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Szabo Yamashita T, Williams-Perez SM, Ehsan S, Mulder M, Kronenfeld D, Huang CY, Zhao H, Merriman K, Peterson SK, Hu MI, Zafereo M, Sosa JA, Grubbs EG. The Multi-Institutional Medullary Thyroid Cancer Collaborative Registry: Can a Rare Tumor Registry Accurately Represent the Real-World Patient Population? Thyroid 2024. [PMID: 38984944 DOI: 10.1089/thy.2024.0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Background: Large population-based registries, such as the Surveillance, Epidemiology and End Results (SEER) Registry, help in the study of rare tumors, including medullary thyroid cancer (MTC), but lack data to understand the natural history of the disease. The Medullary Thyroid Cancer Collaborative Registry (MTCCoRe) is an exhaustive multi-institutional collection of demographic, clinical, and pathological data. To determine the extent to which MTCCoRe represents the real-world MTC population, we compared the characteristics of patients enrolled in MTCCoRe with patients enrolled in population-based cancer registries. Methods: Comparison of demographic and clinical characteristics of MTC patients who were enrolled in MTCCoRe, Texas Cancer Registry (TCR), California Cancer Registry (CCR), and SEER between 1995 and 2018. Results: A total of 1416 patients were identified in MTCCoRe, 329 in TCR, 2105 in CCR, and 3820 in SEER. Percentages of patients 20-54 years in MTCCoRe were 58.0%, 50.2% in TCR, 47.2% in CCR, and 44.8% in SEER (p < 0.0001). About half of the patients were female (55.9% in MTCCoRe, 61.4% in TCR, 59% in CCR, and 57.5% in SEER (p = 0.3). Percentages of Hispanic and Black patients differed among cohorts (10.1% and 3.8% for MTCCoRe, 23.7% and 8.2% for TCR, 24.8% and 4.9% in CCR, and 15.9% and 8.2% for SEER, respectively; p < 0.001). MTCCoRe patients presented with more advanced T and N classifications than patients in the other registries (MTCCoRe, 28.6% T3-4 and 49.4% N1; TCR, 12.7% and 32.2%; CCR, 18.6% and 32.4%; and SEER, 24% and 37.8%; p < 0.0001). Prevalence of M1 disease was 10% in MTCCoRe, 11.9% in TCR, 14.1% in CCR, and 9.5% in SEER (p < 0.0001). In the MTCCoRe, 11.4% underwent systemic therapy (compared with 0.3% in TCR and 5.6% in CCR). Conclusions: The clinicodemographic profile of patients with MTC enrolled in a multi-institutional registry differs from those enrolled in population-based databases, with lower proportions of Hispanic and Black patients but additive data on treatment modalities. Moving forward, MTCCoRe and other registry and clinical trial enrollment efforts should intentionally include underrepresented groups via community engagement techniques, patient stakeholder involvement, and inclusion of languages other than English in study materials to yield more generalizable results and conclusions.
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Affiliation(s)
- Thomas Szabo Yamashita
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sophia M Williams-Perez
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sara Ehsan
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michelle Mulder
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - Daniel Kronenfeld
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - Chiang-Yu Huang
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - Hui Zhao
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kelly Merriman
- Department of Cancer Registry, The University of MD Anderson Cancer Center, Houston, Texas, USA
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mimi I Hu
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mark Zafereo
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Julie Ann Sosa
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - Elizabeth G Grubbs
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Xian TC, Yang MY, Zhang XL, Wang J, Luo Y. Meta-Analysis of the Efficacy and Safety Evaluation of Vandetanib in the Treatment of Medullary Thyroid Cancer. Horm Metab Res 2024. [PMID: 38278145 DOI: 10.1055/a-2231-9192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
The aim of the work was to systematically evaluate the efficacy and safety of Vandetanib in the treatment of advanced medullary thyroid carcinoma (MTC). MeSH entries to search for randomized controlled trials and clinical research literature on the application of Vandetanib in the treatment of medullary thyroid cancer from PubMed, Chinese national knowledge infrastructure (CNKI), and Web of Science databases since their establishment until March 2023 were used. In terms of efficacy, the analysis results showed that Vandetanib had a significantly higher objective response rate compared to the control group using placebo (OR=2.13, 95% CI: 1.38, 3.29). In terms of side effects, Vandetanib significantly increases the incidence of hypertension, rash, and diarrhea, and has statistical significance (p+<+0.05). Vandetanib has a better therapeutic effect on MTC, but it also increases the incidence of hypertension, rash, and diarrhea. Attention should be paid to the relief of side effects when using it.
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Affiliation(s)
- Tong-Cheng Xian
- Department of Thyroid and Breast Surgery, the Nanchong City Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China
| | - Min-Ye Yang
- Department of Thyroid and Breast Surgery, the Nanchong City Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China
| | - Xue-Lin Zhang
- Department of Thyroid and Breast Surgery, the Nanchong City Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China
| | - Jie Wang
- Department of Thyroid and Breast Surgery, the Nanchong City Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China
| | - Yi Luo
- Department of Thyroid and Breast Surgery, the Nanchong City Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China
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Deniz MS, Dindar M. Examining the impact of several factors including COVID-19 on thyroid fine-needle aspiration biopsy. Diagn Cytopathol 2024; 52:42-49. [PMID: 37823334 DOI: 10.1002/dc.25239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/15/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE The study explores various factors, including coronavirus disease 2019 (COVID-19) history and vaccination status, that influence the classification value of ultrasonography-guided thyroid fine needle aspiration biopsy (TFNAB) by comparing non-diagnostic (Bethesda-I) and diagnostic (Bethesda II-VI) results. METHODS We conducted a retrospective observational study in a high-volume tertiary care center involving patients who underwent TFNAB from November 2022 to April 2023. The study retrospectively analyzed the cytopathology of 482 thyroid nodules. Patients were categorized into non-diagnostic (n = 136) and Diagnostic groups (n = 346) based on TFNAB. A comprehensive set of parameters was examined, including demographic, anthropometric and clinical data, thyroid ultrasonography findings, COVID-19 history and immunization status. RESULTS The mean age was 55.1 ± 12.1 years in the non-diagnostic group and 53.5 ± 13 years in the Diagnostic group (p = .223). 75.7% (n = 103) of the non-Diagnostic group and 82.9% (n = 287) of the Diagnostic group were male (p = .070). The mean nodule longitudinal diameter of the Diagnostic group was significantly higher than that of the non-diagnostic group (p = .015). The TIRADS score of the nodules showed a statistical difference between the groups (p = .048). The groups had no significant differences regarding other ultrasonographic parameters and COVID-19-related variables. CONCLUSION It can be assumed that when the longitudinal diameter of the thyroid nodule is small and in TIRADS categories other than the TIRADS3 category, TFNAB is less likely to be diagnostic. However, future research may be needed to confirm these findings and uncover any long-term effects of COVID-19 or vaccines on thyroid nodule diagnostics.
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Affiliation(s)
- Muzaffer Serdar Deniz
- Department of Endocrinology, Faculty of Medicine, Education and Research Hospital, Karabük University, Karabük, Turkey
| | - Merve Dindar
- Department of Internal Medicine, Faculty of Medicine, Education and Research Hospital, Karabük University, Karabük, Turkey
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4
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Wright K, Fisher JC, Rothberger GD, Prescott JD, Allendorf JD, Patel K, Suh I. Incidental 68Ga-DOTATATE uptake in thyroid nodules: Is guideline-directed management still appropriate? Surgery 2024; 175:228-233. [PMID: 38563428 DOI: 10.1016/j.surg.2023.04.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/21/2023] [Accepted: 04/27/2023] [Indexed: 04/04/2024]
Abstract
BACKGROUND Fluorodeoxyglucose uptake on positron emission tomography imaging has been shown to be an independent risk factor for malignancy in thyroid nodules. More recently, a new positron emission tomography radiotracer-Gallium-68 DOTATATE-has gained popularity as a sensitive method to detect neuroendocrine tumors. With greater availability of this imaging, incidental Gallium-68 DOTATATE uptake in the thyroid gland has increased. It is unclear whether current guideline-directed management of thyroid nodules remains appropriate in those that are Gallium-68 DOTATATE avid. METHODS We retrospectively reviewed Gallium-68 DOTATATE positron emission tomography scans performed at our institution from 2012 to 2022. Patients with incidental focal Gallium-68 DOTATATE uptake in the thyroid gland were included. Fine needle aspiration biopsies were characterized via the Bethesda System for Reporting Thyroid Cytopathology. Bethesda III/IV nodules underwent molecular testing (ThyroSeq v3), and malignancy risk ≥50% was considered positive. RESULTS In total, 1,176 Gallium-68 DOTATATE PET scans were reviewed across 837 unique patients. Fifty-three (6.3%) patients demonstrated focal Gallium-68 DOTATATE thyroid uptake. Nine patients were imaged for known medullary thyroid cancer. Forty-four patients had incidental radiotracer uptake in the thyroid and were included in our study. Patients included in the study were predominantly female sex (75%), with an average age of 62.9 ± 13.9 years and a maximum standardized uptake value in the thyroid of 7.3 ± 5.3. Frequent indications for imaging included neuroendocrine tumors of the small bowel (n = 17), lung (n = 8), and pancreas (n = 7). Thirty-three patients underwent subsequent thyroid ultrasound. Sonographic findings warranted biopsy in 24 patients, of which 3 were lost to follow-up. Cytopathology and molecular testing results are as follows: 12 Bethesda II (57.1%), 6 Bethesda III/ThyroSeq-negative (28.6%), 1 Bethesda III/ThyroSeq-positive (4.8%), 2 Bethesda V/VI (9.5%). Four nodules were resected, revealing 2 papillary thyroid cancers, 1 neoplasm with papillary-like nuclear features, and 1 follicular adenoma. There was no difference in maximum standardized uptake value between benign and malignant nodules (7.0 ± 4.6 vs 13.1 ± 5.7, P = .106). Overall, the malignancy rate among patients with sonography and appropriate follow-up was 6.7% (2/30). Among patients with cyto- or histopathology, the malignancy rate was 9.5% (2/21). There were no incidental cases of medullary thyroid cancer. CONCLUSION The malignancy rate among thyroid nodules with incidental Gallium-68 DOTATATE uptake is comparable to rates reported among thyroid nodules in the general population. Guideline-directed management of thyroid nodules remains appropriate in those with incidental Gallium-68 DOTATATE uptake.
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Affiliation(s)
- Kyla Wright
- NYU Grossman School of Medicine, NYU Langone Health, New York, NY
| | | | | | | | | | - Kepal Patel
- Department of Surgery, NYU Langone Health, New York, NY
| | - Insoo Suh
- Department of Surgery, NYU Langone Health, New York, NY.
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Trivedi D, George L. An Aggressive Form of Medullary Thyroid Carcinoma-Melanocytic Subtype: A Case Report. Cureus 2023; 15:e50310. [PMID: 38205465 PMCID: PMC10781584 DOI: 10.7759/cureus.50310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 01/12/2024] Open
Abstract
Medullary thyroid cancer (MTC) represents a small proportion of thyroid cancers. In MTC, melanin production is extremely uncommon. Few case reports have documented this rare variant, and follow-up on these cases has been very limited. Our case studies a 51-year-old female who initially presented with goiter. This tumor recurred multiple times despite surgery with rapid growth and poor response to radiotherapy. Microscopic examination showed high-grade malignant neoplasm with lymphocytic differentiation. Immunohistochemical studies were diffusely positive for S100, SOX10, and Melan-A. Histology confirmed melanocytic medullary carcinoma that had undergone a high-grade transformation with loss of epithelial and neuroendocrine expression. Due to the scarcity and rarity of this subtype, further evaluation and case studies are needed for further categorization and prognostication.
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Affiliation(s)
- Dhaval Trivedi
- Internal Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, USA
| | - Liziamma George
- Pulmonary and Critical Care Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, USA
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Miao Q, Lv X, Luo L, Zhang J, Cai B. Exploring the application value of pro-gastrin-releasing peptide in the clinical diagnosis and surgical treatment of medullary thyroid carcinoma. Cancer Med 2023; 12:19576-19582. [PMID: 37754747 PMCID: PMC10587939 DOI: 10.1002/cam4.6572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/07/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
OBJECTIVE To investigate the relationship between pro-gastrin-releasing peptide (ProGRP) and the clinical characteristics of patients with medullary thyroid carcinoma (MTC) and the value of ProGRP in surgical treatment monitoring. PATIENTS AND METHODS A total of 347 patients with MTC and non-MTC malignant and benign thyroid diseases were enrolled. The concentrations of neuron-specific enolase (NSE), carcinoembryonic antigen (CEA), calcitonin (CT), and ProGRP were determined by Elecsys® assays. The NSE, CEA, CT, and ProGRP levels in different thyroid disease groups were compared, and ProGRP levels in different clinicopathological feature groups pre and postoperatively were further compared. RESULTS The CT, CEA, NSE, and ProGRP levels were upregulated in the MTC group compared to those in the non-MTC malignant and benign thyroid disease groups. The area under the receiver operating characteristic curve (AUC) of ProGRP for the diagnosis of MTC was 0.832(0.787-0.871), similar to that of CT and CEA. The sensitivity and specificity were 71.4% and 92.7%, respectively, and the optimal cut-off value was 61.8 pg/mL. The AUC of ProGRP combined with CT or CEA for the diagnosis of MTC was 0.933 (0.900-0.958) and 0.922 (0.886-0.949), respectively, which were higher than those of a single index. ProGRP levels were higher in patients with lymph nodes and distant metastases than in patients without metastases. The postoperative level of ProGRP was lower than that before treatment. CONCLUSION ProGRP is comparable to CEA and CT as an MTC biomarker with broad prospects. It has potential application value in the progression of MTC assessment and the evaluation of surgical intervention effects.
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Affiliation(s)
- Qiang Miao
- Department of Laboratory Medicine/Research Center of Clinical Laboratory MedicineWest China Hospital of Sichuan UniversityChengduChina
| | - Xiaohui Lv
- Department of Laboratory Medicine/Research Center of Clinical Laboratory MedicineWest China Hospital of Sichuan UniversityChengduChina
| | - Li Luo
- Department of Laboratory Medicine/Research Center of Clinical Laboratory MedicineWest China Hospital of Sichuan UniversityChengduChina
| | - Junlong Zhang
- Department of Laboratory Medicine/Research Center of Clinical Laboratory MedicineWest China Hospital of Sichuan UniversityChengduChina
| | - Bei Cai
- Department of Laboratory Medicine/Research Center of Clinical Laboratory MedicineWest China Hospital of Sichuan UniversityChengduChina
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7
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Citarella A, Besharat ZM, Trocchianesi S, Autilio TM, Verrienti A, Catanzaro G, Splendiani E, Spinello Z, Cantara S, Zavattari P, Loi E, Romei C, Ciampi R, Pezzullo L, Castagna MG, Angeloni A, Elisei R, Durante C, Po A, Ferretti E. Circulating cell-free DNA (cfDNA) in patients with medullary thyroid carcinoma is characterized by specific fragmentation and methylation changes with diagnostic value. Biomark Res 2023; 11:82. [PMID: 37726827 PMCID: PMC10510276 DOI: 10.1186/s40364-023-00522-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023] Open
Abstract
Medullary Thyroid Carcinoma (MTC) is a rare neuroendocrine tumour whose diagnosis includes evaluating calcitonin serum levels, which can present fluctuations unrelated to MTC. Here, we investigated circulating DNA fragmentation and methylation changes as potential biomarkers using ddPCR on cell-free DNA (cfDNA) isolated from the plasma of MTC patients. For cfDNA fragmentation analysis, we investigated the fragment size distribution of a gene family and calculated short fragment fraction (SFF). Methylation analyses evaluated the methylation levels of CG_16698623, a CG dinucleotide in the MGMT gene that we found hypermethylated in MTC tissues by analyzing public databases. The SFF ratio and methylation of CG_16698623 were significantly increased in plasma from MTC patients at diagnosis, and patients with clinical remission or stable disease at follow-up showed no significant SFF difference compared with healthy subjects. Our data support the diagnostic value of cfDNA traits that could enable better management of MTC patients.
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Affiliation(s)
- Anna Citarella
- Department of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Zein Mersini Besharat
- Department of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Sofia Trocchianesi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Tanja Milena Autilio
- Department of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Antonella Verrienti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Giuseppina Catanzaro
- Department of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Elena Splendiani
- Department of Movement, Human and Health Sciences, University of Foro Italico, 00135, Rome, Italy
| | - Zaira Spinello
- Department of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Silvia Cantara
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, 53100, Italy
| | - Patrizia Zavattari
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Cagliari, 09042, Italy
| | - Eleonora Loi
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Cagliari, 09042, Italy
| | - Cristina Romei
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56126, Italy
| | - Raffaele Ciampi
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56126, Italy
| | - Luciano Pezzullo
- Thyroid Surgical Unit, IRCCS Fondazione G.Pascale, Naples, 80131, Italy
| | - Maria Grazia Castagna
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, 53100, Italy
| | - Antonio Angeloni
- Department of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Rosella Elisei
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56126, Italy
| | - Cosimo Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Agnese Po
- Department of Molecular Medicine, Sapienza University of Rome, Rome, 00161, Italy.
| | - Elisabetta Ferretti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy
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Trimboli P, Mian C, Piccardo A, Treglia G. Diagnostic tests for medullary thyroid carcinoma: an umbrella review. Endocrine 2023:10.1007/s12020-023-03326-6. [PMID: 36877452 PMCID: PMC10293444 DOI: 10.1007/s12020-023-03326-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/08/2023] [Indexed: 03/07/2023]
Abstract
PURPOSE To summarize the more robust evidence about the performance of tools useful for diagnosis of medullary thyroid carcinoma (MTC) such as calcitonin (Ctn) and other circulating markers, ultrasound (US), fine-needle aspiration (FNA), and other imaging procedures. METHODS This systematic review of systematic reviews was carried out according to a predefined protocol. A search string was created. An electronical comprehensive search of literature was performed on December 2022. Quality assessment of eligible systematic reviews was performed and main findings were described. RESULTS Twenty-three systematic reviews were included and several findings were achieved. Ctn is the most reliable diagnostic marker of MTC with no evidence of improvement with stimulation test. CEA doubling time is more reliable than Ctn in identifying MTC with poorer prognosis. US sensitivity is suboptimal in MTC and only just over half of cases are at high risk according to Thyroid Imaging And Reporting Data Systems. Cytology can correctly detect MTC in just over half of cases and measuring Ctn in washout fluid from FNA is necessary. PET/CT is useful for detecting recurrent MTC. CONCLUSIONS Future guidelines of both thyroid nodule management and MTC diagnosis should consider these evidence-based data.
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Affiliation(s)
- Pierpaolo Trimboli
- Clinic of Endocrinology and Diabetology, Lugano and Mendrisio Regional Hospital, Ente Ospedaliero Cantonale, 6500, Bellinzona, Switzerland.
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900, Lugano, Switzerland.
| | - Caterina Mian
- Operative Unit of Endocrinology, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Arnoldo Piccardo
- Nuclear Medicine Department, E.O. "Ospedali Galliera", 16128, Genoa, Italy
| | - Giorgio Treglia
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900, Lugano, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, 1011, Lausanne, Switzerland
- Division of Medical Education and Research, Ente Ospedaliero Cantonale, 6500, Bellinzona, Switzerland
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Xu Q, Yang H, Fan G, Zhang B, Yu J, Zhang Z, Jia G. Clinical importance of PLA2R1 and RASSF9 in thyroid cancer and their inhibitory roles on the Wnt/β-catenin pathway and thyroid cancer cell malignant behaviors. Pathol Res Pract 2022; 238:154092. [PMID: 36049438 DOI: 10.1016/j.prp.2022.154092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022]
Abstract
Thyroid cancer is a common malignant tumor with rising incidence worldwide. The purpose of this study was to explore key genes in thyroid cancer. The differentially expressed genes were analyzed according to GEO datasets. PLA2R1 and RASSF9 levels were confirmed by UALCAN and the Human Protein Atlas databases. The disease free survival and linear correlation were analyzed by GEPIA. ROC curve was generated according to The Cancer Genome Atlas (TCGA) database. The methylation level and immune infiltration were analyzed using GSCA platform. PLA2R1, RASSF9 and Wnt/β-catenin-related protein levels were detected by western blotting. Cell proliferation was assessed by 5-ethynyl-2'-deoxyuridine assay. Cell invasion and migration were evaluated by Transwell assay. There were 2 common differentially expressed genes (PLA2R1 and RASSF9) in thyroid cancer from GSE104005, GSE65144 and GSE53157 datasets. Decreased PLA2R1 and RASSF9 were associated with advanced stages and lower disease free survival. PLA2R1 and RASSF9 methylation levels were enhanced in thyroid cancer samples compared with normal samples. PLA2R1 methylation level was negatively correlated to its mRNA level. PLA2R1 and RASSF9 were related to immune infiltration in thyroid cancer. PLA2R1 and RASSF9 expression was associated with radioiodine resistance, and positively correlated to expression of iodide uptake-related factors. Multiple signaling pathways were involved in the action mechanisms of PLA2R1 and RASSF9, including the Wnt/β-catenin signaling. Overexpression of PLA2R1 and RASSF9 inhibited the activation of the Wnt/β-catenin pathway, proliferation, invasion, and migration in thyroid cancer cells. Collectively, PLA2R1 and RASSF9 are two key genes in thyroid cancer, which have potential diagnostic, prognostic, and anti-tumor effects in thyroid cancer.
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Affiliation(s)
- Qiu Xu
- Department of Thyroid and Breast Surgery, Nanyang First People's Hospital affiliated to Henan University, Nanyang 473012, China; Key Laboratory of Thyroid Tumor Prevention and Treatment, Nanyang First People's Hospital affiliated to Henan University, Nanyang 473012, China
| | - Han Yang
- Department of Endocrinology, Nanshi Hospital of Nanyang, Nanyang 473000, China
| | - Gai Fan
- Department of Otolaryngology, Nanyang First People's Hospital affiliated to Henan University, Nanyang 473012, China
| | - Bo Zhang
- Department of Thyroid and Breast Surgery, Nanyang First People's Hospital affiliated to Henan University, Nanyang 473012, China; Key Laboratory of Thyroid Tumor Prevention and Treatment, Nanyang First People's Hospital affiliated to Henan University, Nanyang 473012, China
| | - Jinsong Yu
- Department of Thyroid and Breast Surgery, Nanyang First People's Hospital affiliated to Henan University, Nanyang 473012, China; Key Laboratory of Thyroid Tumor Prevention and Treatment, Nanyang First People's Hospital affiliated to Henan University, Nanyang 473012, China
| | - Zhixin Zhang
- Department of Thyroid and Breast Surgery, Nanyang First People's Hospital affiliated to Henan University, Nanyang 473012, China; Key Laboratory of Thyroid Tumor Prevention and Treatment, Nanyang First People's Hospital affiliated to Henan University, Nanyang 473012, China
| | - Guangwei Jia
- Department of Thyroid and Breast Surgery, Nanyang First People's Hospital affiliated to Henan University, Nanyang 473012, China.
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10
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Update on the Diagnosis and Management of Medullary Thyroid Cancer: What Has Changed in Recent Years? Cancers (Basel) 2022; 14:cancers14153643. [PMID: 35892901 PMCID: PMC9332800 DOI: 10.3390/cancers14153643] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 12/10/2022] Open
Abstract
Medullary thyroid carcinoma (MTC) is a neoplasm originating from parafollicular C cells. MTC is a rare disease, but its prognosis is less favorable than that of well-differentiated thyroid cancers. To improve the prognosis of patients with MTC, early diagnosis and prompt therapeutic management are crucial. In the following paper, recent advances in laboratory and imaging diagnostics and also pharmacological and surgical therapies of MTC are discussed. Currently, a thriving direction of development for laboratory diagnostics is immunohistochemistry. The primary imaging modality in the diagnosis of MTC is the ultrasound, but opportunities for development are seen primarily in nuclear medicine techniques. Surgical management is the primary method of treating MTCs. There are numerous publications concerning the stratification of particular lymph node compartments for removal. With the introduction of more effective methods of intraoperative parathyroid identification, the complication rate of surgical treatment may be reduced. The currently used pharmacotherapy is characterized by high toxicity. Moreover, the main limitation of current pharmacotherapy is the development of drug resistance. Currently, there is ongoing research on the use of tyrosine kinase inhibitors (TKIs), highly specific RET inhibitors, radiotherapy and immunotherapy. These new therapies may improve the prognosis of patients with MTCs.
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11
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Mass Spectrometry and Mass Spectrometry Imaging-based Thyroid Cancer Analysis. JOURNAL OF ANALYSIS AND TESTING 2022. [DOI: 10.1007/s41664-022-00218-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Huang S, Zhong J, Zhang Z, Chen R, Li J, Sun J, Chen H. Prognosis of radiotherapy in medullary thyroid carcinoma patients without distant metastasis. Transl Cancer Res 2022; 10:4714-4726. [PMID: 35116326 PMCID: PMC8798267 DOI: 10.21037/tcr-21-1179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/16/2021] [Indexed: 11/06/2022]
Abstract
Background Medullary thyroid carcinoma (MTC) is an advanced disease with a poor prognosis. Although radiotherapy is widely utilized to treat MTC, it is still controversial. MTC patients without distant metastases have not been investigated to explore indications for adjuvant radiotherapy. This study aims to investigate the impact of radiotherapy on the survival of MTC patients without distant metastases. Methods Data of MTC patients without distant metastasis who underwent total thyroidectomy between 2010 and 2015 were obtained from the Surveillance, Epidemiology and End Results (SEER) database. Propensity score matching was performed to analyze the relationship between radiotherapy and cancer-specific survival (CSS). Results Seventy-four of 718 MTC patients without distant metastases received radiotherapy and underwent total thyroidectomy. A total of 148 patients were screened via propensity score matching analysis. Multivariate Cox regression indicated that factors including age, sex, radiotherapy and chemotherapy were independent predictors of CSS. Based on these factors, MTC patients without distant metastasis were classified into two risk groups using a nomogram and risk classification system. The C-index of the nomogram was 0.791. The calibration curves showed good consistency of CSS between the actual observation and the nomogram prediction, and decision curve analysis (DCA) showed great clinical usefulness of the nomogram. The three-year CSS of the radiotherapy group was 85.3%, and that of the surgery group was 95%. Particularly, compared with the surgery group, the three-year CSS of subgroups of the radiotherapy group, including male patients and those aged >48 years, was decreased. Conclusions Radiotherapy results in worse CSS for MTC patients without distant metastases. To maximize benefits, decisions about individual radiotherapy should weigh its advantages and disadvantages.
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Affiliation(s)
- Shaojun Huang
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiana Zhong
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zhen Zhang
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Rongping Chen
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jitong Li
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jia Sun
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Hong Chen
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Wen X, Li B, Yu X, Huang Y, Cheng W, Su Z. Does shear wave elastography for medullary thyroid carcinoma predict lateral cervical lymph node metastasis? Eur J Radiol 2021; 146:110079. [PMID: 34864615 DOI: 10.1016/j.ejrad.2021.110079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/18/2021] [Accepted: 11/25/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE To assess whether shear wave elastography (SWE) for medullary thyroid carcinoma (MTC) can independently predict lateral cervical lymph node metastasis (LNM). METHOD Patients with MTC who were treated via primary surgery between January 2015 and May 2020 and who had undergone preoperative SWE and ultrasound (US) examinations in the Harbin Medical University Cancer Hospital were retrospectively studied. The relationships between lymphatic status and the clinicopathological and imaging characteristics were evaluated. Afterwards, associations between lateral cervical LNM and SWE parameters, as well as sex, age, invasive size, extrathyroidal extension (ETE), preoperative calcitonin levels, and US features were assessed by using multivariable logistic regressions. RESULTS A total of 76 patients (31 men and 45 women, 48.1 ± 11.8 years) were evaluated. The following factors demonstrated significant associations with lateral cervical LNM: the male sex (P = 0.015), an age ≤ 35 years (P = 0.049), an invasive size > 1.0 cm (P = 0.028), ETE (P = 0.005), a preoperative calcitonin level > 60 pg/ml (P < 0.001), irregular shape on the US (P = 0.001), the presence of a non-circumscribed margin on the US (P = 0.009), an Emax > 66 kPa (P < 0.001), an Emean > 37.5 kPa (P < 0.001), and an ER > 1.65 (P = 0.002). In the multivariable analysis, an age ≤ 35 years (P = 0.049), a preoperative calcitonin level > 60 pg/ml (P = 0.004), an irregular shape on the US (P = 0.036), and an Emax > 66 kPa (P = 0.011) maintained independent significance. CONCLUSION Emax was demonstrated to be an independent predictor for lateral cervical LNM of MTC. SWE may serve as a noninvasive method of preoperative lateral cervical LNM risk assessment for MTC.
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Affiliation(s)
- Xin Wen
- Department of Ultrasound, the Fifth Affiliated Hospital of Sun Yat-Sen University, 52 Meihuadong Rd, Xiangzhou District, Zhuhai 519000, Guangdong Province, China; Department of Ultrasound, Harbin Medical University Cancer Hospital, 150 Haping Rd, Nangang District, Harbin 150081, Heilongjiang Province, China.
| | - Bo Li
- Department of Ultrasound, Harbin Medical University Cancer Hospital, 150 Haping Rd, Nangang District, Harbin 150081, Heilongjiang Province, China.
| | - Xiwen Yu
- PartyCommittee Office, The Fifth Affiliated Hospital of Sun Yat-Sen University, 52 Meihuadong Rd, Xiangzhou District, Zhuhai 519000, Guangdong Province, China
| | - Yongquan Huang
- Department of Ultrasound, the Fifth Affiliated Hospital of Sun Yat-Sen University, 52 Meihuadong Rd, Xiangzhou District, Zhuhai 519000, Guangdong Province, China
| | - Wen Cheng
- Department of Ultrasound, Harbin Medical University Cancer Hospital, 150 Haping Rd, Nangang District, Harbin 150081, Heilongjiang Province, China.
| | - Zhongzhen Su
- Department of Ultrasound, the Fifth Affiliated Hospital of Sun Yat-Sen University, 52 Meihuadong Rd, Xiangzhou District, Zhuhai 519000, Guangdong Province, China.
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