151
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Koterov AN. Causal Criteria in Medical and Biological Disciplines: History, Essence, and Radiation Aspect. Report 1. Problem Statement, Conception of Causes and Causation, False Associations. BIOL BULL+ 2020. [DOI: 10.1134/s1062359019110165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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152
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ÇADIRCI K, YILDIZ F, KESKIN H, BAYRAK M, KİZİLTUNC OZMEN H, ARIKAN DURMAZ Ş, ÇARLIOĞLU A. Investigation of the neutrophil/lymphocyte and monocyte to high-density lipoprotein cholesterol ratios in differentiated thyroid cancers. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2020. [DOI: 10.32322/jhsm.689142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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153
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Development and validation of a nomogram for preoperative prediction of cervical lymph node involvement in thyroid microcarcinoma. Aging (Albany NY) 2020; 12:4896-4906. [PMID: 32170046 PMCID: PMC7138557 DOI: 10.18632/aging.102915] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 03/02/2020] [Indexed: 12/21/2022]
Abstract
Cervical regional lymph node involvement (CRLNI) is common in papillary thyroid microcarcinoma (PTMC), but the way to deal with cervical lymph node involvement of clinically negative PTMC is controversial. We studied data of patients histologically confirmed PTMC in the Surveillance, Epidemiology, and End Results (SEER) Program and Department of Surgical Oncology in Hangzhou First People's Hospital (China). We screened 6 variables of demographic and clinicopathological characteristics as potential predictors and further constructed a lymph node involvement model based on the independent predictors including age, race, sex, extension, multifocality and tumor size. The model was validated by both the internal and the external testing sets, and the visual expression of the model was displayed by a nomogram. As a result, the C-index of this predictive model in the training set was 0.766, and the internal and external testing sets through cross-validation were 0.753 and 0.668, respectively. The area under the receiver operating characteristic curve (AUC) was 0.766 for the training set. We also performed a Decision Curve Analysis (DCA), which showed that predicting the cervical lymph node involvement risk applying this nomogram would be better than having all patients or none patients use this nomogram.
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154
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Feng JW, Qin AC, Ye J, Pan H, Jiang Y, Qu Z. Predictive Factors for Lateral Lymph Node Metastasis and Skip Metastasis in Papillary Thyroid Carcinoma. Endocr Pathol 2020; 31:67-76. [PMID: 31828583 DOI: 10.1007/s12022-019-09599-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In papillary thyroid cancer (PTC) patients, cervical lymph node metastases are common, which disseminate sequentially from the central neck to the lateral neck. However, there is also a chaotic pattern of lymph node metastasis occasionally. In this study, we summarized 653 PTC patients who underwent thyroidectomy and central lymph node dissection with or without lateral lymph node dissection from two hospitals to investigate the pattern and risk factors of lateral lymph node metastasis (LLNM) and skip metastasis. LLNM was significantly associated tumor size > 1 cm, presence of extrathyroidal extension, tumors in the upper-lateral pole, and the number of metastatic lymph nodes in the central compartment. The frequency of skip metastasis was 22.5% (20 of 89 patients). Multivariate analyses showed tumor size ≤ 1 cm, and tumors in the upper-lateral pole were separately and independently associated with the risk of skip metastasis. Presence of LLNM affected the recurrence-free survival (RFS). RFS did not show the significantly difference between patients with LLNM and skip metastasis. Despite the low incidence of skip metastasis, attention should be paid to the possibility of LLNM even in the absence of central lymph node metastases. Besides, for patients with risk factors of LLNM or skip metastasis, detailed preoperative examination for the lateral compartment, especially the level III, is essential.
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Affiliation(s)
- Jia-Wei Feng
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
| | - An-Cheng Qin
- The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China
| | - Jing Ye
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
| | - Hua Pan
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
| | - Yong Jiang
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China.
| | - Zhen Qu
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
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155
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Jun JK, Hwang SY, Hong S, Suh M, Choi KS, Jung KW. Association of Screening by Thyroid Ultrasonography with Mortality in Thyroid Cancer: A Case-Control Study Using Data from Two National Surveys. Thyroid 2020; 30:396-400. [PMID: 31870224 DOI: 10.1089/thy.2019.0460] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: The incidence of thyroid cancer is increasing worldwide due to an increased detection of small well-differentiated papillary thyroid carcinomas. This study aimed to evaluate the effect of screening with ultrasonography on deaths from thyroid cancer. Materials and Methods: We conducted a matched case-control study using data from two sources representative of the adult Korean population. Cases were selected from the National Epidemiologic Survey of Thyroid Cancer database, and controls were selected from the Korean National Cancer Screening Survey database. Controls were individually matched to case patients with respect to age, sex, and area with a ratio of 10:1. The primary outcome was death from thyroid cancer. Controls were required to have been alive on the date of thyroid cancer diagnosis in the corresponding case. Results: The analysis included 120 patients who died from thyroid cancer and 1184 controls. Compared with those who had never been screened, the odds ratios for death from thyroid cancer among those who had been screened were 1.44 (95% confidence interval [CI] 0.68-3.05) if cases with missing information on screening were excluded and 1.13 [CI 0.49-2.63] if all cases were included, and missing information was imputed. Stratification by sex, year of diagnosis, and histological type did not show any statistically significant relationships between screening with ultrasonography and death from thyroid cancer, regardless of the statistical model used. Conclusions: Screening for thyroid cancer with ultrasonography does not prevent death from thyroid cancer; therefore, screening asymptomatic adults for thyroid cancer is unwarranted.
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Affiliation(s)
- Jae Kwan Jun
- National Cancer Control Institute; National Cancer Center, Goyang, Republic of Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Soon-Young Hwang
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seri Hong
- National Cancer Control Institute; National Cancer Center, Goyang, Republic of Korea
| | - Mina Suh
- National Cancer Control Institute; National Cancer Center, Goyang, Republic of Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Kui Son Choi
- National Cancer Control Institute; National Cancer Center, Goyang, Republic of Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Kyu-Won Jung
- National Cancer Control Institute; National Cancer Center, Goyang, Republic of Korea
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156
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Borda A, Zahan AE, Piciu D, Barbuș E, Berger N, Nechifor-Boilă A. A 15 year institutional experience of well-differentiated follicular cell-derived thyroid carcinomas; impact of the new 2017 TNM and WHO Classifications of Tumors of Endocrine Organs on the epidemiological trends and pathological characteristics. Endocrine 2020; 67:630-642. [PMID: 31838728 DOI: 10.1007/s12020-019-02158-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/09/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE Our study aimed to describe the evolution of the rate of pathological subtypes of well-differentiated follicular-cell derived thyroid carcinomas (DTCs) in the Department of Pathology, Emergency County Hospital Targu-Mures, Romania over a 15 year period and to assess the impact the new 2017 WHO and TNM classifications of thyroid tumors had on our cases. METHODS The pathological data were retrieved from the original pathological reports. After applying the exclusion criteria the remaining cases were reviewed on a double-headed microscope and reclassified according to the 2017 WHO and TNM staging system. The follow-up data were collected from the Institute of Oncology Cluj-Napoca, Romania. RESULTS Our study included 396 cases of DTCs (375 papillary, 11 follicular, and 10 Hürthle cell carcinomas). PTCs revealed a significant increasing trend over the study period, whereas follicular and Hurthle cell carcinomas remain rare; 125/131 of noninvasive encapsulated follicular variant PTC (EFVPTC) were reclassified as noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTPs), resulting in a 33.3% reduction in the number of PTCs. According to 2017 TNM stage-grouping 31% of 271 patients with DTC were downstaged. Follow-up data were available for most of the patients (65.7%, mean period 58.1 months). All patients with noninvasive EFVPTC were disease free at the last clinical assessment. CONCLUSIONS The increasing rate of PTC was maintained even after exclusion of NIFTP. By applying 2017 TNM criteria, a significant number of DTC cases were downstaged into a more favorable group. Follow-up data highlight the indolent behavior of noninvasive EFVPTCs reclassified as NIFTPs.
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Affiliation(s)
- Angela Borda
- Department of Histology, George Emil Palade University of Medicine, Pharmacy, Sciences, and Technology of Targu-Mureş, 38 Gh. Marinescu Street, 540139, Targu-Mureş, Romania
- Department of Pathology, Targu-Mureş Emergency County Hospital, 50 Gh. Marinescu Street, 540136, Targu-Mureş, Romania
| | - Ancuța-Elena Zahan
- Department of Histology, George Emil Palade University of Medicine, Pharmacy, Sciences, and Technology of Targu-Mureş, 38 Gh. Marinescu Street, 540139, Targu-Mureş, Romania.
| | - Doina Piciu
- Department of Nuclear Medicine, "Ion Chiricuţă" Institute of Oncology, 34-36 Republicii Street, Cluj-Napoca, 400015, Romania
| | - Elena Barbuș
- Department of Nuclear Medicine, "Ion Chiricuţă" Institute of Oncology, 34-36 Republicii Street, Cluj-Napoca, 400015, Romania
| | - Nicole Berger
- Department of Pathology Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69495, Pierre Bénite, France
| | - Adela Nechifor-Boilă
- Department of Histology, George Emil Palade University of Medicine, Pharmacy, Sciences, and Technology of Targu-Mureş, 38 Gh. Marinescu Street, 540139, Targu-Mureş, Romania
- Department of Pathology, Targu-Mureş County Hospital, 28 December 1/1918 Boulevard, 540061, Targu-Mureş, Romania
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157
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Yang Y, Sun X, Wang J, Yang C, Zhang L. Incidence Rates of Four Major Non-Communicable Chronic Diseases in the Chinese Adult Population from 2007 to 2016: A Study Based on a National Commercial Claims Database. Clin Epidemiol 2020; 12:215-222. [PMID: 32158274 PMCID: PMC7047989 DOI: 10.2147/clep.s238804] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/29/2020] [Indexed: 12/29/2022] Open
Abstract
Background The spread of non-communicable chronic diseases (NCDs) is a global crisis. Understanding the dynamics of NCDs at the population level is crucial to develop prevention strategies as well as to evaluate the effectiveness of intervention. However, studies investigating the incidence rate of NCDs among the general population are limited, especially for developing countries like China. We aim to evaluate the incidence rates of four major NCDs from 2007 to 2016, based on a national commercial claims database in China. Methods Cancer, stroke, coronary heart disease (CHD) and end-stage kidney disease (ESKD) accounted for over 90% of claims data were included as major NCDs. The definition of the above diseases followed the guideline of disease definitions of critical illness insurance released by the Insurance Association of China. Age-standardized incidence rates (ASRs) of those major NCDs among subgroups of sex, demographic regions, and China city tiers were reported. The trends of incidence rates were described as annual percent change (APC) as well as average annual percent change (AAPC) and were then examined by joinpoint models. Results For the population insured in 2007, the average 10-year ASRs of cancer, CHD, stroke, and ESKD were 221.0, 55.5, 43.5, 11.0 per 100,000 person-years, respectively. For males, the ASRs of cancer, CHD, ESKD continuously increase in the past decade with AAPC of 1.4%, 5.2%, and 3.3%; while the ASRs of stroke were decreased with APC of 3.7% after 2009. For females, the increased ASRs of cancer with AAPC of 4.2% and CHD with AAPC of 2.0%; while decreased trends of ASRs were observed for stroke and ESKD. Patterns of ASRs changing varied between different demographic regions and city tiers. Conclusion Commercial claims data could be a valuable data source to evaluate the disease burden for major NCDs in China. The disease burden of severe stroke was decreasing while cancer, CHD and ESKD were still increasing in China. More efforts should be put into control of CHD, especially in the northern part of China.
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Affiliation(s)
- Yu Yang
- National Institute of Health Data Science, Peking University, Beijing, People's Republic of China.,Center for Data Science in Health and Medicine, Peking University, Beijing, People's Republic of China
| | - Xiaoyu Sun
- National Institute of Health Data Science, Peking University, Beijing, People's Republic of China.,Center for Data Science in Health and Medicine, Peking University, Beijing, People's Republic of China
| | - Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology; Key Laboratory of Renal Disease, National Health Commission of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, People's Republic of China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology; Key Laboratory of Renal Disease, National Health Commission of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, People's Republic of China
| | - Luxia Zhang
- National Institute of Health Data Science, Peking University, Beijing, People's Republic of China.,Center for Data Science in Health and Medicine, Peking University, Beijing, People's Republic of China.,Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology; Key Laboratory of Renal Disease, National Health Commission of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, People's Republic of China
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158
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Histopathology and immunohistochemistry as prognostic factors for poorly differentiated thyroid cancer in a series of Polish patients. PLoS One 2020; 15:e0229264. [PMID: 32092093 PMCID: PMC7039429 DOI: 10.1371/journal.pone.0229264] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/02/2020] [Indexed: 11/24/2022] Open
Abstract
Background Poorly differentiated thyroid cancer (PDTC) is a rare but aggressive type of thyroid cancer (TC) and the main cause of death from non-anaplastic follicular cell-derived TC. Although the Turin criteria are well defined, the pathological features that could serve as diagnostic and prognostic factors remain controversial. Materials and methods Forty-nine consecutive PDTC cases were identified in a single cancer center between 2000 and 2018. We analyzed the impact of routine histopathological and immunohistochemical features and several parameters that are not routinely included in pathology reports such as the presence of atypical mitoses, the amount of necrosis, or insulin-like growth factor-II mRNA-binding protein 3 immunostaining on the survival of patients with PDTC. Overall survival (OS) and disease-specific survival (DSS) were calculated using the Kaplan-Meier method. Results Of the 49 PDTC 34 (69.4%) showed the insular pattern of growth. The median of poorly differentiated area was 95% (range, 1–100), and 30 (61.2%) patients had a predominant (>50%) insular area. The 5-year OS and DSS rates at a median follow-up of 57 months were 60.6% and 64.3%, respectively. Univariate analysis showed that tumor size >4 cm, presence of atypical mitoses, Ki-67 >5%, and thyroglobulin (Tg)-negative immunostaining were associated with a higher risk of PDTC-related death. Atypical mitoses and Tg negativity were independent factors of worse DSS in multivariate analysis. Patients with insular and predominant insular areas showed a 3- and 6-fold higher risk of PDTC death when they displayed atypical mitoses. Conclusions In PDTC, the presence of atypical mitoses may be helpful in identifying patients with poorer outcome and worth including in pathology reports, particularly in tumors with a dominant insular pattern of growth. Additionally, the inclusion of Tg immunostaining may be considered in a prognostic context, and not only as a diagnostic feature.
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159
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Miao H, Liu X, Li J, Zhang L, Zhao Y, Liu S, Ni S, Wu Y. Associations of urinary phthalate metabolites with risk of papillary thyroid cancer. CHEMOSPHERE 2020; 241:125093. [PMID: 31629241 DOI: 10.1016/j.chemosphere.2019.125093] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 06/10/2023]
Abstract
Some studies have revealed thyrotoxicity of phthalates; however, associations of phthalate exposure with papillary thyroid cancer (PTC) remain unclear. We conducted a pair-matching case-control study of 111 PTC cases and 111 age- and sex-matched non-PTC controls to examine associations between urinary concentrations of phthalate metabolites and PTC. Phthalate metabolites were determined in fasting urine specimens by ultra-performance liquid chromatography - tandem mass spectrometry (UPLC-MS/MS). After adjusting for potential confounders and other phthalate metabolites, the concentrations of the sum of di (2-ethylhexly) phthalate (DEHP) metabolites in urine were positively associated with PTC [odds ratio (OR) = 5.35; 95% confidence interval (CI): 1.61-17.83], suggesting the effect of phthalates exposure on PTC development. The findings require confirmation.
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Affiliation(s)
- Hongjian Miao
- NHC Key Laboratory of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment, Beijing, 100021, China
| | - Xin Liu
- NHC Key Laboratory of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment, Beijing, 100021, China; Institute of Food Science and Engineering, Wuhan Polytechnic University, Wuhan, 430023, Hubei, China
| | - Jingguang Li
- NHC Key Laboratory of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment, Beijing, 100021, China
| | - Lei Zhang
- NHC Key Laboratory of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment, Beijing, 100021, China.
| | - Yunfeng Zhao
- NHC Key Laboratory of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment, Beijing, 100021, China
| | - Shaoyan Liu
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
| | - Song Ni
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
| | - Yongning Wu
- NHC Key Laboratory of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment, Beijing, 100021, China
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160
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Li Q, Chen W, Luo R, Zhang Z, Song M, Chen W, Yang Z, Yang Y, Guo Z, Yang A. Upregulation of OIP5-AS1 Predicts Poor Prognosis and Contributes to Thyroid Cancer Cell Proliferation and Migration. MOLECULAR THERAPY. NUCLEIC ACIDS 2020; 20:279-291. [PMID: 32193154 PMCID: PMC7078457 DOI: 10.1016/j.omtn.2019.11.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/03/2019] [Accepted: 11/08/2019] [Indexed: 12/17/2022]
Abstract
As a common malignancy, thyroid cancer mainly occurs in the endocrine system. There have been accumulating studies on therapeutic methods of thyroid cancer, but its internal molecular mechanism is still not fully understood. Long noncoding RNA (lncRNA) OIP5-AS1 was confirmed as an oncogene and related to poor prognosis in various cancers. Nevertheless, its role and underlying mechanism remain unclear in thyroid cancer. Here, we observed a significant upregulation of OIP5-AS1 in thyroid cancer tissues and cells, and upregulated OIP5-AS1 was correlated with poor prognosis in thyroid cancer. Moreover, OIP5-AS1 knockdown resulted in the inhibited cell proliferation and migration, while overexpressed OIP5-AS1 exhibited the reverse function in thyroid cancer. Besides, OIP5-AS1 was found to positively regulate Wnt/β-catenin signaling pathway. Through mechanism exploration, OIP5-AS1 was discovered to activate Wnt/β-catenin signaling pathway via FXR1/YY1/CTNNB1 axis. Finally, rescue assays indicated that the inhibitive role of silenced OIP5-AS1 in thyroid cancer cell growth and Wnt/β-catenin signaling pathway could be rescued by overexpression of CTNNB1 or addition of lithium chloride (LiCl). In conclusion, upregulation of OIP5-AS1 predicted unfavorable prognosis and enhanced thyroid cancer cell growth by activating Wnt/β-catenin signaling pathway.
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Affiliation(s)
- Qiuli Li
- Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Weichao Chen
- Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Rongzhen Luo
- Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Zhiyi Zhang
- Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Ming Song
- Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Wenkuan Chen
- Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Zhongyuan Yang
- Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Yuanzhong Yang
- Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Zhuming Guo
- Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Ankui Yang
- Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
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161
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Surgery alone for papillary thyroid microcarcinoma is less costly and more effective than long term active surveillance. Surgery 2020; 167:110-116. [DOI: 10.1016/j.surg.2019.05.078] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/26/2019] [Accepted: 05/09/2019] [Indexed: 11/23/2022]
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162
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Krajewska J, Kukulska A, Oczko-Wojciechowska M, Kotecka-Blicharz A, Drosik-Rutowicz K, Haras-Gil M, Jarzab B, Handkiewicz-Junak D. Early Diagnosis of Low-Risk Papillary Thyroid Cancer Results Rather in Overtreatment Than a Better Survival. Front Endocrinol (Lausanne) 2020; 11:571421. [PMID: 33123090 PMCID: PMC7573306 DOI: 10.3389/fendo.2020.571421] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/14/2020] [Indexed: 12/11/2022] Open
Abstract
We are witnessing a rapid worldwide increase in the incidence of papillary thyroid carcinoma (PTC) in the last thirty years. Extensive implementation of cancer screening and wide availability of neck ultrasound or other imaging studies is the main reason responsible for this phenomenon. It resulted in a detection of a growing number of clinically asymptomatic PTCs, mainly low-risk tumors, without any beneficial impact on survival. An indolent nature of low-risk PTC, particularly papillary thyroid microcarcinoma (PTMC), and the excellent outcomes raise an ongoing discussion regarding the adequacy of treatment applied. The question of whether PTMC is overtreated or not is currently completed by another, whether PTMC requires any treatment. Current ATA guidelines propose less extensive preoperative diagnostics and, if differentiated thyroid cancer is diagnosed, less aggressive surgical approach and limit indications for postoperative radioiodine therapy. However, in intrathyroidal PTMCs in the absence of lymph node or distant metastases, active surveillance may constitute alternative management with a low progression rate of 1%-5% and without any increase in the risk of poorer outcomes related to delayed surgery in patients, in whom it was necessary. This review summarizes the current knowledge and future perspectives of active surveillance in low-risk PTC.
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Affiliation(s)
- Jolanta Krajewska
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
- *Correspondence: Jolanta Krajewska,
| | - Aleksandra Kukulska
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
- Radiotherapy Department, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Malgorzata Oczko-Wojciechowska
- Department of Genetic and Molecular Diagnostics of Cancer, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Agnieszka Kotecka-Blicharz
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Katarzyna Drosik-Rutowicz
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
- Radiotherapy Department, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Malgorzata Haras-Gil
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Barbara Jarzab
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Daria Handkiewicz-Junak
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
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163
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Wu Y, Rao K, Liu J, Han C, Gong L, Chong Y, Liu Z, Xu X. Machine Learning Algorithms for the Prediction of Central Lymph Node Metastasis in Patients With Papillary Thyroid Cancer. Front Endocrinol (Lausanne) 2020; 11:577537. [PMID: 33193092 PMCID: PMC7609926 DOI: 10.3389/fendo.2020.577537] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/25/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Central lymph node metastasis (CLNM) occurs frequently in patients with papillary thyroid cancer (PTC), but performing prophylactic central lymph node dissection is still controversial. There are no reliable models for predicting CLNM. This study aimed to develop predictive models for CLNM by machine learning (ML) algorithms. METHODS Patients with PTC who underwent initial thyroid resection at our hospital between January 2018 and December 2019 were enrolled. A total of 22 variables, including clinical characteristics and ultrasonography (US) features, were used for conventional univariate and multivariate analysis and to construct ML-based models. A 5-fold cross validation strategy was used for validation and a feature selection approach was applied to identify risk factors. RESULTS The areas under the receiver operating characteristic curve (AUC) of 7 models ranged from 0.680 to 0.731. All models performed significantly better than US (AUC=0.623) in predicting CLNM (P<0.05). In decision curve, most of the models also performed better than US. The gradient boosting decision tree model with 7 variables was identified as the best model because of its best performance in both ROC (AUC=0.731) and decision curves. Based on multivariate analysis and feature selection, young age, male sex, low serum thyroid peroxidase antibody and US features such as suspected lymph nodes, microcalcification and tumor size > 1.1 cm were the most contributing predictors for CLNM. CONCLUSIONS It is feasible to develop predictive models of CLNM in PTC patients by incorporating clinical characteristics and US features. The ML algorithm may be a useful tool for the prediction of lymph node metastasis in thyroid cancer.
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Affiliation(s)
- Yijun Wu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Ke Rao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jianghao Liu
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Chang Han
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Liang Gong
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuming Chong
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Ziwen Liu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Xiequn Xu, ; Ziwen Liu,
| | - Xiequn Xu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Xiequn Xu, ; Ziwen Liu,
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164
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Wang Q, Huang H, Zhao N, Ni X, Udelsman R, Zhang Y. Phytoestrogens and Thyroid Cancer Risk: A Population-Based Case-Control Study in Connecticut. Cancer Epidemiol Biomarkers Prev 2019; 29:500-508. [PMID: 31826911 DOI: 10.1158/1055-9965.epi-19-0456] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/28/2019] [Accepted: 12/03/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Very few previous studies have examined the relationship between thyroid cancer risk and intake of phytoestrogens (PE); furthermore, these studies have reached inconsistent results. METHODS We analyzed data from a population-based case-control study in Connecticut from 2010 to 2011, including 387 histologically confirmed thyroid cancer cases and 433 population-based controls, with compound data available concerning specific PEs. Multivariate unconditional logistic regression models were used to estimate the associations between specific PEs and the risk of thyroid cancer, adjusting for potential confounders. RESULTS An elevated risk of thyroid cancer was associated with moderate to high levels of coumestrol intake [OR = 2.48, 95% confidence interval (CI), 1.39-4.43 for 40-80 μg/day; OR = 2.41, 95% CI, 1.32-4.40 for 80-130 μg/day; and OR = 2.38, 95% CI, 1.26-4.50 for >200 μg/day compared with <40 μg/day], and the main elevation in risk appeared among microcarcinomas (≤1 cm). A decreased risk of papillary macrocarcinomas (>1 cm; OR = 0.26, 95% CI, 0.08-0.85 for 1,860-3,110 μg/day compared with <760 μg/day) was associated with moderate genistein intake among women. CONCLUSIONS Our study suggests that high coumestrol intake increases the risk of thyroid cancer, especially microcarcinomas, whereas moderate amounts of genistein intake appear to be protective for females with thyroid macrocarcinomas. IMPACT The study highlights the importance of distinguishing between microcarcinomas and macrocarcinomas in future research on the etiology of thyroid cancer.
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Affiliation(s)
- Qian Wang
- Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut
| | - Huang Huang
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut
| | - Nan Zhao
- Central Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Ni
- Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Robert Udelsman
- Endocrine Neoplasm Institute, Miami Cancer Institute, Miami, Florida
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut. .,Department of Surgery, Yale School of Medicine, Yale University, New Haven, Connecticut
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165
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Lu S, Zhao R, Shen J, Zhang Y, Shi J, Xu C, Chen J, Lin R, Han W, Luo D. Integrated bioinformatics analysis to screen hub genes in the lymph node metastasis of thyroid cancer. Oncol Lett 2019; 19:1375-1383. [PMID: 31966069 PMCID: PMC6956406 DOI: 10.3892/ol.2019.11188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 10/22/2019] [Indexed: 01/13/2023] Open
Abstract
Thyroid cancer (TC) is one of the most common types of malignancy of the endocrine-system. At present, there is a lack of effective methods to predict neck lymph node metastasis (LNM) in TC. The present study compared the expression profiles from The Cancer Genome Atlas between N1M0 and N0M0 subgroups in each T1-4 stages TC in order to identify the four groups of TC LNM-associated differentially expressed genes (DEGs). Subsequently, DEGs were combined to obtain a total of 493 integrated DEGs by using the method of Robust Rank Aggregation. Furthermore, the underlying mechanisms of LNM were investigated. The results from Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses demonstrated that the identified DEGs may promote LNM via numerous pathways, including extracellular matrix-receptor interaction, PI3K-AKT signaling pathway and focal adhesion. Following construction of a protein-protein interaction network, the significance score for each gene was calculated and seven hub genes were screened, including interleukin 6, actinin α2, collagen type I α 1 chain, actin α1, calbindin 2, thrombospondin 1 and parathyroid hormone. These genes were predicted to serve crucial roles in TC with LNM. The results from the present study could therefore improve the understanding of LNM in TC. In addition, the seven DEGs identified may be considered as potential novel targets for the development of biomarkers that could be used in the diagnosis and therapy of TC.
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Affiliation(s)
- Si Lu
- Zhejiang Chinese Medical University Affiliated Hangzhou First Hospital, The Fourth Clinical College, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Rongjie Zhao
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| | - Jie Shen
- Nanjing Medical University Affiliated Hangzhou Hospital, The First Clinical College, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Yu Zhang
- Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, P.R. China
| | - Jingjing Shi
- Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, P.R. China
| | - Chenke Xu
- Department of Ultrasound, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, P.R. China
| | - Jiali Chen
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| | - Renbin Lin
- Department of Gastroenterology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| | - Weidong Han
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| | - Dingcun Luo
- Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, P.R. China
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Ullmann TM, Gray KD, Limberg J, Stefanova D, Moore MD, Buicko J, Finnerty B, Zarnegar R, Fahey TJ, Beninato T. Insurance Status Is Associated with Extent of Treatment for Patients with Papillary Thyroid Carcinoma. Thyroid 2019; 29:1784-1791. [PMID: 31502525 DOI: 10.1089/thy.2019.0245] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Health insurance has been shown to be a key determinant in cancer care, but it is unknown as to what extent insurance status affects treatments provided to papillary thyroid cancer (PTC) patients. We hypothesized that insured patients with PTC would have lower-risk tumors at diagnosis and be more likely to receive adjuvant therapies at follow-up. Methods: The American College of Surgeons' National Cancer Database was queried to identify all patients diagnosed with PTCs >2 mm in size from 2004 to 2015. Patients were grouped according to insurance status, and frequency of high-risk features and microcarcinoma at diagnosis were assessed. Multivariable analyses were used to identify independent predictors of more extensive treatment: total thyroidectomy (vs. lobectomy), lymphadenectomy, and radioactive iodine (RAI). Results: There were 190,298 patients who met inclusion criteria; the majority of patients had private insurance (139,675 [73.4%]) and were female (144,824 [76.1%]). Uninsured patients, as compared with privately insured patients, had higher rates of extrathyroidal extension of their cancers (25.2% vs. 18.9%, p < 0.001), lymphovascular invasion (16.2% vs. 12.0%, p < 0.001), and positive margins on final pathology (16.0% vs. 12.2%, p < 0.001). Conversely, patients with private insurance were 51% more likely to have microcarcinomas at diagnosis (odds ratio [OR] = 1.51 [confidence interval {CI} 1.35-1.68], p < 0.001) than uninsured patients, controlling for demographic, socioeconomic, and hospital factors. Private insurance was an independent predictor for treatment with total thyroidectomy (OR = 1.18 [CI 1.01-1.37], p < 0.05), formal lymphadenectomy (OR = 1.22 [CI 1.09-1.36], p < 0.001), and adjuvant RAI therapy (OR = 1.35 [CI 1.18-1.54], p < 0.001) as compared with no insurance, adjusted for socioeconomic, demographic, hospital, and oncologic differences. Patients with Medicare or Medicaid were no more likely to receive these treatments than uninsured patients. Conclusions: Privately insured patients have less aggressive PTCs at diagnosis, and they are more likely to be treated with total thyroidectomy, lymphadenectomy, and RAI compared with uninsured patients. Clinicians should take caution to ensure proper referral and follow-up for under- and uninsured patients to reduce disparities in treatment.
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Affiliation(s)
- Timothy M Ullmann
- Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York
| | - Katherine D Gray
- Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York
| | - Jessica Limberg
- Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York
| | - Dessislava Stefanova
- Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York
| | - Maureen D Moore
- Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York
| | - Jessica Buicko
- Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York
| | - Brendan Finnerty
- Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York
| | - Rasa Zarnegar
- Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York
| | - Thomas J Fahey
- Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York
| | - Toni Beninato
- Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York
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Zhang YL, Li P, Liu ZY, Yi JP, Chen Y, Zhang M, Lin Q. Does relatively low iodine intake contribute to thyroid cancer? An ecological comparison of epidemiology. Medicine (Baltimore) 2019; 98:e17539. [PMID: 31593131 PMCID: PMC6799855 DOI: 10.1097/md.0000000000017539] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Research on the relationship between iodine intake and thyroid cancer (TC) risk is limited, and the findings are inconclusive. The objective of this study was to provide emerging evidence for the association between iodine intake and TC risk in a Chinese population.An ecological study of epidemiology is used to compare the iodine intake among populations with different TC incidence in Zhoushan, China. Incidence rates of TC were investigated and compared among four counties of the Zhoushan Islands from 2014 to 2018. Iodized salt consumption rate and the level of urinary iodine concentration (UIC) were analyzed for pupils and pregnant women from four counties.During 2014 to 2018, a total of 2495 new cases of TC were diagnosed in Zhoushan Islands. The mean crude incidence rate of TC was 51.29 per 100,000 inhabitants, and the standardized (world population) incidence rate (SIR) was 31.34 per 100,000 population. Incidence rates (SIR and crude incidence rates) were significantly higher in women than in men (χ test, P < .05). Both male and female, the incidence of TC in Daishan County is higher than the other three counties of Zhoushan. Iodized salt consumption rate and median UIC in pupils and pregnant women in Daishan County was significantly lower than the other three counties (χ test and Kruskal-Wallis test, all P < .05). The population with high TC incidence has a lower iodized salt consumption and a lower level of UIC compare with the relative low TC incidence populations.The low consumption of iodized salt with mild iodine deficiency may contribute to explain the exceptionally high incidence of TC in Daishan County. Further subtle designed studies are needed to provide additional insights into the epidemiology and etiology of TC and help identify the safe limit of iodine intake for prevention.
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Affiliation(s)
- Yong-Li Zhang
- Zhoushan Center for Disease Control and Prevention, Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood
| | - Peng Li
- Zhoushan Center for Disease Control and Prevention, Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood
| | - Zhi-Ya Liu
- Zhoushan Traditional Chinese Medicine Hospital, Zhoushan, P.R. China
| | - Jing-Ping Yi
- Zhoushan Center for Disease Control and Prevention, Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood
| | - Yan Chen
- Zhoushan Center for Disease Control and Prevention, Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood
| | - Min Zhang
- Zhoushan Traditional Chinese Medicine Hospital, Zhoushan, P.R. China
| | - Qi Lin
- Zhoushan Center for Disease Control and Prevention, Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood
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168
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Qiu Y, Fei Y, Liu J, Liu C, He X, Zhu N, Zhao WJ, Zhu JQ. Prevalence, Risk Factors And Location Of Skip Metastasis In Papillary Thyroid Carcinoma: A Systematic Review And Meta-Analysis. Cancer Manag Res 2019; 11:8721-8730. [PMID: 31576174 PMCID: PMC6768127 DOI: 10.2147/cmar.s200628] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 08/13/2019] [Indexed: 02/05/2023] Open
Abstract
Background Skip metastasis is a special type in cervical lymph node metastasis (LNM) of patients diagnosed with papillary thyroid carcinoma (PTC) which induced poor prognosis. There are few studies about skip metastasis and conclusions remained uncertain. Therefore, this study aims to explore the frequency and to investigate risk factors of skip metastasis in PTC. Methods Through searching the keyword by PubMed and Embase databases which articles published up to 1st August 2018 about skip metastasis in papillary thyroid carcinoma, we extract data in order to assure whether those materials meet the criteria. Results The prevalence of skip metastasis is 12.02% in light of our meta-analysis of 18 studies with 2165 patients. The upper pole location (RR = 3.35, 95% CI =1.65-6.79, P = 0.0008) and tumors size ≤1 cm (RR = 2.65, 95% CI =1.50-4.70, P = 0.0008) are significantly associated with skip metastasis, whereas lymphovascular invasion (RR = 0.33, 95% CI =0.15-0.75, P = 0.0083) exists lower rate of skip metastasis. Multifocality, gender, age, bilaterality, thyroiditis and Extrathyroidal extension (ETE) are insignificantly associated with skip metastasis. Level II and level III are the most frequently affected areas. Conclusion The lateral compartment should be carefully examined especially for those PTC patients who present primary tumors in the upper lobe with a primary tumor size ≤10 mm which could be detected with skip metastasis.
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Affiliation(s)
- Yuxuan Qiu
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yuan Fei
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jingyan Liu
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Chang Liu
- Public Policy and Administration, Department of Government, London School of Economics and Political Science, London, UK
| | - Xin He
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Ning Zhu
- Library and Information Science, School of Information Management, Nanjing University, Nanjing, People's Republic of China
| | - Wan-Jun Zhao
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jing-Qiang Zhu
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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169
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Carr FE. THYROID CANCER. Cancer 2019. [DOI: 10.1002/9781119645214.ch23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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170
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Kazachkov EL, Pasternak IA, Pasternak AE. [Clinical and morphological characteristics of thyroid tumors in children of the Chelyabinsk Region]. Arkh Patol 2019; 81:53-58. [PMID: 31407719 DOI: 10.17116/patol20198104153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To carry out a clinical and morphological analysis of thyroid cancer cases in the children of the Chelyabinsk Region. SUBJECT AND METHODS Thyroid tumor pathology was verified in 50 of the 196 patients aged 7-17 years, who had been operated on in 2000-2016. Clinical and morphological features, including immunohistochemical and ultrastructural characteristics of thyroid cancer, were studied. RESULTS Over the past 17 years, there has been a decline in the number of children with surgical thyroid diseases, including thyroid carcinomas. There is a predominance of papillary carcinoma (70%) that is characterized by more aggressive clinical and morphological signs than follicular and medullary thyroid carcinoma. The immunophenotype of follicular cell tumors in children is characterized by the expression of growth factors (TTF-1, EGFR-384) and malignancy markers (mesothelial cell, AMACR (P504S), S 100). CONCLUSION The vector change (decrease) in the long-term unfavorable trend toward an increasing incidence of thyroid cancer in children of the Chelyabinsk Region is currently accompanied by the pathomorphism of thyroid carcinoma.
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Affiliation(s)
- E L Kazachkov
- South Ural State Medical University, Ministry of Health of Russia, Chelyabinsk, Russia
| | - I A Pasternak
- South Ural State Medical University, Ministry of Health of Russia, Chelyabinsk, Russia
| | - A E Pasternak
- Chelyabinsk Regional Forensic Medical Examination Bureau, Ministry of Health of the Chelyabinsk Region, Chelyabinsk, Russia
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171
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Toulis KA, Viola D, Gkoutos G, Keerthy D, Boelaert K, Nirantharakumar K. Risk of incident circulatory disease in patients treated for differentiated thyroid carcinoma with no history of cardiovascular disease. Clin Endocrinol (Oxf) 2019; 91:323-330. [PMID: 30993728 DOI: 10.1111/cen.13990] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/04/2019] [Accepted: 04/15/2019] [Indexed: 12/12/2022]
Abstract
CONTEXT The incidence of differentiated thyroid cancer (DTC) is increasing, yet the prognosis is favourable and long-term survival is expected. Exogenous TSH suppression has been used for many years to prevent DTC recurrence and may be associated with increased risks of circulatory diseases. DESIGN Risks of circulatory disease in patients treated for DTC were compared to randomly matched patients without DTC (controls) up to a 1:5 ratio using age, sex, body mass index (BMI) and smoking as the matching parameters in a population-based, open cohort study using The Health Improvement Network. PATIENTS A total of 3009 patients treated for DTC with no pre-existing cardiovascular disease were identified and matched to 11 303 controls, followed up to median of 5 years. RESULTS A total of 1259 incident circulatory events were recorded during the observation period. No difference in the risk of ischaemic heart disease (IHD) (adjusted hazards ratio [aHR]: 1.04, 95% CI: 0.80-1.36) or heart failure (HF) (aHR: 1.27, 95% CI: 0.89-1.81) was detected. The risk of atrial fibrillation (AF) and stroke was significantly higher in patients with DTC (aHR: 1.71, 95% CI: 1.36-2.15 and aHR: 1.34, 95% CI: 1.05-1.72, respectively). In a sensitivity analysis limited to newly diagnosed patients with DTC, only the risk of AF was consistently elevated (aHR: 1.86, 95% CI: 1.33-2.60). CONCLUSIONS The increased risk of AF in patients who have undergone treatment for DTC but without pre-existing CVD may warrant periodic screening for this arrhythmia. Whereas no evidence of increased risk of IHD or HF was observed, the increased risk of stroke/TIA warrants further investigation.
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Affiliation(s)
- Konstantinos A Toulis
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece
| | - David Viola
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - George Gkoutos
- Centre for Computational Biology, University of Birmingham, Birmingham, UK
| | - Deepiksana Keerthy
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kristien Boelaert
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
- Health Data Research UK, London, UK
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172
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Guan Y, Wang Y, Bhandari A, Xia E, Wang O. IGSF1: A novel oncogene regulates the thyroid cancer progression. Cell Biochem Funct 2019; 37:516-524. [PMID: 31343762 DOI: 10.1002/cbf.3426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/02/2019] [Indexed: 11/10/2022]
Abstract
Thyroid cancer has been continuously increasing and extraordinarily prevalent worldwide. The genetic diagnosis has been widely used in fine needle aspiration. IGSF1, an immunoglobulin superfamily member 1, has been shown to be associated with the regulation of thyroid hormone. But the function of IGSF1 in thyroid cancer has not been explored yet. In this article, we will illuminate the correlation between IGSF1 expression and thyroid cancer. We analysed the level of IGSF1 expression in 55 pairs of tissue samples by real-time polymerase chain reaction (PCR) and The Cancer Genome Atlas (TCGA) data portal. After that, we transfected small interfering RNA to silence IGSF1 in thyroid cancer cell lines (KTC-1 and BCPAP) and confirmed the function of IGSF1 by performed colony formation, migration, invasion, cell counting kit-8, and apoptosis assays. IGSF1 was upregulated in thyroid cancer tissues compared with the adjacent normal tissues (t = 5.783, df = 54; P < .0001) and TCGA (T: N = 65.91 ± 3.998, n = 501: 2.824 ± 0.273, n = 58; P < .0001). In thyroid cell lines, experiments showed that downregulated IGSF1 inhibited proliferation, metastasis, and promoted cell apoptosis. Meanwhile, inhibited IGSF1 expression could downregulate N-cadherin, vimentin, and EZH2, which is associated with metastasis. Thyroid cancer cells IGSF1 expression levels are a correlation with its ability to growth, metastasis, and apoptosis.
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Affiliation(s)
- Yaoyao Guan
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Yinghao Wang
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Adheesh Bhandari
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Erjie Xia
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Ouchen Wang
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
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MiR-4500 Regulates PLXNC1 and Inhibits Papillary Thyroid Cancer Progression. Discov Oncol 2019; 10:150-160. [PMID: 31317324 DOI: 10.1007/s12672-019-00366-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/25/2019] [Indexed: 12/25/2022] Open
Abstract
Although most patients with papillary thyroid cancer (PTC) are curable, there are still a few patients showing poor outcomes and increased risk of secondary cancers after therapies. In this study, we aimed to investigate the correlation between miR-4500 and PTC and to explore its molecular functions. A total of 50 patients were included, and sonography and histological examinations were used for diagnosis. Quantitative real-time polymerase chain reaction (qRT-PCR) was applied for detection of mRNA levels while Western blotting was used for measuring protein expression. Cell proliferation was tested using CCK-8 and colony formation assays. Caspase-3 activity and nucleosomal fragmentation assays were employed to test cell apoptosis. Cell invasive ability was measured using transwell assay. MiR-4500 target was identified using luciferase assay and RNA pull-down assay. MiR-4500 expression was significantly decreased in five PTC cell lines compared with Nthy-ori 3-1 cells and in PTC tissues compared with adjacent normal thyroid tissues, respectively. Decreased expression of miR-4500 showed lower survival rate, higher cancer stage, and lymphatic metastasis. Therefore, our results implied that miR-4500 could serve as a potential biomarker for PTC prognosis. Overexpression of miR-4500 repressed colony formation, proliferation, and invasiveness of PTC cells whereas increased cell apoptosis. We identified that PLXNC1 was a direct target of miR-4500. PLXNC1 knockdown showed similar effects on cell viability, colony formation, and cell apoptosis as overexpression of miR-4500 in PTC cells. In conclusion, miR-4500 inhibits the malignant transformation of PTC cells by directly targeting and repressing PLXNC1.
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Birthweight and risk of thyroid cancer and its histological types: A large cohort study. Cancer Epidemiol 2019; 62:101564. [PMID: 31325768 DOI: 10.1016/j.canep.2019.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/05/2019] [Accepted: 07/07/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND The aetiology of thyroid cancer is poorly understood, but it is possible that this malignancy has origins early in life. It is, however, currently unknown if birthweight, as an indicator of prenatal growth, is related to thyroid cancer risk. OBJECTIVE To investigate if birthweight is associated with the later risk of thyroid cancer and its histological types. METHODS 246,141 children (120,505 girls, 125,636 boys) from the Copenhagen School Health Records Register, born 1936-1989, were prospectively followed in the Danish Cancer Registry. Cox regressions were used to estimate hazards ratios (HR) and 95% confidence intervals (CI). RESULTS During follow up, 241 individuals (172 women, 69 men) were diagnosed with thyroid cancer (162 papillary, 53 follicular). Birthweight was significantly and positively associated with risk of thyroid cancer overall (HR = 1.30 [95% CI: 1.03-1.64] per kilogram). There were no sex differences in the associations. Birthweight was positively and significantly associated with follicular thyroid cancer (HR = 1.74 [95% CI: 1.07-2.82] per kilogram), and although there was an indication of a positive association, it did not reach statistical significance for the more common papillary type (HR = 1.20 [95% CI: 0.90-1.59] per kilogram). CONCLUSION A heavier weight at birth is associated with an elevated risk of total and follicular thyroid cancer, which underscores that prenatal exposures may be important in thyroid cancer aetiology.
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175
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Schnadig VJ. Overdiagnosis of Thyroid Cancer: Is This Not an Ethical Issue for Pathologists As Well As Radiologists and Clinicians? Arch Pathol Lab Med 2019; 142:1018-1020. [PMID: 30141995 DOI: 10.5858/arpa.2017-0510-ed] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Vicki J Schnadig
- From the Department of Pathology, University of Texas Medical Branch, Galveston
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176
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Handelsman RS, Alvarez AL, Picado O, Farrá JC, Lew JI. Inverse Relationship of BMI to TSH and Risk of Papillary Thyroid Cancer in Surgical Patients. J Surg Res 2019; 244:96-101. [PMID: 31280000 DOI: 10.1016/j.jss.2019.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/13/2019] [Accepted: 06/06/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Obesity and thyroid cancer has increased in recent decades. Thyroid malignancy is linked with elevated thyroid-stimulating hormone (TSH) levels, which may have a positive association with body mass index (BMI). This study examines obesity and TSH level effect on papillary thyroid cancer (PTC) risk in a surgical population. METHODS A retrospective review of prospectively collected data for 991 patients who underwent thyroidectomy at a single institution was performed. Patients were stratified according to BMI into three groups: nonobese (18.5-29.9 kg/m2), obese (30-39.9 kg/m2), and morbidly obese (≥40 kg/m2). Further subdivisions into benign and malignant outcomes based on final pathology were compared with preoperative TSH levels. Subanalyses according to sex were also performed. RESULTS Of 517 patients with PTC, rate of malignancy (ROM) decreased (55% versus 48% versus 41%, P < 0.05) as BMI increased with a concomitant decrease in average TSH levels (1.75 versus 1.69 versus 1.41 mU/L), respectively. According to sex, decreased ROM (53% versus 44% versus 42%, P < 0.05) and TSH (1.79 versus 1.70 versus 1.33 mU/L), respectively, with increased BMI was identified in women. However, decrease of ROM was not significant in men with increasing TSH levels as BMI increased. Male sex was associated with increased PTC risk (OR, 1.916; 95% CI, 1.331-2.759), whereas obesity with reduced PTC risk (OR, 0.736; 95% CI, 0.555-0.976). CONCLUSIONS Higher BMI correlates with decreased PTC rates and lower TSH levels and suggests other factors may be involved in thyroid tumorigenesis. Obese patients with thyroid cancer should not be managed differently compared with nonobese patients.
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Affiliation(s)
- Rachel S Handelsman
- Division of Endocrine Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, Florida.
| | - Alexandra L Alvarez
- Division of Endocrine Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, Florida
| | - Omar Picado
- Division of Endocrine Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, Florida
| | - Josefina C Farrá
- Division of Endocrine Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, Florida
| | - John I Lew
- Division of Endocrine Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, Florida
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177
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Tortolero-Luna G, Torres-Cintrón CR, Alvarado-Ortiz M, Ortiz-Ortiz KJ, Zavala-Zegarra DE, Mora-Piñero E. Incidence of thyroid cancer in Puerto Rico and the US by racial/ethnic group, 2011-2015. BMC Cancer 2019; 19:637. [PMID: 31253133 PMCID: PMC6599344 DOI: 10.1186/s12885-019-5854-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/19/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Puerto Rico has the highest incidence rate of thyroid cancer (TC) in the Americas and the third highest rate worldwide. The purpose of this study was to compare the burden of TC between the population of PR and United States (US) non-Hispanic Whites (NHW), non-Hispanic Blacks (NHB), and US Hispanics (USH) during the period 2011-2015. METHODS TC data for the period 2011-2015 was obtained from the Puerto Rico Central Cancer Registry (PRCCR) and the Surveillance Epidemiology and Ends Results Program (SEER) 18 Registries Research Data. TC was categorized in: papillary carcinoma (PTC), and other TC histologic types. Data was analyzed by sex, age groups, and histologic type. Racial/ethnic differences by sex, age, and histologic types were assessed using the Standardized Rate Ratio (SRR) and its 95% CI. RESULTS During the period 2011-2015 there were 5175 and 65,528 cases of TC diagnosed in PR and the US, respectively. The overall age-adjusted incidence rate of PTC was almost two-fold higher in PR than in the US (25.8/100,000 vs. 12.9/100,000). Among PR women, the incidence rate of PTC was 40.0/100,000 compared to 19.4/100,000 in US. PR women had 83% increased risk of being diagnosed with PTC than NHW women, a 2.25-fold increased risk than USH, and 3.45-fold increased risk than NHB women. For men, PR had 34% increased risk of being diagnosed with PTC than NHW men, 2.2-fold increased risk than USH men, and 3.2-fold higher risk than in NHB men. CONCLUSION Further research is needed to understand this disparity in the island. This research should address the extent of overdiagnosis in PR, the role of health insurance status and insurance type, characteristics of the healthcare delivery system as well as the role of patient and environmental factors.
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Affiliation(s)
- Guillermo Tortolero-Luna
- Puerto Rico Central Cancer Registry, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
- Division of Cancer Control and Population Sciences, University of Puerto Rico, Comprehensive Cancer Center, PO Box 70344, San Juan, PR 00936-8344 Puerto Rico
| | - Carlos R. Torres-Cintrón
- Puerto Rico Central Cancer Registry, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Mariela Alvarado-Ortiz
- Puerto Rico Central Cancer Registry, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
- Department of Social Sciences, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Karen J. Ortiz-Ortiz
- Puerto Rico Central Cancer Registry, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
- Division of Cancer Control and Population Sciences, University of Puerto Rico, Comprehensive Cancer Center, PO Box 70344, San Juan, PR 00936-8344 Puerto Rico
| | - Diego E. Zavala-Zegarra
- Puerto Rico Central Cancer Registry, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Edna Mora-Piñero
- Division of Cancer Control and Population Sciences, University of Puerto Rico, Comprehensive Cancer Center, PO Box 70344, San Juan, PR 00936-8344 Puerto Rico
- Department of Surgery, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
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Bhandari A, Guan Y, Xia E, Huang Q, Chen Y. VASN promotes YAP/TAZ and EMT pathway in thyroid carcinogenesis in vitro. Am J Transl Res 2019; 11:3589-3599. [PMID: 31312369 PMCID: PMC6614637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 05/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Thyroid cancer incidence has been continuity growing globally. To Find reliable molecular biomarkers to assess prognosis and select optimal treatment is necessary. VASN is a protein-coding gene that plays a vital part in tumor development and angiogenesis. Analyzing the TCGA dates, we found VASN could be a potential marker in assessing thyroid prognosis. The act of VASN in thyroid cancer is not explicit. In this article, we investigate the function of VASN expression in thyroid cancer. METHODS The Cancer Genome Atlas (TCGA) unpaired thyroid cancer and normal RNA-seq data was download and our paired thyroid cancer, and a polymerase chain reaction analyzed normal samples. The expression of VASN was regulated by transfected small interfering RNA, and the function of VASN was determined through migration, invasion and cell proliferation assays. Western blot assay was performed to reveal the relation between the VASN expression and YAP/TAZ pathway, epithelial-mesenchymal transition in thyroid carcinogenesis. RESULTS The significant upregulation of VASN in papillary thyroid carcinoma tissues associated to normal thyroid tissues was revealed by our data and TCGA data. VASN overexpression was significantly correlated to lymph node metastasis, tumor stage and tumor size. In the cell, experiments showed that VASN low expression significantly suppressed the migration, invasion, and proliferation. Western blot assay proves the effect of VASN expression on YAP/TAZ pathway and epithelial-mesenchymal transition. CONCLUSION VASN plays a crucial oncogene in thyroid cancer. Our results indicate that VASN could be a biomarker of thyroid cancer and may act in the YAP/TAZ pathway to regulate epithelial-mesenchymal transition (EMT).
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Affiliation(s)
- Adheesh Bhandari
- Department of Thyroid & Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University Wenzhou 325000, Zhejiang, PR China
| | - Yaoyao Guan
- Department of Thyroid & Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University Wenzhou 325000, Zhejiang, PR China
| | - Erjie Xia
- Department of Thyroid & Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University Wenzhou 325000, Zhejiang, PR China
| | - Qidi Huang
- Department of Thyroid & Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University Wenzhou 325000, Zhejiang, PR China
| | - Yizuo Chen
- Department of Thyroid & Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University Wenzhou 325000, Zhejiang, PR China
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Breast cancer prognosis is better in patients who develop subsequent metachronous thyroid cancer. PLoS One 2019; 14:e0215948. [PMID: 31042767 PMCID: PMC6493754 DOI: 10.1371/journal.pone.0215948] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 03/30/2019] [Indexed: 12/11/2022] Open
Abstract
Breast cancer (BC) and thyroid cancer (TC) are common malignancies among females. However, the connection between TC and BC is not well understood. To explore the relationship between these two cancers and to determine the effect of second metachronous TC on BC survival, we compared BC patients with or without second primary TC using data from the Surveillance, Epidemiology, and End Results (SEER) database. We extracted data from patients with only BC or TC and from BC patients with a second metachronous cancer from 2000–2014. Differences in the clinicopathological and treatment characteristics between BC patients with or without second metachronous TC were analyzed by chi-square tests. Multivariate analyses of BC survival were performed by using Cox regression models. Comparison of disease-specific survival (DSS) curves between these cohorts was performed with the log-rank (Mantel-Cox) test. Survival analyses were also performed using data from 1980–1994. Within this dataset, we found 1,262 BC cases in which a second metachronous TC (BC2TC) developed, accounting for 3.1% of all metachronous cancers following BC from 2000–2014. No significant differences were found in molecular markers. In addition, the mean age at BC diagnosis was younger in the BC2TC group than in the BC group (55.418 y vs 60.273 y). Half of the BC2TC patients developed TC in the first three years following BC diagnosis. Patients with BC2TC showed better DSS than those with BC alone from 2000–2014 (P<0.001). However, this superiority was not significant from 1980–1994 (P = 0.579) or for TNM stage I BC (P = 0.927) and grade I BC (P = 0.431) from 2000–2014. In conclusion, the incidence of BC2TC has increased dramatically during the past 15 years. In addition, patients with BC2TC showed better DSS than patients with BC alone, especially in cases from 2000–2014.
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180
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Kaliszewski K. Does every classical type of well-differentiated thyroid cancer have excellent prognosis? A case series and literature review. Cancer Manag Res 2019; 11:2441-2448. [PMID: 31118764 PMCID: PMC6497976 DOI: 10.2147/cmar.s198514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 02/21/2019] [Indexed: 12/16/2022] Open
Abstract
Introduction: The classical type of well-differentiated thyroid cancer (WDTC) is the most common endocrine tumor with generally excellent prognosis. WDTC of the WHO stage 1 classification metastasizing to the vertebral column is not often seen for this neoplasm. Here, I present a case series of 14 individuals with aggressive classical type of WDTC. Methods: To identify the most aggressive cases of classical type WDTC, I reviewed the medical records of 4,327 patients consecutively admitted and surgically treated in a single institution for thyroid pathology in the years 2008-2016. Demographic, pathological and outcome data were collected and reviewed. Results: During the study period, 14 (4.02%) patients with aggressive forms of the classical type of WDTC were reviewed: 10 (2.87%) cases with papillary thyroid cancer (PTC) and 4 (1.14%) with follicular thyroid cancer (FTC). The median age at diagnosis was 61 years (31-84 years). Aggressive features such as extrathyroid extension 11/14 (78.57%), positive surgical margins 11/14 (78,57%), lymph node metastases 7/14 (50%), multifocality 6/14 (42.85%), regional tissue infiltration 11/14 (78.57%) and distant metastases 4/14 (28.57%) were observed. Long-term follow-up (median 40 months) demonstrated a high rate of locoregional recurrence in 12/14 (85.71%) individuals. Pulmonary and other distant metastases were observed in 4/14 (28.57%) patients, with mortality in 3/14 (21.42%) individuals. Conclusion: In patients with classical type of WDTC characterized by excellent prognosis, extremely aggressive entities might be observed, making WDTC in some cases an unpredictable tumor.
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Affiliation(s)
- Krzysztof Kaliszewski
- First Department and Clinic of General, Gastroenterological, and Endocrine Surgery, Wroclaw Medical University, Wroclaw, Poland
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181
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Differentiated thyroid cancer: A retrospective evaluation of the impact of changes to disease management guidelines on patients in South East Scotland. Surgeon 2019; 17:73-79. [DOI: 10.1016/j.surge.2018.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 04/27/2018] [Accepted: 05/08/2018] [Indexed: 02/02/2023]
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182
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Wang X, Lei J, Wei T, Zhu J, Li Z. Clinicopathological characteristics and recurrence risk of papillary thyroid microcarcinoma in the elderly. Cancer Manag Res 2019; 11:2371-2377. [PMID: 31114316 PMCID: PMC6497470 DOI: 10.2147/cmar.s198451] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 02/27/2019] [Indexed: 02/05/2023] Open
Abstract
Background: The optimal management for elderly patients with papillary thyroid microcarcinoma (PTMC) is not well established. The aim of the present study is to describe the clinicopathological characteristics and identify predictors of recurrence in the elderly PTMC patients. Methods: We conducted a retrospective study of PTMC patients who underwent thyroidectomy. The clinicopathological characteristics were compared between patients with age ≥65 years and <65 years. The independent predictors of recurrence were identified by multivariate Cox regression analysis. Results: The patients in elderly group were more likely to exhibit bilaterality (P<0.050), extrathyroidal extension (P < 0.001), and central compartment lymph node metastasis (CLNM) (P<0.010), especially the ratio of CLNM >0.5 (P<0.010), than the patients with age <65 years. The elderly patients had poorer recurrence-free survival (RFS) than those with younger ages (P=0.002). Multivariate analysis indicated tumor size >5 mm (P=0.009) and CLNM ratio >0.5 (P=0.002) were independent risk factors for recurrence of the elderly patients with PTMC. Conclusions: The elderly PTMC patients have more aggressive biological characteristics and higher recurrence rate. More aggressive treatment and rigorous follow-up could be considered for elderly patients with tumor diameter >5 mm and CLNM ratio >0.5.
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Affiliation(s)
- Xiaofei Wang
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jianyong Lei
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Tao Wei
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jingqiang Zhu
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Zhihui Li
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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183
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Incidental and Non-incidental Papillary Thyroid Microcarcinoma in Denmark 1996-2015: A national study on incidence, outcome and thoughts on active surveillance. Cancer Epidemiol 2019; 60:46-50. [PMID: 30909152 DOI: 10.1016/j.canep.2019.03.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/17/2019] [Accepted: 03/18/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Incidental and non-incidental papillary microcarcinomas (PMC) are associated with different outcomes and treatment options may vary. The least favourable outcome is typically seen when carcinoma is suspected prior to surgery. Only a few studies have addressed the prognosis based on the way of detection for PMC, and they have been limited to retrospective single-center studies. We hypothesize that the "way of detection" may predict prognosis. The aim was to calculate the incidence and outcome of PMC based on the way of detection and to identify patients that may be suitable for active surveillance. METHOD This national cohort study consists of 803 patients diagnosed with PMC in Denmark from 1996 to 2015. Patients were identified from the DATHYRCA database and allocated into groups according to the way of detection leading to surgery: Incidental at surgery (n = 527), non-incidental with symptoms suspected from the index tumor (n = 134) and non-incidental with symptoms suspected from a metastasis (n = 142). RESULTS Age-standardized incidence rates increased from 0.35 per 100,000 per year in 1996 to 1.19 per 100,000 per year in 2015. A significant rise in incidence was found for both the incidental group and non-incidental group with symptoms suspected from a metastasis. Recurrence free survival was significantly worse for patients with suspicion of metastasis prior to surgery than patient groups without. No difference in mortality was found between groups. CONCLUSION PMC patients without suspicion of metastasis have the same low risk of recurrence as incidental cases and may be candidates for active surveillance.
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184
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Predictive factors for central lymph node and lateral cervical lymph node metastases in papillary thyroid carcinoma. Clin Transl Oncol 2019; 21:1482-1491. [PMID: 30879178 DOI: 10.1007/s12094-019-02076-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 02/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Central lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC) is common. But the association between primary tumor characteristics and specific features of metastatic lymph nodes in PTC has not been fully identified. Determining risk factors for LNM may help surgeons determine rational extent of lymph node dissection. METHODS Data from 432 patients who underwent thyroidectomy with cervical lymph node dissection for PTC were retrospectively analyzed. The relationships between LNM to central compartment or lateral compartment and clinicopathologic factors were analyzed. Cox regression model was used to determine the risk factors for recurrence-free survival (RFS). RESULTS Central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) were found in 216 (50.0%) and 65 (15.0%) patients, respectively. In the multivariate analysis for CLNM, patients < 45 years of age (OR 2.037, 95% CI 1.388-2.988, P < 0.001), extrathyroidal invasion (OR: 2.144, 95% CI 0.824-5.457, P = 0.011), vascular invasion (OR 13.817, 95% CI 1.694-112.693, P = 0.014), LLNM (OR 2.851, 95% CI 1.196-6.797, P = 0.014) and TNM Stage III-IV (OR 465.307, 95% CI 113.903-1900.826, P < 0.001) were independent predictors for high prevalence of CLNM. In the multivariate analysis for LLNM, tumor size more than 1cm (OR 3.474, 95% CI 1.728-6.985, P < 0.001) and CLNM (OR 5.532, 95% CI 2.679-11.425, P < 0.001) were independent predictors for high prevalence of LLNM. Moreover, tumor with T3-T4 stage, extrathyroidal invasion and CLNM were the significant factors related to the RFS. CONCLUSION For patients with pre-operative risk factors of LNM, an accurate preoperative evaluation of central compartment or lateral compartment is needed to find suspicious lymph nodes. And prophylactic lymph node dissection should be performed in patients with high risk of CLNM. Moreover, we suggest performing close follow-up for patients with high risk of RFS.
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186
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Feng JW, Yang XH, Wu BQ, Sun DL, Jiang Y, Qu Z. Influence of Body Mass Index on the Clinicopathologic Features of Papillary Thyroid Carcinoma. Ann Otol Rhinol Laryngol 2019; 128:625-632. [PMID: 30841713 DOI: 10.1177/0003489419834314] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Epidemiologic studies have demonstrated an increased risk for papillary thyroid carcinoma (PTC) with increasing body mass index (BMI). However, the relationships between excess weight and the behavior of PTC are inconsistent. The aim of this study was to evaluate the impact of excess weight on clinicopathologic features of PTC and on patient outcomes. METHODS Data from 417 patients with PTC who underwent total thyroidectomy with cervical lymph node dissection were retrospectively analyzed. On the basis of World Health Organization standardized categories of BMI, patients were divided into 4 groups: underweight, normal weight, overweight, and obese. Histopathologic tumor features, stage at diagnosis, and disease status were determined by chart review. Logistic regression models were used to define associations between BMI and clinicopathologic features of PTC. Cox proportional-hazards models were used to assess associations between BMI and locoregional recurrence. RESULTS Overweight (odds ratio [OR], 3.90; P = .040) and obesity (OR, 9.19; P = .012) were independent predictors of vascular invasion. Furthermore, obesity (OR, 6.14; P = .004) was an independent predictor of extrathyroidal invasion. During follow-up (median, 29 months; range, 5-87 months), 48 patients (11.5%) experienced locoregional recurrence. There were no significant differences in locoregional recurrence of PTC among BMI groups. When adjusted for other confounding factors, extrathyroidal invasion (OR, 8.35; P < .001), vascular invasion (OR, 3.57; P < .001), cervical lymph node metastasis (OR, 3.71; P = .009), and advanced tumor-node-metastasis stage (OR, 3.81; P < .001) were identified as independent factors for locoregional recurrence. CONCLUSIONS Higher BMI was associated with extrathyroidal invasion and vascular invasion in patients with PTC, which suggests that excess weight is associated with aggressive clinicopathologic features of PTC. But patients with higher BMI did not have an increased risk for developing postoperative complications and locoregional recurrence.
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Affiliation(s)
- Jia-Wei Feng
- 1 Changzhou First People's Hospital, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Xing-Hai Yang
- 1 Changzhou First People's Hospital, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Bao-Qiang Wu
- 1 Changzhou First People's Hospital, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Dong-Lin Sun
- 1 Changzhou First People's Hospital, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Yong Jiang
- 1 Changzhou First People's Hospital, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Zhen Qu
- 1 Changzhou First People's Hospital, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
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Choi Y, Jung SL, Bae JS, Lee SH, Jung CK, Jang J, Shin NY, Choi HS, Ahn KJ, Kim BS. Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study. Int J Hyperthermia 2019; 36:359-367. [DOI: 10.1080/02656736.2019.1571248] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Yangsean Choi
- Department of Radiology, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
| | - So Lyung Jung
- Department of Radiology, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
| | - Ja-Sung Bae
- Department of Thyroid Surgery, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
| | - So-Hee Lee
- Department of Thyroid Surgery, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
| | - Chan-Kwon Jung
- Department of Pathology, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
| | - Jinhee Jang
- Department of Radiology, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
| | - Na-Young Shin
- Department of Radiology, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
| | - Hyun Seok Choi
- Department of Radiology, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
| | - Kook-Jin Ahn
- Department of Radiology, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
| | - Bum-Soo Kim
- Department of Radiology, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
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Haymart MR, Banerjee M, Reyes-Gastelum D, Caoili E, Norton EC. Thyroid Ultrasound and the Increase in Diagnosis of Low-Risk Thyroid Cancer. J Clin Endocrinol Metab 2019; 104:785-792. [PMID: 30329071 PMCID: PMC6456891 DOI: 10.1210/jc.2018-01933] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 10/10/2018] [Indexed: 12/27/2022]
Abstract
CONTEXT Thyroid cancer incidence increased with the greatest change in adults aged ≥65 years. OBJECTIVE To determine the relationship between area-level use of imaging and thyroid cancer incidence over time. DESIGN, SETTING AND PARTICIPANTS Longitudinal imaging patterns in Medicare patients aged ≥65 years residing in Surveillance, Epidemiology, and End Results (SEER) regions were assessed in relationship to differentiated thyroid cancer diagnosis in patients aged ≥65 years included in SEER-Medicare. Linear mixed-effects modeling was used to determine factors associated with thyroid cancer incidence over time. Multivariable logistic regression was used to determine patient characteristics associated with receipt of thyroid ultrasound as initial imaging. MAIN OUTCOME MEASURE Thyroid cancer incidence. RESULTS Between 2002 and 2013, thyroid ultrasound use as initial imaging increased (P < 0.001). Controlling for time and demographics, use of thyroid ultrasound was associated with thyroid cancer incidence (P < 0.001). Findings persisted when cohort was restricted to papillary thyroid cancer (P < 0.001), localized papillary thyroid cancer (P = 0.004), and localized papillary thyroid cancer with tumor size ≤1 cm (P = 0.01). Based on our model, from 2003 to 2013, at least 6594 patients aged ≥65 years were diagnosed with thyroid cancer in the United States due to increased use of thyroid ultrasound. Thyroid ultrasound as initial imaging was associated with female sex and comorbidities. CONCLUSION Greater thyroid ultrasound use led to increased diagnosis of low-risk thyroid cancer, emphasizing the need to reduce harms through reduction in inappropriate ultrasound use and adoption of nodule risk stratification tools.
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Affiliation(s)
- Megan R. Haymart
- Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
| | - Mousumi Banerjee
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor MI
| | - David Reyes-Gastelum
- Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
| | - Elaine Caoili
- Department of Radiology, University of Michigan, Ann Arbor MI
| | - Edward C. Norton
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor MI
- Department of Economics, University of Michigan, Ann Arbor MI
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189
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Bresler A, Mehta V, Schiff BA, Smith RV, Khader S, Ramos‐Rivera G, Lin J, Libutti SK, Laird AM, Ow TJ. Comparison of Bethesda cytopathology classification to surgical pathology across racial‐ethnic groups. Head Neck 2019; 41:2340-2345. [DOI: 10.1002/hed.25707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 12/19/2018] [Accepted: 01/29/2019] [Indexed: 12/13/2022] Open
Affiliation(s)
- Amishav Bresler
- Department of Otorhinolaryngology‐Head and Neck SurgeryRutgers New Jersey Medical School Newark New Jersey
| | - Vikas Mehta
- Department of Otorhinolaryngology‐Head and Neck SurgeryMontefiore Medical Center/Albert Einstein College of Medicine New York New York
| | - Bradley A. Schiff
- Department of Otorhinolaryngology‐Head and Neck SurgeryMontefiore Medical Center/Albert Einstein College of Medicine New York New York
| | - Richard V. Smith
- Department of Otorhinolaryngology‐Head and Neck SurgeryMontefiore Medical Center/Albert Einstein College of Medicine New York New York
- Department of PathologyMontefiore Medical Center/Albert Einstein College of Medicine New York New York
| | - Samer Khader
- Department of PathologyMontefiore Medical Center/Albert Einstein College of Medicine New York New York
| | - Gloria Ramos‐Rivera
- Department of PathologyMontefiore Medical Center/Albert Einstein College of Medicine New York New York
| | - Juan Lin
- Department of Epidemiology & Population HealthAlbert Einstein College of Medicine New York New York
| | - Steven K. Libutti
- Director, Rutgers Cancer Institute of New Jersey, Vice Chancellor for Cancer Programs, Rutgers Biomedical and Health Sciences, Senior Vice President, Oncology Services, RWJBarnabas HealthProfessor of Surgery, Rutgers Robert Wood Johnson Medical School New Brunswick New Jersey
| | - Amanda M. Laird
- Associate Professor of Surgery, Chief, Section of Endocrine Surgery, Rutgers Cancer Institute of New JerseyAssociate Professor of Surgery, Rutgers Robert Wood Johnson Medical School New Brunswick New Jersey
| | - Thomas J. Ow
- Department of Otorhinolaryngology‐Head and Neck SurgeryMontefiore Medical Center/Albert Einstein College of Medicine New York New York
- Department of PathologyMontefiore Medical Center/Albert Einstein College of Medicine New York New York
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190
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Karadaghy OA, Kallogjeri D, Piccirillo JF. Development of a New Clinical Severity Staging System for Patients With Nonmetastatic Papillary Thyroid Carcinoma. JAMA Otolaryngol Head Neck Surg 2019; 143:1173-1180. [PMID: 28449113 DOI: 10.1001/jamaoto.2017.0550] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Omar A Karadaghy
- University of Missouri, Kansas City School of Medicine, Kansas City, Missouri
| | - Dorina Kallogjeri
- Department of Otolaryngology-Head and Neck Surgery, Washington University in St Louis, St Louis, Missouri
| | - Jay F Piccirillo
- Department of Otolaryngology-Head and Neck Surgery, Washington University in St Louis, St Louis, Missouri.,Statistics Editor
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191
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Mehta V, Ow TJ, Kim S, Tharakan T, Schiff B, Smith RV, In H. Significant racial differences in the incidence and behavior of the follicular variant of papillary thyroid carcinoma. Head Neck 2019; 41:1403-1411. [PMID: 30652370 DOI: 10.1002/hed.25596] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 08/12/2018] [Accepted: 12/03/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Increased detection of papillary thyroid cancer (PTC) has led to overtreatment of the largely indolent follicular variant (fvPTC). To guide management of non-aggressive lesions, we investigated whether race predicts PTC variant and tumor behavior. METHODS Analysis of 258 973 patients from the National Cancer Database diagnosed with PTC in 2004-2014. Clinical and tumor information was compared by race. Multivariate logistic regression was used to predict fvPTC, extrathyroidal extension (ETE), and lymph node metastasis (LNM) of fvPTC. RESULTS Blacks had the highest fvPTC rate (40% vs white 30%, Hispanic 26%, Asian 25%, P < .001). Blacks had higher odds of fvPTC (aOR = 1.33, 95% CI: 1.28-1.37) and lower odds of ETE than whites (aOR = 0.90, 95% CI: 0.82-0.99) (P < .001). Hispanics and Asians had lower odds of fvPTC (aOR = 0.89, 95% CI: 0.86-0.92 and aOR = 0.81, 95% CI: 0.79-0.84) and higher odds of LNM and ETE than whites (P < .001). CONCLUSIONS Racial disparities in fvPTC incidence and behavior should be considered to optimize diagnosis and treatment planning.
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Affiliation(s)
- Vikas Mehta
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York
| | - Thomas J Ow
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York.,Department of Pathology, Montefiore Medical Center, Bronx, New York
| | - Seokhwa Kim
- Gangdong Hana ENT clinic, Hana ENT Hospital, Seoul, South Korea
| | - Theresa Tharakan
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York
| | - Bradley Schiff
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York
| | - Richard V Smith
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York
| | - Haejin In
- Department of Surgery, Montefiore Medical Center, Bronx, New York.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
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192
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Borowczyk M, Janicki A, Dworacki G, Szczepanek-Parulska E, Danieluk M, Barnett J, Antonik M, Kałużna M, Bromińska B, Czepczyński R, Bączyk M, Ziemnicka K, Ruchała M. Decreased staging of differentiated thyroid cancer in patients with chronic lymphocytic thyroiditis. J Endocrinol Invest 2019; 42:45-52. [PMID: 29619749 PMCID: PMC6304183 DOI: 10.1007/s40618-018-0882-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/24/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE The biological association between chronic lymphocytic thyroiditis (CLT) and differentiated thyroid cancer (DTC) has not been elucidated yet. The aim of the study was to assess whether the presence of CLT exerts any influence on clinical or histological presentation of DTC. METHODS Nine hundred and seven consecutive patients with DTC treated in the years 1998-2016 were divided into two groups according to the presence or absence of concomitant CLT. The statistical differences were analysed. RESULTS Out of 907 patients included in the study, 331 were diagnosed with DTC and CLT (studied group), while 576 patients with DTC but without CLT constituted a control group. The distribution of papillary and follicular thyroid cancer did not differ. In CLT group, the prevalence of pT1 was greater than for pT2-pT4 DTC (P = 0.0003; OR = 1.69, 95% CI 1.27-2.24) compared to controls (68.3 vs. 56.1%, respectively). The presence of multifocal lesions was similar. The thyroid capsule infiltration without extrathyroidal invasion (P < 0.0001; OR = 0.21, 95% CI 0.14-0.31) was more frequent in the studied group, unlike extracapsular invasion, which was significantly more often present in patients with DTC but without CLT (P = 0.004; OR = 1.66; 95% CI 1.17-2.34) as well as nodal involvement (P = 0.048; OR = 0.65, 95% CI 0.42-0.99). CONCLUSIONS The collected data indicate a protective role of CLT in preventing the spread of the DTC. The presence of CLT might limit tumour growth to the primary site.
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Affiliation(s)
- M Borowczyk
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland
| | - A Janicki
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland
| | - G Dworacki
- Department of Clinical Immunology, Poznan University of Medical Sciences, 5D, Rokietnicka Street, 60-806, Poznan, Poland
| | - E Szczepanek-Parulska
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland
| | - M Danieluk
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland
| | - J Barnett
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland
| | - M Antonik
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland
| | - M Kałużna
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland
| | - B Bromińska
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland
| | - R Czepczyński
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland
| | - M Bączyk
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland
| | - K Ziemnicka
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland.
| | - M Ruchała
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland
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193
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Feng JW, Pan H, Wang L, Ye J, Jiang Y, Qu Z. Determine the Optimal Extent of Thyroidectomy and Lymphadenectomy for Patients With Papillary Thyroid Microcarcinoma. Front Endocrinol (Lausanne) 2019; 10:363. [PMID: 31275239 PMCID: PMC6593058 DOI: 10.3389/fendo.2019.00363] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 05/22/2019] [Indexed: 12/30/2022] Open
Abstract
Background: The optimal extent of surgery, including lymph node dissection, remains controversial in papillary thyroid microcarcinoma (PTMC). Determining risk factors of central lymph node metastasis (CLNM) and recurrence-free survival (RFS) may help surgeons determine individualized surgery. Methods: A total of 353 patients with PTMC were retrospectively analyzed, including 263 with overt PTMC and 90 with incidental PTMC. The recurrence rates between different extents of thyroidectomy were compared. The relationship between CLNM and clinicopathologic factors was analyzed. The Cox regression model was used to determine the risk factors for RFS. Results: Lobectomy/total thyroidectomy (TT) with central neck dissection (CND) was performed in 263 overt PTMC patients, and lobectomy/partial thyroidectomy was performed in 90 incidental PTMC patients. In 263 overt PTMC patients, 93 (26.3%) had CLNM only and 13 (3.7%) had both CLNM and lateral lymph node metastases (LLNM). Multifocal PTMC patients who underwent lobectomy had a higher rate of thyroid bed and lymph node recurrence than patients who underwent TT (P < 0.05). Independent predictors for CLNM were age <45 years, tumor size >5 mm and presence of extrathyroidal extension (ETE). Tumor size >5 mm, multifocality, presence of ETE, presence of CLNM, and presence of LLNM were the significant factors related to the RFS. Conclusion: Fine-needle aspiration biopsy is advised to distinguish incidental PTMC from the benign nodules. For multifocal PTMC patients, TT should be performed to reduce recurrence. Routine prophylactic CND can be recommended in PTMC patients with independent risk factors of CLNM. Aggressive surgery and close follow-up are essential for patients with risk factors of RFS.
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194
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Meltzer CJ, Irish J, Angelos P, Busaidy NL, Davies L, Dwojak S, Ferris RL, Haugen BR, Harrell RM, Haymart MR, McIver B, Mechanick JI, Monteiro E, Morris JC, Morris LGT, Odell M, Scharpf J, Shaha A, Shin JJ, Shonka DC, Thompson GB, Tuttle RM, Urken ML, Wiseman SM, Wong RJ, Randolph G. American Head and Neck Society Endocrine Section clinical consensus statement: North American quality statements and evidence-based multidisciplinary workflow algorithms for the evaluation and management of thyroid nodules. Head Neck 2018; 41:843-856. [PMID: 30561068 DOI: 10.1002/hed.25526] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 09/28/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Care for patients with thyroid nodules is complex and multidisciplinary, and research demonstrates variation in care. The objective was to develop clinical guidelines and quality metrics to reduce unwarranted variation and improve quality. METHODS Multidisciplinary expert consensus and modified Delphi approach. Source documents were workflow algorithms from Kaiser Permanente Northern California and Cancer Care of Ontario based on the 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. RESULTS A consensus-based, unified preoperative, perioperative, and postoperative workflow was developed for North American use. Twenty-one panelists achieved consensus on 16 statements about workflow-embedded process and outcomes metrics addressing safety, access, appropriateness, efficiency, effectiveness, and patient centeredness of care. CONCLUSION A panel of Canadian and United States experts achieved consensus on workflows and quality metric statements to help reduce unwarranted variation in care, improving overall quality of care for patients diagnosed with thyroid nodules.
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Affiliation(s)
- Charles J Meltzer
- The Permanente Medical Group, Kaiser Permanente, Santa Rosa, California
| | - Jonathan Irish
- Department of Otolaryngology, Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network/University of Toronto, Toronto, Ontario, Canada
| | - Peter Angelos
- Department of Surgery, MacLean Center for Clinical Ethics, The University of Chicago Medicine, Chicago, Illinois
| | - Naifa L Busaidy
- Department of Endocrine Neoplasia & Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Louise Davies
- The VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, Vermont.,Section of Otolaryngology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.,The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire
| | - Sunshine Dwojak
- Northwest Permanente Medicine, Kaiser Permanente, Portland, Oregon
| | - Robert L Ferris
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Bryan R Haugen
- Division of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado
| | - Richard M Harrell
- Departments of Integrative Endocrine Surgery and Pathology, Memorial Healthcare System, Hollywood, Florida
| | - Megan R Haymart
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Bryan McIver
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Jeffrey I Mechanick
- Divisions of Cardiology and Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, Mount Sinai School of Medicine, New York, New York
| | - Eric Monteiro
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - John C Morris
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota
| | - Luc G T Morris
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael Odell
- Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Joseph Scharpf
- Department of Otolaryngology-Head and Neck Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Ashok Shaha
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jennifer J Shin
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts
| | - David C Shonka
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia
| | | | - R Michael Tuttle
- Department of Medicine, Endocrinology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark L Urken
- Department of Otolaryngology Head and Neck Surgery, Mount Sinai Beth Israel, New York, New York.,Icahn School of Medicine, Mount Sinai, New York, New York.,Thyroid, Head and Neck Cancer Foundation, New York, New York
| | - Sam M Wiseman
- Department of Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Richard J Wong
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Gregory Randolph
- Department of Otolaryngology, Massachusetts General Hospital, Boston, Massachusetts
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195
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Xu B, Zhou NM, Cao WT, Gu SY. Comparative study on operative trauma between microwave ablation and surgical treatment for papillary thyroid microcarcinoma. World J Clin Cases 2018; 6:936-943. [PMID: 30568949 PMCID: PMC6288511 DOI: 10.12998/wjcc.v6.i15.936] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/25/2018] [Accepted: 11/07/2018] [Indexed: 02/05/2023] Open
Abstract
AIM To compare the effect and postoperative trauma of ultrasound-guided percutaneous microwave ablation and surgical resection in the treatment of papillary thyroid microcarcinoma (PTMC).
METHODS Eighty-seven patients with PTMC treated at Fudan University affiliated Shanghai Fifth People’s Hospital were enrolled as subjects. The patients were divided into a microwave ablation group (41 cases) and a surgical group (46 cases). The operative time, intraoperative blood loss, length of hospital stay, serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), thyroid-related hormonal changes, and complications 7 d and 30 d after surgery were observed.
RESULTS The operative time, intraoperative blood loss, and length of hospital stay in the surgical group were significantly higher than those in the microwave ablation group (P < 0.05). The levels of CRP, IL-6, and TNF-α in the surgical group were significantly higher than those in the microwave ablation group (P < 0.05). The free triiodothyronine (FT3) and free thyroxin (FT4) levels in the surgical group were significantly lower than those in the microwave ablation group (P < 0.05). However, the postoperative thyroid stimulating hormone (TSH) level was significantly higher than that in the microwave ablation group (P < 0.05). There were significant interactions between the FT3, FT4, and TSH 7 d and 30 d after operation and the treatment methods (P < 0.05). There was no significant difference in the complications between the two groups (P > 0.05).
CONCLUSION Microwave ablation for papillary microcarcinoma of the thyroid gland has less trauma to the body, quicker recovery, and no scars. It can effectively shorten the length of hospital stay and improve the quality of life of patients.
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Affiliation(s)
- Bin Xu
- Department of Ultrasound, Fudan University Affiliated Shanghai Fifth People’s Hospital, Shanghai 200240, China
| | - Ning-Ming Zhou
- Department of Ultrasound, Fudan University Affiliated Shanghai Fifth People’s Hospital, Shanghai 200240, China
| | - Wei-Tian Cao
- Department of Ultrasound, Fudan University Affiliated Shanghai Fifth People’s Hospital, Shanghai 200240, China
| | - Shu-Yan Gu
- Department of Ultrasound, Fudan University Affiliated Shanghai Fifth People’s Hospital, Shanghai 200240, China
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196
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Nakaya T, Takahashi K, Takahashi H, Yasumura S, Ohira T, Ohto H, Ohtsuru A, Midorikawa S, Suzuki S, Shimura H, Yamashita S, Tanigawa K, Kamiya K. Spatial analysis of the geographical distribution of thyroid cancer cases from the first-round thyroid ultrasound examination in Fukushima Prefecture. Sci Rep 2018; 8:17661. [PMID: 30518765 PMCID: PMC6281575 DOI: 10.1038/s41598-018-35971-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 11/13/2018] [Indexed: 01/22/2023] Open
Abstract
Following the Fukushima Daiichi Nuclear Power Plant (FNPP) accident on 11 March 2011, there have been concerns regarding the health impacts of the ensuing radioactive environmental contamination, which was spatially heterogeneous. This study aimed to assess the geographical variability of thyroid cancer prevalence among children and adolescents in Fukushima Prefecture. We computed the sex- and age-standardised prevalence ratio using 115 diagnosed or suspected thyroid cancer cases among approximately 300,000 examinees at the first-round ultrasound examination during 2011–2015 from 59 municipalities in the prefecture, under the Fukushima Health Management Survey. We applied flexibly shaped spatial scan statistics and the maximised excess events test on the dataset to detect locally anomalous high-prevalence regions. We also conducted Poisson regression with selected regional indicators. Furthermore, approximately 200 examinees showed positive ultrasound examination results but did not undergo confirmatory testing; thus, we employed simulation-based sensitivity tests to evaluate the possible effect of such undiagnosed cases in the statistical analysis. In conclusion, this study found no significant spatial anomalies/clusters or geographic trends of thyroid cancer prevalence among the ultrasound examinees, indicating that the thyroid cancer cases detected are unlikely to be attributable to regional factors, including radiation exposure resulting from the FNPP accident.
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Affiliation(s)
- Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Aoba-ku, Sendai-city, Miyagi, 980-0845, Japan.
| | - Kunihiko Takahashi
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya-city, Aichi, 466-8550, Japan
| | - Hideto Takahashi
- National Institute of Public Health, Wako-city, Saitama, 351-0197, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Department of Radiation Health Management, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Sanae Midorikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Department of Radiation Health Management, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Shinichi Suzuki
- Department of Thyroid and Endocrinology, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Hiroki Shimura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Department of Laboratory Medicine, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Shunichi Yamashita
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki-city, Nagasaki, 852-8523, Japan
| | - Koichi Tanigawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Research Institute for Radiation Biology and Medicine, Hiroshima University, Minami-ku, Hiroshima-city, Hiroshima, 734-5844, Japan
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197
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Diagnostic efficacy of multiple MRI parameters in differentiating benign vs. malignant thyroid nodules. BMC Med Imaging 2018; 18:50. [PMID: 30509198 PMCID: PMC6278127 DOI: 10.1186/s12880-018-0294-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 11/21/2018] [Indexed: 12/22/2022] Open
Abstract
Background Diffusion weighted imaging (DWI) has a good diagnostic value for malignant thyroid nodules, but the published protocols suffer from flaws and focus on the apparent diffusion coefficient (ADC). This study investigated the diagnostic performance of multiple MRI parameters in differentiating malignant from benign thyroid nodules. Methods This was a retrospective study of 181 consecutive patients (148 benign and 111 malignant nodules, confirmed by pathological results). The patients underwent conventional MRI, DWI, and dynamic contrast-enhanced MRI before surgery. The chi-square test and the Student t test were used to compare the conventional features and ADC value between malignant and benign groups. Multivariate logistic regression was used to identify the independent predictors and to construct a model. Receiver operator characteristic (ROC) curve analysis was used to assess the diagnostic performance of the independent variables and model. Results Tumor diameter, ADC value, cystic degeneration, pseudocapsule sign, high signal cystic area on T1-weighted imaging, ring sign in the delayed phase, and irregular shape showed significant differences between two groups (all P < 0.05). The multivariable analysis revealed that ADC value (OR = 694.006, P < 0.001), irregular shape (OR = 32.798, P < 0.001), ring sign in the delayed phase (OR = 20.381, P = 0.004), and cystic degeneration (OR = 8.468, P = 0.016) were independent predictors. Among them, ADC performed the best in discriminating benign from malignant nodules, with an area under the curve (AUC) of 0.95, 0.90 sensitivity, and 0.91 specificity. When the independent factors were combined, the diagnostic performance was improved with an AUC of 0.99, 0.97 sensitivity, and 0.95 specificity. Conclusions ADC value could discriminate between benign and malignant thyroid nodules with a good performance. Subjective features such as the ring sign, irregular shape, and cystic degeneration associated with malignant thyroid nodules could provide complementary information for differentiation.
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198
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Li Y, Li X, Pu J, Yang Q, Guan H, Ji M, Shi B, Chen M, Hou P. c-Myc Is a Major Determinant for Antitumor Activity of Aurora A Kinase Inhibitor MLN8237 in Thyroid Cancer. Thyroid 2018; 28:1642-1654. [PMID: 30226440 DOI: 10.1089/thy.2018.0183] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: c-Myc is overexpressed in different types of cancer, including thyroid cancer, and has been considered undruggable. There is evidence showing that MLN8237, a type of aurora A kinase (AURKA) inhibitor, destabilizes c-Myc proteins in liver cancer cells through disruption of the c-Myc/AURKA complex. However, the role of MLN8237 in thyroid cancer remains largely unclear. The aims of this study were to test the therapeutic potential of MLN8237 in thyroid cancer, and to analyze determinant factors affecting the response of thyroid cancer cells to MLN8237 and clarify the corresponding mechanism. Methods: The phenotypic effects of MLN8237 in thyroid cancer cells were evaluated through a series of in vitro and in vivo experiments, and the mechanism of c-Myc affecting MLN8237 response were explored using Western blot, ubiquitination, and cycloheximide chase assays. Results: The data show that the levels of c-Myc protein were strongly associated with MLN8237 cellular response in thyroid cancer cells. Only the cells with high c-Myc expression exhibited growth inhibition upon MLN8237 treatment. However, MLN8237 barely affected the growth of those with low c-Myc expression. Mechanistically, MLN8237 dramatically promoted proteasomal degradation of c-Myc proteins through disruption of the c-Myc/AURKA complex in the cells with high c-Myc expression. A similar antitumor activity of MLN8237 was also found in xenograft tumor models. Conclusions: The data demonstrate that c-Myc is a major determinant for MLN8237 responsiveness in thyroid cancer cells. Thus, indirectly targeting c-Myc by MLN8237 may be an effective strategy for thyroid cancer overexpressing c-Myc.
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Affiliation(s)
- Yiqi Li
- Department of Endocrinology; Xi'an, P.R. China
- Department of Respiratory and Critical Care Medicine; Xi'an, P.R. China
| | - Xinru Li
- Department of Endocrinology; Xi'an, P.R. China
| | - Jun Pu
- Department of Endocrinology; Xi'an, P.R. China
| | - Qi Yang
- Department of Endocrinology; Xi'an, P.R. China
| | - Haixia Guan
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Meiju Ji
- Center for Translational Medicine; Xi'an, P.R. China
| | - Bingyin Shi
- Department of Endocrinology; Xi'an, P.R. China
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province; The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China
| | - Mingwei Chen
- Department of Respiratory and Critical Care Medicine; Xi'an, P.R. China
| | - Peng Hou
- Department of Endocrinology; Xi'an, P.R. China
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province; The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China
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199
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Lima EU, Rubio IGS, Da Silva JC, Galrão AL, Pêssoa D, Oliveira TC, Carrijo F, Silva Campos I, Fonseca Espinheira L, Sampaio LJ, Lima CR, Cerutti JM, Ramos HE. HOPX homeobox methylation in differentiated thyroid cancer and its clinical relevance. Endocr Connect 2018; 7:1333-1342. [PMID: 30400039 PMCID: PMC6280589 DOI: 10.1530/ec-18-0380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 10/24/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND The inactivation of the tumor-suppressor homeodomain-only protein X (HOPX) usually involves promoter methylation in several cancer types. This study aimed to investigate the HOPX-β mRNA expression and promoter methylation and their clinical relevance in differentiated thyroid cancer (DTC). PATIENTS AND METHODS Clinicopathological data and paraffin-embedded thyroid tumor tissues from 21 patients with DTC and 6 with benign tumors (T) and their non-tumor parenchyma (NT) were investigated. Tumor cell lines (FTC238, FTC236 and WRO) were treated with demethylating agent. HOPX-β mRNA expression was assessed by qRT-PCR and methylation status by Q-MSP. Thyroid cancer data from Cancer Genome Atlas (TCGA) was also collected. RESULTS HOPX-β mRNA re-expression in two cell lines treated with demethylating agent was observed concomitantly with reduced promoter methylation. Reduced mRNA expression in T group compared to their NT was observed, and reduced protein expression in T compared to NT was observed in three cases. Low mRNA expression with high methylation status was detected in 6/14 DTC samples. High methylation status was associated with older age at diagnosis, recurrent or progressive disease and with the presence of new neoplasm event post initial therapy while hyper-methylation correlated with worse overall survival, worse disease-free status and older age. CONCLUSION A moderate coupling of downregulation of HOPX-β mRNA expression in DTC followed by high HOPX-β promoter methylation was observed however; high HOPX promoter methylation status was associated with the worse prognosis of DTC patients.
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Affiliation(s)
- Erika Urbano Lima
- Biological Science Department, Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil
- Structural and Functional Biology Program, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ileana G S Rubio
- Biological Science Department, Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil
- Structural and Functional Biology Program, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Joaquim Custodio Da Silva
- Department of Bio-regulation, Thyroid Study Laboratory, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
- Post-graduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
| | - Ana Luiza Galrão
- Biological Science Department, Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Danielle Pêssoa
- Department of Bio-regulation, Thyroid Study Laboratory, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
- Post-graduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
| | - Taise Cerqueira Oliveira
- Department of Bio-regulation, Thyroid Study Laboratory, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
| | - Fabiane Carrijo
- Department of Bio-regulation, Thyroid Study Laboratory, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
- Post-graduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
| | | | - Luciano Fonseca Espinheira
- Department of Pathology, Sao Rafael Hospital, Salvador, Brazil
- Department of Anatomic Pathology & Legal Medicine, Bahia Federal Medical School, Federal University of Bahia, Salvador, Brazil
| | | | | | - Janete Maria Cerutti
- Structural and Functional Biology Program, Universidade Federal de São Paulo, São Paulo, Brazil
- Division of Genetics, Department of Morphology and Genetics, Genetic Basis of Thyroid Tumors Laboratory, Paulista School of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Helton Estrela Ramos
- Department of Bio-regulation, Thyroid Study Laboratory, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
- Post-graduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
- Correspondence should be addressed to H E Ramos:
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Salamanca-Fernández E, Rodriguez-Barranco M, Chang-Chan YL, Redondo-Sánchez D, Domínguez-López S, Bayo E, Narankiewicz D, Expósito J, Sánchez MJ. Thyroid Cancer Epidemiology in South Spain: a population-based time trend study. Endocrine 2018; 62:423-431. [PMID: 30043094 DOI: 10.1007/s12020-018-1681-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/09/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE Thyroid cancer (TC) is the most common malignant disease of the endocrine system. The aim of this study was to analyze incidence and mortality trends of TC (C73 according to ICD-O-3) in Granada (Southern Spain) during the period 1985-2013, by sex, age, and histological type. METHODS This is a population-based cross-sectional study. Incidence data were obtained from the population-based Cancer Registry of Granada. All newly diagnosed cases of thyroid cancer over the period 1985-2013 were included. Joinpoint regression analysis with age-standardized rates were used to estimate annual percentage change (APC), CI 95% and turning points in trends. Results are presented by sex, age group, and histological type. RESULTS During the study period there were 1265 diagnosed cases of TC in Granada (72.6% in women). Incidence trends significantly increased in both men (APC: + 5.4%) and women (APC: + 4.7%). The most common histological types in both sexes were papillary (74.8%) and follicular (16.8%). The incidence has increased during the study period mainly due to papillary carcinoma, which has increased annually around 6% in both sexes. TC mortality trend during this period decreased in men (APC: -0.3%) and women (APC: -2.3%). CONCLUSION Our data showed an increasing trend in incidence of thyroid cancer in Granada, especially in women between 55-64 years. Mortality showed a slight decrease trend during the study period in both sexes. Papillary carcinoma was the most common histological type, with an increase of the relative weight of papillary microcarcinomas. Our study is in accordance with the European and worldwide trends in thyroid cancer incidence and mortality and sex differences.
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Affiliation(s)
- Elena Salamanca-Fernández
- Andalusian School of Public Health (EASP), Granada, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Granada, Spain
- Biosanitary Investigation Institute ibs, Granada, Spain
| | - Miguel Rodriguez-Barranco
- Andalusian School of Public Health (EASP), Granada, Spain.
- CIBER Epidemiology and Public Health (CIBERESP), Granada, Spain.
- Biosanitary Investigation Institute ibs, Granada, Spain.
| | - Yoe-Ling Chang-Chan
- Andalusian School of Public Health (EASP), Granada, Spain
- Biosanitary Investigation Institute ibs, Granada, Spain
| | - Daniel Redondo-Sánchez
- Andalusian School of Public Health (EASP), Granada, Spain
- Biosanitary Investigation Institute ibs, Granada, Spain
| | | | - Eloísa Bayo
- Radiation Oncology Department, University Hospital Virgen Macarena, Sevilla, Spain
| | - Dariusz Narankiewicz
- Preventive Medicine and Public Health Department, Hospital Virgen de la Victoria of Málaga, Málaga, Spain
| | - José Expósito
- Biosanitary Investigation Institute ibs, Granada, Spain
- Radiotherapy and Oncology Department, University Hospital Virgen de las Nieves Granada, Granada, Spain
| | - María José Sánchez
- Andalusian School of Public Health (EASP), Granada, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Granada, Spain
- Biosanitary Investigation Institute ibs, Granada, Spain
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