1
|
Harmantepe AT, Ozdemir K, Bayhan Z, Kocer B. The Underestimated Impact of Hashimoto Thyroiditis on Thyroid Papillary Carcinoma. Updates Surg 2024; 76:1085-1089. [PMID: 38687448 PMCID: PMC11130058 DOI: 10.1007/s13304-024-01854-y] [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: 01/31/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
It is stated that Hashimoto's Thyroiditis (HT) is a risk factor for the development of Papillary Thyroid Cancer (PTC). However, the effect of HT on the coexistence of HT and PTC is still controversial. In this study, our aim is to investigate the effect of the presence of HT on clinicopathological data in patients with PTC. All 356 patients whose pathology was reported as PTC who were operated between 2015 and 2023 were included in the study. PTC patients were divided into 2 groups as those with and without HT. The effect of HT association on clinicopathological features was investigated. In 356 PTC patients, the rate of HT was 31.2%. PTC patients with HT had less multifocality (p < 0.05), more lymph node metastases (LNM) (p < 0.01) compared to PTC patients without HT. The presence of HT did not affect the bilaterality of the tumor, tumor diameter, lymphovascular invasion, or capsule invasion. While multifocality was observed less frequently in PTC patients with HT, lymph node metastasis rates were higher.
Collapse
Affiliation(s)
- Ahmet Tarik Harmantepe
- Faculty of Medicine, Department of Gastrointestinal Surgery, Sakarya University, Sakarya, Turkey
| | - Kayhan Ozdemir
- Faculty of Medicine, Department of General Surgery, Sakarya University, Sakarya, Turkey
| | - Zulfu Bayhan
- Faculty of Medicine, Department of General Surgery, Sakarya University, Sakarya, Turkey.
| | - Belma Kocer
- Faculty of Medicine, Department of General Surgery, Sakarya University, Sakarya, Turkey
| |
Collapse
|
2
|
Cinar I, Sengul I. Coexistence of Hashimoto's thyroiditis and papillary thyroid carcinoma revisited in thyroidology, an experience from an endemic region: fad or future? REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20231380. [PMID: 38747877 PMCID: PMC11095968 DOI: 10.1590/1806-9282.20231380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 10/16/2023] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Papillary thyroid carcinoma, per se, is the most common type of thyroid cancer, and Hashimoto's thyroiditis is the most frequent autoimmune disease of the papillon gland. The liaison between Hashimoto's thyroiditis and thyroid cancers is still an ongoing debate in thyroidology. The aim of the study was to discuss the frequency of the co-occurrence of Hashimoto's thyroiditis and papillary thyroid carcinoma. METHODS This study is designed as a retrospective analytical cohort study. The institutional database and archive of histopathology scanning identified the patients who had undergone thyroidectomy between January 2022 and January 2016. The Statistical Package for Social Sciences v21.0 program was used for statistical purposes. Descriptive and chi-square tests were applied, and a p<0.05 was considered significant. RESULTS Of 498 patients who had undergone thyroidectomy for 4 years, 99 (20%) were male and 399 (80%) were female. Of note, papillary thyroid carcinoma was revealed in 160 (32%) patients, and Hashimoto's thyroiditis was recognized in 178 (35.74%) patients. The prevalence of Hashimoto's thyroiditis in cases with papillary thyroid carcinoma was 43.8%, while the prevalence in patients with Hashimoto's thyroiditis was 41.1%. CONCLUSION A debate still remains on the propriety of these two phenomena. Herewith, we recognized a correlation between the presence of papillary thyroid carcinoma and Hashimoto's thyroiditis. Providers should be vigilant about the coexistence of these phenomena. We might postulate the so-called total thyroidectomy for cases with a cytologic diagnosis of Hashimoto's thyroiditis with a papillary thyroid carcinoma. As a matter of fact, this issue merits further investigation.
Collapse
Affiliation(s)
- Ilkay Cinar
- Giresun University, Faculty of Medicine Department of Pathology – Giresun, Turkey
| | - Ilker Sengul
- Giresun University, Faculty of Medicine, Division of Endocrine Surgery – Giresun, Turkey
- Giresun University, Faculty of Medicine, Department of General Surgery – Giresun, Turkey
| |
Collapse
|
3
|
Hoff G, Bernklev T, Johnsen L, Reitsma L, Sina D, Lauzike A, Gibbs C, Hoel Lende T, Narvestad JK, Kildahl R, Omdal R, Kvaløy JT, Søiland H. Thyroidectomy for Euthyroid Patients with Hashimoto Disease and Persistent Symptoms: An Observational, Postrandomization Study. J Thyroid Res 2024; 2024:5518720. [PMID: 38606313 PMCID: PMC11008973 DOI: 10.1155/2024/5518720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/06/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024] Open
Abstract
Background Despite adequate hormone substitution in Hashimoto disease, some patients may have persistent symptoms with a possible autoimmune pathophysiology. A recent randomized trial (RCT) using patient-reported outcome measures as the primary endpoint showed benefit in total thyroidectomy, but at a cost of high complication rates. Objective To verify results from the RCT in an observational study including a wider range of patients and explore means of predicting who may benefit from such surgery. Design A total of 154 patients with Hashimoto disease, euthyroid with or without thyroid hormone substitution, and persistent Hashimoto-related symptoms were subjected to total thyroidectomy and followed for 18 months after surgery. The primary outcome was the General Health (GH) dimensional score in the Short Form-36 Health Survey (SF-36). Results Eighteen months after surgery, a clinically significant improvement in GH was seen, similar to the findings in the previous RCT. Anti-TPO antibody titers were markedly reduced after surgery, but preoperative titers or other preoperative parameters could not predict the outcome of surgery. Three (1.9%) of 154 patients experienced permanent unilateral recurrent nerve palsy and six (3.9%) experienced hypoparathyroidism after surgery. Conclusions Thyroidectomy had a beneficial symptom-reducing effect in euthyroid patients with Hashimoto disease and persistent symptoms. The pathophysiology of residual symptoms remains unclear, and surgical complication rates are high. If thyroidectomy is considered as a treatment option, it should be performed in dedicated centers with experienced endocrine surgeons and as part of further studies on persistent symptoms. This trial is registered with NCT-02319538.
Collapse
Affiliation(s)
- Geir Hoff
- Department of Research, Telemark Hospital, Skien, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tomm Bernklev
- Department of Research, Vestfold Hospital, Tønsberg, Norway
| | - Lene Johnsen
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Laurens Reitsma
- Department of Breast and Endocrine Surgery, Akershus University Hospital, Campus Oslo, Lørenskog, Norway
| | - Dirk Sina
- Department of Breast and Endocrine Surgery, Telemark Hospital, Skien, Norway
| | - Andromeda Lauzike
- Department of Breast and Endocrine Surgery, Telemark Hospital, Skien, Norway
| | | | - Tone Hoel Lende
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Jon Kristian Narvestad
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | | | - Roald Omdal
- Department of Research, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Jan Terje Kvaløy
- Department of Research, Stavanger University Hospital, Stavanger, Norway
- Department of Mathematics and Physics, University of Stavanger, Stavanger, Norway
| | - Håvard Søiland
- Department of Research, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| |
Collapse
|
4
|
Iskra I, Tomaš MI, Crnčić TB, Kukić E, Hadžisejdić I, Avirović M, Girotto N. Two lymphoma histotypes and papillary thyroid carcinoma coexisting on Hashimoto ground: a case report and review of the literature. Diagn Pathol 2024; 19:52. [PMID: 38461341 PMCID: PMC10924984 DOI: 10.1186/s13000-024-01472-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 02/25/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND Papillary carcinoma is the most frequent type of thyroid carcinoma, while primary thyroid lymphoma is uncommon disease. The coexistence of these entities has already been described, and the common risk factor is considered Hashimoto thyroiditis. The two most frequent histotypes of primary thyroid lymphoma are diffuse large B-cell and mucosa-associated lymphoid tissue lymphoma, but the coexistence of both with papillary carcinoma is rarely reported. METHODS We present a case of a previously healthy 57-years old male with rapidly growing lump on the right side of the neck. Ultrasonography revealed nodules in both thyroid lobes. Fine needle aspiration cytology and pertechnetate scintigraphy were performed. Due to the Bethesda T-5 in the "cold" nodule of the right lobe, surgery with histopathological and immunohistochemistry analysis was indicated. RESULTS Histopathological and immunohistochemistry methods confirmed concomitant malignancies in the thyroid gland: diffuse large B-cell lymphoma and papillary carcinoma in the right, and mucosa-associated lymphoid tissue lymphoma in the left lobe with Hashimoto thyroiditis in the remaining tissue. Patient underwent therapy procedures and was without signs of local recurrence or metastatic spread on subsequent follow-up. CONCLUSIONS Sudden appearance of the neck mass in patients with Hashimoto thyroiditis should raise suspicion on primary thyroid lymphoma and be promptly taken in the diagnostic workup, including fine needle aspiration cytology. Pathology with immunohistochemistry is crucial for further clinical decision making. Since the standardized protocol in management of these complex patients is missing, personal approach and close collaboration between cytologist, pathologist, surgeon, haematologist and nuclear medicine specialist is essential.
Collapse
Affiliation(s)
- Igor Iskra
- Clinical Department of Nuclear Medicine, Clinical Hospital Centre Rijeka, Rijeka, Croatia
| | - Maja Ilić Tomaš
- Clinical Department of Nuclear Medicine, Clinical Hospital Centre Rijeka, Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Tatjana Bogović Crnčić
- Clinical Department of Nuclear Medicine, Clinical Hospital Centre Rijeka, Rijeka, Croatia.
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
| | - Edvin Kukić
- Clinical Department of Nuclear Medicine, Clinical Hospital Centre Rijeka, Rijeka, Croatia
| | - Ita Hadžisejdić
- Clinical Department of Pathology and Cytology, Clinical Hospital Center Rijeka, Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Manuela Avirović
- Clinical Department of Pathology and Cytology, Clinical Hospital Center Rijeka, Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Neva Girotto
- Clinical Department of Nuclear Medicine, Clinical Hospital Centre Rijeka, Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| |
Collapse
|
5
|
Ben Thayer M, Khanchel F, Helal I, Chiboub D, Raoueh H, Ben Brahim E, Jouini R, Chadli-Debbiche A. Epidemiological and histopathological characteristics of thyroid carcinoma in a Tunisian health care center. World J Otorhinolaryngol Head Neck Surg 2024; 10:37-42. [PMID: 38560041 PMCID: PMC10979045 DOI: 10.1002/wjo2.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 08/10/2023] [Accepted: 09/19/2023] [Indexed: 04/04/2024] Open
Abstract
Background Thyroid carcinoma (TC) accounts for almost 0.5%-1% of total malignancies. Its incidence is increasing rapidly worldwide. Several studies have drawn up the epidemiological profile of TC and its clinical and pathological features. However, to date, no similar studies have been conducted in Tunisia. Aims To establish an epidemiological profile of TC in a Tunisian health care institute and to analyze its clinical and histopathological characteristics in our institute. Materials and Methods We present a retrospective study reviewing the cases of TC diagnosed in our institution in a 4-year period. Results We collected a sample of 192 cases of TC. It consisted of 31 males and 161 females (83.8%) with a sex-ratio M/F of 0.19. The mean age was 46.4 years. Papillary thyroid carcinoma was the most frequent histological subtype. The multifocality rate was 33.8%. The mean size of TC was 2.2 ± 1.9 cm. 60.9% of TC were staged pT1 and 20.3% had nodal involvement. Papillary thyroid microcarcinomas were noted in 37.5% of cases. Conclusion Our results were consistent with those of the literature. A high proportion of pT1 and pN0 tumors were noted in our series, suggesting that TC's diagnosis and management was performed at an early stage of the disease in our institution. In addition, our study enabled us to notice the impact of the Coronavirus disease 19 crisis on the management of TC in our institution. Further studies are needed to establish the epidemiological profile of TC in Tunisia and to assess its clinical and pathological features.
Collapse
Affiliation(s)
- Maissa Ben Thayer
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Fatma Khanchel
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Imen Helal
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Dorra Chiboub
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Department of Otorhinolaryngology-Head and Neck surgery Habib Thameur's Hospital Tunis Tunisia
| | - Hedhli Raoueh
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Ehsen Ben Brahim
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Raja Jouini
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Aschraf Chadli-Debbiche
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| |
Collapse
|
6
|
Kalarani IB, Sivamani G, Veerabathiran R. Identification of crucial genes involved in thyroid cancer development. J Egypt Natl Canc Inst 2023; 35:15. [PMID: 37211566 DOI: 10.1186/s43046-023-00177-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/10/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND A malignancy of the endocrine system, one of the most common types, is thyroid cancer. It is proven that children who receive radiation treatment for leukemia or lymphoma are at a heightened risk of thyroid cancer due to low-dose radiation exposure throughout childhood. Several factors can increase the risk of thyroid cancer (ThyCa), such as chromosomal and genetic mutations, iodine intake, TSH levels, autoimmune thyroid disorders, estrogen, obesity, lifestyle changes, and environmental contaminants. OBJECTIVES The study aimed to identify a specific gene as an essential candidate for thyroid cancer progression. We might be able to focus on developing a better understanding of how thyroid cancer is inherited. METHODS The review article uses electronic databases such as PubMed, Google Scholar, Ovid MEDLINE, Embase, and Cochrane Central. The most frequently associated genes with thyroid cancer found on PubMed were BAX, XRCC1, XRCC3, XPO5, IL-10, BRAF, RET, and K-RAS. To perform an electronic literature search, genes derived from DisGeNET: a database of gene-disease associations, including PRKAR1A, BRAF, RET, NRAS, and KRAS, are used. CONCLUSION Examining the genetics of thyroid cancer explicitly emphasizes the primary genes associated with the pathophysiology of young and older people with thyroid cancer. Developing such gene investigations at the beginning of the thyroid cancer development process can identify better outcomes and the most aggressive thyroid cancers.
Collapse
Affiliation(s)
- Iyshwarya Bhaskar Kalarani
- Human Cytogenetics and Genomics Laboratory, Faculty of Allied Health Sciences, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamilnadu, 603103, India
| | - Ganesan Sivamani
- PG & Research Department of Zoology and Biotechnology, AVVM Sri Pushpam College, Poondi, Thanjavur, 613 503, Tamil Nadu, India
| | - Ramakrishnan Veerabathiran
- Human Cytogenetics and Genomics Laboratory, Faculty of Allied Health Sciences, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamilnadu, 603103, India.
| |
Collapse
|
7
|
Tiucă RA, Tiucă OM, Pașcanu IM. The Role of Genetic Polymorphisms in Differentiated Thyroid Cancer: A 2023 Update. Biomedicines 2023; 11:biomedicines11041075. [PMID: 37189693 DOI: 10.3390/biomedicines11041075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/24/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
Thyroid cancer is the most common endocrine malignancy, with an increasing trend in the past decades. It has a variety of different histological subtypes, the most frequent one being differentiated thyroid cancer, which refers to papillary carcinoma, the most common histological type, followed by follicular carcinoma. Associations between genetic polymorphisms and thyroid cancer have been investigated over the years and are an intriguing topic for the scientific world. To date, the results of associations of single nucleotide polymorphisms, the most common genetic variations in the genome, with thyroid cancer have been inconsistent, but many promising results could potentially influence future research toward developing new targeted therapies and new prognostic biomarkers, thus consolidating a more personalized management for these patients. This review focuses on emphasizing the existing literature data regarding genetic polymorphisms investigated for their potential association with differentiated thyroid cancer and highlights the opportunity of using genetic variations as biomarkers of diagnosis and prognosis for thyroid cancer patients.
Collapse
Affiliation(s)
- Robert Aurelian Tiucă
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
- Department of Endocrinology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
- Compartment of Endocrinology, Mures County Clinical Hospital, 540139 Targu Mures, Romania
| | - Oana Mirela Tiucă
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
- Department of Dermatology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
- Dermatology Clinic, Mures County Clinical Hospital, 540015 Targu Mures, Romania
| | - Ionela Maria Pașcanu
- Department of Endocrinology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
- Compartment of Endocrinology, Mures County Clinical Hospital, 540139 Targu Mures, Romania
| |
Collapse
|
8
|
Incidental Papillary Microcarcinoma and Papillary Thyroid Carcinoma in Multinodular Goiter. Anal Cell Pathol (Amst) 2023; 2023:2768344. [PMID: 36691406 PMCID: PMC9867591 DOI: 10.1155/2023/2768344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
Introduction This study aimed to examine the incidence of incidental papillary microcarcinoma (PMC) and papillary thyroid carcinoma (PTC) in patients with benign multinodular goiter (MNG) and to compare their relationship with some prognostic factors from a new perspective. Methods Bilateral total thyroidectomy (BTT) was used to evaluate the data of 716 patients who underwent a surgery for MNG. The prognostic data for these tumors and the relationship between patients with bilateral and multifocal tumors were evaluated using statistical tests. Results Papillary carcinomas were detected in 201 patients, PMC in 134 of them, and PTCs in 67. Bilaterality was more common in patients with PTCs than in those with PMC. The incidence of bilaterality in male patients with PTC was statistically more common. The presence of intra-tumoral lymphocytes was higher in multifocal PTC cases than in unifocal PTC cases. Conclusion The results revealed that the number of PMC s was high in incidental tumors, and patients with PTC with male sex, bilaterality, multifocality, and tumor capsule invasion were associated with poor prognosis.
Collapse
|
9
|
Li J, Liu Y, Jin J, Shi Q, Ji Y, Zhang B, Hu P. Study on Clinicopathological Features and Risk Factors of Patients with Multiple Primary Breast Cancers and Thyroid Disease. Mediators Inflamm 2023; 2023:3133554. [PMID: 37152372 PMCID: PMC10156457 DOI: 10.1155/2023/3133554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/24/2023] [Accepted: 04/09/2023] [Indexed: 05/09/2023] Open
Abstract
Objective To explore the clinicopathological features and risk factors of patients with multiple primary breast cancers and thyroid disease. Method An analytic approach of the reviewing method was adopted to analyze the clinical data of 80 breast cancer patients who were admitted to our hospital from January 2020 to January 2022. They were divided into an observation group (breast cancer with thyroid lesions) and a control group (simple breast cancer) according to whether the clinical data were accompanied with thyroid lesions to compare the clinical characteristics, pathological types, staging characteristics, and molecular biological characteristics of the two groups and to research the risk factors of the two groups. Result (1) In the comparison of clinical data, the number of people aged ≥60 in the observation group was higher than that in the control group, and there was significant difference between the groups in the menopausal status data (P < 0.05). There was no statistical difference between the observation group and the control group in the comparison of clinical data of the body mass index, pregnancy frequency, labor frequency, and abortion history (P > 0.05). (2) In the comparison of pathological type and staging data, there was no statistical difference in the comparison of data on the pathological type, histological grade, T staging, N staging, and TNM staging between the observation group and the control group (P > 0.05). (3) In the comparison of data on molecular biology characteristics, there was a statistical difference in the nuclear proliferation antigen data between the observation group and the control group (P < 0.05). There was no statistical difference in the comparison of data on the estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2, and molecular typing between the observation group and the control group (P > 0.05). (4) Logistic regression analysis showed that age, menopausal status, and nuclear proliferation antigen index were the high-risk inflammatory factors for combined thyroid lesions (P < 0.05). Conclusion For patients with simple breast cancer, age, menopausal status, and nuclear proliferation antigen index are risk factors for combined thyroid lesions. Therefore, clinical attention should be paid to the above factors in the process of clinical treatment, and early-risk screening should be performed to achieve the purpose of improving the prognosis to the greatest extent.
Collapse
Affiliation(s)
- Jie Li
- Cangzhou Central Hospital, Cangzhou 061000, China
| | - Yonghong Liu
- Cangzhou Central Hospital, Cangzhou 061000, China
| | - Jian Jin
- Cangzhou Central Hospital, Cangzhou 061000, China
| | - Qingfeng Shi
- Cangzhou Central Hospital, Cangzhou 061000, China
| | - Yanting Ji
- Cangzhou Central Hospital, Cangzhou 061000, China
| | - Bo Zhang
- Cangzhou Central Hospital, Cangzhou 061000, China
| | - Pengfei Hu
- Hebei Medical University, Shijiazhuang 050017, China
| |
Collapse
|
10
|
Osorio-Covo C, Ballestas-Barrera J, Correa-Palacio J, Zambrano-Pacheco V, Rosales-Becerra A, Camargo-Martínez W, Barrios-Castellar D, Ortega-Caballero D, Herrera-Sáenz F. Association between chronic lymphocityc thyroiditis and papillary thyroid carcinoma: Systematic review and meta-analysis of studies on surgical specimens. REVISTA COLOMBIANA DE CIRUGÍA 2022. [DOI: 10.30944/20117582.2228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Introduction. Inconsistent results exist in the literature regarding the hypothesis statement suggesting an increased likelihood of documenting papillary thyroid carcinoma (PTC) in surgical specimens with changes compatible with chronic lymphocytic thyroiditis. Existing meta-analyses have included studies that are not methodologically comparable and do not propose clear sources of bias, thus, this is justification for the present meta-analysis.
Methods. A literature search in PubMed and Embase was performed from January 1, 1950 to December 31, 2020. Retrospective studies comparing the prevalence of papillary thyroid carcinoma in specimens with and without chronic lymphocytic thyroiditis changes were obtained. The collected evidence was statistically analyzed.
Results. A total of 22 articles were included. The study population consisted of 63,548 surgical specimens. The pooled OR, based on the studies, was 1.81 (95% CI: 1.51-2.21). There was heterogeneity between the distribution of prevalence ratios and opportunity ratios across studies (I²= 91%; p>0.00001). The funnel plot shape of the studies included in the analysis appears to be symmetrical, indicating the absence of bias attributable to small studies.
Conclusions. The current literature suggests that there is an increased risk of documenting papillary thyroid carcinoma in surgical specimens in which chronic lymphocytic thyroiditis-compatible changes are observed; however, there are sources of bias that will not be possible to control for in retrospective studies, so we recommend studying the hypothesis suggesting an increased likelihood of diagnosing PTC in specimens with chronic lymphocytic thyroiditis-compatible changes using prospective methodologies.
Collapse
|
11
|
Wen J, Zhang W, Shi L, Zhou S, Zhou Y, Zhang M, Luo L, Zhou J. Amiodarone-drove XBP1s aggravates endoplasmic reticulum stress and apoptosis in Hashimoto’s thyroiditis through regulating LINC00842/miR-214/FASL axis. Int Immunopharmacol 2022; 113:109298. [DOI: 10.1016/j.intimp.2022.109298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/31/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022]
|
12
|
Wang X, Pan N, Cao J, Du W, Zhang W, Cao S. An Analysis of Clinical and Pathological Characteristics of 14431 Cases of Thyroid Carcinoma. INTERNATIONAL JOURNAL OF SURGERY: ONCOLOGY 2022. [DOI: 10.29337/ijsonco.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
13
|
García González L, García Pascual L. Clinical usefulness of thyroid ultrasonography in patients with primary hypothyroidism. ENDOCRINOL DIAB NUTR 2022; 69:686-693. [PMID: 36428205 DOI: 10.1016/j.endien.2021.11.037] [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: 07/08/2021] [Accepted: 11/04/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Despite the value of ultrasonography in the detection of chronic thyroiditis (CT) as well as in nodular goitre, it is often only indicated in patients with hypothyroidism if a palpable goitre or a thyroid mass is identified. The objective of the study is to evaluate the clinical usefulness of thyroid ultrasonography in patients with primary hypothyroidism without clinical suspicion of nodular goitre. And more specifically, to analyse its value in the aetiological diagnosis of hypothyroidism, and to evaluate its contribution in the detection and characterisation of coexisting subclinical thyroid nodular disease. PATIENTS AND METHOD Prospective cross-sectional observational study of 114 patients with primary hypothyroidism of CT or idiopathic aetiology, without symptoms or cervical palpation suspected of nodular goitre, who underwent a thyroid function test, a serological study of antithyroid antibodies, a thyroid ultrasonound and, when appropriate, a cytological study of the nodules found. RESULTS Ultrasonound allowed CT to be recognised as the cause of hypothyroidism in 19% of patients who had a negative serological study, and detected nodules larger than 9mm in 22 patients (16 with antithyroid antibodies). A cytological study was performed in 18 of the cases. Five patients underwent surgery, with carcinoma found in two of them. CONCLUSIONS Thyroid ultrasound is useful in the aetiological diagnosis of primary hypothyroidism as well as in the detection of a coexisting, unsuspected, but clinically relevant nodular goitre, so this examination should be indicated in the initial study of patients with primary hypothyroidism.
Collapse
Affiliation(s)
- Lluís García González
- Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Luis García Pascual
- Unidad de Endocrinología, Centre Mèdic Àptima Mútua de Terrasa, Terrassa, Barcelona, Spain.
| |
Collapse
|
14
|
Xu H, Hu X, Li J, Nie Z, Kang S, Liu H, Wang Y, Jia X, Lyu Z. The Inverse Association of Serum Magnesium with Papillary Thyroid Cancer in Thyroid Nodules: a Cross-Sectional Survey Based on Thyroidectomy Population. Biol Trace Elem Res 2022; 201:3279-3289. [PMID: 36227448 DOI: 10.1007/s12011-022-03448-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 10/04/2022] [Indexed: 11/02/2022]
Abstract
Magnesium is considered to play a role in preventing cancer. However, the association between serum magnesium and papillary thyroid cancer (PTC) remains unknown. We retrospectively reviewed records of all patients who underwent thyroidectomy with thyroid nodules confirmed pathologically as benign nodule or PTC at our institution from January 2016 to December 2020. Data including demographic characteristics, laboratory tests, and pathological features were analyzed in 5709 adult patients eventually. The subjects with benign nodules had a higher mean serum magnesium level than those with PTC (P < 0.001), and the proportions of PTCs decreased across quartiles of serum magnesium within the normal range. After adjustment for confounders, patients with the lowest quartile of serum magnesium had a higher prevalence of PTC than those with the highest quartile (OR = 1.421, 95%CI: 1.125-1.795, P for trend = 0.005), and the risk of PTC was 0.863 (95%CI: 0.795-0.936) for a per-SD change in serum magnesium. The contribution of serum magnesium remained in subgroup analysis (P for interaction for all analyses > 0.05). Based on the ROC curve, the cut-off value of serum magnesium used to differentiate benign nodules from PTCs was 935 μmol/L. Combining serum magnesium with other clinical indicators can improve the efficacy of predicting PTC. Our results showed that lower serum magnesium within the normal range was associated with a greater risk of PTC among patients with thyroid nodules considering thyroidectomy. Serum magnesium may be an independent protective factor against PTC and provide additional information on the odds of malignancy in uncertain thyroid nodules in combination with other clinical factors.
Collapse
Affiliation(s)
- Huaijin Xu
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Xiaodong Hu
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
| | - Jiefei Li
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Zhimei Nie
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
| | - Shaoyang Kang
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
| | - Hongzhou Liu
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
| | - Yuhan Wang
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
| | - Xiaomeng Jia
- Center for Endocrine Metabolism and Immune Disease, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China
| | - Zhaohui Lyu
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China.
- School of Medicine, Nankai University, Tianjin, 300071, China.
| |
Collapse
|
15
|
Hu X, Chen Y, Shen Y, Tian R, Sheng Y, Que H. Global prevalence and epidemiological trends of Hashimoto's thyroiditis in adults: A systematic review and meta-analysis. Front Public Health 2022; 10:1020709. [PMID: 36311599 PMCID: PMC9608544 DOI: 10.3389/fpubh.2022.1020709] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/29/2022] [Indexed: 01/28/2023] Open
Abstract
Objective Although Hashimoto's thyroiditis is associated with cardiovascular disease and malignancy, the global status of Hashimoto's thyroiditis is not well characterized across regions. Our objective was to evaluate the prevalence and trends of Hashimoto's thyroiditis in adults in regions with different economic income levels around the world. Methods For this systematic review and meta-analysis, we searched PubMed, Embase, MEDLINE, Scopus, and Web of Science databases, and 48 random-effects representative studies from the inception to June 2022 were included without language restrictions to obtain the overall prevalence of Hashimoto's thyroiditis in adults worldwide. In addition, we stratified by time of publication, geographic region, economic level of the region of residence, gender, diagnostic method, etc. Results A total of 11,399 studies were retrieved, of which 48 met the research criteria: 20 from Europe, 16 from Asia, five from South America, three from North America, and three from Africa. Furthermore, there are two projects involving 19 countries and 22,680,155 participants. The prevalence of Hashimoto's thyroiditis was 7.5 (95%CI 5.7-9.6%), while in the low-middle-income group the prevalence was 11.4 (95%CI 2.5-25.2%). Similarly, the prevalence was 5.6 (95%Cl 3.9-7.4%) in the upper-middle-income group, and in the high-income group, the prevalence was 8.4 (95%Cl 5.6-11.8). The prevalence of Hashimoto's varied by geographic region: Africa (14.2 [95% CI 2.5-32.9%]), Oceania (11.0% [95% CI 7.8-14.7%]), South America and Europe 8.0, 7.8% (95% Cl 0.0-29.5%) in North America, and 5.8 (95% Cl 2.8-9.9%) in Asia. Although our investigator heterogeneity was high (I2), our results using a sensitivity analysis showed robustness and reliability of the findings. People living in low-middle-income areas are more likely to develop Hashimoto's thyroiditis, while the group in high-income areas are more likely to develop Hashimoto's thyroiditis than people in upper-middle-income areas, and women's risk is about four times higher than men's. Conclusions Global Hashimoto's thyroiditis patients are about four times as many as males, and there are discrepancies in the regions with different economic levels. In low-middle-income areas with a higher prevalence of Hashimoto's thyroiditis, especially countries in Africa, therefore local health departments should take strategic measures to prevent, detect, and treat Hashimoto's thyroiditis. At the same time, the hidden medical burden other diseases caused by Hashimoto's thyroiditis should also be done well. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD 42022339839.
Collapse
Affiliation(s)
- Xiaojie Hu
- Department of Traditional Chinese Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China,Longhua Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuquan Chen
- Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yiting Shen
- Department of Traditional Chinese Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rui Tian
- Department of Traditional Chinese Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuqin Sheng
- Department of Traditional Chinese Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huafa Que
- Department of Traditional Chinese Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China,Longhua Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China,*Correspondence: Huafa Que
| |
Collapse
|
16
|
Cappellacci F, Canu GL, Lai ML, Lori E, Biancu M, Boi F, Medas F. Association between hashimoto thyroiditis and differentiated thyroid cancer: A single-center experience. Front Oncol 2022; 12:959595. [PMID: 35965566 PMCID: PMC9366466 DOI: 10.3389/fonc.2022.959595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/30/2022] [Indexed: 12/29/2022] Open
Abstract
Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the iodine-sufficient areas of the world. Differentiated thyroid cancer is the most common thyroid cancer subtype, accounting for more than 95% of cases, and it is considered a tumor with a good prognosis, although a certain number of patients experience a poor clinical outcome. Hashimoto’s thyroiditis has been found to coexist with differentiated thyroid cancer in surgical specimens, but the relationship between these two entities has not yet been clarified. Our study aims to analyze the relationship between these two diseases, highlighting the incidence of histological diagnosis of Hashimoto thyroiditis in differentiated thyroid cancer patients, and assess how this autoimmune disorder influences the risk of structural disease recurrence and recurrence rate.
Collapse
Affiliation(s)
- Federico Cappellacci
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
- *Correspondence: Federico Cappellacci,
| | - Gian Luigi Canu
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Maria Letizia Lai
- Department of Cytomorphology, University of Cagliari, Cagliari, Italy
| | - Eleonora Lori
- Department of Surgical Science, Sapienza University of Rome, Rome, Italy
| | - Miriam Biancu
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Francesco Boi
- Endocrinology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Fabio Medas
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| |
Collapse
|
17
|
Deep learning to diagnose Hashimoto's thyroiditis from sonographic images. Nat Commun 2022; 13:3759. [PMID: 35768466 PMCID: PMC9243092 DOI: 10.1038/s41467-022-31449-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/17/2022] [Indexed: 11/08/2022] Open
Abstract
Hashimoto's thyroiditis (HT) is the main cause of hypothyroidism. We develop a deep learning model called HTNet for diagnosis of HT by training on 106,513 thyroid ultrasound images from 17,934 patients and test its performance on 5051 patients from 2 datasets of static images and 1 dataset of video data. HTNet achieves an area under the receiver operating curve (AUC) of 0.905 (95% CI: 0.894 to 0.915), 0.888 (0.836-0.939) and 0.895 (0.862-0.927). HTNet exceeds radiologists' performance on accuracy (83.2% versus 79.8%; binomial test, p < 0.001) and sensitivity (82.6% versus 68.1%; p < 0.001). By integrating serologic markers with imaging data, the performance of HTNet was significantly and marginally improved on the video (AUC, 0.949 versus 0.888; DeLong's test, p = 0.004) and static-image (AUC, 0.914 versus 0.901; p = 0.08) testing sets, respectively. HTNet may be helpful as a tool for the management of HT.
Collapse
|
18
|
Abstract
Background: Sex dimorphism strongly impacts tumor biology, with most cancers having a male predominance. Uniquely, thyroid cancer (TC) is the only nonreproductive cancer with striking female predominance with three- to four-fold higher incidence among females, although males generally have more aggressive disease. The molecular basis for this observation is not known, and current approaches in treatment and surveillance are not sex specific. Summary: Although TC has overall good prognosis, 6-20% of patients develop regional or distant metastasis, one third of whom are not responsive to conventional treatment approaches and suffer a 10-year survival rate of only 10%. More efficacious treatment strategies are needed for these aggressive TCs, as tyrosine kinase inhibitors and immunotherapy have major toxicities without demonstrable overall survival benefit. Emerging evidence indicates a role of sex hormones, genetics, and the immune system in modulation of both risk for TC and its progression in a sex-specific manner. Conclusion: Greater understanding of the molecular mechanisms underlying sex differences in TC pathogenesis could provide insights into the development of sex-specific, targeted, and effective strategies for prevention, diagnosis, and management. This review summarizes emerging evidence for the importance of sex in the pathogenesis, progression, and response to treatment in differentiated TC with emphasis on the role of sex hormones, genetics, and the immune system.
Collapse
Affiliation(s)
- Leila Shobab
- MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Kenneth D Burman
- MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Leonard Wartofsky
- Medstar Health Research Institute, Washington, District of Columbia, USA
| |
Collapse
|
19
|
García González L, García Pascual L. Utilidad clínica de la ecografía tiroidea en los pacientes con hipotiroidismo primario. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
20
|
Hu Q, Zhang WJ, Liang L, Li LL, Yin W, Su QL, Lin FF. Establishing a Predictive Nomogram for Cervical Lymph Node Metastasis in Patients With Papillary Thyroid Carcinoma. Front Oncol 2022; 11:766650. [PMID: 35127475 PMCID: PMC8809373 DOI: 10.3389/fonc.2021.766650] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/27/2021] [Indexed: 01/21/2023] Open
Abstract
Objectives The purpose of this study was to establish a nomogram for predicting cervical lymph node metastasis (CLNM) in patients with papillary thyroid carcinoma (PTC). Materials and Methods A total of 418 patients with papillary thyroid carcinoma undergoing total thyroidectomy with cervical lymph node dissection were enrolled in the retrospective study from January 2016 to September 2019. Univariate and multivariate Logistic regression analysis were performed to screen the clinicopathologic, laboratory and ultrasound (US) parameters influencing cervical lymph nodes metastasis and develop the predicting model. Results CLNM was proved in 34.4% (144/418) of patients. In the multivariate regression analysis, Male, Age < 45 years, Tumor size > 20mm, multifocality, ambiguous boundary, extracapsular invasion and US-suggested lymph nodes metastasis were independent risk factors of CLNM (p < 0.05). Prediction nomogram showed an excellent discriminative ability, with a C-index of 0.940 (95% confidence interval [CI], 0.888-0.991), and a good calibration. Conclusion The established nomogram showed a good prediction of CLNM in patients with PTC. It is conveniently used and should be considered in the determination of surgical procedures.
Collapse
Affiliation(s)
- Qiao Hu
- Department of Ultrasound, The People’s Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
- *Correspondence: Qiao Hu,
| | - Wang-Jian Zhang
- School of Public Health, Sun Yet-Sen University, Guangzhou, China
| | - Li Liang
- Department of Ultrasound, The People’s Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
| | - Ling-Ling Li
- Department of Ultrasound, The People’s Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
| | - Wu Yin
- Department of Pathology, The People’s Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
| | - Quan-Li Su
- Department of Ultrasound, The People’s Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
| | - Fei-Fei Lin
- Department of Ultrasound, The People’s Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
| |
Collapse
|
21
|
Jin P, Chen J, Dong Y, Zhang C, Chen Y, Zhang C, Qiu F, Zhang C, Huang P. Ultrasound-based radiomics nomogram combined with clinical features for the prediction of central lymph node metastasis in papillary thyroid carcinoma patients with Hashimoto's thyroiditis. Front Endocrinol (Lausanne) 2022; 13:993564. [PMID: 36060946 PMCID: PMC9439618 DOI: 10.3389/fendo.2022.993564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/08/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Hashimoto thyroiditis (HT) is the most common autoimmune thyroid disease and is considered an independent risk factor for papillary thyroid carcinoma (PTC), with a higher incidence of PTC in patients with HT. OBJECTIVE To build an integrated nomogram using clinical information and ultrasound-based radiomics features in patients with papillary thyroid carcinoma (PTC) with Hashimoto thyroiditis (HT) to predict central lymph node metastasis (CLNM). METHODS In total, 235 patients with PTC with HT were enrolled in this study, including 101 with CLNM and 134 without CLNM. They were divided randomly into training and validation datasets with a 7:3 ratio for developing and evaluating clinical features plus conventional ultrasound features (Clin-CUS) model and clinical features plus radiomics scores (Clin-RS) model, respectively. In the Clin-RS model, the Pyradiomics package (V1.3.0) was used to extract radiomics variables, and LASSO regression was used to select features and construct radiomics scores (RS). The Clin-CUS and Clin-RS nomogram models were built using logistic regression analysis. RESULTS Twenty-seven CLNM-associated radiomics features were selected using univariate analysis and LASSO regression from 1488 radiomics features and were calculated to construct the RS. The integrated model (Clin-RS) had better diagnostic performance than the Clin-CUS model for differentiating CLNM in the training dataset (AUC: 0.845 vs. 0.778) and the validation dataset (AUC: 0.808 vs. 0.751), respectively. CONCLUSION Our findings suggest that applying an ultrasound-based radiomics approach can effectively predict CLNM in patients with PTC with HT. By incorporating clinical information and RS, the Clin-RS model can achieve a high diagnostic performance in diagnosing CLNM in patients with PTC with HT.
Collapse
Affiliation(s)
- Peile Jin
- Department of Ultrasound in Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
- Research Center of Ultrasound in Medicine and Biomedical Engineering, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Jifan Chen
- Department of Ultrasound in Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
- Research Center of Ultrasound in Medicine and Biomedical Engineering, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Yiping Dong
- Department of Ultrasound in Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
- Research Center of Ultrasound in Medicine and Biomedical Engineering, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Chengyue Zhang
- Department of Ultrasound in Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
- Research Center of Ultrasound in Medicine and Biomedical Engineering, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Yajun Chen
- Department of Ultrasound in Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
- Research Center of Ultrasound in Medicine and Biomedical Engineering, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Cong Zhang
- Department of Ultrasound in Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
- Research Center of Ultrasound in Medicine and Biomedical Engineering, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Fuqiang Qiu
- Department of Ultrasound in Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
- Research Center of Ultrasound in Medicine and Biomedical Engineering, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Chao Zhang
- Department of Ultrasound in Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
- Research Center of Ultrasound in Medicine and Biomedical Engineering, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Pintong Huang
- Department of Ultrasound in Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
- Research Center of Ultrasound in Medicine and Biomedical Engineering, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang University, Hangzhou, China
- Research Center for Life Science and Human Health, Binjiang Institute of Zhejiang University, Hangzhou, China
- *Correspondence: Pintong Huang,
| |
Collapse
|
22
|
Feng N, Wei P, Kong X, Xu J, Yao J, Cheng F, Ou D, Wang L, Xu D, Han Z. The value of ultrasound grayscale ratio in the diagnosis of papillary thyroid microcarcinomas and benign micronodules in patients with Hashimoto's thyroiditis: A two-center controlled study. Front Endocrinol (Lausanne) 2022; 13:949847. [PMID: 36034442 PMCID: PMC9412962 DOI: 10.3389/fendo.2022.949847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The value of ultrasound grayscale ratio (UGSR) in the diagnosis of papillary thyroid microcarcinomas (PTMCs) and benign micronodules (BMNs) has been recognized by some authors, but studies have not examined these aspects in patients with Hashimoto's thyroiditis (HT). This retrospective study investigated the value of UGSR in the diagnosis of PTMCs and BMNs in patients with HT using data from two medical centers. METHODS Ultrasound images of 428 PTMCs in 368 patients with HT and 225 BMNs in 181 patients with HT in center A were retrospectively analyzed and compared to the ultrasound images of 412 PTMCs in 324 patients with HT and 315 BMNs in 229 patients with HT in medical center B. All of the cases were surgically confirmed. The UGSR was calculated as the ratio of the grayscale value of lesions to the surrounding normal thyroid tissues. The optimal UGSR thresholds for the PTMCs and BMNs in patients with HT from the two medical centers were determined using a receiver operating characteristic (ROC) curve. Furthermore, other statistics, including the area under the curve (AUC), the optimal UGSR threshold, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of the two medical centers, were pair analyzed in this study. RESULTS The UGSR of PTMCs and BMNs in patients with HT from medical center A were 0.513 (0.442, 0.592) and 0.857 (0.677, 0.977) (Z = -15.564, p = 0), and those from medical center B were 0.514 (0.431, 0.625) and 0.917 (0.705, 1.131) (Z = -15.564, p = 0). For both medical centers A and B, the AUC, optimal UGSR threshold, sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the UGSR in differentiating between PTMCs and BMNs in patients with HT were 0.870 and 0.889, 0.68 and 0.70, 0.921 and 0.898, 0.747 and 0.759, 0.874 and 0.829, 0.832 and 0.848, and 0.861 and 0.836, respectively. There were no significant differences in the UGSR for the PTMCs between patients from the two medical centers (Z = -0.815, p = 0.415), while there was a significant difference in the UGSR of the BMNs between patients from the two medical centers (Z = -3.637, p = 0). CONCLUSION In the context of HT, UGSR still has high sensitivity, accuracy, and stability in differentiating between PTMCs and BMNs, making it a complementary differentiator of thyroid imaging reporting and data systems. However, due to its low specificity, a comprehensive analysis of other ultrasound signs is required.
Collapse
Affiliation(s)
- Na Feng
- Department of Ultrasound, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Peiying Wei
- Department of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiangkai Kong
- Department of Ultrasound, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Jingjing Xu
- Department of Pathology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - Jincao Yao
- Department of Ultrasound, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
- Research Center for Cancer Intelligent Diagnosis and Molecular Technology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - Fang Cheng
- Department of Ultrasound, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Di Ou
- Department of Ultrasound, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Liping Wang
- Department of Ultrasound, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Dong Xu
- Department of Ultrasound, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
- Research Center for Cancer Intelligent Diagnosis and Molecular Technology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- *Correspondence: Dong Xu, ; Zhijiang Han,
| | - Zhijiang Han
- Department of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Dong Xu, ; Zhijiang Han,
| |
Collapse
|
23
|
Hu X, Wang X, Liang Y, Chen X, Zhou S, Fei W, Yang Y, Que H. Cancer Risk in Hashimoto's Thyroiditis: a Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2022; 13:937871. [PMID: 35903279 PMCID: PMC9318815 DOI: 10.3389/fendo.2022.937871] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/09/2022] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Research data suggest that patients with Hashimoto's thyroiditis may increase the risk of cancer. However, existing research is inconsistent with this view. Therefore, to investigate the effect of Hashimoto's thyroiditis on the risk of developing cancer, we conducted this study. METHODS We searched the PubMed and Embase databases from database establishment until March 2022. After rigorous literature screening by two authors, 23 studies that met the inclusion criteria were identified, and the required data were independently extracted. RESULTS We retrieved 3591 records, and after the screening, 11 case-control studies and 12 cohort studies were included in the analysis. Data analysis suggested that patients with Hashimoto's thyroiditis had an increased risk of developing breast cancer, urogenital cancer, digestive organs cancer, hematologic cancer, and a low risk of respiratory cancers. CONCLUSIONS This systematic review and meta-analysis showed that patients with HT may have a significantly increased risk of thyroid cancer, breast cancers, lung cancer, digestive system cancer, urogenital cancers, blood cancers, and prolactinoma people without HT. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier CRD 42022320741.
Collapse
Affiliation(s)
- Xiaojie Hu
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xuanyu Wang
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yue Liang
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xin Chen
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Siyuan Zhou
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenting Fei
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuxin Yang
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huafa Que
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Huafa Que,
| |
Collapse
|
24
|
Mao L, Zheng C, Ou S, He Y, Liao C, Deng G. Influence of Hashimoto thyroiditis on diagnosis and treatment of thyroid nodules. Front Endocrinol (Lausanne) 2022; 13:1067390. [PMID: 36619577 PMCID: PMC9816323 DOI: 10.3389/fendo.2022.1067390] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND As the prevalence of Hashimoto's thyroiditis (HT) and thyroid cancer (TC) has been increasing dramatically in recent years, the association between the two diseases has been widely debated and studied. However, no consistent findings are available and the relationship remains controversial. In this study, we analyzed the influence of HT on the diagnosis and treatment of thyroid nodules and investigated the relationship between HT and TC. METHODS From Jan 2017 to Apr 2021, 4678 patients underwent thyroid surgery were collected. Of these patients, 440 were diagnosed with HT (242 nodular goiter (NG) with HT, 198 TC with HT). These patients were grouped when appropriate and the data from these patients were statistically analyzed by using SPSS and GraphPad Prism 6. RESULTS HT occurred in 198 of 1089 (18.2%) TC patients and 242 of 3589 (6.74%) patients without TC (p=0.000). In terms of the ultrasonography features, in the NG with HT group, 33.1% (80/242) of patients had fine calcification and 45.9% (111/242) of patients whose TI-RADS classification were > Level 3. In the isolated PTC group, 32.3% (2343/7260) LN were metastasis-positive while in the NG with HT group, only 26.0% (504/1939) LN were metastasis-positive (P=0.000). The proportion of PTMC was significantly higher (P=0.000), while the proportion of multifocal carcinoma was significantly lower when coexisting with HT (P=0.029). When comparing the data from the two groups diagnosed as PTMC coexisting with HT or not, there was no significant difference in the composition ratio of tumor number, LN metastasis, LN dissection area, regional LN metastasis and number of negative/positive LN (P=0.614, P=0.051, P=0.139, P=0.350, P=1.000 and P=0.333 respectively). In the MPTC group, 42.2% (872/2065) LN were metastasis-positive while in the MPTC with HT group, only 23.6% (50/212) LN were metastasis-positive (P=0.000). CONCLUSIONS Our data suggested that HT is associated with an increased risk of developing TC but may be a protective factor against PTC progression and metastasis. The coexistence of HT affects the judgment of thyroid nodules by ultrasonography.
Collapse
Affiliation(s)
- Linfeng Mao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of GuangXi Medical University, Nanning, Guangxi, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
- Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
| | - Chunmei Zheng
- Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shengzhao Ou
- Department of General Surgery, The Hepu People’s Hospital, Beihai, Guangxi, China
| | - Youwu He
- Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Chuanjie Liao
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Ganlu Deng
- Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- *Correspondence: Ganlu Deng,
| |
Collapse
|
25
|
Benvenga S, Famà F, Perdichizzi LG, Antonelli A, Brenta G, Vermiglio F, Moleti M. Fish and the Thyroid: A Janus Bifrons Relationship Caused by Pollutants and the Omega-3 Polyunsaturated Fatty Acids. Front Endocrinol (Lausanne) 2022; 13:891233. [PMID: 35712237 PMCID: PMC9196333 DOI: 10.3389/fendo.2022.891233] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/21/2022] [Indexed: 12/20/2022] Open
Abstract
Benefits of the omega-3 polyunsaturated fatty acids (PUFA) on a number of clinical disorders, including autoimmune diseases, are widely reported in the literature. One major dietary source of PUFA are fish, particularly the small oily fish, like anchovy, sardine, mackerel and others. Unfortunately, fish (particularly the large, top-predator fish like swordfish) are also a source of pollutants, including the heavy metals. One relevant heavy metal is mercury, a known environmental trigger of autoimmunity that is measurable inside the thyroid. There are a number of interactions between the omega-3 PUFA and thyroid hormones, even at the level of the thyroid hormone transport proteins. Concerning the mechanisms behind the protection from/amelioration of autoimmune diseases, including thyroiditis, that are caused by the omega-3 PUFA, one can be the decreased production of chemokines, a decrease that was reported in the literature for other nutraceuticals. Recent studies point also to the involvement of resolvins. The intracellular increase in resolvins is associated with the tissue protection from inflammation that was observed in experimental animals after coadministration of omega-3 PUFA and thyroid hormone. After having presented data on fish consumption at the beginning, we conclude our review by presenting data on the market of the dietary supplements/nutraceuticals. The global omega-3 products market was valued at USD 2.10 billion in 2020, and was projected to go up at a compound annual growth rate of 7.8% from 2020 to 2028. Among supplements, fish oils, which are derived mainly from anchovies, are considered the best and generally safest source of omega-3. Taking into account (i) the anti-autoimmunity and anti-cancer properties of the omega-3 PUFA, (ii) the increasing incidence of both autoimmune thyroiditis and thyroid cancer worldwide, (iii) the predisposing role for thyroid cancer exerted by autoimmune thyroiditis, and (iv) the risk for developing metabolic and cardiovascular disorders conferred by both elevated/trendwise elevated serum TSH levels and thyroid autoimmunity, then there is enough rationale for the omega-3 PUFA as measures to contrast the appearance and/or duration of Hashimoto's thyroiditis as well as to correct the slightly elevated serum TSH levels of subclinical hypothyroidism.
Collapse
Affiliation(s)
- Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Fausto Famà
- Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
- *Correspondence: Fausto Famà, ;
| | | | - Alessandro Antonelli
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Gabriela Brenta
- Division of Endocrinology, Dr. Cesar Milstein Hospital, Buenos Aires, Argentina
| | - Francesco Vermiglio
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Mariacarla Moleti
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| |
Collapse
|
26
|
Abbasgholizadeh P, Naseri A, Nasiri E, Sadra V. Is Hashimoto thyroiditis associated with increasing risk of thyroid malignancies? A systematic review and meta-analysis. Thyroid Res 2021; 14:26. [PMID: 34861884 PMCID: PMC8641157 DOI: 10.1186/s13044-021-00117-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/16/2021] [Indexed: 11/21/2022] Open
Abstract
Background and purpose Hashimoto thyroiditis (HT) is the most common inflammatory autoimmune thyroid disease and also the most common cause of hypothyroidism in developed countries. There is evidence of the role of HT in developing thyroid cancers (TCs). This study investigated the association between HT and different types of TCs. Methods Results of a comprehensive search in three major databases, as well as hand searching, were screened in title/abstract and full-text stages and the relevant data were extracted from the studies that met the inclusion criteria. Risk of bias (RoB) was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools and the meta-analysis was conducted with Comprehensive Meta-Analysis software. Results Out of 4785 records, 50 studies were included in the systematic review, and 27 of them met the criteria for quantitative synthesis. The results indicated a significant role for HT in developing papillary TC (OR: 1.65; 95% CI: 1.04 to 2.61), medullary TC (OR: 2.70; 95% CI: 1.20 to 6.07) and lymphoma (OR:12.92; 95% CI: 2.15 to 77.63); but not anaplastic TC (OR: 1.92; 95% CI: 0.29 to 1.90) and follicular TC (OR: 0.73; 95% CI: 0.41 to 1.27). Also, this study found a significant association between HT and thyroid malignancies (OR: 1.36; 95% CI: 1.05 to 1.77). Conclusion Although we found a significant association between HT and some types of TCs, High RoB studies, high level of heterogeneity, and the limited number of well-designed prospective studies, suggested the need for more studies to reach more reliable evidence. Supplementary Information The online version contains supplementary material available at 10.1186/s13044-021-00117-x.
Collapse
Affiliation(s)
| | - Amirreza Naseri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Nasiri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute (JBI) Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahideh Sadra
- Endocrine Research Center, Tabriz University of Medical Sciences, Golgasht street, Tabriz, Iran.
| |
Collapse
|
27
|
Cardoso-Duarte LCA, Fratelli CF, Pereira ASR, Souza JNGD, Freitas RDS, Morais RMD, Sobrinho AB, Sousa Silva CM, de Oliveira JR, Oliveira DMD, Silva ICR. BAX gene (-248 G > A) polymorphism in a sample of patients diagnosed with thyroid cancer in the Federal District, Brazil. Int J Biol Markers 2021; 36:21-26. [PMID: 34825595 DOI: 10.1177/17246008211057576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Papillary thyroid cancer corresponds to approximately 1% of all carcinomas; nevertheless, it is the most prevalent endocrine neoplasm in the world. Studies reveal that the BAX (-248 G > A) polymorphism may be associated with negative regulation of BAX gene transcription activity, causing a decrease in its protein expression. OBJECTIVE The present study aimed to describe the genotype and allele frequencies of BAX single nucleotide polymorphisms (-248 G > A) (rs4645878) in the research patients, and to associate its presence with susceptibility to papillary thyroid cancer. METHODS This case-control study was conducted with 30 patients with papillary thyroid cancer. For the evaluation of genetic polymorphisms, the polymerase chain reaction-restriction fragment length polymorphism technique was employed. Allele and genotype frequencies were estimated using the SPSS program, and significant associations were considered when p < 0.05. RESULTS There was a significant genotypic difference between papillary thyroid cancer and the control group (p = 0.042). The GG genotype provided a protective factor for papillary thyroid cancer (p = 0.012, odds ratio (OR) = 0.313; confidence interval (CI) = 0.123-0.794). Likewise the G allele was a protective factor for papillary thyroid cancer (p = 0.009; OR = 0.360; CI = 0.163-0.793). The BAX gene polymorphism (-248 G > A) was associated with papillary thyroid cancer. CONCLUSION BAX (-248 G > A) GG genotype carriers, or at least one mutated allele, was associated with papillary thyroid cancer in the Brazilian population studied, and the G allele presence is considered a protective factor against papillary thyroid cancer occurrence.
Collapse
Affiliation(s)
- Ligia C A Cardoso-Duarte
- Programa de Pós-graduação em Ciências e Tecnologias em Saúde - 28127Universidade de Brasília (UnB), Brasília, DF, Brazil
| | - Caroline F Fratelli
- Programa de Pós-graduação em Ciências e Tecnologias em Saúde - 28127Universidade de Brasília (UnB), Brasília, DF, Brazil
| | - Alexandre S R Pereira
- Programa de Pós-graduação em Ciências e Tecnologias em Saúde - 28127Universidade de Brasília (UnB), Brasília, DF, Brazil
| | - Jéssica Nayane Gomes de Souza
- Programa de Pós-graduação em Ciências e Tecnologias em Saúde - 28127Universidade de Brasília (UnB), Brasília, DF, Brazil
| | | | | | | | | | | | - Diêgo Madureira de Oliveira
- Programa de Pós-graduação em Ciências e Tecnologias em Saúde - 28127Universidade de Brasília (UnB), Brasília, DF, Brazil
| | - Izabel Cristina R Silva
- Programa de Pós-graduação em Ciências e Tecnologias em Saúde - 28127Universidade de Brasília (UnB), Brasília, DF, Brazil
| |
Collapse
|
28
|
Masetti R, Tiri A, Tignanelli A, Turrini E, Argentiero A, Pession A, Esposito S. Autoimmunity and cancer. Autoimmun Rev 2021; 20:102882. [PMID: 34229048 DOI: 10.1016/j.autrev.2021.102882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 04/28/2021] [Indexed: 12/20/2022]
Abstract
In many autoimmune rheumatic diseases, there is an increased risk of cancer compared to the general population. The link between autoimmunity and cancer is dynamic and bidirectional. Recent advances in terms of knowledge of biology, epidemiology, and long-term outcomes for the autoimmune rheumatic diseases have revealed several new connections between these two entities. Data suggest that chronic inflammation from the rheumatic diseases or their therapies may contribute to the onset and promotion of cancer. Conversely, antitumor immune responses may become cross-reactive with self-tissues resulting in the development of autoimmunity. In this review, we discuss about the potential mechanisms that link autoimmune rheumatic diseases and cancer and the association of malignancies with common autoimmune disorders. The increased incidence of malignancy in autoimmune rheumatic diseases has been largely described, although the biology underpinning this relationship should be further investigated. The development of evidence-based cancer screening recommendations in patients with autoimmune rheumatic diseases is complex due to the heterogeneity of clinical rheumatic phenotypes, cancer sites at risk and exposure to anti-neoplastic and anti-rheumatic treatment. In order to lay the foundation of risk stratification and targeted cancer screening, larger longitudinal cohort studies that provide a more detailed framework of the links between cancer and autoimmunity are urgently needed.
Collapse
Affiliation(s)
- Riccardo Masetti
- Pediatric Clinic, IRCCS Ospedale Maggiore Policlinico Sant'Orsola, Department of Medicine and Surgery, University of Bologna, Bologna, Italy
| | - Alessandra Tiri
- Pediatric Clinic, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Anna Tignanelli
- Pediatric Clinic, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Elena Turrini
- Pediatric Clinic, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Alberto Argentiero
- Pediatric Clinic, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Andrea Pession
- Pediatric Clinic, IRCCS Ospedale Maggiore Policlinico Sant'Orsola, Department of Medicine and Surgery, University of Bologna, Bologna, Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy.
| |
Collapse
|
29
|
Implications of a background of Hashimoto's thyroiditis on the current conservative surgical trend towards papillary thyroid carcinoma. Updates Surg 2021; 73:1931-1935. [PMID: 34014496 DOI: 10.1007/s13304-021-01087-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/10/2021] [Indexed: 10/21/2022]
Abstract
The purpose is to delineate the clinico-pathologic features of papillary thyroid carcinoma (PTC) occurring in a background of Hashimoto's thyroiditis (HT). A retrospective analysis of consecutive PTC patients who underwent surgery at an academic center between Jan. 2010 and Jan. 2020 was performed. The primary end point was to assess whether a background of HT implied a higher likelihood for postoperatively determined high-risk histopathologic features. Accordingly, its implication on initial surgical planning. Tumor high-risk features included aggressive histologic variants, lymphovascular invasion, extrathyroidal extension, multifocality, and positive nodal metastasis. To achieve the primary outcome of interest, a two group-designation was followed: group A (none-HT-group) and group B (HT-group). The two groups were also compared regarding postoperative complications as a secondary outcome of interest. In the specified period, 331 patients were found to have a histologically proven diagnosis of PTC. Group A accounted for 80% (265/331) of the study cohort, while group B accounted for the remainder 20%. PTC was significantly more prevalent in the absence of HT (p < 0.0001). Both groups were comparable in mean-patient-age. However, Group B demonstrated a considerably higher male:female ratio (1:10 vs. 1:3; p = 0.01). All postoperatively determined high-risk histopathologic features were comparable in both groups (p > 0.05). Nevertheless, transient hypoparathyroidism was considerably higher in group B (12% vs. 23%; p = 0.02). A background of HT does not seem to reflect a more aggressive cancerous biologic behavior. Therefore, it should not preclude the conservative surgical strategy adopted by the most recent clinical practice guidelines.
Collapse
|
30
|
Yue CY, Peng Y, Gao CB, Zhang GS, Zhang F, Dong LL. Relationship between Helicobacter pylori infection and Hashimoto's thyroiditis: A prospective study. Shijie Huaren Xiaohua Zazhi 2021; 29:75-80. [DOI: 10.11569/wcjd.v29.i2.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hashimoto's thyroiditis is the most common autoimmune disease, the incidence of which is increasing year by year, but its etiology and pathogenesis are not very clear. The relationship between Helicobacter pylori (H. pylori) infection and Hashimoto's thyroiditis is a current research hotspot, but whether patients with Hashimoto's thyroiditis should undergo routine screening and eradication of H. pylori remains unclear.
AIM To investigate the relationship between H. pylori infection and Hashimoto's thyroiditis, and to prospectively investigate the benefit of H. pylori eradication in Hashimoto's thyroiditis, in order to provide a reference for the early screening and eradication of H. pylori in patients with Hashimoto's thyroiditis.
METHODS A total of 300 Hashimoto's thyroiditis patients with normal thyroid function who first visited the Thyroid Engineering and Technical Treatment Center of our hospital from January to December 2018 were randomly included. Another 300 matched healthy people from the physical examination center were selected as a control group. Thyroid peroxidase antibody (TPOAb), thyroid globulin antibody (TGAb), and thyroid function were determined by chemiluminescence. H. pylori infection was detected by C-13 urea breath test. The prevalence of Hashimoto's thyroiditis was compared between H. pylori infected and non-infected patients. Titers of TPOAb and TGAb between H. pylori-positive and H. pylori-negative patients in the Hashimoto's thyroiditis group were also compared. H. pylori-positive Hashimoto's thyroiditis patients were randomly divided into a treatment subgroup and non-treatment subgroup; the treatment subgroup received anti-H. pylori treatment, and the non-treatment subgroup did not receive anti-H. pylori treatment. The C13-urea breath test was reviewed 1 mo after the treatment to assess the success of the eradication therapy. The titers of TPOAb and TGAb in the two subgroups were measured 6 and 12 mo after treatment and compared with those before treatment at.
RESULTS The prevalence of Hashimoto's thyroiditis in the H. pylori-positive group was 64.67% (194/300), which was significantly higher than that of the H. pylori-negative group [35.33% (106/300), P < 0.05]. In the Hashimoto's thyroiditis group, TPOAb and TGAb were significantly higher in H. pylori-positive patients than in H. pylori-negative patients. After the eradication of H. pylori in the treatment group, the titers of TPOAb and TGAb decreased significantly (P < 0.05), while the titers did not change significantly in the non-treatment subgroup.
CONCLUSION The infection rate of H. pylori is higher in patients with Hashimoto's thyroiditis. H. pylori infection can increase TPOAb and TGAb titers in patients with Hashimoto's thyroiditis. Eradication of H. pylori significantly reduces TPOAb and TGAb titers in Hashimoto's thyroiditis. Early routine screening for H. pylori infection and aggressive eradication are recommended for patients with Hashimoto's thyroiditis.
Collapse
Affiliation(s)
- Chun-Yan Yue
- Department of Endocrinology, The First Hospital of Zhangjiakou, Zhangjiakou 075000, Hebei Province, China
| | - Yi Peng
- Department of Endocrinology, The First Hospital of Zhangjiakou, Zhangjiakou 075000, Hebei Province, China
| | - Chun-Bin Gao
- Department of Endocrinology, The First Hospital of Zhangjiakou, Zhangjiakou 075000, Hebei Province, China
| | - Gui-Shan Zhang
- Department of Endocrinology, The First Hospital of Zhangjiakou, Zhangjiakou 075000, Hebei Province, China
| | - Fang Zhang
- Physical Examination Center, The First Hospital of Zhangjiakou, Zhangjiakou 075000, Hebei Province, China
| | - Lu-Ling Dong
- Department of Endocrinology, The First Hospital of Zhangjiakou, Zhangjiakou 075000, Hebei Province, China
| |
Collapse
|
31
|
Apostolou K, Zivaljevic V, Tausanovic K, Zoric G, Chelidonis G, Slijepcevic N, Jovanovic M, Paunovic I. Prevalence and risk factors for thyroid cancer in patients with multinodular goitre. BJS Open 2020; 5:6054049. [PMID: 33688954 PMCID: PMC7944849 DOI: 10.1093/bjsopen/zraa014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/25/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Rates of thyroid cancer in patients with multinodular goitre (MNG) vary widely, from 3 per cent in older studies to 35 per cent in more recent studies. The purpose of the present study was to evaluate the prevalence of thyroid cancer in patients operated on for MNG, and to determine risk factors for incidental thyroid malignancy. METHODS A prospectively developed database of all patients who underwent thyroidectomy for a benign MNG at the high-volume endocrine surgery unit of a tertiary referral university hospital was interrogated. RESULTS A total of 3233 patients were analysed, separated into three groups according to their functional thyroid status (hypothyroid, hyperthyroid or euthyroid). There were 2788 women (86.2 per cent); the mean patient age was 56.4 years and mean preoperative disease duration was 106.2 months. Incidental thyroid cancer was identified in 1026 patients (31.7 per cent), of which 917 (89.4 per cent) were papillary cancers. Multivariable regression analysis identified functional thyroid status, younger age, male sex, smaller adenoma size, smaller thyroid glands, Hashimoto's thyroiditis and chronic non-specific thyroiditis as independent risk factors for thyroid cancer. CONCLUSION MNG was associated with a considerable rate of incidental thyroid cancer, which has been underestimated. A variety of factors should be taken into account when considering the malignant potential of a presumed benign MNG.
Collapse
Affiliation(s)
- K Apostolou
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Belgrade, Serbia
| | - V Zivaljevic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - K Tausanovic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - G Zoric
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Belgrade, Serbia
| | | | - N Slijepcevic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - M Jovanovic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Belgrade, Serbia
| | - I Paunovic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| |
Collapse
|
32
|
Dias Lopes NM, Mendonça Lens HH, Armani A, Marinello PC, Cecchini AL. Thyroid cancer and thyroid autoimmune disease: A review of molecular aspects and clinical outcomes. Pathol Res Pract 2020; 216:153098. [PMID: 32825964 DOI: 10.1016/j.prp.2020.153098] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/24/2020] [Accepted: 06/29/2020] [Indexed: 12/24/2022]
Abstract
Thyroid cancer (TC) is the most prevalent malignant neoplasm that affects the endocrine system. Hashimoto's thyroiditis (HT), also known as chronic lymphocytic thyroiditis, is the most common autoimmune thyroid disease (AITD) that, together with Graves' disease (GD), represent the main autoimmune diseases that affect the thyroid gland. Some studies suggest a greater risk of AITD and the development of TC, while others, investigate its relationship with TC progression and patient prognosis. In this review, we have analyzed published data on the molecular aspects related to the association between AITD and TC, addressing their influence on TC progression, diagnosis, and prognosis of the patients. MEDLINE database (PubMed) platform was used as a search engine and the original articles related to the topic were selected using the keywords combination "thyroid cancer and Hashimoto thyroiditis" or "thyroid carcinoma and thyroid autoimmune disease". After the selection, we categorized the main findings of the papers into four topics: antitumor immunity, tumor progression, diagnosis, and prognosis. Although most of the studies have pointed out the presence of AITD as a factor that increases the risk of TC, few molecular mechanisms to support this conclusion have been described. Additionally, little information is available to explain, pathophysiologically, the effects of autoimmunity in TC diagnosis, progression, and prognosis.
Collapse
Affiliation(s)
- Natália Medeiros Dias Lopes
- Laboratory of Molecular Pathology, Department of Pathological Sciences, State University of Londrina (UEL), Londrina, PR, Brazil
| | - Hannah Hamada Mendonça Lens
- Laboratory of Molecular Pathology, Department of Pathological Sciences, State University of Londrina (UEL), Londrina, PR, Brazil
| | - André Armani
- Department of Surgical Clinic, State University of Londrina (UEL), Londrina, PR, Brazil
| | - Poliana Camila Marinello
- Laboratory of Molecular Pathology, Department of Pathological Sciences, State University of Londrina (UEL), Londrina, PR, Brazil
| | - Alessandra Lourenço Cecchini
- Laboratory of Molecular Pathology, Department of Pathological Sciences, State University of Londrina (UEL), Londrina, PR, Brazil.
| |
Collapse
|
33
|
AATF and SMARCA2 are associated with thyroid volume in Hashimoto's thyroiditis patients. Sci Rep 2020; 10:1754. [PMID: 32019955 PMCID: PMC7000742 DOI: 10.1038/s41598-020-58457-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/13/2020] [Indexed: 12/13/2022] Open
Abstract
Thyroid volume of Hashimoto’s thyroiditis (HT) patients varies in size over the course of disease and it may reflect changes in biological function of thyroid gland. Patients with subclinical hypothyroidism predominantly have increased thyroid volume whereas patients with more pronounced hypothyroidism have smaller thyroid volumes. Suggested mechanism for thyroid atrophy is thyrocyte death due to apoptosis. We performed the first genome-wide association study (GWAS) of thyroid volume in two groups of HT patients, depending on levothyroxine (LT4) therapy, and then meta-analysed across. Study included 345 HT patients in total and 6 007 322 common autosomal genetic variants. Underlying hypothesis was that genetic components that are involved in regulation of thyroid volume display their effect in specific pathophysiologic conditions of thyroid gland of HT patients. We additionally performed immunohistochemical analysis using thyroid tissues and analysed differences in expression levels of identified proteins and apoptotic marker between HT patients and controls. We found genome-wide significant association of two loci, both involved in apoptosis, with thyroid volume of HT patients: rs7212416 inside apoptosis-antagonizing transcription factor AATF (P = 8.95 × 10−9) and rs10738556 near chromatin-remodeling SMARCA2 (P = 2.83 × 10−8). In immunohistochemical analysis we observed that HT patients with homozygous AATF risk genotypes have decreased AATF expression (0.46-fold, P < 0.0001) and increased apoptosis (3.99-fold, P = 0.0001) in comparison to controls. HT patients with heterozygous SMARCA2 genotypes have decreased SMARCA2 expression, albeit without reaching statistical significance (1.07-fold, P = 0.5876), and significantly increased apoptosis (4.11-fold, P < 0.0001). By two lines of evidence we show that two highly plausible genetic loci, AATF and SMARCA2, may be involved in determining the thyroid volume of HT patients. The results of our study significantly add to the current knowledge of disturbed biological mechanisms in thyroid gland of HT patients.
Collapse
|
34
|
Chen Y, Gao H, Li Y. Inhibition of LncRNA FOXD3-AS1 suppresses the aggressive biological behaviors of thyroid cancer via elevating miR-296-5p and inactivating TGF-β1/Smads signaling pathway. Mol Cell Endocrinol 2020; 500:110634. [PMID: 31678422 DOI: 10.1016/j.mce.2019.110634] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/27/2019] [Accepted: 10/26/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Thyroid cancer is the most common malignant tumor with relatively high incidence and mortality in endocrine system. Research about thyroid cancer-related targets is the basis for the diagnosis of thyroid cancer and the development of new drugs. However, the predictive value of long non-coding RNA (lncRNA) for the diagnosis and prognosis of thyroid cancer is still in the preliminary stage of exploration. Thus, we for the first time investigated the effects and associated regulatory mechanism of lncRNA Forkhead box D3 antisense RNA 1 (FOXD3-AS1) in thyroid cancer in vitro and in vivo. METHODS Quantitative real-time polymerase chain reaction (qRT-PCR) was used to measure the expression of lncRNA FOXD3-AS1 and miR-296-5p. Cell proliferation was detected through colony formation assay. Cell cycle was analyzed through flow cytometry. Cell mobility was valued through transwell invasion assay and wound healing assay. Western blotting was used to examine the expression of proteins related to cell proliferation and cell migration and TGF-β1/Smads signaling pathway. Luciferase reporter assay was used to verify the targeting relationship between FOXD3-AS1 and miR-296-5p. Tumor xenograft model was established and immunohistochemistry (IHC) was used to examine the expression of Ki67 and VEGF. RESULTS We found that the expression of lncRNA FOXD3-AS1was upregulated and it had negative correlation with the level of miR-296-5p in thyroid cancer tissues and cells. LncRNA FOXD3-AS1 knockdown effectively suppressed cell proliferation and cell invasion in vitro. Further study revealed that miR-296-5p was a target of lncRNA FOXD3-AS1 and FOXD3-AS1 exerted anti-tumor effect through up-regulating miR-296-5p. Moreover, we found that FOXD3-AS1 knockdown suppressed the aggressive biological behaviors of thyroid cancer through inactivating the TGF-β1/Smads signaling pathway. Subsequently, the in vivo experiments further verified that the FOXD3-AS1/miR-296-5p axis exerted obvious anti-tumor effect through inhibiting tumor growth and metastasis and the TGF-β1/Smads signaling pathway was also inactivated in vivo by the inhibition of FOXD3-AS1. CONCLUSION Inhibition of LncRNA FOXD3-AS1 suppresses the aggressive biological behaviors of thyroid cancer via elevating miR-296-5p and inactivating TGF-β1/Smads signaling pathway.
Collapse
Affiliation(s)
- Yonghui Chen
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Beijing, 100730, China.
| | - Hongbo Gao
- Department of Radionuclide Treatment center, Beijing Nuclear Industry Hospital, Beijing, 100045, China
| | - Yaomei Li
- Department of Nuclear Medicine, The Mine Hospital of Xuzhou, Jiangsu, 221000, China
| |
Collapse
|
35
|
Dou Y, Chen Y, Hu D, Su X. The Recovery of Thyroid Function in Low-Risk Papillary Thyroid Cancer After Lobectomy: A 3-Year Follow-Up Study. Front Endocrinol (Lausanne) 2020; 11:619841. [PMID: 33633689 PMCID: PMC7899978 DOI: 10.3389/fendo.2020.619841] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/18/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Management strategies after lobectomy for low-risk papillary thyroid carcinoma (PTC) are controversial. This study aimed to identify the proportion of patients among low-risk PTC patients who do not require hormone replacement therapy and to evaluate the risk factors for postoperative hypothyroidism after lobectomy. PATIENTS AND METHODS The records of 190 PTC patients who underwent thyroid lobectomy from January 2017 to December 2018 were retrospectively reviewed. Clinicopathological characteristics and follow-up data were collected. Univariate and multivariate analyses were performed to identify the risk factors associated with postoperative hypothyroidism and the recovery of thyroid function. RESULTS In summary, 74.21% of patients (141/190) had normal thyroid function without levothyroxine supplementation, while 40.53% (77/190) developed temporary or permanent hypothyroidism. Multivariate analysis indicated that higher preoperative thyroid-stimulating hormone (TSH) levels (>2.62 mIU/L), Hashimoto's thyroiditis (HT), and right lobectomy were associated with hypothyroidism (all P<0.05). The Area Under Curve (AUC) by logistic analysis was 0.829. Twenty-eight (28/77, 36.4%) patients recovered to the euthyroid state in the first year after surgery, and this recovery was significantly associated with preoperative TSH level. Forty-nine (49/77, 63.6%) patients developed persistent hypothyroidism. The thyroid function of most patients (11/28, 39.3%) recovered in the third month after surgery. CONCLUSION Patients with a lower level of preoperative TSH, with left lobectomy and without Hashimoto's thyroiditis had a higher chance of normal thyroid function within the first year after lobectomy. The recovery of thyroid function was associated with the level of preoperative TSH.
Collapse
|
36
|
Liu S, An Y, Cao B, Sun R, Ke J, Zhao D. The Composition of Gut Microbiota in Patients Bearing Hashimoto's Thyroiditis with Euthyroidism and Hypothyroidism. Int J Endocrinol 2020; 2020:5036959. [PMID: 33224194 PMCID: PMC7673947 DOI: 10.1155/2020/5036959] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/27/2020] [Accepted: 10/09/2020] [Indexed: 02/06/2023] Open
Abstract
AIMS Hashimoto's thyroiditis (HT), a type of autoimmune disease, occurs due to genetic predisposition and environmental factors. It is well known that thyroid function may affect the gut microbiota. However, the composition of gut microbiota in HT patients with different thyroid function status has been less highlighted. Therefore, we focused on the alterations in the composition of gut microbiota in HT patients with euthyroidism and hypothyroidism. METHODS We performed a cross-sectional study, including 45 HT patients with euthyroidism, 18 HT patients with hypothyroidism, and 34 healthy controls. Fecal samples were collected, and microbiota was examined by using 16S RNA ribosomal RNA gene sequencing. Then, we analyzed the possible pathways in relation to the enriched bacteria by linear discriminant analysis (LDA) effect size (LEfSe). RESULTS Compared with the controls, bacterial richness and diversity were significantly lower in patients with HT, especially in hypothyroidism. Moreover, Lachnospiraceae_incertae_sedis, Lactonifactor, Alistipes, and Subdoligranulum were more enriched in HT patients with euthyroidism, while Phascolarctobacterium was more abundant in those with hypothyroidism. Further analysis suggested that Phascolarctobacterium was negatively related to several pathways, including environmental information processing and metabolism. CONCLUSION In summary, our study demonstrated the altered composition of gut microbiota in HT patients with different thyroid function status. Moreover, Phascolarctobacterium may be involved in the development of HT.
Collapse
Affiliation(s)
- Simo Liu
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149, China
| | - Yaxin An
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149, China
| | - Bin Cao
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149, China
| | - Rongxin Sun
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149, China
| | - Jing Ke
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149, China
| | - Dong Zhao
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149, China
| |
Collapse
|
37
|
Ruiz J, Ríos A, Rodríguez JM, Paredes M, Soriano V, Oviedo MI, Hernández AM, Parrilla P. Incidental versus clinical diagnosis of papillary thyroid microcarcinoma. Long-term prognosis. ACTA ACUST UNITED AC 2019; 67:317-325. [PMID: 31882257 DOI: 10.1016/j.endinu.2019.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 09/23/2019] [Accepted: 09/26/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The incidence of papillary thyroid microcarcinoma (PTMC) has increased in recent years, especially in patients operated on for presumably benign thyroid disease. The aim of this study was to analyze the differences between PTMC incidentally diagnosed and PTMC clinically diagnosed, as well as its long-term prognosis. MATERIAL AND METHODS The study population consisted of patients with a histological diagnosis of PTMC. Patients with previous thyroid surgery, other synchronous thyroid or extrathyroid malignancies and an ectopic location of PTMC were excluded. Two groups were compared: patients with PTMC incidentally diagnosed (group 1) and patients with PTMC clinically diagnosed (group 2). A multivariate analysis of differentiating factors was performed. RESULTS PTMC clinically diagnosed had a high frequency of hypothyroidism (4.6% vs. 18.9%; P=.004), extrathyroidal extension (5.7% vs. 17.6%; P=.018), metastatic lymph nodes (1.1% vs. 18.9%; P<.001) and lymphocytic thyroiditis (5.7% vs. 27%; P<.001). In the multivariate analysis, metastatic lymph nodes (OR: 22.011, IC 95%: 2.621-184.829; P=.004) and lymphocytic thyroiditis (OR: 4.949; IC 95%: 1.602-15.288; P=.005) were associated with the clinical diagnosis of PTMC. During a mean follow-up of 119.8±65.1 months, one recurrence was detected in group 2 (0% vs. 1,4%; P=.460). No patient died due to the disease. CONCLUSIONS PTMC clinically diagnosed, although it has more aggressive histopathological characteristics (extrathyroidal extension and metastatic lymph nodes), presents a long-term prognosis similar to the PTMC incidentally diagnosed. The presence of metastatic lymph nodes and lymphocytic thyroiditis were independent factors associated with PTMC clinically diagnosed.
Collapse
Affiliation(s)
- José Ruiz
- Servicio de Cirugía General y de Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Antonio Ríos
- Servicio de Cirugía General y de Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España; Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, España; Departamento de Cirugía, Pediatría y Obstetricia y Ginecología, Universidad de Murcia, Murcia, España.
| | - José Manuel Rodríguez
- Servicio de Cirugía General y de Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España; Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, España; Departamento de Cirugía, Pediatría y Obstetricia y Ginecología, Universidad de Murcia, Murcia, España
| | - Miriam Paredes
- Servicio de Cirugía General y de Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Víctor Soriano
- Servicio de Cirugía General y de Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - María Isabel Oviedo
- Servicio de Anatomía Patológica, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Antonio Miguel Hernández
- Servicio de Endocrinología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Pascual Parrilla
- Servicio de Cirugía General y de Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España; Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, España; Departamento de Cirugía, Pediatría y Obstetricia y Ginecología, Universidad de Murcia, Murcia, España
| |
Collapse
|
38
|
Anti-Thyroid Antibodies and TSH as Potential Markers of Thyroid Carcinoma and Aggressive Behavior in Patients with Indeterminate Fine-Needle Aspiration Cytology. World J Surg 2019; 44:363-370. [DOI: 10.1007/s00268-019-05153-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
39
|
Preda C, Branisteanu D, Armasu I, Danila R, Velicescu C, Ciobanu D, Covic A, Grigorovici A. Coexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism: same incidence, different characteristics. BMC Surg 2019; 19:94. [PMID: 31311533 PMCID: PMC6636032 DOI: 10.1186/s12893-019-0556-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The coexistence of hyperparathyroidism and thyroid cancer presents important diagnostic and management challenges. With minimally invasive parathyroid surgery trending, preoperative thyroid imaging becomes more important as concomitant thyroid and parathyroid lesions are reported. The aim of the study was to evaluate the rate of thyroid cancer in patients operated for either primary (PHPT) or secondary hyperparathyroidism (SHPT). METHODS Our retrospective study included PHPT and SHPT patients submitted to parathyroidectomy and, when indicated, concomitant thyroid surgery between 2010 and 2017. RESULTS Parathyroidectomy was performed in 217 patients: 140 (64.5%) for PHPT and 77 (35.5%) for SHPT. Concomitant thyroid surgery was performed in 75 patients with PHPT (53.6%), and 19 papillary thyroid carcinomas (PTC) were found, accounting for 13.6% from all cases with PHPT and 25.3% from PHPT cases with concomitant thyroid surgery. Thirty-one of operated SHPT patients (40.3%) also underwent thyroid surgery and 9 PTC cases were diagnosed (11.7% of all SHPT patients and 29% of patients with concomitant thyroid surgery). We found differences between PHPT and SHPT patients (p < 0.001) with respect to age (54.6 ± 13y versus 48.8 ± 12y), female-to-male ratio (8:1 versus ~ 1:1), surgical technique (single gland parathyroidectomy in 82.8% PHPT cases; versus subtotal parathyroidectomy in 85.7% SHPT cases) and presurgical PTH (357.51 ± 38.11 pg/ml versus 1020 ± 161.38 pg/ml). Morphopathological particularities, TNM classification and multifocality incidence of PTC were similar in the two groups. All PTC from patients with SHPT were thyroid microcarcinomas (TMC, i.e. tumors with a diameter smaller than 1 cm), whereas seven out of the 19 cases with PTC and PHPT were larger than 1 cm. CONCLUSIONS PTC was frequently and similarly associated with both PHPT and SHPT irrespective of presurgical PTH levels. Thyroid tumors above 1 cm were found only in patients with PHPT. Investigators should focus also on associated thyroid nodular pathology in patients with PHPT.
Collapse
Affiliation(s)
- Cristina Preda
- Faculty of Medicine, Department of Endocrinology, "Gr igore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania
| | - Dumitru Branisteanu
- Faculty of Medicine, Department of Endocrinology, "Gr igore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania.
| | - Ioana Armasu
- Department of Morphofunctional Sciences, "Grigore T. Popa" University of Medicine, Iasi, Romania
| | - Radu Danila
- Faculty of Medicine, Department of Surgery, "Grigore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania
| | - Cristian Velicescu
- Faculty of Medicine, Department of Surgery, "Grigore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania
| | - Delia Ciobanu
- Faculty of Medicine, Department of Morphopathology, "Grigore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania
| | - Adrian Covic
- Faculty of Medicine, Department of Nephrology, "Grigore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania.,Academy of Romanian Scientists, Bucuresti, Romania
| | - Alexandru Grigorovici
- Faculty of Medicine, Department of Surgery, "Grigore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania
| |
Collapse
|
40
|
Shafique K, LiVolsi VA, Montone K, Baloch ZW. Papillary Thyroid Microcarcinoma: Reclassification to Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP): a Retrospective Clinicopathologic Study. Endocr Pathol 2018; 29:339-345. [PMID: 30196478 DOI: 10.1007/s12022-018-9546-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Papillary thyroid microcarcinoma (PTMC) accounts for nearly 50% of newly diagnosed PTC cases. There is considerable debate in literature about the clinicopathologic features and prognostic significance of PTMC and whether it should be treated as a separate entity. Due to lack of agreement and supportive data, the consensus study group that established the criteria for non-invasive thyroid neoplasm with papillary-like features (NIFTP) kept its size above 1 cm i.e., excluding PTMC from this new group. As a result, to date, some patients diagnosed with PTMC get aggressive treatments such as partial or total thyroidectomy and even radioactive iodine ablation. We retrospectively studied clinicopathologic features and long-term follow-up of 48 cases of papillary thyroid microcarcinoma. Of these, 7 cases (15%) had capsular invasion, 2 cases (4%) had extrathyroidal extension, 1 case (2%) had lymphovascular invasion, 5 cases (25%) had lymph node metastases, no case (0%) had any distant metastases, and 1 case had recurrence after long-term follow-up (mean 13.7 years, range 1-21 years). Upon slide review, 8 cases fulfilled the criteria for NIFTP and were sub-classified under this new category. These 8 cases had no recurrence after long-term follow-up (mean 12.1 years, range 7-19 years). In this study, we confirmed the previous published reports exhibiting indolent nature of PTMC and also suggested that PTMC cases that fulfill all the criteria for NIFTP can be sub-classified under this term in order to avoid unnecessary aggressive treatment.
Collapse
Affiliation(s)
- Khurram Shafique
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 6 Founders, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Virginia A LiVolsi
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 6 Founders, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Kathleen Montone
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 6 Founders, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Zubair W Baloch
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 6 Founders, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| |
Collapse
|