFV600E, TERT promoter (TERT-p), and their combinations on Vietnamese patients with RAI-R recurrent PTC. Methods: This cross-sectional study included 174 cases of locoregional recurrent PTC, including 135 and 39 RAI-R and RAI-avid (RAI-A) cases, respectively. Logistic regression analyses were used to evaluate the associations between pathological features, mutations, and RAI-R with tissues from recurrent lesions. Results: Loss of polarity/loss of cell cohesiveness (LOP/LCC) component was exclusively observed in recurrent cancers in the RAI-R group. RAI-R was associated with BRAFV600E mutation, TERT-p mutation, BRAFV600E/TERT-p single mutant (Smut), BRAFV600E/TERT-p double mutant (Dmut), tall cell component, and mitosis ≥ 2/2 mm2 in the unadjusted logistic regression analysis. Multivariable logistic regression analysis revealed that BRAFV600E mutation and Dmut were independent predictors of RAI-R. The presence of Dmut (odds ratio [OR] = 6.64) was more significantly associated with RAI-R compared with that of Smut (OR = 2.75). There was a marginal association between tall cell > 5%, mitosis count ≥ 2/2 mm2 and RAI-R. The combination of BRAFV600E/tall cell components was the strongest predictor of RAI-R. Conclusions: RAI-R PTC cases were independently associated with BRAFV600E, Dmut. The association between Dmut and RAI-R PTC was stronger than that between Smut and RAI-R PTC. Future studies should focus on elucidating the role of mitotic count and LOP/LCC in RAI-R PTC.
BRAFV600E , Mitosis , Radioactive iodine refractory , Recurrent papillary thyroid carcinoma , Tall cell , TERT promoter
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Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
Department of Fundamental Medicine, Al-Farabi Kazakh National University, Almaty, 050040, Kazakhstan
Medical Oncology Clinical Trial Unit Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, 6150, WA, Australia
Department of Nuclear Medicine, 108 Military Central Hospital, Ha Noi, Viet Nam
Department of Pathology, 108 Military Central Hospital, Ha Noi, Viet Nam
Department of Tumor and Diagnostic Pathology
Department of Fundamental Medicine
Medical Oncology Clinical Trial Unit Fiona Stanley Hospital
Department of Nuclear Medicine
Department of Pathology
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