1. TERT promoter mutations contribute to adverse clinical outcomes and poor prognosis in radioiodine refractory differentiated thyroid cancer
- Author
-
Gongxun Tan, Bingquan Jin, Xiaoqin Qian, Yuguo Wang, Guoliang Zhang, Enock Adjei Agyekum, Feng Wang, Liang Shi, Yue Zhang, Zhenwei Mao, Chunhe Shi, Ying Xu, Xiuying Li, Lele Zhang, and Shaohua Li
- Subjects
TERT promoter mutations ,Differentiated thyroid cancer ,Multifocal metastases ,Iodine refractory differentiated thyroid cancer ,Radioiodine therapy ,Nuclear medicine ,Medicine ,Science - Abstract
Abstract Telomerase reverse transcriptase promoter (TERTp) mutations are associated with non-radioiodine avidity. However, the role of these mutations in the clinical outcomes of patients with radioiodine-refractory differentiated thyroid cancer (RAIR-DTC) remains unknown. Herein, we aim to analyze gene mutations and clinical manifestations to verify TERTp’s role in driving disease progression to RAIR-DTC and clinical outcomes. Next-generation sequencing data and clinical data were obtained from 243 patients with DTC. Of the 25 patients with TERTp mutations, 80% (20/25) had RAIR-DTC. RAIR-DTC was significantly less prevalent in patients with BRAF V600E (9/143, 6.3%) than those with both BRAF V600E and TERTp mutations (14/17, 82.4%). Patients with RAIR-DTC harboring both BRAF V600E and TERTp mutations were more likely to have > 3 distant metastatic sites (85.7%, 12/14) than those with BRAF V600E alone (33.3%, 3/9). Only one patient with both BRAF V600E and TERTp mutations had non-RAIR-DTC. The time from initial radioactive iodine therapy to RAIR-DTC diagnosis was significantly shorter in patients with TERTp mutations than in those without. Patients with BRAF V600E and TERTp mutations progressed faster to RAIR-DTC than those with BRAF V600E alone (p
- Published
- 2024
- Full Text
- View/download PDF