MINISTRY OF EDUCATION AND TRAINING MINISTRY OF HEATH
HANOI MEDICAL UNIVERSITY
NGO THI MINH HANH
HISTOPATHOLOY, IMMUNOHISTOCHEMISTRY,
BRAF V600E MUTATION IN RECURRENT,
METASTATIC DIFFERENTIATED THYROID
CARCINOMA
Specialty: Pathology
Code: 62720105
SUMMARY OF MEDICAL DOCTORAL THESIS
HA NOI - 2020
The thesis was completed at:
HANOI MEDICAL UNIVERSITY
Scientific Supervisor: 1. Assoc. Prof. Trinh Tuan Dung, MD, PhD
2. PhD. Hoang Quoc Truong
Reviewer 1: Assoc. Prof. Nguy n o ng, MD, PhD
Reviewer 2: Assoc. Prof. Trần Vân Khánh, MD, PhD
Reviewer 3: Assoc. Prof. Tạ Văn Tờ, MD, PhD
The thesis was defended at Council of Scientists in Ha Noi Medical
University.
At on date month 2020
References the thesis in:
1. Vietnam National Library
2. Library of Ha Noi Medical University
THE LIST OF ANNOUNCED RESEACHES
RELATED TO THE THESIS TOPIC
1. Ngo Thi Minh Hanh, Trinh Tuan Dung, Nguyen Duc Vinh,
Le Thi Thanh Xuan, Dao Anh Tuan, Nguyen Van Phu Thang
(2017), Histopathological characteristics of recurrent,
metastatic differentiated thyroid carcinoma. Journal of 108 -
Clinical Medicine and Pharmacy, Special issue 11, 423-427.
2. Ngo Thi Minh Hanh, Trinh Tuan Dung, Hoang Quoc Truong
(2018), Study on expression of some immunohistochemical
makers in recurrent, metastatic differentiated thyroid
carcinoma. Journal of 108 - Clinical Medicine and
Pharmacy, Special issue 7, 103-108.
3. Ngo Thi Minh Hanh, Trinh Tuan Dung, Hoang Quoc
Truong, Nguyen Thi Ngoc Anh, Le Minh Son (2018), The
value of BRAF V600E immunohistochemiscal expression in
recurrent, metastatic differentiated thyroid carcinoma,
Vietnam Medical Journal, 471(10), 166-172.
4. Ngo Thi Minh Hanh, Trinh Tuan Dung, Hoang Quoc Truong
(2019), BRAF V600E mutation and relationship with
histopathological characteristics of metastasic, recurrent
differentiated thyroid carcinoma, Journal of 108 - Clinical
Medicine and Pharmacy, 14, 127-133.
5. Ngo Thi Minh Hanh, Trinh Tuan Dung, Hoang Quoc Truong
(2019), BRAF V600E mutation in variants of metastatic,
recurrent and differentiated thyroid carcinoma, Ho Chi Minh
City Jounal of Medicine, 23(5), 94-98.
1
INTRODUCTION
Differentiated thyroid carcinoma (DTC) derived from follicular
cells, which are follicular thyroid carcinoma (FTC) and papillary
thyroid carcinoma (PTC). The disease tends to increase globally and
ranks number 1st in total cancers in Korea, 9th in United States and
Vietnam. The disease has good prognosis but 4 - 30% of cases recur,
metastasize, invasively progress, especially in radioactive iodine
(RAI)-refractory DTC.
Histopathology is considered as a hallmark for cancer diagnosis.
The histopathological types and variants of thyroid cancer could be
easily identified by pathologists, using routine hematoxylin - eosin
staining. However, in some difficult cases, pathologists must base on
immunohistochemistry (IHC), which is based on the principle
antibody - antigen reaction, to confirm diagnosis.
A number of studies have shown a link between BRAF V600E
mutation and pathogenesis, the risk of progresive disease and RAI-
refactory mechanism. The understanding of BRAF V600E mutation
is opening the trend of a target therapy for patients with RAI-
refractory DTC. With the aim to provide clinicians more
comprehensive information on the histological characteristics and
prevalence of BRAF V600E mutations in patients with recurrent,
metastatic DTC to help them choose an optimal treatment and give
better prognosis, we conducted the present study with two objectives:
2
1. To describe histopathological and immunoshistochemical
characteristics of recurrent, metastatic differentiated thyroid
carcinoma.
2. To determine the prevalence of BRAF V600E mutation, and
investigate potential association between BRAF V600E mutation and
some histopathological and clinical characteristics.
The essential of the thesis
DTC is the most common of the endocrine system and tends to
increase worldwide. The disease has a good prognosis due to
advantages of thyroid and lymph node surgery as well as RAI
therapy. However, recurrence and metastasis occur in 4 - 30% of
DTC cases, which results in poor prognosis, especially, in RAI-
refractory DTC. Histopathology is gold standard for the diagnosis,
and IHC helps confirm the metastasis, progression of the disease.
BRAF V600E mutation is associated with pathogenesis, its
progression and resistance to RAI therapy, and opens a targeted
approach of cancer treatment, especially the group that no longer
respond to RAI therapy. Understanding pathogenesis, the status of
BRAF V600E mutation is essential for clinicians in selection of
appropriate therapy, management and better prognosis of DTC
patients.