BRAF Immunohistochemistry Using Clone VE1 is Strongly Concordant with BRAFV600E Mutation Test in Papillary Thyroid Carcinoma

The aim of this study was to investigate the concordance between BRAF(V600E) mutation test and immunohistochemistry (IHC) and determine the diagnostic accuracy of IHC for papillary thyroid carcinoma (PTC) through a systematic review, meta-analysis, and diagnostic test accuracy review. The current systematic review and meta-analysis included 1141 PTCs in 11 eligible studies. We investigated the concordance rate and performed subgroup analysis using tissue and cytologic samples. Diagnostic test accuracy review was conducted and calculated using the value of area under curve (AUC) on the summary receiver operating characteristic (SROC) curve. The positive rate of BRAF IHC was 79.1 % (903 of 1141 cases), and the BRAF(V600E) mutation was found in 76.6 % (874 of 1141 cases). The concordance rates were 0.921 (95 % confidence interval (CI) 0.877-0.950) and 0.894 (95 % CI 0.801-0.946) in IHC positive and negative subgroups, respectively. In the diagnostic test accuracy review, the pooled sensitivity and specificity were 0.97 (95 % CI 0.95-0.98) and 0.78 (95 % CI 0.72-0.83). The value of AUC on SROC curve was 0.983, and diagnostic odds ratio was 164.28 (95 % CI 57.69-467.80). Our results showed that BRAF IHC was strongly concordant with BRAF mutation test and had high diagnostic accuracy in BRAF mutation analysis of PTC.