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Rinaldi S, Dossus L, Keski-Rahkonen P, Kiss A, Navionis AS, Biessy C, Travis R, Weiderpass E, Romieu I, Eriksen AK, Tjonneland A, Kvaskoff M, Canonico M, Truong T, Katzke V, Kaaks R, Catalano A, Panico S, Masala G, Tumino R, Lukic M, Olsen KS, Zamora-Ros R, Santiuste C, Aizpurua Atxega A, Guevara M, Rodriguez-Barranco M, Sandstrom M, Hennings J, Almquist M, Aglago Kouassivi E, Christakoudi S, Gunter M, Franceschi S. Circulating endogenous sex steroids and risk of differentiated thyroid carcinoma in men and women. Int J Cancer 2024; 154:2064-2074. [PMID: 38357914 DOI: 10.1002/ijc.34872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 02/16/2024]
Abstract
Thyroid cancer (TC) is substantially more common in women than in men, pointing to a possible role of sex steroid hormones. We investigated the association between circulating sex steroid hormones, sex hormone binding globulin (SHBG) and the risk of differentiated TC in men and women within the European Prospective Investigation into Cancer and nutrition (EPIC) cohort. During follow-up, we identified 333 first primary incident cases of differentiated TC (152 in pre/peri-menopausal women, 111 in post-menopausal women, and 70 in men) and 706 cancer-free controls. Women taking exogenous hormones at blood donation were excluded. Plasma concentrations of testosterone, androstenedione, dehydroepiandrosterone, estradiol, estrone and progesterone (in pre-menopausal women only) were performed using liquid chromatography/mass spectrometry method. SHBG concentrations were measured by immunoassay. Odds ratios (ORs) were estimated using conditional logistic regression models adjusted for possible confounders. No significant associations were observed in men and postmenopausal women, while a borderline significant increase in differentiated TC risk was observed with increasing testosterone (adjusted OR T3 vs T1: 1.68, 95% CI: 0.96-2.92, ptrend = .06) and androstenedione concentrations in pre/perimenopausal women (adjusted OR T3 vs T1: 1.78, 95% CI: 0.96-3.30, ptrend = .06, respectively). A borderline decrease in risk was observed for the highest progesterone/estradiol ratio (adjusted OR T3 vs T1: 0.54, 95% CI: 0.28-1.05, ptrend = .07). Overall, our results do not support a major role of circulating sex steroids in the etiology of differentiated TC in post-menopausal women and men but may suggest an involvement of altered sex steroid production in pre-menopausal women.
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Affiliation(s)
- Sabina Rinaldi
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Laure Dossus
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | | | - Agneta Kiss
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | | | - Carine Biessy
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Ruth Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Isabelle Romieu
- Center for Research on Population Health, National Institute of Public Health, Mexico, Mexico
| | | | - Anne Tjonneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marina Kvaskoff
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, Inserm, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Marianne Canonico
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, Inserm, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Thérèse Truong
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, Inserm, CESP, Team "Exposome and Heredity", Villejuif, France
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alberto Catalano
- Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology and Public Health, University of Turin, Turin, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Giovanna Masala
- Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE ONLUS, Ragusa, Italy
| | - Marko Lukic
- Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway
| | | | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Carmen Santiuste
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Amaia Aizpurua Atxega
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
- Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain
| | - Marcela Guevara
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Miguel Rodriguez-Barranco
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Maria Sandstrom
- Department of Radiation Sciences, Oncology Umeå University, Umeå, Sweden
| | - Joakim Hennings
- Department of Surgical and Perioperative Sciences, Umeå University, Östersund, Sweden
| | - Martin Almquist
- Department of Clinical Sciences Lund, Skåne University Hospital, Lund University, Lund, Sweden
- Department of Surgery Section of Endocrine and Sarcoma Lund, Skåne University Hospital, Lund University, Lund, Sweden
| | - Elom Aglago Kouassivi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK
| | - Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Marc Gunter
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
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Vuylsteke A, Hannes L, Brems H, Devis K, Renard M, Uyttebroeck A, Legius E, Decallonne B. Germline founder variant c.1998delinsTTCT in the RET oncogene: a cohort study in 15 Belgian families. Eur J Endocrinol 2023; 189:402-408. [PMID: 37713609 DOI: 10.1093/ejendo/lvad126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/06/2023] [Accepted: 09/07/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE The c.1998delinsTTCT variant in the RET gene (codon 666) is linked to medullary thyroid carcinoma in Belgium. We aimed to study the clinical phenotype and the age-dependent penetrance in predictive variant carriers. DESIGN Retrospective study of index patients and predictive variant carriers, identified through familial cascade testing between 2001 and 2020. RESULTS The total cohort comprised 119 patients: 15 index patients, 102 heterozygous, and 2 homozygous predictive variant carriers. Among heterozygous carriers, high suspicion of clinical disease was present in 25 patients at initial evaluation and in 3 patients during follow-up. No high suspicion of clinical disease was observed during surveillance in 56 patients, and 18 patients did not proceed to screening for clinical disease. Compared to index patients, surgically treated heterozygous predictive variant carriers had a lower presurgical basal calcitonin, a lower disease stage, less need for adjuvant therapy, and higher chances of remission. In heterozygous carriers, median age at developing high suspicion of disease is 52 years (range 7-75), with a predicted penetrance of 62% (9% SE) at the age of 70 years. Two patients were identified with pheochromocytoma and 1 patient with primary hyperparathyroidism. The 2 homozygous predictive variant carriers presented with higher disease severity at first clinical evaluation. CONCLUSION The c.1998delinsTTCT variant in the RET gene is pathogenic and associated with a moderate risk for medullary thyroid carcinoma and rarely with other multiple endocrine neoplasia type 2A (MEN2A) manifestations. Active surveillance is a possible option in heterozygous gene carriers with a negative first clinical evaluation.
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Affiliation(s)
- Axelle Vuylsteke
- Department of Pediatrics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Laurens Hannes
- Department of Human Genetics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Hilde Brems
- Department of Human Genetics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Koen Devis
- Department of Nuclear Medicine, AZ Turnhout, 2300 Turnhout, Belgium
| | - Marleen Renard
- Department of Pediatrics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Anne Uyttebroeck
- Department of Pediatrics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Eric Legius
- Department of Human Genetics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Brigitte Decallonne
- Department of Endocrinology, University Hospitals Leuven, 3000 Leuven, Belgium
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Bellastella G, Scappaticcio L, Caiazzo F, Tomasuolo M, Carotenuto R, Caputo M, Arena S, Caruso P, Maiorino MI, Esposito K. Mediterranean Diet and Thyroid: An Interesting Alliance. Nutrients 2022; 14:4130. [PMID: 36235782 PMCID: PMC9571437 DOI: 10.3390/nu14194130] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/30/2022] Open
Abstract
The Mediterranean diet, recognized as being cultural heritage by UNESCO, is mostly plant-based and includes a high consumption of whole-grain, fruit, and vegetables with a moderate consumption of alcohol during meals. Thus, it provides a small amount of saturated fatty acids and a high quantity of antioxidants and fiber. For this reason, it has been considered to have an important role in preventing cardiovascular diseases, chronic kidney diseases, type 2 diabetes mellitus, and cancer, but its relationship with thyroid function and diseases is still under debate. The aim of this review was to search for the possible correlation between the Mediterranean diet and thyroid function, and to critically evaluate the pathophysiological link between selected food intake and thyroid disorders.
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Affiliation(s)
- Giuseppe Bellastella
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Lorenzo Scappaticcio
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Francesco Caiazzo
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Maria Tomasuolo
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Raffaela Carotenuto
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Mariangela Caputo
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Stefania Arena
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Paola Caruso
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Maria Ida Maiorino
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Katherine Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Zamagni F, Bucchi L, Mancini S, Crocetti E, Dal Maso L, Ferretti S, Biggeri A, Villani S, Baldacchini F, Giuliani O, Ravaioli A, Vattiato R, Brustolin A, Candela G, Carone S, Carrozzi G, Cavallo R, Dinaro YM, Ferrante M, Iacovacci S, Mazzoleni G, Musolino A, Rizzello RV, Serraino D, Stracci F, Tumino R, Masini C, Ridolfi L, Palmieri G, Stanganelli I, Falcini F. The relative contribution of the decreasing trend in tumour thickness to the 2010s increase in net survival from cutaneous malignant melanoma in Italy: a population-based investigation. Br J Dermatol 2022; 187:52-63. [PMID: 35253204 PMCID: PMC9542017 DOI: 10.1111/bjd.21051] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/03/2022] [Accepted: 02/06/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The long-term increase in survival from cutaneous malignant melanoma (CMM) is generally attributed to the decreasing trend in tumour thickness, the single most important prognostic factor. OBJECTIVES To determine the relative contribution of decreased tumour thickness to the favourable trend in survival from CMM in Italy. METHODS Eleven local cancer registries covering a population of 8 056 608 (13.4% of the Italian population in 2010) provided records for people with primary CMM registered between 2003 and 2017. Age-standardized 5-year net survival was calculated. Multivariate analysis of 5-year net survival was undertaken by calculating the relative excess risk (RER) of death. The relative contribution of the decrease in tumour thickness to the RER of death was evaluated using a forward stepwise flexible parametric survival model including the available prognostic factors. RESULTS Over the study period, tumour thickness was inversely associated with 5-year net survival and multivariate RER in both sexes. The median thickness was 0.90 mm in 2003-2007, 0.85 mm in 2008-2012 and 0.75 mm in 2013-2017 among male patients, and 0.78 mm, 0.77 mm and 0.68 mm among female patients, respectively. The 5-year net survival was 86.8%, 89.2% and 93.2% in male patients, and 91.4%, 92.0% and 93.4% in female patients, respectively. In 2013-2017, male patients exhibited the same survival as female patients despite having thicker lesions. For them, the increasing survival trend was more pronounced with increasing thickness, and the inclusion of thickness in the forward stepwise model made the RER in 2013-2017 vs. 2003-2007 increase from 0.64 [95% confidence interval (CI) 0.51-0.80] to 0.70 (95% CI 0.57-0.86). This indicates that the thickness trend accounted for less than 20% of the survival increase. For female patients, the results were not significant but, with multiple imputation of missing thickness values, the RER rose from 0.74 (95% CI 0.58-0.93) to 0.82 (95% CI 0.66-1.02) in 2013-2017. CONCLUSIONS For male patients in particular, decrease in tumour thickness accounted for a small part of the improvement in survival observed in 2013-2017. The introduction of targeted therapies and immune checkpoint inhibitors in 2013 is most likely to account for the remaining improvement.
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Affiliation(s)
- Federica Zamagni
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Lauro Bucchi
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Silvia Mancini
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Emanuele Crocetti
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Luigino Dal Maso
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | - Stefano Ferretti
- Romagna Cancer Registry, Section of FerraraLocal Health Authority and University of FerraraFerraraItaly
| | - Annibale Biggeri
- Department of Statistics, Computer Science, Applications G. ParentiUniversity of FlorenceFlorenceItaly
| | - Simona Villani
- Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical EpidemiologyUniversity of PaviaPaviaItaly
| | - Flavia Baldacchini
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Orietta Giuliani
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Alessandra Ravaioli
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Rosa Vattiato
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Angelita Brustolin
- UOSD Epidemiologia e Registro Tumori (Dip. di Prevenzione ASL VT) c/o Cittadella della SaluteViterboItaly
| | - Giuseppa Candela
- Trapani Cancer Registry, Dipartimento di Prevenzione della SaluteServizio Sanitario Regionale Sicilia, Azienda Sanitaria Provinciale (ASP)TrapaniItaly
| | - Simona Carone
- Registro tumori di TarantoUnità operativa complessa di statistica ed epidemiologiaAzienda sanitaria locale TarantoItaly
| | - Giuliano Carrozzi
- Modena Cancer Registry, Public Health DepartmentLocal Health AuthorityModenaItaly
| | | | | | - Margherita Ferrante
- Integrated Cancer Registry of Catania‐Messina‐EnnaAzienda Ospedaliero‐Universitaria Policlinico ‘Rodolico‐San Marco’CataniaItaly
| | | | | | - Antonino Musolino
- Department of Medicine and SurgeryUniversity of Parma; Medical Oncology Unit and Cancer Registry, University Hospital of ParmaParmaItaly
| | - Roberto Vito Rizzello
- Trento Province Cancer Registry, Unit of Clinical EpidemiologyAzienda Provinciale per i Servizi Sanitari (APSS) TrentoItaly
| | - Diego Serraino
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | - Fabrizio Stracci
- Department of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Rosario Tumino
- Former Director Cancer RegistryProvincial Health Authority (ASP)RagusaItaly
| | - Carla Masini
- Unit of Oncological PharmacyIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Laura Ridolfi
- Immunotherapy, Cell Therapy and BiobankIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Giuseppe Palmieri
- Institute of Research on Genetics and Biomedicine (IRGB), National Research Council (CNR)SardegnaSassariItaly
| | - Ignazio Stanganelli
- Skin Cancer UnitIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
- Department of DermatologyUniversity of ParmaParmaItaly
| | - Fabio Falcini
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
- Cancer Prevention UnitLocal Health AuthorityForlìItaly
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Association of Helicobacter pylori Infection with Papillary Thyroid Carcinoma: A Case-control Study. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2022. [DOI: 10.5812/ijcm-118031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The thyroid nodules incidence has risen worldwide. Although factors such as increasing the use of imaging techniques and more rapid detection of small thyroid nodules have been implicated in the recent rise in thyroid cancer incidence, some environmental parameters such as infectious agents may be involved. Helicobacter pylori infection is an environmental risk factor, which may mimic the antigenic properties of membranes of thyrocytes. Objectives: This study aimed at evaluating the association of H. pylori infection with benign and malignant thyroid nodules in comparison with the control group. Methods: Patients with benign thyroid nodules, papillary thyroid cancer (PTC), and euthyroid healthy controls without thyroid nodules that had just been diagnosed were included in the study. All participants underwent clinical examination. Various biochemical parameters such as serum H. pylori Ab (IgG) and thyroid function tests were measured. Comparisons were made between groups. Results: Finally, 370 patients with benign thyroid nodules, 364 patients with PTC, and 360 healthy subjects without nodules participated as a control group. In the patients with PTC, the prevalence of H. pylori infection was 89.6%, while in the group of patients with benign thyroid nodules and the control group was 81.1% and 75%, respectively (P < 0.001). Helicobacter pylori antibody (Ab) titer was not significantly associated with any of the anthropometric and biochemical variables. Conclusions: Helicobacter pylori infection was significantly higher in patients with benign thyroid nodules and PTC than in the control group. Also, the rate of infection was significantly higher in the malignant nodule group than in the benign thyroid nodules group.
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Pizzato M, Li M, Vignat J, Laversanne M, Singh D, La Vecchia C, Vaccarella S. The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020. Lancet Diabetes Endocrinol 2022; 10:264-272. [PMID: 35271818 DOI: 10.1016/s2213-8587(22)00035-3] [Citation(s) in RCA: 261] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Thyroid cancer incidence rates have increased in many countries and settings; however, mortality rates have remained stable at lower rates. This epidemiological pattern has been largely attributed to an overdiagnosis effect. Timely evidence for the global epidemiological status is necessary to identify the magnitude of this problem and the areas mostly affected by it. We therefore aimed to provide an up-to-date assessment on the global distribution of thyroid cancer incidence and mortality rates in 2020. METHODS We extracted age-standardised incidence and mortality rates per 100 000 person-years of thyroid cancer as defined by the International Classification of Diseases for Oncology 10th Revision (code C73), for 185 countries or territories by sex and 18 age groups (ie, 0-4, 5-9, …, 80-84, and ≥85 years) from the GLOBOCAN database. Both incidence and mortality estimates were presented by country and aggregated across the 20 UN-defined world regions and according to the UN's four-tier Human Development Index (ie, low, medium, high, and very high) in 2020. FINDINGS Globally, in 2020, the age-standardised incidence rates of thyroid cancer were 10·1 per 100 000 women and 3·1 per 100 000 men, and age-standardised mortality rates were 0·5 per 100 000 women and 0·3 per 100 000 men. In both sexes, incidence rates were five times higher in high and very high Human Development Index countries than in low and medium Human Development Index countries, whereas mortality rates were relatively similar across different settings. Incidence rates in women differed by more than 15 times across world regions, with the highest incidence rates being in the Federated States of Micronesia and French Polynesia (18·5 per 100 000 women), North America (18·4 per 100 000), and east Asia (17·8 per 100 000, with South Korea reaching 45 per 100 000). Mortality rates were less than one per 100 000 in most countries and in both sexes. South Korea had the highest incidence-to-mortality rate ratio in both sexes, followed by Cyprus and Canada. INTERPRETATION The current thyroid cancer epidemiological landscape is strongly suggestive of a large effect of overdiagnosis in many countries and settings worldwide, confirming the relevance of thyroid cancer overdiagnosis as a global public health problem. FUNDING None.
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Affiliation(s)
- Margherita Pizzato
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; International Agency for Research on Cancer, Lyon, France.
| | - Mengmeng Li
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jerome Vignat
- International Agency for Research on Cancer, Lyon, France
| | - Mathieu Laversanne
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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7
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Wang B, Liu Z, Wu J, Liu Y, Wang P, Liu H, Wang H, Wang T, Wang J, Tang Y, Zhang J. Bioelectrical impedance spectroscopy can assist to identify the parathyroid gland during thyroid surgery. Front Endocrinol (Lausanne) 2022; 13:963520. [PMID: 36187105 PMCID: PMC9521317 DOI: 10.3389/fendo.2022.963520] [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: 06/08/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study aimed to explore the effectiveness of bioelectrical impedance spectroscopy in the identification of parathyroid glands during thyroid surgeries. METHOD All patients who received thyroid surgeries at our department from January 2018 to February 2020 were recruited for this study. The bioelectrical impedance spectroscopy analyzer was applied to analyze on following tissues: thyroid tissues, lymph nodes, adipose tissues, and the tissues suspected to be parathyroid glands. Postoperative pathological reports were obtained as the golden standard to compare with the characteristic parameters obtained from bioelectrical impedance spectroscopy. The receiver operating characteristic curve analysis was used to assess the diagnostic value and the selection of the optimal threshold of these parameters from bioelectrical impedance spectroscopy. RESULTS A total of 512 patients were enrolled in the study and 1898 specimens were measured by the bioelectrical impedance spectroscopy analyzer. There were significant differences in the parameter of f c among parathyroid glands, thyroid tissues, lymph nodes, and adipose tissues (252.2 ± 45.8 vs 144.7 ± 26.1, 491.7 ± 87.4, 602.3 ± 57.3; P<0.001, P<0.001, P<0.001). The area under the receiver operating characteristic curves was 0.993 (95%CI: 0.989-0.996) for f c. When the diagnostic criterion of f c was set at 188.85 kHz~342.55 kHz, the sensitivity and specificity to identify parathyroid glands from lymph nodes and adipose tissues were both 100%. At this f c, the sensitivity and specificity to identify parathyroid glands from thyroid tissues were 91.1% and 99.0%, respectively. CONCLUSION In conclusion, bioelectrical impedance spectroscopy could assist to differentiate parathyroid glands from peripheral tissues during thyroid surgeries.
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Affiliation(s)
- Bin Wang
- Center of Breast and Thyroid Surgery, Department of General Surgery, Chengdu Third People’s Hospital, Chengdu, China
| | - Zaoyang Liu
- Department of General Thoracic Surgery, Chengdu Third People’s Hospital, Chengdu, China
| | - Jian Wu
- Center of Breast and Thyroid Surgery, Department of General Surgery, Chengdu Third People’s Hospital, Chengdu, China
- *Correspondence: Jian Wu,
| | - Ying Liu
- Department of Ultrasound, Chengdu Third People’s Hospital, Chengdu, China
| | - Pin Wang
- Center of Breast and Thyroid Surgery, Department of General Surgery, Chengdu Third People’s Hospital, Chengdu, China
| | - Hong Liu
- Center of Breast and Thyroid Surgery, Department of General Surgery, Chengdu Third People’s Hospital, Chengdu, China
| | - Haobin Wang
- Center of Breast and Thyroid Surgery, Department of General Surgery, Chengdu Third People’s Hospital, Chengdu, China
| | - Tielin Wang
- Center of Breast and Thyroid Surgery, Department of General Surgery, Chengdu Third People’s Hospital, Chengdu, China
| | - Juan Wang
- Department of Ultrasound, Chengdu Third People’s Hospital, Chengdu, China
| | - Yan Tang
- Department of Pathology, Chengdu Third People’s Hospital, Chengdu, China
| | - Junyan Zhang
- Department of Computer Science, George Washington University, Washington, DC, United States
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Abstract
Thyroid cancer (TC) represents the most common endocrine malignancy, with an increasing incidence all over the world. Papillary TC (PTC), a differentiated TC subtype, is the most common and, even though it has an excellent prognosis following radioiodine (RAI) ablation, it shows an aggressive behavior in 20–30% of cases, becoming RAI-resistant and/or metastatic. On the other side, anaplastic thyroid carcinoma (ATC), the most undifferentiated TC, is a rare but devastating disease, indicating that progression of differentiated to undifferentiated forms of TC could be responsible for RAI-resistance and increased mortality. The epithelial-to-mesenchymal transition (EMT) plays a pivotal role in both tumor progression and resistance to therapy. Moreover, during tumor progression, cancer cells modify their metabolism to meet changed requirements for cellular proliferation. Through these metabolic changes, cancer cells may adopt cancer stem cell-like properties and express an EMT phenotype. EMT, in turn, can induce metabolic changes to which cancer cells become addicted. Here we review metabolic reprogramming in TC highlighting the role of EMT with the aim to explore a potential field to find out new therapeutic strategies for advanced-stage PTC. Accordingly, we discuss the identification of the metabolic enzymes and metabolites, critical to TC progression, which can be employed either as predicting biomarkers of tumor response to RAI therapy or possible targets in precision medicine.
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Li M, Pei J, Xu M, Shu T, Qin C, Hu M, Zhang Y, Jiang M, Zhu C. Changing incidence and projections of thyroid cancer in mainland China, 1983-2032: evidence from Cancer Incidence in Five Continents. Cancer Causes Control 2021; 32:1095-1105. [PMID: 34152517 DOI: 10.1007/s10552-021-01458-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/08/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE An increasing incidence of thyroid cancer has been seen in China during the past several decades. The aim of this study was to analyze potential age, period, and cohort effects on the incidence of thyroid cancer in mainland China and to predict new cases up to 2032. METHODS We calculated age-adjusted and age-specific incidence rates of thyroid cancer, conducted an age-period-cohort analysis of 35,037 thyroid cancer incidence cases reported to Cancer Incidence in Five Continents from 1983 to 2012 in mainland China, and predicted incidence up to 2032 using the Bayesian age-period-cohort method. RESULTS The age-adjusted overall incidence rate of thyroid cancer increased from 1.93/100,000 in 1983-1987 to 12.18/100,000 in 2008-2012 among females and from 0.77/100,000 in 1983-1987 to 3.89/100,000 in 2008-2012 among males, with a female-to-male ratio of approximately 3.0 during the three decades. Strong birth cohort and period effects on the incidence of thyroid cancer were observed for both sexes, and such an increasing trend is predicted to continue for at least the next 20 years. More than 3.7 million new cases are projected in the 2028-2032 period. CONCLUSION The increasing trend of thyroid cancer in mainland China will cause a great burden in the future. In addition to the potential impact of improvement in medical diagnostics, potential exposure to risk factors have played a role in the observed rising trend. Further population-based epidemiologic studies are required to identify risk factors to aid in thyroid cancer prevention and control.
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Affiliation(s)
- Mandi Li
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jiao Pei
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Minghan Xu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ting Shu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chengjie Qin
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Meijing Hu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yawei Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Jiang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
| | - Cairong Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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Rossi D, Belotti A, di Tonno C, Midolo V, Maffini FA, Nicosia L, De Fiori E, Mauri G. Changes in thyroid fine needle aspiration practice during the COVID-19 pandemic. Cytopathology 2021; 32:732-737. [PMID: 34137099 PMCID: PMC8597111 DOI: 10.1111/cyt.13020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/03/2021] [Accepted: 06/06/2021] [Indexed: 12/30/2022]
Abstract
Purpose To investigate the diagnostic accuracy of a different sample preparation protocol for fine needle aspiration cytology (FNAC) of thyroid nodules established during the COVID‐19 pandemic. Methods From April 2020, conventional smears during FNAC were ceased according to World Health Organization recommendations due to the increased infection risk for operators, and a new protocol using only liquid‐based cytology (LBC) was adopted. FNACs performed between April and July 2020 (COVID‐19 group) were retrospectively compared with those from December 2019 through March 2020 (Pre‐COVID‐19 group). The distribution of diagnoses based on SIAPEC‐IAP categories and the concordance between cytological and histological results were compared using the chi‐squared test. Results Categories based on FNAC for 90 and 82 thyroid nodules in the Pre‐COVID‐19 and COVID‐19 groups showed no significant difference in distribution (P = .081), with the following respective cases (and percentages): TIR1, 7 (8%) and 8 (10%); TIR1C, 0 (0%) and 6 (7%); TIR2, 59 (66%) and 55 (67%); TIR3A, 8 (9%) and 5 (6%); TIR3B, 1 (1%) and 2 (3%); TIR4, 5 (6%) and 1 (1%); and TIR5, 10 (12%) and 5 (7%). Among patients with potentially malignant lesions, surgery was performed for 12/16 (75%) nodules in the Pre‐COVID‐19 and 7/8 (88%) nodules in the COVID‐19 groups, with no significant differences between cytological and histological diagnoses (P = .931). Conclusion The new LBC‐only protocol provided similar diagnostic accuracy in comparison with conventional smears, and can be effectively applied during a viral pandemic improving operator safety.
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Affiliation(s)
- Duccio Rossi
- Postgraduate School of Radiodiagnostics, Università Degli Studi di Milano, Milan, Italy
| | - Alessia Belotti
- Postgraduate School of Pathology, Università Degli Studi di Milano, Milan, Italy
| | - Clementina di Tonno
- Division of Cytopathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Valeria Midolo
- Division of Cytopathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Luca Nicosia
- Department of Breast Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elvio De Fiori
- Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giovanni Mauri
- Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy.,Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
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11
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Risk factors for central lymph node metastasis in the cervical region in papillary thyroid carcinoma: a retrospective study. World J Surg Oncol 2021; 19:138. [PMID: 33941214 PMCID: PMC8091777 DOI: 10.1186/s12957-021-02247-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/19/2021] [Indexed: 12/13/2022] Open
Abstract
Background To investigate the influence of different risk factors on central lymph node metastasis (CLNM) in the cervical region in patients with papillary thyroid carcinoma (PTC). Methods This retrospective study included 2586 PTC patients. Potential risk factors were identified by univariate analysis, and the relationships between these factors and CLNM were ascertained by multivariable analysis. A scoring system was constructed, and the optimal cut-off value was determined. Results On univariate analysis, sex, age, tumor diameter, multifocality, capsule invasion, vascular invasion, total number of lymph nodes in the central region, and serum thyroid peroxidase antibody (TPOAb) concentration were identified as potential risk factors for CLNM in the cervical region, whereas nerve invasion, thyroid-stimulating hormone concentration, and thyroglobulin antibody (TgAb) concentration were not. Multivariable analysis indicated that male sex, young age, large tumor diameter, multifocality, vascular invasion, a large number of central lymph nodes, and a low TPOAb concentration were significant risk factors. From these factors, a preoperative CLNM risk assessment scale was constructed for predicting CLNM in the cervical region for PTC patients. Conclusion Male sex, young age, large tumor diameter, multifocality, vascular invasion, a large number of central lymph nodes, and a low TPOAb concentration were positively correlated with CLNM in the cervical region in PTC patients. The preoperative CLNM risk assessment scale based on these risk factors is expected to offer accurate preoperative assessment of central lymph node status in PTC patients.
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12
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Azadnajafabad S, Saeedi Moghaddam S, Mohammadi E, Rezaei N, Ghasemi E, Fattahi N, Aminorroaya A, Azadnajafabad R, Aryannejad A, Rezaei N, Naderimagham S, Haghpanah V, Mokdad AH, Gharib H, Farzadfar F, Larijani B. Global, regional, and national burden and quality of care index (QCI) of thyroid cancer: A systematic analysis of the Global Burden of Disease Study 1990-2017. Cancer Med 2021; 10:2496-2508. [PMID: 33665966 PMCID: PMC7982631 DOI: 10.1002/cam4.3823] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/30/2021] [Accepted: 02/20/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Thyroid cancer (TC) is the most prevalent malignancy of the endocrine system. Over the past decades, TC incidence rates have been increasing. TC quality of care (QOC) has yet to be well understood. We aimed to assess the quality of TC care and its disparities. METHODS We retrieved primary epidemiologic indices from the Global Burden of Disease (GBD) 1990-2017 database. We calculated four secondary indices of mortality to incidence ratio, disability-adjusted life years (DALYs) to prevalence ratio, prevalence to incidence ratio, and years of life lost (YLLs) to years lived with disability (YLD) ratio and summarized them by the principal component analysis (PCA) to produce one unique index presented as the quality of care index (QCI) ranged between 0 and 100, to compare different scales. The gender disparity ratio (GDR), defined as the QCI for females divided by QCI for males, was applied to show gender inequity. RESULTS In 2017, there were 255,489 new TC incident cases (95% uncertainty interval [UI]: 245,709-272,470) globally, which resulted in 41,235 deaths (39,911-44,139). The estimated global QCI was 84.39. The highest QCI was observed in the European region (93.84), with Italy having the highest score (99.77). Conversely, the lowest QCI was seen in the African region (55.09), where the Central African Republic scored the lowest (13.64). The highest and lowest socio-demographic index (SDI) regions scored 97.27 and 53.85, respectively. Globally, gender disparity was higher after the age of 40 years and in favor of better care in women. CONCLUSION TC QOC is better among those countries of higher socioeconomic status, possibly due to better healthcare access and early detection in these regions. Overall, the quality of TC care was higher in women and younger adults. Countries could adopt the introduced index of QOC to investigate the quality of provided care for different diseases and conditions.
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Affiliation(s)
- Sina Azadnajafabad
- Non‐Communicable Diseases Research CenterEndocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Sahar Saeedi Moghaddam
- Non‐Communicable Diseases Research CenterEndocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Esmaeil Mohammadi
- Non‐Communicable Diseases Research CenterEndocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Negar Rezaei
- Non‐Communicable Diseases Research CenterEndocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Erfan Ghasemi
- Non‐Communicable Diseases Research CenterEndocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Nima Fattahi
- Non‐Communicable Diseases Research CenterEndocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Arya Aminorroaya
- Non‐Communicable Diseases Research CenterEndocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Reza Azadnajafabad
- Department of ElectricalElectronic and Information EngineeringUniversity of BolognaBolognaItaly
| | - Armin Aryannejad
- Non‐Communicable Diseases Research CenterEndocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Nazila Rezaei
- Non‐Communicable Diseases Research CenterEndocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Shohreh Naderimagham
- Non‐Communicable Diseases Research CenterEndocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Vahid Haghpanah
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Ali H. Mokdad
- Institute for Health Metrics and EvaluationUniversity of WashingtonSeattleWAUSA
| | | | - Farshad Farzadfar
- Non‐Communicable Diseases Research CenterEndocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
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13
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Cui Y, Mubarik S, Li R, Nawsherwan, Yu C. Trend dynamics of thyroid cancer incidence among China and the U.S. adult population from 1990 to 2017: a joinpoint and age-period-cohort analysis. BMC Public Health 2021; 21:624. [PMID: 33789605 PMCID: PMC8010947 DOI: 10.1186/s12889-021-10635-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Thyroid cancer (TC) is the most common malignant disease of the endocrine system. Based on the previously published reports, the incidence of TC has been increasing in the past 25 years, and the reason for the increase is not yet clear. The present study aims to reveal the long-term trends and age-period-cohort effects for the incidence of TC in China and the U.S. from 1990 to 2017. METHODS We examined the trends of TC incidence and the average annual percentage change (AAPC) of rate using the Joinpoint regression analysis in the two countries, for the different genders (men/women) in the Global Burden of Disease (GBD 2017). We further used an age-period-cohort model to analyze age-period-cohort effects on TC incidence. RESULTS The ASIR of China increased markedly with AAPC of 4.5% (95% confidence interval (CI): 4.0, 5.0%) and 1.8% (1.6, 2.0%) for men and women during 1990-2017. The ASIR of the U. S increased by 1.4% (1.0, 1.8%) and 1.3% (0.9, 1.7%) for men and women from 1990 to 2017.TC increased with the age and period. Aging was one of the most influential factors of TC in China. The age effect increased markedly in the U.S. compared with China. The period effect showed an increase in China while that tended to grow steadily during 1990-2017 in the U.S. The cohort effect peaked in 1963-1967 birth cohorts for men and women in China and declined consistently in the birth cohort in the U.S. CONCLUSION From 1990 to 2017, due to ionizing radiation and over-diagnosis, age-standardized TC incidence rates in both genders rose in China and the U.S. The standardized incidence rate of women is higher than that of men. It is necessary to provide women with reasonable prevention and protection measures for TC. We need to apply for health services and screening to reduce ionizing radiation.
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Affiliation(s)
- Yiran Cui
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan, 430071, China
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan, 430071, China
| | - Ruijia Li
- Global Health Institute, Wuhan University, Wuhan, 430071, China
| | - Nawsherwan
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan, 430071, China.
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14
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Baicry F, Molinié F, Plouvier S, Colonna M, Daubisse-Marliac L, Grosclaude P, Trétarre B, Bara S, Lapôtre-Ledoux B, Woronoff AS, Guizard AV, Bouvier V, Troussard X, Marrer E, Klein D, Velten M, Jégu J. What is the most appropriate period to define synchronous cancers? Cancer Epidemiol 2021; 71:101900. [PMID: 33578073 DOI: 10.1016/j.canep.2021.101900] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/23/2021] [Accepted: 01/29/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Studies about second primary cancers (SPC) incidence exclude a period following the first cancer diagnosis given the high probability of diagnosing another primary cancer during this phase (synchronous cancers). However, definition of synchronicity period varies widely, from one to six months, without clear epidemiological justification. The objective of this study was to determine the most appropriate synchronicity period. METHODS Data from 13 French population-based cancer registries were used to establish a cohort of all patients diagnosed with a first cancer between 1989 and 2010. The incidence rate of subsequent cancer was computed by day within 1 year of follow-up after the first diagnosis. Incidence was modelized by joinpoint regression models with an initial quadratic trend and a second constant part (plateau). The joinpoint was the point from which the plateau began and defining the synchronicity period. RESULTS Our cohort included 696,775 patients with a first cancer, of which 12,623 presented a SPC. The median joinpoint for all sites combined was estimated at 120.5 days [112.0-129.0]. Analysis by gender reported a higher difference in 32 days for males (127.8 vs 96.1 days). Noteworthy differences were found depending on patient age and the site of first cancer, with joinpoint ranging from 84.7 (oesophagus cancer) to 250.1 days (bladder cancer). CONCLUSION Although some heterogeneity was observed based on the characteristic of the patients, the appropriate synchronicity period appears to be 4 months after the diagnosis of first cancer.
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Affiliation(s)
- Florent Baicry
- Registre des Cancers du Bas-Rhin, Inserm UMR-S1113, FMTS, Université de Strasbourg, France; Service des Urgences Médico-chirurgicales Adultes, Hôpitaux Universitaires de Strasbourg, France.
| | - Florence Molinié
- Registre des Cancers de Loire-Atlantique et Vendée, CHU de Nantes, France
| | - Sandrine Plouvier
- Registre Général des Cancers de Lille et de sa Région, GCS C2RC, Lille, France
| | - Marc Colonna
- Registre des Cancers de l'Isère, CHU de Grenoble, France
| | - Laetitia Daubisse-Marliac
- Registre des Cancers du Tarn - Institut Claudius Regaud, Centre Régional de Lutte Contre le Cancer, UMR 1027 Inserm, Université Toulouse III, France
| | - Pascale Grosclaude
- Registre des Cancers du Tarn - Institut Claudius Regaud, Centre Régional de Lutte Contre le Cancer, UMR 1027 Inserm, Université Toulouse III, France
| | - Brigitte Trétarre
- Registre des Tumeurs de l'Hérault, Centre de Recherche, Montpellier, France
| | - Simona Bara
- Registre des Cancers de la Manche, Centre Hospitalier Public du Cotentin, Cherbourg-Octeville, France
| | - Bénédicte Lapôtre-Ledoux
- Registre du Cancer de la Somme, Service Épidémiologie Hygiène et Santé Publique, CHU Nord, Amiens, France
| | - Anne-Sophie Woronoff
- Registre des Tumeurs du Doubs et du Territoire de Belfort, EA3181, Centre Hospitalier Régional Universitaire, Besançon, France
| | - Anne-Valérie Guizard
- Registre Général des Tumeurs du Calvados, Cancers & Préventions - U1086 Inserm, Centre François Baclesse, Caen, France
| | - Véronique Bouvier
- Registre des Tumeurs Digestives du Calvados, Cancers & Préventions, U1086 Inserm, Centre François Baclesse, Caen, France
| | - Xavier Troussard
- Registre des Hémopathies Malignes de Basse-Normandie, Unité Fonctionnelle Hospitalo-Universitaire n° 0350, Centre Hospitalier Universitaire, Caen, France
| | | | - Delphine Klein
- Registre des Cancers du Bas-Rhin, Inserm UMR-S1113, FMTS, Université de Strasbourg, France
| | - Michel Velten
- Registre des Cancers du Bas-Rhin, Inserm UMR-S1113, FMTS, Université de Strasbourg, France; Service d'épidémiologie et de Biostatistique, Centre Paul Strauss, Strasbourg, France; Service de Santé Publique, Hôpitaux Universitaires de Strasbourg, France
| | - Jérémie Jégu
- Registre des Cancers du Bas-Rhin, Inserm UMR-S1113, FMTS, Université de Strasbourg, France; Service de Santé Publique, Hôpitaux Universitaires de Strasbourg, France
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Dong X, Wu W, Yao S, Li H, Li Z, Zhang L, Jiang J, Xu J, Zhang F. PM 2.5 disrupts thyroid hormone homeostasis through activation of the hypothalamic-pituitary-thyroid (HPT) axis and induction of hepatic transthyretin in female rats 2.5. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 208:111720. [PMID: 33396051 DOI: 10.1016/j.ecoenv.2020.111720] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/21/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
Fine particulate matter (PM2.5), a ubiquitous environmental pollutant, has been indicated to affect thyroid hormone (TH) homeostasis in women, but the detailed mechanism behind this effect remains unclear. The objective of this study was to evaluate the roles of the hypothalamic-pituitary-thyroid (HPT) axis and hepatic transthyretin in the thyroid-disrupting effects of PM2.5. Sprague Dawley rats were treated with PM2.5 (0, 15 and 30 mg/kg) by passive pulmonary inhalation for 49 days; and recovery experimental group rats were dosed with PM2.5 (30 mg/kg) for 35 days, and no treatment was done during the subsequent 14 days. PM2.5 was handled twice a day by passive pulmonary inhalation throughout the study. After treatment, pathological changes were analyzed by performing haemotoxylin and eosin staining, measuring levels of THs and urine iodine (UI) in serum, plasma, and urine samples using enzyme-linked immunoabsorbent assay, and expression of proteins in the hypothalamus, pituitary, thyroid, and liver tissues of rats were analyzed by immunohistochemistry and Western blotting. The levels of oxidative stress factors, such as reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (Gpx), and nuclear factor-kappa B (NF-κB) in female rats' plasma were also evaluated by ELISA. The results of these analyses revealed that PM2.5 treatment induced pathologic changes in rat thyroid and liver characterized by increased follicular cavity size and decreased amounts of follicular epithelial cells and fat vacuoles, respectively. Serum levels of triiodothyronine, thyroxine, and thyroid stimulating hormone were significantly decreased, plasma NF-κB level was increased and plasma redox state was unbalanced (enhanced ROS, MDA and Gpx levels; reduced SOD activities) in female rats treated with PM2.5 (P < 0.05). PM2.5 treatment suppressed the biosynthesis and biotransformation of THs by increasing sodium iodide symporter, thyroid transcription factor 1, thyroid transcription factor 2, and paired box 8 protein expression levels (P < 0.05). Additionally, thyroid stimulating hormone receptor and thyroid peroxidase levels were significantly decreased (P < 0.05). Both thyrotropin releasing hormone receptor and thyroid stimulating hormone beta levels were enhanced (P < 0.05). Moreover, transport of THs was inhibited due to reduced protein expression of hepatic transthyretin upon treatment with PM2.5. In summary, PM2.5 treatment could perturb TH homeostasis by affecting TH biosynthesis, biotransformation, and transport, affecting TH receptor levels, and inducing oxidative stress and inflammatory responses. Activation of the HPT axis and altered hepatic transthyretin levels therefore appear to play a crucial role in PM2.5-induced thyroid dysfunction.
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Affiliation(s)
- Xinwen Dong
- Department of Environmental and Occupational Health, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China 453003.
| | - Weidong Wu
- Department of Environmental and Occupational Health, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China 453003.
| | - Sanqiao Yao
- Department of Environmental and Occupational Health, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China 453003.
| | - Haibin Li
- Department of Environmental and Occupational Health, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China 453003.
| | - Zhichun Li
- Department of Environmental and Occupational Health, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China 453003.
| | - Li Zhang
- Center for Bioinformatics and Statistical Health Research, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China 453003.
| | - Jing Jiang
- Experimental Teaching Center of Public Health and Preventive Medicine, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China 453003.
| | - Jie Xu
- Experimental Teaching Center of Public Health and Preventive Medicine, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China 453003.
| | - Fengquan Zhang
- Experimental Teaching Center of Public Health and Preventive Medicine, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China 453003.
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Na HY, Moon JH, Choi JY, Yu HW, Jeong WJ, Kim YK, Choe JY, Park SY. Preoperative diagnostic categories of fine needle aspiration cytology for histologically proven thyroid follicular adenoma and carcinoma, and Hurthle cell adenoma and carcinoma: Analysis of cause of under- or misdiagnoses. PLoS One 2020; 15:e0241597. [PMID: 33147258 PMCID: PMC7641403 DOI: 10.1371/journal.pone.0241597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 10/17/2020] [Indexed: 11/18/2022] Open
Abstract
Cytologic diagnosis of thyroid follicular adenoma and carcinoma, and Hurthle cell adenoma and carcinoma (FACHAC) is challenging due to cytomorphologic features that overlap with other follicular-patterned lesions. This study was designed to analyze diagnostic categories (DCs) of preoperative fine needle aspiration cytology (FNAC) of histologically proven thyroid FACHACs to evaluate under- or misdiagnoses in FNAC and elucidate potential causes for such phenomena. A total of 104 thyroid nodules with preoperative FNAC which were diagnosed as FACHAC in resection specimens were included in this study. Of these, 66 cases had also undergone thyroid core needle biopsy (CNB); FNAC and CNB DCs were compared in these cases. Various cytologic and histologic parameters were compared between the nodules with different FNAC DCs. After a review of FNAC slides, DCs were re-assigned in 20 (19.2%) out of the 104 cases. Of the 66 cases with CNB diagnoses which were mostly classified as lower DCs in FNAC, 31 (47.0%) were diagnosed as suspicious for a follicular neoplasm in CNB. Cases which were underdiagnosed in FNACs were associated with lower cellularity, predominant macrofollicular pattern, absence of microfollicles arranged in trabecular pattern, and absence of transgressing vessels in cytology smears. High cellularity, microfollicles arranged in trabecular pattern, nucleolar prominence, and large cell dysplasia were more frequently found in malignancy than in benign neoplasm. In conclusion, thyroid FACHACs seem to be under- and misdiagnosed in preoperative FNAC. Innate characteristics of the nodules were associated with under-diagnosis as well as the quality of the FNAC specimens. Certain cytomorphologic features can be helpful in differentiating malignancy among FACHACs.
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Affiliation(s)
- Hee Young Na
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Hoon Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - June Young Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyeong Won Yu
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woo-Jin Jeong
- Department of Otorhinolaryngology–Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yeo Koon Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji-Young Choe
- Department of Pathology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - So Yeon Park
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- * E-mail:
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17
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Changes in the Demographic and Clinicopathological Characteristics of Thyroid Cancer: A Population-Based Investigation in Algeria, 1993-2013. J Cancer Epidemiol 2020; 2020:7812791. [PMID: 33029144 PMCID: PMC7528096 DOI: 10.1155/2020/7812791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/19/2020] [Accepted: 09/14/2020] [Indexed: 01/09/2023] Open
Abstract
Over the last three decades, the incidence of thyroid cancer has increased worldwide. The reasons for this increase remain controversial. In Algeria, however, to date, information on thyroid cancer has been limited to a hospital-based case series. We analyzed data from a population-based cohort study in Oran District, Algeria, to describe demographic and clinicopathological characteristics of patients diagnosed with thyroid cancer between 1993 and 2013. Medical records and pathology reports of thyroid cancer patients who had surgery were reviewed. Changes in demographic and clinicopathological features over the 21-year period are described. During the study period, thyroid cancer was diagnosed in 1248 women (86.5%, mean age 43.7 ± 15.2 years) and 195 men (23.4%, mean age 48.1 ± 15.9 years). Most cases (83.1% for women and 69.8% for men) sought a diagnosis following a self-neck check. The most common histologic types were papillary (58.3%), follicular (29.7%), anaplastic (4.1%), and medullary (0.8%) carcinomas. The incidence of papillary carcinomas significantly increased (p < 0.001) while the incidence of other histologic types significantly decreased over time. Tumor size overall significantly decreased (p < 0.001) while the frequency of small (≤20 mm) and larger (>20 mm) carcinomas significantly increased (p < 0.05). The frequency of thyroid cancers with capsular effractions and angioinvasions also decreased over time. Thyroid cancer incidence in Algeria has increased substantially in line with international trends with changes in clinical practice being a possible contributing factor. However, the increasing papillary-to-follicular cancer ratio may be due to changes in iodine nutrition status in Algeria. Further research, including exploration of biological and molecular features of thyroid cancer, will enable a better understanding of risk factors and etiopathogenetic mechanisms.
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18
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Bucchi L, Mancini S, Crocetti E, Dal Maso L, Baldacchini F, Vattiato R, Giuliani O, Ravaioli A, Caldarella A, Carrozzi G, Ferretti S, Filiberti RA, Fusco M, Gatti L, Gili A, Magoni M, Mangone L, Mazzoleni G, Michiara M, Panato C, Piffer S, Piras D, Rosso S, Rugge M, Scala U, Tagliabue G, Tumino R, Stanganelli I, Falcini F. Mid-term trends and recent birth-cohort-dependent changes in incidence rates of cutaneous malignant melanoma in Italy. Int J Cancer 2020; 148:835-844. [PMID: 33405292 DOI: 10.1002/ijc.33259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/21/2020] [Accepted: 07/28/2020] [Indexed: 01/12/2023]
Abstract
In Oceania, North America and north-western Europe, after decades of increase, cutaneous malignant melanoma (CMM) rates began to stabilise or decline before 2000. Anecdotal evidence suggests that the reversal of the incidence trend is extending to southern Europe. To obtain a formal confirmation, this nationwide study from Italy investigated the incidence trends by birth cohort. Twenty-one local cancer registries covering a population of 15 814 455 provided incidence data for primary CMM registered between 1994 and 2013. Trends in age-standardised rates were analysed using joinpoint regression models and age-period-cohort models. Age-standardised incidence showed a consistent increase throughout the period (estimated annual percent change, 3.6 [95% confidence interval, 3.2-4.0] among men and 2.5 [2.0-3.1] among women). This pattern was confirmed by a sensitivity analysis with removal of low-risk populations of southern Italy. The rates, however, showed a stabilisation or a decrease in men and women aged below 35. Using the cohort of 1949-the median cohort with respect to the number of cases for both genders-as a reference, the incidence rate ratio increased for successive cohorts born until 1973 (women) and 1975 (men), and subsequently tended to decline. For the most recent cohorts in both genders, the risk of disease returned to the level of the cohort of 1949. The changes observed in the latest generations can be interpreted as the earliest manifestations of a birth-cohort-dependent incidence decrease. Our study adds to previous data indicating that the reversal of the long-term upward incidence trend of CMM is extending to southern Europe.
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Affiliation(s)
- Lauro Bucchi
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Silvia Mancini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Emanuele Crocetti
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Rosa Vattiato
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Orietta Giuliani
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Alessandra Ravaioli
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Giuliano Carrozzi
- Modena Cancer Registry, Public Health Department, Local Health Authority, Modena, Italy
| | - Stefano Ferretti
- Romagna Cancer Registry, section of Ferrara, Local Health Authority, and University of Ferrara, Ferrara, Italy
| | | | | | - Luciana Gatti
- Mantova Cancer Registry, Epidemiology Unit, Agenzia di Tutela della Salute (ATS) della Val Padana, Mantova, Italy
| | - Alessio Gili
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Michele Magoni
- Registry of Brescia Province, Epidemiology Unit, Brescia Health Protection Agency, Brescia, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Maria Michiara
- Parma Cancer Registry, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Chiara Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Silvano Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | - Daniela Piras
- Sassari Cancer Registry, Azienda Regionale per la Tutela della Salute - ATS, Sassari, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Giovanna Tagliabue
- Lombardy Cancer Registry-Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP), Ragusa, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy.,Department of Dermatology, University of Parma, Parma, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy.,Cancer Prevention Unit, Local Health Authority, Forlì, Italy
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Li R, Wang Y, Du L. A rapidly increasing trend of thyroid cancer incidence in selected East Asian countries: Joinpoint regression and age-period-cohort analyses. Gland Surg 2020; 9:968-984. [PMID: 32953606 PMCID: PMC7475344 DOI: 10.21037/gs-20-97] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 06/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study described the incidence and mortality trends and analyzed age-period-cohort effects on incidences in China, Japan, and Korea. METHODS Data were extracted from the Cancer Incidence in Five Continents series and the World Health Organization Cancer Mortality Database, and the age-standardized incidence and mortality rates by Segi's world population were calculated. Joinpoint regression analysis was used to evaluate the time trend of age-standardized incidence and mortality rates and the age-period-cohort model with intrinsic estimator was applied for estimating the effects of age, period, and cohort on thyroid cancer (TC) incidence in individuals between 20 and 84 years of age. RESULTS An increasing trend in TC incidence rates was observed among males from China (10.3%), Japan (4.7%), and Korea (20.8%) and among females from China (9.4%), Japan (3.5%), and Korea (20.5%). TC incidence rates in females were much higher than those in males. A downward trend of TC mortality rates was observed, especially in both sexes of Japan and Chinese females. The slope of the age effect curve peaked at an earlier age in females than males in Japan and Korea. A strong period effect and remarkedly increasing rate ratios were observed in all regions and for both sexes. The cohort effect had a declining tendency on TC incidence in males and females in these areas. CONCLUSIONS The rapidly upward incidence trend and strong period effect suggest that overdiagnosis caused by higher diagnostic intensity might be an explanation for the upward trend, and some environmental risk factor exposures are also not excluded. In addition, the discrepant trends of TC incidence and mortality reveal the need to identify the few high-risk patients who needed further treatment from those patients who may not need treatment.
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Affiliation(s)
- Runhua Li
- Department of Health Care and Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Youqing Wang
- Department of Health Care and Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Lingbin Du
- Department of Health Care and Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
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20
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Mancini S, Bucchi L, Baldacchini F, Giuliani O, Ravaioli A, Vattiato R, Preti M, Tumino R, Ferretti S, Biggeri A, Brustolin A, Boschetti L, Caiazzo AL, Caldarella A, Cesaraccio R, Cirilli C, Citarella A, Filiberti RA, Fusco M, Galasso R, Gatti L, Lotti FL, Magoni M, Mangone L, Masanotti G, Mazzoleni G, Mazzucco W, Melcarne A, Michiara M, Pesce P, Piffer S, Pinto A, Rognoni M, Rosso S, Rugge M, Sampietro G, Scalzi S, Scuderi T, Tagliabue G, Tisano F, Toffolutti F, Vitarelli S, Falcini F. Incidence trends of vulvar squamous cell carcinoma in Italy from 1990 to 2015. Gynecol Oncol 2020; 157:656-663. [PMID: 32273199 DOI: 10.1016/j.ygyno.2020.03.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/08/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The incidence of vulvar squamous cell carcinoma has increased for decades in most Western countries - a trend virtually restricted to women aged <50 or 60 years. In southern Europe, conversely, the trends have been insufficiently studied. This article reports a study from Italy. METHOD Thirty-eight local cancer registries, currently covering 15,274,070 women, equivalent to 49.2% of the Italian national female population, participated. Invasive cancers registered between 1990 and 2015 with an International Classification of Diseases for Oncology, 3rd revision, topography code C51 and morphology codes compatible with vulvar squamous cell carcinoma (n = 6294) were eligible. Incidence trends were analysed using joinpoint regression models, with calculation of the estimated annual percent change (EAPC), and age-period-cohort models. RESULTS Total incidence showed a regular and significant decreasing trend (EAPC, -0.96; 95% confidence interval (CI), -1.43 to -0.48). This was entirely accounted for by women aged ≥60 years (EAPC, -1.34; 95% CI, -1.86 to -0.81). For younger women, the EAPC between 1990 and 2012 was 1.20 (95% CI, 0.34 to 2.06) with a non-significant acceleration thereafter. This pattern did not vary substantially in a sensitivity analysis for the effect of geographic area and duration of the registry. The age-period-cohort analysis revealed a risk decrease in cohorts born between 1905 and 1940 and a new increase in cohorts born since 1945. CONCLUSIONS The decreasing trend observed among older women and the resulting decrease in total rate are at variance with reports from most Western countries. Age-period-cohort analysis confirmed a decreasing trend for earliest birth cohorts and an opposite one for recent ones.
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Affiliation(s)
- Silvia Mancini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Lauro Bucchi
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Orietta Giuliani
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Alessandra Ravaioli
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy.
| | - Rosa Vattiato
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Mario Preti
- Department of Obstetrics and Gynaecology, University of Torino, Torino, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP), Ragusa, Italy
| | | | - Annibale Biggeri
- Department of Statistics, Computer Science, Applications G. Parenti, University of Florence, Florence, Italy
| | - Angelita Brustolin
- Unit of Epidemiology and Cancer Registry, Local Health Authority, Viterbo, Italy
| | | | - Anna L Caiazzo
- Cancer Registry of Local Health Authority Salerno, Salerno, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Rosaria Cesaraccio
- Sassari Cancer Registry, Azienda Regionale per la Tutela della Salute - ATS, Sassari, Italy
| | - Claudia Cirilli
- Modena Cancer Registry, Public Health Department, Local Health Authority, Modena, Italy
| | - Annarita Citarella
- Cancer Registry, Department of Prevention, Unit of Epidemiology, Local Health Authority, Benevento, Italy
| | - Rosa A Filiberti
- Liguria Cancer Registry, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Rocco Galasso
- Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS-CROB, Basilicata, Rionero in Vulture, Italy
| | - Luciana Gatti
- Mantova Cancer Registry, Epidemiology Unit, Agenzia di Tutela della Salute (ATS) della Val Padana, Mantova, Italy
| | - Fernanda L Lotti
- Brindisi Cancer Registry, Local Health Authority, Brindisi, Italy
| | - Michele Magoni
- Cancer Registry of Brescia Province, Epidemiology Unit, Brescia Health Protection Agency, Brescia, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Giuseppe Masanotti
- Section of Public Health and RTUP Register, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | | | - Walter Mazzucco
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | | | - Maria Michiara
- Parma Cancer Registry, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Paola Pesce
- Catania, Messina, and Enna Cancer Registry, Catania, Italy
| | - Silvano Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | - Angela Pinto
- Barletta, Andria, Trani Cancer Registry, BAT Province, Barletta, Italy
| | - Magda Rognoni
- Epidemiology Unit, Cancer Registry of ATS Brianza, Health Protection Agency, Monza, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Massimo Rugge
- Veneto Tumour Registry, Azienda Zero, University of Padova-DIMED, Padova, Italy
| | | | | | | | - Giovanna Tagliabue
- Lombardy Cancer Registry-Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | | | - Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Susanna Vitarelli
- Macerata Province Cancer Registry, University of Camerino, Camerino, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy; Cancer Prevention Unit, Local Health Authority, Forlì, Italy
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21
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Zhang C, Li Y, Li J, Chen X. Total thyroidectomy versus lobectomy for papillary thyroid cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e19073. [PMID: 32028431 PMCID: PMC7015547 DOI: 10.1097/md.0000000000019073] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND This systematic review and meta-analysis collected data for evaluating the effect of surgical extent on overall survival (OS) and recurrence-free survival (RFS) in patients with papillary thyroid cancer (PTC). METHODS We searched the PubMed, Embase, and Cochrane Library databases. The included studies compared two groups of patients with PTC: the total thyroidectomy (TT) group and the lobectomy (LT) group. The combined hazard ratio (HR) was calculated. RESULTS Thirteen studies were included in the present study. The TT and LT groups had similar OS results (HR = 1.04; 95% CI: 0.90-1.21; P = .60). In the subgroup analysis, the combined HR of the ≤1 cm group and the 1.0 to 2.0 cm group showed that TT had no advantage with regard to OS compared to LT. In the 2.0 to 4.0 cm group, TT provided better OS than LT (HR = 0.88; 95% CI: 0.79-0.99; P = .03). Patients who underwent TT had a better RFS outcome than those who underwent LT (HR = 0.56; 95% CI: 0.41-0.77; P < .0001). In the subgroup analysis, both the ≤1 cm group and >1 cm group that underwent TT were associated with better RFS. CONCLUSIONS Our meta-analysis suggested that LT increased the risk of recurrence in PTC patients with tumors ≤1.0 cm and in PTC patients with tumors >1.0 cm. More importantly, LT was associated with higher mortality in PTC patients with 2.0 to 4.0 cm tumors. Caution is warranted when LT is performed in this group of patients.
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Affiliation(s)
- Chi Zhang
- Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University
| | - Yanshuang Li
- Department of Neurology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Jiyu Li
- Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University
| | - Xiao Chen
- Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University
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22
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Krajewska J, Kukulska A, Oczko-Wojciechowska M, Kotecka-Blicharz A, Drosik-Rutowicz K, Haras-Gil M, Jarzab B, Handkiewicz-Junak D. Early Diagnosis of Low-Risk Papillary Thyroid Cancer Results Rather in Overtreatment Than a Better Survival. Front Endocrinol (Lausanne) 2020; 11:571421. [PMID: 33123090 PMCID: PMC7573306 DOI: 10.3389/fendo.2020.571421] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/14/2020] [Indexed: 12/11/2022] Open
Abstract
We are witnessing a rapid worldwide increase in the incidence of papillary thyroid carcinoma (PTC) in the last thirty years. Extensive implementation of cancer screening and wide availability of neck ultrasound or other imaging studies is the main reason responsible for this phenomenon. It resulted in a detection of a growing number of clinically asymptomatic PTCs, mainly low-risk tumors, without any beneficial impact on survival. An indolent nature of low-risk PTC, particularly papillary thyroid microcarcinoma (PTMC), and the excellent outcomes raise an ongoing discussion regarding the adequacy of treatment applied. The question of whether PTMC is overtreated or not is currently completed by another, whether PTMC requires any treatment. Current ATA guidelines propose less extensive preoperative diagnostics and, if differentiated thyroid cancer is diagnosed, less aggressive surgical approach and limit indications for postoperative radioiodine therapy. However, in intrathyroidal PTMCs in the absence of lymph node or distant metastases, active surveillance may constitute alternative management with a low progression rate of 1%-5% and without any increase in the risk of poorer outcomes related to delayed surgery in patients, in whom it was necessary. This review summarizes the current knowledge and future perspectives of active surveillance in low-risk PTC.
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Affiliation(s)
- Jolanta Krajewska
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
- *Correspondence: Jolanta Krajewska,
| | - Aleksandra Kukulska
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
- Radiotherapy Department, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Malgorzata Oczko-Wojciechowska
- Department of Genetic and Molecular Diagnostics of Cancer, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Agnieszka Kotecka-Blicharz
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Katarzyna Drosik-Rutowicz
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
- Radiotherapy Department, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Malgorzata Haras-Gil
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Barbara Jarzab
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Daria Handkiewicz-Junak
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
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23
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Mekraksakit P, Rattanawong P, Karnchanasorn R, Kanitsoraphan C, Leelaviwat N, Poonsombudlert K, Kewcharoen J, Dejhansathit S, Samoa R. PROGNOSIS OF DIFFERENTIATED THYROID CARCINOMA IN PATIENTS WITH GRAVES DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract 2019; 25:1323-1337. [PMID: 31412224 DOI: 10.4158/ep-2019-0201] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: It is still controversial whether differentiated thyroid carcinoma (DTC) in patients with Graves disease (GD) can be more aggressive than non-Graves DTC. We conducted a systematic review and meta-analysis to examine the association between GD and prognosis in patients with DTC. Methods: We comprehensively searched the databases of MEDLINE and EMBASE from inception to March 2019. We included published studies that compared the risk of mortality and prognosis between DTC patients with GD and those with non-GD. Data from each study were combined using the random-effects model. Results: Twenty-five studies from February 1988 to May 2018 were included (987 DTC patients with GD and 2,064 non-Graves DTC patients). The DTC patients with GD had a significantly higher risk of associated multifocality/multicentricity (odds ratio, 1.45; 95% confidence interval, 1.04 to 2.02; I2, 6.5%; P = .381) and distant metastasis at the time of cancer diagnosis (odds ratio, 2.19; 95% confidence interval, 1.08 to 4.47; I2, 0.0%; P = .497), but this was not associated with DTC-related mortality and recurrence/persistence during follow-up. Conclusion: Our meta-analysis demonstrates a statistically significant increased risk of multifocality/multicentricity and distant metastasis at the time of cancer diagnosis in DTC patients with GD than those without GD. Abbreviations: CI = confidence interval; DTC = differentiated thyroid carcinoma; GD = Graves disease; LN = lymph node; OR = odds ratio; PTC = papillary thyroid carcinoma; TC = thyroid carcinoma; TSAb = thyroid-stimulating antibody; TSH = thyroid-stimulating hormone.
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Wang B, Zhu CR, Liu H, Wu J. The effectiveness of parathyroid gland autotransplantation in preserving parathyroid function during thyroid surgery for thyroid neoplasms: A meta-analysis. PLoS One 2019; 14:e0221173. [PMID: 31412080 PMCID: PMC6693848 DOI: 10.1371/journal.pone.0221173] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/31/2019] [Indexed: 12/13/2022] Open
Abstract
Objective We conducted this meta-analysis to assess the effectiveness of parathyroid gland autotransplantation in preserving parathyroid function during thyroid surgery for thyroid neoplasms. Methods We conducted a search by using PubMed, Embase, and the Cochrane Library electronic databases for studies that were published up to January 2019. The reference lists of the retrieved articles were also reviewed. Two authors independently assessed the methodological quality and extracted the data. A random-effects model was used to calculate the overall combined risk estimates. Publication bias was evaluated with a funnel plot using Egger’s and Begg’s tests. Results A total of 25 independent studies involving 10,531 participants were included in the meta-analysis. Compared with patients who did not undergo parathyroid gland autotransplantation, the overall pooled relative risks for patients who underwent parathyroid gland autotransplantation were 1.75 (95% CI: 1.51–2.02, p<0.001) for postoperative hypoparathyroidism, 1.72 (95% CI: 1.45–2.05, p<0.001) for protracted hypoparathyroidism, 1.06 (95% CI: 0.44–2.58, p = 0.894) and 0.71 (95% CI: 0.22–2.29, p = 0.561) for biochemical hypoparathyroidism and biochemical hypocalcemia at 6 months postoperatively, respectively, and 1.89 (95% CI: 1.33–2.69, p<0.001) and 0.22 (95% CI: 0.09–0.52, p = 0.001) for biochemical hypoparathyroidism and biochemical hypocalcemia at 12 months postoperatively, respectively. The pooled relative risks for patients who underwent one parathyroid gland autotransplantation and patients who underwent two or more parathyroid gland autotransplantations were 1.71 (95% CI: 1.25–2.35, p = 0.001) and 2.22 (95% CI: 1.43–3.45, p<0.001) for postoperative hypoparathyroidism, 1.09 (95% CI: 0.59–2.01, p = 0.781) and 0.55 (95% CI: 0.16–1.87, p = 0.341) for hypoparathyroidism at 6 months postoperatively compared with those of patients who did not undergo parathyroid gland autotransplantation. Conclusions Parathyroid gland autotransplantation is significantly associated with increased risk of postoperative and protracted hypoparathyroidism, and the number of autoplastic parathyroid glands is positively correlated with the incidence of postoperative hypoparathyroidism.
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Affiliation(s)
- Bin Wang
- Department of Thyroid and Breast Surgery, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Chun-Rong Zhu
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
- Department of Chemistry, School of Basic Medical Science, North Sichuan Medical College, Nanchong, China
| | - Hong Liu
- Department of Thyroid and Breast Surgery, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Jian Wu
- Department of Thyroid and Breast Surgery, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China
- * E-mail:
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Panato C, Serraino D, De Santis E, Forgiarini O, Angelin T, Bidoli E, Zanier L, Del Zotto S, Vaccarella S, Franceschi S, Dal Maso L. Thyroid cancer in Friuli Venezia Giulia, northeastern Italy: incidence, overdiagnosis, and impact of type of surgery on survival. TUMORI JOURNAL 2019; 105:296-303. [PMID: 30917766 DOI: 10.1177/0300891619839307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Incidence rates of thyroid cancer (TC) increased in the last decades worldwide. This study aimed to describe TC incidence in the Friuli Venezia Giulia (FVG) region, to estimate the quota of overdiagnosis, and to investigate the impact of surgery on long-term survival after TC diagnosis. METHODS TC cases reported to the FVG population-based cancer registry during 2002-2013, aged <85 years, were included. Age standardized rates (ASR) on the European population were computed, while proportion of TC overdiagnosis was estimated in comparison with expected age-specific incidence rates from published time series. Adjusted hazard ratios of death, with 95% confidence intervals, were also estimated. RESULTS During 2002-2013, 1701 TC cases were reported to the FVG cancer registry, with papillary TC (78.2%) as the most frequent histologic type. ASR increased from 12.4 to 16.5 in women and from 4.3 to 6.2 in men (+33.1% and +44.2%, respectively). Overdiagnosis was estimated as 79% of TC cases in women and 64% in men. Almost all TC cases (97.1%) underwent surgery, including 84.6% of women and 78.9% of men who underwent total thyroidectomy. Up to 10 years after TC diagnosis, the type of surgery did not appear to influence survival. CONCLUSIONS This study documented an increase in TC incidence in FVG in the last decade, with overdiagnosis accounting for a large proportion of TC diagnoses and total thyroidectomy in more than 80% of cases. These findings suggest reconsidering thyroid screening practice and aggressive therapeutic strategies, as recommended by new TC guidelines.
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Affiliation(s)
- Chiara Panato
- 1 Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Diego Serraino
- 1 Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Emilia De Santis
- 2 Friuli Venezia Giulia Cancer Registry, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Ornella Forgiarini
- 2 Friuli Venezia Giulia Cancer Registry, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Tiziana Angelin
- 1 Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Ettore Bidoli
- 1 Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Loris Zanier
- 3 Epidemiological Service, Azienda Regionale di Coordinamento per la Salute (ARCS), Udine, Italy
| | - Stefania Del Zotto
- 3 Epidemiological Service, Azienda Regionale di Coordinamento per la Salute (ARCS), Udine, Italy
| | | | - Silvia Franceschi
- 5 Scientific Directorate, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Luigino Dal Maso
- 1 Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
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Salazar-Vega J, Ortiz-Prado E, Solis-Pazmino P, Gómez-Barreno L, Simbaña-Rivera K, Henriquez-Trujillo AR, Brito JP, Toulkeridis T, Coral-Almeida M. Thyroid Cancer in Ecuador, a 16 years population-based analysis (2001-2016). BMC Cancer 2019; 19:294. [PMID: 30940122 PMCID: PMC6444541 DOI: 10.1186/s12885-019-5485-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thyroid cancer is the most frequent endocrine neoplasia worldwide. Information from Andean countries is scarce. In Ecuador there is no reports available of the epidemiology of this type of cancer. The aim of this study is to present the epidemiology and the burden of disease of thyroid cancer. METHODS This is a cross-sectional population-based analysis of thyroid cancer epidemiology in Ecuador from 2001 to 2016. The variables studied were the overall mortality rate, socio-demographics characteristics of the hospitalized patients, geographical trends and the burden of thyroid cancer in Ecuador. All the data was obtained from the official records reported by the Ministry of Public Health's and retrieved from the public databases of the Vital Statistics Deaths and Births Databases and the National Institute of Census and Statistics (INEC). RESULTS In Ecuador, over a period of 16 years from 2001 to 2016 a total of 23,632 hospital admissions were reported, which caused 1539 deaths due thyroid cancer. Data demonstrated an annual mean of 1477 cases, which caused 96 deaths per year in average. The annual incidence fluctuated from 3 in 2001 to 22 in 2016 per 100,000 inhabitants. Women were 5 times more likely than men to have thyroid cancer. The average length of stay for both sexes were 4 days. The mortality attributable to thyroid cancer represent less than 0.3% of all cancer deaths. CONCLUSION Ecuador has one of the highest rates of thyroid cancer in Latin America, ranking first among women in Latin America. Although this cancer is frequent, mortality rate is relatively low. As this is the first national report of thyroid cancer in the country, a further analysis of the pathological variants and the grading of this neoplasia is needed.
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Affiliation(s)
- Jorge Salazar-Vega
- OneHealth Research Group, Faculty of Medicine, Universidad de las Americas, Calle de los Colimes y Avenida De los Granados, 170137, Quito, Ecuador.,Endocrinology Department, Hospital Eugenio Espejo, Quito, Ecuador
| | - Esteban Ortiz-Prado
- OneHealth Research Group, Faculty of Medicine, Universidad de las Americas, Calle de los Colimes y Avenida De los Granados, 170137, Quito, Ecuador. .,Department of Cell Biology, Physiology and Immunology, Universidad de Barcelona, Barcelona, Spain.
| | | | - Lenin Gómez-Barreno
- OneHealth Research Group, Faculty of Medicine, Universidad de las Americas, Calle de los Colimes y Avenida De los Granados, 170137, Quito, Ecuador
| | - Katherine Simbaña-Rivera
- OneHealth Research Group, Faculty of Medicine, Universidad de las Americas, Calle de los Colimes y Avenida De los Granados, 170137, Quito, Ecuador
| | - Aquiles R Henriquez-Trujillo
- OneHealth Research Group, Faculty of Medicine, Universidad de las Americas, Calle de los Colimes y Avenida De los Granados, 170137, Quito, Ecuador
| | - Juan P Brito
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine and the Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | | | - Marco Coral-Almeida
- OneHealth Research Group, Faculty of Medicine, Universidad de las Americas, Calle de los Colimes y Avenida De los Granados, 170137, Quito, Ecuador
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Gandini S, Lazzeroni M, Peccatori FA, Bendinelli B, Saieva C, Palli D, Masala G, Caini S. The risk of extra-ovarian malignancies among women with endometriosis: A systematic literature review and meta-analysis. Crit Rev Oncol Hematol 2019; 134:72-81. [PMID: 30771877 DOI: 10.1016/j.critrevonc.2018.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/29/2018] [Accepted: 12/30/2018] [Indexed: 01/23/2023] Open
Abstract
We conducted a meta-analysis of studies reporting on the risk of extra-ovarian malignancies among women with endometriosis. Summary relative risk (SRR) and 95% confidence intervals (CI) were calculated through random effect models. We explored causes of between-studies heterogeneity and assessed the presence of publication bias. We included 32 studies published between 1989 and 2018. We found an increased risk of endometrial (SRR 1.38, 95%CI 1.10-1.74) and thyroid cancer (SRR 1.38, 95%CI 1.17-1.63), and inverse association with cervical cancer (SRR 0.78, 95%CI 0.60-0.95). No association emerged for breast cancer (SRR 1.04, 95%CI 0.99-1.09) and melanoma (SRR 1.31, 95%CI 0.86-1.96). Between-study heterogeneity was large for breast and endometrial cancer and melanoma. Associations were generally stronger in case-control, cross-sectional, and cohort studies with internal control group, compared to cohort studies with external control group. No indication for publication bias was found. Our conclusions need to be confirmed in properly designed cohort studies with clinical confirmation of endometriosis.
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Affiliation(s)
- S Gandini
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - M Lazzeroni
- Division of Cancer Prevention and Genetics, European Institute of Oncology IRCCS, Milan, Italy
| | - F A Peccatori
- Division of Gynecology Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - B Bendinelli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - C Saieva
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - D Palli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - G Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - S Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy.
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Salamanca-Fernández E, Rodriguez-Barranco M, Chang-Chan YL, Redondo-Sánchez D, Domínguez-López S, Bayo E, Narankiewicz D, Expósito J, Sánchez MJ. Thyroid Cancer Epidemiology in South Spain: a population-based time trend study. Endocrine 2018; 62:423-431. [PMID: 30043094 DOI: 10.1007/s12020-018-1681-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/09/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE Thyroid cancer (TC) is the most common malignant disease of the endocrine system. The aim of this study was to analyze incidence and mortality trends of TC (C73 according to ICD-O-3) in Granada (Southern Spain) during the period 1985-2013, by sex, age, and histological type. METHODS This is a population-based cross-sectional study. Incidence data were obtained from the population-based Cancer Registry of Granada. All newly diagnosed cases of thyroid cancer over the period 1985-2013 were included. Joinpoint regression analysis with age-standardized rates were used to estimate annual percentage change (APC), CI 95% and turning points in trends. Results are presented by sex, age group, and histological type. RESULTS During the study period there were 1265 diagnosed cases of TC in Granada (72.6% in women). Incidence trends significantly increased in both men (APC: + 5.4%) and women (APC: + 4.7%). The most common histological types in both sexes were papillary (74.8%) and follicular (16.8%). The incidence has increased during the study period mainly due to papillary carcinoma, which has increased annually around 6% in both sexes. TC mortality trend during this period decreased in men (APC: -0.3%) and women (APC: -2.3%). CONCLUSION Our data showed an increasing trend in incidence of thyroid cancer in Granada, especially in women between 55-64 years. Mortality showed a slight decrease trend during the study period in both sexes. Papillary carcinoma was the most common histological type, with an increase of the relative weight of papillary microcarcinomas. Our study is in accordance with the European and worldwide trends in thyroid cancer incidence and mortality and sex differences.
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Affiliation(s)
- Elena Salamanca-Fernández
- Andalusian School of Public Health (EASP), Granada, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Granada, Spain
- Biosanitary Investigation Institute ibs, Granada, Spain
| | - Miguel Rodriguez-Barranco
- Andalusian School of Public Health (EASP), Granada, Spain.
- CIBER Epidemiology and Public Health (CIBERESP), Granada, Spain.
- Biosanitary Investigation Institute ibs, Granada, Spain.
| | - Yoe-Ling Chang-Chan
- Andalusian School of Public Health (EASP), Granada, Spain
- Biosanitary Investigation Institute ibs, Granada, Spain
| | - Daniel Redondo-Sánchez
- Andalusian School of Public Health (EASP), Granada, Spain
- Biosanitary Investigation Institute ibs, Granada, Spain
| | | | - Eloísa Bayo
- Radiation Oncology Department, University Hospital Virgen Macarena, Sevilla, Spain
| | - Dariusz Narankiewicz
- Preventive Medicine and Public Health Department, Hospital Virgen de la Victoria of Málaga, Málaga, Spain
| | - José Expósito
- Biosanitary Investigation Institute ibs, Granada, Spain
- Radiotherapy and Oncology Department, University Hospital Virgen de las Nieves Granada, Granada, Spain
| | - María José Sánchez
- Andalusian School of Public Health (EASP), Granada, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Granada, Spain
- Biosanitary Investigation Institute ibs, Granada, Spain
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29
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Borges AKDM, Miranda-Filho A, Koifman S, Koifman RJ. Thyroid Cancer Incidences From Selected South America Population-Based Cancer Registries: An Age-Period-Cohort Study. J Glob Oncol 2018; 4:1-11. [PMID: 30241178 PMCID: PMC6180755 DOI: 10.1200/jgo.17.00024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The incidence of thyroid cancer (TC) has increased substantially worldwide. However, there is a lack of knowledge about age-period-cohort (APC) effects on incidence rates in South American countries. This study describes the TC incidence trends and analyzes APC effects in Cali, Colombia; Costa Rica; Goiânia, Brazil; and Quito, Ecuador. MATERIALS AND METHODS Data were obtained from the Cancer Incidence in Five Continents series, and the crude and age-standardized incidence rates were calculated. Trends were assessed using the estimated annual percentage change, and APC models were estimated using Poisson regression for individuals between age 20 and 79 years. RESULTS An increasing trend in age-standardized incidence rates was observed among women from Goiânia (9.2%), Costa Rica (5.7%), Quito (4.0%), and Cali (3.4%), and in men from Goiânia (10.0%) and Costa Rica (3.4%). The APC modeling showed that there was a period effect in all regions and for both sexes. Increasing rate ratios were observed among women over the periods. The best fit model was the APC model in women from all regions and in men from Quito, whereas the age-cohort model showed a better fit in men from Cali and Costa Rica, and the age-drift model showed a better fit among men from Goiânia. CONCLUSION These findings suggest that overdiagnosis is a possible explanation for the observed increasing pattern of TC incidence. However, some environmental exposures may also have contributed to the observed increase.
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Affiliation(s)
- Anne Karin da Mota Borges
- Anne Karin da Mota Borges, Sérgio
Koifman,† and Rosalina Jorge Koifman, National
Public Health School, Oswaldo Cruz Foundation; Anne Karin da Mota
Borges, Brazilian National Cancer Institute, Rio de Janeiro, Brazil;
and Adalberto Miranda-Filho, International Agency for Research on
Cancer, Lyon, France
| | - Adalberto Miranda-Filho
- Anne Karin da Mota Borges, Sérgio
Koifman,† and Rosalina Jorge Koifman, National
Public Health School, Oswaldo Cruz Foundation; Anne Karin da Mota
Borges, Brazilian National Cancer Institute, Rio de Janeiro, Brazil;
and Adalberto Miranda-Filho, International Agency for Research on
Cancer, Lyon, France
| | - Sérgio Koifman
- Anne Karin da Mota Borges, Sérgio
Koifman,† and Rosalina Jorge Koifman, National
Public Health School, Oswaldo Cruz Foundation; Anne Karin da Mota
Borges, Brazilian National Cancer Institute, Rio de Janeiro, Brazil;
and Adalberto Miranda-Filho, International Agency for Research on
Cancer, Lyon, France
| | - Rosalina Jorge Koifman
- Anne Karin da Mota Borges, Sérgio
Koifman,† and Rosalina Jorge Koifman, National
Public Health School, Oswaldo Cruz Foundation; Anne Karin da Mota
Borges, Brazilian National Cancer Institute, Rio de Janeiro, Brazil;
and Adalberto Miranda-Filho, International Agency for Research on
Cancer, Lyon, France
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30
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Wang B, Su AP, Xing TF, Luo H, Zhao WJ, Zhu JQ. The function of carbon nanoparticles to improve lymph node dissection and identification of parathyroid glands during thyroid reoperation for carcinoma. Medicine (Baltimore) 2018; 97:e11778. [PMID: 30095634 PMCID: PMC6133593 DOI: 10.1097/md.0000000000011778] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
To evaluate the function of carbon nanoparticles during the thyroid reoperation for carcinoma, we conducted this study by retrospectively analyzing the data of patients who underwent at least completion thyroidectomy with bilateral central lymph nodes dissection for thyroid carcinoma from January 2009 to June 2016. The clinicopathologic characteristics and surgical details were compared between the patient who accepted intraoperative carbon nanoparticles injection and those who accepted nothing injection during the surgery. The main monitoring indicators were the number of dissected lymph nodes and metastatic lymph nodes in central zone, the number of identified parathyroid glands and autoplastic parathyroid glands and unintentionally resected parathyroid glands. A total of 69 patients were enrolled into the carbon nanoparticles group and 128 patients were enrolled into the control group.The average number of lymph nodes harvested in the central zone was higher in the carbon nanoparticles group than that in the control group (11.2 ± 5.7 vs 7.7 ± 4.0, P < .001), so was the average number of metastatic lymph nodes (4.5 ± 4.5 vs 2.7 ± 2.9, P = .004). The average number of identified parathyroid gland was greater in the carbon nanoparticles group than that in the control group (2.4 ± 1.2 vs 1.6 ± 1.1, P < .001). The average number of autoplastic parathyroid gland was comparable between the 2 groups (0.6 ± 0.6 vs 0.4 ± 0.7, P = .052). But the average number of unintentionally resected parathyroid gland was less in the carbon nanoparticles group than that in the control group (0.1 ± 0.2 vs 0.2 ± 0.4, P = .007). Carbon nanoparticles can improve lymph nodes dissection and identification of parathyroid gland during thyroid reoperation for carcinoma.
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Affiliation(s)
- Bin Wang
- Thyroid and Parathyroid Surgery Center, West China Hospital, Sichuan University Department of Thyroid and Breast Surgery, The Third People's Hospital of Chengdu, Chengdu Department of Thyroid and Breast Surgery, Dazhou Central Hospital, Dazhou, Sichuan Province, China
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31
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Ke Z, Liu Y, Zhang Y, Li J, Kuang M, Peng S, Liang J, Yu S, Su L, Chen L, Sun C, Li B, Cao J, Lv W, Xiao H. Diagnostic value and lymph node metastasis prediction of a custom‑made panel (thyroline) in thyroid cancer. Oncol Rep 2018; 40:659-668. [PMID: 29901149 PMCID: PMC6072293 DOI: 10.3892/or.2018.6493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/05/2018] [Indexed: 01/21/2023] Open
Abstract
Differentiation of benign and malignant thyroid nodules is crucial for clinical management. Here, we explored the efficacy of next-generation sequencing (NGS) in predicting the classification of benign and malignant thyroid nodules and lymph node metastasis status, and simultaneously compared the results with ultrasound (US). Thyroline was designed to detect 15 target gene mutations and 2 fusions in 98 formalin-fixed, paraffin-embedded (FFPE) tissues, including those from 82 thyroid cancer (TC) patients and 16 patients with benign nodules. BRAF mutations were found in 57.69% of the papillary thyroid cancer (PTC) cases, while RET mutations were detected among all the medullary thyroid cancer (MTC) cases. Multiple mutations were positive but none showed dominance in anaplastic thyroid cancer (ATC) and follicular thyroid cancer (FTC). The sensitivity and specificity of NGS prediction in differentiation of benign and malignant thyroid nodules were 79.27 and 93.75%, respectively, and the positive predictive value (PPV) and negative predictive value (NPV) were 98.48 and 46.88%, respectively. The sensitivity and specificity of US were 76.83 and 6.25%, respectively, and the PPV and NPV were 80.77 and 5.00%, respectively. The area under curve (AUC) of NGS and US were 0.865 and 0.415, respectively. A total of 27 patients had ≥1 metastases to lymph nodes, 19 of which carried mutations, including BRAF, RET, NRAS, PIK3CA, TP53, CTNNB1 and PTEN. However, there was no correlation between the variant allele frequency of specific gene mutations and the number of metastatic lymph nodes. In conclusion, the prediction value of NGS was higher than the US-based Thyroid Imaging Reporting and Data System (TI-RADS). NGS is valuable for the accurate differentiation of benign and malignant thyroid nodules, and pathological subtypes in FFPE samples. The findings of the present study may pave the way for the application of NGS in analyzing fine-needle aspiration (FNA) biopsy samples.
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Affiliation(s)
- Zunfu Ke
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Yihao Liu
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Yunjian Zhang
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Jie Li
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Ming Kuang
- Cancer Center, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Sui Peng
- Clinical Trial Unit, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Jinyu Liang
- Department of Ultrasound, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Shuang Yu
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Lei Su
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Lili Chen
- Department of Pathology, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Cong Sun
- Department of Pathology, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Bin Li
- Clinical Trial Unit, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Jessica Cao
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Weiming Lv
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Haipeng Xiao
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
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Mathiesen JS, Kroustrup JP, Vestergaard P, Stochholm K, Poulsen PL, Rasmussen ÅK, Feldt-Rasmussen U, Schytte S, Londero SC, Pedersen HB, Hahn CH, Djurhuus BD, Bentzen J, Möller S, Gaustadnes M, Rossing M, Nielsen FC, Brixen K, Frederiksen AL, Godballe C. Incidence and prevalence of sporadic and hereditary MTC in Denmark 1960-2014: a nationwide study. Endocr Connect 2018; 7:829-839. [PMID: 29760189 PMCID: PMC6000757 DOI: 10.1530/ec-18-0157] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 05/14/2018] [Indexed: 12/20/2022]
Abstract
Recent studies have shown a significant increase in the temporal trend of medullary thyroid carcinoma (MTC) incidence. However, it remains unknown to which extent sporadic medullary thyroid carcinoma (SMTC) and hereditary MTC (HMTC) affect the MTC incidence over time. We conducted a nationwide retrospective study using previously described RET and MTC cohorts combined with review of medical records, pedigree comparison and relevant nationwide registries. The study included 474 MTC patients diagnosed in Denmark between 1960 and 2014. In the nationwide period from 1997 to 2014, we recorded a mean age-standardized incidence of all MTC, SMTC and HMTC of 0.19, 0.13 and 0.06 per 100,000 per year, respectively. The average annual percentage change in incidence for all MTC, SMTC and HMTC were 1.0 (P = 0.542), 2.8 (P = 0.125) and -3.1 (P = 0.324), respectively. The corresponding figures for point prevalence at January 1, 2015 were 3.8, 2.5 and 1.3 per 100,000, respectively. The average annual percentage change in prevalence from 1998 to 2015 for all MTC, SMTC and HMTC was 2.8 (P < 0.001), 3.8 (P < 0.001) and 1.5 (P = 0.010), respectively. We found no significant change in the incidence of all MTC, SMTC and HMTC possibly due to our small sample size. However, due to an increasing trend in the incidence of all MTC and opposing trends of SMTC (increasing) and HMTC (decreasing) incidence, it seems plausible that an increase for all MTC seen by others may be driven by the SMTC group rather than the HMTC group.
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Affiliation(s)
- Jes Sloth Mathiesen
- Department of ORL Head & Neck SurgeryOdense University Hospital, Odense, Denmark
- Department of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
| | - Jens Peter Kroustrup
- Department of Clinical Medicine and EndocrinologyAalborg University Hospital, Aalborg, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine and EndocrinologyAalborg University Hospital, Aalborg, Denmark
| | - Kirstine Stochholm
- Department of Internal Medicine and EndocrinologyAarhus University Hospital, Aarhus, Denmark
- Center for Rare DiseasesAarhus University Hospital, Aarhus N, Denmark
| | - Per Løgstrup Poulsen
- Department of Internal Medicine and EndocrinologyAarhus University Hospital, Aarhus, Denmark
| | - Åse Krogh Rasmussen
- Department of Medical EndocrinologyCopenhagen University Hospital, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical EndocrinologyCopenhagen University Hospital, Copenhagen, Denmark
| | - Sten Schytte
- Department of ORL Head & Neck SurgeryAarhus University Hospital, Aarhus, Denmark
| | | | | | - Christoffer Holst Hahn
- Department of ORL Head & Neck SurgeryCopenhagen University Hospital, Copenhagen, Denmark
| | | | - Jens Bentzen
- Department of OncologyHerlev Hospital, Herlev, Denmark
| | - Sören Möller
- Department of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN)Odense University Hospital, Odense, Denmark
| | - Mette Gaustadnes
- Department of Molecular MedicineAarhus University Hospital, Aarhus, Denmark
| | - Maria Rossing
- Center for Genomic MedicineCopenhagen University Hospital, Copenhagen, Denmark
| | - Finn Cilius Nielsen
- Center for Genomic MedicineCopenhagen University Hospital, Copenhagen, Denmark
| | - Kim Brixen
- Department of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
| | - Anja Lisbeth Frederiksen
- Department of Clinical ResearchUniversity of Southern Denmark, Odense, Denmark
- Department of Clinical GeneticsOdense University Hospital, Odense, Denmark
| | - Christian Godballe
- Department of ORL Head & Neck SurgeryOdense University Hospital, Odense, Denmark
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Dal Maso L, Panato C, Franceschi S, Serraino D, Buzzoni C, Busco S, Ferretti S, Torrisi A, Falcini F, Zorzi M, Cirilli C, Mazzucco W, Magoni M, Collarile P, Pannozzo F, Caiazzo AL, Russo AG, Gili A, Caldarella A, Zanetti R, Michiara M, Mangone L, Filiberti RA, Fusco M, Gasparini F, Tagliabue G, Cesaraccio R, Tumino R, Gatti L, Tisano F, Piffer S, Sini GM, Mazzoleni G, Rosso S, Fanetti AC, Vaccarella S. The impact of overdiagnosis on thyroid cancer epidemic in Italy,1998-2012. Eur J Cancer 2018; 94:6-15. [PMID: 29502036 DOI: 10.1016/j.ejca.2018.01.083] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/16/2018] [Accepted: 01/20/2018] [Indexed: 01/08/2023]
Abstract
AIMS In Italy, incidence rates of thyroid cancer (TC) are among the highest worldwide with substantial intracountry heterogeneity. The aim of the study was to examine time trends of TC incidence in Italy and to estimate the proportion of TC cases potentially attributable to overdiagnosis. METHODS Data on TC cases reported to Italian cancer registries during 1998-2012 aged <85 years were included. Age-standardised incidence rates (ASR) were computed by sex, period, and histology. TC overdiagnosis was estimated by sex, period, age, and Italian region. RESULTS In Italy between 1998-2002 and 2008-2012, TC ASR increased of 74% in women (from 16.2 to 28.2/100,000) and of 90% in men (from 5.3 to 10.1/100,000). ASR increases were nearly exclusively due to papillary TC (+91% in women, +120% in men). In both sexes, more than three-fold differences emerged between regions with highest and lowest ASR. Among TC cases diagnosed in 1998-2012 in Italy, we estimated that overdiagnosis accounted for 75% of cases in women and 63% in men and increased over the study period leading to overdiagnosis of 79% in women and 67% in men in 2008-2012. Notably, overdiagnosis was over 80% among women aged <55 years, and substantial variations were documented across Italian regions, in both genders. CONCLUSION(S) Incidence rates of TC are steadily increasing in Italy and largely due to overdiagnosis. These findings call for an update of thyroid gland examination practices in the asymptomatic general population, at national and regional levels.
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Affiliation(s)
- Luigino Dal Maso
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy.
| | - Chiara Panato
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | | | - Diego Serraino
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | - Carlotta Buzzoni
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy; AIRTUM Database, Florence, Italy
| | - Susanna Busco
- Cancer Registry of Latina Province, ASL Latina, Italy
| | - Stefano Ferretti
- Ferrara Cancer Registry, University of Ferrara, Azienda USL Ferrara, Italy
| | - Antonietta Torrisi
- Registro Tumori Integrato Catania-Messina-Siracusa-Enna, Università Degli Studi di Catania, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (Forlì), Italy-Azienda Usl della Romagna, Forlì, Italy
| | - Manuel Zorzi
- Veneto Tumor Registry, Veneto Region, Padua, Italy
| | - Claudia Cirilli
- Modena Cancer Registry, Public Health Department, AUSL Modena, Italy
| | - Walter Mazzucco
- Palermo and Province Cancer Registry, Clinical Epidemiology Unit with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", University of Palermo, Italy
| | - Michele Magoni
- Brescia Cancer Registry, Epidemiology Unit, Brescia Health Protection Agency, Italy
| | - Paolo Collarile
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | | | | | | | - Alessio Gili
- Public Health Section, Dept. of Experimental Medicine, University of Perugia, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - Roberto Zanetti
- Piedmont Cancer Registry, City of Torino, Ospedale S. Giovanni Battista-CPO, Torino, Italy
| | - Maria Michiara
- Parma Cancer Registry, Oncology Unit, Azienda Ospedaliera Universitaria di Parma, Italy
| | - Lucia Mangone
- Reggio Emilia Cancer Registry, Epidemiology Unit, AUSL ASMN-IRCCS, Azienda USL di Reggio Emilia, Italy
| | - Rosa Angela Filiberti
- Liguria Region Cancer Registry, Epidemiologia Clinica, Ospedale Policlinico San Martino IRCCS, Genova, Italy
| | - Mario Fusco
- Cancer Registry of ASL Napoli 3 Sud, Napoli, Italy
| | | | - Giovanna Tagliabue
- Lombardy Cancer Registry, Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosaria Cesaraccio
- North Sardinia Cancer Registry, Azienda Regionale per la Tutela della Salute, Sassari, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, "Civic - M.P. Arezzo" Hospital, ASP Ragusa, Italy
| | - Luciana Gatti
- Mantova Cancer Registry, Epidemilogy Unit, Agenzia di Tutela Della Salute (ATS) Della Val Padana, Mantova, Italy
| | - Francesco Tisano
- Cancer Registry of the Province of Siracusa, Local Health Unit of Siracusa, Italy
| | - Silvano Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | | | | | - Stefano Rosso
- Piedmont Cancer Registry, Biella Province, Biella, Italy
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Abstract
The objective was to quantify thyroid cancer incidence and mortality trends in Portugal. The number of thyroid cancer cases and incidence rates were retrieved from the Regional Cancer Registries for the period 1989-2011. The number of deaths and mortality rates were obtained from the WHO cancer mortality database (1988-2003 and 2007-2012) and Statistics Portugal (2004-2006; 1988-2012 by region). Joinpoint regression of the standardized incidence and mortality rates was performed. A significant, rapid and continued increase in incidence was observed for both sexes in each of the Regional Cancer Registries, with annual per cent changes (APCs) ranging between 2 and 9. Incidence in Portuguese women is higher than estimates for the world and Europe. Mortality decreased for women (APC: -1.5), with the greatest decrease in the North, and increased marginally for men (APC: +0.2), with a greater increase in the South. The significant increases in incidence in Portugal are predominantly because of the increase in incidence among women from the North. These trends, combined with an overall low mortality and high 5-year relative survival, raise concerns on the extent to which overdiagnosis may be taking place. Further research is needed, quantifying the importance of the most likely determinants of these trends as well as the extent and potentially deleterious effects of overdiagnosis and overtreatment in the Portuguese setting.
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Xhaard C, Rubino C, Souchard V, Maillard S, Ren Y, Borson-Chazot F, Sassolas G, Schvartz C, Colonna M, Lacour B, Woronoff AS, Velten M, Marrer E, Bailly L, Mariné Barjoan E, Schlumberger M, Drozdovitch V, Bouville A, Orgiazzi J, Adjadj E, de Vathaire F. Dietary habits during the 2 months following the Chernobyl accident and differentiated thyroid cancer risk in a population-based case-control study. Cancer Epidemiol 2018; 52:142-147. [PMID: 29324353 DOI: 10.1016/j.canep.2017.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 11/14/2017] [Accepted: 12/22/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Chernobyl nuclear power plant accident occurred in Ukraine on April 26th 1986. In France, the radioactive fallout and thyroid radiation doses were much lower than in highly contaminated areas. However, a number of risk projections have suggested that a small excess in differentiated thyroid cancer (DTC) might occur in eastern France due to this low-level fallout. In order to investigate this potential impact, a case-control study on DTC risk factors was started in 2005, focusing on cases who were less than 15 years old at the time of the Chernobyl accident. Here, we aim to evaluate the relationship between some specific reports of potentially contaminated food between April and June 1986 - in particular fresh dairy products and leafy vegetables - and DTC risk. METHODS After excluding subjects who were not born before the Chernobyl accident, the study included 747 cases of DTC matched with 815 controls. Odds ratios were calculated using conditional logistic regression models and were reported for all participants, for women only, for papillary cancer only, and excluding microcarcinomas. RESULTS The DTC risk was slightly higher for participants who had consumed locally produced leafy vegetables. However, this association was not stronger in the more contaminated areas than in the others. Conversely, the reported consumption of fresh dairy products was not statistically associated with DTC risk. CONCLUSION Because the increase in DTC risk associated with a higher consumption of locally produced vegetables was not more important in the most contaminated areas, our study lacked power to provide evidence for a strong association between consumption of potentially contaminated food and DTC risk.
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Affiliation(s)
- Constance Xhaard
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, Villejuif, F-94805, France; Gustave Roussy, Villejuif, F-94805, France; University of Paris-Sud, Villejuif, F-94800, France
| | - Carole Rubino
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, Villejuif, F-94805, France; Gustave Roussy, Villejuif, F-94805, France; University of Paris-Sud, Villejuif, F-94800, France
| | - Vincent Souchard
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, Villejuif, F-94805, France; Gustave Roussy, Villejuif, F-94805, France; University of Paris-Sud, Villejuif, F-94800, France
| | - Stéphane Maillard
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, Villejuif, F-94805, France; Gustave Roussy, Villejuif, F-94805, France; University of Paris-Sud, Villejuif, F-94800, France
| | - Yan Ren
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, Villejuif, F-94805, France; Gustave Roussy, Villejuif, F-94805, France; University of Paris-Sud, Villejuif, F-94800, France
| | | | | | | | | | - Brigitte Lacour
- French National Childhood Solid Cancer Registry, CHU Nancy, France
| | | | | | | | - Laurent Bailly
- Public Health Department, University Hospital Nice, France
| | | | | | | | | | | | - Elisabeth Adjadj
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, Villejuif, F-94805, France; Gustave Roussy, Villejuif, F-94805, France; University of Paris-Sud, Villejuif, F-94800, France
| | - Florent de Vathaire
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, Villejuif, F-94805, France; Gustave Roussy, Villejuif, F-94805, France; University of Paris-Sud, Villejuif, F-94800, France.
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Partial thyroidectomy for papillary thyroid microcarcinoma: Is completion total thyroidectomy indicated? Int J Surg 2018; 41 Suppl 1:S34-S39. [PMID: 28506411 DOI: 10.1016/j.ijsu.2017.02.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/04/2017] [Accepted: 02/08/2017] [Indexed: 12/18/2022]
Abstract
AIM Papillary thyroid microcarcinoma (PTMC) is increasing in incidence. Despite its excellent clinical outcomes, there is still debate regarding which surgical approach is more appropriate for PTMC, procedures including hemithyroidectomy (HT), total thyroidectomy (TT), and completion thyroidectomy (CT) after initial HT and histopathologic examination confirming a PTMC. Here we report our experience in the surgical management of PTMC. METHODS We conducted a retrospective evaluation of all patients who received a postoperative diagnosis of PTMC between January 2001 and January 2016. Every patient was divided according to the type of surgery performed (TT or HT alone). Follow-up consisted of regular clinical and neck ultrasonographic examination. Clinical and histopathological parameters (e.g. age, sex, lesion size, histological features, multifocality, lymph node metastases, BRAF status when available) as well as clinical outcomes (e.g. complications rates, recurrence, overall survival) were analyzed. RESULTS Group A consisted of 86 patients who underwent TT, whereas Group encompassed 19 patients who underwent HT. Mean follow-up period was 58.5 months. In Group A, one patient (1.2%) experienced recurrence in cervical lymph nodes with need for reoperation. In Group B, eight patients (42%) underwent completion thyroidectomy after histopathological examination confirming PTMC, while one patient (5.3%) developed PTMC in the contralateral lobe with need for reoperation at 2 years after initial surgery. Multifocality was found in 19 patients in Group A (22%). Of these, 14 presented bilobar involvement, whereas in 3 cases multifocality involved only one lobe. 1 patient in Group B (5.3%) presented with unilateral multifocal PTMC (p = 0.11). CONCLUSIONS Low-risk patients with PTMC may benefit from a more conservative treatment, e.g. HT followed by close follow-up. However, appropriate selection of patients based on risk stratification is the key to differentiate therapy options and gain better results.
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Heidari Z, Abdani M, Mansournia MA. Insulin Resistance Associated With Differentiated Thyroid Carcinoma: Penalized Conditional Logistic Regression Analysis of a Matched Case-Control Study Data. Int J Endocrinol Metab 2018; 16:e14545. [PMID: 29696038 PMCID: PMC5903382 DOI: 10.5812/ijem.14545] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/07/2017] [Accepted: 10/04/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND In the recent years, thyroid cancer incidence has increased worldwide. It has been questioned whether factors, such as insulin resistance, are involved in this rise. The main aim of this study was to examine the association between insulin resistance and differentiated thyroid cancer. METHODS This case-control study was performed on 30 newly diagnosed patients with differentiated thyroid cancer and 30 healthy controls. Thirty euthyroid patients recently diagnosed with differentiated thyroid cancer, based on the fine needle aspiration cytology, were examined for insulin resistance before thyroidectomy in the euthyroid state. For each patient in the case group, one healthy euthyroid individual without thyroid nodule from general population was matched based on gender, age (± 1 year), and body mass index (BMI) (± 1). Thyroid function test, thyroid antibodies, serum glucose, serum insulin, and thyroid ultrasonography was performed for all participants. Insulin resistance was defined based on homeostasis model assessment of insulin resistance (HOMA-IR) to be more than 2.5. RESULTS In the patient group, 24 (80%) cases were female and 6 (20%) were male. Insulin resistance was more prevalent in the case group than the control group (43.3% versus 13.3%). Insulin sensitivity index was lower in the case group than in the control group (50 and 81, respectively). There was a significant positive association between serum HOMA-IR levels and differentiated thyroid cancer (OR: 2.43 for 1 unit increase in HOMA-IR, 95% CI: 1.35 - 5.51; P = 0.001). Insulin resistance was significantly associated with differentiated thyroid cancer (OR: 4, 95 % CI: 1.27 - 17.6; P = 0.016). CONCLUSIONS There was a significant association between insulin resistance and differentiated thyroid carcinoma. More research with a larger sample size and prospective design are needed to determine the role of this factor in the development of differentiated thyroid cancers.
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Affiliation(s)
- Zahra Heidari
- MD, Department of Endocrinology and Metabolism, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Mahdi Abdani
- MD, Department of Endocrinology and Metabolism, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Mohammad Ali Mansournia
- MD, MPH, PhD, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Mohammad Ali Mansournia, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, PO Box: 14155-6446, Tehran, IR Iran. E-mail:
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Heidari Z, Nikbakht M, Mashhadi MA, Jahantigh M, Mansournia N, Sheikhi V, Mansournia MA. Vitamin D Deficiency Associated with Differentiated Thyroid Carcinoma: A Case- Control Study. Asian Pac J Cancer Prev 2017; 18:3419-3422. [PMID: 29286613 PMCID: PMC5980904 DOI: 10.22034/apjcp.2017.18.12.3419] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective: In recent decades, the incidence of thyroid cancer has increased throughout the world. It is unclear whether factors such as vitamin D deficiency may have been involved in this increase. The present case-control study was conducted to examine any association between Vitamin D deficiency and thyroid cancers. Methods: The study was conducted on 85 patients with differentiated thyroid cancer diagnosed based on fine needle aspiration biopsy as the case group and 85 healthy controls. Serum levels of vitamin D were evaluated before thyroidectomy. For each patient in the case group, one healthy euthyroid person without any thyroid nodules from the general population matched based on season, sex, age (± 1 year) and BMI (± 1) was selected. Finally, 85 pairs were obtained considering inclusion and exclusion criteria. Thyroid function, thyroid antibodies and serum vitamin D were assessed and thyroid sonography was performed in all participants. Results: In the patient group, 72 (85%) were female and 13 (15%) were male. The mean (SD) serum vitamin D level was 8.00 (±3.7) in patient group, as compared to 13.4 (±7.90) in the control group, the difference being significant (OR: 6, 95 %CI: 1.02-113.3; P=0.046). Conclusion: A significant association was noted between vitamin D deficiency and differentiated thyroid cancer. Further studies with a prospective design are necessary to further define the roles of this factor.
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Affiliation(s)
- Zahra Heidari
- Department of Endocrinology and Metabolism, Zahedan University of Medical Sciences, Zahedan, Iran.
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Sanabria A, Kowalski LP, Shah JP, Nixon IJ, Angelos P, Williams MD, Rinaldo A, Ferlito A. Growing incidence of thyroid carcinoma in recent years: Factors underlying overdiagnosis. Head Neck 2017; 40:855-866. [PMID: 29206325 DOI: 10.1002/hed.25029] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/24/2017] [Accepted: 10/25/2017] [Indexed: 01/03/2023] Open
Abstract
There is an increasing incidence of well-differentiated thyroid cancer worldwide. Much of the increase is secondary to increased detection of small, low-risk tumors, with questionable clinical significance. This review addresses the factors that contribute to the increasing incidence and considers environmental, and patient-based and clinician-led influences. Articles addressing the causes of the increased incidence were critically reviewed. A complex interplay of environmental, medical, and social pressures has resulted in increased awareness of the thyroid disease risk, increased screening of thyroid cancers, and increased diagnosis of thyroid cancers. Although there is evidence to suggest that the true disease incidence may be changing slightly, most of the increase is related to factors that promote early diagnosis of low-risk lesions, which is resulting in a significant phenomenon of overdiagnosis. An improved understanding of these pressures at a global level will enable healthcare policymakers to react appropriately to this challenge in the future.
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Affiliation(s)
- Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia, Clinica Vida/Instituto de Cancerología Las Americas, Medellin, Colombia, South America
| | - Luiz P Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paulo, SP, Brazil
| | - Jatin P Shah
- Department of Head and Neck Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Peter Angelos
- Department of Surgery, University of Chicago, Chicago, Illinois
| | - Michelle D Williams
- Department of Pathology, Division of Pathology/Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group
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Ukekwe FI, Olusina DB, Okere PCN. Patterns of Thyroid Cancers in Southeastern Nigeria: A 15 Year Histopathologic Review (2000-2014). J Clin Diagn Res 2017; 11:EC16-EC19. [PMID: 28969135 DOI: 10.7860/jcdr/2017/26971.10418] [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: 01/24/2017] [Accepted: 07/13/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Thyroid Cancer (TC) continues to be the most common endocrine cancer with a worldwide increase in incidence over the last three decades. This trend has been reported in all continents except Africa, where detection is adjudged to be insufficient, making it imperative for us to re-evaluate the patterns in our environment. AIM To determine the patterns of TCs in Southeastern Nigeria. MATERIALS AND METHODS This was a 15-year retrospective review of all thyroidectomy specimens received at the Depart-ment of Morbid Anatomy, University of Nigeria, Enugu Campus, Enugu, Nigeria. The age, sex and histologic subtypes of diagnosed TCs were analysed using Predictive Analytics Software (PASW) Statistics for Windows, Version 18 (Chicago: SPSS Inc.) and the results were expressed in descriptive statistics. RESULTS Sixty one cases of TCs were identified in this study constituting 10.8% of thyroid biopsies received at our centre during the period under review. There were 51 (83.6%) females and 10 (16.4%) males giving a ratio of 5.1:1, and a mean age of 45.9 years. The commonest histologic type was Papillary Thyroid Carcinoma (PTC) (42.6%), followed by; follicular thyroid carcinoma (37.7%), medullary thyroid carcinoma (4.9%), anaplastic carcinomas (3.3%), Non-Hodgkin lymphoma (1.6%) and metastatic squamous cell carcinoma (3.3%). Mixed papillary/ follicular carcinoma (4.9%) and mixed papillary/ anaplastic carcinoma (1.6%) were also identified. CONCLUSION TC continues to predominate amongst females, occurring mainly in early middle age group in Southeastern Nigeria. PTC is now the commonest histologic type.
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Affiliation(s)
- Francis Ikechukwu Ukekwe
- Lecturer/Consultant, Department of Morbid Anatomy, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Daniel Bankole Olusina
- Senior Lecturer/Consultant, Department of Morbid Anatomy, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Philip C N Okere
- Senior Lecturer/Consultant, Department of Radiation Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
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Liu W, Cheng R, Su Y, Diao C, Qian J, Zhang J, Ma Y, Fan Y. Risk factors of central lymph node metastasis of papillary thyroid carcinoma: A single-center retrospective analysis of 3273 cases. Medicine (Baltimore) 2017; 96:e8365. [PMID: 29069024 PMCID: PMC5671857 DOI: 10.1097/md.0000000000008365] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Due to the lack of an accurate preoperative diagnostic method of central lymph node metastasis (CLNM) of papillary thyroid cancer (PTC), the prophylaxis of central lymph node dissection remains controversial. The present study investigated the clinicopathological features of PTC patients and the risk factors of CLNM. The clinicopathological features of PTC patients with respect to sex, age, initial symptoms, observation, tumor diameter, multifocality, extrathyroidal invasion, and pathological data combined with other thyroid diseases, were analyzed retrospectively. The risk factors of CLNM were analyzed by Chi-squared test and multivariate logistic regression model. The CLNM rate of PTC was 40.6% (1331/3273). On average, 7.0 (4.0, 12.0) central lymph nodes were dissected, and 3.70 (±3.8) lymph nodes were proved to be metastatic. Univariate analysis showed that sex (P < .001), age (P < .001), tumor diameter (P < .001), extrathyroid invasion (P < .001), multifocality (P = .001), concurrent nodular goiter (P < .001), initial symptoms (P < .001), and observation or not (P < .001) were related to CLNM. The observation time was neither related to CLNM (P = .469) nor extrathyroidal invasion (P = .137). Tumors localized in the lower part of the thyroid were the risk factors for CLNM (P < .001) while multifocality was unrelated (P = .68). The metastasis rate of bilateral multiple regions > unilateral multiple regions > single region (P = .003). Multivariate logistic regression analysis showed that sex, age, tumor diameter, extrathyroidal invasion, and observation were independent risk factors of CLNM. Male, younger age, large tumor size, and extrathyroidal invasion were independent risk factors for CLNM. CLNM was related to multiple regions occupied by tumors in the thyroid but unrelated to multifocality. The tumor occupying a single region and localized in the lower part of thyroid could be used as a predictive factor for CLNM. For tumors that could not be diagnosed as benign or malignant, observation may be an option, since no evidence of disease progression was presented during observation.
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Marotta V, Sciammarella C, Chiofalo MG, Gambardella C, Bellevicine C, Grasso M, Conzo G, Docimo G, Botti G, Losito S, Troncone G, De Palma M, Giacomelli L, Pezzullo L, Colao A, Faggiano A. Hashimoto's thyroiditis predicts outcome in intrathyroidal papillary thyroid cancer. Endocr Relat Cancer 2017; 24:485-493. [PMID: 28696209 DOI: 10.1530/erc-17-0085] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 07/10/2017] [Indexed: 12/31/2022]
Abstract
Hashimoto's thyroiditis (HT) seems to have favourable prognostic impact on papillary thyroid cancer (PTC), but data were obtained analysing all disease stages. Given that HT-related microenvironment involves solely the thyroid, we aimed to assess the relationship between HT, as detected through pathological assessment, and outcome in intrathyroidal PTC. This was a multicentre, retrospective, observational study including 301 PTC with no evidence of extrathyroidal disease. Primary study endpoint was the rate of clinical remission. Auxiliary endpoint was recurrence-free survival (RFS). HT was detected in 42.5% of the cohort and was associated to female gender, smaller tumour size, lower rate of aggressive PTC variants and less frequent post-surgery radio-iodine administration. HT showed relationship with significantly higher rate of clinical remission (P < 0.001, OR 4, 95% CI 1.78-8.94). PTCs with concomitant HT had significantly longer RFS, as compared with non-HT tumours (P = 0.004). After adjustment for other parameters affecting disease outcome at univariate analysis (age at diagnosis, histology, tumour size and multifocality), prognostic effect of HT remained significant (P = 0.006, OR 3.28, 95% CI 1.39-7.72). To verify whether HT could optimise the identification of PTCs with unfavourable outcome, we assessed the accuracy of 'non-HT status' as negative prognostic marker, demonstrating poor capability of identifying patients not maintaining clinical remission until final follow-up (probability of no clinical remission in PTCs without HT: 21.05%, 95% CI 15.20-27.93). In conclusion, our data show that HT represents an independent prognostic parameter in intrathyroidal PTC, but cannot improve prognostic specificity.
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Affiliation(s)
- Vincenzo Marotta
- Department of Clinical Medicine and SurgeryFederico II University, Naples, Italy
| | | | - Maria Grazia Chiofalo
- Thyroid and Parathyroid Surgery UnitIstituto Nazionale per lo Studio e la Cura dei Tumori-IRCCS 'Fondazione G. Pascale', Naples, Italy
| | - Claudio Gambardella
- Department of AnesthesiologicSurgical and Emergency Sciences, Division of General and Oncologic Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Claudio Bellevicine
- Department of Public HealthUniversity of Naples 'Federico II,', Naples, Italy
| | - Marica Grasso
- San Giovanni di Dio e Ruggi D'AragonaUniversitary Hospital, Division of General Surgery, University of Salerno, Salerno, Italy
| | - Giovanni Conzo
- Department of AnesthesiologicSurgical and Emergency Sciences, Division of General and Oncologic Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giovanni Docimo
- Department of AnesthesiologicSurgical and Emergency Sciences, Division of General and Oncologic Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Gerardo Botti
- Department of PathologyIstituto Nazionale per lo Studio e la Cura dei Tumori-IRCCS 'Fondazione G. Pascale', Naples, Italy
| | - Simona Losito
- Department of PathologyIstituto Nazionale per lo Studio e la Cura dei Tumori-IRCCS 'Fondazione G. Pascale', Naples, Italy
| | - Giancarlo Troncone
- Department of Public HealthUniversity of Naples 'Federico II,', Naples, Italy
| | - Maurizio De Palma
- Dipartimento Chirurgico Generale e PolispecialisticoChirurgia 2, AORN Cardarelli, Naples, Italy
| | - Laura Giacomelli
- Dipartimento di Scienze ChirurgicheUniversità di Roma Sapienza, Roma, Italy
| | - Luciano Pezzullo
- Thyroid and Parathyroid Surgery UnitIstituto Nazionale per lo Studio e la Cura dei Tumori-IRCCS 'Fondazione G. Pascale', Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and SurgeryFederico II University, Naples, Italy
| | - Antongiulio Faggiano
- Thyroid and Parathyroid Surgery UnitIstituto Nazionale per lo Studio e la Cura dei Tumori-IRCCS 'Fondazione G. Pascale', Naples, Italy
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Rojo Álvaro J, Bermejo Fraile B, Menéndez Torre E, Ardanaz E, Guevara M, Anda Apiñániz E. Increased incidence of thyroid cancer in Navarra (Spain). Evolution and clinical characteristics, 1986-2010. ACTA ACUST UNITED AC 2017; 64:303-309. [PMID: 28604340 DOI: 10.1016/j.endinu.2017.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 02/22/2017] [Accepted: 02/28/2017] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The latest published studies show an increased incidence of thyroid cancer worldwide. The aim of this study was to analyze the changes in the incidence of thyroid cancer in Navarra and its clinical presentation regarding sex, histological subtype and size over the last 25 years. METHODS Thyroid cancer incidence rates were calculated on the basis of data from the Cancer Registry of Navarra during 1986-2010. Clinical data were obtained from the historical cohort of the Hospital Registry of Cancer of Navarra, which includes all the new cases of differentiated thyroid carcinoma diagnosed and treated in the public health network of this Community in that period. RESULTS The overall incidence of thyroid cancer in Navarra increased over the last 25 years, with an increase in the adjusted rate in men from 2.24 (1986-1990) to 5.85 (2006-2010) per 100,000 population/year (P<.001) and in women from 9.05 to 14.04, respectively (P<.001). This increase occurs only in papillary carcinoma. The clinical characteristics of 739 patients with differentiated thyroid cancer were studied. The mean age at diagnosis increased over the years and the predominance of women (about 80%) remains stable. Mean tumor size decreased over the five-year periods from 30.9 to 22.5mm (P<.001), the proportion of microcarcinomas (T1a) increased from 8.8% to 30% (P<.001) and, despite this increase, there were no statistical differences in the TNM stage at diagnosis during the study period. The distribution of histological variants of papillary and follicular carcinoma did not change over 25 years. CONCLUSIONS During the period studied, the incidence of thyroid cancer increased in Navarra in both sexes. The increase occurred only in papillary carcinoma, without changes in the distribution of his histological variants. The increase in the proportion of T1a tumors is remarkable, but the TNM stage distribution was maintained. These results suggest an increase in the diagnosis of thyroid microcarcinomas due to changes in clinical practice, without ruling out a real increase in the incidence of papillary carcinoma in Navarra.
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Affiliation(s)
- Jorge Rojo Álvaro
- Servicio de Endocrinología, Complejo Hospitalario de Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona, España
| | - Begoña Bermejo Fraile
- Servicio de Medicina Preventiva, Complejo Hospitalario de Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona, España
| | | | - Eva Ardanaz
- Instituto de Salud Pública de Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), Pamplona, España
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), Pamplona, España
| | - Emma Anda Apiñániz
- Servicio de Endocrinología, Complejo Hospitalario de Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona, España.
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Xhaard C, Dumas A, Souchard V, Ren Y, Borson-Chazot F, Sassolas G, Schvartz C, Colonna M, Lacour B, Wonoroff AS, Velten M, Clero E, Maillard S, Marrer E, Bailly L, Mariné Barjoan E, Schlumberger M, Orgiazzi J, Adjadj E, Rubino C, Bouville A, Drozdovitch V, de Vathaire F. Are dietary reports in a case-control study on thyroid cancer biased by risk perception of Chernobyl fallout? Rev Epidemiol Sante Publique 2017; 65:301-308. [PMID: 28579185 DOI: 10.1016/j.respe.2017.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 02/07/2017] [Accepted: 02/13/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND In retrospective case-control studies performed following nuclear tests or nuclear accidents, individual thyroid radiation dose reconstructions are based on fallout and meteorological data from the residential area, demographic characteristics, and lifestyle as well as dietary information. Collecting the latter is a controversial step, as dietary declarations may be affected by the subjects' beliefs about their risk behavior. This report analyses the potential for such bias in a case-control study performed in eastern France. METHODS The study included 765 cases of differentiated thyroid carcinoma matched with 831 controls. Risk perceptions and beliefs of cases and controls were compared using Chi2 tests and differences in dietary reports were analyzed using a two-way ANOVA. RESULTS In general, atmospheric pollution and living near a nuclear power plant were the two major risks that may influence thyroid cancer occurrence cited by cases and controls. When focusing in particular on the consequences of the Chernobyl accident, cases were more likely to think that the consequences were responsible for thyroid cancer occurrence than controls. Vegetable consumption during the two months after the Chernobyl accident was correlated with the status of subjects, but not to their beliefs. Conversely, consumption of fresh dairy products was not correlated with the status or beliefs of subjects. CONCLUSION We found no evidence of systematic bias in dietary reports according to the status or beliefs held by subjects about the link between thyroid cancer occurrence and Chernobyl fallout. As such, these dietary reports may be used in further studies involving individual dosimetric reconstructions.
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Affiliation(s)
- C Xhaard
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - A Dumas
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - V Souchard
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - Y Ren
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - F Borson-Chazot
- Fédération d'endocrinologie, hospices civils de Lyon, groupement hospitalier Lyon-Est, 69677 Bron, France; Rhône-Alpes thyroid cancer registry, cancer research center of Lyon (UMR Inserm 1052, CNRS 5286), RTH Laennec faculty of medicine, university of Lyon, 69008 Lyon, France
| | - G Sassolas
- Rhône-Alpes thyroid cancer registry, cancer research center of Lyon (UMR Inserm 1052, CNRS 5286), RTH Laennec faculty of medicine, university of Lyon, 69008 Lyon, France
| | - C Schvartz
- Thyroid cancer registry of Champagne-Ardennes, institut Jean-Godinot, 51100 Reims, France
| | - M Colonna
- Cancer registry of Isère, 38240 Meylan, France
| | - B Lacour
- French national registry of childhood solid tumours, CHU de Nancy, 54505 Vandœuvre, France; Inserm UMRS1018, CESP, 94800 Villejuif, France
| | - A S Wonoroff
- Cancer registry of doubs, EA 3181, university hospital Besançon, 25030 Besançon, France
| | - M Velten
- Cancer Registry of Bas-Rhin, EA 3430, faculty of medicine, university of Strasbourg, 67085 Strasbourg, France
| | - E Clero
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - S Maillard
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - E Marrer
- Cancer registry of Haut-Rhin, Mulhouse hospital, 68051 Mulhouse, France
| | - L Bailly
- Public health department, university hospital Nice, 06202 Nice, France
| | - E Mariné Barjoan
- Public health department, university hospital Nice, 06202 Nice, France
| | | | - J Orgiazzi
- Department of endocrinology, Hospices civils de Lyon, 69310 Lyon, France
| | - E Adjadj
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - C Rubino
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - A Bouville
- Radiation epidemiology branch, division of cancer epidemiology and genetics, national cancer institute, Bethesda, USA
| | - V Drozdovitch
- Radiation epidemiology branch, division of cancer epidemiology and genetics, national cancer institute, Bethesda, USA
| | - F de Vathaire
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France.
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Thyroid cancer has a small impact on patient–partner relationships and their frequency of sexual activity. Palliat Support Care 2017; 16:335-346. [DOI: 10.1017/s1478951517000384] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTObjective:This cross-sectional survey examined changes in perceived relationships and sexual activity in a sample of thyroid cancer patients and their partners, taking into account sociodemographic and disease-related variables, as well as such outcome measures as anxiety, depression, fatigue, and quality of life (QoL).Method:A total of 38 patients with thyroid cancer who were being treated at the department of nuclear medicine in Zürich or Lucerne over the preceding seven years, as well as their partners, completed questionnaires about the quality of their relationships (RQ), about perceptions of changes in their relationships, and about their frequency of sexual activity. They also filled out prevalidated questionnaires related to anxiety, depression, fatigue, and QoL.Results:Some 17 patients (44.7%) and 16 partners (42.1 %) reported that the cancer diagnosis had changed their relationships. Of these, 10 (26.3%) patients and 9 (23.7%) partners reported positive changes only, while 7 patients (18.4%) and 7 partners (18.4%) reported mixed or negative changes. A perceived mixed/negative relationship change was associated with increased depression and lower RQ in patients and partners, as well as with increased anxiety in patients. While the frequency of sexual activity only changed in roughly half of patients and partners (16 patients [42.1%] and 20 partners [52.6%]), increased sexual activity was associated with lower physical QoL scores and a higher depression score than in counterparts who reported no change.Significance of Results:Compared to other cancer sites, in our sample thyroid cancer had a relatively small impact on patient–partner relationships and levels of intimacy. We found that screening patients and their partners with a simple question—“Did the diagnosis of cancer change your relationship?”—can lead to early detection of couples who are potentially at risk for perceived negative relationship changes and can facilitate timely psychosocial referral for couple's therapy.
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Liu Y, Su L, Xiao H. Review of Factors Related to the Thyroid Cancer Epidemic. Int J Endocrinol 2017; 2017:5308635. [PMID: 28555155 PMCID: PMC5438865 DOI: 10.1155/2017/5308635] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 04/12/2017] [Indexed: 12/11/2022] Open
Abstract
Thyroid cancer is the most common endocrine cancer, of which the incidence has dramatically increased worldwide in the past few decades. The reasons for the observed rapid increase still are not fully understood, but evidence suggests that overdiagnosis, with the advancement in detection methods and screening policies, is not the sole driver of the substantial increase of the incidence. However, the effect of environmental/lifestyle factors remains speculative other than that of radiation exposure at a young age. This review tries to give a balanced view of debated factors leading to the thyroid cancer epidemic, to offer some alternatives in understanding the controversies, and to suggest potential directions in the search of modifiable risk factors to help reduce thyroid cancer.
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Affiliation(s)
- Yihao Liu
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, China
| | - Lei Su
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, China
| | - Haipeng Xiao
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, China
- *Haipeng Xiao:
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Zane M, Parello C, Pennelli G, Townsend DM, Merigliano S, Boscaro M, Toniato A, Baggio G, Pelizzo MR, Rubello D, Boschin IM. Estrogen and thyroid cancer is a stem affair: A preliminary study. Biomed Pharmacother 2016; 85:399-411. [PMID: 27899250 DOI: 10.1016/j.biopha.2016.11.043] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 11/10/2016] [Accepted: 11/11/2016] [Indexed: 11/30/2022] Open
Abstract
Gender influences Papillary Thyroid Cancer (PTC) with an incidence of 3:1 when comparing women to men with different aggressiveness. This gender discrepancy suggests some role of sex hormones in favoring the malignant progression of thyroid tissue to cancer. Estrogens are known to promote Stem Cell self-renewal and, therefore, may be involved in tumor initiation. The goals of these studies are to investigate the underlying causes of gender differences in PTC by studying the specific role of estrogens on tumor cells and their involvement within the Cancer Stem Cell (CSC) compartment. Exposure to 1nmoll-1 Estradiol for 24h promotes growth and maintenance of PTC Stem Cells, while inducing dose-dependent cellular proliferation and differentiation following Estradiol administration. Whereas mimicking a condition of hormonal imbalance led to an opposite phenotype compared to a continuous treatment. In vivo we find that Estradiol promotes motility and tumorigenicity of CSCs. Estradiol-treated mice inoculated with Thyroid Cancer Stem Cell-enriched cells developed larger tumor masses than control mice. Furthermore, Estradiol-pretreated Cancer Stem cells migrated to distant organs, while untreated cells remained circumscribed. We also find that the biological response elicited by estrogens on Papillary Thyroid Cancer in women differed from men in pathways mediated. This could explain the gender imbalance in tumor incidence and development and could be useful to develop gender specific treatment of (PTC).
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Affiliation(s)
- Mariangela Zane
- Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Carmelo Parello
- Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Gianmaria Pennelli
- Surgical Pathology and Cytopathology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Danyelle M Townsend
- Department of Drug Discovery and Pharmaceutical Sciences, Medical University of South Carolina, USA
| | - Stefano Merigliano
- Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Marco Boscaro
- Endocrinology, Department of Medicine, University of Padova, Padova, Italy
| | - Antonio Toniato
- Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Giovannella Baggio
- Internal Medicine Unit, Department of Molecular Medicine, University of Padua, Padova, Italy
| | - Maria Rosa Pelizzo
- Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, Italy
| | | | - Isabella Merante Boschin
- Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, Italy
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Marotta V, Sciammarella C, Colao A, Faggiano A. Application of molecular biology of differentiated thyroid cancer for clinical prognostication. Endocr Relat Cancer 2016; 23:R499-R515. [PMID: 27578827 DOI: 10.1530/erc-16-0372] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 08/30/2016] [Indexed: 12/28/2022]
Abstract
Although cancer outcome results from the interplay between genetics and environment, researchers are making a great effort for applying molecular biology in the prognostication of differentiated thyroid cancer (DTC). Nevertheless, role of molecular characterisation in the prognostic setting of DTC is still nebulous. Among the most common and well-characterised genetic alterations related to DTC, including mutations of BRAF and RAS and RET rearrangements, BRAFV600E is the only mutation showing unequivocal association with clinical outcome. Unfortunately, its accuracy is strongly limited by low specificity. Recently, the introduction of next-generation sequencing techniques led to the identification of TERT promoter and TP53 mutations in DTC. These genetic abnormalities may identify a small subgroup of tumours with highly aggressive behaviour, thus improving specificity of molecular prognostication. Although knowledge of prognostic significance of TP53 mutations is still anecdotal, mutations of the TERT promoter have showed clear association with clinical outcome. Nevertheless, this genetic marker needs to be analysed according to a multigenetic model, as its prognostic effect becomes negligible when present in isolation. Given that any genetic alteration has demonstrated, taken alone, enough specificity, the co-occurrence of driving mutations is emerging as an independent genetic signature of aggressiveness, with possible future application in clinical practice. DTC prognostication may be empowered in the near future by non-tissue molecular prognosticators, including circulating BRAFV600E and miRNAs. Although promising, use of these markers needs to be refined by the technical sight, and the actual prognostic value is still yet to be validated.
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Affiliation(s)
| | | | - Annamaria Colao
- Department of Clinical Medicine and SurgeryFederico II University, Naples, Italy
| | - Antongiulio Faggiano
- Thyroid and Parathyroid Surgery UnitIstituto Nazionale per lo Studio e la Cura dei Tumori-IRCCS "Fondazione G. Pascale", Naples, Italy
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Cecoli F, Ceresola E, Altrinetti V, Cabria M, Cappagli M, Montepagani A, Cuttica C, Filippi U, Saverino D, Raffa M, Caputo M, Minuto F, Giusti M, Bagnasco M. Therapeutic Strategies and Clinical Outcome in Papillary Thyroid Microcarcinoma: A Multicenter Observational Study. Eur Thyroid J 2016; 5:180-186. [PMID: 27843808 PMCID: PMC5091244 DOI: 10.1159/000446746] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 05/10/2016] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Papillary thyroid microcarcinoma (MPTC) has an excellent prognosis. We aimed to evaluate the evolution of therapeutic strategies over time and the clinical outcome of MPTC. METHODS In this retrospective multicenter observational study in a northwest Italian region, patients with intrathyroidal, unifocal tumor ≤1 cm in size, incidentally found at histology or preoperative cytology diagnosis, were included. Exclusion criteria were a previous head-and-neck irradiation and/or node metastases. RESULTS From 1985 to 2012, 437 patients had an MPTC diagnosis, which was incidental in 85% and preoperative in 15%. Patients with a preoperative diagnosis were younger at the time of diagnosis (47.6 ± 12.7 years, p < 0.01) and had a larger tumor (7.0 ± 2.5 mm, p < 0.0001) than patients with an incidental diagnosis (age 52 ± 13.5 years, size 4.4 ± 2.8 mm), but there were no differences in clinical outcome between both groups. We observed a significant (p < 0.001) reduction in radioiodine remnant ablation during the years. TSH levels were: <0.1 mIU/l in 27.5%, 0.1-0.5 mlU/l in 33.7%, 0.5-2.5 mlU/l in 32.6%, 2.5-4.2 mlU/l in 3.9%, and >4.2 mlU/l in 2.3% of patients. Six patients (1.37%) had nodal recurrence; 5 of them were cured after therapy. MPTC-linked mortality was null. CONCLUSIONS We confirmed the favorable clinical outcome of MPTC. Despite the reduction in radioiodine ablation, overtreatment of MPTC is still observed.
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Affiliation(s)
- F. Cecoli
- Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy
| | - E.M. Ceresola
- Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy
| | - V. Altrinetti
- Endocrinology and Nuclear Medicine, Galliera Hospital, Genoa, Italy
| | - M. Cabria
- Endocrinology and Nuclear Medicine, Galliera Hospital, Genoa, Italy
| | - M. Cappagli
- Endocrine Unit, Sant'Andrea Hospital, La Spezia, Italy
| | | | - C.M. Cuttica
- Endocrinology and Nuclear Medicine, Galliera Hospital, Genoa, Italy
| | - U. Filippi
- Evangelico Internazionale Hospital, Genoa, Italy
| | - D. Saverino
- Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy
| | - M. Raffa
- Endocrine-Metabolic Center, ASL 1, Imperia, Italy
| | - M. Caputo
- Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy
| | - F. Minuto
- Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy
| | - M. Giusti
- Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy
| | - M. Bagnasco
- Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy
- *Prof. Marcello Bagnasco, MD, Department of Internal Medicine (DiMI), University of Genoa, Viale Benedetto XV 6, IT-16132 Genoa (Italy), E-Mail
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Iodine deficiency and thyroid cancer trends in three regions of Thailand, 1990-2009. Cancer Epidemiol 2016; 43:92-9. [PMID: 27420631 DOI: 10.1016/j.canep.2016.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 06/16/2016] [Accepted: 07/04/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Iodine deficiency may play a role in thyroid cancer carcinogenesis. Because Thailand has region-specific historical iodine deficiency, it is ideal to evaluate the potential impact of recent national iodine supplementation policies on thyroid cancer incidence trends. METHODS We examined thyroid cancer trends in Thailand from 1990 to 2009 in three geographically separated populations (Songkhla Province [south], Chiang Mai Province [north], and Khon Kaen Province [northeast]), each with a different historical prevalence of iodine deficiency. We used Joinpoint analysis and age-period-cohort (APC) models to investigate trends in thyroid cancer incidence. RESULTS Pooled incidence of papillary cancers significantly increased (Males APC: 2.0, p<0.05; Females APC: 7.3 [1990-2001, p<0.05], -2.1 [2001-2009]) and incidence of follicular cancers significantly decreased (Males APC: -5.2, p<0.05; Females APC: -4.3 [1990-1998, p<0.05], 12.3 [1998-2001], -17.0 [2001-2005, p<0.05], 8.2 [2005-2009]) in both males and females between 1990 and 2009. The largest increases in papillary cancer incidence, and the largest decreases in follicular cancer incidence, occurred in historically iodine-deficient regions. Interestingly, the significant histological changes coincided with Thailand's most recent national iodination policy. The thyroid cancer trends in females were better explained by period effects than cohort effects. CONCLUSIONS This study adds to the research indicating that papillary carcinoma incidence increases, and follicular carcinoma incidence decreases, as population-level iodine deficiency declines, and suggests that iodine exposure may affect late stages of thyroid carcinogenesis. However, our findings are limited by the ecological study design and lack of data prior to iodine supplementation.
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