Evidence map›Paper›PMID 27689252›Full record

ArticleThe Journal of clinical endocrinology and metabolism2016

Clinical, Sonographic, and Pathological Characteristics of RAS-Positive Versus BRAF-Positive Thyroid Carcinoma.

Sujay Kakarmath, Howard T Heller, Caroline A Alexander, Edmund S Cibas, Jeffrey F Krane, Justine A Barletta, Neal I Lindeman, Mary C Frates, Carol B Benson, Atul A Gawande and 9 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.

  1. Pooled it
  2. PRECISE: A Prognostic Thyrocyte-Derived Gene Signature for Papillary Thyroid Carcinoma.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026
    Article
  3. Current evidence and strategies for preventing tumor recurrence following thermal ablation of papillary thyroid carcinoma.Cancer imaging : the official publication of the International Cancer Imaging Society · 2025
    Review
  4. Article
  5. Review
  6. Review
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Fusion Oncogenes Are Associated With Increased Metastatic Capacity and Persistent Disease in Pediatric Thyroid Cancers.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022
    Article
  14. Mutational status may supersede tumor size in predicting the presence of aggressive pathologic features in well differentiated thyroid cancer.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2022
    Article
  15. Article
  16. Review
  17. Article
  18. Review
  19. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 2 institutions in 1 country.

Sujay KakarmathThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Howard T HellerThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Caroline A AlexanderThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Edmund S CibasThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Jeffrey F KraneThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Justine A BarlettaThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Neal I LindemanThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Mary C FratesThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Carol B BensonThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Atul A GawandeThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Nancy L ChoThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Matthew NehsThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Francis D MooreThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Ellen MarquseeThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Mathew I KimThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
P Reed LarsenThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Norra KwongThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Trevor E AngellThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Erik K AlexanderThyroid Section, Division of Endocrinology, Hypertension, and Diabetes (S.K., T.E.A., N.K., C.A.A., E.M., M.I.K., P.R.L., E.K.A.), and Departments of Radiology (H.T.H., M.C.F., C.B.B.), Pathology (E.S.C., J.F.K., J.A.B., N.I.L.), and Surgery (A.A.G., N.L.C., M.N., F.D.M.), The Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115.
Harvard University · USBrigham and Women's Hospital · US

Funding

TRAINING GRANT IN ACADEMIC ENDOCRINOLOGYT32DK007529 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI Ursula B. Kaiser, Anand Vaidya · 1986 to 2026
$6.3M
NIDDK NIH HHS T32 DK007529
6 · The paper itself

Abstract

contextMutations in the BRAF and RAS oncogenes are responsible for most well-differentiated thyroid cancer. Yet, our clinical understanding of how BRAF-positive and RAS-positive thyroid cancers differ is incomplete.

objectiveWe correlated clinical, radiographic, and pathological findings from patients with thyroid cancer harboring a BRAF or RAS mutation.

designProspective cohort study.

settingAcademic, tertiary care hospital. PATIENTS: A total of 101 consecutive patients with well-differentiated thyroid cancer.

main outcome measureWe compared the clinical, sonographic, and pathological characteristics of patients with BRAF-positive cancer to those with RAS-positive cancer.

resultsOf 101 patients harboring these mutations, 71 were BRAF-positive, whereas 30 were RAS-positive. Upon sonographic evaluation, RAS-positive nodules were significantly larger (P = .04), although BRAF-positive nodules were more likely to harbor concerning sonographic characteristics (hypoechogenicity [P < .001]; irregular margins [P = .04]). Cytologically, 70% of BRAF-positive nodules were classified positive for PTC, whereas 87% of RAS-positive nodules were indeterminate (P < .001). Histologically, 96% of RAS-positive PTC malignancies were follicular variants of PTC, whereas 70% of BRAF-positive malignancies were classical variants of PTC. BRAF-positive malignancies were more likely to demonstrate extrathyroidal extension (P = .003), lymphovascular invasion (P = .02), and lymph node metastasis (P < .001).

conclusionsBRAF-positive malignant nodules most often demonstrate worrisome sonographic features and are frequently associated with positive or suspicious Bethesda cytology. In contrast, RAS-positive malignancy most often demonstrates indolent sonographic features and more commonly associates with lower risk, "indeterminate" cytology. Because BRAF and RAS mutations are the most common molecular perturbations associated with well-differentiated thyroid cancer, these findings may assist with improved preoperative risk assessment by suggesting the likely molecular profile of a thyroid cancer, even when postsurgical molecular analysis is unavailable.

Indexed as

CarcinomaThyroid NeoplasmsThyroid NoduleAdultAgedCarcinoma, PapillaryFemaleHumansMaleMiddle AgedProspective StudiesProto-Oncogene Proteins B-rafProto-Oncogene Proteins p21(ras)Thyroid Cancer, PapillaryYoung AdultBRAF protein, humanHRAS protein, humanProto-Oncogene Proteins B-rafProto-Oncogene Proteins p21(ras)

Identifiers

PMID27689252
PMCPMC5155682
OpenAlexW2524450171

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.