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Tan Y, Zhong J, Zheng T, Fu Y, Liu M, Wang G. Associations of BRAF V600E mutation with the American College of Radiology Thyroid Imaging Reporting and Data System and clinicopathological characteristics in pediatric patients with papillary thyroid carcinoma. Pediatr Radiol 2024; 54:1128-1136. [PMID: 38771344 DOI: 10.1007/s00247-024-05943-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Identifying the associations between BRAFV600E mutation, the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) and clinicopathological characteristics could assist in making appropriate treatment strategies for pediatric patients with papillary thyroid carcinoma. OBJECTIVE To retrospectively assess the associations between BRAFV600E mutation, TI-RADS, and clinicopathological characteristics in pediatric patients with papillary thyroid carcinoma. MATERIALS AND METHODS Between May 2013 and May 2023, pediatric patients with papillary thyroid carcinoma who underwent thyroidectomy were retrospectively evaluated. Univariate and multivariate logistic regression analyses were performed to determine the associations between BRAFV600E mutation, TI-RADS, and clinicopathological characteristics. The diagnostic performance of TI-RADS to predict BRAFV600E mutation was assessed. RESULTS The BRAFV600E mutation was found in 59.1% (39/66) of pediatric patients with papillary thyroid carcinoma. Multivariate analyses showed that hypoechoic/very hypoechoic [odds ratio (OR) = 8.48; 95% confidence interval (CI) = 1.48-48.74); P-value = 0.02] and punctate echogenic foci (OR = 24.3; 95% CI = 3.80-155.84; P-value = 0.001) were independent factors associated with BRAFV600E mutation. In addition, BRAFV600E mutation was significantly associated with TI-RADS 5 (OR = 12.61; 95% CI = 1.28-124.49; P-value = 0.03). There were no associations between BRAFV600E mutation and nodule size, composition, shape, margin, cervical lymph node metastasis, or Hashimoto's thyroiditis (P-value > 0.05). Combined with hypoechoic/very hypoechoic and punctate echogenic foci, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 89.7%, 85.2%, 89.7%, 85.2%, and 87.9%, respectively. CONCLUSIONS Hypoechoic/very hypoechoic, punctate echogenic foci, and TI-RADS 5 are independently associated with BRAFV600E mutation in pediatric patients with papillary thyroid carcinoma.
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Affiliation(s)
- Yan Tan
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, China
| | - Jia Zhong
- Department of Ultrasound, Mawangdui District of Hunan Provincial People's Hospital, Hunan Normal University, Changsha, China
| | - Taiqing Zheng
- Department of Pathology, Hunan Children's Hospital, Changsha, China
| | - Yusi Fu
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, China
| | - Minghui Liu
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, China
| | - Guotao Wang
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, China.
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Wei B, Yao J, Peng C, Zhao S, Wang H, Wang L, Zhu X, Kong Y, Chen L, Xu D. Clinical features and imaging examination assessment of cervical lymph nodes for thyroid carcinoma. BMC Cancer 2023; 23:1225. [PMID: 38087256 PMCID: PMC10717540 DOI: 10.1186/s12885-023-11721-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUNDS The purpose of this study is to investigate the relationship between clinical characteristics and cervical lymph node metastasis (LNM) in patients with thyroid carcinoma, as well as estimate the preoperative diagnosis values of ultrasound (US) and contrast enhanced computed tomography (CECT) examinations on the neck for detection of cervical LNM in thyroid carcinoma. METHODS A retrospective analysis of 3 026 patients with surgically proven thyroid carcinoma was conducted. Patients' clinical characteristics, including gender, age, tumor size, bilateral lesions, multifocality, adenomatous nodules, Hashimoto's thyroiditis (HT), and extrathyroidal extension, were collected to explore their association with cervical LNM in thyroid carcinoma. Preoperative assessments for central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) were conducted through US and CECT. The diagnostic value of US, CECT and US combined with CECT for detection of LNM located in various cervical compartments was estimated based on the pathological results. RESULTS The risk of cervical LNM was higher in thyroid cancer patients who were male, age < 55 years old, tumor size > 10 mm, bilateral lesions, and extrathyroidal extension, while multifocality, adenomatous nodules and HT had no significant effect on LNM. US, CECT and US combined with CECT all had a higher sensitivity to LLNM (93.1%, 57.8%, 95.4%) than to CLNM (32.3%, 29.0%, 43.4%). US and CECT had a high specificity to both CLNM and LLNM (94.3-97.8%). CONCLUSION Preoperative clinical characteristics and imaging examinations on patients with thyroid carcinoma are crucial to the evaluation of cervical lymph nodes and conducive to individualizing surgical treatments by clinicians. US combined with CECT are superior to single US or CECT alone in detection of CLNM and LLNM.
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Affiliation(s)
- Bei Wei
- Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China
| | - Jincao Yao
- Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China
- Chinese Academy of Sciences, Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China
- Zhejiang Provincial Research Center for Cancer Intelligent Diagnosis and Molecular Technology, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China
| | - Chanjuan Peng
- Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China
| | - Shanshan Zhao
- Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China
| | - Hui Wang
- Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China
| | - Liping Wang
- Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China
| | - Xi Zhu
- Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China
| | - Yuting Kong
- Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China
| | - Liyu Chen
- Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China.
- Zhejiang Provincial Research Center for Cancer Intelligent Diagnosis and Molecular Technology, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China.
| | - Dong Xu
- Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China.
- Chinese Academy of Sciences, Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China.
- Zhejiang Provincial Research Center for Cancer Intelligent Diagnosis and Molecular Technology, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China.
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Janicki L, Patel A, Jendrzejewski J, Hellmann A. Prevalence and Impact of BRAF mutation in patients with concomitant papillary thyroid carcinoma and Hashimoto's thyroiditis: a systematic review with meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1273498. [PMID: 38047109 PMCID: PMC10691376 DOI: 10.3389/fendo.2023.1273498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/25/2023] [Indexed: 12/05/2023] Open
Abstract
Background Evidence suggests that patients with Hashimoto thyroiditis (HT) are at significantly higher risk of developing papillary thyroid cancer (PTC). However, the course of PTC in patients with both diseases concomitantly has been found to be more indolent than conventional PTC. Additionally, it has been well proven that BRAF mutation results in an aggressive course of PTC. The aims of this meta-analysis were to identify prevalence of BRAF mutation and its impact on clinicopathological features in patients with concomitant PTC-HT. Methods Medline, Cochrane Library, Scopus, and Web of Science were searched until 16.09.2022, resulting in 227 articles, of which nine studies were included. Summary estimates, comparing patients with (A) BRAF (+) PTC-HT versus BRAF (+) PTC, and (B) BRAF (+) PTC-HT versus BRAF (-) PTC-HT, were generated with Review Manager 5.0. Results In total, 6395 patients were included in this review. PTC-HT patients had significantly less BRAF mutation than PTC patients (Odds Ratio (OR) (95% Confidence Interval (CI))=0.45 (0.35-0.58), P<0.001). BRAF (+) PTC-HT patients were significantly more likely to have multifocal lesions (OR (95% CI)=1.22 (1.04-1.44), P=0.01) but less likely to have lymph node metastasis (OR (95% CI)=0.65 (0.46-0.91), P=0.01) and extrathyroidal extension (OR (95% CI)=0.55 (0.32-0.96), P=0.03) compared to BRAF (+) PTC patients. BRAF (+) PTC-HT patients were more likely to have multifocal lesions (OR (95% CI)=0.71 (0.53-0.95), P=0.02), lymph node metastasis (OR (95% CI)=0.59 (0.44-0.78), P<0.001) and extrathyroidal extension (OR (95% CI)=0.72 (0.56-0.92), P=0.01) compared to BRAF (-) PTC-HT patients. Conclusion This meta-analysis highlights that the lower prevalence of BRAF mutation in patients with PTC-HT than conventional PTC may explain the indolent clinicopathological course in this cohort.
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Affiliation(s)
- Lukasz Janicki
- Department of Surgical Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Agastya Patel
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
- Regional Hepato-Pancreato-Biliary Surgical Unit, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Jarosław Jendrzejewski
- Department of Endocrinology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Andrzej Hellmann
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
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Pani F, Caria P, Yasuda Y, Makoto M, Mariotti S, Leenhardt L, Roshanmehr S, Caturegli P, Buffet C. The Immune Landscape of Papillary Thyroid Cancer in the Context of Autoimmune Thyroiditis. Cancers (Basel) 2022; 14:cancers14174287. [PMID: 36077831 PMCID: PMC9454449 DOI: 10.3390/cancers14174287] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 12/26/2022] Open
Abstract
Simple Summary The association between papillary thyroid cancer and Hashimoto’s thyroiditis went through a long-standing human debate recently elucidated by the establishment of a novel mouse model. Papillary thyroid carcinoma is an excellent model for studying the tumor immune microenvironment because it is naturally accompanied by immune cells, making it a good candidate for the treatment with immune checkpoint inhibitors. Abstract Papillary thyroid cancer (PTC) often co-occurs with Hashimoto’s thyroiditis, an association that has long been reported in clinical studies, remaining controversial. Experimental evidence has recently shown that pre-existing thyroiditis has a beneficial effect on PTC growth and progression by a distinctive expansion of effector memory CD8 T cells. Although the link between inflammation and PTC might involve different components of the immune system, a deep characterization of them which includes T cells, B cells and tertiary lymphoid structures, Mye-loid cells, Neutrophils, NK cells and dendritic cells will be desirable. The present review article considers the role of the adaptive and innate immune response surrounding PTC in the context of Hashimoto’s thyroiditis. This review will focus on the current knowledge by in vivo and in vitro studies specifically performed on animals’ models; thyroid cancer cells and human samples including (i) the dual role of tumor-infiltrating lymphocytes; (ii) the emerging role of B cells and tertiary lymphoid structures; (iii) the role of myeloid cells, dendritic cells, and natural killer cells; (iv) the current knowledge of the molecular biomarkers implicated in the complex link between thyroiditis and PTC and the potential implication of cancer immunotherapy in PTC patients in the context of thyroiditis.
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Affiliation(s)
- Fabiana Pani
- Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, 75013 Paris, France
- Correspondence: or
| | - Paola Caria
- Department of Biomedical Sciences, Biochemistry, Biology and Genetics Unit, University of Cagliari, Cittadella Universitaria di Monserrato, SP 8, Km 0.700, Monserrato, 09042 Cagliari, Italy
| | - Yoshinori Yasuda
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Miyara Makoto
- Inserm, Centre d’Immunologie et des Maladies Infectieuses-Paris (CIMI-PARIS), AP-HP Hôpital Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France
| | - Stefano Mariotti
- Department of Medical Sciences and Public Health, Endocrinology Unit, University of Cagliari, Monserrato, 09042 Cagliari, Italy
| | - Laurence Leenhardt
- Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, 75013 Paris, France
| | - Solmaz Roshanmehr
- Division of Immunology, Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Patrizio Caturegli
- Division of Immunology, Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Camille Buffet
- Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, 75013 Paris, France
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Tang Q, Pan W, Peng L. Association between Hashimoto thyroiditis and clinical outcomes of papillary thyroid carcinoma: A meta-analysis. PLoS One 2022; 17:e0269995. [PMID: 35709179 PMCID: PMC9202927 DOI: 10.1371/journal.pone.0269995] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 06/01/2022] [Indexed: 11/18/2022] Open
Abstract
Objective To assess association between Hashimoto thyroiditis (HT) and clinical outcomes of papillary thyroid carcinoma (PTC). Methods Databases including Pubmed, Embase, Cochrane Library, and Web of Science were searched. Weighed mean differences (WMDs) and odds ratios (ORs) were used to evaluate association between HT and clinical outcomes of PTC, and the effect size was represented by 95% confidence intervals (CIs). Heterogeneity test was performed for each indicator. If the heterogeneity statistic I2≥50%, random-effects model analysis was carried out, otherwise, fixed-effect model analysis was performed. Sensitivity analysis was performed for all outcomes, and publication bias was tested by Begg’s test. Results Totally 47,237 patients in 65 articles were enrolled in this study, of which 12909 patients with HT and 34328 patients without HT. Our result indicated that PTC patients with HT tended to have lower risks of lymph node metastasis (OR: 0.787, 95%CI: 0.686–0.903, P = 0.001), distant metastasis (OR: 0.435, 95%CI: 0.279–0.676, P<0.001), extrathyroidal extension (OR: 0.745, 95%CI: 0.657–0.845, P<0.001), recurrence (OR: 0.627, 95%CI: 0.483–0.813, P<0.001), vascular invasion (OR: 0.718, 95%CI: 0.572–0.901, P = 0.004), and a better 20-year survival rate (OR: 1.396, 95%CI: 1.109–1.758, P = 0.005) while had higher risks of multifocality (OR: 1.245, 95%CI: 1.132–1.368, P<0.001), perineural infiltration (OR: 1.922, 95%CI: 1.195–3.093, P = 0.007), and bilaterality (OR: 1.394, 95%CI: 1.118–1.739, P = 0.003). Conclusions PTC patients with HT may have favorable clinicopathologic characteristics, compared to PTCs without HT. More prospective studies are needed to further elucidate this relationship.
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Affiliation(s)
- Qizhi Tang
- Department of Endocrinology, Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, P.R. China
- * E-mail:
| | - Weiyu Pan
- Department of Endocrinology, Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, P.R. China
| | - Liangyue Peng
- Department of Endocrinology, Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, P.R. China
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Xu J, Ding K, Mu L, Huang J, Ye F, Peng Y, Guo C, Ren C. Hashimoto's Thyroiditis: A "Double-Edged Sword" in Thyroid Carcinoma. Front Endocrinol (Lausanne) 2022; 13:801925. [PMID: 35282434 PMCID: PMC8907134 DOI: 10.3389/fendo.2022.801925] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/18/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The prevalence of thyroid carcinoma (TC) and Hashimoto's thyroiditis (HT) has been increasing dramatically over the past decades. We investigated the relationship between HT and TC. METHODS We followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines for carrying out and reporting this meta-analysis. The literature from January 1, 2010 to December 31, 2020, regardless of region and publication type, was searched comprehensively in PubMed, Embase, Web of Science, and Cochrane Library databases. After careful selection and data extraction, the pooled odds ratio of various clinical characteristics in 39 studies were calculated. Publication bias was analyzed using funnel plots. RESULTS Meta-analysis of 39 original research articles showed HT to be a risk factor of TC (pooled odds ratio = 1.71; 95% confidence interval, 1.57-1.80; p < 0.00001) and papillary thyroid carcinoma (1.67, 1.51-1.85, <0.00001). Patients with papillary thyroid carcinoma (PTC) combined with HT were more likely to have multifocal carcinomas. The prevalence of an extrathyroidal extension, metastasis, BRAFV600E mutation, and recurrence was significantly lower in patients with PTC combined with HT. CONCLUSIONS HT is a "double-edged sword" in TC patients. HT increases the risk of TC and PTC but is a protective factor against PTC progression.
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Affiliation(s)
- Jiangyue Xu
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ke Ding
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Lan Mu
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jiangsheng Huang
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Fei Ye
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yu Peng
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Can Guo
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chutong Ren
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Chutong Ren,
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Sun CX, Liu BJ, Su Y, Shi GW, Wang Y, Chi JF. MiR-181a promotes cell proliferation and migration through targeting KLF15 in papillary thyroid cancer. Clin Transl Oncol 2021; 24:66-75. [PMID: 34312797 DOI: 10.1007/s12094-021-02670-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/10/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Papillary thyroid cancer (PTC) is the predominant histological type of thyroid cancer, accounting for 80% of thyroid cancers. MiR-181a is a novel microRNA that is usually upregulated in multiple cancers. This study aims to explore the role and underlying mechanism of miR-181a in PTC. METHODS CCK8 and Transwell assays were performed to evaluate cell viability and migration. The mRNA level of miR-181a and KLF15 was calculated by qRT-PCR. The protein level of E-Cadherin, N-Cadherin and GAPDH was evaluated by western blot. Dual luciferase assay was conducted to validate that miR-181a directly targeting the 3'-UTR of KLF15 mRNA in TPC-1 cells. RESULTS We observed that miR-181a was overexpressed and KLF15 was low expressed in PTC tissues and cell lines. Upregulation of miR-181a or downregulation of KLF15 predicted poor outcomes in PTC patients. MiR-181a improved cell growth of PTC, migration and epithelial-mesenchymal transition (EMT) in TPC-1 cells. KLF15 was a target gene of miR-181a and its expression was mediated by miR-181a. KLF15 partially reversed the facilitating effect of miR-181a on cell proliferation and migration in TPC-1 cells. CONCLUSION We discovered that miR-181a served as an oncogene downregulating KLF15, thereby inhibiting cell proliferation, migration and the EMT. These findings demonstrate that miR-181a plays a significant role in PTC progression and could be a therapeutic target for PTC.
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Affiliation(s)
- C X Sun
- Department of Endocrinology, Yantaishan Hospital, Yantai, 264000, Shandong, China
| | - B J Liu
- Operation Room, Rizhao Hospital of TCM, Rizhao, 276800, Shandong, China
| | - Y Su
- Operation Room, Qingdao Hospital of Traditional Chinese Medicine, Qingdao Hiser Hospital, Qingdao, 266033, Shandong, China
| | - G W Shi
- Health Management Center, Zhangqiu District People's Hospital, Jinan, 250200, Shandong, China
| | - Y Wang
- Health Management Center, Zhangqiu District People's Hospital, Jinan, 250200, Shandong, China
| | - J F Chi
- Department of Endocrinology, Jinan Central Hospital, 105 Jiefang Road, Lixia District, Jinan, 250013, Shandong, China.
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Issing PR, Köhler T, Tebben H, Wenger M, Issing C. [The Therapy of Malignant Thyroid Disease from ENT-Perspective]. Laryngorhinootologie 2021; 100:889-895. [PMID: 33906243 DOI: 10.1055/a-1475-4939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Malignant tumours of the thyroid gland show a rising incidence. As in the ENT-department Bad Hersfeld the management of thyroid disorders has been in focus for a longer period, we want to share our experiences in this field. MATERIAL AND METHODS The investigation started in the year of 2014 till July 2020. All patients who underwent thyroid surgery were evaluated concerning important demographic and medical parameters such as age, sex, histology, calcium, recurrent nerve palsy, etc. RESULTS: So far 63 patients with a malignant thyroid disease were enrolled in this study. The sex ratio showed a preponderance of the female patients with 42 and 21 males. Age had a wide range from 11 to 95 years. Patients with a differentiated cancer were in average younger than those with anaplastic disease. Histologically the papillary variant dominated with 65 % (n = 41) the other tumours as the follicular (n = 6), the medullary (n = 5) and the anaplastic carcinoma (n = 6). In two female patients with primary hyperparathyroidism a carcinoma of the parathyroid was found surprisingly. All patients underwent surgery; those with an advanced differentiated carcinoma were treated with radioiodine additionally. To our knowledge there was just one tumour related death in case of a differentiated carcinoma, whereas all patients with an anaplastic disease died of their malignancy. CONCLUSIONS The otorhinolaryngologist is involved in the management of thyroid malignancies. As well as in the benign diseases of the endocrine neck organs the interdisciplinary collaboration is mandatory for a high medical standard.
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Affiliation(s)
- Peter Rolf Issing
- Klinik für Hals-Nasen-Ohrenheilkunde, Klinikum Bad Hersfeld GmbH, Bad Hersfeld, Germany
| | - Torsten Köhler
- Klinik für Hals-Nasen-Ohrenheilkunde, Klinikum Bad Hersfeld GmbH, Bad Hersfeld, Germany
| | - Hendrik Tebben
- Klinik für Hals-Nasen-Ohrenheilkunde, Klinikum Bad Hersfeld GmbH, Bad Hersfeld, Germany
| | - Martin Wenger
- Nuklearmedizin, Klinikum Bad Hersfeld GmbH, Bad Hersfeld, Germany
| | - Christian Issing
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
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Wang N, Qian LX. Predictive Factors for Occult Bilateral Papillary Thyroid Carcinoma. Acad Radiol 2021; 28:328-332. [PMID: 32253114 DOI: 10.1016/j.acra.2020.01.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/10/2020] [Accepted: 01/11/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Bilateral papillary thyroid carcinoma (PTC) requires aggressive treatment, such as total thyroidectomy (TT). If there is only an isolated PTC focus in one lobe that can be diagnosed preoperatively, and it is unknown whether there are foci in the contralateral lobe that are too small to be detected, it is difficult to know whether to perform TT or to remove only the lobe with the isolated PTC focus. Here, we investigated the prevalence of and predictive factors for occult bilateral PTC that was only diagnosed unilaterally before surgery. METHODS This retrospective study involved 586 patients with unilateral PTC who were diagnosed preoperatively by ultrasound. They underwent TT and cervical lymph node dissection. According to the pathology, they were divided into unilateral PTC and bilateral (Bil)-PTC groups. Student's t test, chi-squared test, and multivariate analysis were performed to identify features of the malignant tumor that increased the likelihood of malignancy in the contralateral lobe. The prevalence of occult Bil-PTC was calculated. RESULTS Bil-PTC was found in 70 of 586 (11.95%) PTC patients. Multivariate analysis showed that vascularity (odds ratio[OR]: 2.180, 95% confidence interval [CI]: 1.142-4.162, p = 0.018) and ultrasound diagnosis of lymph node metastasis (USLNM) (OR: 2.056, 95% CI: 1.056-4.004, p = 0.034) were independent predictors of occult Bil-PTC. CONCLUSION The prevalence of occult PTC in the contralateral lobe was only 11.95%. Vascularity and USLNM were risk factors for Bil-PTC. In terms of these preoperative risk factors for PTC, TT should be cautiously performed in patients with preoperative diagnosis of PTC with isolated focus.
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Affiliation(s)
- Ning Wang
- Department of Ultrasonography, Beijing Friendship Hospital, Capital Medical University, 95 Yong an Street, Xicheng District, Beijing, China
| | - Lin-Xue Qian
- Department of Ultrasonography, Beijing Friendship Hospital, Capital Medical University, 95 Yong an Street, Xicheng District, Beijing, China.
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10
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Association between BRAF V600E mutation and the clinicopathological features in incidental papillary thyroid microcarcinoma: A single-center study in Turkish patients. North Clin Istanb 2020; 7:321-328. [PMID: 33043255 PMCID: PMC7521097 DOI: 10.14744/nci.2020.69586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 02/24/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE: In this study, we evaluated the influences of BRAFV600E mutation on clinicopathological features in incidentally found papillary thyroid microcarcinomas (PTMCs). METHODS: This retrospective cohort study included 72 patients with PTMC who underwent surgery from 2008 to 2012. The mean follow-up of the whole cohort was three years. DNA was isolated using QIAamp DNA formalin-fixed, paraffin-embedded (FFPE) tissue kit. BRAF gene was amplified by the polymerase chain reaction-restriction fragment length (PCR-RFL) polymorphism method with the following primers. The clinicopathologic features (age, gender, histologic subtype, tumor size, presence of tumor capsule, bilaterality, multifocality, extrathyroidal extension (ETE), thyroid capsular invasion, presence of Hashimoto’s thyroiditis, lymph node metastasis (LNM) and distant metastasis) were compared between the BRAF (+) and BRAF (-) patient groups. RESULTS: BRAFV600E mutation was detected in 30 of the 72 patients (41.6%). The presence of the mutation was statistically significantly associated with classic variant (p=0.046), invasion of thyroid capsule (p=0.002) and absence of tumor capsule (p=0.003). CONCLUSION: Although incidental PTMCs positive for the BRAFV600E mutation had more invasive behavior, the presence of the mutation was not associated with recurrences within three years of follow-up.
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Kun HMD, Ji-Bin LMD. Application of Ultrasonography in the Diagnosis and Management of Papillary Thyroid Microcarcinoma. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2020. [DOI: 10.37015/audt.2020.200001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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12
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Silva AL, Faria M, Matos P. Inflammatory Microenvironment Modulation of Alternative Splicing in Cancer: A Way to Adapt. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1219:243-258. [PMID: 32130703 DOI: 10.1007/978-3-030-34025-4_13] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The relationship between inflammation and cancer has been long recognized by the medical and scientific community. In the last decades, it has returned to the forefront of clinical oncology since a wealth of knowledge has been gathered about the cells, cytokines and physiological processes that are central to both inflammation and cancer. It is now robustly established that chronic inflammation can induce certain cancers but also that solid tumors, in turn, can initiate and perpetuate local inflammatory processes that foster tumor growth and dissemination. Inflammation is the hallmark of the innate immune response to tissue damage or infection, but also mediates the activation, expansion and recruitment to the tissues of cells and antibodies of the adaptive immune system. The functional integration of both components of the immune response is crucial to identify and subdue tumor development, progression and dissemination. When this tight control goes awry, altered cells can avoid the immune surveillance and even subvert the innate immunity to promote their full oncogenic transformation. In this chapter, we make a general overview of the most recent data linking the inflammatory process to cancer. We start with the overall inflammatory cues and processes that influence the relationship between tumor and the microenvironment that surrounds it and follow the ever-increasing complexity of processes that end up producing subtle changes in the splicing of certain genes to ascertain survival advantage to cancer cells.
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Affiliation(s)
- Ana Luísa Silva
- Serviço de Endocrinologia, Diabetes e Metabolismo do CHLN-Hospital Santa Maria, Lisbon, Portugal
- ISAMB-Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Márcia Faria
- Serviço de Endocrinologia, Diabetes e Metabolismo do CHLN-Hospital Santa Maria, Lisbon, Portugal
- Faculdade de Ciências, BioISI-Biosystems and Integrative Sciences Institute, Universidade de Lisboa, Lisbon, Portugal
| | - Paulo Matos
- Faculdade de Ciências, BioISI-Biosystems and Integrative Sciences Institute, Universidade de Lisboa, Lisbon, Portugal
- Departamento de Genética Humana, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
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Jianming L, Jibin L, Linxue Q. Suspicious ultrasound characteristics correlate with multiple factors that predict central lymph node metastasis of papillary thyroid carcinoma: Significant role of HBME-1. Eur J Radiol 2019; 123:108801. [PMID: 31918249 DOI: 10.1016/j.ejrad.2019.108801] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 09/04/2019] [Accepted: 12/15/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE Papillary thyroid carcinoma (PTC) is frequently associated with central lymph node metastasis (CLNM). In the present study, we aimed to identify possible risk factors for CLNM in PTC, including suspicious ultrasound (US) features coexisting with thyroid diseases, immunohistochemical markers, and BRAFV600E. These were used to establish a model to predict the risk of CLNM. METHODS From January 2016 to March 2018, we identified a cohort of patients with classic PTC who underwent cervical US and were diagnosed by postoperative pathology. Fine-needle aspiration biopsies were analyzed for the presence ofBRAFV600E, and immunohistochemistry was used to detect tumor markers. US imaging was performed in accordance with a standardized protocol. A model to determine the risk of CLNM was established using the outcomes of univariate and multivariate analyses. RESULTS Age of ≥45 years, male sex, mean tumor diameter of ≥1.0 cm, taller-than-wide tumor shape, multiple PTCs, capsule contact, and HBME-1 expression were significant independent risk predictors of CLNM. Hashimoto's thyroiditis, nodular goiter, andBRAFV600E were not significantly associated with CLNM. The cutoff value (area under the curve = 0.760) for predicting risk was determined from receiver operating characteristic curves (sensitivity, 75.6 %; specificity, 60.7 %). CONCLUSIONS Male sex, age of ≥45 years, mean tumor diameter of ≥1.0 cm, taller-than-wide shape, multiple tumors, capsule contact, and HBME-1 expression were independent predictors of the risk of CLNM in patients with PTC. The risk model may be useful for evaluating patients' prognoses and selecting optimal surgical strategies.
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Affiliation(s)
- Li Jianming
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Liu Jibin
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Qian Linxue
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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14
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Lei Y, Yang J, Li H, Zhong H, Wan Q. Changes in glucose-lipid metabolism, insulin resistance, and inflammatory factors in patients with autoimmune thyroid disease. J Clin Lab Anal 2019; 33:e22929. [PMID: 31350776 PMCID: PMC6757119 DOI: 10.1002/jcla.22929] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/11/2019] [Accepted: 05/14/2019] [Indexed: 12/18/2022] Open
Abstract
Background Autoimmune thyroid disease (AITD) is a common organ‐specific autoimmune disorder, and genetic, environmental, and endogenous factors are responsible for initiation of thyroid autoimmunity. Some AITD patients suffer from a certain degree of glucose‐lipid metabolism disorder. This study aims to explore the changes in glucose‐lipid metabolism, insulin resistance, and inflammatory factors in patients with AITD. Methods A total of 91 patients with Hashimoto's thyroiditis were retrospectively analyzed and divided into hypothyroidism group (n = 42) and normal thyroid group (n = 49), while 50 healthy people were selected as control group. The changes in glucose‐lipid metabolism, insulin resistance, and inflammatory factors in each group were compared, and their correlations with the thyroid function were analyzed. Results The levels of serum interleukin‐6 (IL‐6), tumor necrosis factor‐α (TNF‐α), IL‐12, IL‐10, (FINS), and homeostasis model assessment of insulin resistance (HOMA‐IR) were gradually declined in sequence of hypothyroidism group, normal thyroid group, and control group (P < 0.05). In hypothyroidism group, the levels of serum‐free triiodothyronine (FT3), free thyroxine (FT4), (TC), triglyceride (TG), and low‐density lipoprotein cholesterol (LDL‐C) were significantly lower than those in normal thyroid group (P < 0.05), while the level of serum thyroid stimulating hormone (TSH) was significantly higher than that in normal thyroid group (P < 0.05). However, the fasting blood glucose and 2‐hour postprandial blood glucose levels had no statistically significant differences among the three groups (P > 0.05). Conclusion Autoimmune thyroid disease patients are prone to fat metabolism disorder, and the serum thyroid hormone level has a close correlation with blood lipid metabolism, insulin metabolism, and inflammatory factors.
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Affiliation(s)
- Yi Lei
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jun Yang
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Hua Li
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Haihua Zhong
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Qin Wan
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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Sulaieva O, Chernenko O, Chereshneva Y, Tsomartova D, Larin O. Thyroid stimulating hormone levels and BRAFV600E mutation contribute to pathophysiology of papillary thyroid carcinoma: Relation to outcomes? ACTA ACUST UNITED AC 2019; 26:129-135. [PMID: 31097263 DOI: 10.1016/j.pathophys.2019.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 05/02/2019] [Accepted: 05/07/2019] [Indexed: 12/13/2022]
Abstract
AIMS The aim of this study was to evaluate the relation between the level of thyroid stimulating hormone (TSH) and progression of papillary thyroid carcinoma (PTC) with or without BRAFV600E mutation. METHODS The medical records and laboratory data of 547 patients with PTC and 94 patients with follicular adenoma (FA) were collected. The relationship between hormones levels and such end-points as extrathyroid extension (ETE), lymphovascular invasion (LVI) and lymph node metastasis (LNM) was assessed. In addition, age, gender, BRAFV600E mutation status, histological type and Hashimoto's thyroiditis (HT) were considered. KEY FINDINGS Most of the patients with PTC had hormones levels within the normal range, however, serum TSH concentration was significantly higher in PTC comparing with FA (P = 0.022). High levels of TSH in PTC were more frequent among women rather than men (P = 0.03) due to the gender differences in coexisting HT rate (P = 0.003). In contrast, LNM rate was higher in men (P = 0.0014). Coexisting HT significantly decreased the risk of ETE (OR = 0.67; 95%CI 0.44-1.00; P = 0.05) and LNM (OR = 0.59; 95%CI 0.37-0.94; P = 0.028) among males with PTC. However, there was no significant relationship between HT and PTC-related ETE and LNM in females. BRAFV600E mutation was associated with presence of lymphocytic infiltration (P < 0.001) but not with HT (P = 0.08) and violation of thyroid function. CONCLUSION The present study showed the lack of significant relationship between TSH levels and PTC aggressiveness (LNM, TNM stage, BRAFV600E mutation). Higher TSH levels were found in patients with coexisting HT that was associated with female sex and multifocality of PTC.
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Affiliation(s)
| | - Olena Chernenko
- Ukrainian Research and Practical Center for Endocrine Surgery, Ukraine
| | - Yelisaveta Chereshneva
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Russia
| | - Dibahan Tsomartova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Russia
| | - Oleksandr Larin
- Ukrainian Research and Practical Center for Endocrine Surgery, Ukraine
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Wei ZL, Gao AB, Wang Q, Lou XE, Zhao J, Lu QJ. MicroRNA-221 promotes papillary thyroid carcinoma cell migration and invasion via targeting RECK and regulating epithelial-mesenchymal transition. Onco Targets Ther 2019; 12:2323-2333. [PMID: 30992669 PMCID: PMC6445232 DOI: 10.2147/ott.s190364] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim The aim of this study was to detect the effects and potential mechanisms of microRNA-221 on a series of biological behaviors of papillary thyroid carcinoma (PTC) cells in vitro and in vivo. Methods First, we analyzed the relationship between the expression of miR-221 and several clinicopathological features of PTC patients and then detected the expression of the miR-221 in tumor tissues and cell lines. The effects of miR-221 on proliferation and invasion of PTC cells were verified by cell counting kit-8 (CCK-8) assay, wound healing assay and transwell assay. Western blot assay was applied to explore the correlation between miR-221 and RECK expression in PTC K1 cells. Finally, a xenograft model was established to further confirm the tumor-promoting effects of miR-221 in vivo. Results Our data indicated that miR-221 was relatively upregulated in metastatic PTC tissues. MiR-221 promoted the proliferation, migration and invasion activities of PTC K1 cells, following variations of epithelial-mesenchymal transition (EMT)-related protein expression. We identified RECK as a direct target of miR-221, revealed its expression to be inversely correlated with miR-221 in PTC samples and showed that its reintroduction reverses miR-221-induced PTC invasiveness. In addition, miR-221 was also verified to promote tumor growth and increase tumor volume and weight in vivo. Taken together, miR-221/RECK axis could be an effective way to regulate biological behaviors of PTC. Conclusion MiR-221 may be involved in PTC cell invasion and metastasis by targeting RECK, indicating that the miR-221/RECK pathway could be studied further as a potential new diagnostic or prognostic biomarker for PTC.
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Affiliation(s)
- Zhao-Li Wei
- Department of Endocrinology, Binzhou Central Hospital, Binzhou Medical University, Binzhou 251700, Shandong Province, People's Republic of China
| | - Ai-Bin Gao
- Department of Endocrinology, Binzhou Central Hospital, Binzhou Medical University, Binzhou 251700, Shandong Province, People's Republic of China
| | - Qing Wang
- Department of Endocrinology, Binzhou Central Hospital, Binzhou Medical University, Binzhou 251700, Shandong Province, People's Republic of China
| | - Xiu-E Lou
- Department of Endocrinology, Binzhou Central Hospital, Binzhou Medical University, Binzhou 251700, Shandong Province, People's Republic of China
| | - Jing Zhao
- Department of Oncology, Provincal Hospital of Shandong University, Jinan 250000, Shandong Province, People's Republic of China
| | - Qing-Jun Lu
- Department of Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200001, People's Republic of China,
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Shangguan R, Hu YP, Huang J, Yang SJ, Ye L, Lin RX, Zhu J, Zhang TL, Ying L, Li P. Association Between BRAF V600E Mutation and the American College of Radiology Thyroid Imaging, Reporting and Data System in Solitary Papillary Thyroid Carcinoma. Acad Radiol 2019; 26:154-160. [PMID: 29941398 DOI: 10.1016/j.acra.2018.05.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 04/29/2018] [Accepted: 05/02/2018] [Indexed: 01/05/2023]
Abstract
RATIONALE AND OBJECTIVES The purpose of this study was to evaluate the associations between BRAFV600E mutation, the American College of Radiology (ACR) thyroid imaging, reporting and data system (TI-RADS) on ultrasound and clinicopathological characteristics in patients with a solitary papillary thyroid carcinoma (PTC). MATERIALS AND METHODS This retrospective study included 397 patients with a solitary PTC, proved pathologically. BRAFV600E mutation status was detected in postoperative samples by real-time fluorescent polymerase chain reaction. Associations of BRAFV600E mutation with the ACR TI-RADS and clinicopathological characteristics were analyzed. RESULTS In this study, the incidence of BRAFV600E mutation was 81.4% (323/397) in patients with a solitary PTC. Univariate analyses showed that BRAFV600E mutation was significantly associated with margin, higher ACR TI-RADS point scores, and Hashimoto's thyroiditis. In multivariate analyses, lobulated or irregular margin was independently associated with BRAFV600E mutation in total solitary PTC. Furthermore, both in total solitary PTC and papillary thyroid microcarcinoma, BRAFV600E mutation was associated with ACR TI-RADS point scores, which was positively correlated with the risk of BRAFV600E mutation. There was no significant relationship between BRAFV600E mutation and ACR TI-RADS point scores in PTC >10 mm. In addition, Hashimoto's thyroiditis had a significant negative association with BRAFV600E mutation. CONCLUSION A lobulated or irregular margin of the thyroid nodule is independently associated with BRAFV600E mutation in patients with PTC. In addition, higher ACR TI-RADS point scores is an independent risk factor for BRAFV600E mutation, and ACR TI-RADS point scores is positively associated with the risk of BRAFV600E mutation in solitary PTC, especially in papillary thyroid microcarcinoma. Our findings may be helpful for preoperative identification and medical management of PTC patients with BRAFV600E mutation.
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Molnár C, Molnár S, Bedekovics J, Mokánszki A, Győry F, Nagy E, Méhes G. Thyroid Carcinoma Coexisting with Hashimoto's Thyreoiditis: Clinicopathological and Molecular Characteristics Clue up Pathogenesis. Pathol Oncol Res 2019; 25:1191-1197. [PMID: 30666518 PMCID: PMC6614143 DOI: 10.1007/s12253-019-00580-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 01/10/2019] [Indexed: 01/14/2023]
Abstract
Thyroid cancer (TC) coexisting with Hashimoto’s thyroiditis (HT) presents with several characteristic features including multifocality and lower clinical stages compared to de novo carcinomas but its exact biology is still not understood. We reexamined clinico-pathological and molecular correlations between Hashimoto’s thyroditis and papillary thyroid cancer. A total of 262 patients with TC was evaluated who underwent thyroidectomy at the Surgical Department of the University of Debrecen. Clinical data, histology and molecular data were evaluated. Our cohort included 43 patients (16.4%) with (5 male, 38 female) and 219 (83.6%) patients without coexisting HT (48 male, 171 female). Hashimoto’s thyroiditis related thyroid cancer presented predominantly (93.0% of the cases) with the papillary histological type. Multifocality was observed more frequently with coexisting HT (16/40; 40.0%) compared to cases uninvolved (45/190; 23.7%)(p = 0.034). In contrast, lymphatic metastasis (pN1) with a significantly reduced frequency in patients with HT (4/11; 36.4%) then without HT (34/41 pN1; 82.9%)(p = 0.002). BRAF V600E mutation could be demonstrated at significantly lower rates in cases of PTC + HT (32.1 vs 60.7%, p < 0.005). High incidence, multifocality and papillary morphology strongly support a causal relation between TC and preexisting Hashimoto’s thyroiditis, the latter to be considered as a preneoplastic condition promoting thyroid carcinogenesis.
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Affiliation(s)
- Csaba Molnár
- Department of Pathology, University of Debrecen, Nagyerdei krt. 98, Debrecen, H-4042, Hungary.
| | - Sarolta Molnár
- Department of Pathology, University of Debrecen, Nagyerdei krt. 98, Debrecen, H-4042, Hungary
| | - Judit Bedekovics
- Department of Pathology, University of Debrecen, Nagyerdei krt. 98, Debrecen, H-4042, Hungary
| | - Attila Mokánszki
- Department of Pathology, University of Debrecen, Nagyerdei krt. 98, Debrecen, H-4042, Hungary
| | - Ferenc Győry
- Department of Surgery, Clinical Center, University of Debrecen, Debrecen, Hungary
| | - Endre Nagy
- Department of Internal Medicine, Clinical Center, University of Debrecen, Debrecen, Hungary
| | - Gábor Méhes
- Department of Pathology, University of Debrecen, Nagyerdei krt. 98, Debrecen, H-4042, Hungary
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Xue S, Zhang L, Wang P, Liu J, Yin Y, Jin M, Guo L, Zhou Y, Chen G. Predictive Factors of Recurrence for Multifocal Papillary Thyroid Microcarcinoma With Braf v600e Mutation: A Single Center Study of 1,207 Chinese Patients. Front Endocrinol (Lausanne) 2019; 10:407. [PMID: 31297091 PMCID: PMC6607364 DOI: 10.3389/fendo.2019.00407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 06/07/2019] [Indexed: 01/08/2023] Open
Abstract
Background: The American Thyroid Association (ATA) guidelines risk stratify Brafv600e mutated multifocal papillary thyroid microcarcinoma (BMPTMC) into different recurrence risk groups by the extent of extrathyroidal extension (ETE). These findings and modifications for BMPTMC need to be verified in additional studies. Methods: A retrospective cohort study was conducted in BMPTMC patients who underwent total thyroidectomy (TT) and central lymph node dissection (CLND) from 2008 to 2013. Overall, 1,207 patients were included, and predictive factors were identified by univariate and multivariate analysis over a mean 7.5-year follow up. Results: BMPTMC with ETE to capsule shows the same recurrence rate (3.8%) with intrathyroidal BMPTMC. Moreover, BMPTMC with ETE only to strap muscle, which belongs to high-risk group according to ATA guideline, shows relatively lower recurrence rate (13.3%) compared with some intermediate risk categories such as cN1 and >5 pN1. Multivariate analysis using a Cox proportional hazards regression model shows that total tumor diameter (TTD) is associated with significantly higher recurrence for BMPTMC with or without other risk factors (Hazard Ratio (HRO) = 9.86 [95%CI 5.35-18.20], p = 0.00; HRO = 2.32 [95%CI 1.12-4.85], p = 0.02; respectively), while Hashimoto thyroiditis (HT) is found to be protective against the recurrence (HRO = 0.51 [95%CI 0.33-0.79], p = 0.00; HRO = 0.47 [95%CI 0.25-0.89], p = 0.02; respectively). Conclusions: Taken together, capsular ETE and gross ETE to the strap muscles did not have the expected significant influence on recurrence for Chinese BMPTMC patients who underwent TT and CLND. Rather than the extent of ETE, TTD and the lack of HT were identified as predictors for recurrence among BMPTMC with or without other risk factors (vascular invasion, cN1, pN1>5, pN1>3 cm).
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Affiliation(s)
- Shuai Xue
- Department of Thyroid Surgery, The 1st Hospital of Jilin University, Changchun, China
| | - Li Zhang
- Department of Nephrology, The 1st Hospital of Jilin University, Changchun, China
| | - Peisong Wang
- Department of Thyroid Surgery, The 1st Hospital of Jilin University, Changchun, China
| | - Jia Liu
- Department of Thyroid Surgery, The 1st Hospital of Jilin University, Changchun, China
| | - Yue Yin
- Department of Thyroid Surgery, The 1st Hospital of Jilin University, Changchun, China
| | - Meishan Jin
- Department of Pathology, The 1st Hospital of Jilin University, Changchun, China
| | - Liang Guo
- Department of Pathology, The 1st Hospital of Jilin University, Changchun, China
| | - Yuhua Zhou
- Department of Pathology, The 1st Hospital of Jilin University, Changchun, China
| | - Guang Chen
- Department of Thyroid Surgery, The 1st Hospital of Jilin University, Changchun, China
- *Correspondence: Guang Chen
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Moon S, Chung HS, Yu JM, Yoo HJ, Park JH, Kim DS, Park YJ. Associations between Hashimoto Thyroiditis and Clinical Outcomes of Papillary Thyroid Cancer: A Meta-Analysis of Observational Studies. Endocrinol Metab (Seoul) 2018; 33:473-484. [PMID: 30513562 PMCID: PMC6279904 DOI: 10.3803/enm.2018.33.4.473] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 09/19/2018] [Accepted: 10/05/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Epidemiological studies have suggested an association between Hashimoto thyroiditis (HT) and papillary thyroid cancer (PTC) development. Other studies, however, have reported a protective role of HT against PTC progression. Through this updated meta-analysis, we aimed to clarify the effects of HT on the progression of PTC. METHODS We searched citation databases, including PubMed and Embase, for relevant studies from inception to September 2017. From these studies, we calculated the pooled odds ratios (ORs) of clinicopathologic features and the relative risk (RR) of PTC recurrence with 95% confidence intervals (CIs) using the Mantel-Haenszel method. Additionally, the Higgins I² statistic was used to test for heterogeneity. RESULTS The meta-analysis included 71 published studies with 44,034 participants, among whom 11,132 had HT. We observed negative associations between PTC with comorbid HT and extrathyroidal extension (OR, 0.74; 95% CI, 0.68 to 0.81), lymph node metastasis (OR, 0.82; 95% CI, 0.72 to 0.94), distant metastasis (OR, 0.49; 95% CI, 0.32 to 0.76), and recurrence (RR, 0.50; 95% CI, 0.41 to 0.61). CONCLUSION In this meta-analysis, PTC patients with HT appeared to exhibit more favorable clinicopathologic characteristics and a better prognosis than those without HT.
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Affiliation(s)
- Shinje Moon
- Division of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon, Korea
- Department of Internal Medicine, Graduate School, Hanyang University, Seoul, Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon, Korea
| | - Jae Myung Yu
- Division of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon, Korea
| | - Hyung Joon Yoo
- Department of Internal Medicine, CM Hospital, Seoul, Korea
| | - Jung Hwan Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Dong Sun Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
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Lee YK, Park KH, Park SH, Kim KJ, Shin DY, Nam KH, Chung WY, Lee EJ. Association between diffuse lymphocytic infiltration and papillary thyroid cancer aggressiveness according to the presence of thyroid peroxidase antibody and BRAF V600E mutation. Head Neck 2018; 40:2271-2279. [PMID: 29935011 DOI: 10.1002/hed.25327] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/15/2018] [Accepted: 04/19/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Diffuse lymphocytic infiltration (DLI) is frequently found with papillary thyroid cancer (PTC), so there has been long interest in how it affects the characteristics of PTC. This purpose of this study was to define the association between DLI and PTC aggressiveness according to thyroperoxidase antibody (TPOAb) and B-type Raf (BRAF)V600E mutation positivity. METHODS There were 1879 patients with PTC who underwent surgery and were enrolled in this study. Clinicopathologic characteristics were compared between groups according to the presence of DLI and TPOAb. Multiple logistic regression analysis was conducted to assess odds ratio (OR) for each dependent variable (BRAFV600E mutation, tumor size >1.0 cm, multifocality, extrathyroidal extension, and lymph node metastasis) of each group according to the presence of DLI and TPOAb, with the group with neither DLI or TPOAb (DLI-negative TPOAb-negative PTC) as the reference. RESULTS The DLI-positive PTC showed more frequent multifocality and less frequent BRAFV600E mutation than DLI-negative PTC. Among patients with DLI-positive PTC, extrathyroidal extension and BRAFV600E mutation was less frequent when serum TPOAb was positive. In multiple logistic regressions, DLI-positive TPOAb-positive PTC showed a high OR for multifocality (1.410; P = .017), but low ORs for BRAFV600E mutation (0.521; P < .001) and extrathyroidal extension (0.691; P = .008). The patients with DLI-positive TPOAb-positive PTCs showed a high OR for multifocality (1.588; P = .002), and high ORs for tumor size >1.0 cm (2.205; P = .019) and lymph node metastasis (2.005; P = .032) in subgroup analyses of PTC with wild-type BRAF. The DLI-negative TPOAb-positive group was not associated with any tumor aggressiveness-related variables. CONCLUSION Although DLI was associated with multifocality regardless of TPOAb positivity, it was associated with an indolent feature when TPOAb was positive but with aggressive features in PTC with wild-type BRAF when TPOAb was negative. The TPOAb and BRAF status may help to define the clinical implication of lymphocytic infiltration found with PTC.
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Affiliation(s)
- Young Ki Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyeong Hye Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi, Republic of Korea.,Yonsei University Graduate school of Medicine, Seoul, Republic of Korea
| | - Se Hee Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kwang Joon Kim
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong Yeob Shin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kee Hyun Nam
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woong Youn Chung
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Jig Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Kim WW, Ha TK, Bae SK. Clinical implications of the BRAF mutation in papillary thyroid carcinoma and chronic lymphocytic thyroiditis. J Otolaryngol Head Neck Surg 2018; 47:4. [PMID: 29316976 PMCID: PMC5759356 DOI: 10.1186/s40463-017-0247-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/15/2017] [Indexed: 11/30/2022] Open
Abstract
Background The purpose of this study was to examine the possible prognostics and clinicopathologic characteristics underlying the BRAFV600E mutation and papillary thyroid carcinoma (PTC) coexisting or in absence of chronic lymphocytic thyroiditis (CLT). Methods This study was conducted on 172 patients who had undergone total thyroidectomy or unilateral total thyroidectomy for PTC; the patients were then examined for the BRAFV600E mutation using specimens obtained after their surgery from January 2013 to August 2015. Results BRAF mutations were found in 130 of 172 patients (75.6%). CLT was present in 27.9% of patients (48/172). The incidence of the BRAFV600E mutation was significantly increased in the group with no CLT (P = 0.001). The findings of the multivariate analysis pertaining to the coexistence of CLT and PTC showed no significant correlation other than the BRAFV600E mutation. No significant difference was noted in the clinicopathologic factors between the two groups based on the coexistence of CLT in univariate and multivariate analyses. Conclusions The BRAFV600E mutation is less frequent in PTC coexisting with CLT presumably because CLT and the BRAFV600E mutation operate independently in the formation and progression of thyroid cancer.
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Affiliation(s)
- Woon Won Kim
- Department of General Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Tae Kwun Ha
- Department of General Surgery, Busan Paik Hospital, Inje University College of Medicine, 75, Bokji-ro, Busanjin-gu, 614-735, Busan, Republic of Korea.
| | - Sung Kwon Bae
- Department of Medical Management, Kosin University, Busan, Republic of Korea
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Ren H, Shen Y, Hu D, He W, Zhou J, Cao Y, Mao Y, Dou Y, Xiong W, Xiao Q, Zhang Y, Su X. Co-existence of BRAFV600E and TERT promoter mutations in papillary thyroid carcinoma is associated with tumor aggressiveness, but not with lymph node metastasis. Cancer Manag Res 2018; 10:1005-1013. [PMID: 29760568 PMCID: PMC5937490 DOI: 10.2147/cmar.s159583] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Mutations of BRAFV600E and TERT promoters are associated with thyroid cancer development. This study further investigated association of these mutations with clinicopathological characteristics from patients with papillary thyroid carcinoma (PTC). METHODS Tumor tissues from 342 PTC patients were obtained for DNA extraction and polymerase chain reaction amplification to detect the BRAFV600E mutation using amplification-refractory mutation system-polymerase chain reaction. TERT promoter mutations were assessed using Sanger DNA sequencing. The association of these gene mutations with clinicopathological characteristics was then statistically analyzed. RESULTS Two hundred and seventy of 342 (78.9%) PTC patients harbored the BRAFV600E mutation, which was associated with older age male patients. Moreover, TERT promoter mutations occurred in 12 of 342 (3.5 %) PTC patients, all of whom also had the BRAF mutation. One hundred thirty-three patients with papillary thyroid microcarcinoma (PTMC) had no TERT mutations. Statistically, the coexistence of BRAF and TERT promoter mutations were significantly associated with older age, larger tumor size, extrathyroidal extension, and advanced tumor stage, but not with central lymph node metastasis, lateral lymph node metastasis, numbers of lymph node metastasis >5, and numbers of involved/harvested lymph nodes (No. of LNs involved or harvested). The multivariate analyses showed older age (odds ratio [OR], 2.194; 95% CI: 1.117-4.311; p=0.023), larger tumor size (OR, 4.100; 95% CI: 2.257-7.450; p<0.001), and multiplicity (OR, 2.240; 95% CI: 1.309-3.831; p=0.003) were all independent predictors for high prevalence of extrathyroidal extension. However, there was no statistical association with any clinicopathological characteristics except for Hashimoto thyroiditis in PTMC. CONCLUSION The current study demonstrated that the coexistence of BRAF and TERT promoter mutations were associated with the PTC aggressiveness, although these mutations were not associated with PTC lymph node metastasis or with PTMC.
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Affiliation(s)
- Haoyu Ren
- Department of Endocrine and Breast Surgery
| | - Yifan Shen
- The Center for Clinical Molecular Medical Detection, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Daixing Hu
- Department of Endocrine and Breast Surgery
| | - Wei He
- Department of Endocrine and Breast Surgery
| | - Jing Zhou
- Department of Endocrine and Breast Surgery
| | - Yijia Cao
- Department of Endocrine and Breast Surgery
| | - Yu Mao
- Department of Endocrine and Breast Surgery
| | - Yi Dou
- Department of Endocrine and Breast Surgery
| | - Wei Xiong
- Department of Endocrine and Breast Surgery
| | - Qi Xiao
- Department of Endocrine and Breast Surgery
| | - Yuhong Zhang
- The Center for Clinical Molecular Medical Detection, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Xinliang Su
- Department of Endocrine and Breast Surgery
- Correspondence: Xinliang Su, Department of Endocrine and Breast Surgery, The First Affiliated Hospital, Chongqing Medical University, 1 Friendship Road, Yuzhong District, Chongqing 400016, China, Tel +86 135 0830 9161, Fax +86 23 8901 1463, Email
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BRAF and TERT promoter mutations in the aggressiveness of papillary thyroid carcinoma: a study of 653 patients. Oncotarget 2017; 7:18346-55. [PMID: 26943032 PMCID: PMC4951292 DOI: 10.18632/oncotarget.7811] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/29/2016] [Indexed: 01/04/2023] Open
Abstract
The role of telomerase reverse transcriptase (TERT) gene promoter mutations in the aggressiveness of papillary thyroid cancer (PTC) remains to be further investigated. Here we examined the relationship of TERT promoter mutations and BRAF V600E with the clinicopathological features of PTC in 653 patients. Sanger sequencing of genomic DNA from primary PTC tumors was performed for mutation detection and genotype-clinicopathological correlation of the tumor was analyzed. BRAF V600E and TERT promoter mutations were found in 63.7% (416 of 653) and 4.1% (27 of 653) of patients, respectively; the latter became 9.8% when only tumors ≥ 1.5 cm were analyzed. TERT promoter mutations occurred more frequently in BRAF mutation-positive cases compared to wild-type cases, being 5.3% in the former versus 2.1% in the latter (P = 0.050). BRAF and TERT promoter mutations were each significantly associated with high-risk clinicopathological features of PTC, such as old patient age, large tumor size, extrathyroidal invasion, capsular invasion, and advanced disease stages. Coexistence of BRAF V600E and TERT promoter mutations was particularly associated with high-risk clinicopathological features, as exemplified by extrathyroidal invasion seen in 54.5% (12/22) of patients harboring both mutations versus 9.9% (23/232) of patients harboring neither mutation (P < 0.001). Thus, this study, the largest on TERT mutation so far, demonstrates a significant role of BRAF V600E and TERT promoter mutations in the aggressiveness of PTC, which is particularly robust and cooperative when the two mutations coexist. These results, together with previous studies, establish a significant role of these mutations in the aggressiveness of PTC.
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