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Wang X, Yu Y, Ji Y, Ma Z, Tan J, Jia Q, Li N, Zheng W. Clinical characteristics and therapeutic response of differentiated thyroid carcinoma with obesity and diabetes. BMC Cancer 2023; 23:1077. [PMID: 37940857 PMCID: PMC10631042 DOI: 10.1186/s12885-023-11591-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND The effects of obesity and diabetes on the clinical outcomes of differentiated thyroid cancer (DTC) remain unclear. OBJECTIVES To explore the association between obesity and diabetes with pathological features and therapeutic response of DTC. METHODS Patients were categorized based on body mass index (BMI) and glycemic status. Compare the correlation between BMI and glycemic status with pathological features and therapeutic response of DTC. To analyze the independent risk factors for the aggressiveness of DTC. RESULTS The proportion of patients with bilateral tumors was higher in the overweight, obese and diabetes group (P = 0.001, 0.045). The overweight group demonstrated a higher TNM stage (P = 0.004), while the T and TNM stages were higher in the diabetes group (P = 0.032, 0.000). The probability of distant metastasis increases by 37.4% for each unit of BMI increase (odds ratio (OR) = 1.374, CI 95% 1.061-1.778, P < 0.05). The BMI of Biochemical Incomplete Response (BIR) is significantly higher than that of Excellent Response (ER) (P = 0.015), the fasting plasma glucose (FPG) of Structural Incomplete (SIR) was significantly higher than that of ER and BIR (P = 0.030, 0.014). CONCLUSION Obesity and diabetes have effect on DTC aggressiveness. BMI and FPG have correlation with the therapeutic response of DTC patients.
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Affiliation(s)
- Xuan Wang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Yang Yu
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Yanhui Ji
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Ziyu Ma
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Jian Tan
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiang Jia
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Ning Li
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Zheng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China.
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Zhou Y, Yang Y, Zhou T, Li B, Wang Z. Adiponectin and Thyroid Cancer: Insight into the Association between Adiponectin and Obesity. Aging Dis 2021; 12:597-613. [PMID: 33815885 PMCID: PMC7990371 DOI: 10.14336/ad.2020.0919] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/13/2020] [Indexed: 12/14/2022] Open
Abstract
In recent decades, the incidence and diagnosis of thyroid cancer have risen dramatically, and thyroid cancer has now become the most common endocrine cancer in the world. The onset of thyroid cancer is insidious, and its progression is slow and difficult to detect. Therefore, early prevention and treatment have important strategic significance. Moreover, an in-depth exploration of the pathogenesis of thyroid cancer is key to early prevention and treatment. Substantial evidence supports obesity as an independent risk factor for thyroid cancer. Adipose tissue dysfunction in the obese state is accompanied by dysregulation of a variety of adipocytokines. Adiponectin (APN) is one of the most pivotal adipocytokines, and its connection with obesity and obesity-related disease has gradually become a hot topic in research. Recently, the association between APN and thyroid cancer has received increasing attention. The purpose of this review is to systematically review previous studies, give prominence to APN, focus on the relationship between APN, obesity and thyroid cancer, and uncover the underlying pathogenic mechanisms.
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Affiliation(s)
- Yuanyuan Zhou
- 1Department of Endocrinology and Metabolism, The Second People's Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, China.,2Department of Endocrinology and Metabolism, Sixth Affiliated Hospital of Kunming Medical University, The People's Hospital of Yuxi City, Yuxi, China
| | - Ying Yang
- 1Department of Endocrinology and Metabolism, The Second People's Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Taicheng Zhou
- 1Department of Endocrinology and Metabolism, The Second People's Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Bai Li
- 3School of Medicine, Yunnan University, Kunming, China
| | - Zhanjian Wang
- 4Department of Endocrinology and Metabolism, The Third Hospital of Hebei Medical University, Shijiazhuang, China
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Samà MT, Grosso E, Mele C, Laurora S, Monzeglio O, Marzullo P, Boldorini R, Aluffi Valletti P, Aimaretti G, Scatolini M, Pagano L. Molecular characterisation and clinical correlation of papillary thyroid microcarcinoma. Endocrine 2021; 71:149-157. [PMID: 32621051 DOI: 10.1007/s12020-020-02380-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/01/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Papillary thyroid microcarcinoma (mPTC) is defined as a papillary thyroid cancer sized 10 mm or less. Despite their generally indolent clinical course and good prognosis, a subset of mPTCs shows potentially aggressive behaviour. METHODS To search for predictors of clinical outcome of mPTCs, we retrospectively evaluated the genetic tumour profile of 100 patients (23 M/77 F, mean age ± SD 53.8 ± 13.4 years) with histologically confirmed mPTCs through analysis of BRAF, NRAS and TERT promoter mutations as well as RET/PTC translocations. RESULTS Mean follow-up period was 8.4 ± 3.6 years. In 55 cases, mPTC were detected incidentally after surgery. Capsular invasion, bilateralism and multifocality were found in 11/100, 17/100 and 24/100 cases, respectively, while lymph-nodes metastases were present at diagnosis in 9/100 cases. After 3.5 ± 2.0 years, tumour relapse occurred in 6/100 cases and was locoregional in five (two in the thyroid bed, three in laterocervical lymph-nodes), while lung metastasis occurred in one case. Biochemical persistence of disease was seen in 1/100 case. Mutations occurred in 55/100 cases; BRAFV600E was the most frequently detected (49/100) and was associated with higher tumour size, bilateralism and follicular variant but not with capsular invasion. RET/PTC rearrangements were found in 2/100 cases, NRASQ61R in 4/100, while no mutations of TERT promoter gene were detected. Despite the observed association between BRAFV600E mutation and unfavourable histopathological features, we found no direct association with tumour recurrence, distant metastases and mortality. CONCLUSION In our study, the search for the most frequent genetic alterations as prognostic markers in mPTCs would not have changed the therapeutic strategy.
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Affiliation(s)
- Maria Teresa Samà
- Endocrinology, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy.
| | - Enrico Grosso
- Laboratory of Molecular Oncology, Fondazione Edo ed Elvo Tempia, Ponderano, Biella, Italy
| | - Chiara Mele
- Endocrinology, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
- Division of General Medicine, Istituto Auxologico Italiano, IRCCS, San Giuseppe Hospital, Piancavallo, Verbania, Italy
| | - Sara Laurora
- Laboratory of Molecular Oncology, Fondazione Edo ed Elvo Tempia, Ponderano, Biella, Italy
| | - Oriana Monzeglio
- Endocrinology, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Paolo Marzullo
- Endocrinology, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
- Division of General Medicine, Istituto Auxologico Italiano, IRCCS, San Giuseppe Hospital, Piancavallo, Verbania, Italy
| | - Renzo Boldorini
- Pathology Department, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Paolo Aluffi Valletti
- ENT Division, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Gianluca Aimaretti
- Endocrinology, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Maria Scatolini
- Laboratory of Molecular Oncology, Fondazione Edo ed Elvo Tempia, Ponderano, Biella, Italy
| | - Loredana Pagano
- Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Città della Salute e della Scienza, Torino, Italy
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Mele C, Caputo M, Samà MT, Bullara V, Mauri MG, Prodam F, Aimaretti G, Pagano L, Marzullo P. The role of metabolic setting in predicting the risk of early tumour relapse of differentiated thyroid cancer (DTC). Eur J Clin Nutr 2020; 74:1038-1046. [PMID: 32518296 DOI: 10.1038/s41430-020-0671-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/23/2020] [Accepted: 05/28/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The role of insulin resistance and adipocytokines in determining the phenotype and recurrence of differentiated thyroid cancer (DTC) is still unknown. In a previous study, we observed an association between metabolic setting, circulating adipocytokines and thyroid cancer phenotype. The aim of this study was to evaluate the clinical follow-up of patients with DTC and the predictive role of metabolic setting on the risk of tumour relapse. METHODS Between September 2016 and January 2017, 57 patients were admitted to our institution to undergo total thyroidectomy because of suspected DTC. Thirty patients with post-surgical histological diagnosis of DTC were included in the study. Each subject underwent pre-surgical analysis of anthropometric parameters, thyroid function and autoimmunity, glucose metabolism, insulin resistance (HOMA-IR) and levels of unacylated and acylated ghrelin, obestatin, leptin and adiponectin. Tumour recurrence at 1 and 3 years from diagnosis was assessed. RESULTS Most patients were females (21F, 9M) with a median age at diagnosis of 50.0 (41.0-58.8). At baseline, overweight was found in 7 patients and obesity in 6 cases. Insulin resistance was detected in 14 patients. Overall, 17 patients (56.7%) underwent radioiodine treatment after surgery. During the follow-up, we observed a persistent biochemical disease in one patient whereas tumour relapse was found in six patients at 1 year from diagnosis (lymph node metastases) and in one patient at 3 years from diagnosis (lung metastases). Independently from age, sex, stage of disease and the presence of lymph node metastasis at diagnosis, higher BMI, leptin and insulin levels as well as HOMA-IR were associated with a higher risk of tumour relapse (p < 0.05 for all). CONCLUSIONS Our results highlight a possible role for BMI, leptin and insulin resistance as predictors of early DTC relapse.
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Affiliation(s)
- Chiara Mele
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy. .,Division of General Medicine, S. Giuseppe Hospital, I.R.C.C.S. Istituto Auxologico Italiano, Verbania, Italy.
| | - Marina Caputo
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.,Division of Endocrinology, University Hospital "Maggiore della Carità", Novara, Italy
| | - Maria Teresa Samà
- Division of Endocrinology, University Hospital "Maggiore della Carità", Novara, Italy
| | - Valentina Bullara
- Division of Endocrinology, University Hospital "Maggiore della Carità", Novara, Italy
| | - Maria Grazia Mauri
- Division of Endocrinology, University Hospital "Maggiore della Carità", Novara, Italy
| | - Flavia Prodam
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.,Division of Endocrinology, University Hospital "Maggiore della Carità", Novara, Italy
| | - Gianluca Aimaretti
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,Division of Endocrinology, University Hospital "Maggiore della Carità", Novara, Italy
| | - Loredana Pagano
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paolo Marzullo
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,Division of General Medicine, S. Giuseppe Hospital, I.R.C.C.S. Istituto Auxologico Italiano, Verbania, Italy
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Mele C, Samà MT, Bisoffi AA, Caputo M, Bullara V, Mai S, Walker GE, Prodam F, Marzullo P, Aimaretti G, Pagano L. Circulating adipokines and metabolic setting in differentiated thyroid cancer. Endocr Connect 2019; 8:997-1006. [PMID: 31252407 PMCID: PMC6652238 DOI: 10.1530/ec-19-0262] [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: 05/27/2019] [Accepted: 06/17/2019] [Indexed: 12/18/2022]
Abstract
The associative link relating insulin resistance (IR) and adipokines to the occurrence and phenotype of differentiated thyroid cancer (DTC) is unknown. The aim of this study was to evaluate the relationship between IR and adipokines in DTC patients, as compared with carriers of benign thyroid diseases (BTD) and healthy controls. This observational study enrolled 77 subjects phenotyped as DTC (N = 30), BTD (N = 27) and healthy subjects (N = 20). Each subject underwent preoperative analysis of anthropometric parameters, thyroid function and autoimmunity, insulin resistance (HOMA-IR) and levels of unacylated (UAG) and acylated ghrelin (AG), obestatin, leptin and adiponectin. Multivariate regression models were used to test the predictive role of metabolic correlates on thyroid phenotypes and DTC extension. The three groups showed similar age, gender distribution, smoking habit, BMI and thyroid parameters. Obestatin was significantly higher in DTC group compared to BTD (P < 0.05) and control subjects (P < 0.0001). DTC and BTD groups showed higher levels of UAG (P < 0.01) and AG (P < 0.05). Leptin levels were comparable between groups, whereas adiponectin levels were lower in DTC compared to BTD group (P < 0.0001) and controls (P < 0.01). In parallel, HOMA-IR was higher in DTC than BTD (P < 0.05) and control group (P < 0.01). Stepwise multivariable regression analysis showed that obestatin and UAG were independent predictors of DTC (P = 0.01 for both). In an analysis restricted to the DTC group, obestatin levels were associated with the absence of lymph node metastases (P < 0.05). Our results highlight a potential association between metabolic setting, circulating adipokines and thyroid cancer phenotype.
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Affiliation(s)
- Chiara Mele
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- Division of General Medicine, Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Piancavallo di Oggebbio (VB), Italy
- Correspondence should be addressed to C Mele:
| | - Maria Teresa Samà
- Division of Endocrinology, University Hospital ‘Maggiore della Carità’, Novara, Italy
| | - Alessandro Angelo Bisoffi
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Marina Caputo
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Valentina Bullara
- Division of Endocrinology, University Hospital ‘Maggiore della Carità’, Novara, Italy
| | - Stefania Mai
- Laboratory of Metabolic Research, Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Piancavallo di Oggebbio (VB), Italy
| | | | - Flavia Prodam
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Paolo Marzullo
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- Division of General Medicine, Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Piancavallo di Oggebbio (VB), Italy
| | - Gianluca Aimaretti
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Loredana Pagano
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
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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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