الفهرس 
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Abstract
Thyroid cancer (TC) is the most popular endocrine-related malignant tumor, as well as the most prevalent cancer of the neck and head. Thyroid tumors have become increasingly prevalent in the past twenty years. Thyroid cancer has four main forms: follicular thyroid carcinoma, papillary thyroid carcinoma, undifferentiated carcinoma, and medullary thyroid carcinoma. Papillary thyroid cancer is the most common kind. One of the most significant genetic indicators for cancer is the BRAF V600E mutation, also known as the V-Raf murine sarcoma viral oncogene homolog B1 (BRAF). BRAF mutations are an A-T point mutation. Many types of malignancies, including thyroid carcinoma, are linked to BRAF gene mutations. Mutations may be causing an inaccurate NIS localization to the cell membrane. The most frequent genetic abnormalities related to thyroid malignancies are KRAS mutations in the RAS genes. The most prevalent oncogenes are members of the RAS family, whose activated RAS protein functions as a molecular stabilizer and is crucial for cell division and proliferation.
The aim of the study was to evaluate the role of BRAF and KRAS mutation in the response of thyroid cancer patient to Radioactive iodine therapy.
Our results indicate that the most prevalent type of thyroid gland cancer is papillary thyroid carcinoma and is more prevalent in women than in men. Our statistical analysis showed a significant decrease in the levels of TSH when comparing pre- and post-treatment levels (p<0.001). And showed a significant increase in the levels of F-T3 and F-T4 in post compared to pre-treatment levels P<0.001 and P=0.004, respectively. Significant increase in the levels of TgAb in post-treatment samples compared to pre-treatment levels P<0.001. While no significant difference in level of TPOAb, P = 0.748.
We investigated the relation between BRAF V600E and KRAS genotypes and pre- and post-treatment of the thyroid function parameters TSH, F-T3, F-T4, TPOAb, and TgAb, there is no statistically significant difference between BRAF V600E genotypes and pre- and post-treatment values of the thyroid function tests.
Our study showed that there is a statistically significant difference at the distribution of number of patients within tumor stage or metastasis (M) with different alleles. Our study investigated that relation between RIA dose requirement and BRAF genotype whereas the highest dose with mutant alleles (AA) compared to (TA) and (TT). We concluded that there is a significant relation between dose requirement and KRAS genotype, where the highest dose with mutant alleles (AA) compared to (GA) and (GG).
We indicated that presence of KRAS and BRAF v600E mutations has significant impact on the treatment of patients with Radioiodine uptake, A high dose of Radioiodine uptake(I-131) is the best choice for good therapeutic effects and adjuvant treatment after surgical treatment to reduce the possibility of tumor recurrence.
from these results we can conclude:
• BRAF V600E and KRAS G13V mutations in thyroid cancer are significantly associated with clinicopathological parameters including metastasis, positive vascular invasion and advanced clinical stage.
• TC patients who tested positive for either one or both of BRAF V600E and KRAS G13V mutations required higher doses of radioactive iodine-131 during the course of treatment.
• BRAF V600E and KRAS G13V mutations’ testing might be promising indicators for predicting patients’ response to RIA therapy.
from these results we can recommend:
• Genotyping of the mutations present may contribute to determine the method of treatment and the use of appropriate doses of RIA therapy for each patient, which may improve the treatment effect of patients.
• Further investigation of the response of patients with partial removal of thyroid gland and longer follow up period will help in determining the association between BRAF/KRAS mutation and clinical outcomes of TC treatment.