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Cawood TJ, Mackay GR, Hunt PJ, O'Shea D, Skehan S, Ma Y. TIRADS Management Guidelines in the Investigation of Thyroid Nodules; Illustrating the Concerns, Costs, and Performance. J Endocr Soc 2020; 4:bvaa031. [PMID: 32285020 PMCID: PMC7138277 DOI: 10.1210/jendso/bvaa031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/03/2020] [Indexed: 01/21/2023] Open
Abstract
Context Ultrasound (US) risk-stratification systems for investigation of thyroid nodules may not be as useful as anticipated. Objective We aimed to assess the performance and costs of the American College of Radiology Thyroid Image Reporting And Data System (ACR-TIRADS). Design, Settings and Participants We examined the data set upon which ACR-TIRADS was developed, and applied TR1 or TR2 as a rule-out test, TR5 as a rule-in test, or applied ACR-TIRADS across all nodule categories. We assessed a hypothetical clinical comparator where 1 in 10 nodules are randomly selected for fine needle aspiration (FNA), assuming a pretest probability of clinically important thyroid cancer of 5%. Results The gender bias (92% female) and cancer prevalence (10%) of the data set suggests it may not accurately reflect the intended test population. Applying ACR-TIRADS across all nodule categories did not perform well, with sensitivity and specificity between 60% and 80% and overall accuracy worse than random selection (65% vs 85%). Test performance in the TR3 and TR4 categories had an accuracy of less than 60%. Using TR5 as a rule-in test was similar to random selection (specificity 89% vs 90%). Using TR1 and TR2 as a rule-out test had excellent sensitivity (97%), but for every additional person that ACR-TIRADS correctly reassures, this requires >100 ultrasound scans, resulting in 6 unnecessary operations and significant financial cost. Conclusions Perhaps surprisingly, the performance ACR-TIRADS may often be no better than random selection. The management guidelines may be difficult to justify from a cost/benefit perspective. A prospective validation study that determines the true performance of TIRADS in the real-world is needed.
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Affiliation(s)
- Tom James Cawood
- Department of Endocrinology, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
| | - Georgia Rose Mackay
- University of Otago, Christchurch School of Medicine, Christchurch, New Zealand
| | - Penny Jane Hunt
- Department of Endocrinology, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.,University of Otago, Christchurch School of Medicine, Christchurch, New Zealand
| | - Donal O'Shea
- Department of Endocrinology, St Vincent's University Hospital, Dublin, Ireland
| | - Stephen Skehan
- Department of Radiology, St Vincent's University Hospital, Dublin 4 and University College Dublin, Ireland
| | - Yi Ma
- Biostatistician, Department of Medical & Women's Business Management, Canterbury District Health Board, Christchurch, New Zealand
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Liu XZ, Wang JM, Ji YX, Zhao DB. Monocyte-to-high-density lipoprotein cholesterol ratio is associated with the presence and size of thyroid nodule irrespective of the gender. Lipids Health Dis 2020; 19:36. [PMID: 32164741 PMCID: PMC7069177 DOI: 10.1186/s12944-020-1196-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/19/2020] [Indexed: 12/20/2022] Open
Abstract
Background Systemic inflammation may be involved in the formation and progression of thyroid nodule (TN). The aim of this large-scale study was to investigate the association of several simple inflammatory markers with the presence and size of TN. Methods A total of 133,698 adults were included for the current analysis. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and monocyte-to-high-density lipoprotein cholesterol ratio (MHR) were calculated. The logistic regression was used to explore the association of the four markers with the presence and size of TN. Results The prevalence of TN was 55.1% among females and 44% among males; 13% of women and 8% of men had non-micronodule. In women, MHR and PLR were significantly associated with the presence of TN and non-micronodule; in men, MHR and NLR were significantly associated with the presence of TN and non-micronodule. Conclusions As a low-cost, simple, and reproducible inflammatory marker, MHR is strongly associated with the presence and size of TN irrespective of the gender.
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Affiliation(s)
- Xing Zhen Liu
- Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, No. 27, Yang Gong Di, Xihu District, Zhejiang, 310007, Hangzhou, China
| | - Jun Min Wang
- Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, No. 27, Yang Gong Di, Xihu District, Zhejiang, 310007, Hangzhou, China
| | - Yi Xin Ji
- Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, No. 27, Yang Gong Di, Xihu District, Zhejiang, 310007, Hangzhou, China.
| | - Dong Bao Zhao
- Department of Rheumatology, Changhai Hospital, Naval Military Medical University (The Second Military Medical University), No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China.
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Tadesse T, Hailu T, Getachew A, Abebe SM. Prevalence and Associated Factors of Thyroid Incidentaloma among Adult People Attending Gondar University Hospital, Northwest Ethiopia. Ethiop J Health Sci 2020; 30:23-30. [PMID: 32116429 PMCID: PMC7036460 DOI: 10.4314/ejhs.v30i1.4] [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] [Indexed: 11/17/2022] Open
Abstract
Background Incidentally discovered thyroid lesions have become highly common in the development and more frequent utilization of highly sensitive imaging modalities, like ultrasound. However, little is known about its prevalence and associated factors in Ethiopia. The aim of this study was to determine the prevalence of thyroid incidentalomas and associated factors through ultrasound (US) among adults attending Gondar University Hospital. Methods A hospital-based cross-sectional study was carried out on 290 adults aged 15 years and above. Out of the adults who visited the hospital during the study, those who neither had history of thyroid disease, thyroid surgery, nor clinically palpable thyroid nodules were involved in the investigation. The participants were examined using a high frequency linear-array transducer (7 MHz). For comparing men and women, the unpaired t-test was used. Binary logistic analysis was used to identify the associated factors, and a P-value < 0.05 was considered statistically significant. Result The frequency of thyroid incidentaloma was found to be 33.4% (95% CI: 27.9, 38.9). Thyroid incidentaloma was detected in 42.4% of the females and 22.7% of the males (P<0.001). About 63% had single and 37% multiple thyroid nodules. About 25.8% had thyroid nodules greater than 1cm. In the multivariable logistic regression analysis, increasing age (AOR=5.96; 2.34, 15.15) and female sex (AOR=3.01; 1.73, 5.26) were significantly associated with thyroid incidentalomas. Conclusion The frequency of thyroid incidentaloma (TI) was found to be high in this study and much higher among older women. Solitary and small sized thyroid nodules were commonly seen in the study.
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Affiliation(s)
- Temesgen Tadesse
- Department of Radiology, College of Medical and Health Sciences, University of Gondar
| | - Tigist Hailu
- Department of Radiology, College of Medical and Health Sciences, University of Gondar
| | - Assefa Getachew
- Department of Radiology, College of Health Sciences, Addis Ababa university
| | - Solomon M Abebe
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gond
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Lai X, Zhang B, Wang Y, Jiang Y, Li J, Gao L, Wang Y. Adiposity and the risk of thyroid nodules with a high-suspicion sonographic pattern: a large cross-sectional epidemiological study. J Thorac Dis 2020; 11:5014-5022. [PMID: 32030217 DOI: 10.21037/jtd.2019.11.79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background To our knowledge, no previous studies have evaluated the association between obesity and the risk of thyroid nodules with a high-suspicion sonographic pattern defined by the 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancers. In this large cross-sectional epidemiological study, we investigated whether a positive association existed between anthropometric measurements and the risk of thyroid nodules. Methods In total, 10,504 individuals from two towns in northern China were enrolled between May to September 2016. The height and weight were measured and the body mass index (BMI), body fat percentage (BFP), and body surface area (BSA) were calculated. A logistic regression model was used to estimate age-, sex-, and study site-adjusted odds ratios (ORs) and confidence intervals (CIs) for each of the anthropometric measurements with respect to the risk of thyroid nodules. Results The final analyses included 9,096 participants, among whom 3,614 (39.7%) had thyroid nodules and 365 (4.0%) had thyroid nodules with a high-suspicion sonographic pattern. An increased risk of any thyroid nodules was associated with greater height, weight, BFP, and BSA in both men and women. Compared with the lowest quartile of BFP, the ORs for the highest quartile were 1.33 (95% CI: 1.09-1.62) in women and 1.89 (95% CI: 1.35-2.65) in men. An increased risk of thyroid nodules with a high-suspicion sonographic pattern was associated with greater weight, BMI, BFP, and BSA in both men and women. Compared with the lowest quartile of BFP, the ORs for the highest quartile were 2.19 (95% CI: 1.32-3.64) in women and 3.10 (95% CI: 1.31-7.36) in men. Conclusions Our results demonstrated that BFP was the most pronounced anthropometric factor associated with an increased risk of any thyroid nodules and thyroid nodules with a high-suspicion sonographic pattern.
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Affiliation(s)
- Xingjian Lai
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
| | - Bo Zhang
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing 100029, China
| | - Yong Wang
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yuxin Jiang
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
| | - Jianchu Li
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
| | - Luying Gao
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
| | - Ying Wang
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
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Malandrino P, Russo M, Ronchi A, Moretti F, Gianì F, Vigneri P, Masucci R, Pellegriti G, Belfiore A, Vigneri R. Concentration of Metals and Trace Elements in the Normal Human and Rat Thyroid: Comparison with Muscle and Adipose Tissue and Volcanic Versus Control Areas. Thyroid 2020; 30:290-299. [PMID: 31880996 DOI: 10.1089/thy.2019.0244] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: The concentration of trace elements and metals in the thyroid is the result of exposure, uptake, retention, and clearance. The specificity and selectivity of thyroid capacity to concentrate these elements relative to other tissues are not known. To obtain this information, we measured the tissue concentration of 26 elements in the thyroid, muscle, and fat of euthyroid human subjects and also in normal rats. Methods: At programmed surgery, small (<1 g) tissue fragments were collected in 77 euthyroid subjects. Macroscopically normal thyroid tissue, sternothyroid muscle, and neck subcutaneous fat samples were excised, and thyroid tissue was confirmed to be morphologically normal through microscopy. Tissue specimens (thyroid, hindlimb muscle, and abdominal fat) were also obtained from normal rats. Measurements of trace elements were performed on tissues using inductively coupled plasma mass spectrometry (DRC-ICP-MS). Results: Only 19 of the 26 investigated elements were measurable as 7 elements were below the limit of detection. The ranking concentration in human thyroid tissue, not considering iodide, indicated that Zn, Br, Cu, Cr, Se, and Mn represented over 95% of the measured elements. A similar ranking was observed in the rat thyroid. A comparison with other tissues indicated that in addition to I, also Br, Mn, Se, and Sn were significantly more concentrated in the thyroid, and this was also the case for the recognized carcinogens As, Cd, and Hg. As and Hg, but not Cd (which was not detectable in any of the rat tissues), were also more concentrated in the rat thyroid. Since human thyroid specimens were also obtained from residents of a volcanic area, where environmental pollution may cause human biocontamination, we compared the trace element concentration in specimens from the volcanic area with controls. Many trace elements were slightly, but not significantly, increased in the volcanic area specimens. Conclusions: In the normal human thyroid, many trace elements, including Br, Mn, Se, and Sn, and the recognized carcinogens, As, Cd, and Hg, are significantly more concentrated than in muscle and fat of the same individual. Similar data were observed in rats. The reason for the differential element accumulation in the thyroid is unclear; a better understanding may be useful to further clarify thyroid biology.
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Affiliation(s)
- Pasqualino Malandrino
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Catania, Italy
| | - Marco Russo
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Catania, Italy
| | - Anna Ronchi
- Laboratory of Experimental and Clinical Toxicology-Toxicology Unit, Maugeri Clinical Scientific Institute Spa-SC, IRCCS Pavia, Pavia, Italy
| | - Fabiola Moretti
- Institute of Cell Biology and Neurobiology, National Research Council of Italy, Roma, Italy
| | - Fiorenza Gianì
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Catania, Italy
| | - Paolo Vigneri
- Medical Oncology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Romilda Masucci
- Surgical Oncology, Garibaldi-Nesima Medical Center, Catania, Italy
| | - Gabriella Pellegriti
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Catania, Italy
| | - Antonino Belfiore
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Catania, Italy
| | - Riccardo Vigneri
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Catania, Italy
- Section of Catania, Institute of Biostructures and Bioimages of the National Research Council (CNR-IBB), Catania, Italy
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Ben Hamou A, Ghanassia E, Espiard S, Abi Rached H, Jannin A, Correas JM, Do Cao C, Kyheng M, Vantyghem MC, Monpeyssen H. Safety and efficacy of thermal ablation (radiofrequency and laser): should we treat all types of thyroid nodules? †. Int J Hyperthermia 2020; 36:666-676. [PMID: 31317800 DOI: 10.1080/02656736.2019.1627432] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: Thermal ablation is a minimally invasive technique that is gradually acknowledged as an effective alternative to surgery to treat thyroid nodules. Two main techniques have been described: radiofrequency (RFA) and laser ablation. Objective: To evaluate the safety and efficacy of the two main techniques (RFA and laser ablation) for the treatment of benign thyroid nodules. Patients: This bicentric retrospective study included 166 consecutive patients, who received clinical, biological and ultrasound evaluations for thyroid nodules, from October 2013 to November 2017. Methods: One of the two techniques was proposed if a nodule was proven to be benign after fine needle aspiration cytology or micro-biopsy. Adverse events and outcomes (symptoms, nodule reduction) were assessed at 6 weeks and 6, 12, and 18 months after treatment. Results: One hundred and eighty-nine nodules (mean size 17.5 ± 16.9 mL, 86.1% palpable) were treated by RFA (n = 108 (57.1%)) or laser ablation (n = 81 (42.9%)) in 166 patients (80.1% women, mean age 51.7 years). Two cases of transient recurrent laryngeal nerve palsy, one hematoma, and two successfully drained abscesses (5/166 = 3%) were observed. Clinical symptoms improved significantly in the two groups (anterior cervical discomfort -83.6%, esthetic complaints -84.9% and dysphagia -86.4%). Nodule volume (mL) decreased significantly (baseline vs. 18 months) from 20.4 ± 18.6 to 5.8 ± 6.6 (-75%) in the RFA, and from 13.6 ± 13.3 to 3.4 ± 4.1 (-83.9%) in the laser ablation groups. Conclusions: Transient but potentially serious adverse events were reported in 3% of patients. A significant volumetric reduction was achieved with both techniques, regardless of nodule's characteristics, at 18 months.
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Affiliation(s)
- Adrien Ben Hamou
- a Department of Endocrinology, Diabetology and Metabolism , CHU Lille , Lille , France
| | - Edouard Ghanassia
- a Department of Endocrinology, Diabetology and Metabolism , CHU Lille , Lille , France.,b American Hospital of Paris, Thyroid Unit , Neuilly-sur-Seine , France.,c Polyclinique Sainte-Thérèse , Sète , France
| | - Stephanie Espiard
- a Department of Endocrinology, Diabetology and Metabolism , CHU Lille , Lille , France
| | | | - Arnaud Jannin
- a Department of Endocrinology, Diabetology and Metabolism , CHU Lille , Lille , France
| | | | - Christine Do Cao
- a Department of Endocrinology, Diabetology and Metabolism , CHU Lille , Lille , France
| | - Maeva Kyheng
- f Public Health, Epidemiology and Quality of Care , Lille , France
| | - Marie Christine Vantyghem
- a Department of Endocrinology, Diabetology and Metabolism , CHU Lille , Lille , France.,g Inserm , University of Lille, CHU Lille , Lille , France
| | - Herve Monpeyssen
- b American Hospital of Paris, Thyroid Unit , Neuilly-sur-Seine , France
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Ma H, Wang R, Fang J, Zhong Q, Chen X, Hou L, Feng L, Chen X, Huang Z, Zhao H. A meta-analysis evaluating the relationship between B-type Raf kinase mutation and cervical lymphatic metastasis in papillary thyroid cancer. Medicine (Baltimore) 2020; 99:e18917. [PMID: 32000400 PMCID: PMC7004699 DOI: 10.1097/md.0000000000018917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND B-type Raf kinase (BRAF) mutation is proved to be a critical predictive factor in papillary thyroid cancer (PTC) with aggressive characteristics. However, the association between BRAF mutation and cervical lymphatic metastasis in PTC is controversial. METHODS We searched papers on the study of BRAF mutation and cervical lymphatic metastasis in PTC patients through PubMed, Web of Science, Embase, and Cochranelibrary. The BRAF (+) cases, BRAF (-) cases, and cervical lymphphatic metastatic cases in both BRAF (+) and BRAF (-) groups were collected. After Quality assessment, statistical Analysis (funnel plot and Harbord evaluation, Random-effect model, heterogeneity, subgroup analysis, sensitivity analysis, and metacum analysis) were done by the Review Manager (RevMan) 5.3 and stata14 statistical software. RESULTS There were 78 cross-section studies which met our inclusion criteria. And all of them had no selection bias, publication bias, or any other bias. A significant association existed between BRAF mutation and cervical lymph node metastasis (LNM) (odds ratio [OR] = 1.63; 95% confidence interval [CI]: 1.44-1.84; P < .05). Overall, 46 studies were conducted among East Asians. Twenty four articles had provided the data of central lymph node metastasis (CLNM), 11 articles with the data of lateral lymph node metastasis (LLNM), and classic/conventional PTC (CPTC) was analyzed in 10 studies. Subgroup analyses were performed based on ethnicity, metastatic site, and subtype of PTC. Significant association between BRAF (+) mutation and cervical LNM were indicated in East Asians (OR = 1.73; 95% CI: 1.49-2.02; P < .05), in non-East Asians (OR = 1.57; 95% CI: 1.26-1.96; P < .05), and in CLNM (OR = 1.80; 95% CI: 1.56-2.07; P < .05). While no significant association was found in LLNM (OR = 1.37; 95% CI: 0.76-2.48; P = .29 > .05) and in CPTC (OR = 1.32; 95% CI: 0.97-1.80; P = .08 > .05). We did not find any other major changes when sensitivity analysis was performed. The metacum analysis showed no significant association existed before 2012. While a significant association began to exist between BRAF mutation and LNM from 2012, and this association became stable from 2017. CONCLUSIONS We consider that a significant association exists between BRAF mutation and cervical LNM. Further meta-analysis on subgroup may reveal some valuable factors between BRAF gene mutation and LNM. And we do not recommend that BRAF (+) as the biomarker for LNM in PTC.
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Affiliation(s)
- Hongzhi Ma
- Department of Otolaryngology, Head and Neck Surgery, Thyroid Center, Beijing Tong Ren Hospital, Capital Medical University, Beijing
| | - Ru Wang
- Department of Otolaryngology, Head and Neck Surgery, Thyroid Center, Beijing Tong Ren Hospital, Capital Medical University, Beijing
| | - Jugao Fang
- Department of Otolaryngology, Head and Neck Surgery, Thyroid Center, Beijing Tong Ren Hospital, Capital Medical University, Beijing
| | - Qi Zhong
- Department of Otolaryngology, Head and Neck Surgery, Thyroid Center, Beijing Tong Ren Hospital, Capital Medical University, Beijing
| | - Xiao Chen
- Department of Otolaryngology, Head and Neck Surgery, Thyroid Center, Beijing Tong Ren Hospital, Capital Medical University, Beijing
| | - Lizhen Hou
- Department of Otolaryngology, Head and Neck Surgery, Thyroid Center, Beijing Tong Ren Hospital, Capital Medical University, Beijing
| | - Ling Feng
- Department of Otolaryngology, Head and Neck Surgery, Thyroid Center, Beijing Tong Ren Hospital, Capital Medical University, Beijing
| | - Xiaohong Chen
- Department of Otolaryngology, Head and Neck Surgery, Thyroid Center, Beijing Tong Ren Hospital, Capital Medical University, Beijing
| | - Zhigang Huang
- Department of Otolaryngology, Head and Neck Surgery, Thyroid Center, Beijing Tong Ren Hospital, Capital Medical University, Beijing
| | - Huanhu Zhao
- School of Pharmacy, Minzu University of China, China
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Pastoricchio M, Cubisino A, Lanzaro A, Troian M, Zanconati F, Bernardi S, Fabris B, de Manzini N, Dobrinja C. Impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology Classification of Thyroid Nodules in the Treatment of Indeterminate Follicular Lesions: Five-Year Results at a Single Center. Int J Endocrinol 2020; 2020:7325260. [PMID: 32351561 PMCID: PMC7178537 DOI: 10.1155/2020/7325260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Aim of the study was to assess the impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology (SIAPEC) classification of 2014, on the treatment of indeterminate thyroid lesions (TIR3). METHODS We retrospectively analyzed patients undergoing thyroid surgery for TIR3 lesions between 2013 and 2018, at the General Surgery Department of Trieste University Hospital. According to the SIAPEC classification, patients were divided into TIR3A and TIR3B groups. All patients treated before 2014 underwent surgical treatment, and surgical specimens were retrospectively classified after revision of fine-needle aspiration cytology. Starting 2014, TIR3A patients were treated only when symptomatic (i.e., coexistent bilateral thyroid goiter or growing TIR3A nodules), whereas TIR3B patients always received surgical treatment. Hemithyroidectomy (HT) was the procedure of choice. Total thyroidectomy (TT) was performed in case of concurrent bilateral goiter, autoimmune thyroid disease, and/or presence of BRAF and/or RAS mutation. Lastly, we analyzed the malignancy rate in the two groups. RESULTS 29 TIR3A and 90 TIR3B patients were included in the study. HT was performed in 10 TIR3A patients and 37 TIR3B patients, respectively, with need for reoperation in 4 TIR3B (10.8%) patients due to histological findings of follicular thyroid carcinoma >1 cm. The malignancy rates were 17.2% in TIR3A and 31.1% in TIR3B, (p = 0.16). Predictability of malignancy was almost 89% in BRAF mutation and just 47% in RAS mutation. CONCLUSIONS The new SIAPEC classification in association with biomolecular markers has improved diagnostic accuracy, patient selection, and clinical management of TIR3 lesions.
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Affiliation(s)
- M. Pastoricchio
- Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, Italy
| | - A. Cubisino
- Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, Italy
| | - A. Lanzaro
- Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, Italy
| | - M. Troian
- Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, Italy
| | - F. Zanconati
- Department of Medical, Surgical and Health Sciences, Università Degli Studi di Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy
| | - S. Bernardi
- Department of Medical, Surgical and Health Sciences, Università Degli Studi di Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy
- Endocrinology Unit—Azienda Sanitaria Universitaria Integrata Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy
| | - B. Fabris
- Department of Medical, Surgical and Health Sciences, Università Degli Studi di Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy
- Endocrinology Unit—Azienda Sanitaria Universitaria Integrata Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy
| | - N. de Manzini
- Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, Italy
| | - C. Dobrinja
- Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, Italy
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Lou X, Wang X, Wang Z, Mao G, Zhu W, Wang Y, Pan X, Chen Z, Mo Z. The Effect of Iodine Status on the Risk of Thyroid Nodules: A Cross-Sectional Study in Zhejiang, China. Int J Endocrinol 2020; 2020:3760375. [PMID: 32908502 PMCID: PMC7450337 DOI: 10.1155/2020/3760375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/09/2020] [Accepted: 08/05/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The aim of this study was to explore whether iodine nutrition is associated with the risk of thyroid nodules among adult population in Zhejiang Province, China. METHODS A cross-sectional study was conducted in the general population aged 18 years or older. A total of 2,710 subjects received physical examination, questionnaires, and thyroid ultrasonography. Urinary iodine concentration (UIC) and thyroid hormone levels were measured and documented for each subject. 4 multiple logistic regression models adjusted for other risk factors were applied to analyze the association between iodine nutrition and thyroid nodules. RESULTS The prevalence of thyroid nodules was 15.5% among all adults. As indicated by all 4 models, subjects with UIC varying from 200 μg l-1 to 399 μg l-1 had lower risk of thyroid nodules compared with those with relatively low UIC (<100 μg l-1), with approximately 37-57 percent reduction in risk. Moreover, subjects with UIC between 100 and 199 μg l-1 had a decreased risk of thyroid nodules in model 1 and 2 (OR = 0.75, 95% CI, 0.58-0.97; OR = 0.75, 95% CI, 0.58-0.97, respectively). However, there was no significant difference of risk in thyroid nodules between subjects with high UIC (≥400 μg l-1) and low UIC (<100 μg l-1). Furthermore, intake of iodized salt was inversely associated with risk of thyroid nodules, with approximately 69-77 percent reduction in risk. CONCLUSION The relationship between UIC and the risk of thyroid nodules is U-shaped. Consumption of noniodized salt is an independent risk factor of thyroid nodules.
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Affiliation(s)
- Xiaoming Lou
- Department of Environmental Health, Zhejiang Provincial Center for Disease Prevention and Control, 3399 Binsheng Road, Hangzhou 310051, Zhejiang, China
| | - Xiaofeng Wang
- Department of Environmental Health, Zhejiang Provincial Center for Disease Prevention and Control, 3399 Binsheng Road, Hangzhou 310051, Zhejiang, China
| | - Zhifang Wang
- Department of Environmental Health, Zhejiang Provincial Center for Disease Prevention and Control, 3399 Binsheng Road, Hangzhou 310051, Zhejiang, China
| | - Guangming Mao
- Department of Environmental Health, Zhejiang Provincial Center for Disease Prevention and Control, 3399 Binsheng Road, Hangzhou 310051, Zhejiang, China
| | - Wenming Zhu
- Department of Environmental Health, Zhejiang Provincial Center for Disease Prevention and Control, 3399 Binsheng Road, Hangzhou 310051, Zhejiang, China
| | - Yuanyang Wang
- Department of Environmental Health, Zhejiang Provincial Center for Disease Prevention and Control, 3399 Binsheng Road, Hangzhou 310051, Zhejiang, China
| | - Xuejiao Pan
- Department of Environmental Health, Zhejiang Provincial Center for Disease Prevention and Control, 3399 Binsheng Road, Hangzhou 310051, Zhejiang, China
| | - Zhijian Chen
- Department of Environmental Health, Zhejiang Provincial Center for Disease Prevention and Control, 3399 Binsheng Road, Hangzhou 310051, Zhejiang, China
| | - Zhe Mo
- Department of Environmental Health, Zhejiang Provincial Center for Disease Prevention and Control, 3399 Binsheng Road, Hangzhou 310051, Zhejiang, China
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Yildirim Simsir I, Cetinkalp S, Kabalak T. Review of Factors Contributing to Nodular Goiter and Thyroid Carcinoma. Med Princ Pract 2020; 29:1-5. [PMID: 31542786 PMCID: PMC7024874 DOI: 10.1159/000503575] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 09/22/2019] [Indexed: 01/07/2023] Open
Abstract
There is an increased incidence of thyroid nodules and cancer. In this article, the reasons for this increase are evaluated and discussed. The factors causing increases in the incidence of nodules are the same as those causing increases in thyroid cancer. There are publications from all over the world regarding the rising incidence of thyroid cancer; it is especially associated with papillary cancer. The literature was reviewed and evaluated with regard to this significant phenomenon. Thyroid-stimulating hormone (TSH) is the main mitotic factor. Any agent that elevates TSH will stimulate nodule formation. Therefore, the incidence of thyroid nodules is high in endemic goiter regions due to iodine deficiency. This paper has described many of the factors causing this higher incidence. Of note, metabolic syndrome and insulin resistance are important factors associated with the increased incidence of nodular goiter and papillary thyroid cancer today. However, these data must be confirmed by other studies in the future.
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Affiliation(s)
- Ilgin Yildirim Simsir
- Division of Endocrinology and Metabolism Disorders, Department of Internal Medicine, Ege University Medical Faculty, Izmir, Turkey,
| | - Sevki Cetinkalp
- Division of Endocrinology and Metabolism Disorders, Department of Internal Medicine, Ege University Medical Faculty, Izmir, Turkey
| | - Taylan Kabalak
- Division of Endocrinology and Metabolism Disorders, Department of Internal Medicine, Ege University Medical Faculty, Izmir, Turkey
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Li G, Wang L, Lei J, Song L, Tang H, Li Z, Gong R, Zhu J. Large-Scale Comparative Analysis Reveals A Simple Model To Predict The Prevalence Of Thyroid Nodules. Risk Manag Healthc Policy 2019; 12:225-232. [PMID: 31814785 PMCID: PMC6861839 DOI: 10.2147/rmhp.s228752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/03/2019] [Indexed: 02/05/2023] Open
Abstract
Background The frequency of thyroid nodules (TNs) has increased rapidly in recent decades. We established a simple, effective model to predict TN occurrence by a large-scale comparative analysis of the Chinese population. Subjects and methods A total of 13,307 subjects were included to screen risk factors between the case group (TN+) and the control group (TN-) by univariate and multivariate analyses. A simple prediction model formed by a subset of five factors was established. The optimal index points for predicting the prevalence of TNs, the model discriminatory power and the association of the model with the size of TNs were assessed. Results Age at diagnosis ≥45 years, female sex, body mass index (BMI) ≥24 kg/m2, hypertension, antithyroglobulin antibody (TGAB) ≥16.5 IU/mL were independently related to an increased risk of TNs. The cutoff value of 4 points was found to be the best prediction for the prevalence of TNs in the current study, and the model had better discriminatory power than other single independent predictors. In addition, a positive correlation was also found between the index points and the diameter of TNs. Conclusion Based on our prediction model, thyroid high-resolution ultrasound and associated laboratory tests may be necessary for patients with index points ≥4 due to a higher prevalence of thyroid nodules.
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Affiliation(s)
- Genpeng Li
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Lijuan Wang
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Jianyong Lei
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Linlin Song
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Huairong Tang
- Health and Management Center, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Zhihui Li
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Rixiang Gong
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Jingqiang Zhu
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
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Yang HX, Zhong Y, Lv WH, Zhang F, Yu H. Association of adiposity with thyroid nodules: a cross-sectional study of a healthy population in Beijing, China. BMC Endocr Disord 2019; 19:102. [PMID: 31619235 PMCID: PMC6794777 DOI: 10.1186/s12902-019-0430-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 09/16/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The relationship between thyroid nodules (TNs) and adiposity is controversial. This paper describes a cross-sectional investigation performed to determine the existence of any such relationship. To assess adiposity, body mass index (BMI) and visceral fat area (VFA) were utilized. METHODS Between January 1, 2017 and March 3, 2019. Three thousand five hundred thirty four healthy people were examined using thyroid ultrasonography, visceral fat and anthropometric measurements, laboratory tests and questionnaire interview. Binary logistic regression analyses were used. RESULTS Of the 3534 healthy subjects, 58.69% (2074/3534) of the subjects had TNs. A total of 55.91% (1976/3534) had BMI ≥ 25 kg/m2 and 39.67% (1402/3534) had VFA ≥ 100 cm2. After adjustment to address confounders, BMI-based overweight and obesity levels only correlated with higher risk TNs when used as a continuous variable (OR = 1.031, 95% CI: 1.008-1.055, P = 0.008), while VFA was both a continuous variable (OR = 1.003, 95% CI: 1.000-1.005, P = 0.034) and a categorical variable (OR = 1.198, 95% CI: 1.014-1.417, P = 0.034) associated with significantly elevated risk of TNs. Analyzing the subgroups, BMI ≥ 25 kg/m2 (OR = 1.500, 95% CI: 1.110-2.026, P = 0.008) was significantly correlated with TN risk in individuals with TG ≥ 1.7 mmol/L. VFA ≥ 100 cm2 correlated with the TN risk irrespective of age (< 50 years: OR = 1.374, 95% CI: 1.109-1.703, P = 0.004; ≥ 50 years: OR = 1.367, 95% CI: 1.063-1.759, P = 0.015) and in the following subgroups: women (OR = 4.575, 95% CI: 2.558-8.181, P = 0.000), FBG ≥ 6.1 mmol/L (OR = 1.522, 95% CI: 1.048-2.209, P = 0.027), and TG ≥ 1.7 mmol/L (OR = 1.414, 95% CI: 1.088-1.838, P = 0.010). CONCLUSIONS Adiposity correlates with TNs. To assess TN risk in Chinese individuals, VFA is better than BMI.
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Affiliation(s)
- Hui-xia Yang
- Beijing Rehabilitation Hospital, Capital Medical University, Xixiazhuang, Badachu, Shijingshan District, Beijing, 100144 China
| | - Yu Zhong
- Beijing Rehabilitation Hospital, Capital Medical University, Xixiazhuang, Badachu, Shijingshan District, Beijing, 100144 China
| | - Wei-hua Lv
- Beijing Rehabilitation Hospital, Capital Medical University, Xixiazhuang, Badachu, Shijingshan District, Beijing, 100144 China
| | - Feng Zhang
- Beijing Rehabilitation Hospital, Capital Medical University, Xixiazhuang, Badachu, Shijingshan District, Beijing, 100144 China
| | - Hong Yu
- Beijing Rehabilitation Hospital, Capital Medical University, Xixiazhuang, Badachu, Shijingshan District, Beijing, 100144 China
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Alshoabi SA, Binnuhaid AA. Diagnostic accuracy of ultrasonography versus fine-needle-aspiration cytology for predicting benign thyroid lesions. Pak J Med Sci 2019; 35:630-635. [PMID: 31258566 PMCID: PMC6572947 DOI: 10.12669/pjms.35.3.292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and Objective Thyroid nodules (TNs) are abnormal growths of thyroid cells that form masses within the thyroid gland. TNs are common, and the importance lies in need to exclude thyroid cancer. This study was intended to evaluate the diagnostic accuracy of ultrasonography for differentiating benign from malignant thyroid lesions in comparison with fine-needle aspiration cytology (FNA cytology). Methods This study involved 133 patients with thyroid lesions. All patients underwent thyroid ultrasonography and ultrasound (US)-guided-FNA cytology and results were compared. Results Out of 133 patients included in this study, the mean age was 41.2±15 years, and 113 (85%) were female. Thyroid lesions were benign in 126 cases (94.7%) and malignant in nine cases (5.3%). Among 124 patients with thyroid lesions diagnosed as benign with US, 122 (98.38%) were confirmed to be benign with FNA cytology, and only 2 (1.6%) were proved to be malignant. Among nine patients with thyroid lesions diagnosed as malignant by US, 5 (55.6%) were confirmed to be malignant by FNA cytology, and 4 (44.4%) were proved to be benign. The US diagnosed benign thyroid lesions with a sensitivity, specificity, positive predictive value, and negative predictive value of 98.38%, 71.42%, 98.38%, and 55.55%, respectively. The results revealed strong compatibility between diagnosis of benign thyroid lesions by the US and proved diagnosis by FNA cytology (p<0.001). Conclusion B-mode ultrasonography is a valuable tool in differentiating benign from malignant thyroid lesions. It can almost always predict the benign nature of thyroid lesions with excellent diagnostic accuracy.
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Affiliation(s)
- Sultan Abdulwadoud Alshoabi
- Sultan Abdulwadoud Alshoabi, MBBS, MD, Department of Diagnostic Radiologic Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah, Saudi Arabia
| | - Abdulkhaleq Ayedh Binnuhaid
- Abdulkhaleq Ayedh Binnuhaid, MBBS, MD, Department of Specialized Surgery, Radiology Section, Faculty of Medicine, Hadhramout University, Hadhramout, Republic of Yemen
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Alnasser Allah D, Haj Hassan L, Alourfi Z. Anthropometric Parameters and Thyroid Morphology in a Sample of Overweight and Obese Syrian Women. EUROPEAN MEDICAL JOURNAL 2019. [DOI: 10.33590/emj/10310986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: Obesity and thyroid nodules are very common. Many studies have reported that weight gain is a new risk factor for goiters and thyroid nodules. In this study, the authors aimed to evaluate thyroid morphology in obese women and tried to link thyroid morphology with anthropometric parameters.
Design: A cross-sectional study was conducted between January 2017 and January 2018. Overweight and obese Syrian females, aged >35 years, without past or recent thyroid complaints, and living in the southern region of Syria were included in the study. Weight, height, and hip and waist circumference were measured to calculate anthropometric parameters. Thyroid volume and prevalence of thyroid nodules were compared among BMI groups as defined by World Health Organization classifications. Body Surface Area (BSA), waist circumference (WC), waist:hip ratio, and waist-to-height ratio (WtHR) were compared between nodule groups.
Results: A total of 140 overweight and obese females, with a mean age of aged 53±7 years were studied. Mean thyroid volume was 12.4±7.4 mL, with the highest volume identified in the Obesity Class III group (14.9±10.9 mL). Significant positive correlations were found between thyroid volume and weight, BMI, WC, BSA, and WtHR (p<0.05). Thyroid nodule prevalence was 84.3%, and 22.0% of the nodules were fine needle aspiration indicated. Weight and BSA were positively correlated with thyroid nodules (p<0.05), while BMI was not.
Conclusion: Thyroid volume was positively correlated with increased weight, BMI, WC, BSA, and WtHR in Syrian females. Positive correlations were found between weight, BSA, and thyroid nodules after age and thyroid stimulating hormone were excluded.
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Affiliation(s)
- Dareen Alnasser Allah
- Endocrinology Department, Al-Mouwasat University Hospital, Damascus University, Damascus, Syria
| | - Lilianne Haj Hassan
- Endocrinology Department, Al-Mouwasat University Hospital, Damascus University, Damascus, Syria
| | - Zaynab Alourfi
- Department of Internal Medicine, Faculty of Medicine, Damascus University, Damascus, Syria
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Li L, Ying Y, Zhang C, Wang W, Li Y, Feng Y, Liang J, Song H, Wang Y. Bisphenol A exposure and risk of thyroid nodules in Chinese women: A case-control study. ENVIRONMENT INTERNATIONAL 2019; 126:321-328. [PMID: 30825751 DOI: 10.1016/j.envint.2019.02.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/27/2019] [Accepted: 02/10/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Thyroid nodules (TNs) are highly prevalent worldwide and have a pattern of female predominance. Bisphenol A (BPA) is an endocrine disruptor that can lead to adverse effects in human health. However, epidemiologic studies revealing the association between BPA exposure and TNs are limited and the results are inconsistent. We aimed to examine the association between urinary BPA and TNs in women who are more susceptible to TNs. METHODS We conducted a case-control study with 1416 women aged 18 years or older (705 cases, 711 controls). All participants underwent thyroid ultrasonography. Urinary total BPA (free and conjugated) concentration was quantified using the HPLC-MS/MS. We analyzed the association between urinary BPA concentration and the risk of TNs using crude and multivariable logistic regression models. Participants were further stratified into thyroid autoantibody positive group (at least one positive) and thyroid autoantibody negative group (both negative) according to the thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) levels, and restricted cubic spline regression was also applied to determine the possible nonlinear relationship between urinary BPA and TNs. RESULTS Compared with women in the first quartile, the odds of TNs was 72% (adjusted OR = 1.72, 95% CI: 1.25 to 2.35) higher for those in the second quartile, 54% (adjusted OR = 1.54, 95% CI: 1.12 to 2.12) higher for those in the third quartile, and 108% (adjusted OR = 2.08, 95% CI: 1.50 to 2.90) higher for those in the fourth quartile after adjusting for age, BMI, education, HDL-C, LDL-C, triglyceride, total cholesterol, urinary iodine, TGAb and TPOAb. When the study population was stratified into thyroid autoantibody positive group and thyroid autoantibody negative group, we found that only in the positive group, the association was significant in model 1 (crude OR = 2.80; 95% CI = 1.90 to 4.12), model 2 (adjusted OR = 2.84; 95% CI = 1.91 to 4.22), model 3 (adjusted OR = 4.01; 95% CI = 2.57 to 6.27) and model 4 (adjusted OR = 3.71; 95% CI = 2.36 to 5.83). Multivariable-adjusted restricted cubic spline analysis demonstrated a similar result that in the thyroid autoantibody positive group, the association between urinary BPA and TNs risk was near linear (P-overall <0.001; P-non-linear = 0.054). CONCLUSION In Chinese women, higher urinary BPA concentration was associated with increased risk of TNs only in those with positive thyroid autoantibodies. Moreover, this association was near linear, indicating that any rise in BPA exposure was associated with elevated TNs risk.
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Affiliation(s)
- Lu Li
- The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200011, China
| | - Yingxia Ying
- The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200011, China
| | - Changrun Zhang
- The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200011, China
| | - Wei Wang
- School of Public Health, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200025, China
| | - Yan Li
- School of Public Health, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200025, China
| | - Yan Feng
- School of Public Health, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200025, China
| | - Jun Liang
- Department of Endocrinology, the Central Hospital of Xuzhou, Affiliated Hospital of Southeast University, Xuzhou 221009, Jiangsu Province, China
| | - Huaidong Song
- The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200011, China.
| | - Yan Wang
- The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200011, China; School of Public Health, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200025, China.
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Zatelli MC, Lamartina L, Meringolo D, Arvat E, Damiani L, Grani G, Nervo A, Durante C, Giacomelli L. Thyroid nodule recurrence following lobo-isthmectomy: incidence, patient's characteristics, and risk factors. J Endocrinol Invest 2018; 41:1469-1475. [PMID: 30182360 DOI: 10.1007/s40618-018-0946-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 08/11/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE This study was aimed at assessing the incidence and timing of thyroid nodules recurrence, defined as appearance of new benign or malignant nodules in contralateral lobe in patients with benign thyroid nodules or thyroid microcarcinoma treated with lobo-isthmectomy. Patient's characteristics and risk factors associated with this phenomenon were also investigated. METHODS A retrospective study was performed by evaluating 413 patients undergoing lobo-isthmectomy with a minimum follow-up of 1 year. Clinical characteristics, surgical interventions and complications, histological diagnosis, and thyroid function at last follow-up were collected. RESULTS Single or multiple thyroid nodule recurrence equally occurred in 80 patients (23%) with a median time to relapse of ~ 5 years (range 0.3-34.5 years) after lobo-isthmectomy. Recurrence was significantly associated with younger age (< 46 years) and number of pregnancies in women. Development of hypothyroidism was not rare either (~ 10%) and appeared in 3-19 months; a preoperative TSH level > 2.43 mIU/L was associated with the need of l-thyroxin replacement therapy after surgery. The most frequent surgical complication was transient hypoparathyroidism (4.6%), while the rate of permanent hypoparathyroidism significantly increased in patients submitted to completion thyroidectomy (5.3%). CONCLUSIONS Thyroid nodules recurrence following lobo-isthmectomy is not a rare event and occurs within 5 years after surgery, more frequently in younger patients with family history of nodular goiter and in women with multiple pregnancies. Pre-surgical TSH levels may predict the development of post-surgical hypothyroidism, possibly improving the management of patients addressed to surgery.
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Affiliation(s)
- M C Zatelli
- Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
| | - L Lamartina
- Department of Internal Medicine and Medical Specialties, University of Rome 'Sapienza', Rome, Italy
| | - D Meringolo
- Endocrinology Unit, AUSL Bologna-Bentivoglio Hospital, Bologna, Italy
| | - E Arvat
- Division of Oncological Endocrinology, Department of Medical Sciences, Azienda Ospedaliera Città DELLA Salute E Della Scienza, Turin, Italy
| | - L Damiani
- Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - G Grani
- Department of Internal Medicine and Medical Specialties, University of Rome 'Sapienza', Rome, Italy
| | - A Nervo
- Division of Oncological Endocrinology, Department of Medical Sciences, Azienda Ospedaliera Città DELLA Salute E Della Scienza, Turin, Italy
| | - C Durante
- Department of Internal Medicine and Medical Specialties, University of Rome 'Sapienza', Rome, Italy
| | - L Giacomelli
- Department of Surgical Sciences, University of Rome 'Sapienza', Rome, Italy
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Hwangbo Y, Lee EK, Son HY, Im SW, Kwak SJ, Yoon JW, Kim MJ, Kim J, Choi HS, Ryu CH, Lee YJ, Kim JI, Cho NH, Park YJ. Genome-Wide Association Study Reveals Distinct Genetic Susceptibility of Thyroid Nodules From Thyroid Cancer. J Clin Endocrinol Metab 2018; 103:4384-4394. [PMID: 30099483 DOI: 10.1210/jc.2017-02439] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 08/01/2018] [Indexed: 01/02/2023]
Abstract
CONTEXT Thyroid nodules are very common, and 7% to 15% of them are diagnosed as thyroid cancer. However, the inherited genetic risk factors for thyroid nodules and their associations with thyroid cancer remain unknown. OBJECTIVE To identify the genetic variants associated with susceptibility to thyroid nodules in comparison with thyroid cancer. DESIGN AND SETTING We performed a three-stage genome-wide association study for thyroid nodules. The discovery stage involved a genome-wide scan of 811 subjects with thyroid nodules and 691 subjects with a normal thyroid from a population-based cohort. Replication studies were conducted in an additional 1981 cases and 3100 controls from the participants of a health checkup. We also performed expression quantitative trait loci analysis of public data. RESULTS The most robust association was observed in TRPM3 (rs4745021) in the joint analysis (OR, 1.26; P = 6.12 × 10-8) and meta-analysis (OR, 1.28; P = 2.11 × 10-8). Signals at MBIP/NKX2-1 were replicated but did not reach genome-wide significance in the joint analysis (rs2415317, P = 4.62 × 10-5; rs944289, P = 8.68 × 10-5). The expression quantitative trait loci analysis showed that TRPM3 expression was associated with the rs4745021 genotype in thyroid tissues. CONCLUSIONS To the best of our knowledge, we have performed the first genome-wide association study of thyroid nodules and identified a susceptibility locus associated with thyroid nodules, suggesting that thyroid nodules have a genetic predisposition distinct from that of thyroid cancer.
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Affiliation(s)
- Yul Hwangbo
- Center for Thyroid Cancer, National Cancer Center, Korea, Goyang, Republic of Korea
| | - Eun Kyung Lee
- Center for Thyroid Cancer, National Cancer Center, Korea, Goyang, Republic of Korea
| | - Ho-Young Son
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Sun-Wha Im
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Soo-Jung Kwak
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Ji Won Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Min Joo Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Jeongseon Kim
- Molecular Epidemiology Branch, Division of Cancer Epidemiology and Prevention, Research Institute, National Cancer Center, Goyang, Republic of Korea
| | - Hoon Sung Choi
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Chang Hwan Ryu
- Center for Thyroid Cancer, National Cancer Center, Korea, Goyang, Republic of Korea
| | - You Jin Lee
- Center for Thyroid Cancer, National Cancer Center, Korea, Goyang, Republic of Korea
| | - Jong-Il Kim
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Nam H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Fan L, Tan L, Chen Y, Du C, Zhu M, Wang K, Wei H, Wang W, Gao M, Zhang Y, Cui T, Chen W, Shen J, Zhang W. Investigation on the factors that influence the prevalence of thyroid nodules in adults in Tianjin, China. J Trace Elem Med Biol 2018; 50:537-542. [PMID: 29544745 DOI: 10.1016/j.jtemb.2018.03.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 03/06/2018] [Accepted: 03/06/2018] [Indexed: 11/23/2022]
Abstract
Studies have shown that prevalence of thyroid nodules (TNs) has been increasing recently. However, the factors that may influence TN prevalence is not fully understood. In this study, we aimed to understand the prevalence of TNs and identify possible factors that are associated with the prevalence of TNs in Tianjin, China. Subjects aged 18 years or older were randomly collected and all subjects received thyroid ultrasonography, physical examination and questionnaires. Subjects (n = 2647) were divided into the case group in which the subjects had TNs and the control group in which the subjects did not have TNs. Potential influencing factors on TNs including sex, age, iodine status, thyroid volume, thyroid hormone (TSH), thyroid autoantibody TPOAb, TGAb and living habits were analyzed. Our results showed that the overall TN prevalence was 26.7%. The prevalence of TNs in women was higher than that in men (P < 0.05). TN prevalence increased with age (P < 0.001), and a U-shaped curve relationship between urine iodine concentrations (UICs) and prevalence of TNs was observed. The positive rate of TPOAb and goiter rate in case group was higher than that in control group (P < 0.05). The thyroid volume in case group was larger than that in control group (P < 0.001). Other factors that may influence TNs included high blood pressure, iodized salt, menopause, seafood intake, and education levels. None of UIC, TSH, TPOAb and TGAb were associated with TN prevalence in regression models. In conclusion, our results showed that TNs prevalence in Tianjin was high. TNs prevalence was higher in women than in men, and it increases with age. The older, female, high education level physical labor and goiter are independent risk factors for TNs.
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Affiliation(s)
- Lili Fan
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Long Tan
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yanting Chen
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Cong Du
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Mei Zhu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No 154 Anshan Road, Heping District, Tianjin 300052, China
| | - Kunling Wang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No 154 Anshan Road, Heping District, Tianjin 300052, China
| | - Hongyan Wei
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No 154 Anshan Road, Heping District, Tianjin 300052, China
| | - Wei Wang
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Min Gao
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yixin Zhang
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Tingkai Cui
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Wen Chen
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Jun Shen
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Wanqi Zhang
- School of Public Health, Tianjin Medical University, Tianjin 300070, China; Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No 154 Anshan Road, Heping District, Tianjin 300052, China.
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Mileva M, Stoilovska B, Jovanovska A, Ugrinska A, Petrushevska G, Kostadinova-Kunovska S, Miladinova D, Majstorov V. Thyroid cancer detection rate and associated risk factors in patients with thyroid nodules classified as Bethesda category III. Radiol Oncol 2018; 52:370-376. [PMID: 30265655 PMCID: PMC6287180 DOI: 10.2478/raon-2018-0039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/23/2018] [Indexed: 01/21/2023] Open
Abstract
Background Ultrasound guided fine-needle aspiration (FNA) is a standard procedure for thyroid nodules management and selecting patients for surgical treatment. Atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS), as stated by The Bethesda System for Reporting Thyroid Cytopathology, is a diagnostic category with an implied malignancy risk of 5-15%. The aim of our study was to review cytology and histopathology reports, as well as clinical and ultrasound data, for thyroid nodules reported as AUS/FLUS, in order to evaluate the malignancy rate and to assess factors associated with malignant outcome. Patients and methods A total of 112 AUS/FLUS thyroid nodules in 105 patients were evaluated, of which 85 (75.9%) were referred to surgery, 21 (18.8%) were followed-up by repeat FNA and 6 nodules (5.3%) were clinically observed. Each was categorized in two final diagnostic groups - benign or malignant, which were further compared to clinical data of patients and ultrasonographic features of the nodules. Results Final diagnosis of malignancy was reached in 35 cases (31.2%) and 77 (68.8%) had benign lesions. The most frequent type of cancer was papillary thyroid carcinoma (PTC) - 58.1% PTC and 25.8% had follicular variant of PTC. Patients' younger age, smaller nodule size, hypoechoic nodule and presence of calcifications were shown to be statistically significant risk factors for malignancy. Conclusions The rate of malignancy for the AUS/FLUS diagnostic category in our study was higher than estimated by the Bethesda System. Clinical and ultrasound factors should be considered when decision for patient treatment is being made.
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Affiliation(s)
- Magdalena Mileva
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
| | - Bojana Stoilovska
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
| | - Anamarija Jovanovska
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
| | - Ana Ugrinska
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
| | - Gordana Petrushevska
- Institute of Pathology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
| | | | - Daniela Miladinova
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
| | - Venjamin Majstorov
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
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Chen J, Li XL, Zhao CK, Wang D, Wang Q, Li MX, Wei Q, Ji G, Xu HX. Conventional Ultrasound, Immunohistochemical Factors and BRAF V600E Mutation in Predicting Central Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:2296-2306. [PMID: 30100099 DOI: 10.1016/j.ultrasmedbio.2018.06.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 05/28/2018] [Accepted: 06/29/2018] [Indexed: 12/18/2022]
Abstract
The study was aimed at evaluating the correlation between central cervical lymph node metastasis (CLNM) in papillary thyroid carcinoma (PTC) patients and ultrasound (US) features, immunohistochemical factors and BRAFV600E mutation. A total of 225 consecutive patients (225 PTCs) who had undergone surgery were included. All PTCs were pre-operatively analysed by US with respect to size, components, echogenicity, shape, margins, microcalcification, multiple cancers or not, internal vascularity and capsule contact or involvement. The presence of four immunohistochemical factors, including cytokeratin 19, human bone marrow endothelial cell 1, galectin-3 and thyroid peroxidase, and BRAFV600E mutation was also evaluated. Univariate and multivariate analyses were performed to identify the risk factors for central CLNM, and a risk model was established. Pathologically, 44% (99/225) of the PTCs had central CLNMs. Multivariate analysis revealed that size ≤10mm, microcalcification, internal vascularity, capsule contact or involvement and BRAFV600E mutation were independent risk factors for central CLNM. The risk score for central CLNM was calculated as follows: risk score = 1.5 × (if lesion size ≤10 mm) + 1.9 × (if microcalcification) + 0.8 × (if internal flow) + 3.0 × (if capsule contact or involvement) + 1.5 × (if BRAFV600E mutation). The rating result was divided into six stages, and the relevant risk rates of central CLNM were 0% (0/1), 0% (0/22), 7.4% (4/54), 48.6% (34/70), 71.2% (42/59) and 100% (19/19), respectively. In conclusion, PTC ≤10mm, microcalcification, internal vascularity, capsule contact or involvement and BRAFV600E mutation are risk factors for central CLNM. The risk model may be useful in treatment planning and management of patients with PTCs.
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Affiliation(s)
- Jie Chen
- Department of Medical Ultrasound, The Affiliated Shanghai Tenth People's Hospital of Nanjing Medical University, Shanghai, China; Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China; Thyroid Institute, Tongji University School of Medicine, Shanghai, China; Shanghai Center for Thyroid Disease, Shanghai, China; Department of Medical Ultrasound, Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiao-Long Li
- Department of Medical Ultrasound, The Affiliated Shanghai Tenth People's Hospital of Nanjing Medical University, Shanghai, China; Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China; Thyroid Institute, Tongji University School of Medicine, Shanghai, China; Shanghai Center for Thyroid Disease, Shanghai, China
| | - Chong-Ke Zhao
- Department of Medical Ultrasound, The Affiliated Shanghai Tenth People's Hospital of Nanjing Medical University, Shanghai, China; Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China; Thyroid Institute, Tongji University School of Medicine, Shanghai, China; Shanghai Center for Thyroid Disease, Shanghai, China
| | - Dan Wang
- Department of Medical Ultrasound, The Affiliated Shanghai Tenth People's Hospital of Nanjing Medical University, Shanghai, China; Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China; Thyroid Institute, Tongji University School of Medicine, Shanghai, China; Shanghai Center for Thyroid Disease, Shanghai, China
| | - Qiao Wang
- Department of Medical Ultrasound, The Affiliated Shanghai Tenth People's Hospital of Nanjing Medical University, Shanghai, China; Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China; Thyroid Institute, Tongji University School of Medicine, Shanghai, China; Shanghai Center for Thyroid Disease, Shanghai, China
| | - Ming-Xu Li
- Department of Medical Ultrasound, The Affiliated Shanghai Tenth People's Hospital of Nanjing Medical University, Shanghai, China; Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China; Thyroid Institute, Tongji University School of Medicine, Shanghai, China; Shanghai Center for Thyroid Disease, Shanghai, China
| | - Qing Wei
- Department of Pathology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Guo Ji
- Department of Pathology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hui-Xiong Xu
- Department of Medical Ultrasound, The Affiliated Shanghai Tenth People's Hospital of Nanjing Medical University, Shanghai, China; Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China; Thyroid Institute, Tongji University School of Medicine, Shanghai, China; Shanghai Center for Thyroid Disease, Shanghai, China.
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Zhao H, Li H, Huang T. High Urinary Iodine, Thyroid Autoantibodies, and Thyroid-Stimulating Hormone for Papillary Thyroid Cancer Risk. Biol Trace Elem Res 2018; 184:317-324. [PMID: 29164514 DOI: 10.1007/s12011-017-1209-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/17/2017] [Indexed: 10/18/2022]
Abstract
Thyroid nodules have become a common clinical problem, and the clinical importance of thyroid nodules lies in the determination of thyroid cancer. This study aims to evaluate the risk factors for papillary thyroid cancer (PTC) with regard to urinary iodine concentration (UIC), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TGAb) in comparison to thyroid nodular goiter (NG). Among the 2041 patients, 43.8% of which showed more than adequate (UIC 200-299 μg/L) and excessive iodine (UIC ≥ 300.0 μg/L) status. Compared with adequate iodine intake, iodine deficiency (UIC < 100 μg/L) was inversely associated with multifocality (OR 0.59, P = 0.040), while more than adequate iodine intake was independently associated with an increased risk of larger tumor size (OR 1.33, P = 0.002) in female PTC patients but not in males. No significant difference in UIC was observed between patients with PTC and NG, suggesting that high iodine intake may be related with the growth of PTC, but not with its oncogenesis. Besides, positive for TPOAb and TGAb were individually associated with papillary thyroid microcarcinoma (PTMC) risk (OR 2.05 and 1.71, respectively, both P < 0.05) in female patients with tumor foci < 1 cm but not in males. Furthermore, younger age (< 46 years), TGAb positivity and small thyroid nodules in both sexes, higher TSH, TPOAb positivity, and multifocality in females could all predict PTC risk (all P < 0.05). These results might have clinical significance for managing patients with thyroid nodules and those with thyroidectomy.
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Affiliation(s)
- Hengqiang Zhao
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Hehe Li
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Tao Huang
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Yao Y, Chen X, Wu S, Guo L, Zhang H, Zhu Q, Tang J, Luan F, Zhao Y, Lv F, He Y. Thyroid nodules in centenarians: prevalence and relationship to lifestyle characteristics and dietary habits. Clin Interv Aging 2018; 13:515-522. [PMID: 29662307 PMCID: PMC5892957 DOI: 10.2147/cia.s162425] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Thyroid nodules (TNs) are common thyroid lesions in older population. Few studies have focused on the prevalence of TNs and their relationship to lifestyle characteristics and dietary habits in centenarians. The current study aimed at determining the prevalence of TNs in Chinese centenarians by using high-resolution ultrasound (US) equipment and at investigating its relationship to lifestyle characteristics and dietary habits. Participants and methods The current study was part of the China Hainan Centenarian Cohort Study that was conducted in Hainan, an iodine-sufficient region in People’s Republic of China. A total of 874 permanent residents aged ≥100 years (mean age =102.8±2.8 years) without any missing data were included in the analysis. Results Among the participants, 649 of them were detected at least one TN under the US examinations. The overall prevalence rate of TNs was 74.3%. The prevalence of TNs was higher in participants who were women, had hypertension, had diabetes, and were underweight compared with their counterparts. Multivariate logistic regression analyses showed that being female, hypertensive, and diabetic; betel quid consumption; and red meat consumption were independent risk factors, while being underweight and nut consumption were independent protective factors for TNs. Conclusion Our findings indicate that the presence of TNs was highly prevalent in Chinese centenarians, particularly in women. In addition to gender, having hypertension, having diabetes, and being underweight, the presence of TNs was independently associated with betel quid, red meat, and nut consumption. Further prospective studies are warranted to verify these associations in populations from different age strata, races, cultures, and iodine supplementation.
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Affiliation(s)
- Yao Yao
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Xianghui Chen
- Department of Ultrasonography, Hainan Branch of PLA General Hospital, Sanya, People's Republic of China
| | - Shengzheng Wu
- Department of Ultrasonography, Hainan Branch of PLA General Hospital, Sanya, People's Republic of China
| | - Liang Guo
- Department of Ultrasonography, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Hao Zhang
- Department of Health Policy and Management, Texas A&M University, College Station, TX, USA
| | - Qiao Zhu
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, People's Republic of China
| | - Jie Tang
- Department of Ultrasonography, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Fuxin Luan
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, People's Republic of China
| | - Yali Zhao
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, People's Republic of China
| | - Faqin Lv
- Department of Ultrasonography, Hainan Branch of PLA General Hospital, Sanya, People's Republic of China
| | - Yao He
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, People's Republic of China
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Song B, Zuo Z, Tan J, Guo J, Teng W, Lu Y, Liu C. Association of thyroid nodules with adiposity: a community-based cross-sectional study in China. BMC Endocr Disord 2018; 18:3. [PMID: 29374470 PMCID: PMC5787304 DOI: 10.1186/s12902-018-0232-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 01/19/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The association between thyroid nodules and adiposity remains controversial. We performed a cross-sectional, community-based study to examine whether thyroid nodules are associated with overweight and obesity, as defined with body mass index (BMI) and waist circumference. METHODS The study included 1482 subjects (≥20 years of age; residing in Nanjing, China) receiving questionnaire interview, anthropometric measurements, laboratory tests and thyroid ultrasonography in 2009-2010. Overweight and obesity were defined as BMI ≥24 and ≥28 kg/m2, respectively. Central obesity was defined as waist circumference at ≥90 cm in men and ≥80 cm in women. A sensitivity analysis was conducted using the American Diabetes Association (ADA) criteria for overweight and obesity (BMI ≥ 23 and ≥25 kg/m2). RESULTS Thyroid nodules were identified in 12.6% of the subjects. A greater proportion of the subjects with thyroid nodules had a BMI at ≥24 kg/m2 (51.9% vs. 40.5% in those without thyroid nodules, P = 0.003) and central obesity (43.3% vs. 24.2%, P < 0.001). After adjustment for other confounders, central obesity was still associated with significantly elevated risk of thyroid nodules (OR 1.62, 95%CI 1.14-2.28), whereas obesity/overweight based on BMI was not in both the main analysis and sensitivity analysis with the alternative criteria. In the subgroup analysis, BMI ≥24 kg/m2 (OR 1.61, 95%CI 1.01-2.54), as well as BMI ≥25 kg/m2 (OR 1.95, 95%CI 1.14-3.34), was significantly associated with higher risk of thyroid nodules among women. Using the ADA criteria, overweight and obesity were associated with thyroid nodules (OR 5.59, 95%CI 1.39-22.51 and 5.15, 95%CI 1.30-20.37) in thyroid-stimulating hormone (TSH) > 4.2 mIU/L subgroup. Central obesity correlated with higher risk of thyroid nodules regardless of age (< 50 years: OR 1.87, 95%CI 1.05-3.32: ≥50 years: OR 1.54, 95%CI 1.00-2.37) and in the following subgroups: men (OR 1.91, 95%CI 1.14-3.20), TSH > 4.2 mIU/L (OR 3.05, 95%CI 1.01-9.22), and urine iodine ≥200 µg/L (OR 1.79, 95%CI 1.14-2.81). CONCLUSION Waist circumference is superior to BMI for assessing risk of thyroid nodules in Chinese subjects.
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Affiliation(s)
- Bin Song
- Department of Endocrinology, The Second Affiliated Hospital of Nanjing Medical University, 125 Jiangjiayuan Road, Nanjing, 211166 China
- Department of Endocrinology, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, 225001 China
| | - Zhihua Zuo
- Department of Endocrinology, The Second Affiliated Hospital of Nanjing Medical University, 125 Jiangjiayuan Road, Nanjing, 211166 China
| | - Juan Tan
- Department of Gerontology, Huai’an First People’s Hospital, Nanjing Medical University, 6 Beijing West Road, Huai’an, 223300 China
| | - Jianjin Guo
- Department of Endocrinology, Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001 China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, The First Hospital of China Medical University, 155 Nanjing Road, Shenyang, 110001 China
| | - Yibing Lu
- Department of Endocrinology, The Second Affiliated Hospital of Nanjing Medical University, 125 Jiangjiayuan Road, Nanjing, 211166 China
| | - Chao Liu
- Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 8 Huadian East Road, Nanjing, 210028 China
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Chen Y, Zhu C, Chen Y, Wang N, Li Q, Han B, Zhao L, Chen C, Zhai H, Lu Y. The Association of Thyroid Nodules with Metabolic Status: A Cross-Sectional SPECT-China Study. Int J Endocrinol 2018; 2018:6853617. [PMID: 29721016 PMCID: PMC5867611 DOI: 10.1155/2018/6853617] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 02/08/2018] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the association of thyroid nodules (TNs) and their ultrasound (US) characteristics related to malignancy with metabolic status. METHODS The data were obtained from a cross-sectional study (SPECT-China, 2014-2015). The study included 9898 participants older than 18 years. Participants underwent several checkups, which included the measurement of anthropometric parameters, blood pressure, TSH levels, glucose, and lipid profiles. TN and nonalcoholic fatty liver disease (NAFLD) were diagnosed by US. TN US characteristics, including microcalcification and a taller-than-wide shape, were recorded. RESULTS Participants with TN [TN(+)] had a higher prevalence of metabolic syndrome (Met-S), obesity, central obesity, hyperlipidaemia, diabetes, hypertension, and NAFLD, especially women (all P ≤ 0.001). After full adjustment, logistic regression analysis indicated that metabolic syndrome, obesity, central obesity, and hyperlipidaemia were all independent risk factors for the increased prevalence of TN in both genders (P < 0.05). In terms of TN US imaging characteristics associated with malignancy, being female with obesity, central obesity, and NAFLD had 1.91-fold, 2.09-fold, and 1.75-fold increased risks of developing a taller-than-wide nodule (P = 0.014, 0.004, and 0.027, resp.). CONCLUSIONS The status of metabolic disorders might be associated with higher risks of TN in both genders. In women, obesity, central obesity, and NAFLD might contribute to the development of a taller-than-wide nodule. The potential role of metabolic status in the pathogenesis of the thyroid nodule and thyroid cancer remains to be elucidated.
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Affiliation(s)
- Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunfang Zhu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingchao Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Li
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bing Han
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Zhao
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hualing Zhai
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Chen Y, Chen Y, Wang N, Chen C, Nie X, Li Q, Han B, Xia F, Zhai H, Jiang B, Shen Z, Lu Y. Are thyroid nodules associated with sex-related hormones? A cross-sectional SPECT-China study. BMJ Open 2017; 7:e015812. [PMID: 28775186 PMCID: PMC5629675 DOI: 10.1136/bmjopen-2016-015812] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Little is known about the association between thyroid nodules (TNs) and endogenous sex hormones. We aimed to investigate the relationship between TNs and sex-related hormones among men in China. SETTING The data were obtained from a cross-sectional study Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China study, 2014-2015) based on the population. PARTICIPANTS In total, 4024 men over 18 years of age who were not using hormone replacement therapy and who underwent complete assays of the serum total testosterone (T), oestradiol (E2), follicle-stimulating hormone (FSH), luteinising hormone (LH) and sex hormone-binding globulin (SHBG) levels as well as thyroid ultrasonography (US) enrolled in this study. RESULTS Of the 4024 participants (54.15±13.08 years old), 1667 participants (41.4%) had TNs. Men with TN(s) (TN(+) group) had significantly lower levels of total T and SHBG and higher E2/T levels compared with the men without TN(s) (TN(-) group) (p<0.05). The TN prevalence decreased with the quartiles of the SHBG level (p<0.05). Binary logistic analysis showed that lower quartiles of SHBG had a greater risk of TN(s) (all p for trend <0.05). This association persisted in the fully adjusted model (p for trend=0.017), in which, for the lowest compared with the highest quartile of SHBG, the OR of TN(s) was 1.42 (95% CI 1.07 to 1.89). No statistically significant association was found between sex-related hormones and US characteristics associated with malignancy (nodule >10 mm, microcalcification and a 'taller' than 'wider' shape). CONCLUSIONS TNs are highly prevalent in men in China. A lower SHBG level was significantly associated with TN among men. The potential role of SHBG in the pathogenesis of the TN remains to be elucidated.
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Affiliation(s)
- Yi Chen
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yingchao Chen
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chi Chen
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiaomin Nie
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Qin Li
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Bing Han
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Fangzhen Xia
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Hualing Zhai
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Boren Jiang
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Zhoujun Shen
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yingli Lu
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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Panagiotou G, Komninou D, Anagnostis P, Linardos G, Karoglou E, Somali M, Duntas L, Kita M, Tziomalos K, Pazaitou-Panayiotou K. Association between lifestyle and anthropometric parameters and thyroid nodule features. Endocrine 2017; 56:560-567. [PMID: 28390011 DOI: 10.1007/s12020-017-1285-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 03/20/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Thyroid nodularity has been associated with obesity, but data regarding associations of body composition parameters with specific ultrasound features of thyroid nodules are lacking. The aim of the present study was to assess associations between thyroid nodule ultrasound characteristics, lifestyle, and anthropometric parameters. SUBJECTS AND METHODS This was a cross-sectional study in the general apparently healthy population of Northern Greece. Thyroid ultrasound data together with medical history, demographic, and anthropometric characteristics were individually recorded. Body composition was evaluated using bioelectrical impedance. RESULTS Three hundred and six subjects [215 females (70.3%), aged 20-83 years] were included. Ultrasound revealed one or more thyroid nodules in 168 subjects (54.9%). Subjects with thyroid nodules were more frequently females (p = 0.033), older (p < 0.001) and had higher fat mass (p = 0.011), total body fat percentage (p < 0.001) and waist circumference (p = 0.045) than subjects without nodules. In logistic regression analyses, age and female gender were the only independent predictors of presence of thyroid nodules, as well as specific sonographic features. Additionally, total body fat percentage was positively correlated with nodule size (rho = 0.210, p = 0.006) and was the only independent predictor of hypoechoic thyroid nodule(s) and peripheral vascularity, while lack of exercise was predictive of internal vascularity. CONCLUSIONS Body fat accumulation and lack of exercise, used as surrogate markers of sedentary lifestyle, influence thyroid nodule size and could predict some ultrasonographic characteristics, like hypoechoicity and internal vascularity. Therefore, routine thyroid examination of obese patients and promotion of active lifestyle may be warranted to prevent thyroid nodule formation and possibly progression to malignancy.
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Affiliation(s)
- Grigorios Panagiotou
- Department of Endocrinology-Endocrine Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Despina Komninou
- Department of Endocrinology-Endocrine Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece
| | | | - George Linardos
- Department of Endocrinology-Endocrine Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Eleni Karoglou
- Department of Endocrinology-Endocrine Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Maria Somali
- Department of Endocrinology, Hippokration General Hospital, Thessaloniki, Greece
| | - Leonidas Duntas
- Department of Endocrinology-Endocrine Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Marina Kita
- Department of Endocrinology, Hippokration General Hospital, Thessaloniki, Greece
| | - Konstantinos Tziomalos
- Department of Endocrinology-Endocrine Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece
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77
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Gender Disparity in the Relationship between Prevalence of Thyroid Nodules and Metabolic Syndrome Components: The SHDC-CDPC Community-Based Study. Mediators Inflamm 2017; 2017:8481049. [PMID: 28607535 PMCID: PMC5457761 DOI: 10.1155/2017/8481049] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 02/20/2017] [Indexed: 12/31/2022] Open
Abstract
The study is aimed to investigate the pathogenesis underlying the increased prevalence of thyroid nodule (TN) in different levels of metabolic syndrome (MetS) components and analyze the relationships between TN and MetS components. A total of 6,798 subjects, including 2201 patients with TN, were enrolled in this study. Anthropometric, biochemical, thyroid ultrasonographic, and other metabolic parameters were all measured. There was obviously sexual difference in the prevalence of TN (males 26.0%, females 38.5%, resp.). The prevalence of TN in hyperuricemia (45.7% versus 37.4%, P = 0.001), NAFLD (41.2% versus 36.4%, P < 0.05), and MetS (41.4% versus 35.4%, P < 0.001) groups was significantly increased only in females. Insulin resistance [OR = 1.31 (1.15, 1.49)], MetS [OR = 1.18 (1.03, 1.35)], and diabetes [OR = 1.25 (1.06, 1.48)] were all independent risk factors for TN in total subjects, whereas, after stratified analysis of gender, MetS [OR = 1.29, (1.09, 1.53)] and diabetes [OR = 1.47, (1.17, 1.84)] are still strongly and independently associated with the higher risks of TN in female subjects, but not in males. Our results suggest that the components of MetS might associate with the higher risks of TN in women than in men, but further cohort study of this gender disparity in the association between TN and MetS is required.
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78
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Mutation spectrum of genes associated with steroid-resistant nephrotic syndrome in Chinese children. Gene 2017; 625:15-20. [PMID: 28476686 DOI: 10.1016/j.gene.2017.04.050] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 03/21/2017] [Accepted: 04/30/2017] [Indexed: 12/11/2022]
Abstract
Approximately 20% of children with idiopathic nephrotic syndrome do not respond to steroid therapy. More than 30 genes have been identified as disease-causing genes for the steroid-resistant nephrotic syndrome (SRNS). Few reports were from the Chinese population. The coding regions of genes commonly associated with SRNS were analyzed to characterize the gene mutation spectrum in children with SRNS in central China. The first phase study involved 38 children with five genes (NPHS1, NPHS2, PLCE1, WT1, and TRPC6) by Sanger sequencing. The second phase study involved 33 children with 17 genes by next generation DNA sequencing (NGS. 22 new patients, and 11 patients from first phase study but without positive findings). Overall deleterious or putatively deleterious gene variants were identified in 19 patients (31.7%), including four NPHS1 variants among five patients and three PLCE1 variants among four other patients. Variants in COL4A3, COL4A4, or COL4A5 were found in six patients. Eight novel variants were identified, including two in NPHS1, two in PLCE1, one in NPHS2, LAMB2, COL4A3, and COL4A4, respectively. 55.6% of the children with variants failed to respond to immunosuppressive agent therapy, while the resistance rate in children without variants was 44.4%. Our results show that screening for deleterious variants in some common genes in children clinically suspected with SRNS might be helpful for disease diagnosis as well as prediction of treatment efficacy and prognosis.
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79
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Cintosun U, Naharci MI, Doruk H. Comment on "Metformin Decreases Thyroid Volume and Nodule Size in Subjects with Insulin Resistance: A Preliminary Study". Med Princ Pract 2017; 26:199-200. [PMID: 27802445 PMCID: PMC5588353 DOI: 10.1159/000452955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Umit Cintosun
- *Umit Cintosun, Department of Geriatrics, Gulhane School of Medicine, TR-06018 Ankara (Turkey), E-Mail
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80
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Dauksiene D, Petkeviciene J, Klumbiene J, Verkauskiene R, Vainikonyte-Kristapone J, Seibokaite A, Ceponis J, Sidlauskas V, Daugintyte-Petrusiene L, Norkus A, Zilaitiene B. Factors Associated with the Prevalence of Thyroid Nodules and Goiter in Middle-Aged Euthyroid Subjects. Int J Endocrinol 2017; 2017:8401518. [PMID: 28356911 PMCID: PMC5357546 DOI: 10.1155/2017/8401518] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 12/17/2016] [Accepted: 01/04/2017] [Indexed: 01/19/2023] Open
Abstract
The aim of the present study was to determine associations of thyroid hormone levels and different metabolic parameters and anthropometric measurements with volume of nodular and nonnodular thyroid as well as with prevalence of goiter and thyroid nodules in middle-aged euthyroid subjects. Methods. The study consisted of 317 euthyroid subjects aged 48-49 from the Kaunas Cardiovascular Risk Cohort study. Thyroid-stimulating hormone (TSH), free thyroxine (FT4), and antithyroid peroxidase antibody (ATPO) levels, as well as anthropometric and metabolic parameters and smoking information, were evaluated. Results. In subjects with and without thyroid nodules, thyroid volume correlated with components of metabolic syndrome, body mass index (BMI), smoking, and TSH levels. In the nonnodular thyroid group, thyroid volume was also positively related to serum insulin and HOMA-IR, whereas a negative correlation between thyroid volume and leptin was identified in the nodular thyroid group. The goiter was identified in 12.3% of subjects. Female gender, thyroid nodules, smoking, BMI, and levels of TSH were independent predictors for goiter. Thyroid nodules were found in 31.2% of participants. Female gender, higher TSH levels, and thyroid volume were independent risk factors for thyroid nodules. Conclusions. Female gender, thyroid nodules, smoking, BMI, and TSH levels were identified as potential predictors of goiter. Female gender, TSH levels, and thyroid volume predicted the presence of thyroid nodules.
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Affiliation(s)
- Dalia Dauksiene
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
- *Dalia Dauksiene:
| | - Janina Petkeviciene
- Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jurate Klumbiene
- Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rasa Verkauskiene
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Audrone Seibokaite
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jonas Ceponis
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vygantas Sidlauskas
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Antanas Norkus
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Birute Zilaitiene
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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81
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Chen BD, Xu HX, Zhang YF, Liu BJ, Guo LH, Li DD, Zhao CK, Li XL, Wang D, Zhao SS. Calcification of thyroid nodules increases shear-wave speed (SWS) measurement: using multiple calcification-specific SWS cutoff values outperforms a single uniform cutoff value in diagnosing malignant thyroid nodules. Oncotarget 2016; 7:66149-66159. [PMID: 27588492 PMCID: PMC5323222 DOI: 10.18632/oncotarget.11710] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 08/26/2016] [Indexed: 11/25/2022] Open
Abstract
Conventional ultrasound cannot satisfactorily distinguish malignant and benign thyroid nodules. Shear-wave elastography (SWE) can evaluate tissue stiffness and complement conventional ultrasound in diagnosing malignant nodules. However, calcification of nodules may affect the results of SWE. The purposes of this study are to compare the differences of shear-wave speed (SWS) measurement among different calcification groups and compare the diagnostic performance between using a single uniform SWS cutoff value and multiple individual calcification-specific cutoff values using technique of point SWS measurement. We retrospectively identified 517 thyroid nodules (346 benign and 171 malignant nodules) examined by conventional ultrasound and point SWS measurement. There were 177 non-calcified, 159 micro-calcified and 181 macro-calcified nodules. The diagnostic performance was evaluated by receiver operating characteristic (ROC) curve and area under the curve (AUC) was computed. The mean SWS in malignant nodules more than doubled that of benign nodules (4.81±2.03 m/s vs. 2.29±0.99 m/s, p<0.001). The mean SWS of nodules progressively increased from the non-calcification (2.60±1.49 m/s), to micro-calcification (3.27±1.85 m/s) and to macro-calcification (3.68±2.26 m/s) groups (p<0.001), which was true in both the benign and malignant nodules. If we used individual SWS cutoff values for non- (SWS >2.42 m/s), micro- (SWS >2.88 m/s) and macro-calcification (SWS >3.59 m/s) nodules in the whole group, the AUC was 0.859 (95% confidence interval [CI], 0.826-0.888), which was significantly better than the AUC of 0.816 (95% CI, 0.780-0.848) if a single uniform cutoff value (SWS >2.72 m/s) was applied to all the nodules regardless of calcification status (p=0.011). The cutoff values of SWS for different calcified nodules warrant future prospective validation.
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Affiliation(s)
- Bao-Ding Chen
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Educational Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Clinical College of Nanjing Medical University, Shanghai, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai, China.,Shanghai Center of Thyroid Diseases, Shanghai, China.,Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Hui-Xiong Xu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Educational Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Clinical College of Nanjing Medical University, Shanghai, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai, China.,Shanghai Center of Thyroid Diseases, Shanghai, China
| | - Yi-Feng Zhang
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Educational Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Clinical College of Nanjing Medical University, Shanghai, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai, China.,Shanghai Center of Thyroid Diseases, Shanghai, China
| | - Bo-Ji Liu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Educational Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Clinical College of Nanjing Medical University, Shanghai, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai, China.,Shanghai Center of Thyroid Diseases, Shanghai, China
| | - Le-Hang Guo
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Educational Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Clinical College of Nanjing Medical University, Shanghai, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai, China.,Shanghai Center of Thyroid Diseases, Shanghai, China
| | - Dan-Dan Li
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Educational Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Clinical College of Nanjing Medical University, Shanghai, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai, China.,Shanghai Center of Thyroid Diseases, Shanghai, China
| | - Chong-Ke Zhao
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Educational Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Clinical College of Nanjing Medical University, Shanghai, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai, China.,Shanghai Center of Thyroid Diseases, Shanghai, China
| | - Xiao-Long Li
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Educational Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Clinical College of Nanjing Medical University, Shanghai, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai, China.,Shanghai Center of Thyroid Diseases, Shanghai, China
| | - Dan Wang
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Educational Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Clinical College of Nanjing Medical University, Shanghai, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai, China.,Shanghai Center of Thyroid Diseases, Shanghai, China
| | - Shuang-Shuang Zhao
- Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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