Table 2.
Summary of Clinicopathological and Molecular Associations With TERT Promoter Mutations in Thyroid Cancers
| Tumor Type | All Patients | TERT Wild Type | TERT Mutated | P Value |
|---|---|---|---|---|
| DTCs (n = 402) | ||||
| Clinicopathological | ||||
| Age at diagnosis, y (n = 402) | 46.0 ± 16.0 | 44.5 ± 15.6 | 60.2 ± 12.7 | <.001 |
| Gender (n = 395) | ||||
| Female | 304 (77.0) | 278 (77.7) | 26 (70.3) | NS (.31) |
| Male | 91 (23.0) | 80 (22.3) | 11 (29.7) | |
| Mean tumor size, cm (n = 376) | 2.7 ± 1.9 | 2.6 ± 1.8 | 3.6 ± 2.3 | .002 |
| Extrathyroidal extension (n = 317)a | ||||
| Present | 184 (58.0) | 167 (57.4) | 17 (65.4) | NS (.43) |
| Vascular invasion (n = 310)b | ||||
| Present | 142 (45.8) | 129 (45.4) | 13 (50.0) | NS (.65) |
| LN metastases (n = 345) | ||||
| Present | 210 (60.9) | 189 (61.0) | 21 (60.0) | NS (.91) |
| Distant metastases (n = 294) | ||||
| Present | 44 (15.0) | 34 (12.5) | 10 (43.5) | <.001 |
| Stage (n = 254) | ||||
| I | 132 (52.0) | 129 (55.1) | 3 (15.0) | <.001 |
| II | 33 (13.0) | 31 (13.3) | 2 (10.0) | |
| III | 41 (16.1) | 37 (15.8) | 4 (20.0) | |
| IV | 48 (18.9) | 37 (15.8) | 11 (55.0) | |
| Other genetic alterations | ||||
| BRAF mutation (n = 357) | 148 (41.5) | 130 (40.2) | 18 (52.9) | NS (.15) |
| NRAS mutation (n = 365) | 29 (7.9) | 24 (7.3) | 5 (14.3) | NS (.15) |
| PTCs (n = 332) | ||||
| Clinicopathological | ||||
| Age at diagnosis, y (n = 332) | 44.8 ± 15.6 | 43.6 ± 15.3 | 58.4 ± 13.2 | <.001 |
| Gender (n = 327) | ||||
| Female | 254 (77.7) | 237 (78.5) | 17 (68.0) | NS (.23) |
| Male | 73 (22.3) | 65 (21.5) | 8 (32.0) | |
| Mean tumor size, cm (n = 315) | 2.4 ± 1.5 | 2.3 ± 1.4 | 3.2 ± 2.2 | .005 |
| Extrathyroidal extension (n = 268)a | ||||
| Present | 176 (65.7) | 162 (64.8) | 14 (77.8) | NS (.26) |
| Vascular invasion (n = 257)b | ||||
| Present | 103 (40.1) | 98 (40.7) | 5 (31.3) | NS (.46) |
| LN metastases (n = 298) | ||||
| Present | 202 (67.8) | 184 (66.9) | 18 (78.3) | NS (.26) |
| Distant metastases (n = 263) | ||||
| Present | 36 (13.7) | 31 (14.7) | 5 (27.8) | NS (.07) |
| Stage (n = 225) | ||||
| I | 124 (55.1) | 121 (57.3) | 3 (21.4) | .02 |
| II | 25 (11.1) | 24 (11.4) | 1 (7.1) | |
| III | 36 (16.0) | 32 (15.2) | 4 (28.6) | |
| IV | 40 (17.8) | 34 (16.1) | 6 (42.9) | |
| Other genetic alterations | ||||
| BRAF mutation (n = 301) | 148 (49.2) | 130 (46.9) | 18 (75.0) | .008 |
| NRAS mutation (n = 301) | 15 (5.0) | 14 (5.1) | 1 (4.2) | NS (.85) |
| FTCs (n = 70) | ||||
| Clinicopathological | ||||
| Age at diagnosis, y (n = 70) | 51.8 ± 16.4 | 49.3 ± 16.3 | 63.8 ± 11.0 | .004 |
| Gender (n = 68) | ||||
| Female | 50 (73.5) | 41 (73.2) | 9 (75.0) | NS (.90) |
| Male | 18 (26.5) | 15 (26.8) | 3 (25.0) | |
| Mean tumor size, cm (n = 61) | 4.4 ± 2.6 | 4.4 ± 2.6 | 4.4 ± 2.5 | NS (.96) |
| Extrathyroidal extension (n = 49)a | ||||
| Present | 8 (16.3) | 5 (12.2) | 3 (37.5) | NS (.08) |
| Vascular invasion (n = 53)b | ||||
| Present | 39 (73.6) | 31 (72.1) | 8 (80.0) | NS (.61) |
| LN metastases (n = 47) | ||||
| Present | 8 (17.0) | 5 (14.3) | 3 (25.0) | NS (.39) |
| Distant metastases (n = 31) | ||||
| Present | 8 (25.8) | 3 (11.5) | 5 (100.0) | <.001 |
| Stage (n = 29) | ||||
| I | 8 (27.6) | 8 (34.8) | 0 | .007 |
| II | 8 (27.6) | 7 (30.4) | 1 (16.7) | |
| III | 5 (17.2) | 5 (21.7) | 0 | |
| IV | 8 (27.6) | 3 (13.1) | 5 (83.3) | |
| Other genetic alterations | ||||
| BRAF mutation (n = 56) | 0 | 0 | 0 | c |
| NRAS mutation (n = 64) | 14 (21.9) | 10 (18.9) | 4 (36.4) | NS (0.20) |
| Undifferentiated thyroid carcinomas (poorly differentiated + anaplastic) (n = 67) | ||||
| Clinicopathological | ||||
| Age at diagnosis, y (n = 67) | 61.5 ± 16.2 | 58.3 ± 17.6 | 68.7 ± 9.6 | .003 |
| Gender (n = 64) | ||||
| Female | 38 (59.4) | 22 (50.0) | 16 (80.0) | .02 |
| Male | 26 (40.6) | 22 (50.0) | 4 (20.0) | |
| Mean tumor size, cm (n = 42) | 6.5 ± 3.2 | 6.3 ± 3.4 | 6.8 ± 2.9 | NS (.62) |
| Extrathyroidal extension (n = 56)a | ||||
| Present | 47 (83.9) | 32 (82.1) | 15 (88.2) | NS (.56) |
| Vascular invasion (n = 15)b | ||||
| Present | 15 (100.0) | 11 (100.0) | 4 (100.0) | c |
| LN metastases (n = 46) | ||||
| Present | 24 (52.2) | 16 (57.1) | 8 (44.4) | NS (.40) |
| Distant metastases (n = 43) | ||||
| Present | 32 (74.4) | 19 (70.4) | 13 (81.3) | NS (.43) |
| Stage (n = 56) | ||||
| I | 2 (3.6) | 2 (5.3) | 0 | NS (.39) |
| II | 3 (5.4) | 3 (7.9) | 0 | |
| III | 4 (7.1) | 2 (5.3) | 2 (11.1) | |
| IV | 47 (83.9) | 31 (81.5) | 16 (88.9) | |
| Other genetic alterations | ||||
| BRAF mutation (n = 65) | 10 (15.4) | 6 (13.6) | 4 (19.0) | NS (0.57) |
| NRAS mutation (n = 61) | 17 (27.9) | 9 (22.5) | 8 (38.1) | NS (0.20) |
Abbreviations: LN, lymph node; n, number of patients with available data for each feature; NS, not significant. Numbers in parentheses represent percentages within each category. Bold values indicate the result was statistically significant.
a
Extrathyroidal extension was defined as having disease extending beyond the thyroid capsule, including either microscopic or macroscopic invasion.
b
Vascular invasion was defined as the presence of intravascular tumor cells either covered by endothelium or associated with thrombus, affecting lymphatic or blood vessels within or beyond the tumor capsule.
c
No statistics were computed due to constant numbers of one feature.