101
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Chen Y, Sadow PM, Suh H, Lee KE, Choi JY, Suh YJ, Wang TS, Lubitz CC. BRAF(V600E) Is Correlated with Recurrence of Papillary Thyroid Microcarcinoma: A Systematic Review, Multi-Institutional Primary Data Analysis, and Meta-Analysis. Thyroid 2016; 26:248-55. [PMID: 26671072 DOI: 10.1089/thy.2015.0391] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Given the increasing incidence of papillary thyroid carcinoma despite stable disease-specific mortality rates, the potential for the disease to reoccur is a key outcome to predict. The BRAF(V600E) mutation has been associated with recurrent disease in larger tumors. However, its correlation in papillary thyroid microcarcinoma (PTMC) is not clear in individual series. METHODS The MEDLINE, EMBASE, Web of Science, and Cochrane databases were searched for studies including patients with PTMC undergoing initial surgical treatment. Studies with at least two years of follow-up, BRAF genotyping (the comparator), and recurrence as an outcome were included, as were unpublished primary data on 485 patients from two institutions. The metameter analyzed was odds ratio (OR) for recurrence between patients with BRAF(V600E) versus BRAF wild type (BRAFwt). RESULTS The initial search identified 431 references. After screening of the abstracts for inclusion, 44 manuscripts were reviewed in full by two independent reviewers. Four published studies and primary data from two institutional cohorts were included in the final analysis. A meta-analysis of 2247 PTMC patients revealed that patients with a BRAF(V600E) mutation had a higher likelihood for recurrence (odds ratio 2.09 [confidence interval 1.31-3.33], p = 0.002). CONCLUSIONS This meta-analysis shows that BRAF mutational status correlates with recurrence of PTMCs, highlighting the potential utility of genotyping in preoperative and postoperative planning. BRAF mutation may be helpful in risk-stratifying patients with PTMC for surgical management versus observation.
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Affiliation(s)
- Yufei Chen
- 1 Department of Surgery, Massachusetts General Hospital , Boston, Massachusetts
| | - Peter M Sadow
- 2 Department of Pathology, Massachusetts General Hospital , Boston, Massachusetts
| | - Hyunsuk Suh
- 3 Department of Surgery, Mount Sinai Medical Center , New York, New York
| | - Kyu Eun Lee
- 4 Department of Surgery, Seoul National University Hospital and College of Medicine , Seoul, Korea
| | - June Young Choi
- 4 Department of Surgery, Seoul National University Hospital and College of Medicine , Seoul, Korea
| | - Yong Joon Suh
- 4 Department of Surgery, Seoul National University Hospital and College of Medicine , Seoul, Korea
| | - Tracy S Wang
- 5 Department of Surgery, Medical College of Wisconsin , Milwaukee, Wisconsin
| | - Carrie C Lubitz
- 1 Department of Surgery, Massachusetts General Hospital , Boston, Massachusetts
- 6 Institute for Technology Assessment , Boston, Massachusetts
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102
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Lee S, Lee YY, Yoon HJ, Choi E, Suh M, Park B, Jun JK, Kim Y, Choi KS. Responses to Overdiagnosis in Thyroid Cancer Screening among Korean Women. Cancer Res Treat 2015; 48:883-91. [PMID: 26727718 PMCID: PMC4946348 DOI: 10.4143/crt.2015.218] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 12/11/2015] [Indexed: 01/17/2023] Open
Abstract
Purpose Communicating the harms and benefits of thyroid screening is necessary to help individuals decide on whether or not to undergo thyroid cancer screening. This study was conducted to assess changes in thyroid cancer screening intention in response to receiving information about overdiagnosis and to determine factors with the greatest influence thereon. Materials and Methods Data were acquired from subjects included in the 2013 Korean National Cancer Screening Survey (KNCSS), a nationwide, population-based, cross-sectional survey. Of the 4,100 respondents in the 2013 KNCSS, women were randomly subsampled and an additional face-to-face interview was conducted. Finally, a total of 586 female subjects were included in this study. Intention to undergo thyroid cancer screening was assessed before and after receiving information on overdiagnosis. Results Prior awareness of overdiagnosis in thyroid cancer screening was 27.8%. The majority of subjects intended to undergo thyroid cancer screening before and after receiving information on overdiagnosis (87% and 74%, respectively). Only a small number of subjects changed their intention to undergo thyroid cancer screening from positive to negative after receiving information on overdiagnosis. Women of higher education level and Medical Aid Program recipients reported being significantly more likely to change their intention to undergo thyroid cancer screening afterreceiving information on overdiagnosis,whilewomen with stronger beliefs on the efficacy of cancer screening were less likely to change their intention. Conclusion Women in Korea appeared to be less concerned about overdiagnosis when deciding whether or not to undergo thyroid cancer screening.
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Affiliation(s)
- Sangeun Lee
- Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Yoon Young Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hyo Joong Yoon
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eunji Choi
- Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Boyoung Park
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jae Kwan Jun
- Graduate School of Cancer Science and Policy, Goyang, Korea.,National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Yeol Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, Goyang, Korea.,National Cancer Control Institute, National Cancer Center, Goyang, Korea
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103
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Kwon H, Kim WG, Sung TY, Jeon MJ, Song DE, Lee YM, Yoon JH, Chung KW, Hong SJ, Baek JH, Lee JH, Kim TY, Shong YK, Kim WB. Changing trends in the clinicopathological features and clinical outcomes of medullary thyroid carcinoma. J Surg Oncol 2015; 113:152-8. [PMID: 26799259 DOI: 10.1002/jso.24126] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 11/22/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND The early detection of papillary thyroid cancer has contributed to the increase in the incidence and improved clinical outcomes. However, recent changes of medullary thyroid carcinoma (MTC) over time remain unclear. We evaluated changes of the clinicopathological characteristics and clinical outcomes in patients with MTC in recent years. METHODS A total of 109 MTC patients were classified based on the year of initial surgery: 1996-2000 (n = 14), 2001-2006 (n = 39), and 2007-2011 (n = 56). RESULTS The primary tumor size significantly decreased and the proportion of microMTCs (size ≤1 cm) increased over time (P = 0.002 and P < 0.001, respectively). The proportion of patients with cervical lymph node (LN) metastasis significantly decreased (P = 0.037), and the ratio of metastatic LNs significantly decreased (P = 0.011). Disease-free survival (DFS) rate of patients was significantly improved over time (P = 0.007). There was no significant difference in DFS between microMTC and macroMTC patients. However, more advanced LN stage patients demonstrated more recurrences (P < 0.001). Especially, there were significantly more recurrences in patients with N1b diseases in comparison with patients without cervical LN metastases (P < 0.001). CONCLUSIONS The prognosis of MTC patients has significantly improved in recent years. These changes could be associated with the early diagnosis before development of lateral and extensive cervical LN metastases. J. Surg. Oncol. 2016;113:152-158. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Hyemi Kwon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Gu Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae-Yon Sung
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Ji Jeon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Eun Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yu-Mi Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Ho Yoon
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ki-Wook Chung
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suck Joon Hong
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Hwan Baek
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Hyun Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Yong Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Kee Shong
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Bae Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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104
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An JH, Hwangbo Y, Ahn HY, Keam B, Lee KE, Han W, Park DJ, Park IA, Noh DY, Youn YK, Cho BY, Im SA, Park YJ. A Possible Association Between Thyroid Cancer and Breast Cancer. Thyroid 2015; 25:1330-8. [PMID: 26442580 DOI: 10.1089/thy.2014.0561] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Several lines of evidence suggest that breast cancer (BC) and thyroid cancer (TC) occur together in the same female patients more frequently than would be expected by chance. This study investigated the prevalence and clinicopathological characteristics of second primary BC in TC patients and second primary TC in BC patients. METHODS A retrospective case-controlled study was performed in 4243 patients with differentiated TC and 6833 patients with BC. Age-matched control groups without second malignancies were selected. RESULTS Of the 4243 patients with TC, 55 patients developed subsequent BC during a five-year follow-up (range 2-40 years); the standardized incidence ratio (SIR) was 2.45 [confidence interval (CI) 1.83-2.96]. Among the 6833 patients with BC, 81 patients developed subsequent TC during a 6.2-year follow-up (range 2-40 years); the SIR was 2.18 [CI 1.43-2.82]. Subsequent second BC or TC diagnosed within five years of the initial primary malignancy showed more clinical characteristics consistent with early-stage cancer than did control BC or TC patients. Notably, the expression of both the estrogen and progesterone receptors was significantly higher in the tissues of BC patients with coexisting TC compared with those with BC alone. CONCLUSIONS The overall risk of second primary TC or BC is increased in patients with prior BC or TC, respectively. The early detection of second cancer might have contributed to these findings. However, BC that coexisted with TC had a higher expression of hormone receptors, suggesting an association between the molecular pathogenesis of TC and BC.
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MESH Headings
- Adenocarcinoma, Follicular/epidemiology
- Adult
- Breast Neoplasms/epidemiology
- Breast Neoplasms/metabolism
- Carcinoma/epidemiology
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Intraductal, Noninfiltrating/epidemiology
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Papillary
- Case-Control Studies
- Female
- Humans
- Incidence
- Middle Aged
- Neoplasms, Multiple Primary/epidemiology
- Neoplasms, Second Primary/epidemiology
- Prevalence
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Retrospective Studies
- Thyroid Cancer, Papillary
- Thyroid Neoplasms/epidemiology
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Affiliation(s)
- Jee Hyun An
- 1 Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Korea
- 2 Department of Internal Medicine, Korea University College of Medicine , Seoul, Korea
| | - Yul Hwangbo
- 1 Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Korea
| | - Hwa Young Ahn
- 1 Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Korea
- 3 Department of Internal Medicine, Chung-Ang University College of Medicine , Seoul, Korea
| | - Bhumsuk Keam
- 1 Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Korea
| | - Kyu Eun Lee
- 4 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea
| | - Wonshik Han
- 4 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea
| | - Do Joon Park
- 1 Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Korea
| | - In Ae Park
- 5 Department of Pathology, Seoul National University College of Medicine , Seoul, Korea
| | - Dong-Young Noh
- 4 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea
| | - Yeo-Kyu Youn
- 4 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea
| | - Bo Youn Cho
- 1 Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Korea
- 3 Department of Internal Medicine, Chung-Ang University College of Medicine , Seoul, Korea
| | - Seock-Ah Im
- 1 Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Korea
| | - Young Joo Park
- 1 Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Korea
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105
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Park SH, Lee B, Lee S, Choi E, Choi EB, Yoo J, Jun JK, Choi KS. A qualitative study of women's views on overdiagnosis and screening for thyroid cancer in Korea. BMC Cancer 2015; 15:858. [PMID: 26546276 PMCID: PMC4635590 DOI: 10.1186/s12885-015-1877-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 10/30/2015] [Indexed: 11/15/2022] Open
Abstract
Background The incidence of thyroid cancer in Korea has increased by about 25 % every year for the past 10 years. This increase is largely due to a rising incidence in papillary thyroid cancer, which is associated with an overdiagnosis of small tumors that may never become clinically significant. This study was conducted to explore Korean women’s understanding of overdiagnosis and to investigate changes in screening intention in response to overdiagnosis information. Methods Focus group interviews were conducted among women of ages 30–69 years, who are commonly targeted in Korea for cancer screening. Women were divided into four groups according to thyroid cancer screening history and history of thyroid disease. Of 51 women who were contacted, 29 (57 %) participated in the interviews. Results Prior awareness of thyroid cancer overdiagnosis was minimal. When informed about the risks of overdiagnosis, the participants were often surprised. Overcoming initial malcontent, many women remained skeptic about overdiagnosis and trusted in the advice of their physicians. Meanwhile, some of the study participants found explanations of overdiagnosis difficult to understand. Further, hearing about the risks of overdiagnosis had limited impact on the participants’ attitudes and intentions to undergo thyroid cancer screening, as many women expressed willingness to undergoing continued screening in the future. Conclusion A large majority of Korean women eligible for and had undergone thyroid cancer screening were unaware of the potential for overdiagnosis. Nevertheless, overdiagnosis information generally had little impact on their beliefs about thyroid cancer screening and their intentions to undergo future screening. Further research is needed to determine whether these findings could be generalized to the wider Korean population.
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Affiliation(s)
- Sang Hee Park
- Graduate School of Communication, Sogang University, 35 Baekbeom-ro, Mapo-gu, Seoul, 121-742, Republic of Korea.
| | - Bomyee Lee
- National Cancer Control Institute, National Cancer Centre, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.
| | - Sangeun Lee
- Graduate School of Cancer Science and Policy, National Cancer Centre, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.
| | - Eunji Choi
- Graduate School of Cancer Science and Policy, National Cancer Centre, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.
| | - Eun-Bi Choi
- National Cancer Control Institute, National Cancer Centre, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.
| | - Jisu Yoo
- National Cancer Control Institute, National Cancer Centre, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Centre, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Centre, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.
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106
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Zhou Q, Chen J, Feng J, Wang J. Long noncoding RNA PVT1 modulates thyroid cancer cell proliferation by recruiting EZH2 and regulating thyroid-stimulating hormone receptor (TSHR). Tumour Biol 2015; 37:3105-13. [PMID: 26427660 DOI: 10.1007/s13277-015-4149-9] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/23/2015] [Indexed: 01/13/2023] Open
Abstract
The purposes of this study were to investigate the potential roles of long noncoding RNA (lncRNA) PVT1 in thyroid cancer cell proliferation and to explore their possible mechanisms. A total of 84 patients who were diagnosed as having thyroid cancer (papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC), and anaplastic thyroid carcinoma (ATC)) in Renji Hospital were enrolled in this study. Expressions of lncRNA PVT1 in thyroid cancer tissues and cell lines (IHH-4, FTC-133, and 8505C) were analyzed using RT-polymerase chain reaction (PCR) and western blotting analysis. The effects of lncRNA PVT1 expression on thyroid cancer cell proliferation and cell cycle were analyzed using flow cytometry. Furthermore, the effects of lncRNA expression on thyroid-stimulating hormone receptor (TSHR) expression and polycomb enhancer of zeste homolog 2 (EZH2) were also analyzed using RNA immunoprecipitation (RIP) assay and chromatin immunoprecipitation (ChIP) assay, respectively. Compared to the controls, lncRNA PVT1 was significantly up-regulated in thyroid tissues, as well as in three kinds of tumor cell lines (P < 0.05). Silenced PVT1 significantly inhibited thyroid cell line IHH-4, FTC-133, and 8505C cell proliferation and arrested cell cycle at G0/G1 stage and significantly decreased cyclin D1 and TSHR expressions (P < 0.05). Moreover, lncRNA PVT1 could be enriched by EZH2, and silencing PVT1 resulted in the decreased recruitment of EZH2. This study suggested that lncRNA PVT1 may contribute to tumorigenesis of thyroid cancer through recruiting EZH2 and regulating TSHR expression.
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Affiliation(s)
- Qinyi Zhou
- Department of Head and Neck Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, #145 Shandong Road, Huangpu District, Shanghai, 200001, China
| | - Jun Chen
- Department of Head and Neck Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, #145 Shandong Road, Huangpu District, Shanghai, 200001, China
| | - Jialin Feng
- Department of Head and Neck Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, #145 Shandong Road, Huangpu District, Shanghai, 200001, China
| | - Jiadong Wang
- Department of Head and Neck Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, #145 Shandong Road, Huangpu District, Shanghai, 200001, China.
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107
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Jeon MJ, Kim WG, Choi YM, Kwon H, Song DE, Lee YM, Sung TY, Yoon JH, Hong SJ, Baek JH, Lee JH, Ryu JS, Kim TY, Shong YK, Chung KW, Kim WB. Recent Changes in the Clinical Outcome of Papillary Thyroid Carcinoma With Cervical Lymph Node Metastasis. J Clin Endocrinol Metab 2015; 100:3470-7. [PMID: 26120792 DOI: 10.1210/jc.2015-2084] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT The prognosis of papillary thyroid cancer (PTC) with cervical lymph node (LN) metastasis has changed with increased detection of subclinical metastatic LNs. The number and size of metastatic LNs were proposed as new prognostic factors in PTC with cervical LN metastasis (N1). OBJECTIVE The objective of the study was to evaluate changes in N1 PTC characteristics and clinical outcome over time and to confirm the prognostic value of the number and size of metastatic LNs. DESIGN AND PATIENTS This study included 1815 N1 PTC patients diagnosed between 1997 and 2011. Patients were classified into three risk groups according to the number and size of metastatic LNs: very low risk, five or fewer and 0.2 cm or less; low risk, five or fewer and 0.2 cm or greater; and high risk, more than five. MAIN OUTCOME MEASURES Response to initial therapy and disease-free survival (DFS) was measured. RESULTS Metastatic LNs became smaller, and the ratio of metastatic LNs, which represents the extent of LN involvement and the completeness of surgery, decreased significantly over time. The proportion of patients with excellent response significantly increased from 33% to 67% over time (P < .001). These improvements were more evident in the low- and high-risk groups than in the very low-risk group. The DFS 5 years after initial surgery was also significantly increased from 73% to 91% over time (P < .001). The new LN classification was strongly associated with outcome. Patients in the very low-risk group had longer DFS than those in the low- and high-risk groups during the study period. CONCLUSIONS The clinical outcome of N1 PTC has significantly changed over time with the earlier detection of thyroid cancers with less extensive LN involvement. More complete surgical neck dissection also might be responsible for these changes. The number and size of metastatic LNs are important prognostic factors of recurrence in N1 PTC.
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Affiliation(s)
- Min Ji Jeon
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Won Gu Kim
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Yun Mi Choi
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Hyemi Kwon
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Dong Eun Song
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Yu-Mi Lee
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Tae-Yon Sung
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Jong Ho Yoon
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Suck Joon Hong
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Jung Hwan Baek
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Jeong Hyun Lee
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Jin-Sook Ryu
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Tae Yong Kim
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Young Kee Shong
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Ki-Wook Chung
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Won Bae Kim
- Departments of Internal Medicine (M.J.J., W.G.K., Y.M.C., H.K., T.Y.K., Y.K.S., W.B.K.), Pathology (D.E.S.), Surgery (Y.-M.L., T.-Y.S., J.H.Y., S.J.H., K.-W.C.), Radiology (J.H.B., J.H.L.), and Nuclear Medicine (J.-S.R.), Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
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108
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Oh JR, Ahn BC, Jeong SY, Lee SW, Lee J. Radioiodine Scan Index: A Simplified, Quantitative Treatment Response Parameter for Metastatic Thyroid Carcinoma. Nucl Med Mol Imaging 2015; 49:174-81. [PMID: 26279690 PMCID: PMC4532690 DOI: 10.1007/s13139-015-0335-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 03/30/2015] [Accepted: 04/01/2015] [Indexed: 11/28/2022] Open
Abstract
PURPOSE We aimed to develop and validate a simplified, novel quantification method for radioiodine whole-body scans (WBSs) as a predictor for the treatment response in differentiated thyroid carcinoma (DTC) patients with distant metastasis. METHODS We retrospectively reviewed serial WBSs after radioiodine treatment from 2008 to 2011 in patients with metastatic DTC. For standardization of TSH simulation, only a subset of patients whose TSH level was fully enhanced (TSH > 80 mU/l) was enrolled. The radioiodine scan index (RSI) was calculated by the ratio of tumor-to-brain uptake. We compared correlations between the RSI and TSH-stimulated serum thyroglobulin (TSH_s_Tg) level and between the RSI and Tg reduction rate of consecutive radioiodine treatments. RESULTS A total of 30 rounds of radioiodine treatment for 15 patients were eligible. Tumor histology was 11 papillary and 4 follicular subtypes. The TSH_s_Tg level was mean 980 ng/ml (range, 0.5-11,244). The Tg reduction rate after treatment was a mean of -7 % (range, -90 %-210 %). Mean RSI was 3.02 (range, 0.40-10.97). RSI was positively correlated with the TSH_s_Tg level (R(2) = 0.3084, p = 0.001) and negatively correlated with the Tg reduction rate (R(2) = 0.2993, p = 0.037). The regression equation to predict treatment response was as follows: Tg reduction rate = -14.581 × RSI + 51.183. CONCLUSIONS Use of the radioiodine scan index derived from conventional WBS is feasible to reflect the serum Tg level in patients with metastatic DTC, and it may be useful for predicting the biologic treatment response after radioiodine treatment.
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Affiliation(s)
- Jong-Ryool Oh
- />Department of Nuclear Medicine, Kyungpook National University School of Medicine and Hospital, 50, Samduk 2-ga, Jung gu Daegu, Republic of Korea 700-721
- />Department of Nuclear Medicine, Raphael Hospital, 303, Jungang-daero, Jung-gu Daegu, Republic of Korea 700-803
| | - Byeong-Cheol Ahn
- />Department of Nuclear Medicine, Kyungpook National University School of Medicine and Hospital, 50, Samduk 2-ga, Jung gu Daegu, Republic of Korea 700-721
| | - Shin Young Jeong
- />Department of Nuclear Medicine, Kyungpook National University School of Medicine and Hospital, 50, Samduk 2-ga, Jung gu Daegu, Republic of Korea 700-721
| | - Sang-Woo Lee
- />Department of Nuclear Medicine, Kyungpook National University School of Medicine and Hospital, 50, Samduk 2-ga, Jung gu Daegu, Republic of Korea 700-721
| | - Jaetae Lee
- />Department of Nuclear Medicine, Kyungpook National University School of Medicine and Hospital, 50, Samduk 2-ga, Jung gu Daegu, Republic of Korea 700-721
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109
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Girardi FM, Barra MB, Zettler CG. Analysis of pattern of occurrence of thyroid carcinoma between 2001 and 2010. Braz J Otorhinolaryngol 2015; 81:541-8. [PMID: 26277590 PMCID: PMC9449006 DOI: 10.1016/j.bjorl.2015.07.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 09/21/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION An ongoing discussion is found in medical literature about the reasons for changes in thyroid carcinoma incidence patterns over the last decades. OBJECTIVE To analyze the clinical and pathological characteristics of thyroid carcinoma cases over a decade. METHODS Cross-sectional study over an historical cohort. Medical records of 628 thyroid cancer cases in a single center were reviewed. 597 patients were included. Microcarcinoma cases were selected for a qualitative analysis phase, in which medical records were reviewed for better understanding of thyroid nodule and thyroid cancer diagnosis process. RESULTS An increase in the proportion of cases with thyroid cancer diagnosis was observed throughout the decade; new cases were predominantly tumors of less than 2 cm, with histopathological signs of low aggressiveness. There was an increase in proportion of cases with malignant cytological results among microcarcinomas. CONCLUSION There is a trend for increase in thyroidectomies due to cancer in this institution, with proportional increment of cases with histopathological characteristics indicative of early disease. Among microcarcinomas, there is an increasing group represented by cancer cases that were not incidentally diagnosed, related to an enhancement in preoperative diagnostic methods.
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Affiliation(s)
- Fábio Muradás Girardi
- Head and Neck Surgery Department, Hospital Santa Rita, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil.
| | - Marinez Bizarro Barra
- Pathology Department, Hospital Santa Rita, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil
| | - Cláudio Galleano Zettler
- Pathology Department, Hospital Santa Rita, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil
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110
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The Risk of Relapse in Papillary Thyroid Cancer (PTC) in the Context of BRAFV600E Mutation Status and Other Prognostic Factors. PLoS One 2015; 10:e0132821. [PMID: 26177218 PMCID: PMC4503446 DOI: 10.1371/journal.pone.0132821] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 06/18/2015] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The risk of over-treatment in low-advanced PTC stages has prompted clinicians to search for new reliable prognostic factors. The presence of BRAF mutation, the most frequent molecular event in PTC, seems to be a good candidate. However, there is still lack of randomised trials and its significance has been proved by retrospective analyses, involving a large group of patients. The question arises whether this factor is useful in smaller populations, characterised for specialised centres. Thus, the aim of the study was to evaluate the use of BRAF mutation as a potential predictive marker in PTC patients. MATERIAL 233 PTC subjects treated between 2004-2006, were retrospectively analysed. Stage pT1 was diagnosed in 64.8% patients and lymph node metastases in 30.9%. Median follow-up was 7.5 years. BRAFV600E mutation was assessed postoperatively in all cases. RESULTS BRAF V600E mutation was found in 54.5%. It was more frequent in patients > 45 years (p=0.0001), and associated with larger tumour size (p=0.004). Patients with tumours <= 10 mm were over-represented among BRAF negative population (p=0.03). No association between BRAF mutation and other clinicopathological factors was observed. BRAF status was associated neither with relapse nor with disease-free survival (DFS) (p=0.76). Nodal status, extrathyroidal invasion and tumour size significantly influenced DFS. CONCLUSION The risk of PTC recurrence is mainly related to the presence of lymph node metastases and extrathyroidal invasion, whereas no impact of BRAF V600E mutation has been demonstrated.
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Khang AR, Cho SW, Choi HS, Ahn HY, Yoo WS, Kim KW, Kang KW, Yi KH, Park DJ, Lee DS, Chung JK, Cho BY, Park YJ. The risk of second primary malignancy is increased in differentiated thyroid cancer patients with a cumulative (131)I dose over 37 GBq. Clin Endocrinol (Oxf) 2015; 83:117-23. [PMID: 25115234 DOI: 10.1111/cen.12581] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 04/14/2014] [Accepted: 08/07/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND The aim of this study was to investigate the risk factors for second primary malignancy (SPM) diagnosed after differentiated thyroid cancer (DTC). METHODS A total of 2468 DTC patients who underwent thyroidectomy were reviewed. SPM was defined as a non-thyroidal malignancy, diagnosed at least 1 year after the diagnosis of thyroid cancer. Patients were divided into five groups according to cumulative (131)I dose: very high-activity (≥ 37.0 GBq), high-activity (22.3-36.9 GBq), intermediate-activity (5.56-22.2 GBq), low-activity (1.1-5.55 GBq) and no RAI. RESULTS Among the 2468 patients, 61 (2.5%) had SPMs during 7.0 (1.0-33.0) years of median follow-up. Age above 40 years, male sex and very high-activity RAI were independent risk factors for the development of SPM. SPM-related mortality was highest in the very high-activity group, while DTC-related mortality was highest in the high-activity group. The overall mortality both from SPM and DTC was highest in the high-activity group. CONCLUSION A cumulative (131)I dose <37.0 GBq did not increase the risk of SPM. A cumulative (131) I dose ≥ 37.0 GBq increased the risk of SPM and SPM-related mortality and decreased the DTC-specific mortality, resulting in a similar all-cause mortality compared with the low-activity RAI group. Using repeated high-dose RAI for treating RAI-responsive but persistent DTC patients needs careful consideration of the individual benefits from RAI vs the risk of developing SPM.
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Affiliation(s)
- Ah Reum Khang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sun Wook Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Hoon Sung Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hwa Young Ahn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Won Sang Yoo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Dankook University Hospital, Cheonan-si, Korea
| | - Kyung Won Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ka Hee Yi
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Do Joon Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Soon Lee
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - June-Key Chung
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Bo Youn Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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112
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Lee YA, Jung HW, Kim HY, Choi H, Kim HY, Hah JH, Park DJ, Chung JK, Yang SW, Shin CH, Park YJ. Pediatric patients with multifocal papillary thyroid cancer have higher recurrence rates than adult patients: a retrospective analysis of a large pediatric thyroid cancer cohort over 33 years. J Clin Endocrinol Metab 2015; 100:1619-29. [PMID: 25632969 DOI: 10.1210/jc.2014-3647] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT Large-sample studies with long-term follow-up data are limited for pediatric patients with thyroid cancer. OBJECTIVE Secular changes in clinicopathological characteristics and outcomes in pediatric patients with thyroid cancer were investigated and compared with those of adults. DESIGN AND PATIENTS A retrospective review of 150 pediatric patients with thyroid cancer managed between 1980 and 2013 was conducted. The long-term outcomes of 124 patients followed up for 12 months or longer were evaluated. Predictors of recurrence-free survival (RFS) in pediatric patients with papillary thyroid cancer (ped-PTC group) were compared with those of 3071 adult patients. RESULTS The proportion of small tumors (<1 cm) increased from 9.0% before 2010 to 36.8% after 2010 (P < .001); however, neither pathological presentations such as multifocality, extrathyroidal extension (ETE), lymph node (LN) metastasis, or lung metastasis nor the RFS rate changed over time. The 5- and 10-year recurrence rates were 14.5% and 34.4% in pediatric patients, respectively. In respective analyses of the ped-PTC group and patients of all ages with papillary thyroid cancer (all ages group), the rates of ETE, LN metastasis, and lung metastasis were higher with younger age (all P for trend <.05). RFS was lower in the pediatric than the adult patients aged 20-54 years (P < .005) and was comparable with that of older patients (≥ 55 y). Only tumor multifocality and size predicted recurrence in the ped-PTC group (P < .05), whereas LN metastasis and ETE also predicted recurrence in the all-ages group (P < .01). Among patients in the all-ages group with multifocal tumors, pediatric patients had the lowest RFS (P < .05). CONCLUSIONS The pathological characteristics and recurrence rates of pediatric thyroid cancer have not changed over 33 years. Although younger patients present with more advanced disease, multifocality rather than age at diagnosis predicted recurrence. Recurrence was higher in pediatric than adult patients with multifocal papillary thyroid cancer.
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Affiliation(s)
- Young Ah Lee
- Department of Pediatrics (Y.A.L., H.W.J., H.Y.K., S.W.Y., C.H.S.), Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, 110-769, Korea; and Departments of Internal Medicine (H.C., D.J.P., Y.J.P.), Nuclear Medicine (J.J.-K.C.), Surgery (H.-Y.K.), and Otorhinolaryngology and Cancer Research Institute (J.H.H.), Seoul National University College of Medicine, Seoul 110-744, Korea
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Suh YJ, Kwon H, Kim SJ, Choi JY, Lee KE, Park YJ, Park DJ, Youn YK. Factors Affecting the Locoregional Recurrence of Conventional Papillary Thyroid Carcinoma After Surgery: A Retrospective Analysis of 3381 Patients. Ann Surg Oncol 2015; 22:3543-9. [DOI: 10.1245/s10434-015-4448-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Indexed: 02/04/2023]
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Kwon H, Tae SY, Kim SJ, Jung KC, Kim JH, Lee KE, Youn YK. Role of charcoal tattooing in localization of recurred papillary thyroid carcinoma: initial experiences. Ann Surg Treat Res 2015; 88:140-4. [PMID: 25741493 PMCID: PMC4347043 DOI: 10.4174/astr.2015.88.3.140] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 09/11/2014] [Accepted: 09/22/2014] [Indexed: 11/30/2022] Open
Abstract
Purpose Surgical excision is the definitive treatment for localized recurrence of papillary thyroid carcinoma. Reoperation for recurrence, however, is challenging and associated with increased operative times and complication rates. For safe and effective reoperation, ultrasound-guided charcoal tattooing localization can be used. The aim of this study was to investigate the feasibility and safety of the ultrasound-guided charcoal tattooing localization. Methods Between November 2012 and August 2013, ten patients underwent preoperative charcoal tattooing localization for twelve recurrent lesions. Patient demographics, pathologic features, and operation results were reviewed. Results The technical success rate of charcoal tattooing was 100%. Eight patients had one recurrent lesion, and two patients had double lesions. Among these 12 recurrent lesions, three (25%) were found in level II, four (33%) in level IV, four (33%) in level VI, and one (8%) was found in the thyroidectomy bed site. The mean size of lesions was 0.87 ± 0.35 cm. Of these 10 patients, eight patients underwent selective lymph node dissection, one patient underwent modified radical neck dissection, and one patient underwent recurrent mass excision. Transient hypocalcemia developed in one patient, and no recurrent laryngeal nerve palsy occurred. There were no major complications related to the injection of the charcoal. The mean follow-up period after reoperation was 8.6 ± 2.7 months; in the follow-up ultrasound, there were no remnant lesions in all patients. Conclusion Preoperative ultrasound-guided charcoal tattooing localization for recurrent thyroid cancer appears to be a feasible and safe procedure for reoperation. Further evaluation is warranted in larger patients' cohorts.
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Affiliation(s)
- Hyungju Kwon
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Soon Young Tae
- Department of Surgery, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea
| | - Su-Jin Kim
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyeong Cheon Jung
- Department of Pathology, Seoul National University Hospital, Seoul National College of Medicine, Seoul, Korea
| | - Ji-Hoon Kim
- Department of Radiology, Seoul National University Hospital, Seoul National College of Medicine, Seoul, Korea
| | - Kyu Eun Lee
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yeo-Kyu Youn
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. ; Department of Surgery, National Medical Center, Seoul, Korea
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115
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Song CM, Kwon TK, Park BL, Ji YB, Tae K. Single nucleotide polymorphisms of ataxia telangiectasia mutated and the risk of papillary thyroid carcinoma. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2015; 56:70-76. [PMID: 25196645 DOI: 10.1002/em.21898] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 08/20/2014] [Indexed: 06/03/2023]
Abstract
Genetic factors associated with susceptibility to papillary thyroid carcinoma (PTC) are not well known. We evaluated the association between single nucleotide polymorphisms (SNPs) of ataxia telangiectasia mutated (ATM) and the risk of PTC. A total of 437 histologically confirmed PTC cases and 184 cancer-free controls without thyroid nodules were recruited. Genotypes with respect to five ATM SNPs (rs189037, rs664677, rs373759, rs664143, and rs4585) were determined by the TaqMan assay, and odds ratios and 95% confidence intervals were obtained by logistic regression analysis. Linkage disequilibria and haplotypes were examined from the genotype data. When evaluated separately the genotype distributions of the five ATM SNPs were similar in the PTC cases and controls. Three ATM SNPs (rs373759, rs664143, and rs4585) were found to be in strong linkage disequilibrium (D' = 1.00, P < 0.001). When the three haplotypes (C-A-G), (T-G-T), and (C-G-T) of these three ATM SNP sites were analyzed, ATM haplotype (C-G-T) +/- was associated with a lower risk of PTC than ATM haplotype (C-G-T) -/- (P = 0.03) after adjusting for age and gender. Our results suggest that genetic polymorphisms of ATM may play an important role in the development of thyroid cancer in the Korean population.
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Affiliation(s)
- Chang Myeon Song
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Korea
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116
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Lee J, Seol MY, Jeong S, Lee CR, Ku CR, Kang SW, Jeong JJ, Shin DY, Nam KH, Lee EJ, Chung WY, Jo YS. A metabolic phenotype based on mitochondrial ribosomal protein expression as a predictor of lymph node metastasis in papillary thyroid carcinoma. Medicine (Baltimore) 2015; 94:e380. [PMID: 25590838 PMCID: PMC4602546 DOI: 10.1097/md.0000000000000380] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Metabolic reprogramming has been regarded as an essential component of malignant transformation. However, the clinical significance of metabolic heterogeneity remains poorly characterized. The aim of this study was to characterize metabolic heterogeneity in thyroid cancers via the analysis of the expression of mitochondrial ribosomal proteins (MRPs) and genes involved in oxidative phosphorylation (OxPhos), and investigate potential prognostic correlations. Gene set enrichment analysis (GSEA) verified by reverse transcription polymerase chain reaction and gene network analysis was performed using public repository data. Cross-sectional observational study was conducted to classify papillary thyroid cancer (PTC) by the expression of MRP L44 (MRPL44) messenger RNA (mRNA), and to investigate the clinicopathological features. GSEA clearly showed that the expression of OxPhos and MRP gene sets was significantly lower in primary thyroid cancer than in matched normal thyroid tissue. However, 8 of 49 primary thyroid tumors (16.3%) in the public repository did not show a reduction in OxPhos mRNA expression. Remarkably, strong positive correlations between MRPL44 expression and those of OxPhos and MRPs such as reduced nicotinamide adenine dinucleotide dehydrogenase (ubiquinone) 1 α subcomplex, 5; succinate dehydrogenase complex, subunit D; cytochrome c, somatic; adenosine triphosphate synthase, H+ transporting, mitochondrial Fo complex, subunit C1 (subunit 9); and MRP S5 (MRPS5) (P < 0.0001) were clearly denoted, suggesting that MRPL44 is a representative marker of OxPhos and MRP expressions. In laboratory experiments, metabolic heterogeneity in oxygen consumption, extracellular acidification rates (ECARs), and amounts of OxPhos complexes were consistently observed in BCPAP, TPC1, HTH-7, and XTC.UC1 cell lines. In PTCs, metabolic phenotype according to OxPhos amount defined by expression of MRPL44 mRNA was significantly related to lymph node metastasis (LNM) (P < 0.001). Furthermore, multivariate analysis clearly indicated that expression of MRPL44 is associated with an increased risk of lateral neck LNM (odds ratio 9.267, 95% confidence interval 1.852-46.371, P = 0.007). MRPL44 expression may be a representative marker of metabolic phenotype according to OxPhos amount and a useful predictor of LNM.
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Affiliation(s)
- Jandee Lee
- From the Department of Surgery (JL, M-YS, CRL, S-WK, JJJ, K-HN, WYC); and the Department of Internal Medicine (SJ, CRK, DYS, EJL, YSJ), Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
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Seo JH, Je JH, Lee HJ, Na YJ, Jeong IW, An JH, Kim SG, Choi DS, Kim NH. Metastatic papillary thyroid cancers with malignant pleural effusion aggravated during thyroid hormone withdrawal for radioiodine therapy. Yeungnam Univ J Med 2015. [DOI: 10.12701/yujm.2015.32.2.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ji Hye Seo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Hye Je
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyun Jung Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Ju Na
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Il Woo Jeong
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jee Hyun An
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sin Gon Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Dong Seop Choi
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Nam Hoon Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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118
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Choi YM, Kim TY, Jang EK, Kwon H, Jeon MJ, Kim WG, Shong YK, Kim WB. Standardized Thyroid Cancer Mortality in Korea between 1985 and 2010. Endocrinol Metab (Seoul) 2014; 29:530-5. [PMID: 25559576 PMCID: PMC4285027 DOI: 10.3803/enm.2014.29.4.530] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 10/24/2014] [Accepted: 10/27/2014] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The prevalence of thyroid cancer has increased very rapidly in Korea. However, there is no published report focusing on thyroid cancer mortality in Korea. In this study, we aimed to evaluate standardized thyroid cancer mortality using data from Statistics Korea (the Statistical Office of Korea). METHODS Population and mortality data from 1985 to 2010 were obtained from Statistics Korea. Age-standardized rates of thyroid cancer mortality were calculated according to the standard population of Korea, as well as World Health Organization (WHO) standard population and International Cancer Survival Standard (ICSS) population weights. RESULTS The crude thyroid cancer mortality rate increased from 0.1 to 0.7 per 100,000 between 1985 and 2010. The pattern was the same for both sexes. The age-standardized mortality rate (ASMR) for thyroid cancer for Korean resident registration population increased from 0.19 to 0.67 between 1985 and 2000. However, it decreased slightly, from 0.67 to 0.55, between 2000 and 2010. When mortality was adjusted using the WHO standard population and ICSS population weights, the ASMR similarly increased until 2000, and then decreased between 2000 and 2010. CONCLUSION Thyroid cancer mortality increased until 2000 in Korea. It started to decrease from 2000.
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Affiliation(s)
- Yun Mi Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Yong Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Eun Kyung Jang
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyemi Kwon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Ji Jeon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Gu Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Kee Shong
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Bae Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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119
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Hong AR, Lim JA, Kim TH, Choi HS, Yoo WS, Min HS, Won JK, Lee KE, Jung KC, Park DJ, Park YJ. The Frequency and Clinical Implications of the BRAF(V600E) Mutation in Papillary Thyroid Cancer Patients in Korea Over the Past Two Decades. Endocrinol Metab (Seoul) 2014; 29:505-13. [PMID: 25325273 PMCID: PMC4285045 DOI: 10.3803/enm.2014.29.4.505] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 05/30/2014] [Accepted: 06/02/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Over the past several decades, there has been a rapid worldwide increase in the prevalence of papillary thyroid cancer (PTC) as well as a number of changes in the clinicopathological characteristics of this disease. BRAF(V600E), which is a mutation of the proto-oncogene BRAF, has become the most frequent genetic mutation associated with PTC, particularly in Korea. Thus, the present study investigated whether the prevalence of the BRAF(V600E) mutation has increased over the past two decades in the Korean population and whether various PTC-related clinicopathological characteristics have changed. METHODS The present study included 2,624 patients who underwent a thyroidectomy for PTC during two preselected periods; 1995 to 2003 and 2009 to 2012. The BRAF(V600E) mutation status of each patient was confirmed using the polymerase chain reaction-restriction fragment length polymorphism method or by the direct sequencing of DNA. RESULTS The prevalence of the BRAF(V600E) mutation in Korean PTC patients increased from 62.2% to 73.7% (P=0.001) over the last two decades. Additionally, there was a greater degree of extrathyroidal extension (ETE) and lymph node metastasis in 2009 to 2012 patients with the BRAF(V600E) mutation and a higher frequency of thyroiditis and follicular variant-PTC in 2009 to 2012 patients with wild-type BRAF. However, only the frequency of ETE was significantly higher in 1995 to 2003 patients with the BRAF(V600E) mutation (P=0.047). Long-term recurrence rates during a 10-year median follow-up did not differ based on BRAF(V600E) mutation status. CONCLUSION The BRAF(V600E) mutation rate in Korean PTC patients has been persistently high (approximately 70%) over the past two decades and continues to increase. The present findings demonstrate that BRAF(V600E)-positive PTC was associated with more aggressive clinicopathological features, especially in patients who were recently diagnosed, suggesting that BRAF(V600E) mutation status may be a useful prognostic factor for PTC in patients recently diagnosed with this disease.
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Affiliation(s)
- A Ram Hong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Ah Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hoon Sung Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Won Sang Yoo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Department of Internal Medicine, Dankook University Hospital, Cheonan, Korea
| | - Hye Sook Min
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Kyung Won
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu Eun Lee
- Department of General Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyeong Cheon Jung
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Do Joon Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
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Oh CM, Jung KW, Won YJ, Shin A, Kong HJ, Lee JS. Age-Period-Cohort Analysis of Thyroid Cancer Incidence in Korea. Cancer Res Treat 2014; 47:362-9. [PMID: 25672579 PMCID: PMC4506117 DOI: 10.4143/crt.2014.110] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 06/02/2014] [Indexed: 12/24/2022] Open
Abstract
Purpose South Korea has the highest incidence rate of thyroid cancer in the world, and the incidence rate continues to increase. The aim of this study was to determine the age-period-cohort effects on the incidence of thyroid cancer in Korea. Materials and Methods Using the Korean National Cancer registry database, age-standardized incidence rates and annual percent changes (APCs) in thyroid cancer according to sex and histologic type were analyzed between 1997 and 2011. Age-period-cohort models were applied using an intrinsic estimator method according to sex. Results In both men and women, the incidence of thyroid cancer showed a sharp increase from 1997 through 2011. Among the histologic types, papillary carcinoma showed the greatest increase, with APCs of 25.1% (95% confidence interval [CI], 22.7% to 27.5%) in men and 23.7% (95% CI, 21.9% to 25.5%) in women, whereas anaplastic carcinoma did not show a significant increase in either sex. An increase in overall thyroid cancer incidence over time was observed in all birth cohorts. An age-period-cohort model indicated a steeply increasing period effect, which increased prominently from 1997 to 2011 in both men and women. The age effect showed an inverted U-shaped trend. The cohort effect tended to show a slight increase or remain constant from 1952 to 1977, followed by a decrease. Conclusion The period effect can explain the sharp increase in thyroid cancer incidence, strongly suggesting the role of thyroid screening.
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Affiliation(s)
- Chang-Mo Oh
- The Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
| | - Kyu-Won Jung
- The Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
| | - Young-Joo Won
- The Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
| | - Aesun Shin
- The Korea Central Cancer Registry, National Cancer Center, Goyang, Korea.,Molecular Epidemiology Branch, Research Institute, National Cancer Center, Goyang, Korea
| | - Hyun-Joo Kong
- The Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
| | - Jin-Soo Lee
- The Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
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Affiliation(s)
- Jae-Ho Lee
- Department of Family Medicine, The Catholic University of Korea, College of Medicine, Seoul, South Korea
| | - Sang Won Shin
- Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, South Korea.
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Choi H, Lim JA, Ahn HY, Cho SW, Lee KE, Kim KW, Yi KH, Sung MW, Youn YK, Chung JK, Park YJ, Park DJ, Cho BY. Secular trends in the prognostic factors for papillary thyroid cancer. Eur J Endocrinol 2014; 171:667-75. [PMID: 25163726 DOI: 10.1530/eje-14-0225] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE With the recent increasing rates of screening for thyroid cancer, the cancers now tend to be smaller and less aggressive than those that are diagnosed when presented with symptoms, suggesting changes in the clinical validity of conventional prognostic factors for outcomes. We performed the retrospective study to identify the secular trends in the prognostic factors of thyroid cancer. METHODS We used medical records of 3147 patients diagnosed with papillary thyroid cancer (PTC) at the Seoul National University Hospital Thyroid Cancer Clinic between 1962 and 2009. RESULTS During the median 5.1-year follow-up, the overall recurrence rate was 13.3%, and male sex, tumor size, lymph node (LN) involvement, and extrathyroidal extension (ETE) were the significant prognostic factors for recurrence. Thyroid cancer-specific mortality was 1.4%, and the associated prognostic factors were older age, male sex, and LN involvement. For tumor recurrence, the hazard ratio (HR) for male sex decreased from 2.809 (95% CI, 1.497-5.269) in the pre-1989 period to 1.142 (95% CI, 0.736-1.772) in the post-1999 period. The pathologic characteristics, such as tumor size, LN involvement, and ETE, showed similar or increasing HRs over the time periods. For cancer-specific mortality, the HR for male sex decreased from 6.460 (95% CI, 1.714-24.348) in the pre-1990 period to 0.781 (95% CI, 0.083-7.379) in the post-1999 period. CONCLUSION The risk for poor outcomes in PTC associated with male sex decreased over time; in contrast, the risk associated with pathologic characteristics remained the same or increased over time. These trends might be associated with recent changes in the characteristics of patients with thyroid cancer.
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Affiliation(s)
- Hoonsung Choi
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
| | - Jung Ah Lim
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
| | - Hwa Young Ahn
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
| | - Sun Wook Cho
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
| | - Kyu Eun Lee
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
| | - Kyung Won Kim
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
| | - Ka Hee Yi
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
| | - Myung-Whun Sung
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
| | - Yeo-Kyu Youn
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
| | - June-Key Chung
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
| | - Young Joo Park
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
| | - Do Joon Park
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
| | - Bo Youn Cho
- Department of Internal MedicineSeoul National University College of Medicine, Seoul, KoreaDepartment of Internal MedicineChung-Ang University College of Medicine, Seoul, KoreaDepartment of Internal MedicineNational Medical Center, Seoul, KoreaDepartment of Surgery and Cancer Research InstituteSeoul National University College of Medicine, Seoul, KoreaDepartment of Otorhinolaryngology and Head and Neck SurgerySeoul National University College of Medicine, Seoul, KoreaDepartment of SurgeryNational Medical Center, Seoul, KoreaDepartment of Nuclear MedicineSeoul National University College of Medicine, Seoul, Korea
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Jung YY, Yoo JH, Park ES, Kim MK, Lee TJ, Cho BY, Chung YJ, Kang KH, Ahn HY, Kim HS. Clinicopathologic correlations of the BRAFV600E mutation, BRAF V600E immunohistochemistry, and BRAF RNA in situ hybridization in papillary thyroid carcinoma. Pathol Res Pract 2014; 211:162-70. [PMID: 25468810 DOI: 10.1016/j.prp.2014.10.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 10/13/2014] [Accepted: 10/15/2014] [Indexed: 01/21/2023]
Abstract
BACKGROUND The BRAF(V600E) mutation is the most common genetic alteration in papillary thyroid carcinoma (PTC). The aim of this study is to analyze the clinicopathologic correlations of the BRAF(V600E) mutation, BRAF V600E immunohistochemistry (IHC) and BRAF RNA in situ hybridization (ISH) in PTC. METHODS This study included 467 patients with PTC who underwent surgical resection. We studied the BRAF(V600E) mutation using real-time PCR and BRAF V600E and BRAF RNA ISH using tissue microarray (TMA). RESULTS The frequencies of a positive BRAF(V600E) mutation by real-time PCR, positive BRAF V600E IHC, and high BRAF RNA ISH were 84%, 86%, and 70%, respectively, in PTC. Conventional PTC had higher positive rates in all three tests than other histologic types. The BRAF(V600E) mutation, BRAF V600E IHC, low ΔCt, and high BRAF RNA ISH were significantly associated with lymph node metastasis. The BRAF(V600E) mutation was significantly associated with positive immunostaining for BRAF V600E mutant protein (P<0.001) overall, with high BRAF RNA ISH only in the follicular variant (P=0.035). No significant correlation was noted between BRAF V600E IHC and BRAF RNA ISH. The sensitivity of BRAF V600E IHC for the BRAF(V600E) mutation was 95%, and the specificity was 61% overall, 96% and 54% in the conventional type, and 85% and 70% in the follicular variant. CONCLUSIONS Our results showed that positive BRAF V600E IHC significantly correlated with the BRAF(V600E) mutation. This suggests its clinical utility as a screening tool for the BRAF(V600E) mutation. In addition, a high BRAF RNA ISH score could be a candidate marker of aggressive behavior in BRAF(V600E) mutation-positive cases of PTC.
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Affiliation(s)
- Yoon Yang Jung
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae Hyung Yoo
- Department of Pathology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Eon Sub Park
- Department of Pathology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Mi Kyung Kim
- Department of Pathology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Tae Jin Lee
- Department of Pathology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Bo Youn Cho
- Department of Internal Medicine, Division of Endocrinology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea; Thyroid Center, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Yun Jae Chung
- Department of Internal Medicine, Division of Endocrinology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea; Thyroid Center, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Kyung Ho Kang
- Department of Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea; Thyroid Center, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Hwa Young Ahn
- Department of Internal Medicine, Division of Endocrinology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea; Thyroid Center, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Hee Sung Kim
- Department of Pathology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea; Thyroid Center, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea.
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Nagataki S, Takamura N. A review of the Fukushima nuclear reactor accident: radiation effects on the thyroid and strategies for prevention. Curr Opin Endocrinol Diabetes Obes 2014; 21:384-93. [PMID: 25122492 DOI: 10.1097/med.0000000000000098] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE OF REVIEW This is a summary of the nuclear accident at the Tokyo Electric Power Company Fukushima Daiichi Nuclear Power Stations (FDNPS) on 11 March 2011 to be used as a review of the radiation effects to the thyroid and strategies of prevention. RECENT FINDINGS The amount of radioiodine released to the environment following the Fukushima accident was 120 Peta Becquerel, which is approximately one-tenth of that in the Chernobyl accident. Residents near the FDNPS were evacuated within a few days and foodstuffs were controlled within 1 or 2 weeks. Therefore, thyroid radiation doses were less than 100 mSv (intervention levels for stable iodine administration) in the majority of children, including less than 1 year olds, living in the evacuation areas. Because the incidence of childhood thyroid cancer increased in those residing near the site following the Chernobyl accident, thyroid screening of all children (0-18 years old) in the Fukushima Prefecture was started. To date, screening of more than 280 000 children has resulted in the diagnosis of thyroid cancer in 90 children (approximate incidence, 313 per million). Thus, although the dose of radiation was much lower, the incidence of thyroid cancer appears to be much higher than that following the Chernobyl accident. SUMMARY A comparison of the thyroidal consequences following the Fukushima and Chernobyl nuclear reactor accidents is discussed. We also summarize the recent increased incidence in thyroid cancer in the Fukushima area following the accident in relation to increased thyroid ultrasound screening and the use of advanced ultrasound techniques. VIDEO ABSTRACT http://links.lww.com/COE/A8.
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Affiliation(s)
- Shigenobu Nagataki
- aNagasaki University bDepartment of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Nagasaki Prefecture, Japan
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Jeon MJ, Kim TY, Kim WG, Han JM, Jang EK, Choi YM, Song DE, Yoon JH, Chung KW, Hong SJ, Shong YK, Kim WB. Differentiating the location of cervical lymph node metastasis is very useful for estimating the risk of distant metastases in papillary thyroid carcinoma. Clin Endocrinol (Oxf) 2014; 81:593-9. [PMID: 24750108 DOI: 10.1111/cen.12463] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 01/06/2014] [Accepted: 03/22/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE A larger primary tumour size, greater numbers of cervical lymph node (LN) metastasis are associated with a higher risk of distant metastases in papillary thyroid carcinoma (PTC). However, the impact of the location of cervical LN metastasis on distant metastasis is controversial. The aim of this study was to evaluate the risk of distant metastases according to the tumour size and LN status in PTC patients, with special consideration of the LN metastasis pattern. PATIENTS This retrospective cohort study reviewed 1700 classical PTC patients who underwent initial thyroid surgery at Asan Medical Center between 2000 and 2004. RESULTS The cumulative risk of distant metastases was increased with the increase in tumour size and was significantly different according to the location of involved LNs by the tumour node metastasis (TNM) staging. The cumulative risk in pN1b group showed the steepest increasing pattern with the increase in tumour size compared with pN1a and pN0/Nx group. When we analysed the cumulative risk of distant metastases according to the number of involved LNs, patients with more than 20 involved LNs also had the steepest increase in the risk of distant metastases with the increase in tumour size. However, only the location of involved LNs, not the number of involved LNs, was associated with distant metastases in multivariate analysis. CONCLUSIONS We confirm that the location of involved LNs categories based on the TNM staging system is more useful than the number of involved LNs categories for estimating the risk of distant metastasis in PTC. Differentiating N1a disease from N1b disease is important for the follow-up and management of patients with PTC.
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Affiliation(s)
- Min Ji Jeon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Lee JE, Kim SK, Han KH, Cho MO, Yun GY, Kim KH, Choi HY, Ryu YH, Ha SK, Park HC. Risk factors for developing hyponatremia in thyroid cancer patients undergoing radioactive iodine therapy. PLoS One 2014; 9:e106840. [PMID: 25170831 PMCID: PMC4149575 DOI: 10.1371/journal.pone.0106840] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 08/02/2014] [Indexed: 12/28/2022] Open
Abstract
Background Due to the alarming increase in the incidence of thyroid cancer worldwide, more patients are receiving postoperative radioactive iodine (RAI) therapy and these patients are given a low-iodine diet along with levothyroxine withdrawal to induce a hypothyroid state to maximize the uptake of RAI by thyroid tissues. Recently, the reported cases of patients suffering from life-threatening severe hyponatremia following postoperative RAI therapy have increased. This study aimed to systematically assess risk factors for developing hyponatremia following RAI therapy in post-thyroidectomy patients. Methods We reviewed the medical records of all thyroid cancer patients who underwent thyroidectomy and postoperative RAI therapy from July 2009 to February 2012. Demographic and biochemical parameters including serum sodium and thyroid function tests were assessed along with medication history. Results A total of 2229 patients (47.0±11.0 years, female 76.3%) were enrolled in the analysis. Three hundred seven patients (13.8%) of all patients developed hyponatremia; 44 patients (2.0%) developed moderate to severe hyponatremia (serum Na+≤130 mEq/L) and another 263 (11.8%) patients showed mild hyponatremia (130 mEq/L<serum Na+≤135 mEq/L). In univariate analysis, old age, female sex, presence of hypertension, presence of diabetes, use of thiazide diuretics, use of angiotensin receptor blocker or angiotensin-converting enzyme inhibitors, lung metastasis, and hyponatremia and lower estimated glomerular filtration rate at the start of RAI therapy were significantly associated with hyponatremia in patients undergoing RAI therapy after total thyroidectomy. Multivariate analysis showed that old age, female sex, use of thiazide diuretics, and hyponatremia at the initiation of RAI therapy were independent risk factors for the development of hyponatremia. Conclusion Our data suggest that age greater than 60 years, female sex, use of thiazide, and hyponatremia at the initiation of RAI therapy are important risk factors for developing hyponatremia following RAI therapy in post-thyroidectomy patients.
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Affiliation(s)
- Jung Eun Lee
- Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Kyu Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung Hwa Han
- Biostatistics Collaboration Unit, Gangnam Medical Research Center, Seoul, Republic of Korea
| | - Mi Ok Cho
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Gi Young Yun
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ki Hyun Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hoon Young Choi
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Kyu Ha
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyeong Cheon Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Republic of Korea
- * E-mail:
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Cho SW, Yi KH, Han SK, Sun HJ, Kim YA, Oh BC, Park YJ, Park DJ. Therapeutic potential of metformin in papillary thyroid cancer in vitro and in vivo. Mol Cell Endocrinol 2014; 393:24-9. [PMID: 24905037 DOI: 10.1016/j.mce.2014.05.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 05/07/2014] [Accepted: 05/23/2014] [Indexed: 01/09/2023]
Abstract
Metformin, an anti-diabetic drug used in type 2 diabetes treatment, is reported to have oncopreventive or therapeutic roles in several human cancers. The present study investigated the therapeutic potential of physiologic dose of metformin in PTC. Metformin inhibited PTC cell viability and increased cell apoptosis in various doses (0.5-20mM) in BCPAP and BHP10-3SC cells. Western blot analysis demonstrated that the p-AMPK/AMPK ratio increased with increased metformin treatment. The ectopic tumor experiment was performed using BHP10-3SC cells and athymic nude mice. Oral metformin treatment via drinking water significantly delayed tumor growth in both tumor development model and established tumor models. Necrotic area in tumors significantly increased with metformin treatment. Western blot analysis revealed an increase in p-AMPK/AMPK ratio and suppressions of mTOR and Akt expressions in metformin-treated mice compared to the results in mock-treated control mice. Our results indicate that a physiologic dose of metformin has anti-tumorigenic effects that result from activation of AMPK signaling and inhibition of Akt signaling.
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Affiliation(s)
- Sun Wook Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea
| | - Ka Hee Yi
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sun Kyoung Han
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyun Jin Sun
- Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea
| | - Ye An Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Byung-Chul Oh
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University Graduate School of Medicine, Incheon, Republic of Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Do Joon Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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128
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Affiliation(s)
- Jae Hoon Chung
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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129
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Tartaglia F, Blasi S, Giuliani A, Sgueglia M, Tromba L, Carbotta S, Carbotta G, Tortorelli G. Central neck dissection in papillary thyroid carcinoma: Results of a retrospective study. Int J Surg 2014; 12 Suppl 1:S57-62. [DOI: 10.1016/j.ijsu.2014.05.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 05/03/2014] [Indexed: 11/26/2022]
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130
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Oh CM, Park S, Lee JY, Won YJ, Shin A, Kong HJ, Choi KS, Lee YJ, Chung KW, Jung KW. Increased prevalence of chronic lymphocytic thyroiditis in Korean patients with papillary thyroid cancer. PLoS One 2014; 9:e99054. [PMID: 24927027 PMCID: PMC4057257 DOI: 10.1371/journal.pone.0099054] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 05/08/2014] [Indexed: 11/18/2022] Open
Abstract
Background In recent years, some reports have suggested that papillary thyroid cancers are more frequently associated with lymphocytic thyroiditis or Hashimoto's thyroiditis. This study investigated a potential increase in the prevalence of chronic lymphocytic thyroiditis among papillary thyroid cancer patients. Materials and Methods We used national epidemiological survey data on thyroid cancer patients diagnosed in 1999, 2005, and 2008. A retrospective medical record survey was conducted by representative sampling of a national cancer incidence database. The analysis included 5,378 papillary thyroid cancer patients aged 20–79 years. We calculated the age-standardized prevalence and age-adjusted prevalence ratios using a binomial regression model with a log link for the prevalence of chronic lymphocytic thyroiditis among papillary thyroid cancer patients by sex for each year. Results The prevalence of chronic lymphocytic thyroiditis among papillary thyroid cancer patients was 4.0% and 12.8% for men and women in 1999, 6.5% and 24.6% in 2005, and 10.7% and 27.6% in 2008, respectively. Between 1999 and 2008, the age-standardized prevalence of chronic lymphocytic thyroiditis increased 4.1-fold in male patients and 2.0-fold in female patients with papillary thyroid cancer. The prevalence of other thyroid diseases, however, did not increase in either gender. Conclusions Among Korean papillary thyroid cancer patients, the prevalence of chronic lymphocytic thyroiditis increased between 1999 and 2008, whereas the prevalence of other thyroid disorders did not change.
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Affiliation(s)
- Chang-Mo Oh
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Sohee Park
- Department of Epidemiology and Health Promotion, Yonsei University, Graduate School of Public Health, Seoul, Korea
| | - Joo Young Lee
- National Emergency Medical Center, National Medical Center, Seoul, Korea
| | - Young-Joo Won
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University, College of Medicine, Seoul, Korea
| | - Hyun-Joo Kong
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Kui-Sun Choi
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - You Jin Lee
- Center for Thyroid Cancer, National Cancer Center, Goyang, Korea
| | - Ki- Wook Chung
- Division of endocrine surgery, Department of surgery, Asan Medical Center, Seoul, Korea
| | - Kyu-Won Jung
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- * E-mail:
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131
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Herh SJ, Kim EK, Sung JM, Yoon JH, Moon HJ, Kwak JY. Heterogeneous echogenicity of the thyroid parenchyma does not influence the detection of multi-focality in papillary thyroid carcinoma on preoperative ultrasound staging. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:884-889. [PMID: 24462158 DOI: 10.1016/j.ultrasmedbio.2013.11.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 11/12/2013] [Accepted: 11/18/2013] [Indexed: 06/03/2023]
Abstract
Heterogeneous echogenicity and micro-nodulations of diffuse thyroid disease on ultrasonography (US) might influence the diagnostic performance of pre-operative US staging, especially the detection of multi-focality. This study was designed to determine whether heterogeneous echogenicity of the thyroid parenchyma influences the diagnostic performance of US in the detection of multi-focality in papillary thyroid carcinoma. Between December 2010 and April 2011, 811 patients underwent pre-operative staging US for papillary thyroid carcinoma and surgery. Twelve radiologists performed the pre-operative US for T and N staging. Underlying parenchymal echogenicity and unilateral and bilateral multi-focality of the thyroid nodules were also evaluated. Patients were divided into two groups on the basis of the underlying echogenicity of the thyroid gland. To evaluate the diagnostic accuracy of US with respect to underlying echogenicity, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated and compared between the two groups. Among the 811 patients included, US revealed underlying heterogeneous echogenicity of the thyroid parenchyma in 204 (25.2%) and underlying homogeneous echogenicity of the thyroid parenchyma in 607 (74.8%). There were no significant differences between the two groups in the diagnostic performance of pre-operative staging US in predicting unilateral multi-focality and bilaterality. Underlying heterogeneous echogenicity in a thyroid gland with Hashimoto's thyroiditis does not significantly influence the detection of multi-focality in papillary thyroid cancer on pre-operative US staging.
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Affiliation(s)
- Sun Jin Herh
- Department of Radiology, Research Institute of Radiologic Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun-Kyung Kim
- Department of Radiology, Research Institute of Radiologic Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji Min Sung
- Graduate School of Health and Welfare CHA University, Seongnam, South Korea
| | - Jung Hyun Yoon
- Department of Radiology, Research Institute of Radiologic Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Hee Jung Moon
- Department of Radiology, Research Institute of Radiologic Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Young Kwak
- Department of Radiology, Research Institute of Radiologic Science, Yonsei University College of Medicine, Seoul, South Korea.
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132
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Hyeon J, Ahn S, Shin JH, Oh YL. The prediction of malignant risk in the category "atypia of undetermined significance/follicular lesion of undetermined significance" of the Bethesda System for Reporting Thyroid Cytopathology using subcategorization and BRAF mutation results. Cancer Cytopathol 2014; 122:368-76. [PMID: 24591408 DOI: 10.1002/cncy.21396] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 12/26/2013] [Accepted: 01/01/2014] [Indexed: 01/21/2023]
Abstract
BACKGROUND The "atypia of undetermined significance/follicular lesion of undetermined significance" (AUS/FLUS) category in the Bethesda System for Reporting Thyroid Cytopathology is a heterogeneous category of cases that are not clearly benign or malignant. METHODS We conducted an analysis of cytologic and histologic evaluations of thyroid nodules that had been interpreted as AUS/FLUS on fine-needle aspiration (FNA) at a single institution from April 2011 to April 2012. Those cases were classified into 2 subgroups according to the predominance of nuclear atypia (AUS) or microfollicular architecture (FLUS). In addition, for a number of these cases, BRAF gene mutation analyses were performed. RESULTS Of 6402 thyroid FNAs performed, 431 cases were diagnosed as AUS and 120 as FLUS. Follow-up cytologic or histologic outcome data were available for 315 AUS cases and 73 FLUS cases. Among AUS cases, 52.7% were malignant on repeat FNA or histologic diagnosis. In contrast, for FLUS, 6.8% were malignant on repeat FNA or histologic diagnosis. Among AUS/FLUS cases, 147 had adequate BRAF mutation analysis, which accompanied the histologic diagnosis. BRAF mutations were found in 87 AUS cases, 86 of which were papillary carcinoma. In contrast, there was only 1 case of BRAF mutation in FLUS. Correlating molecular results with histologic outcome revealed a 98.9% cancer probability for AUS cases with BRAF mutation. CONCLUSIONS The AUS subcategory indicates a higher risk of malignancy than the FLUS subcategory. Furthermore, BRAF molecular testing is helpful in stratifying the malignant risk of AUS cases into high-risk and low-risk groups.
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Affiliation(s)
- Jiyeon Hyeon
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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133
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Cho SW, Choi HS, Yeom GJ, Lim JA, Moon JH, Park DJ, Chung JK, Cho BY, Yi KH, Park YJ. Long-term prognosis of differentiated thyroid cancer with lung metastasis in Korea and its prognostic factors. Thyroid 2014; 24:277-86. [PMID: 23758653 PMCID: PMC3926138 DOI: 10.1089/thy.2012.0654] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Distant metastasis, generally to lung and bone, is rare in differentiated thyroid carcinoma (DTC) and the prognosis is still elusive. We investigated long-term outcomes of lung metastasis in DTC patients and its prognostic factors. METHODS A retrospective review was performed of 4572 patients who underwent surgery for DTC from 1962 to 2009 at Seoul National University Hospital. Among them, 164 patients were identified with lung metastasis and 152 patients were enrolled in the final analysis. Poor prognosis was defined as progressive disease or death. RESULTS Of these 152 patients, 10- and 20-year survival rates were 85.0% and 71.0%, respectively. No evidence of disease, stable disease, progressive disease, and death was identified in 22.4%, 28.3%, 35.5%, and 13.8%, respectively, after 11 years of median follow-up (range 2-41 years). Older age at diagnosis (≥45 years), primary tumor size ≥2 cm, follicular thyroid cancer, metastasis diagnosed after initial evaluation or (131)I remnant ablation (late metastasis), multiple metastases other than lung, (131)I nonavidity, and the presence of macronodules (≥1 cm) were more frequent in poor prognoses. Cox proportional hazard ratio for progression-free survival showed that (131)I nonavidity was the only independent predictive factor for poor prognosis. CONCLUSIONS The prognosis of lung metastasis from DTC in Korea within this study was favorable. (131)I nonavidity, observed more frequently in late metastasis, was the only independent factor predicting poor prognosis.
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Affiliation(s)
- Sun Wook Cho
- Department of Internal Medicine, Seoul National University, Seoul, Korea
| | - Hoon Sung Choi
- Department of Internal Medicine, Seoul National University, Seoul, Korea
| | - Gye Jeong Yeom
- Department of Internal Medicine, Seoul National University, Seoul, Korea
| | - Jung Ah Lim
- Department of Internal Medicine, Seoul National University, Seoul, Korea
| | - Jae Hoon Moon
- Department of Internal Medicine, Bundang Hospital, Seoul National University, Seoul, Korea
| | - Do Joon Park
- Department of Internal Medicine, Seoul National University, Seoul, Korea
| | - June-Key Chung
- Department of Nuclear Medicine, College of Medicine, Seoul National University, Seoul, Korea
| | - Bo Youn Cho
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Ka Hee Yi
- Department of Internal Medicine, Boramae Medical Center; Seoul National University, Seoul, Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University, Seoul, Korea
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134
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Seo GH, Chung JH. Analysis of Therapeutic Modalities of Thyroid Cancer in Korea between 2008 and 2012. ACTA ACUST UNITED AC 2014. [DOI: 10.11106/cet.2014.7.2.167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Gi Hyeon Seo
- Health Insurance Review and Assessment Service, Korea
| | - Jae Hoon Chung
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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135
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Jung HS, Jeon MJ, Song DE, Hong SJ, Kim WG, Kim TY, Shong YK, Kim WB. Time Trends Analysis of Characteristics of Patients with Thyroid Cancer in a Single Medical Center. ACTA ACUST UNITED AC 2014. [DOI: 10.11106/cet.2014.7.2.159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Hyung Seo Jung
- University of Ulsan College of Medicine, Division of Endocrinology & Metabolism, Asan Medical Center, Seoul, Korea
| | - Min Ji Jeon
- Department of Internal Medicine, Asan Medical Center, Seoul, Korea
| | - Dong Eun Song
- Department of Pathology, Asan Medical Center, Seoul, Korea
| | - Suck Joon Hong
- Department of Surgery, Asan Medical Center, Seoul, Korea
| | - Won Gu Kim
- Department of Internal Medicine, Asan Medical Center, Seoul, Korea
| | - Tae Yong Kim
- Department of Internal Medicine, Asan Medical Center, Seoul, Korea
| | - Young Kee Shong
- Department of Internal Medicine, Asan Medical Center, Seoul, Korea
| | - Won Bae Kim
- Department of Internal Medicine, Asan Medical Center, Seoul, Korea
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136
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Jeon MJ, Kim WG, Park WR, Han JM, Kim TY, Song DE, Chung KW, Ryu JS, Hong SJ, Shong YK, Kim WB. Modified dynamic risk stratification for predicting recurrence using the response to initial therapy in patients with differentiated thyroid carcinoma. Eur J Endocrinol 2014; 170:23-30. [PMID: 24088549 DOI: 10.1530/eje-13-0524] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE A new risk stratification system was proposed to estimate the risk of recurrence in patients with differentiated thyroid carcinoma (DTC) using the response to initial therapy. Here, we describe the modified dynamic risk stratification system, which takes into consideration the status of serum anti-Tg antibody (TgAb), and validate this system for assessing the risk of recurrence in patients with DTC. PATIENTS AND METHODS Patients who underwent total thyroidectomy with radioiodine remnant ablation due to DTC between 2000 and 2005 were included. We classified patients into four groups based on the response to the initial therapy ('excellent', 'acceptable', 'biochemical incomplete', and 'structural incomplete' response). RESULTS The median follow-up period of 715 patients with DTC was 8 years. The response to initial therapy was an important risk predictor for recurrent/persistent DTC. The relative risks (95% CI) of recurrence were 16.5 (6.3-43.0) in the 'acceptable response' group, 41.3 (15.4-110.8) in the 'biochemical incomplete response' group, and 281.2 (112.9-700.5) in the 'structural incomplete response' group compared with the 'excellent response' group (P<0.001, P<0.001, and P<0.001 respectively). The disease-free survival rate of the 'excellent response' group to initial therapy was 98.3% whereas that of the 'structural incomplete response' group was only 6.8%. CONCLUSIONS Our study validates the usefulness of the modified dynamic risk stratification system including the status of serum TgAb for predicting recurrent/persistent disease in patients with DTC. Personalized risk assessment using the response to initial therapy could be useful for the follow-up and management of patients with DTC.
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137
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Affiliation(s)
- Jae Hoon Chung
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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