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Age-associated mortality is partially mediated by TERT promoter mutation status in differentiated thyroid carcinoma.


ABSTRACT:

Background

Age at diagnosis (AAD) and telomerase reverse transcriptase (TERT) promoter mutations are prognostic factors in differentiated thyroid carcinoma (DTC), and the prevalence of the mutations increases with AAD. Considering this correlation, we investigated whether an interaction between AAD and the mutations is present and whether the mutation mediates the effect of AAD on the mortality rate in DTC.

Methods

The study included 393 patients with DTC who were followed-up after thyroidectomy at a single medical center in Korea from 1994 to 2004. Multivariable Cox regression was used to investigate the interaction of AAD and TERT promoter mutation. Mediation analysis was conducted using a regression-based causal mediation model.

Results

The age-associated mortality rate increased progressively in all DTC patients and wild-type TERT group (WT-TERT) with a linear trend (p < 0.001) contrary to mutant TERT group (M-TERT) (p = 0.301). Kaplan-Meier curves declined progressively with increasing AAD in the entire group, but the change was without significance in M-TERT. The effect of AAD on mortality was not significant (adjusted HR: 1.07, 95% CI 0.38-3.05) in M-TERT. An interaction between AAD and TERT promoter mutation (p = 0.005) was found in a multivariable Cox regression. TERT promoter mutations mediated the effect of AAD on the mortality rate by 36% in DTC in a mediation analysis.

Conclusions

Considering the mediation of TERT promoter mutation on the effect of AAD on mortality, inclusion of TERT promoter mutation in a stage classification to achieve further individualized prediction in DTC is necessary.

SUBMITTER: Heo J 

PROVIDER: S-EPMC10637683 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Age-associated mortality is partially mediated by TERT promoter mutation status in differentiated thyroid carcinoma.

Heo Jung J   Lee Sungjoo S   Park Jun J   Yang Heera H   Park Hyunju H   Ki Chang-Seok CS   Oh Young Lyun YL   Kim Hye In HI   Kim Sun Wook SW   Chung Jae Hoon JH   Kim Kyunga K   Kim Tae Hyuk TH  

PloS one 20231110 11


<h4>Background</h4>Age at diagnosis (AAD) and telomerase reverse transcriptase (TERT) promoter mutations are prognostic factors in differentiated thyroid carcinoma (DTC), and the prevalence of the mutations increases with AAD. Considering this correlation, we investigated whether an interaction between AAD and the mutations is present and whether the mutation mediates the effect of AAD on the mortality rate in DTC.<h4>Methods</h4>The study included 393 patients with DTC who were followed-up afte  ...[more]

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