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Hu W, Zhuang Y, Tang L, Chen H, Wang H, Wei R, Wang L, Ding Y, Xie X, Ge Y, Wu PY, Song B. Preoperative Cervical Lymph Node Metastasis Prediction in Papillary Thyroid Carcinoma: A Noninvasive Clinical Multimodal Radiomics (CMR) Nomogram Analysis. JOURNAL OF ONCOLOGY 2023; 2023:3270137. [PMID: 36936372 PMCID: PMC10019962 DOI: 10.1155/2023/3270137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/10/2022] [Accepted: 02/11/2023] [Indexed: 03/12/2023]
Abstract
This study aimed to evaluate the feasibility of applying a clinical multimodal radiomics nomogram based on ultrasonography (US) and multiparametric magnetic resonance imaging (MRI) for the prediction of cervical lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC) preoperatively. We performed retrospective evaluations of 133 patients with pathologically confirmed PTC, who were assigned to the training cohort and validation cohort (7 : 3), and extracted radiomics features from the preoperative US, T2-weighted (T2WI),diffusion-weighted (DWI), and contrast-enhanced T1-weighted (CE-T1WI) images. Optimal subsets were selected using minimum redundancy, maximum relevance, and recursive feature elimination in the support vector machine (SVM). For LNM prediction, the radiomics model was constructed by SVM, and Multi-Omics Graph cOnvolutional NETworks (MOGONET) was used for the effective classification of multiradiomics data. Multivariable logistic regression incorporating multiradiomics signatures and clinical risk factors was used to generate a nomogram, whose performance and clinical utility were assessed. Results showed that the nine most predictive features were separately selected from US, T2WI, DWI, and CE-T1WI images, and 18 features were selected in the combined model. The combined radiomics model showed better performance than models based on US, T2WI, DWI, and CE-T1WI. In a comparison of the combined radiomics and MOGONET model, receiver operating curve analysis showed that the area under the curve (AUC) value (95% CI) was 0.84 (0.76-0.93) and 0.84 (0.71-0.96) for the MOGONET model in the training and validation cohorts, respectively. The corresponding values (95% CI) for the combined radiomics model were 0.82 (0.74-0.90) and 0.77 (0.61-0.94), respectively. The MOGONET model had better performance and better prediction specificity compared with the combined radiomics model. The nomogram including the MOGONET signature showed a better predictive value (AUC: 0.81 vs. 0.88) in the training and validation (AUC: 0.74vs. 0.87) cohorts, as compared with the clinical model. Calibration curves showed good agreement in both cohorts. The applicability of the clinical multimodal radiomics (CMR) nomogram in clinical settings was validated by decision curve analysis. In patients with PTC, the CMR nomogram could improve the prediction of cervical LNM preoperatively and may be helpful in clinical decision-making.
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Affiliation(s)
- Wenjuan Hu
- 1Department of Radiology, Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | - Yuzhong Zhuang
- 1Department of Radiology, Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | - Lang Tang
- 2Department of Ultrasonography, Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | - Hongyan Chen
- 2Department of Ultrasonography, Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | - Hao Wang
- 1Department of Radiology, Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | - Ran Wei
- 1Department of Radiology, Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | - Lanyun Wang
- 1Department of Radiology, Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | - Yi Ding
- 1Department of Radiology, Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | - Xiaoli Xie
- 3Department of Pathology, Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | | | | | - Bin Song
- 1Department of Radiology, Minhang Hospital, Fudan University, Minhang District, Shanghai, China
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O’Shea R, Gaffney M, Kaare M, Fenton JE. Laryngopharyngeal reflux induced sleep-related laryngospasm. Ir J Med Sci 2023; 192:335-340. [PMID: 35099721 PMCID: PMC9892074 DOI: 10.1007/s11845-022-02934-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/19/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Sleep-related laryngospasm (SRL) has been defined as the sustained closure of the vocal cords during sleep. Studies have suggested that it is a rare manifestation of laryngopharyngeal reflux (LPR). Difficulties in diagnosing SRL and LPR have led to the condition being under-recognised in the clinical setting. AIMS The aim of this study was to determine if LPR was the cause of the SRL symptoms seen in our patients. METHODS A retrospective chart assessment of patients with SRL. Patients with risk factors for LPR were identified. These included smoking status, alcohol intake, a history of dyspepsia or history of gastroesophageal reflux disease, a history of late-night eating and a history of eating spicy or fatty foods before bed. A clinical diagnosis based on the history and response to management was made for the diagnosis of LPR. All were advised to refrain from late meals and those with signs of nasopharyngitis were commenced on proton pump inhibitor therapy. RESULTS Nineteen patients (mean age ± SD: 57.21 ± 15.18) were included in the study. All had at least one risk factor for LPR. Ten (52.6%) had signs of nasopharyngitis on nasendoscopy. Following treatment, 17 (89.5%) reported no further SRL symptoms at 1-year follow-up. CONCLUSION SRL is a largely unknown and under-diagnosed condition. We believe this study provides supportive evidence for the causal relationship between LPR and SRL.
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Affiliation(s)
- Ross O’Shea
- grid.10049.3c0000 0004 1936 9692Faculty of Education and Health Sciences, University of Limerick Medical School, Garraun, Castletroy Limerick, Ireland
| | - Máire Gaffney
- grid.10049.3c0000 0004 1936 9692Faculty of Education and Health Sciences, University of Limerick Medical School, Garraun, Castletroy Limerick, Ireland
| | - Majura Kaare
- grid.10049.3c0000 0004 1936 9692Department of Otorhinolaryngology Head and Neck Surgery, University Limerick Medical School, Limerick, Ireland
| | - John Eugene Fenton
- grid.10049.3c0000 0004 1936 9692Department of Otorhinolaryngology Head and Neck Surgery, University Limerick Medical School, Limerick, Ireland
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Xie J, Chen P, Wang J, Luo X, Luo J, Xiong X, Li C, Pan L, Wu J, Feng H, Ouyang W. Incorporation size of lymph node metastasis focus and pre-ablation stimulated Tg could more effectively predict clinical outcomes in differentiated thyroid cancer patients without distant metastases. Front Endocrinol (Lausanne) 2023; 14:1094339. [PMID: 37025409 PMCID: PMC10072321 DOI: 10.3389/fendo.2023.1094339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/07/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND The size of lymph node metastasis (LNM) and pre-ablation stimulated Tg (ps-Tg) were key predictors of clinical prognosis in differentiated thyroid cancer (DTC) patients, however, very few studies combine the above two as predictors of clinical prognosis of DTC patients. METHODS Persistent/recurrent disease and clinicopathologic factors were analyzed in 543 DTC patients without distant metastases who underwent LN dissection, near-total/total thyroidectomy, and radioiodine ablation. RESULTS In the multivariate analysis, size of LNM, ps-Tg, and the activity of 131I significantly correlated with long-term remission. The optimal cutoff size of LNM 0.4 cm-1.4 cm (intermediate-risk patients) and >1.4cm (high-risk patients) increased the recurrence risk (hazard ratio [95% CI], 4.674 [2.881-7.583] and 13.653 [8.135-22.913], respectively). Integration of ps-Tg into the reclassification risk stratification showed that ps-Tg ≤ 10.0 ng/mL was relevant to a greatly heightened possibility of long-term remission (92.2%-95.4% in low-risk patients, 67.3%-87.0% in intermediate-risk patients, and 32.3%-57.7% in high-risk patients). CONCLUSION The cutoff of 0.4 cm and 1.4 cm for a definition of size of LNM in DTC patients without distant metastases can reclassify risk assessment, and incorporating ps-Tg could more effectively predict clinical outcomes and modify the postoperative management plan.
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Kang HJ, Noh JK, Lee MK, Woo SR, Park JM, Lee YC, Ko SG, Eun YG. Changes of Pepsin Concentration in Saliva Sample According to Storage Period. J Voice 2022:S0892-1997(22)00411-8. [PMID: 36588013 DOI: 10.1016/j.jvoice.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To determine whether the concentration of pepsin in the saliva sample changes according to the storage period of the sample. METHODS Forty eight patients with suspected laryngopharyngeal reflux were included in this study. Saliva samples were collected from each patient and each sample divided into six and stored for different period of time. Pepsin concentration was measured using enzyme-linked immunosorbent assay. A comparison was made between the pepsin concentration measured immediately and the concentration measured after storage for 1 week, 2 weeks, 1 month, 3 months, and 6 months. RESULTS No significant difference in pepsin concentrations were detected between the sample analyzed immediately and those analyzed at 1 week, 2 weeks, 1 month, and 3 months after saliva collection. A significant difference in pepsin concentration was observed in the sample analyzed immediately and the sample analyzed 6 months after saliva collection. CONCLUSIONS Pepsin concentration in saliva samples did not demonstrate a significant difference between the concentration measured immediately and the concentration measured 3 months after saliva collection, although a significant difference was observed in the concentration measured 6 months after collection.
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Affiliation(s)
- Hee Jin Kang
- Department of Otolaryngology Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Joo Kyung Noh
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Min Kyeong Lee
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Seon Rang Woo
- Department of Otolaryngology Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea; Central Laboratory, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Jung Min Park
- Department of Otolaryngology Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Young Chan Lee
- Department of Otolaryngology Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Young-Gyu Eun
- Department of Otolaryngology Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea; Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
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Liu Z, Zhang C, Wang X, Zhang J, Liu L, Wang J, Zhao J, Zou S, Ma X, Li J. Characteristics of Laryngopharyngeal Reflux in Patients of Different Genders and Ages. J Voice 2022:S0892-1997(22)00387-3. [PMID: 36567235 DOI: 10.1016/j.jvoice.2022.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To investigate the differences in laryngopharyngeal reflux (LPR) characteristics between gender and age groups based on the Reflux Symptom Index (RSI), Reflux Finding Score (RFS) scale and 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH (HEMII-pH) monitoring. METHODS The enrolled were patients with LPR symptoms completed the 24h-HEMII-pH monitoring and divided into two gender groups (male and female) and elderly group (>60 years), middle-aged group (41-60 years) and young group (18-40 years). The total RSI and RFS scores of individuals were counted. Various potential differences as well as incidence of each type of LPR events between gender and age groups were analyzed. RESULTS A total of 420 patients were included, with 333 (79.3%) diagnosed with LPR confirmed by 24h-HEMII-pH monitoring. Females (n=49) had a statistically higher LPR positivity (91.0% vs. 76.6%, P < 0.01) than males (n=342). Female patients with LPR had significantly higher RSI scores (14.08 ± 6.72 vs. 11.08 ± 4.82, P < 0.001) than male patients. The positive rate of LPR were 82.6%, 80.7% and 63.3% in the elderly, middle-aged and young groups. The Elderly group had significantly lower RSI scores (10.20 ± 4.06 vs. 12.80 ± 6.58, 12.24 ± 5.57, P < 0.001) but higher RFS scores (9.37 ± 3.25 vs. 8.16 ± 3.34, 8.57 ± 2.58, P < 0.05) than the other two groups. The number of acid hypopharyngeal-proximal reflux episodes (HREs) and distal esophageal acid reflux were significantly higher in elderly than in young patients. Except for non-acid gas HREs, the positive rates of other types of HREs were increasing from young to middle-aged to the elderly group (P < 0.05). CONCLUSIONS Female patients with suspected LPR symptoms had a higher positive rate of LPR and RSI score than males. The prevalence of LPR and the number of acid reflux were progressively increasing with age, but the perception of reflux symptoms may diminish.
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Affiliation(s)
- Zhi Liu
- Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, P.R.China; Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Chun Zhang
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Xiaoyu Wang
- Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, P.R.China; Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Jinhong Zhang
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Lianlian Liu
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Jiasen Wang
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Jing Zhao
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Shizhen Zou
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Xin Ma
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Jinrang Li
- Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, P.R.China; Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China.
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Kang JW, Lee YC, Ko SG, Eun YG. The key timing of pharyngeal reflux in patients with laryngopharyngeal reflux. Auris Nasus Larynx 2022:S0385-8146(22)00221-8. [DOI: 10.1016/j.anl.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/13/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022]
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Bobin F, Lechien JR. The role of pH-impedance monitoring in swallowing disorders. Curr Opin Otolaryngol Head Neck Surg 2022; 30:406-416. [PMID: 36004789 DOI: 10.1097/moo.0000000000000841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To review the current evidence about the usefulness and the place of pH study in the management of patients with swallowing disorders. RECENT FINDINGS Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) are found in approximately 30% of patients with esophageal or oropharyngeal dysphagia. Patients with suspected GERD may benefit from gastrointestinal endoscopy and proton pump inhibitors according to guidelines. The diagnosis of LPR in patients with oropharyngeal dysphagia is more controversial because there are no gold standard and diagnostic guidelines. The clinical diagnosis based on empirical therapeutic trial is a reasonable first-line strategy, but many dysphagic patients should not respond to treatment. These patients require hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring (HEMII-pH), which is the most effective examination providing important information on GERD and LPR features. At the HEMII-pH, GERD patients often report upright (daytime) and supine (nighttime) liquid acid esophageal events with significant esophageal distal acid exposure time. LPR patients have more frequently upright (daytime) gaseous weakly acid or nonacid pharyngeal reflux events without distal esophageal acid exposure abnormalities in many times. The features of reflux at the HEMII-pH may indicate a personalized treatment for dysphagic patients combining proton pump inhibitors, alginate/magaldrate or gastroprokinetic in cases of esophageal dysmotility. SUMMARY GERD and LPR are prevalent causes of dysphagia. The large number of reflux patients who do not respond to empirical treatment makes important the awareness of otolaryngologists about pH-impedance monitoring indication, features, and interpretation.
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Affiliation(s)
- Francois Bobin
- Polyclinic of Poitiers, Elsan Hospital, Poitiers, France
| | - Jerome R Lechien
- Polyclinic of Poitiers, Elsan Hospital, Poitiers, France
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons
- Department of Otolaryngology-Head and Neck Surgery, EpiCURA Hospital, Baudour, Belgium
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France
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Sahoo A, Jena AK, Panda M. Experimental and clinical trial investigations of phyto-extracts, phyto-chemicals and phyto-formulations against oral lichen planus: A systematic review. JOURNAL OF ETHNOPHARMACOLOGY 2022; 298:115591. [PMID: 35963418 DOI: 10.1016/j.jep.2022.115591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Bio-assay guided phytoextracts and derived phytoconstituents reported having multipotent biological activities and nearly 60-80% of the global population still using natural regimens as an alternative therapeutic source. This study focused on the ethnopharmacological and experimental evidence of natural remedies that are effective in treating oral lichen planus (OLP), a chronic T-cell mediated autoimmune disease that is associated with oral cancer transmission. AIM OF THE REVIEW A number of studies have shown that antioxidants and antiinflammatory phytoextracts and phyto-constituents are effective against OLP. In this systematic review, we summarize the details of experimentally assessed ancient Traditional Chinese Medicine (TCM), Indian Ayurveda or Ayurvedic Medicine, and Japanese Kampo Medicine (JKM) regimens (crude extracts, individual phytochemicals, and phyto-formulations) that reduce oral lesion, severity index and pain associated with OLP based on studies conducted in vivo, in vitro, and in randomized controlled trials (RCTs). MATERIALS AND METHODS Experimental, clinical and RCT investigation reports were gathered and presented according to PRISMA-2020 format. Briefly, the information was obtained from PubMed, ScienceDirect, Wiley journal library, Scopus, Google Scholar with ClinicalTrials.gov (a clinical trial registry database operated by the National Library of Medicine in the United States). Further, individual phytochemical structures were verified from PubChem and ChemSpider databases and visualized by ChemDraw 18.0 software. RESULTS We summarized 11 crude phytoextracts, 7 individual phytochemicals, 9 crude formulations, 8 specific TCM and JKM herbal cocktails, and 6 RCTs/patents corroborated by multiple in vitro, in vivo and enzyme assay methods. Briefly, plants and their family name, used plant parts, reported phytochemicals and their chemical structure, treatment doses, and duration of each experiment were presented more concisely and scientifically. CONCLUSION Documentation of evidence-based natural ethnomedicines or remedies could be useful for promoting them as potential, cost-effective and less toxic alternatives or as complementary to commonly prescribed steroids towards the control of OLP.
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Affiliation(s)
- Alaka Sahoo
- Department of Skin & VD, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, 751003, Odisha, India.
| | - Ajaya K Jena
- Department of Skin & VD, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, 751003, Odisha, India
| | - Maitreyee Panda
- Department of Skin & VD, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, 751003, Odisha, India.
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Lechien JR. Treating and Managing Laryngopharyngeal Reflux Disease in the Over 65s: Evidence to Date. Clin Interv Aging 2022; 17:1625-1633. [PMID: 36411760 PMCID: PMC9675328 DOI: 10.2147/cia.s371992] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose The clinical presentation and therapeutic outcomes of elderly patients may be different from those in younger populations, leading to additional diagnostic and therapeutic difficulties. The present study reviewed the findings on the epidemiology, and clinical, diagnostic, and therapeutic outcomes of elderly patients with laryngopharyngeal reflux (LPR). Methods A PubMed, Cochrane Library, and Scopus literature search was conducted on the epidemiological, clinical, diagnostic, and therapeutic findings of elderly LPR patients. Findings The prevalence of LPR in the elderly population remains unknown. From a clinical standpoint, older LPR patients report overall lower symptom scores and related quality-of-life outcomes at the time of the diagnosis. The required treatment time to obtain symptom relief appears to be longer in older compared with younger patients. Particular attention needs to be paid to prolonged medication use because the elderly population is characterized by polypharmacy and there is a higher risk of proton-pump inhibitor (PPI) interactions and adverse events. The plasma clearance of most PPIs is reduced with age, which must be considered by practitioners in the prescription of antireflux therapy. Conclusion The clinical presentation and treatment efficacy of elderly LPR patients differ from those in younger patients. Practitioners need to carefully consider the risk of drug interactions and adverse events in elderly patients.
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Affiliation(s)
- Jerome R Lechien
- Polyclinic of Poitiers, Elsan Hospital, Poitiers, France
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
- Department of Otolaryngology–Head and Neck Surgery, EpiCURA Hospital, University of Mons, Baudour, Belgium
- Correspondence: Jerome R Lechien, Department of Otolaryngology–Head and Neck Surgery, EpiCURA Hospital, University of Mons, Rue L. Cathy, Mons, Belgium, Tel +32 65 37 35 84, Email
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Damasio MPS, Nascimento CS, Andrade LM, de Oliveira VL, Calzavara-Silva CE. The role of T-cells in head and neck squamous cell carcinoma: From immunity to immunotherapy. Front Oncol 2022; 12:1021609. [PMID: 36338731 PMCID: PMC9632296 DOI: 10.3389/fonc.2022.1021609] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/10/2022] [Indexed: 12/24/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) encompass a group of complex entities of tumours affecting the aerodigestive upper tract. The main risk factors are strongly related to tobacco and alcohol consumption, but also HPV infection is often associated. Surgery, radiotherapy and/or chemotherapy are the standard treatments, though the 5-year overall survival is less than 50%. The advances in genomics, molecular medicine, immunology, and nanotechnology have shed a light on tumour biology which helps clinical researchers to obtain more efficacious and less toxic therapies. Head and neck tumours possess different immune escape mechanisms including diminishing the immune response through modulating immune checkpoints, in addition to the recruitment and differentiation of suppressive immune cells. The insights into the HNSCC biology and its strong interaction with the tumour microenvironment highlights the role of immunomodulating agents. Recently, the knowledge of the immunological features of these tumours has paved the way for the discovery of effective biomarkers that allow a better selection of patients with odds of improving overall survival through immunotherapy. Specially biomarkers regarding immune checkpoint inhibitors antibodies, such as anti-PD-1/PD-L1 and anti-CTLA-4 in combination with standard therapy or as monotherapy. New immunotherapies to treat head and neck cancer carcinomas, such as CAR T cells and nanoparticles have been the center of attention and in this review, we discuss the necessity of finding targets for the T cell in the cancer cells to generate CAR T cells, but also the relevance of evaluating specificity and safety of those therapies.
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Affiliation(s)
- Marcos Paulo S. Damasio
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Camila Sales Nascimento
- Grupo de pesquisa em Imunologia Celular e Molecular, Fundação Oswaldo Cruz, Instituto Rene Rachou, Belo Horizonte, MG, Brazil
| | - Lidia M. Andrade
- Departamento de Genética, Ecologia e Evolução, Departamento de Física, Nanobiomedical Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Vivian L. de Oliveira
- Universidade Federal do ABC, Centro de Ciências Naturais e Humanas, São Paulo, Brazil
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Carlos Eduardo Calzavara-Silva
- Grupo de pesquisa em Imunologia Celular e Molecular, Fundação Oswaldo Cruz, Instituto Rene Rachou, Belo Horizonte, MG, Brazil
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Deng Y, Li X, Jiang W, Tang J. SNRPB promotes cell cycle progression in thyroid carcinoma via inhibiting p53. Open Med (Wars) 2022; 17:1623-1631. [PMID: 36329787 PMCID: PMC9579862 DOI: 10.1515/med-2022-0531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/16/2022] [Accepted: 07/11/2022] [Indexed: 12/12/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) accounts for more than 80% of all thyroid carcinoma cases. Small nuclear ribonucleoprotein polypeptides B and B1 (SNRPB) has been indicated to be carcinogenic in several cancers; however, its function and mechanism in PTC are unclarified. Real time quantitative polymerase chain reaction and western blotting revealed the upregulation of SNRPB and downregulation of tumor protein p53 in PTC tissues compared with the normal tissues. Flow cytometry and western blotting displayed that SNRPB silencing induced cell cycle arrest at G1 phase and suppressed the expression levels of Cyclin family proteins in PTC cells. In vivo experiments suggested that SNRPB silencing inhibited PTC tumor growth in mice. Bioinformatics analysis revealed that the expression of SNRPB and cell cycle-associated genes in thyroid carcinoma tissues is positively correlated. Immunofluorescence staining and co-immunoprecipitation demonstrated that SNRPB directly interacted with p53 and suppressed its expression in PTC cells. In conclusion, SNRPB facilitates cell cycle progression in PTC by inhibiting p53 expression.
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Affiliation(s)
- Yan Deng
- Department of Nuclear Medicine, Wuhan Fifth Hospital, Wuhan, 430050 Hubei, China
| | - Xin Li
- Department of Nuclear Medicine, Wuhan Fifth Hospital, Wuhan, 430050 Hubei, China
| | - Wenlei Jiang
- Department of Emergency, Wuhan Fifth Hospital, Wuhan, 430050 Hubei, China
| | - Jindan Tang
- Department of Nursing, Wuhan Fifth Hospital, No. 122, Xianzheng Street, Hanyang District, Wuhan, 430050 Hubei, China
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Zhang J, Wang X, Wang J, Zhao J, Zhang C, Liu Z, Li J. Optimal Timing of the Salivary Pepsin Test for the Diagnosis of Laryngopharyngeal Reflux. Laryngoscope 2022. [PMID: 36149876 DOI: 10.1002/lary.30408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/13/2022] [Accepted: 08/29/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate the optimal time point for diagnosing laryngopharyngeal reflux (LPR) through combining 24-h hypopharyngeal-esophageal multichannel intraluminal impedance-pH (24-h HEMII-pH) monitoring and the multi-time point salivary pepsin test (MTPSPT). STUDY DESIGN Prospective uncontrolled trial. METHOD Patients with and without LPR symptoms were included as the test group and the control group, respectively. The patients in the test group underwent 24-h HEMII-pH and MTPSPT. The results of 24-h HEMII-pH were used as a diagnostic criterion for LPR, and the diagnostic value of salivary pepsin tests performed at different time points was compared by receiver operating characteristic (ROC) analysis. RESULTS A total of 153 patients were included. Based on 24-h HEMII-pH, the positive rate of LPR in the test group of patients was 84.00%. In the control group, only one person (3.57%) had a positive salivary pepsin test result. The area under the curve (AUC) of the MTPSPT was 0.827. In addition, we separately calculated the AUC of the combined salivary pepsin test at different time points, and found good diagnostic value (AUC = 0.799) when the test was combined with the waking, 1 and 2 h after breakfast and lunch, and 1 h after dinner tests. However, when the number of tests were further increased, the diagnostic value did not improve significantly. CONCLUSION Salivary pepsin testing combined with waking, 1 h and 2 h after breakfast and lunch, and 1 h after dinner has almost the same diagnostic value as MTPSPT, and testing at these time points can be an effective method for diagnosing LPR. LEVEL OF EVIDENCE 3 Laryngoscope, 2022.
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Affiliation(s)
- Jinhong Zhang
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China.,Department of Otolaryngology, School of Medicine, South China University of Technology, Guangzhou, China
| | - Xiaoyu Wang
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China
| | - Jiasen Wang
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China
| | - Jing Zhao
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China
| | - Chun Zhang
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China.,Department of Otolaryngology, School of Medicine, South China University of Technology, Guangzhou, China
| | - Zhi Liu
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China
| | - Jinrang Li
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China.,Department of Otolaryngology, School of Medicine, South China University of Technology, Guangzhou, China
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Ageeli RS, Mossery RA, Othathi RJ, Khawaji EA, Tarshi MM, Khormi GJ, Bingasem SM, Khmees RA, Aburasain NS, Al Ghadeeb M. The Importance of the Thyroid Nodule Location in Determining the Risk of Malignancy: A Retrospective Study. Cureus 2022; 14:e29421. [PMID: 36299930 PMCID: PMC9586744 DOI: 10.7759/cureus.29421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Thyroid nodules are very common. However, the majority of thyroid nodules are benign. Ultrasound is the first-line imaging investigation of choice for thyroid nodules. Certain sonographic features are associated with an increased risk of malignancy. Recent studies suggested that the location of the nodule may be associated with the malignancy risk. Hence, this study aims to investigate this association. Methods After obtaining approval from the ethics committee, we conducted a retrospective study that involved all patients who attended our hospital, and who underwent fine-needle aspiration cytology for the evaluation of suspicious thyroid nodules (TR3-5). Electronic medical records were used to obtain data about the ultrasound and cytology reports. A multivariable binary logistic regression analysis model was conducted to identify the independent factors significantly associated with malignant thyroid nodules. Results The study included 366 patients who underwent fine-needle aspiration cytology for suspicious nodules on thyroid ultrasound. In total, 52 (14.2%) nodules were found to be malignant on cytology. By far, the most common thyroid malignancy was papillary carcinoma. The multivariable analysis model revealed that women were 24% less likely to have malignant thyroid nodules compared with men. After adjusting for the age, gender, and Thyroid Imaging Reporting and Data System (TI-RADS) group, the nodules located within the isthmus were four times more likely to be malignant compared to those located in the right or left lobes. Conclusions The study demonstrates that the isthmus location of thyroid nodules is associated with a higher risk of malignancy. Physicians should have a lower threshold to biopsy such nodules. Further studies are needed to confirm this interesting finding.
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Byeon HK, Jeong GC, Kim B, Lee Y, Park JH, Lee SM. Clinical Utility of Quantitative Parameters of Salivary Gland Scintigraphy for Diagnosing Burning Mouth Syndrome. Diagnostics (Basel) 2022; 12:diagnostics12092256. [PMID: 36140657 PMCID: PMC9497528 DOI: 10.3390/diagnostics12092256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 11/30/2022] Open
Abstract
Burning mouth syndrome (BMS) is a chronic disorder characterized by a burning sensation in the oral cavity, often accompanied by xerostomia, with no relevant clinical or laboratory findings. This study aimed to investigate diagnostic values of quantitative parameters of salivary gland scintigraphy for BMS in patients with xerostomia. A total of 164 patients who underwent salivary gland scintigraphy for the workup of xerostomia were retrospectively reviewed. All patients were classified into patient groups with primary BMS, secondary BMS, and non-specific xerostomia. From salivary gland scintigraphy, 22 quantitative parameters were calculated and their diagnostic values were assessed based on the area under the receiver operating characteristic curve (AUC) values. Among salivary gland scintigraphy parameters, uptake speed in the left submandibular gland showed the highest AUC value (0.647) for detecting BMS and pre-stimulatory oral activity showed the highest AUC value (0.710) for detecting primary BMS. A salivary gland scintigraphy scoring system based on these two parameters further enhanced the diagnostic ability, demonstrating AUC values of 0.731 for BMS and 0.782 for primary BMS. These results suggest a potential diagnostic value of the quantitative parameters of salivary gland scintigraphy for detecting BMS in patients with xerostomia.
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Affiliation(s)
- Hyung Kwon Byeon
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea
| | - Geum Cheol Jeong
- Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Korea
| | - Beomsoo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Korea
| | - Yeongrok Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Korea
| | - Jae Hong Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Korea
- Correspondence: (J.H.P.); (S.M.L.); Tel.: +82-41-570-2265 (J.H.P.); +82-41-570-3540 (S.M.L.)
| | - Sang Mi Lee
- Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Korea
- Correspondence: (J.H.P.); (S.M.L.); Tel.: +82-41-570-2265 (J.H.P.); +82-41-570-3540 (S.M.L.)
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Jeon SY, Park JM, Lee YC, Ko SG, Eun YG. Differences in Diagnostic Rates After Hypopharyngeal-esophageal Impedance-pH Monitoring of Laryngopharyngeal Reflux Patients by Age and Sex. J Voice 2022:S0892-1997(22)00215-6. [PMID: 36085096 DOI: 10.1016/j.jvoice.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To evaluate the differences in diagnostic rates according to the age and sex of patients with suspected laryngopharyngeal reflux (LPR) symptoms and completed the 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH (24h-HEMII-pH) monitoring. METHODS Patients with LPR symptoms underwent the 24h-HEMII-pH monitoring. We compared the diagnostic rates of LPR in patients with LPR symptoms according to age and sex. The number of reflux episodes and type of reflux were compared among patients who were confirmed to have LPR according to age and sex. RESULTS A total of 249 patients with suspected LPR symptoms who completed 24h-HEMII-pH monitoring were analyzed. A total of 170 patients (68.3%) were diagnosed with LPR after 24h-HEMII-pH monitoring. There were 57 (67.1%) men and 113 (68.9%) women. The old age group (older than 55 years) showed a statistically significant higher diagnostic rate than the young age group (73.5%, 60.8%, p=0.034). Women's diagnostic rate was statistically higher in the old age group than that in the young age group (75% vs. 58.3%, p=0.026). There were no specific differences in the number of refluxes in the diagnosed patients between the age groups, and there were no differences in the initial reflux symptom index. CONCLUSIONS Among those who visited the clinic with suspected LPR symptoms and performed 24h-HEMII-pH monitoring, the diagnostic rate of LPR was higher in the older age group than that in the younger age group.
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Affiliation(s)
- So Young Jeon
- Department of Otolaryngology-Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Jung Min Park
- Department of Otolaryngology-Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Young Chan Lee
- Department of Otolaryngology-Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Young-Gyu Eun
- Department of Otolaryngology-Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea.
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Weitzman RE, Justicz NS, Kamani D, Kyriazidis N, Chen MH, Randolph GW. How Many Nodes to Take? Lymph Node Ratio Below 1/3 Reduces Papillary Thyroid Cancer Nodal Recurrence. Laryngoscope 2022; 132:1883-1887. [PMID: 35229306 DOI: 10.1002/lary.30084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 02/02/2022] [Accepted: 02/17/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Papillary thyroid carcinoma (PTC) accounts for the majority of thyroid malignancies; risk of PTC recurrence over a 30-year period is approximately 30%, of which 70% occur as nodal metastases. Patients with nodal disease who are treated with therapeutic dissection are at higher risk for recurrence, but optimal nodal yield has not been defined. We aim to determine variables predictive of nodal recurrence of PTC within the first 5 years of surgery, with a focus on lymph node ratio (LNR), to inform clinical decision-making. METHODS Retrospective chart review identified 41 patients with nodal recurrence of PTC and 284 without nodal recurrence following thyroid surgery from 2000 to 2015. Cohorts were compared with regards to clinical history, surgical findings, and tumor characteristics. RESULTS The fraction of the patients who underwent therapeutic central or lateral lymph node dissection was significantly higher in the nodal recurrence cohort. Maximum tumor size, presence of extrathyroidal extension, largest lymph node focus, LNR, postoperative thyroglobulin level, and administration of postoperative radioactive iodine were significantly increased in the PTC nodal recurrence group. LNR greater than 0.3 held the highest level of significance as a binary cutoff and captured the larger proportion of patients in the nodal recurrence cohort (68.3%). CONCLUSION This study demonstrates characteristics to help assess risk of nodal recurrence of PTC and suggests LNR of lower than 0.3 is optimal to reduce risk of recurrence. The next steps include cohort studies to validate findings and weight variable analysis to optimize the extent of surgical therapeutic dissection. LEVEL OF EVIDENCE 4 Laryngoscope, 132:1883-1887, 2022.
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Affiliation(s)
- Rachel E Weitzman
- Department of Otolaryngology - Head & Neck Surgery, Thyroid and Parathyroid Endocrine Surgical Division, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Natalie S Justicz
- Department of Otolaryngology - Head & Neck Surgery, Thyroid and Parathyroid Endocrine Surgical Division, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Dipti Kamani
- Department of Otolaryngology - Head & Neck Surgery, Thyroid and Parathyroid Endocrine Surgical Division, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Natalia Kyriazidis
- Department of Otolaryngology - Head & Neck Surgery, Thyroid and Parathyroid Endocrine Surgical Division, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Ming-Hsu Chen
- Department of Otolaryngology - Head & Neck Surgery, Thyroid and Parathyroid Endocrine Surgical Division, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Gregory W Randolph
- Department of Otolaryngology - Head & Neck Surgery, Thyroid and Parathyroid Endocrine Surgical Division, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
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Yang J, Zhao C, Niu X, Wu S, Li X, Li P, Ning C. Predictive value of Ultrasonic features and microscopic extrathyroidal extension in the recurrence of PTC. Eur J Radiol 2022; 157:110518. [DOI: 10.1016/j.ejrad.2022.110518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/09/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022]
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The diverse functions of FAT1 in cancer progression: good, bad, or ugly? J Exp Clin Cancer Res 2022; 41:248. [PMID: 35965328 PMCID: PMC9377080 DOI: 10.1186/s13046-022-02461-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022] Open
Abstract
FAT atypical cadherin 1 (FAT1) is among the most frequently mutated genes in many types of cancer. Its highest mutation rate is found in head and neck squamous cell carcinoma (HNSCC), in which FAT1 is the second most frequently mutated gene. Thus, FAT1 has great potential to serve as a target or prognostic biomarker in cancer treatment. FAT1 encodes a member of the cadherin-like protein family. Under normal physiological conditions, FAT1 serves as a molecular "brake" on mitochondrial respiration and acts as a receptor for a signaling pathway regulating cell-cell contact interaction and planar cell polarity. In many cancers, loss of FAT1 function promotes epithelial-mesenchymal transition (EMT) and the formation of cancer initiation/stem-like cells. However, in some types of cancer, overexpression of FAT1 leads to EMT. The roles of FAT1 in cancer progression, which seems to be cancer-type specific, have not been clarified. To further study the function of FAT1 in cancers, this review summarizes recent relevant literature regarding this protein. In addition to phenotypic alterations due to FAT1 mutations, several signaling pathways and tumor immune systems known or proposed to be regulated by this protein are presented. The potential impact of detecting or targeting FAT1 mutations on cancer treatment is also prospectively discussed.
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Zhang JW, Fei MJ, Hou YQ, Tang ZY, Zhan WW, Zhou JQ. Long-term follow-up ultrasonography surveillance in a large cohort of patients with papillary thyroid carcinoma. Endocrine 2022; 77:297-304. [PMID: 35588346 DOI: 10.1007/s12020-022-03071-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/03/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to investigate the predictive factors as well as the time and age course of recurrence/persistence in a large cohort of postoperative patients with papillary thyroid carcinoma (PTC) based on the long-term ultrasonography (US) follow-up data. METHODS Between January 2007 and December 2016, 3106 patients underwent surgery for PTC and at least two postoperative US follow-up examination over more than three years. Tumor recurrence/persistence was confirmed based on the follow-up US data and histopathological results. Univariate and multivariate analyses were performed to evaluate the predictive factors of tumor recurrence/persistence. Kaplan-Meier survival analysis was used to evaluate the recurrence-/persistence-free survival curve based on the US results. RESULTS A total of 321(10.3%) patients developed tumor recurrence/persistence during 54.3 months of mean follow-up (range 36-135 months), including 268(83.5%) cases of lymph node recurrence/persistence, 37 (11.5%) cases of non-lymph node recurrence/persistence, and 16(5%) cases of both types. Recurrence/persistence was observed using US examination at a mean interval of 23.6 ± 21.6 months (range 1-135 months) after surgery and peak incidence was observed 1-2 years after initial treatment. Younger (20-30 years old) and older (70-80 years old) patients had a higher proportion of tumor recurrence/persistence. Multifocality, advanced T and advanced N stages were independent risk factors of tumor recurrence/persistence. CONCLUSION Tumor recurrence/persistence of PTC usually occurs during the early postoperative period. For patients with multifocal cancer, advanced T and N stage, the US surveillance examination should be cautiously performed, especially in younger and older patients.
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Affiliation(s)
- Jing-Wen Zhang
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Meng-Jia Fei
- Department of Head and Neck Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200001, China
| | - Yi-Qing Hou
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Zhen-Yun Tang
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Wei-Wei Zhan
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Jian-Qiao Zhou
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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Ujvary LP, Chirilă M, Țiple C, Maniu AA, Pop SS, Blebea CM, Vesa S, Cosgarea M. The Effect of Platelet-Rich Plasma Injection on Short Term Vocal Outcomes Following Phonosurgery-A Pilot Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58080988. [PMID: 35893104 PMCID: PMC9331366 DOI: 10.3390/medicina58080988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: The efficiency and optimal voice rest period following phonosurgery remains debatable. Platelet-rich plasma (PRP) is a safe and cheap alternative to many bioactive agents being studied on animal models, and is already in use in many medical areas. We investigate the short-term effects of PRP and voice rest on voice outcomes following phonosurgery as an alternative to voice rest alone. Materials and Methods: A prospective single-blinded pilot study was conducted. Sixteen patients with a diagnosis of vocal fold cyst and polyps were included, forming equal groups (PRP and voice rest vs. voice rest alone). Voice analysis was carried out on the preoperative day, day three, and week three following surgery. The measured parameters were fundamental frequency (F0), noise–signal ratio (NSR), harmonic poverty (HP), attack alteration (AL), pitch instability (PI), and amplitude instability (AI).VHI(Voice Handicap Index)-30 questionnaires were carried out before surgery and three weeks following surgery to assess the impact of subjective voice change on quality of life. PRP was obtained using commercial kits with separator gel. Results: An average 3.68-fold increase in platelets was obtained with PRP. No side effects were noted after injection. All voice parameters improved on day three and week three following surgery. Statistical significance was noted only in the fundamental frequency of male patients (p = 0.048) in favor of the PRP-voice rest group. In addition, the VHI- 30 questionnaire results between preoperative and postoperative assessments showed statistically significant differences in total VHI score (p = 0.02) as well as the physical (p = 0.05) and emotional (p = 0.02) scale in favor of the PRP-voice rest group. Conclusions: PRP presents short term safety in patients who undergo phonosurgery, although long-term outcomes are unknown. PRP and voice rest are superior to voice rest alone when considering subjective assessment of the voice. When analyzing acoustic parameters, PRP and voice rest are not superior to voice rest alone.
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Affiliation(s)
- Laszlo Peter Ujvary
- Department of Otolaryngology, “Iuliu Hatieganu” University of medicine and Pharmacy, Cluj, 400349 Cluj-Napoca, Romania; (L.P.U.); (C.Ț.); (A.A.M.); (S.S.P.); (C.M.B.); (M.C.)
| | - Magdalena Chirilă
- Department of Otolaryngology, “Iuliu Hatieganu” University of medicine and Pharmacy, Cluj, 400349 Cluj-Napoca, Romania; (L.P.U.); (C.Ț.); (A.A.M.); (S.S.P.); (C.M.B.); (M.C.)
- Cluj County Emergency Hospital, Cluj, 400006 Cluj-Napoca, Romania
- Correspondence: ; Tel.: +40-756-917-456
| | - Cristina Țiple
- Department of Otolaryngology, “Iuliu Hatieganu” University of medicine and Pharmacy, Cluj, 400349 Cluj-Napoca, Romania; (L.P.U.); (C.Ț.); (A.A.M.); (S.S.P.); (C.M.B.); (M.C.)
- Cluj County Emergency Hospital, Cluj, 400006 Cluj-Napoca, Romania
| | - Alma Aurelia Maniu
- Department of Otolaryngology, “Iuliu Hatieganu” University of medicine and Pharmacy, Cluj, 400349 Cluj-Napoca, Romania; (L.P.U.); (C.Ț.); (A.A.M.); (S.S.P.); (C.M.B.); (M.C.)
- Cluj County Emergency Hospital, Cluj, 400006 Cluj-Napoca, Romania
| | - Septimiu Sever Pop
- Department of Otolaryngology, “Iuliu Hatieganu” University of medicine and Pharmacy, Cluj, 400349 Cluj-Napoca, Romania; (L.P.U.); (C.Ț.); (A.A.M.); (S.S.P.); (C.M.B.); (M.C.)
- Cluj County Emergency Hospital, Cluj, 400006 Cluj-Napoca, Romania
| | - Cristina Maria Blebea
- Department of Otolaryngology, “Iuliu Hatieganu” University of medicine and Pharmacy, Cluj, 400349 Cluj-Napoca, Romania; (L.P.U.); (C.Ț.); (A.A.M.); (S.S.P.); (C.M.B.); (M.C.)
| | - Stefan Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania;
| | - Marcel Cosgarea
- Department of Otolaryngology, “Iuliu Hatieganu” University of medicine and Pharmacy, Cluj, 400349 Cluj-Napoca, Romania; (L.P.U.); (C.Ț.); (A.A.M.); (S.S.P.); (C.M.B.); (M.C.)
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Meta-analysis of Proton Pump Inhibitors in the Treatment of Pharyngeal Reflux Disease. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9105814. [PMID: 35912160 PMCID: PMC9334091 DOI: 10.1155/2022/9105814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 01/26/2023]
Abstract
The present study aimed to examine the safety and healing effects of proton pump inhibitors (PPIs) in people with laryngopharyngeal reflux disease (LPRD). To find all relevant studies published before April 1, 2022, we searched the PubMed, Embase, Web of Science, Clinical Trials, Cochrane Library, CNKI, and Wanfang databases. For SLE, we looked for all randomized controlled clinical trials related to PPIs versus placebo-controlled treatment of LPRD. Overall efficiency, reflux symptom index (RSI), reflux finding score (RFS), improvement in cough and hoarseness, and adverse reactions were compared using the Review Manager 5.3. Using the reflux symptom index (RSI) as an outcome indicator for efficacy assessment, the PPI group showed significant improvement compared with the placebo group [MD = 3.35, 95% CI (1.34, 5.37, P < 0.05)]. In terms of overall efficacy, the PPI group showed effectiveness, but its efficacy was not statistically significantly dissimilar from that of the placebo group [OR = 1.62, 95% CI (0.89, 2.95), P > 0.05].
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Perina V, Szaraz D, Harazim H, Urik M, Klabusayova E. Paediatric Deep Neck Infection—The Risk of Needing Intensive Care. CHILDREN 2022; 9:children9070979. [PMID: 35883963 PMCID: PMC9315740 DOI: 10.3390/children9070979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/19/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022]
Abstract
Deep neck infections are potentially dangerous complications of upper respiratory tract or odontogenic infections. The pathophysiology, clinical presentation, and potential spreading depend on the complex anatomy of the neck fascia. These infections can lead to severe pathological conditions, such as mediastinitis, sepsis, and especially airway impairment with difficult management. Because of the risk of life-threatening emergency situations and the possible impacts on the overall health status of affected children, their early recognition is of utmost importance. Torticollis, drooling, and stridor are the most common signs of advancing disease. Children presenting with these symptoms should be admitted to the paediatric intensive care unit for vital function monitoring, where the airway could be readily secured if function is compromised.
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Affiliation(s)
- Vojtech Perina
- Department of Oral and Maxillofacial Surgery, University Hospital Brno, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic; (V.P.); (D.S.)
| | - David Szaraz
- Department of Oral and Maxillofacial Surgery, University Hospital Brno, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic; (V.P.); (D.S.)
| | - Hana Harazim
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic;
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Milan Urik
- Department of Paediatric Otorhinolaryngology, University Hospital Brno, Faculty of Medicine, Masaryk University, Cernopolni 9, 662 63 Brno, Czech Republic;
| | - Eva Klabusayova
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic;
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
- Correspondence: ; Tel.: +420-532-234-693
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Zhan L, Feng HF, Yu XZ, Li LR, Song JL, Tu Y, Yuan JP, Chen C, Sun SR. Clinical and prognosis value of the number of metastatic lymph nodes in patients with papillary thyroid carcinoma. BMC Surg 2022; 22:235. [PMID: 35725426 PMCID: PMC9210823 DOI: 10.1186/s12893-022-01635-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/05/2022] [Indexed: 12/04/2022] Open
Abstract
Objective It has been reported that papillary thyroid carcinoma (PTC) patients with lymph node metastasis (LNM) are largely associated with adverse outcomes. The present study aimed to assess the correlation between the number of metastatic lymph nodes (NMLNs) and clinical prognosis in patients with PTC. Methods We retrospectively reviewed the medical records of patients with PTC who underwent initial thyroid cancer surgery in Renmin Hospital of Wuhan University between 2017 and 2019. A total of 694 patients with PTC and cervical lymph node dissection as well as a total checked number of lymph nodes ≥ 5 were involved in this study. The clinicopathological characteristics of patients were compared according to NMLNs, the number of central cervical lymph nodes (CLNs) and the number of lateral lymph nodes (LLNs). Results NMLNs > 5, CLNs > 5 and LLNs > 5 were 222 (32.0%), 159 (24.3%) and 70 (10.1%) seen in the analyzed samples, respectively. Young patients, patients with larger tumor diameter, bilaterality, multifocality and gross extrathyroidal extension (ETE) were more inclined to NMLNs > 5, CLNs > 5 and LLNs > 5 (P < 0.05). It was found that the recurrence-free survival among pN1 patients was significantly discrepant between different groups (NMLNs ≤ 5/5: P = 0.001; LLNs ≤ 5/5: P < 0.001). In multivariate logistic regression analysis, patients aged < 55 years (OR = 1.917), primary tumor size > 10 mm (OR = 2.131), bilaterality (OR = 1.889) and tumor gross ETE (OR = 2.759) were independent predictors for high prevalence of total NMLNs > 5 (P < 0.05). Specially, patients aged < 55 years (OR = 2.864), primary tumor size > 10 mm (OR = 2.006), and tumor gross ETE (OR = 2.520) were independent predictors for high prevalence of CLNs > 5 (P < 0.01); Bilaterality (OR = 2.119), CLNs > 5 (OR = 6.733) and tumor gross ETE (OR = 4.737) were independent predictors for high prevalence of LLNs > 5 (P < 0.05). Conclusions In conclusion, it is evident that NMLNs is related to the invasive clinicopathological features and adverse outcome of patients with PTC which should be correctly evaluated to provide an appropriate guidance for reasonable treatment and careful follow-up.
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Affiliation(s)
- Ling Zhan
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, 17th Tiyu Street, Wuhan, Hubei, 430060, The People's Republic of China.,Department of Anesthesiology, East Hospital, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, The People's Republic of China
| | - Hong-Fang Feng
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, 17th Tiyu Street, Wuhan, Hubei, 430060, The People's Republic of China.,Department of Breast Surgery, Thyroid Surgery, Huangshi Central Hospital of Edong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi, 435000, Hubei, The People's Republic of China
| | - Xi-Zi Yu
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, 17th Tiyu Street, Wuhan, Hubei, 430060, The People's Republic of China
| | - Ling-Rui Li
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, 17th Tiyu Street, Wuhan, Hubei, 430060, The People's Republic of China
| | - Jun-Long Song
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, 17th Tiyu Street, Wuhan, Hubei, 430060, The People's Republic of China
| | - Yi Tu
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, 17th Tiyu Street, Wuhan, Hubei, 430060, The People's Republic of China
| | - Jing-Ping Yuan
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, The People's Republic of China
| | - Chuang Chen
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, 17th Tiyu Street, Wuhan, Hubei, 430060, The People's Republic of China
| | - Sheng-Rong Sun
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, 17th Tiyu Street, Wuhan, Hubei, 430060, The People's Republic of China.
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Lechien JR. Clinical Update Findings about pH-Impedance Monitoring Features in Laryngopharyngeal Reflux Patients. J Clin Med 2022; 11:3158. [PMID: 35683545 PMCID: PMC9181144 DOI: 10.3390/jcm11113158] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 02/01/2023] Open
Abstract
Purpose: The diagnosis of laryngopharyngeal reflux (LPR) is commonly based on non-specific symptoms and findings and a positive response to an empirical therapeutic trial. The therapeutic response is, however, unpredictable, and many patients need pH-impedance monitoring to confirm the diagnosis. Methods: A review of the recent literature was conducted in PubMED, Scopus, and Embase about the pH-study features of LPR patients. A summary of last evidence was proposed. Results: The awareness of otolaryngologists about indications and interpretation of pH-impedance monitoring is low. The hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring (HEMII-pH) is the most reliable examination determining the type and composition of hypopharyngeal reflux events (HRE) and the LPR features. The use of HEMII-pH is important to confirm the diagnosis in selected patients because non-specificity of symptoms and findings. There are no international consensus guidelines for the LPR diagnosis at the HEMII-pH. However, most studies supported the occurrence of >1 acid/weakly acid/nonacid HRE as diagnostic threshold. HREs are more frequently gaseous, weakly/nonacid compared with reflux events of gastroesophageal reflux. HREs occurred as daytime and upright, which does not support the value of double proton pump inhibitors or bedtime alginate. Oropharyngeal pH-monitoring is another approach reporting different sensitivity and specificity outcomes from HEMII-pH. The use of Ryan score for the LPR diagnosis at the oropharyngeal pH monitoring may be controversial regarding the low consideration of alkaline HREs. Conclusions: The awareness of otolaryngologists about HEMII-pH indication, features, and interpretation is an important issue regarding the high prevalence of LPR in outpatients consulting in otolaryngology. The HEMII-pH findings may indicate a more personalized treatment considering type and occurrence time of HREs.
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Affiliation(s)
- Jerome R. Lechien
- Polyclinic of Poitiers, Elsan Hospital, 86000 Poitiers, France;
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium
- Department of Otolaryngology-Head and Neck Surgery, EpiCURA Hospital, 7301 Baudour, Belgium
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Paris Saclay University, 92150 Paris, France
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75
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Kang JW, Park JM, Lee YC, Eun YG. Reply to: letter to the editor regarding "The association between laryngopharyngeal reflux and insomnia". Eur Arch Otorhinolaryngol 2022; 279:3751-3752. [PMID: 35501404 DOI: 10.1007/s00405-022-07405-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Jeong Wook Kang
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Korea
| | - Jung Min Park
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Korea
| | - Young Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Korea
| | - Young-Gyu Eun
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Korea.
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Zhou J, Li DX, Gao H, Su XL. Relationship between subgroups of central and lateral lymph node metastasis in clinically node-negative papillary thyroid carcinoma. World J Clin Cases 2022; 10:3709-3719. [PMID: 35647144 PMCID: PMC9100740 DOI: 10.12998/wjcc.v10.i12.3709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/08/2021] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Lymph node metastasis (LNM) of papillary thyroid carcinoma (PTC) has a certain regularity and occurs first to the central lymph node and then to the lateral lymph node. The pathway of PTC LNM can guide surgical prophylactic lymph node dissection (LND) for clinical surgeons.
AIM To investigate the relationship between subgroups of central LNM and lateral LNM in unilateral clinically node-negative PTC (cN0-PTC).
METHODS Data were collected for 1089 PTC patients who underwent surgical treatment at the Department of Endocrine and Breast Surgery of the First Hospital of Chongqing Medical University from January 2016 to December 2017. A total of 388 unilateral cN0-PTC patients met the inclusion criteria and were enrolled in this study. The clinical and pathological data for these 388 patients who underwent total thyroidectomy + central LND + lateral LND were retrospectively analyzed. The relationship between the central LNM and lateral LNM subgroups was investigated.
RESULTS The coincidence rate of cN0-PTC was only 30.0%.Optimal scaling regression analysis showed that sex (57.1% vs 42.9%, P = 0.026), primary tumor size (68.8% vs 31.2%, P = 0.008), tumor location (59.7% vs 40.3%, P = 0.007), extrathyroid extension (ETE) (50.6% vs 49.9%, P = 0.046), and prelaryngeal LNM (57.1% vs 42.9%, P = 0.004) were significantly associated with ipsilateral level-II LNM. Their importance levels were 0.122, 0.213, 0.172, 0.110, and 0.227, respectively. Primary tumor size (74.6% vs 30.2%, P = 0.016), pretracheal LNM (67.5% vs 32.5%, P < 0.001), and paratracheal LNM (71.4% vs 28.6%, P < 0.001) were significantly associated with ipsilateral level-III LNM. Their importance levels were 0.120, 0.408, and 0.351, respectively. Primary tumor size (72.1% vs 27.9%, P = 0.003), ETE (70.4% vs 29.6%, P = 0.016), pretracheal LNM (68.3% vs 31.7%, P=0.001), and paratracheal LNM (80.8% vs 19.2%, P < 0.001) were significantly associated with ipsilateral level-IV LNM. Their importance levels were 0.164, 0.146, 0.216, and 0.472, respectively.
CONCLUSION The LNM pathway of thyroid cancer has a certain regularity. For unilateral cN0-PTC patients with a tumor diameter > 2 cm and pretracheal or ipsilateral paratracheal LNM, LND at ipsilateral level III and level IV must be considered. When there is a tumor in the upper third of the thyroid with prelaryngeal LNM, LND at level II, level III and level IV must be considered.
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Affiliation(s)
- Jing Zhou
- Department of Thyroid and Breast Surgery, Chongqing Health Center for Women and Children, Chongqing 401120, China
| | - Da-Xue Li
- Department of Thyroid and Breast Surgery, Chongqing Health Center for Women and Children, Chongqing 401120, China
| | - Han Gao
- Department of Thyroid and Breast Surgery, Chongqing Health Center for Women and Children, Chongqing 401120, China
| | - Xin-Liang Su
- Department of Thyroid and Breast Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Mootz M, Jakwerth CA, Schmidt‐Weber CB, Zissler UM. Secretoglobins in the big picture of immunoregulation in airway diseases. Allergy 2022; 77:767-777. [PMID: 34343347 DOI: 10.1111/all.15033] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/31/2021] [Indexed: 12/15/2022]
Abstract
The proteins of the secretoglobin (SCGB) family are expressed by secretory tissues of barrier organs. They are embedded in immunoregulatory and anti-inflammatory processes of airway diseases. This review particularly illustrates the immune regulation of SCGBs by cytokines and their implication in the pathophysiology of airway diseases. The biology of SCGBs is a complex topic of increasing importance, as they are highly abundant in the respiratory tract and can also be detected in malignant tissues and as elements of immune control. In addition, SCGBs react to cytokines, they are embedded in Th1 and Th2 immune responses, and they are expressed in a manner dependent on cell maturation. The big picture of the SCGB family identifies these factors as critical elements of innate immune control at the epithelial barriers and highlights their potential for diagnostic assessment of epithelial activity. Some members of the SCGB family have so far only been superficially examined, but have high potential for translational research.
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Affiliation(s)
- Martine Mootz
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Center MunichGerman Research Center for Environmental Health (HMGU) Munich Germany
- Member of the German Center of Lung Research (DZL)CPC‐M Munich Germany
- Technical University of Munich (TUM)TUM School of MedicineKlinikum Rechts der Isar Munich Germany
| | - Constanze A. Jakwerth
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Center MunichGerman Research Center for Environmental Health (HMGU) Munich Germany
- Member of the German Center of Lung Research (DZL)CPC‐M Munich Germany
| | - Carsten B. Schmidt‐Weber
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Center MunichGerman Research Center for Environmental Health (HMGU) Munich Germany
- Member of the German Center of Lung Research (DZL)CPC‐M Munich Germany
| | - Ulrich M. Zissler
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Center MunichGerman Research Center for Environmental Health (HMGU) Munich Germany
- Member of the German Center of Lung Research (DZL)CPC‐M Munich Germany
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78
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Goo ZQ, Muthusamy KA. Early versus standard tracheostomy in ventilated patients in neurosurgical intensive care unit: A randomized controlled trial. J Clin Neurosci 2022; 98:162-167. [PMID: 35182846 DOI: 10.1016/j.jocn.2022.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 02/05/2022] [Accepted: 02/09/2022] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Tracheostomy is performed in patients with prolonged mechanical ventilation, who suffered catastrophic neurologic insult or upper airway obstruction. Thus far, there is no consensus on the optimal timing in performing a tracheostomy. This study aims to test whether early tracheostomy in mechanically ventilated patients in a neurosurgical setting would be associated with a shorter time of mechanical ventilation as compared to standard tracheostomy. METHODS This single-center prospective randomized controlled trial was conducted at University Malaya Medical Centre from July 2019 to July 2021. The likelihood of prolonged ventilation was determined objectively using the TRACH score and the patient's clinical presentation. The outcomes measured were days of mechanical ventilation post-tracheostomy, days of neuro-intensive care unit stay, and days of hospital stay. Tracheostomy-related complications were collected. The data collected were analyzed using Statistical Package for the Social Sciences version 25 for Windows (SPSS Inc., Chicago, IL, USA). RESULTS In all, 39 patients were randomly assigned. Of these, 20 were allocated to the early tracheostomy group (ET) and 19 were allocated to the standard tracheostomy group (ST). The demographic characteristics were similar between the groups. The primary outcome, mean (SD) days of mechanical ventilation post-tracheostomy, was statistically different in the 2 groups- early 11.9 (9.3) days, standard 18.9 (32.5) days; p = 0.014. There were comparable tracheostomy-related complications in both groups. CONCLUSION Early tracheostomy is associated with a shorter duration of mechanical ventilation in a neurosurgical intensive care unit setting.
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Affiliation(s)
- Zhen Qiang Goo
- Division of General Surgery, Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
| | - Kalai Arasu Muthusamy
- Division of Neurosurgery, Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
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79
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The association between laryngopharyngeal reflux and insomnia. Eur Arch Otorhinolaryngol 2022; 279:3535-3541. [PMID: 35129631 DOI: 10.1007/s00405-022-07280-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/19/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate the prevalence of insomnia in patients with laryngopharyngeal reflux (LPR) and to analyze the relationship between the severity of insomnia and LPR-related symptoms. METHODS We analyzed 69 patients with LPR and 61 healthy controls. The LPR was confirmed via the 24-h hypopharyngeal-esophageal multichannel intraluminal impedance pH monitoring. Reflux symptoms and sleep disturbances were assessed using the Reflux Symptom Index and Insomnia Severity Index. We compared the prevalence of insomnia between the two groups. We analyzed the relationship between reflux symptoms and severity of insomnia. RESULTS The prevalence of insomnia was significantly higher in patients with LPR than in healthy controls (46.3% vs. 29.5%; p = 0.049). The severity of reflux-related symptoms was correlated with insomnia severity (rho = 0.44; p < 0.001). Patients with LPR with nighttime reflux were more likely to have sleep disturbances than patients with LPR without nighttime reflux. CONCLUSION Patients with LPR are more likely to experience insomnia than healthy controls, and the severity of reflux symptoms was related to the severity of insomnia.
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80
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Zhao Y, Shi W, Dong F, Wang X, Lu C, Liu C. Risk prediction for central lymph node metastasis in isolated isthmic papillary thyroid carcinoma by nomogram: A retrospective study from 2010 to 2021. Front Endocrinol (Lausanne) 2022; 13:1098204. [PMID: 36733797 PMCID: PMC9886574 DOI: 10.3389/fendo.2022.1098204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/12/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Isthmic papillary thyroid carcinoma (IPTC) is an aggressive thyroid cancer associated with a poor prognosis. Guidelines elaborating on the extent of surgery for IPTC are yet to be developed. This study aims to construct and validate a model to predict central lymph node metastasis (CLNM) in patients with IPTC, which could be used as a risk stratification tool to determine the best surgical approach for patients. METHODS Electronic medical records for patients diagnosed with isolated papillary thyroid carcinoma who underwent surgery at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2010 to December 2021 were reviewed. All patients who underwent thyroidectomy with central neck dissection (CND) for isolated IPTC were included. We conducted univariate and multivariate logistic regression analyses to assess risk factors for ipsilateral and contralateral CLNM and the number of CLNM in IPTC patients. Based on the analysis, the nomogram construction and internal validations were performed. RESULTS A total of 147 patients with isolated IPTC were included. The occurrence of CLNM was 53.7% in the patients. We identified three predictors of ipsilateral CLNM, including age, gender, and size. For contralateral CLNM, three identified predictors were age, gender, and capsular invasion. Predictors for the number of CLNM included age, gender, capsular invasion, tumor size, and chronic lymphocytic thyroiditis (CLT). The concordance index(C-index) of the models predicting ipsilateral CLNM, contralateral CLNM, 1-4 CLNM, and ≥5 CLNM was 0.779 (95%CI, 0.704, to 0.854), 0.779 (95%CI, 0.703 to 0.855), 0.724 (95%CI, 0.629 to 0.818), and 0.932 (95%CI, 0.884 to 0.980), respectively. The corresponding indices for the internal validation were 0.756 (95%CI, 0.753 to 0.758), 0.753 (95%CI, 0.750 to 0.756), 0.706 (95%CI, 0.702 to 0.708), and 0.920 (95%CI, 0.918 to 0.922). Receiver operating characteristic (ROC) curves, calibration, and decision curve analysis (DCA) results confirmed that the three nomograms could precisely predict CLNM in patients with isolated IPTC. CONCLUSION We constructed predictive nomograms for CLNM in IPTC patients. A risk stratification scheme and corresponding surgical treatment recommendations were provided accordingly. Our predictive models can be used as a risk stratification tool to help clinicians make individualized surgical plans for their patients.
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Affiliation(s)
- Yu Zhao
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Shi
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Dong
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiuhua Wang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chong Lu
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Chunping Liu, ; Chong Lu,
| | - Chunping Liu
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Chunping Liu, ; Chong Lu,
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81
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Singh R, Shekhar S, De R, Singh R, Akhileshwar, Kumar N. Early versus late tracheostomy in patients with acute brain injury: Importance of SET score. Anesth Essays Res 2022; 16:7-11. [PMID: 36249128 PMCID: PMC9558650 DOI: 10.4103/aer.aer_22_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/08/2022] [Accepted: 03/02/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction: Patients with acute brain injury presents are unique subset of neurocritical care patients with its long-term functional prognosis difficult to determine. They often have long intensive care unit (ICU) stay and presents as challenge to decide when to transfer out of ICU. This prospective study aims to assess the benefits of early tracheostomy in terms of ICU-length of stay (ICU-LOS), number of days on ventilator (ventilator days), incidence of ventilator-associated pneumonia (VAP), and mortality rates. Materials and Methods: After institutional ethical clearance, 80 patients were randomized into two groups: Group A, early tracheostomy group (tracheostomy within 3 days of intubation) and Group B, standard of care group (tracheostomy after 10 days of intubation: late tracheostomy). A cutoff of 10 in the SET score was used in predicting need of early tracheostomy; both groups were compared with respect to ICU-LOS, number of ventilator days (ventilation time), need of analgesia and sedation, incidence of VAP, and mortality data. Results: Both the groups were comparable in terms of demographic profile and various disease severity scores. ICU-LOS was 14.9 ± 3.6 days in Group A and 17.2 ± 4.6 in Group B. The number of days on ventilator and incidence of VAP was significantly lower in Group A as compared to Group B. There was significantly lower mortality in Group A subset of patients in ICU. Conclusion: SET score is a simple and reliable score with fair accuracy and high sensitivity and specificity in predicting need of tracheostomy in neurocritical patients. A cutoff of 10 in the score can be reliably used in predicting need of early tracheostomy as in few other studies. Early tracheostomy is clearly advantageous in neurocritical patients, but has no advantage in terms of long-term mortality rates.
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Liu Y, Huang J, Zhang Z, Huang Y, Du J, Wang S, Wu Z. Ultrasonic Characteristics Improve Prediction of Central Lymph Node Metastasis in cN0 Unifocal Papillary Thyroid Cancer. Front Endocrinol (Lausanne) 2022; 13:870813. [PMID: 35795144 PMCID: PMC9250971 DOI: 10.3389/fendo.2022.870813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/16/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Prediction of central lymph node metastasis (CLNM) is vital for clinical decision-making processes in clinically N0 (cN0) unifocal papillary thyroid carcinoma (PTC), but the sensitivity of preoperative detection of CLNM is limited. The aim of the present study was to determine whether there are ultrasonic (US) characteristics associated with CLNM. METHODS In total, 1657 PTC patients (514 men and 1143 women) were enrolled in the present study between January 2018 and May 2021. The patients met the following inclusion criteria based on preoperative detection: suspected nodule confirmed as PTC by biopsy; the nodule was unifocal and less than 4 cm in diameter; no prior neck radiation exposure; no extrathyroidal extension; and no CLNM or distant metastases on imaging. All the enrolled patients underwent total thyroidectomy with prophylactic central lymph node dissection (CLND). A postoperative pathological diagnosis was made. RESULTS CLNM was found in 58.4% of male patients and 36.9% of female patients. In univariate analysis, size, adjacent anterior capsule, distance to the lower pole and color Doppler flow imaging (CDFI) were considered risk factors for the male and female groups (p < 0.05). In multivariate analyses, size, adjacent anterior capsule, distance to the lower pole and CDFI were independent risk factors for male patients. For females, the independent risk factors included size, adjacent anterior capsule, distance to the lower pole and CDFI. CONCLUSION In the present cohort, US imaging characteristics, including size, adjacent anterior capsule, distance to the lower pole and CDFI, were identified to be potentially beneficial in preoperative clinical decision-making processes for cN0 unifocal PTC patients.
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Affiliation(s)
- Yongchen Liu
- Department of Thyroid and Hernia Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jianhao Huang
- Department of Thyroid and Hernia Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Zhiyuan Zhang
- Department of Thyroid and Hernia Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yijie Huang
- Department of Thyroid and Hernia Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jialin Du
- Department of Thyroid and Hernia Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Sanming Wang
- Department of Thyroid and Hernia Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- *Correspondence: Sanming Wang, ; Zeyu Wu,
| | - Zeyu Wu
- Department of Thyroid and Hernia Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- *Correspondence: Sanming Wang, ; Zeyu Wu,
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83
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Lechien JR, Barillari MR, De Marrez LG, Hans S. Dysphonia in COVID-19 patients: Direct or indirect symptom? Am J Otolaryngol 2022; 43:103246. [PMID: 34555788 PMCID: PMC8450233 DOI: 10.1016/j.amjoto.2021.103246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/05/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Jerome R Lechien
- Elsan Group, Paris, France; Department of Otorhinolaryngology-Head & Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France; Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Belgium.
| | - Maria R Barillari
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, L. Vanvitelli University, Naples, Italy
| | - Lisa G De Marrez
- Department of Otorhinolaryngology-Head & Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France
| | - Stephane Hans
- Department of Otorhinolaryngology-Head & Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France
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He J, Wang C, Li W. Laryngopharyngeal Reflux in Obstructive Sleep Apnea-Hypopnea Syndrome: An Updated Meta-Analysis. Nat Sci Sleep 2022; 14:2189-2201. [PMID: 36545474 PMCID: PMC9762266 DOI: 10.2147/nss.s390272] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/04/2022] [Indexed: 12/15/2022] Open
Abstract
Laryngopharyngeal reflux (LPR) is a common disorder in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). This meta-analysis was carried out to evaluate the LPR prevalence in individuals with OSAHS and to analyze the correlation of LPR positivity with the clinical features of patients with OSAHS. A detailed review of the English and Chinese literature on the occurrence of LPR in patients with OSAHS was performed by employing online search tools such as PubMed, EMBASE, Web of Science, VIP, CNKI, WanFang, etc. Two researchers analyzed the studies for quality according to the STROBE standard checklist. The acquired data were analyzed using Stata 11.0 and R 3.6.1 software. The effect size was estimated and calculated using weighted mean difference (WMD) and correlation coefficients. Moreover, a combined analysis was performed by employing either a random- or fixed-effects model. Ultimately, 27 studies met our inclusion criteria. Our study revealed that the LPR prevalence in OSAHS patients was 49%. We carried out subgroup analyses as per OSAHS severity, ethnicity, and body mass index (BMI). The results suggested that the probability of LPR in European and American patients with OSAHS was higher, and the prevalence of LPR was higher in obese individuals and patients with severe OSAHS. Moreover, apnea-hypopnea index (AHI) and BMI were higher in LPR-positive OSAHS patients than in LPR-negative OSAHS patients, but no significant variation in age was observed in the two groups. Moreover, the reflux symptom index (RSI) scores and the reflux finding score (RFS) exhibited a positive correlation with AHI. The current literature shows a higher incidence of LPR in individuals with OSAHS (49%). The severity of AHI in individuals with OSAHS is associated with the presence of LPR. Patients with OSAHS accompanied by LPR showed higher BMI and AHI as compared to those patients with LPR-negative OSAHS.
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Affiliation(s)
- Jie He
- Clinical Medical College of Chengdu Medical College, Chengdu, People's Republic of China.,Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, People's Republic of China
| | - Chunmao Wang
- Clinical Medical College of Chengdu Medical College, Chengdu, People's Republic of China.,Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, People's Republic of China
| | - Wancheng Li
- Clinical Medical College of Chengdu Medical College, Chengdu, People's Republic of China.,Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, People's Republic of China
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85
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Li Y, Xu G, Zhou B, Tang Y, Liu X, Wu Y, Wang Y, Kong J, Xu T, He C, Zhu S, Wang X, Zhang J. Effects of acids, pepsin, bile acids, and trypsin on laryngopharyngeal reflux diseases: physiopathology and therapeutic targets. Eur Arch Otorhinolaryngol 2021; 279:2743-2752. [PMID: 34860271 PMCID: PMC9072476 DOI: 10.1007/s00405-021-07201-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/23/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE Laryngopharyngeal reflux disease (LPRD) is a general term for the reflux of gastroduodenal contents into the laryngopharynx, oropharynx and even the nasopharynx, causing a series of symptoms and signs. Currently, little is known regarding the physiopathology of LPRD, and proton pump inhibitors (PPIs) are the drugs of choice for treatment. Although acid reflux plays a critical role in LPRD, PPIs fail to relieve symptoms in up to 40% of patients with LPRD. The influence of other reflux substances on LPRD, including pepsin, bile acid, and trypsin, has received increasing attention. Clarification of the substances involved in LPRD is the basis for LPRD treatment. METHODS A review of the effects of acids, pepsin, bile acids, and trypsin on laryngopharyngeal reflux diseases was conducted in PubMed. RESULTS Different reflux substances have different effects on LPRD, which will cause various symptoms, inflammatory diseases and neoplastic diseases of the laryngopharynx. For LPRD caused by different reflux substances, 24-h multichannel intraluminal impedance combined with pH-metry (MII-pH), salivary pepsin, bile acid and other tests should be established so that different drugs and treatment courses can be used to provide patients with more personalized treatment plans. CONCLUSION This article summarizes the research progress of different reflux substances on the pathogenesis, detection index and treatment of LPRD and lays a theoretical foundation to develop target drugs and clinical diagnosis and treatment.
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Affiliation(s)
- Yading Li
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
| | - Gaofan Xu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
| | - Bingduo Zhou
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
| | - Yishuang Tang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
| | - Xiaowen Liu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
| | - Yue Wu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
| | - Yi Wang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
| | - Jing Kong
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
| | - Tingting Xu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
| | - Cong He
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
| | - Shengliang Zhu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
| | - Xiaosu Wang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
| | - Jianning Zhang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
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张 青, 谢 萌, 郭 瑞, 马 思, 刘 小, 杨 敏, 李 娜, 刘 海, 任 晓, 罗 花. [Effect of proton pump inhibitort on salivary pepsin concentration in patients with laryngopharyngeal reflux]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2021; 35:965-970. [PMID: 34886597 PMCID: PMC10128359 DOI: 10.13201/j.issn.2096-7993.2021.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Indexed: 06/13/2023]
Abstract
Objective:To investigate the effect of proton pump inhibitor(PPI) treatment on salivary pepsin concentration in laryngopharyngeal reflux(LPR). Methods:152 patients with suspected LPR complaining non-specific symptoms such as foreign body sensation, dry throat, phlegm and other non-specific symptoms were enrolled, in the Second Affiliated Hospital of Xi'an Jiaotong University from August 2019 to December 2020. According to the scores of reflux symptom index(RSI) and reflux finding score(RFS), all the patients were divided into LPR (+) group and LPR (-) group, RSI (+) group and RSI (-) group, RFS (+) group and RFS (-) group . Patients in the LPR (+) group were reassessed after 1 month of PPI treatment. Saliva samples were collected from all the patients at initial diagnosis and follow-up diagnosis after treatment. The salivary pepsin concentration was determined by enzyme linked immunosorbent assay (ELISA). The differences of RSI, RFS scores and salivary pepsin concentrations before and after treatment were compared. Results:The median concentration of salivary pepsin in LPR (+) group was significantly higher than that in LPR (-) group, and (73.01 ng/mL vs 25.66 ng/mL, P<0.01), the median concentration of salivary pepsin in RFS (+) group were significantly higher than that in RFS (-) group(78.00 ng/mL vs 35.79 ng/mL, P<0.01) Furthermore, the median scores of RSI (11.00 vs 7.00, P<0.05) and RFS (9.00 vs 7.00, P<0.01) of LPR (+) patients notably decreased after PPI treatment for 1 month, and the salivary pepsin median concentration was memorably lower than that before treatment(53.60 ng/mL vs 46.49 ng/mL, P<0.05). Meanwhile, the scores of symptoms such as pharyngeal paraesthesia, heartburn, chest pain, stomachache, and the scores of signs such as false vocal fold, erythema or congestion, vocal fold edema, posterior commissure hypertrophy and thick endolaryngeal mucus were conspicuously lower after treatment than those before treatment(P<0.05). Conclusion:After 1 month of PPI treatment, the scores of partial symptoms and signs, and the salivary pepsin concentrations of LPR patients decreased significantly, suggesting that pepsin plays an important role in the pathogenesis of LPR, and pepsin may be closely related to the symptoms and signs such as pharyngeal paraesthesia and vocal fold edema.
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Affiliation(s)
- 青青 张
- 西安交通大学第二附属医院耳鼻咽喉头颈外科病院(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 萌 谢
- 西安交通大学第二附属医院耳鼻咽喉头颈外科病院(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 瑞昕 郭
- 西安交通大学第二附属医院耳鼻咽喉头颈外科病院(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 思敬 马
- 西安交通大学第二附属医院耳鼻咽喉头颈外科病院(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 小红 刘
- 西安交通大学第二附属医院耳鼻咽喉头颈外科病院(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 敏娟 杨
- 西安交通大学第二附属医院耳鼻咽喉头颈外科病院(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 娜 李
- 西安交通大学第二附属医院耳鼻咽喉头颈外科病院(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 海琴 刘
- 西安交通大学第二附属医院耳鼻咽喉头颈外科病院(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 晓勇 任
- 西安交通大学第二附属医院耳鼻咽喉头颈外科病院(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 花南 罗
- 西安交通大学第二附属医院耳鼻咽喉头颈外科病院(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
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Yun C, Xiao J, Cao J, Shao C, Wang L, Zhang W, Jia H. Lymph node metastases >5 and metastatic lymph node ratio >0.30 of differentiated thyroid cancer predict response to radioactive iodine. Cancer Med 2021; 10:7610-7619. [PMID: 34622559 PMCID: PMC8559488 DOI: 10.1002/cam4.4288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 07/20/2021] [Accepted: 07/20/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The study was designed to elucidate the predictive value of the number of lymph node metastases (LNMs) and lymph node ratio (LNR) for response to therapy restratification system (RTRS). METHODS From December 2015 to December 2019, 1228 patients who accepted radioactive iodine (RAI) were collected in the study. After 6-8 months, response to RAI was evaluated as complete response (excellent response) and incomplete response (indeterminate, biochemical, and structural incomplete response). The study developed classification tree to determine the optimum LNMs and LNR that predicted response to RAI. Multivariate logistic regression analyses were further analyzed to find independent factors of response to RAI. RESULT The mean age of patients was 44 ± 12 and 71.09% (873/1228) were females. The best cutoff value of LNMs to affect RAI treatment response determined by classification tree was 5. Further in 388 patients with LNMs >5, the best cutoff value of LNR to affect RAI treatment response determined by classification tree was 0.30. With multivariate analysis, the study found that LNMs (>5), gender, lymph node dissection, and American Thyroid Association (ATA) risk classification were independent predictors of response to RAI for all 1228 patients; and LNR (>0.30), gender, and ATA risk classification for 388 patients with LNMs >5. The sensitivity analysis indicated that whether patients with LNM or not were included, the multivariate logistic regression model was kept stable. On subgroup analysis, no significant interactions were observed between the effect of LNMs/LNR and gender, N stage, ATA risk classification, lymph node dissection, or T stage. CONCLUSIONS With classification tree, the study found that LNMs and LNR could predict initial response to RAI, and their optimal cutoff values were 5 and 0.30, separately.
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Affiliation(s)
- Canhua Yun
- Department of Nuclear Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Juan Xiao
- Center of Evidence-Based Medicine, The Second Hospital, Cheeloo College of Medicine, Institute of Medical Sciences, Shandong University, Jinan, China
| | - Jingjia Cao
- Department of Nuclear Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chunchun Shao
- Center of Evidence-Based Medicine, The Second Hospital, Cheeloo College of Medicine, Institute of Medical Sciences, Shandong University, Jinan, China
| | - Lihua Wang
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wei Zhang
- Department of Nuclear Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hongying Jia
- Center of Evidence-Based Medicine, The Second Hospital, Cheeloo College of Medicine, Institute of Medical Sciences, Shandong University, Jinan, China
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Saglam E, Ozsagir ZB, Unver T, Alinca SB, Toprak A, Tunali M. Efficacy of injectable platelet-rich fibrin in the erosive oral lichen planus: a split-mouth, randomized, controlled clinical trial. J Appl Oral Sci 2021; 29:e20210180. [PMID: 34614123 PMCID: PMC8523099 DOI: 10.1590/1678-7757-2021-0180] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/19/2021] [Indexed: 11/21/2022] Open
Abstract
Objective Our study compared the effects of injectable platelet-rich fibrin (i-PRF) with those of corticosteroids in the treatment of erosive oral lichen planus (EOLP). Methodology This split-mouth study included 24 individuals diagnosed histopathologically with bilateral EOLP. One bilateral lesion was injected with i-PRF, whereas the other was injected with methylprednisolone acetate in four sessions at 15-day intervals. Visual analog scale (VAS) for pain and satisfaction, oral health impact profile scale-14, and the lesion size were used. Results The intragroup comparisons showed a significant decrease in VAS-pain and lesion size in both the i-PRF group (from 81.88±17.74 to 13.33±18.34, and from 4.79±0.41 to 1.88±1.08, respectively) and the corticosteroid group (from 80.21±17.35 to 23.33±26.81, and from 4.71±0.46 to 2.21±1.35, respectively) in the 6th month compared to baseline (p<0.001). Moreover, VAS-satisfaction increased significantly in both the i-PRF group (from 26.67±17.8 to 85.63±16.24) and the corticosteroid group (from 28.33±17.05 to 74.38±24.11) in the 6th month compared to baseline (p<0.001). However, no significant difference in any value occurred in the intergroup comparisons. Conclusion In patients with EOLP, both methods decreased pain and lesion size similarly, and both increased satisfaction. Therefore, the use of i-PRF may be considered an option in cases refractory to topical corticosteroid therapy. Biochemical and histopathological studies are required to reveal the mechanism of i-PRF action in EOLP treatment.
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Affiliation(s)
- Ebru Saglam
- Health Sciences University, Faculty of Dentistry, Department of Periodontology Istanbul, Turkey
| | - Zeliha Betul Ozsagir
- Health Sciences University, Faculty of Dentistry, Department of Periodontology Istanbul, Turkey
| | - Tugba Unver
- Bezmialem Vakif University, Faculty of Dentistry, Department of Maxillofacial Radiology, Istanbul, Turkey
| | - Suzan Bayer Alinca
- Kecioren Osmanli Public Oral Health Center, Oral and Maxillofacial Surgery, Ankara, Turkey
| | - Ali Toprak
- Bezmialem Vakif University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Istanbul, Turkey
| | - Mustafa Tunali
- Canakkale Onsekiz Mart University, Faculty of Dentistry, Department of Periodontology, Canakkale, Turkey
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Zhang LZ, Xu JJ, Ge XY, Wang KJ, Tan Z, Jin TF, Zhang WC, Li QL, Luo DC, Ge MH. Pathological analysis and surgical modalities selection of cT1N0M0 solitary papillary thyroid carcinoma in the isthmus. Gland Surg 2021; 10:2445-2454. [PMID: 34527556 DOI: 10.21037/gs-21-357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/05/2021] [Indexed: 12/17/2022]
Abstract
Background prognosis, identify clinicopathological characteristics, and determine optimal modalities for cT1N0M0 solitary papillary thyroid carcinoma in the isthmus (PTCI). Methods The clinical data of 124 patients with cT1N0M0 solitary PTCI from 3 medical centers were analyzed retrospectively. Of these, 32 participants had undergone total thyroidectomy plus unilateral central neck dissection, 36 had received total thyroidectomy plus bilateral central neck dissection, 24 had less-than-total thyroidectomy plus unilateral central neck dissection, and 32 had less-than-total thyroidectomy plus bilateral central neck dissection. We compared the effects of different surgical modalities and clinicopathological characteristics on the prognosis of cT1N0M0 solitary PTCI. Results There was no significant difference in postoperative recurrence-free survival between participants who received different extents of central region lymph node dissection and thyroidectomies (P>0.05). Temporary hypocalcemia occurred in participants who underwent total thyroidectomy plus bilateral central neck dissection [chi-square (χ2) =7.87, P=0.005]. Tumors with primary lesions ≥0.55 cm were prone to have central lymph node metastasis [95% confidence interval (CI): 0.51 to 0.71, P=0.047]. Multiple logistic analysis suggested that age over 55 years [odds ratio (OR) =11.90, 95% CI: 1.36 to 104.03, P=0.025], tumor size greater than 0.55 cm (OR =4.16, 95% CI: 1.28 to 13.52, P=0.018), and absence of nodular goiter (OR =2.57, 95% CI: 1.05 to 6.32, P=0.04) were risk factors for central lymph node metastasis of patients with cT1N0M0 solitary PTCI. Conclusions Less-than-total thyroidectomy is recommended for patients with cT1N0M0 solitary PTCI. Central lymph node dissection is recommended for patients who are prone to have central occult lymph node metastases with tumor size ≥55 cm, older than 55 years, and without nodular goiter.
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Affiliation(s)
- Li-Zhuo Zhang
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.,Department of Head and Neck Surgery, Center of Otolaryngology-Head and Neck Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.,Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Jia-Jie Xu
- Department of Head and Neck Surgery, Center of Otolaryngology-Head and Neck Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.,Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Xin-Yang Ge
- College of Letters and Science, University of California, Los Angeles, Los Angeles, California, USA
| | - Ke-Jing Wang
- Department of Head and Neck Surgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - Zhuo Tan
- Department of Head and Neck Surgery, Center of Otolaryngology-Head and Neck Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.,Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Tie-Feng Jin
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.,Department of Head and Neck Surgery, Center of Otolaryngology-Head and Neck Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.,Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Wan-Chen Zhang
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.,Department of Head and Neck Surgery, Center of Otolaryngology-Head and Neck Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.,Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Qing-Lin Li
- Department of Scientific Research, Cancer Hospital, University of Chinese Academy of Sciences, Hangzhou, China
| | - Ding-Cun Luo
- Department of Surgical Oncology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ming-Hua Ge
- Department of Head and Neck Surgery, Center of Otolaryngology-Head and Neck Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.,Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
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Lechien JR, Mouawad F, Bobin F, Bartaire E, Crevier-Buchman L, Saussez S. Review of management of laryngopharyngeal reflux disease. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138:257-267. [DOI: 10.1016/j.anorl.2020.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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91
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Guo Z, Jiang J, Wu H, Zhu J, Zhang S, Zhang C. Salivary peptest for laryngopharyngeal reflux and gastroesophageal reflux disease: A systemic review and meta-analysis. Medicine (Baltimore) 2021; 100:e26756. [PMID: 34397878 PMCID: PMC8360476 DOI: 10.1097/md.0000000000026756] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 07/06/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND A rapid lateral flow test (Peptest) to detect pepsin in saliva/sputum has been considered as a valuable method for diagnosing laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD). The aim of this meta-analysis is to analyze the utility of Peptest for diagnosis of LPR and GERD. METHODS PubMed, EMBASE, and the Cochran Library (from January 1980 to 26 January 2020) were searched for pepsin in saliva for LPR/GERD diagnosis. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve data were summarized to examine the accuracy. RESULTS A total of 16 articles that included 2401 patients and 897 controls were analyzed. The pooled sensitivity and specificity for the diagnosis of GERD/LPR with Peptest were 62% (95% confidence interval [CI] 49%-73%) and 74% (95% CI 50%-90%), respectively. The summarized diagnostic odds ratio and area under the curve were 5.0 (95% CI 2-19) and 0.70 (95% CI 0.66-0.74), respectively. CONCLUSION Peptest shows moderate diagnostic value for LPR and GERD. More studies with standard protocols should be done to verify its usefulness.
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Affiliation(s)
- Zihao Guo
- Department of Gastroenterology, Beijing Tong Ren Hospital, Capital Medical University, Beijing, China
| | - Jiali Jiang
- Department of Gastroenterology, Beijing Tong Ren Hospital, Capital Medical University, Beijing, China
| | - Hao Wu
- Department of Cardiovascular diseases, Beijing Tong Ren Hospital, Capital Medical University, Beijing, China
| | - Jinxia Zhu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Shutian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Digestive Disease, Beijing Digestive Disease Center, Beijing, China
- Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, China
| | - Chuan Zhang
- Department of Gastroenterology, Beijing Tong Ren Hospital, Capital Medical University, Beijing, China
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A prospective randomized controlled trial to assess the efficacy and safety of prophylactic central compartment lymph node dissection in papillary thyroid carcinoma. Surgery 2021; 171:182-189. [PMID: 34391573 DOI: 10.1016/j.surg.2021.03.071] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/22/2021] [Accepted: 03/29/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The efficacy of prophylactic central compartment lymph node dissection for papillary thyroid carcinoma remains controversial. We performed a randomized controlled trial to evaluate the efficacy and safety of prophylactic central compartment lymph node dissection in patients with papillary thyroid carcinoma. METHODS In this parallel-group randomized controlled trial, we assessed 101 patients aged 20 to 70 years with small/noninvasive papillary thyroid carcinoma and no clinical metastases or history of cervical surgery/radiation exposure. Randomization ran from April 2015 to November 2017. Data were collected between April 2015 and October 2020. Of the 101 enrolled patients, 50 underwent total thyroidectomy (TTx group) and 51 underwent total thyroidectomy as well as prophylactic central compartment lymph node dissection (TTx+pCND group). Surgical completeness, local recurrence, successful ablation, postoperative complication, and papillary thyroid carcinoma upstaging were compared between the 2 groups. RESULTS No patient showed structural recurrence after 46.6 ± 9.1 months of follow-up. Both groups had similar rates of surgical completeness and successful ablation. There was no difference in the incidence of complications. More patients were upstaged to pN1a in the TTx+pCND group compared to those in the TTx group (P < .05). CONCLUSIONS Prophylactic central compartment lymph node dissection detected more lymph node metastases but did not affect recurrence. The 2 groups showed similar outcomes with regard to surgical completeness, successful ablation, and complications. In conclusion, for small/noninvasive papillary thyroid carcinoma without clinical evidence of lymph node metastases, prophylactic central compartment lymph node dissection may not be required if total thyroidectomy is planned.
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93
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Lechien JR, Chan WW, Akst LM, Hoppo T, Jobe BA, Chiesa-Estomba CM, Muls V, Bobin F, Saussez S, Carroll TL, Vaezi MF, Bock JM. Normative Ambulatory Reflux Monitoring Metrics for Laryngopharyngeal Reflux: A Systematic Review of 720 Healthy Individuals. Otolaryngol Head Neck Surg 2021; 166:802-819. [PMID: 34313507 DOI: 10.1177/01945998211029831] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To review the normative data for acid, weakly acid, and nonacid proximal esophageal (PRE) and hypopharyngeal reflux (HRE) events in diagnosing laryngopharyngeal reflux (LPR) using ambulatory reflux monitoring. DATA SOURCES PubMed, Cochrane Library, and Scopus. REVIEW METHODS A literature search was conducted about the normative data for PRE and HRE on multichannel intraluminal impedance-pH monitoring (MII-pH), hypopharyngeal-esophageal MII-pH (HEMII-pH), or oropharyngeal pH monitoring using PICOTS (population, intervention, comparison, outcome, timing, and setting) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statements. Outcomes reviewed included device characteristics, impedance/pH sensor placements, study duration, number/average and percentiles of PRE or HRE occurrence, and the event characteristics (pH, composition, and position). RESULTS Of 154 identified studies, 18 met criteria for analysis, including 720 healthy individuals. HEMII-pH, MII-pH, and oropharyngeal pH monitoring were used in 7, 6, and 5 studies, respectively. The definition and inclusion/exclusion criteria of healthy individuals varied substantially across studies, with 6 studies considering only digestive symptoms to exclude potential LPR patients. Substantial heterogeneity across studies was noted, including impedance/pH sensor placements/configurations and definitions of composition (liquid, gas, mixed) and type (acid, weakly acid, nonacid) of PRE/HRE. The 95th percentile thresholds were 10 to 73 events for PRE, 0 to 10 events for HRE on HEMII-pH, and 40 to 128 for events with pH <6.0 on oropharyngeal pH monitoring. Most HREs were nonacid and occurred upright. The mean HRE among healthy individuals was 1. CONCLUSION The low number of studies and the heterogeneity in inclusion criteria, definitions, and characterization of PRE and HRE limit the establishment of consensual normative criteria for LPR on ambulatory reflux monitoring. Future large multicenter studies are needed.
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Affiliation(s)
- Jerome R Lechien
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, University Paris Saclay, Paris, France.,Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Walter W Chan
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lee M Akst
- Department of Otolaryngology-Head Neck Surgery, Johns Hopkins Hospital, Baltimore, MA, USA
| | - Toshitaka Hoppo
- Esophageal Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Blair A Jobe
- Esophageal Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Carlos M Chiesa-Estomba
- Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - Vinciane Muls
- Department of Gastroenterology, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Sven Saussez
- Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Thomas L Carroll
- Department of Otolaryngology-Head Neck Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael F Vaezi
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jonathan M Bock
- Department of Otorhinolaryngology-Head & Neck Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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94
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Radiofrequency Ablation in the Neck for Thyroid Diseases: the Surgical Perspective. CURRENT OTORHINOLARYNGOLOGY REPORTS 2021. [DOI: 10.1007/s40136-021-00360-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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95
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Liu N, Chen B, Li L, Zeng Q, Sheng L, Zhang B, Lv B. Effect of Tumor Location on the Risk of Bilateral Central Lymph Node Metastasis in Unilateral 1-4 cm Papillary Thyroid Carcinoma. Cancer Manag Res 2021; 13:5803-5812. [PMID: 34321927 PMCID: PMC8312608 DOI: 10.2147/cmar.s318076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/07/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Papillary thyroid carcinoma (PTC) has a high incidence of lymph node metastasis (LNM). Our aim was to determine whether tumor location is a useful feature to predict bilateral central lymph node metastasis (CLNM) in unilateral 1–4 cm PTC. Patients and Methods Data on unilateral 1–4 cm PTC patients from 2016 to 2019 were collected retrospectively. The clinical and pathological characteristics of the tumors and lymph nodes were analyzed statistically. Results The mean patient age was 49.1±12.3 (23–73) years, and the majority were women (n=1334, 75.4%). A total of 1767 patients were analyzed, and 256 (14.5%) had bilateral CLNM. Tumor location was an independent risk factor in predicting bilateral CLNM (p<0.001). The odds of bilateral CLNM were the highest in the near isthmus (OR 6.452, 95% CI: 3.658–11.379, p<0.001). In a multivariate regression model adjusting for other risk factors, near-isthmus tumors had the highest risk of bilateral CLNM (OR 7.319, 95% CI: 3.844–13.933, p<0.001), followed by lower lobe tumors (OR 2.338, 95% CI: 1.315–4.155, p=0.004) and middle lobe tumors (OR 1.845, 95% CI: 1.035–3.291, p=0.038), compared to upper lobe tumors. Conclusion Tumor location is an independent risk factor in predicting the risk of bilateral CLNM. Near-isthmus tumors carry the highest risk of bilateral CLNM.
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Affiliation(s)
- Nan Liu
- Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People's Republic of China
| | - Bo Chen
- Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People's Republic of China
| | - Luchuan Li
- Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People's Republic of China
| | - Qingdong Zeng
- Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People's Republic of China
| | - Lei Sheng
- Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People's Republic of China
| | - Bin Zhang
- Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People's Republic of China
| | - Bin Lv
- Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People's Republic of China
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96
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The inappropriate use of proton pump inhibitors and its associated factors among community-dwelling older adults. Heliyon 2021; 7:e07595. [PMID: 34337188 PMCID: PMC8313491 DOI: 10.1016/j.heliyon.2021.e07595] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/13/2021] [Accepted: 07/14/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives Little is known about the inappropriate use of proton pump inhibitors (PPIs) and how mild cognitive impairment (MCI) and high comorbid burden relate to the inappropriate prescribing of PPIs. Therefore, the current study aimed to examine these associations among community-dwelling older adults in Jordan. Method This cross-sectional study was conducted on 215 community-dwelling older adults from three local healthcare centers located in Irbid, Jordan. Data about PPI use, including the name of medication, dose, frequency, duration, and indication, were collected retrospectively from a review of the participating older adults’ medication cards for November and December 2019. The collected data were evaluated based on the Food and Drug Administration (FDA) guidelines. MCI was measured using the Arabic version of the Montreal Cognitive Assessment, and comorbid burden was measured using the Cumulative Illness Rating Scale for Geriatrics. Results Forty-seven percent of the participants were found to have taken a PPI, with 68 % having taken one for a longer period than recommended by the FDA. Older adults with MCI or high comorbid burden were found to be more susceptible than other older adults to the long-term use of PPIs. The logistic regression revealed that MCI is a statistically significant predictor of inappropriate PPI use (p < 0.001). Conclusion Inappropriate PPI use is common among community-dwelling older adults in Jordan, with a significantly higher prevalence of inappropriate PPI use in people with MCI than in people with normal cognitive abilities. Future intervention studies are highly recommended to encourage optimal prescribing of PPIs for community-dwelling older adults.
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97
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Kim SI, Jeong SJ, Kwon OE, Park JM, Lee YC, Eun YG, Ko SG. 24-Hour Multichannel Intraluminal Impedance-pH in Proton Pump Inhibitor Nonresponders vs Responders in Patients With Laryngopharyngeal Reflux. Otolaryngol Head Neck Surg 2021; 166:910-916. [PMID: 34253074 DOI: 10.1177/01945998211026843] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study aimed to evaluate the characteristics of reflux in proton pump inhibitor (PPI) nonresponders vs responders in patients with laryngopharyngeal reflux (LPR) by using 24-hour multichannel intraluminal impedance-pH (MII-pH) monitoring. STUDY DESIGN Prospective cohort study. SETTING A tertiary care otolaryngology clinic. METHODS Patients with typical LPR symptoms showing >1 proximal reflux episode were considered to have LPR and investigated prospectively. Patients were prescribed high-dose PPI twice daily and followed up for at least 2 months. Patients with LPR showing a ≥50% decrease in the follow-up reflux symptom index score during treatment periods as compared with pretreatment were defined as responders; others were defined as nonresponders. Various parameters in 24-hour MII-pH monitoring between nonresponders and responders with LPR were compared with Student's t test and receiver operating characteristic curve. RESULTS Eighty patients were diagnosed with LPR and categorized as nonresponders (n = 19) and responders (n = 61). Proximal all reflux time and proximal longest reflux time in various MII parameters were higher in responders than in nonresponders (P = .0040 and .0216, respectively). Proximal all reflux time >0.000517% was a better cutoff value to predict responders with LPR as compared with the proximal longest reflux time >0.61 minutes (sensitivity + specificity: 1.317 vs 1.291). CONCLUSION Proximal all reflux time in various 24-hour MII-pH monitoring parameters can be helpful to predict the response to PPI therapy in patients with LPR. These findings will help establish a personalized therapeutic scheme for patients with LPR.
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Affiliation(s)
- Su Il Kim
- Department of Otorhinolaryngology, Myongji Hospital, College of Medicine, Hanyang University, Goyang, Korea
| | - Su Jin Jeong
- Statistics Support Part, Kyung Hee Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
| | - Oh Eun Kwon
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University Medical Center, Seoul, Korea
| | - Jung Min Park
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University Medical Center, Seoul, Korea
| | - Young Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University Medical Center, Seoul, Korea
| | - Young-Gyu Eun
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University Medical Center, Seoul, Korea
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
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98
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Wang J, Li J, Nie Q, Zhang R. Are Multiple Tests Necessary for Salivary Pepsin Detection in the Diagnosis of Laryngopharyngeal Reflux? Otolaryngol Head Neck Surg 2021; 166:477-481. [PMID: 34253110 DOI: 10.1177/01945998211026837] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To evaluate the necessity of multiple salivary pepsin tests within a day when diagnosing laryngopharyngeal reflux. STUDY DESIGN Prospective cohort study. SETTING Tertiary hospitals. METHODS A total of 138 patients with signs and/or symptoms associated with laryngopharyngeal reflux were included. Salivary pepsin was detected on the day of 24-hour pH monitoring, and the results of salivary pepsin detected once in the morning and multiple times in 1 day were compared with the results of pH monitoring. RESULTS Among the 138 patients, pH monitoring results were positive in 112. Salivary pepsin was positive in 47 cases in the morning, which was not consistent with the results of pH monitoring (kappa value = 0.117). With the pH monitoring results as the standard, the salivary pepsin detected once in the morning had a sensitivity of 38.4% (43/112) and a specificity of 84.6% (22/26) for the diagnosis of laryngopharyngeal reflux. When salivary pepsin was detected multiple times per day, 102 patients tested positive. The consistency with pH monitoring was moderate (kappa value = 0.587). The sensitivity was 86.6% (97/112), and the specificity was 80.8% (21/26). Of the 97 patients with positive results from pH monitoring and salivary pepsin detected multiple times a day, 54 had negative findings for a single detection in the morning, indicating that 55.7% (54/97) of the true positive cases were missed. CONCLUSION Although a single detection of salivary pepsin in the morning is more economical, the sensitivity is too low, and it is necessary to detect it multiple times a day.
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Affiliation(s)
- Jiasen Wang
- Department of Otolaryngology-Head and Neck Surgery, The Sixth Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Jinrang Li
- Department of Otolaryngology-Head and Neck Surgery, The Sixth Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Qian Nie
- Department of Otolaryngology-Head and Neck Surgery, The Sixth Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Ran Zhang
- Department of Otolaryngology-Head and Neck Surgery, The Sixth Medical Centre of Chinese PLA General Hospital, Beijing, China
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99
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Zhou B, Ge Y, Shao Q, Yang L, Chen X, Jiang G. Long noncoding RNA LINC00284 facilitates cell proliferation in papillary thyroid cancer via impairing miR-3127-5p targeted E2F7 suppression. Cell Death Discov 2021; 7:156. [PMID: 34226533 PMCID: PMC8257569 DOI: 10.1038/s41420-021-00551-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/05/2021] [Accepted: 05/26/2021] [Indexed: 12/21/2022] Open
Abstract
Accumulating evidence has suggested that long noncoding RNAs (lncRNAs) exert crucial modulation roles in the biological behaviors of multiple malignancies. Nonetheless, the specific function of lncRNA LINC00284 in papillary thyroid cancer (PTC) remains not fully understood. The objective of this research was to explore the influence of LINC00284 in PTC and elucidate its potential mechanism. The Cancer Genome Atlas (TCGA), gene expression omnibus (GEO) datasets were used to analyze LINC00284 expression differences in thyroid cancer and normal samples, followed by the verification of qRT-PCR in our own PTC and adjacent non-tumor tissues. The impacts of LINC00284 on PTC cell growth were detected in vitro via CCK-8, colony formation, EdU assays, and in vivo via a xenograft tumor model. Bioinformatics analyses and biological experiments were conducted to illuminate the molecular mechanism. We found that LINC00284 expression was remarkably increased in PTC tissues and its overexpression was closely correlated with larger tumor size. In addition, silencing LINC00284 could effectively attenuate PTC cell proliferation, induce apoptosis and G1 arrest in vitro, as well as suppress tumorigenesis in mouse xenografts. Mechanistic investigations showed that LINC00284 acted as a competing endogenous RNA (ceRNA) for miR-3127-5p, thus resulting in the disinhibition of its endogenous target E2F7. In short, our findings indicated that LINC00284–miR-3127-5p–E2F7 axis exerted oncogenic properties in PTC and may offer a new promising target for the diagnosis and therapy of PTC.
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Affiliation(s)
- Bin Zhou
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China.,Department of Thyroid and Breast Surgery, The Affiliated Jiangyin Hospital of Southeast University Medical College, Wuxi, 214000, Jiangsu Province, China
| | - Yugang Ge
- Department of Thyroid and Breast Surgery, The Affiliated Jiangyin Hospital of Southeast University Medical College, Wuxi, 214000, Jiangsu Province, China
| | - Qing Shao
- Department of Thyroid and Breast Surgery, The Affiliated Jiangyin Hospital of Southeast University Medical College, Wuxi, 214000, Jiangsu Province, China
| | - Liyi Yang
- Department of Thyroid and Breast Surgery, The Affiliated Jiangyin Hospital of Southeast University Medical College, Wuxi, 214000, Jiangsu Province, China
| | - Xin Chen
- Department of Thyroid and Breast Surgery, The Affiliated Jiangyin Hospital of Southeast University Medical College, Wuxi, 214000, Jiangsu Province, China
| | - Guoqin Jiang
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China.
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100
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Sun F, Zou Y, Huang L, Shi Y, Liu J, Cui G, Zhang X, Xia S. Nomogram to assess risk of central cervical lymph node metastasis in patients with cN0 papillary thyroid carcinoma. Endocr Pract 2021; 27:1175-1182. [PMID: 34174413 DOI: 10.1016/j.eprac.2021.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study developed and validated an individualized prediction risk model for the need for central cervical lymph node dissection in patients with cN0 papillary thyroid carcinoma (PTC) diagnosed by ultrasound. METHODS Upon retrospective review, derivation and internal validation cohorts comprised 1585 consecutive patients with PTC treated from January 2017 to December 2019 at Hospital A. The external validation cohort consisted of 406 consecutive patients treated at Hospital B from January 2016 to June 2020. Independent risk factors for central cervical lymph node metastasis (CLNM) were determined through univariable and multivariable logistic regression analysis. An individualized risk prediction model was constructed and illustrated as a nomogram, which was internally and externally validated. RESULTS The following risk factors of CLNM were established: the solitary primary thyroid nodule's diameter, shape, calcification, and capsular abutment-to-lesion perimeter ratio. The areas under the receiver operating characteristic curves of the risk prediction model for the internal and external validation cohorts were 0.921 and 0.923, respectively. The calibration curve showed good agreement between the nomogram-estimated probability of CLNM and the actual CLNM rate in the three cohorts. The decision curve analysis confirmed the clinical usefulness of the nomogram. CONCLUSION This study developed and validated a model for predicting risk of CLNM in the individual patient with cN0 PTC, which should be an efficient tool for guiding clinical treatment.
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Affiliation(s)
- Fang Sun
- Department of Radiology, First Central Clinical College, Tianjin Medical University, No. 24 Fu Kang Road, Nan Kai District, Tianjin 300192, China; Department of Ultrasonography, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou City, Shandong 256603, China
| | - Ying Zou
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314 Anshan West Road, Nan Kai District, Tianjin 300193, China
| | - Lixiang Huang
- Department of Radiology, The Second Hospital of Tianjin Medical University, No. 23, Pingjiang Road, Hexi District, Tianjin 300211, China; Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fu Kang Road, Nan Kai District, Tianjin 300192, China
| | - Yan Shi
- Department of Ultrasonography, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou City, Shandong 256603, China
| | - Jihua Liu
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314 Anshan West Road, Nan Kai District, Tianjin 300193, China
| | - Guanghe Cui
- Department of Ultrasonography, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou City, Shandong 256603, China
| | - Xuening Zhang
- Department of Radiology, The Second Hospital of Tianjin Medical University, No. 23, Pingjiang Road, Hexi District, Tianjin 300211, China.
| | - Shuang Xia
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fu Kang Road, Nan Kai District, Tianjin 300192, China.
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