Clinical impact of BRAF mutation on the diagnosis and prognosis of papillary thyroid carcinoma: a systematic review and meta‐analysis

Abstract Background The possible role of BRAF V 600E mutation in the diagnosis and prognosis of papillary thyroid carcinoma ( PTC ) remains controversial. A systematic review to investigate the diagnostic and prognostic role of BRAF V 600E mutation in patients with PTC is urgently needed. Methods A systematic review of relevant literatures was performed in PubMed, EMBASE and CENTRAL . The incremental accuracy ( IA ) of fine needle aspiration biopsy plus BRAF V 600E mutation analysis over fine needle aspiration biopsy alone, and the statistical data about the association of BRAF V 600E mutation and the prognosis of PTC (risk ratios ( RR ) for dichotomous data, standard mean differences for continuous data and hazard ratios ( HR s) for disease‐free survival ( DFS ) were pooled. Subgroup analysis was performed to explain the heterogeneities. Results A total of 67 studies were included. The pooled IA was 2% (95% confidence interval ( CI ): 0·5–4%). The pooled RR for gender, multifocality, lymph node metastasis, extrathyroidal invasion and pathological stage was 1·11 (95% CI : 0·98–1·25), 1·17 (95% CI : 1·09–1·24), 1·36 (95% CI : 1·20–1·53), 1·60 (95% CI : 1·41–1·82), and 1·49 (95% CI : 1·33–1·68), respectively. The pooled standard mean differences for age and tumour size were 0·14 (95% CI : 0·04–0·23) and 0·21 (95% CI : 0·1–0·32), respectively. The pooled HR for DFS was 1·96 (95% CI : 1·62–2·37). Subgroup analysis showed that these statistical results were affected by the geographical background of patients, study design and detection methods. Conclusions BRAF V 600E mutation analysis can not only be used in the diagnosis of PTC , but can also predict its prognosis.