Prevalence and Clinicopathological Significance of BRAF V600E Mutation in Papillary Thyroid Carcinoma: A Retrospective Cohort Study from Kerala, India

Background: The BRAF V600E mutation is the most frequent genetic alteration in papillary thyroid carcinoma (PTC) and has been implicated in aggressive tumor behaviour. Its prevalence, however, varies across populations. This study aimed to determine the prevalence of BRAF V600E mutation in a South Indian PTC cohort and to evaluate its association with clinicopathological features. Methods: Tumor specimens from 69 patients with histologically confirmed PTC were subjected to immunohistochemical analysis for BRAF V600E expression. Staining intensity was graded from 0 to 3, with scores > 0 defined as positive. Age distribution across score categories was assessed using one-way ANOVA. Associations between BRAF status and clinicopathological variables—including gender, multifocality, tumor stage, nodal status, metastasis, lymphovascular/perineural invasion (LVI/PNI), and capsular invasion—were analyzed using Chi-square or Fisher’s exact tests. Statistical significance was set at p < 0.05. Results: BRAF V600E positivity was detected in 66.7% (46/69) of cases, with 43.5% of positive tumors demonstrating strong expression (score 3). Among the evaluated parameters, only LVI/PNI showed a significant association with BRAF positivity (p = 0.047; OR 3.34; 95% CI 0.98–11.41). No significant associations were observed between BRAF status and age, gender, T stage, N stage, or distant metastasis. Conclusion: This cohort demonstrated a high prevalence of BRAF V600E mutation in PTC. Its significant association with LVI/PNI suggests a potential link with invasive tumor behaviour. Although limited by sample size and retrospective design, these findings support further prospective research to clarify the prognostic utility of BRAF V600E and its relevance in risk stratification and targeted therapy in PTC.