OBJECTIVE The role of BRAF in papillary thyroid carcinoma (PTC) with Hashimoto's thyroiditis (HT) is unknown. We aimed to explore risk factors affecting lymph node (LN) metastasis and interaction effect of BRAF in PTC patients with HT. METHODS We retrospectively collected the data of 994 PTC patients with HT who underwent surgery at the West China Hospital. We analyzed the correlations between preoperative characteristics and LN metastasis in overall, and different BRAF (V600E) mutation patients. Logistic regression was applied to analyze the risk factors for LN metastasis. Finally, we performed an interaction effect analysis to identify the interaction effect of BRAF. RESULTS The overall LN metastasis rate was 52.71% (524/994), overall BRAF mutation rate was 26.9% (268/994). BRAF mutation rates were significantly different in LN metastasis and non-metastasis patients (31.7% vs 21.5%, P<0.001). In all 994 patients, age, BMI, hypertension, tumor maximum diameter, BRAF mutation, tumor location, aspect ratio, calcification, and extrathyroidal invasion were risk factors for LN metastasis (P<0.05). In BRAF mutant patients, smoking, hypertension, maximum diameter, calcification, and multifocality were risk factors for LN metastasis (P<0.05). In BRAF wild-type patients, age, BMI, maximum diameter, tumor location, aspect ratio, tumor shape, calcification, and extrathyroidal invasion were risk factors (P<0.05). Additionally, we found significant interactions between BRAF and BMI, hypertension, maximum diameter, and calcification (P<0.05), suggesting the potential interaction effect of BRAF. CONCLUSION BRAF is a risk factor for LN metastasis in PTC with HT. Meanwhile, BRAF can interacts with age, BMI, hypertension, and calcification which together influence LN metastasis.

中文翻译：

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BRAF对甲状腺乳头状癌合并桥本甲状腺炎淋巴结转移的影响和相互作用。

目的 BRAF 在甲状腺乳头状癌 (PTC) 合并桥本甲状腺炎 (HT) 中的作用尚不清楚。我们的目的是探讨影响 PTC 合并 HT 患者淋巴结（LN）转移的危险因素以及 BRAF 的相互作用。方法回顾性收集在华西医院接受手术的994例PTC合并HT患者的资料。我们分析了总体和不同 BRAF (V600E) 突变患者的术前特征与淋巴结转移之间的相关性。采用Logistic回归分析LN转移的危险因素。最后，我们进行了交互效应分析，以确定 BRAF 的交互效应。结果 总体淋巴结转移率为52.71%（524/994），总体BRAF突变率为26.9%（268/994）。淋巴结转移和非转移患者的BRAF突变率有显着差异（31.7% vs 21.5%，P<0.001）。994例患者中，年龄、BMI、高血压、肿瘤最大直径、BRAF突变、肿瘤部位、纵横比、钙化、甲状腺外侵犯是LN转移的危险因素（P<0.05）。BRAF突变患者中，吸烟、高血压、最大直径、钙化、多灶性是淋巴结转移的危险因素（P<0.05）。在BRAF野生型患者中，年龄、BMI、最大直径、肿瘤位置、纵横比、肿瘤形状、钙化和甲状腺外侵犯是危险因素（P<0.05）。此外，我们发现 BRAF 与 BMI、高血压、最大直径和钙化之间存在显着的交互作用（P<0.05），表明 BRAF 具有潜在的交互作用。结论 BRAF 是 HT PTC 淋巴结转移的危险因素。同时，BRAF可以与年龄、BMI、高血压和钙化相互作用，共同影响淋巴结转移。