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Zhao Y, Mu Z, Liang D, Zhang T, Zhang X, Sun D, Sun Y, Liang J, Lin Y. Prognostic value of postoperative anti-thyroglobulin antibody in patients with differentiated thyroid cancer. Front Endocrinol (Lausanne) 2024; 15:1354426. [PMID: 38721144 PMCID: PMC11076744 DOI: 10.3389/fendo.2024.1354426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/03/2024] [Indexed: 06/09/2024] Open
Abstract
Purpose Postoperative thyroglobulin (Tg) generally serves as a biomarker to monitor the recurrence or persistence of differentiated thyroid cancer (DTC), whereas it constrains to interference from anti-thyroglobulin antibody (TgAb). This study aimed to determine the value of postoperative TgAb as a surrogate for monitoring tumor status in DTCs with positive TgAb after successful radioactive iodine (RAI) remnant ablation. Methods We retrospectively enrolled DTC patients with positive (≥40 IU/mL, Roche) postoperative TgAb measurements. An index of TgAb change (ΔTgAb) was defined to describe the TgAb decrease rate. DTC status was defined as either no evidence of disease (NED) or persistent/recurrent disease (PRD). Univariate and multivariate binary logistic analyses were used to identify the independent risk factors of PRD. Receiver operating characteristic (ROC) curves were performed to determine the optimal cutoff values of each risk factor, and DeLong's test was conducted to compare their predictive powers. Kaplan-Meier curves were used to assess the impact of different TgAb trends in the first year on progression-free survival. Results Of the 232 patients enrolled, the median diagnosis age was 34 years (range, 18-62 years), with a male-to-female ratio of 1:4.66 (41/191). Among them, after a median follow-up of 44 months (range, 4-128 months),183 (78.87%) patients were evaluated as NED, while the other 49 (21.12%) had either persistent (n = 25) or recurrent disease (n = 24). Multivariate regression showed that ΔTgAb (P < 0.001) and lymph node metastasis (LNM) rate (P = 0.009) were independently relevant to the presence of PRD, with optimal cutoff values of 47.0% and 35.1%, respectively. It is important to note that there is a high negative predictive value (96.93%) of ΔTgAb with the cutoff of 47.0%. DeLong's test showed that ΔTgAb alone and the combination of ΔTgAb and LNM rate were significantly greater than the isolated LNM rate (both P < 0.001) in predicting NED, while there was no statistical difference of the predictive power between ΔTgAb and the combination (P = 0.203). Additionally, patients with ΔTgAb >47.0% had longer progression-free survival than those with ΔTgAb ≤47.0% (not reached vs. 50 months, P < 0.001), and those with ΔTgAb >47.0% or negative conversion within the first year after RAI ablation had longer progression-free survival. Conclusion Our study suggested that ΔTgAb could serve as a valuable indicator of disease status in DTC patients with positive TgAb. A ΔTgAb of >47.0% is conducive to identify those with NED and may help to obviate their overtreatment. The decrease rate and negative conversion of TgAb in the first year were good predictors of disease-free survival in patients.
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Affiliation(s)
- Yihan Zhao
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing, China
- Department of Nuclear Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhuanzhuan Mu
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing, China
| | - Dongquan Liang
- Department of Psychology, Pepperdine University Graduate School of Education and Psychology, Los Angeles, CA, United States
| | - Teng Zhang
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xin Zhang
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing, China
| | - Di Sun
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing, China
| | - Yuqing Sun
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing, China
| | - Jun Liang
- Department of Oncology, Peking University International Hospital, Beijing, China
| | - Yansong Lin
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing, China
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Zhao YX, Ma LB, Yang Z, Zhang TH, Wang Y, Xiang C. TET1 is a Diagnostic and Prognostic Biomarker Associated with Immune Infiltration in Papillary Thyroid Cancer. Biochem Genet 2024; 62:718-740. [PMID: 37410307 DOI: 10.1007/s10528-023-10442-5] [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: 07/11/2022] [Accepted: 06/24/2023] [Indexed: 07/07/2023]
Abstract
To investigate the function of ten-eleven translocation 1 (TET1) and its underlying mechanism in papillary thyroid cancer (PTC). Using the RNA-Seq data based on GDC TCGA, we analyzed the gene expression pattern of TET1 in PTC. Immunohistochemistry was carried out to assess the TET1 protein level. Then, its diagnostic and prognostic functions were determined by various bioinformatics approaches. Enrichment analysis was performed to explore the potential pathways in which TET1 is mainly involved. Finally, the immune cell infiltration analysis was conducted and the association of TET1 mRNA expression with the expression levels of immune checkpoints, tumor mutation burden (TMB) score, microsatellite instability (MSI) score, and cancer stem cells (CSC) score was examined. TET1 expression was lower in PTC tissues compared with that in normal tissues (P < 0.01). Besides, TET1 had a certain value in diagnosing PTC, and low-TET1 mRNA expression led to favorable disease-specific survival (DSS) (P < 0.01). The enrichment analysis revealed autoimmune thyroid disease and cytokine-cytokine receptor interaction were the consistent pathways in which TET1 participated. TET1 was negatively correlated with the Stromal score and Immune score. The different proportions of immune cell subtypes were observed between high- and low-TET1 expression groups. Interestingly, TET1 mRNA expression was inversely related to the expression levels of immune checkpoints, and TMB, MSI, and CSC scores. TET1 might be a robust diagnostic and prognostic biomarker for PTC. TET1 affected the DSS of PTC patients possibly through the regulation of immune-related pathways and tumor immunity.
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Affiliation(s)
- Yong-Xun Zhao
- The Seventh Department of General Surgery, The First Hospital of Lanzhou University, No. 1, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu, China.
| | - Li-Bin Ma
- The Seventh Department of General Surgery, The First Hospital of Lanzhou University, No. 1, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu, China
| | - Ze Yang
- The Seventh Department of General Surgery, The First Hospital of Lanzhou University, No. 1, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu, China
| | - Tao-Hua Zhang
- The Seventh Department of General Surgery, The First Hospital of Lanzhou University, No. 1, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu, China
| | - Yong Wang
- Department of Thyroid Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, No.88, Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Cheng Xiang
- Department of Thyroid Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, No.88, Jiefang Road, Hangzhou, 310009, Zhejiang, China.
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Vargas-Uricoechea H. Autoimmune Thyroid Disease and Differentiated Thyroid Carcinoma: A Review of the Mechanisms That Explain an Intriguing and Exciting Relationship. World J Oncol 2024; 15:14-27. [PMID: 38274715 PMCID: PMC10807914 DOI: 10.14740/wjon1728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/24/2023] [Indexed: 01/27/2024] Open
Abstract
Autoimmune thyroid disease is a complex and highly frequent disease, where a wide variety of genetic, epigenetic and environmental factors (among others) come together and interact, and is characterized by the presence of two clinical outcomes: hypothyroidism (in Hashimoto's thyroiditis) and hyperthyroidism (in Graves-Basedow disease). For its part, differentiated thyroid carcinoma (mainly papillary carcinoma) is the most common type of cancer affecting the thyroid (and one of the most prevalent worldwide). An important co-occurrence between autoimmune thyroid disease and differentiated thyroid carcinoma has been documented. In this article, studies that have evaluated possible associations and relationships between autoimmune thyroid disease and differentiated thyroid cancer are systematically described and summarized. To date, the underlying mechanism that explains this association is inflammation; however, the characteristics and designs of the studies evaluated do not yet allow a causal relationship between the two entities to be established. These aspects have made it difficult to establish "causality" in the continuum of the pathogenesis between both conditions.
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Affiliation(s)
- Hernando Vargas-Uricoechea
- Metabolic Diseases Study Group, Department of Internal Medicine, Universidad del Cauca, Popayan, Colombia.
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Gallant JN, Weiss VL, Chen SC, Liang J, Belcher RH, Ye F, Correa H, Wang H. Hashimoto's Thyroiditis and the Risk of Papillary Thyroid Cancer in Children. Cancers (Basel) 2023; 15:4902. [PMID: 37835596 PMCID: PMC10572053 DOI: 10.3390/cancers15194902] [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: 08/01/2023] [Revised: 09/09/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023] Open
Abstract
The association between Hashimoto's thyroiditis (HT) and pediatric thyroid cancer is controversial. Most studies examining this connection have been based on adults, and larger studies in children are lacking. We performed a retrospective study of all sequential pediatric patients who underwent a thyroidectomy for a neoplasm at our institution over a twenty-year period in order to explore the link between HT and pediatric thyroid cancer. A total of 153 patients, median age 16.5 (interquartile range [IQR] 14.2-18.3) years, underwent thyroid surgery for a neoplasm. Patients were mainly female (80%) and White (84%). Median follow-up was 58.6 (IQR 20.7-105.4) months. Thirty-five (23%) patients had HT. Patients who underwent thyroid surgery and had HT were more likely to harbor a malignant neoplasm (p = 0.05); specifically, papillary thyroid carcinoma (PTC, p = 0.02). There was a difference in the distribution of HT among the subtypes of PTC (p = 0.03). Despite this, there was no difference in terms of survival between patients with/without HT. In conclusion, children with a thyroid malignancy, specifically, PTC, are more likely to have HT. The association between HT and pediatric PTC appears to be subtype-specific but does not seem to affect patient survival.
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Affiliation(s)
- Jean-Nicolas Gallant
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Vivian L. Weiss
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Sheau-Chiann Chen
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Jiancong Liang
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Monroe Carell Jr. Children’s Hospital, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Ryan H. Belcher
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Monroe Carell Jr. Children’s Hospital, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Fei Ye
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Hernan Correa
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Monroe Carell Jr. Children’s Hospital, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Huiying Wang
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Monroe Carell Jr. Children’s Hospital, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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Liu TT, Yin DT, Wang N, Li N, Dong G, Peng MF. Identifying and analyzing the key genes shared by papillary thyroid carcinoma and Hashimoto's thyroiditis using bioinformatics methods. Front Endocrinol (Lausanne) 2023; 14:1140094. [PMID: 37324256 PMCID: PMC10266228 DOI: 10.3389/fendo.2023.1140094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/09/2023] [Indexed: 06/17/2023] Open
Abstract
Background Hashimoto's thyroiditis (HT) is a chronic autoimmune disease that poses a risk factor for papillary thyroid carcinoma (PTC). The present study aimed to identify the key genes shared by HT and PTC for advancing the current understanding of their shared pathogenesis and molecular mechanisms. Methods HT- and PTC-related datasets (GSE138198 and GSE33630, respectively) were retrieved from the Gene Expression Omnibus (GEO) database. Genes significantly related to the PTC phenotype were identified using weighted gene co-expression network analysis (WGCNA). Differentially expressed genes (DEGs) were identified between PTC and healthy samples from GSE33630, and between HT and normal samples from GSE138198. Subsequently, functional enrichment analysis was performed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Transcription factors and miRNAs regulating the common genes in PTC and HT were forecasted using the Harmonizome and miRWalk databases, respectively, and drugs targeting these genes were investigated using the Drug-Gene Interaction Database (DGIdb). The key genes in both GSE138198 and GSE33630 were further identified via Receiver Operating Characteristic (ROC) analysis. The expression of key genes was verified in external validation set and clinical samples using quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC). Results In total, 690 and 1945 DEGs were associated with PTC and HT, respectively; of these, 56 were shared and exhibited excellent predictive accuracy in the GSE138198 and GSE33630 cohorts. Notably, four genes, Alcohol Dehydrogenase 1B (ADH1B), Active BCR-related (ABR), alpha-1 antitrypsin (SERPINA1), and lysophosphatidic acid receptor 5 (LPAR5) were recognized as key genes shared by HT and PTC. Subsequently, EGR1 was identified as a common transcription factor regulating ABR, SERPINA1, and LPAR5 expression. These findings were confirmed using qRT-PCR and immunohistochemical analysis. Conclusion Four (ADH1B, ABR, SERPINA1, and LPAR5) out of 56 common genes exhibited diagnostic potential in HT and PTC. Notably, this study, for the first time, defined the close relationship between ABR and HT/PTC progression. Overall, this study provides a basis for understanding the shared pathogenesis and underlying molecular mechanisms of HT and PTC, which might help improve patient diagnosis and prognosis.
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Affiliation(s)
- Ting-ting Liu
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - De-tao Yin
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Engineering Research Center of Multidisciplinary Diagnosis and Treatment of Thyroid Cancer of Henan Province, Zhengzhou, China
- Key Medicine Laboratory of Thyroid Cancer of Henan Province, Zhengzhou, China
| | - Nan Wang
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Na Li
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Gang Dong
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Meng-fan Peng
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Remer LF, Linhares SM, Scola WH, Lew JI. Chronic Lymphocytic Thyroiditis May Limit the Utility of Molecular Testing in AUS/FLUS Thyroid Nodules. J Surg Res 2023; 289:229-233. [PMID: 37148856 DOI: 10.1016/j.jss.2023.03.034] [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: 02/26/2022] [Revised: 03/23/2023] [Accepted: 03/25/2023] [Indexed: 05/08/2023]
Abstract
INTRODUCTION Chronic lymphocytic thyroiditis (CLT) may increase the likelihood of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) results in thyroid nodules by fine needle aspiration (FNA). Gene expression classifier (GEC) and Thyroid Sequencing (ThyroSeq) may better stratify rate of malignancy (ROM) of AUS/FLUS thyroid nodules. This study compares the utility of molecular tests in determining malignancy in surgical patients with concomitant AUS/FLUS thyroid nodules and CLT. METHODS A retrospective review of 1648 patients with index thyroid nodules who underwent FNA and thyroidectomy at a single institution was performed. Patients with concomitant AUS/FLUS thyroid nodules and CLT were subdivided into three diagnostic groups: FNA only, FNA with GEC, and FNA with ThyroSeq. Patients with AUS/FLUS thyroid nodules without CLT were subdivided into similar groups. Final histopathology of the cohorts was further stratified into benignity and malignancy and analyzed using Chi-squared statistics. RESULTS Of 463 study patients, 86 had concomitant AUS/FLUS thyroid nodules and CLT with a 52% ROM, and the difference of ROM among FNA only (48%), suspicious GEC (50%), or positive ThyroSeq (69%) was not significant. In 377 patients with AUS/FLUS thyroid nodules without CL, ROM was 59%. ROM among these patients was significantly higher when molecular testing was used (FNA only 51%, suspicious GEC 65%, and positive ThyroSeq 68%; P < 0.05). CONCLUSIONS Molecular tests may have limited value in predicting malignancy in surgical patients with concomitant AUS/FLUS thyroid nodules and CLT.
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Affiliation(s)
- Lindsay F Remer
- Division of Endocrine Surgery, DeWitt Daughtry Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida.
| | - Samantha M Linhares
- Division of Endocrine Surgery, DeWitt Daughtry Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida
| | - William H Scola
- Division of Endocrine Surgery, DeWitt Daughtry Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida
| | - John I Lew
- Division of Endocrine Surgery, DeWitt Daughtry Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida
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Zhao Z, Han N, Lu C, Wang C, Zhang Y, Liu X, Wang G, Li J, Wang Z, Si Z, Li F, Wang X. Efficacy evaluation and influencing factor analysis of postoperative 131I for the treatment of primary hyperthyroidism combined with differentiated thyroid cancer (DTC)-a retrospective cohort study. Gland Surg 2023; 12:93-100. [PMID: 36761477 PMCID: PMC9906095 DOI: 10.21037/gs-22-749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/06/2023] [Indexed: 01/18/2023]
Abstract
Background 131I treatment is one of the important methods of comprehensive postoperative treatment for patients with hyperthyroidism complicated with differentiated thyroid cancer (DTC). Early identification of patients with poor treatment efficacy of 131I is particularly important. Current studies mainly focus on the relationship between hyperthyroidism and the occurrence and development of DTC, and there are few studies on the factors affecting the curative effect. The purpose of this study was to find the influencing factors of efficacy evaluation and provide evidence for early identification of patients with poor efficacy in DTC combined with primary hyperthyroidism patients. Methods This was a retrospective analysis of DTC patients with primary hyperthyroidism who received 131I treatment in our department from 2012 to 2021. Follow-up intervals were 3 months within 1 year, 6 months within 1 to 2 years, and annual follow-up thereafter, the median follow-up time was 12.0 (3.0, 24.0) months. Serological examination and imaging examination were used to evaluate the efficacy. Patients were classified into an excellent response (ER) group and a non-ER group based on treatment response more than 6 months after 131I treatment. Univariate analysis and multivariate logistic regression analysis were performed on the basic clinical characteristics, pathological characteristics and curative effect of the patients, in order to find independent risk factors affecting the curative effect. Results Eighty-nine patients were mostly female (80.9%), the average age was 43.47±11.88 years old, and tumor size was 1.2 (0.75, 1.80) cm, 56 patients (62.9%) in the ER group. psTg [odds ratio (OR): 1.325; 95% confidence interval (CI): 1.135-1.547; P<0.001], maximum tumor diameter (OR: 2.428; 95% CI: 1.392-4.235; P=0.002) and pathology-confirmed combined HT (OR: 8.669; 95% CI: 1.877-40.038; P=0.006) were independent risk factors for predicting ER. Conclusions Our findings demonstrate that most hyperthyroidism combined with DTC patients could get favorable clinical outcomes from 131I treatment. The tumor diameter, pathology-confirmed diagnosis of combined HT, and psTg level can be used to identify patients who can get ER by the effect of 131I in hyperthyroidism combined with DTC at an early stage.
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Affiliation(s)
- Zilong Zhao
- School of Medical Imaging, Weifang Medical University, Weifang, China
| | - Na Han
- Department of Nuclear Medicine, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chenghui Lu
- Department of Nuclear Medicine, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Congcong Wang
- Department of Nuclear Medicine, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yingying Zhang
- Department of Nuclear Medicine, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xinfeng Liu
- Department of Nuclear Medicine, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guoqiang Wang
- Department of Nuclear Medicine, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jiao Li
- Department of Nuclear Medicine, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zenghua Wang
- Department of Nuclear Medicine, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zengmei Si
- Department of Nuclear Medicine, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Fengqi Li
- Department of Nuclear Medicine, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xufu Wang
- Department of Nuclear Medicine, Affiliated Hospital of Qingdao University, Qingdao, China
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Fu Y, Sun Y, Pei Q, Han X, Qin W, Mei F, Tan S, Cui L. Factors Influencing the Sample Adequacy of Ultrasound-Guided Fine-Needle Aspiration from Solid Thyroid Nodules for Liquid-Based Cytology: A Demographic, Sonographic, and Technical Perspective. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58111639. [PMID: 36422179 PMCID: PMC9698410 DOI: 10.3390/medicina58111639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/06/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: To identify factors that influence the sample adequacy of solid thyroid nodules based on ultrasound-guided fine-needle aspiration (FNA) with subsequent liquid-based cytology. Materials and Methods: We retrospectively reviewed 855 patients who underwent ultrasound-guided FNA at our hospital between July 2019 and July 2020. The final analysis included 801 solid thyroid nodules in 801 patients. After reviewing the demographic data, ultrasonic features, and FNA technique-related factors, we defined 14 potential variables. For cytological results, the Bethesda categories II−VI were defined as adequate sample results. Univariate and multivariate analyses were performed to identify factors that influenced sample adequacy. Results: The adequate sample rate was 87.1%. The univariate analysis showed that four factors were related to adequate sampling in patients with thyroid FNA. These factors included age (p < 0.001), nodule orientation (p = 0.0232), calcification (p = 0.0034), and operator experience (p = 0.0286). After the multivariate analysis, five independent factors were identified to improve the diagnostic results of FNA for solid thyroid nodules: (1) the presence of Hashimoto’s thyroiditis (odds ratio (OR) = 1.810; 95% confidence interval (CI): 1.076−3.045; p = 0.0254), (2) a taller-than-wide orientation (OR = 2.038; 95% CI: 1.260−3.296; p = 0.0037), (3) the presence of calcification (OR = 1.767; 95% CI: 1.115−2.799; p = 0.0153), (4) four needle passes to obtain material (OR = 1.750; 95% CI: 1.094−2.799; p = 0.0196), and (5) an experienced operator (OR = 0.561; 95% CI: 0.319−0.987; p = 0.0451). Conclusions: A taller-than-wide orientation, the presence of calcification, and the presence of Hashimoto’s thyroiditis were found to affect the sample adequacy of ultrasound-guided FNA with liquid-based cytology. The sample adequacy could be improved when FNA is performed with four needle passes by experienced doctors.
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Affiliation(s)
- Ying Fu
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - Yan Sun
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - Qianqian Pei
- Department of Ultrasound, Tongxiang First People’s Hospital, Tongxiang 314500, China
| | - Xiaobo Han
- Department of Ultrasound, Qinhuangdao Third Hospital, Qinhuangdao 066000, China
| | - Wen Qin
- Department of Ultrasound, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang 441021, China
| | - Fang Mei
- Department of Pathology, Peking University Third Hospital, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - Shi Tan
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - Ligang Cui
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
- Correspondence: ; Tel.: +86-13263493931
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Keefe G, Culbreath K, Cherella CE, Smith JR, Zendejas B, Shamberger RC, Richman DM, Hollowell ML, Modi BP, Wassner AJ. Autoimmune Thyroiditis and Risk of Malignancy in Children with Thyroid Nodules. Thyroid 2022; 32:1109-1117. [PMID: 35950619 DOI: 10.1089/thy.2022.0241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: It is uncertain whether the presence of autoimmune thyroiditis (AIT) increases the risk of thyroid cancer in children with thyroid nodules. This study evaluated the association between AIT and thyroid cancer in pediatric patients with thyroid nodules. Methods: A cross-sectional study was performed of pediatric patients (<19 years old) with a thyroid nodule (≥1 cm) who underwent fine-needle aspiration in an academic pediatric thyroid center. AIT was defined by the presence of thyroid autoantibodies or diffusely heterogeneous sonographic echotexture. The primary outcome was diagnosis of thyroid cancer. The association of AIT with thyroid cancer was evaluated with univariable and multivariable logistic regression. Associations of AIT with subject and nodule characteristics were also assessed. Results: Four hundred fifty-eight thyroid nodules in 385 patients (81% female) were evaluated at a median age of 15.5 years (interquartile range 13.5-17.0). Thyroid cancer was present in 108 nodules (24%). AIT was present in 95 subjects (25%) and was independently associated with an increased risk of thyroid cancer (multivariable odds ratio [OR] 2.19, 95% confidence interval [CI] 1.32-3.62). Thyroid cancer was also independently associated with younger age, nodule size, and solitary nodules, but was not associated with serum thyrotropin concentration. AIT was not associated with the likelihood of subjects undergoing thyroid surgery (p = 0.17). AIT was less commonly associated with follicular thyroid carcinoma than with papillary thyroid carcinoma (OR 0.22, CI 0.05-1.06). Among papillary thyroid carcinomas, AIT was strongly associated with the diffuse sclerosing variant (OR 4.74, CI 1.33-16.9). AIT was not associated with the extent of local, regional, or distant disease at thyroid cancer diagnosis. Conclusions: AIT is independently associated with an increased risk of thyroid cancer in children with thyroid nodules. These findings suggest that the evaluation of thyroid autoantibodies and thyroid echotexture may inform thyroid cancer risk assessment and surgical decision-making in children with thyroid nodules.
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Affiliation(s)
| | | | - Christine E Cherella
- Thyroid Center, Boston, Massachusetts, USA
- Division of Endocrinology, Department of Pediatrics, Boston, Massachusetts, USA
| | - Jessica R Smith
- Thyroid Center, Boston, Massachusetts, USA
- Division of Endocrinology, Department of Pediatrics, Boston, Massachusetts, USA
| | - Benjamin Zendejas
- Department of Surgery, Boston, Massachusetts, USA
- Thyroid Center, Boston, Massachusetts, USA
| | - Robert C Shamberger
- Department of Surgery, Boston, Massachusetts, USA
- Thyroid Center, Boston, Massachusetts, USA
| | - Danielle M Richman
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Monica L Hollowell
- Thyroid Center, Boston, Massachusetts, USA
- Department of Pathology; Boston Children's Hospital, Boston, Massachusetts, USA
| | - Biren P Modi
- Department of Surgery, Boston, Massachusetts, USA
- Thyroid Center, Boston, Massachusetts, USA
| | - Ari J Wassner
- Thyroid Center, Boston, Massachusetts, USA
- Division of Endocrinology, Department of Pediatrics, Boston, Massachusetts, USA
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10
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Omidakhsh N, Heck JE, Cockburn M, Ling C, Hershman JM, Harari A. Thyroid Cancer and Pesticide Use in a Central California Agricultural Area: A Case Control Study. J Clin Endocrinol Metab 2022; 107:e3574-e3582. [PMID: 35881539 DOI: 10.1210/clinem/dgac413] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine environmental factors that influence risk of thyroid cancer. METHODS We performed a case-control study utilizing thyroid cancer cases from the California Cancer Registry (1999-2012) and controls sampled in a population-based manner. Study participants were included if they were diagnosed with thyroid cancer, lived in the study area at their time of diagnosis, and were ≥35 years of age. Controls were recruited from the same area and eligible to participate if they were ≥35 years of age and had been living in California for at least 5 years prior to the interview. We examined residential exposure to 29 agricultural use pesticides, known to cause DNA damage in vitro or are known endocrine disruptors. We employed a validated geographic information system-based system to generate exposure estimates for each participant. RESULTS Our sample included 2067 cases and 1003 controls. In single pollutant models and within a 20-year exposure period, 10 out of 29 selected pesticides were associated with thyroid cancer, including several of the most applied pesticides in the United States such as paraquat dichloride [odds ratio (OR): 1.46 (95% CI: 1.23, 1.73)], glyphosate [OR: 1.33 (95% CI: 1.12, 1.58)], and oxyfluorfen [OR: 1.21 (95% CI: 1.02, 1.43)]. Risk of thyroid cancer increased proportionately to the total number of pesticides subjects were exposed to 20 years before diagnosis or interview. In all models, paraquat dichloride was associated with thyroid cancer. CONCLUSIONS Our study provides first evidence in support of the hypothesis that residential pesticide exposure from agricultural applications is associated with an increased risk of thyroid cancer.
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Affiliation(s)
- Negar Omidakhsh
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Julia E Heck
- College of Health and Public Service, University of North Texas, Denton, TX, USA
| | - Myles Cockburn
- Department of Preventative Medicine, Keck School of Medicine and Department of Geography, University of Southern California, Los Angeles, California, USA
| | - Chenxiao Ling
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Jerome M Hershman
- Department of Medicine, Section of Endocrinology, University of California Los Angeles, Los Angeles, CA, USA
| | - Avital Harari
- Department of Surgery, Section of Endocrine Surgery, University of California Los Angeles, Los Angeles, CA, USA
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11
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Osborne D, Choudhary R, Vyas A, Kampa P, Abbas LF, Chigurupati HD, Alfonso M. Hashimoto’s Thyroiditis Effects on Papillary Thyroid Carcinoma Outcomes: A Systematic Review. Cureus 2022; 14:e28054. [PMID: 36120263 PMCID: PMC9476374 DOI: 10.7759/cureus.28054] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/15/2022] [Indexed: 11/05/2022] Open
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12
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Gao T, Zhao L, Zhang F, Cao C, Fan S, Shi X. Evaluate the diagnostic and prognostic value of NUSAP1 in papillary thyroid carcinoma and identify the relationship with genes, proteins, and immune factors. World J Surg Oncol 2022; 20:207. [PMID: 35710427 PMCID: PMC9202173 DOI: 10.1186/s12957-022-02652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 05/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Nucleolar spindle-associated protein 1 (NUSAP1) is reported to be a useful diagnostic and prognostic marker for a variety of cancers, but relevant studies are lacking in papillary thyroid carcinoma (PTC). Methods The relationship between NUSAP1 expression and the overall survival (OS) of pan-cancer was examined by GEPIA and KMplot. We explored the relationship between NUSAP1 and clinical PTC data based on the THCA dataset of TCGA and the GEO dataset of NCBI; GO, KEGG analysis, and ceRNA networks were performed on co-expressed genes through LinkedOmics and Starbase. We assessed the relevance between NUSAP1 and the tumor microenvironment using ESTIMATE, correlations between NUSAP1 and immune cells with TIMER, the relationship between NUSAP1 and immunotherapy by TCIA, and small-molecule drugs targeting NUSAP1 that can be discovered using the CMap database. Results Higher expression of NUSAP1 in pan-cancer tissues was correlated with shorter OS. NUSAP1 was also significantly expressed in PTC tissues and was an independent prognostic risk factor. Compared to the NUSAP1 low expression group, the NUSAP1 high expression group was more likely to also have lymph node metastasis, pathological PTC type, shorter progression-free survival (PFS), and higher scores for immune checkpoint inhibitor treatment. The genes associated with NUSAP1 were mostly involved in the cell cycle, immune-related pathways, and AITD. Ten lncRNAs (GAS5, SNHG7, UCA1, SNHG1, HCP5, DLEU2, HOTAIR, TP53TG1, SNHG12, C9orf106), eleven miRNAs (hsa-miR-10a-5p, hsa-miR-10b-5p, hsa-miR-18a-5p, hsa-miR-18b-5p, hsa-miR-128-3p, hsa-miR-214-3p, hsa-miR-219a-2-3p, hsa-miR-339-5p, hsa-miR-494-3p, hsa-miR-545-3p, hsa-miR-769-5p), and one mRNA (NUSAP1) were constructed. NUSAP1 participated in the formation of the tumor microenvironment. CMap predicted the 10 most important small molecules about NUSAP1. Conclusions In PTC, NUSAP1 shows good diagnostic value and prognostic value; NUSAP1 impacts the cell cycle, immune-related pathways, and AITD and has a complex effect on the tumor microenvironment in PTC. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02652-9.
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Affiliation(s)
- Tiantian Gao
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, 110001, People's Republic of China
| | - Lei Zhao
- Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, 110001, People's Republic of China
| | - Fan Zhang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, 110001, People's Republic of China
| | - Conghui Cao
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, 110001, People's Republic of China
| | - Shuting Fan
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, 110001, People's Republic of China
| | - Xiaoguang Shi
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, 110001, People's Republic of China.
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Słowińska-Klencka D, Popowicz B, Klencki M. Hashimoto's Thyroiditis Does Not Influence the Malignancy Risk in Nodules of Category III in the Bethesda System. Cancers (Basel) 2022; 14:cancers14081971. [PMID: 35454876 PMCID: PMC9025593 DOI: 10.3390/cancers14081971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/28/2022] [Accepted: 04/11/2022] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to evaluate the risk of malignancy (RoM) in category III thyroid nodules of the Bethesda system in patients with and without Hashimoto thyroiditis (HT) and to analyze whether obtaining category III with a repeat FNA (rFNA) increases RoM. The study included 563 HT and 1250 non-HT patients; rFNA was performed in 349 and 575 patients, and surgical treatment in 160 and 390, respectively. There was no difference in RoM between HT and non-HT patients in the whole examined population (lower limit of RoM), nor in operated patients (upper limit of RoM), HT: 5.0−17.5%, non-HT: 4.7−15.1%. RoM in patients with AUS nodules (with nuclear atypia) was similar in both groups (HT: 21.7−40.0%, non-HT: 16.9−41.4%), as it was in patients with FLUS nodules (with architectural atypia) (HT: 3.5−13.3%, non-HT: 4.0−13.0%). In patients from both groups together, with category III diagnosed twice and AUS identified at least once, RoM was 16.7−50.0% and it was higher than that in patients with FLUS nodule diagnosed twice: 3.2−13.0% (p < 0.005). Concluding, RoM in category III nodules is not affected by the presence of HT. Subcategorization of category III nodules (FLUS vs. AUS) may provide guidance toward further follow-up or surgery in both groups.
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14
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Zhong H, Liu S, Wang Y, Xu D, Li M, Zhao Y, Zeng X. Primary Sjögren's syndrome is associated with increased risk of malignancies besides lymphoma: A systematic review and meta-analysis. Clin Exp Rheumatol 2022; 21:103084. [PMID: 35341972 DOI: 10.1016/j.autrev.2022.103084] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/23/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Patients with primary Sjögren's syndrome(pSS) have increased risk of non-Hodgkin lymphoma (NHL). However, whether pSS patients have increased risk of other malignancies is unclear. The aim of this study is to investigate the association between pSS and the risk of malignancy, with a focus on hematological malignancies besides lymphoma and solid tumors through a systematic review and meta-analysis. METHOD We searched PubMed and EMBASE by March 21st 2021. Inclusion criteria were as follows: (1) pSS was the exposure of interest; (2) newly developed malignancies were the outcome of interest; (3) standardized incidence ratio or relative risk with 95% confidence interval or essential data to calculate them were reported. (4) Study design was cohort study. Patient with other connective diseases were excluded. Quality assessment was conducted according to Newcastle-Ottawa Scale for cohort study. Random or fixed effect models were used to calculate the pooled SIR according to heterogeneity measured by I2. RESULTS A total of 1003 articles were found by a comprehensive search in PubMed and EMBASE. Twenty-eight articles were eligible. Four of them were from the same database, the one with longest observational span was chosen. Therefore, twenty-five articles were included for final analysis, which involved more than 47,607 pSS patients with the follow-up of more than 452,468 person-year. We found that pSS was significantly associated with increased risks of overall malignancy(pooled SIR 2.17, 95%1.57-3.00), hematological malignancy(pooled SIR 11.55, 95%CI 4.32-30.90) including NHL(pooled SIR 13.71, 95%CI 8.83-21.29), Hodgkin lymphoma(pooled SIR 8.84, 95%CI 5.00-15.61), multiple myeloma(pooled SIR 8.27, 95%CI 3.08-22.24), leukemia(pooled SIR 2.56, 95%CI 1.78-3.69) and solid tumors(pooled SIR 1.39, 95%CI 0.90-2.13) including lung cancer(pooled SIR 1.55, 95%CI 1.29-1.85), thyroid cancer(pooled SIR 2.05, 95%CI 1.20-3.48), non-melanoma skin cancer(pooled SIR 1.71, 95%CI 1.08-2.72), kidney/urinary tract cancer(pooled SIR 1.36, 95%CI 1.02; 1.81), liver cancer(pooled SIR 1.70, 95%CI 1.13-2.57) and prostate cancer(pooled SIR 1.50, 95%CI 1.02-2.22). CONCLUSION This meta-analysis showed that pSS patients had increased risk of overall cancer, which not only contributed by NHL, but also by other hematological malignancies and solid tumors.
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Affiliation(s)
- Hui Zhong
- Department of Rheumatology and Clinical Immunology of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Siyao Liu
- Department of Rheumatology and Clinical Immunology of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Yanhong Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, PR China
| | - Dong Xu
- Department of Rheumatology and Clinical Immunology of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
| | - Mengtao Li
- Department of Rheumatology and Clinical Immunology of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
| | - Yan Zhao
- Department of Rheumatology and Clinical Immunology of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
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15
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Xu J, Ding K, Mu L, Huang J, Ye F, Peng Y, Guo C, Ren C. Hashimoto's Thyroiditis: A "Double-Edged Sword" in Thyroid Carcinoma. Front Endocrinol (Lausanne) 2022; 13:801925. [PMID: 35282434 PMCID: PMC8907134 DOI: 10.3389/fendo.2022.801925] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/18/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The prevalence of thyroid carcinoma (TC) and Hashimoto's thyroiditis (HT) has been increasing dramatically over the past decades. We investigated the relationship between HT and TC. METHODS We followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines for carrying out and reporting this meta-analysis. The literature from January 1, 2010 to December 31, 2020, regardless of region and publication type, was searched comprehensively in PubMed, Embase, Web of Science, and Cochrane Library databases. After careful selection and data extraction, the pooled odds ratio of various clinical characteristics in 39 studies were calculated. Publication bias was analyzed using funnel plots. RESULTS Meta-analysis of 39 original research articles showed HT to be a risk factor of TC (pooled odds ratio = 1.71; 95% confidence interval, 1.57-1.80; p < 0.00001) and papillary thyroid carcinoma (1.67, 1.51-1.85, <0.00001). Patients with papillary thyroid carcinoma (PTC) combined with HT were more likely to have multifocal carcinomas. The prevalence of an extrathyroidal extension, metastasis, BRAFV600E mutation, and recurrence was significantly lower in patients with PTC combined with HT. CONCLUSIONS HT is a "double-edged sword" in TC patients. HT increases the risk of TC and PTC but is a protective factor against PTC progression.
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Affiliation(s)
- Jiangyue Xu
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ke Ding
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Lan Mu
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jiangsheng Huang
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Fei Ye
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yu Peng
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Can Guo
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chutong Ren
- Department of General Surgery Thyroid Specialty, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Chutong Ren,
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16
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Hu X, Wang X, Liang Y, Chen X, Zhou S, Fei W, Yang Y, Que H. Cancer Risk in Hashimoto's Thyroiditis: a Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2022; 13:937871. [PMID: 35903279 PMCID: PMC9318815 DOI: 10.3389/fendo.2022.937871] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/09/2022] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Research data suggest that patients with Hashimoto's thyroiditis may increase the risk of cancer. However, existing research is inconsistent with this view. Therefore, to investigate the effect of Hashimoto's thyroiditis on the risk of developing cancer, we conducted this study. METHODS We searched the PubMed and Embase databases from database establishment until March 2022. After rigorous literature screening by two authors, 23 studies that met the inclusion criteria were identified, and the required data were independently extracted. RESULTS We retrieved 3591 records, and after the screening, 11 case-control studies and 12 cohort studies were included in the analysis. Data analysis suggested that patients with Hashimoto's thyroiditis had an increased risk of developing breast cancer, urogenital cancer, digestive organs cancer, hematologic cancer, and a low risk of respiratory cancers. CONCLUSIONS This systematic review and meta-analysis showed that patients with HT may have a significantly increased risk of thyroid cancer, breast cancers, lung cancer, digestive system cancer, urogenital cancers, blood cancers, and prolactinoma people without HT. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier CRD 42022320741.
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Affiliation(s)
- Xiaojie Hu
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xuanyu Wang
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yue Liang
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xin Chen
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Siyuan Zhou
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenting Fei
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuxin Yang
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huafa Que
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Huafa Que,
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17
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Mao L, Zheng C, Ou S, He Y, Liao C, Deng G. Influence of Hashimoto thyroiditis on diagnosis and treatment of thyroid nodules. Front Endocrinol (Lausanne) 2022; 13:1067390. [PMID: 36619577 PMCID: PMC9816323 DOI: 10.3389/fendo.2022.1067390] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND As the prevalence of Hashimoto's thyroiditis (HT) and thyroid cancer (TC) has been increasing dramatically in recent years, the association between the two diseases has been widely debated and studied. However, no consistent findings are available and the relationship remains controversial. In this study, we analyzed the influence of HT on the diagnosis and treatment of thyroid nodules and investigated the relationship between HT and TC. METHODS From Jan 2017 to Apr 2021, 4678 patients underwent thyroid surgery were collected. Of these patients, 440 were diagnosed with HT (242 nodular goiter (NG) with HT, 198 TC with HT). These patients were grouped when appropriate and the data from these patients were statistically analyzed by using SPSS and GraphPad Prism 6. RESULTS HT occurred in 198 of 1089 (18.2%) TC patients and 242 of 3589 (6.74%) patients without TC (p=0.000). In terms of the ultrasonography features, in the NG with HT group, 33.1% (80/242) of patients had fine calcification and 45.9% (111/242) of patients whose TI-RADS classification were > Level 3. In the isolated PTC group, 32.3% (2343/7260) LN were metastasis-positive while in the NG with HT group, only 26.0% (504/1939) LN were metastasis-positive (P=0.000). The proportion of PTMC was significantly higher (P=0.000), while the proportion of multifocal carcinoma was significantly lower when coexisting with HT (P=0.029). When comparing the data from the two groups diagnosed as PTMC coexisting with HT or not, there was no significant difference in the composition ratio of tumor number, LN metastasis, LN dissection area, regional LN metastasis and number of negative/positive LN (P=0.614, P=0.051, P=0.139, P=0.350, P=1.000 and P=0.333 respectively). In the MPTC group, 42.2% (872/2065) LN were metastasis-positive while in the MPTC with HT group, only 23.6% (50/212) LN were metastasis-positive (P=0.000). CONCLUSIONS Our data suggested that HT is associated with an increased risk of developing TC but may be a protective factor against PTC progression and metastasis. The coexistence of HT affects the judgment of thyroid nodules by ultrasonography.
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Affiliation(s)
- Linfeng Mao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of GuangXi Medical University, Nanning, Guangxi, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
- Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
| | - Chunmei Zheng
- Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shengzhao Ou
- Department of General Surgery, The Hepu People’s Hospital, Beihai, Guangxi, China
| | - Youwu He
- Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Chuanjie Liao
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Ganlu Deng
- Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- *Correspondence: Ganlu Deng,
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18
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Abbasgholizadeh P, Naseri A, Nasiri E, Sadra V. Is Hashimoto thyroiditis associated with increasing risk of thyroid malignancies? A systematic review and meta-analysis. Thyroid Res 2021; 14:26. [PMID: 34861884 PMCID: PMC8641157 DOI: 10.1186/s13044-021-00117-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/16/2021] [Indexed: 11/21/2022] Open
Abstract
Background and purpose Hashimoto thyroiditis (HT) is the most common inflammatory autoimmune thyroid disease and also the most common cause of hypothyroidism in developed countries. There is evidence of the role of HT in developing thyroid cancers (TCs). This study investigated the association between HT and different types of TCs. Methods Results of a comprehensive search in three major databases, as well as hand searching, were screened in title/abstract and full-text stages and the relevant data were extracted from the studies that met the inclusion criteria. Risk of bias (RoB) was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools and the meta-analysis was conducted with Comprehensive Meta-Analysis software. Results Out of 4785 records, 50 studies were included in the systematic review, and 27 of them met the criteria for quantitative synthesis. The results indicated a significant role for HT in developing papillary TC (OR: 1.65; 95% CI: 1.04 to 2.61), medullary TC (OR: 2.70; 95% CI: 1.20 to 6.07) and lymphoma (OR:12.92; 95% CI: 2.15 to 77.63); but not anaplastic TC (OR: 1.92; 95% CI: 0.29 to 1.90) and follicular TC (OR: 0.73; 95% CI: 0.41 to 1.27). Also, this study found a significant association between HT and thyroid malignancies (OR: 1.36; 95% CI: 1.05 to 1.77). Conclusion Although we found a significant association between HT and some types of TCs, High RoB studies, high level of heterogeneity, and the limited number of well-designed prospective studies, suggested the need for more studies to reach more reliable evidence. Supplementary Information The online version contains supplementary material available at 10.1186/s13044-021-00117-x.
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Affiliation(s)
| | - Amirreza Naseri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Nasiri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute (JBI) Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahideh Sadra
- Endocrine Research Center, Tabriz University of Medical Sciences, Golgasht street, Tabriz, Iran.
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Elmaoğulları S, Özalkak Ş, Çetinkaya S, Karaman İ, Üner Ç, Arda N, Savaş-Erdeve Ş, Aycan Z. Evaluation of Children and Adolescents with Thyroid Nodules: A Single Center Experience. J Clin Res Pediatr Endocrinol 2021; 13:276-284. [PMID: 33374093 PMCID: PMC8388051 DOI: 10.4274/jcrpe.galenos.2020.2020.0213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE We aimed to evaluate the clinical, radiological and pathological findings of children and adolescents with thyroid nodules. METHODS Data of 121 children and adolescent with thyroid nodules and had fine needle aspiration (FNA) were examined retrospectively. Concomitant thyroid disease, ultrasonography (US) features of the nodule, FNA and histopathological results were recorded. FNA results were assessed according to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). RESULTS Median (range) age of the cases was 14 (3-18) years and 81% were female. FNA results of patients were: insufficient in 1 (0.8%); benign in 68 (56.2%); indeterminate in 44 (36.4%); and malignant in 8 (6.6%) patients. Among 39 patients who underwent surgery, 10 (25.6%) had differentiated thyroid cancer (DTC) and the overall malignancy rate was 10.0% (10/100). Follow-up FNA results showed progress based on TBSRTC in 18.7% of benign results and 4/75 patients had DTC on surgical excision. Two of 22 patients with atypia of undetermined significance (AUS) who continued follow-up was diagnosed with DTC. Male gender, presence of Hashimoto thyroiditis and US findings of uninodularity, hypoechogenicity, increased blood flow, irregular margins, solid structure, microcalcification and presence of abnormal cervical lymph nodes were associated with malignancy. CONCLUSION In this study 10% of thyroid nodules were malignant in children and adolescents. Patients with AUS have a 9% potential for malignancy. Patients with initially benign FNA result may have changes on repeat FNA when assessed with TBSTRC indicating a 5.3% false negative rate.
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Affiliation(s)
- Selin Elmaoğulları
- University of Health Sciences Turkey, Ankara Dr. Sami Ulus Children’s Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey,* Address for Correspondence: University of Health Sciences Turkey, Ankara Dr. Sami Ulus Children’s Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey Phone: +90 532 580 88 62 E-mail:
| | - Şervan Özalkak
- University of Health Sciences Turkey, Ankara Dr. Sami Ulus Children’s Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Semra Çetinkaya
- University of Health Sciences Turkey, Ankara Dr. Sami Ulus Children’s Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - İbrahim Karaman
- University of Health Sciences Turkey, Ankara Dr. Sami Ulus Children’s Training and Research Hospital, Clinic of Pediatric Surgery, Ankara, Turkey
| | - Çiğdem Üner
- University of Health Sciences Turkey, Ankara Dr. Sami Ulus Children’s Training and Research Hospital, Clinic of Pediatric Radiology, Ankara, Turkey
| | - Nilüfer Arda
- University of Health Sciences Turkey, Ankara Dr. Sami Ulus Children’s Training and Research Hospital, Clinic of Pediatric Pathology, Ankara, Turkey
| | - Şenay Savaş-Erdeve
- University of Health Sciences Turkey, Ankara Dr. Sami Ulus Children’s Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Zehra Aycan
- University of Health Sciences Turkey, Ankara Dr. Sami Ulus Children’s Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey,Ankara University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
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Valduga JAG, Rebeiko LB, Skare TL. Prevalence of Hashimoto's thyroiditis in psoriasis patients. ACTA ACUST UNITED AC 2021; 67:52-57. [PMID: 34161490 DOI: 10.1590/1806-9282.67.01.20200274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/20/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To study the prevalence of Hashimoto's Thyroiditis in a sample of psoriasis patients. METHODS Cross-sectional observational study of 120 individuals (60 with psoriasis and 60 control subjects) paired by gender and age for thyroid function (thyroid stimulating hormone, free T4), antithyroperoxidase and antithyroglobulin tests and physical examination. Psoriasis Area and Severity Index and Nail Psoriasis Severity Index were evaluated simultaneously. Epidemiological, clinical and treatment data was collected from medical records. Patients with documented hypothyroidism and/or goiter associated with positive antithyroperoxidase antibody were considered to have Hashimoto's Thyroiditis. RESULTS The prevalence of Hashimoto's Thyroiditis in the group with psoriasis was 21.6%; in the control group, it was 4/60 (6.6%) with p=0.03 (OR=3.8; 95%CI 1.18-12.6). In the group of patients with psoriasis, Hashimoto's Thyroiditis was more common in women (p=0.002) and less common in those who had polyarticular arthropathic psoriasis (p=0.05) and plaque psoriasis (p=0.005). A logistic regression showed that the only independent variable associated with Hashimoto's thyroiditis was plaque psoriasis. CONCLUSIONS There is a high prevalence of Hashimoto's Thyroiditis in psoriatic patients, especially in women. Hashimoto's Thyroiditis is less common in patients with the plaque form of psoriasis.
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Liu Y, Shan Z. Expert consensus on diagnosis and treatment for elderly with thyroid diseases in China (2021). Aging Med (Milton) 2021; 4:70-92. [PMID: 34250426 PMCID: PMC8251868 DOI: 10.1002/agm2.12165] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/15/2023] Open
Abstract
In order to improve the diagnosis and treatment of senile thyroid diseases in China and to promote healthy aging, the Endocrine Metabolic Diseases Group of the Chinese Geriatrics Society, and the Thyroid Group of the Chinese Society of Endocrinology jointly drafted the "Expert consensus on diagnosis and treatment for Chinese elderly with thyroid diseases" (referred to as consensus). The Consensus consists of five parts that set 40 recommendations on main clinical issues. The consensus emphasizes clinical focus on the age-related changes of the hypothalamus-pituitary-thyroid axis in the elderly, and it recommends application of comprehensive geriatric assessment to thoroughly evaluate the impact of thyroid diseases and relevant intervention on overall health condition. Meanwhile, it recommends generalization of screening for hypothyroidism during admission to nursing institution or hospital, and routine health check-ups. Furthermore, it develops individualized stratified management on hyperthyroidism, hypothyroidism, thyroid nodules, and differentiated thyroid carcinoma in the elderly distinguished from the youngers, including treatment regimen, control ranges, and flowcharts for diagnosis and treatment. The Consensus will provide the basis for clinical decisions and health management of thyroid diseases in the elderly by geriatrician, endocrinologist, and general practitioners.
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Affiliation(s)
- Youshuo Liu
- Department of Geriatrics and Geriatric EndocrinologyThe Second Xiangya Hospitaland the Institute of Aging and GeriatricsCentral South UniversityNational Clinical Research Center for Metabolic Diseases (The Second Xiangya Hospital)ChangshaChina
| | - Zhongyan Shan
- Department of Endocrinology and MetabolismThe Institute of EndocrinologyThe First Hospital of China Medical University, NHC Key Laboratory
Diagnosis and Treatment of Thyroid DiseasesShenyangChina
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22
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Khan A, Sultan M, Fawzy W, Habib SS, Haq MUU. Thyroid "claw sign" a useful diagnostic marker in the outsized lesions of isthmus: A large colloid cyst. Radiol Case Rep 2021; 16:1688-1694. [PMID: 34007385 PMCID: PMC8111453 DOI: 10.1016/j.radcr.2021.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 11/26/2022] Open
Abstract
Thyroid isthmus lesions are generally small sized and can be solid or cystic. Discerning isthmic origin of a large nodule, especially if purely cystic, can become a diagnostic challenge because of thin thyroid tissue in it. We report a case of a 68-year-old male patient who had 6 weeks history of non- inflammatory central neck swelling associated with recent dysphagia, for which he underwent ultrasound and computed tomography (CT) scan examinations. Colloid nodules usually do not require further attention. Despite being commonest and benign thyroid nodules, they may require treatment if causing pressure symptoms. Its imaging characteristics can be variable, but they usually exhibit comet tail artifacts on ultrasound. In equivocal cases, claw sign on CT scan is diagnostic to confirm the site. Radiologists have a principle role to rule out other differentials of cystic neck lesions by careful examination of imaging features. In our case, CT scan allowed to rule out primary differential of thyroglossal cyst and guided clinicians for specific management plan.
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Affiliation(s)
- Adeena Khan
- Department of Radiology and Medical Imaging, King Saud University Riyadh 11451, Saudi Arabia
| | - Mamoona Sultan
- Department of Internal Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Waleed Fawzy
- Department of Radiology and Medical Imaging, King Saud University Riyadh 11451, Saudi Arabia
| | - Syed Shahid Habib
- Department of Clinical Physiology, King Saud University, Riyadh, Saudi Arabia
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Bioinformatics analysis of key genes and pathways in Hashimoto thyroiditis tissues. Biosci Rep 2021; 40:225785. [PMID: 32662826 PMCID: PMC7374273 DOI: 10.1042/bsr20200759] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/23/2020] [Accepted: 07/13/2020] [Indexed: 02/06/2023] Open
Abstract
Hashimoto thyroiditis (HT) is one of the most common autoimmune diseases, and the incidence of HT continues to increase. Long-term, uncontrollable HT results in thyroid dysfunction and even increases carcinogenesis risks. Since the origin and development of HT involve many complex immune processes, there is no effective therapy for HT on a pathogenesis level. Although bioinformatics analysis has been utilized to seek key genes and pathways of thyroid cancer, only a few bioinformatics studies that focus on HT pathogenesis and mechanisms have been reported. In the present study, the Gene Expression Omnibus dataset (GSE29315) containing 6 HT and 8 thyroid physiological hyperplasia samples was downloaded, and differentially expressed gene (DEG) analysis, Gene Ontology analysis, Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, protein–protein interaction analysis, and gene set enrichment analysis were performed. In total, 85 DEGs, containing 76 up-regulated and 9 down-regulated DEGS, were identified. The DEGs were mainly enriched in immune and inflammatory response, and the signaling pathways were involved in cytokine interaction and cytotoxicity. Moreover, ten hub genes were identified, and IFN-γ, IFN-α, IL6/JAK/STAT3, and inflammatory pathways may promote the origin and progression of HT. The present study indicated that exploring DEGs and pathways by bioinformatics analysis has important significance in understanding the molecular mechanisms of HT and providing potential targets for the prevention and treatment of HT.
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24
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The Presence of Hypoechoic Micronodules in Patients with Hashimoto's Thyroiditis Increases the Risk of an Alarming Cytological Outcome. J Clin Med 2021; 10:jcm10040638. [PMID: 33562377 PMCID: PMC7915457 DOI: 10.3390/jcm10040638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/31/2021] [Accepted: 02/04/2021] [Indexed: 12/22/2022] Open
Abstract
The aim of the study was to identify a possible relation between various ultrasonographic (US) appearances of Hashimoto's thyroiditis (HT) and the risk of obtaining an alarming cytology of coexisting nodules. The study included 557 patients with HT, who had been referred for fine needle aspiration biopsy (FNA). We divided US patterns of HT (UP-HT) into eight groups: (a) Hypoechoic (compared to submandibular glands), homogeneous/fine echotexture; (b) hypoechoic, heterogeneous/coarse echotexture; (c) marked hypoechoic (darker than strap muscles), heterogeneous/coarse echotexture; (d) heterogeneous echotexture with hyperechoic, fibrous septa; (e) multiple, discrete marked hypoechoic areas (sized as 1 to 6 mm); (f) normoechoic pseudo-nodular areas; (g) echostructure similar to connective tissue; (h) thyroid parenchyma with no signs of HT. Indications for a surgical treatment resulting from the FNA outcome (categories IV-VI of Bethesda System for Reporting Thyroid Cytopathology) were identified only in patients with variants b, c, and e of UP-HT, but merely the "multiple, discrete marked hypoechoic areas" variant significantly increased the odds of obtaining such cytology (OR:5.7). The presence of the "normoechoic pseudo-nodular areas" variant significantly increased the odds for the benign cytology (OR:1.7). There are significant differences in the frequency of obtaining an alarming cytology in relation to the UP-HT variant.
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25
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Piskunowicz M, Back SJ, Darge K, Humphries PD, Jüngert J, Ključevšek D, Lorenz N, Mentzel HJ, Squires JH, Huang DY. Contrast-enhanced ultrasound of the small organs in children. Pediatr Radiol 2021; 51:2324-2339. [PMID: 33830288 PMCID: PMC8566395 DOI: 10.1007/s00247-021-05006-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/17/2020] [Accepted: 02/08/2021] [Indexed: 11/28/2022]
Abstract
In pediatric and adult populations, intravenous contrast-enhanced ultrasound (CEUS) remains off-label for imaging of organs other than the liver and heart. This limited scope inhibits potential benefits of the new modality from a more widespread utilization. Yet, CEUS is potentially useful for imaging small organs such as the thyroid gland, lymph nodes, testes, ovaries and uterus, with all having locations and vasculature favorable for this type of examination. In the adult population, the utility of CEUS has been demonstrated in a growing number of studies for the evaluation of these small organs. The aim of this article is to present a review of pediatric CEUS of the thyroid gland, lymph nodes, testes, ovaries and uterus as well as to draw from the adult literature indications for possible applications in children.
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Affiliation(s)
- Maciej Piskunowicz
- Department of Radiology, Medical University of Gdansk, M. Sklodowskiej-Curie 3a Street, 80-210, Gdansk, Poland.
| | - Susan J. Back
- grid.25879.310000 0004 1936 8972Department of Radiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Kassa Darge
- grid.25879.310000 0004 1936 8972Department of Radiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Paul D. Humphries
- grid.424537.30000 0004 5902 9895Department of Radiology, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Jörg Jüngert
- grid.5330.50000 0001 2107 3311Department of Pediatrics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Damjana Ključevšek
- grid.29524.380000 0004 0571 7705Department of Radiology, University Children’s Hospital Ljubljana, Ljubljana, Slovenia
| | - Norbert Lorenz
- grid.4488.00000 0001 2111 7257Children’s Hospital, Dresden Municipal Hospital, Teaching-Hospital of Technical University Dresden, Dresden, Germany
| | - Hans-Joachim Mentzel
- grid.275559.90000 0000 8517 6224Section of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, University Hospital, Jena, Germany
| | - Judy H. Squires
- grid.239553.b0000 0000 9753 0008Department of Radiology, University of Pittsburgh Medical Center, Children’s Hospital of Pittsburgh, Pittsburgh, PA USA
| | - Dean Y. Huang
- grid.46699.340000 0004 0391 9020Department of Radiology, King’s College Hospital, Denmark Hill, London, UK
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26
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Liu C, Pan Y, Li Q, Zhang Y. Bioinformatics analysis identified shared differentially expressed genes as potential biomarkers for Hashimoto's thyroiditis-related papillary thyroid cancer. Int J Med Sci 2021; 18:3478-3487. [PMID: 34522174 PMCID: PMC8436097 DOI: 10.7150/ijms.63402] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/27/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Although the etiology of Hashimoto's thyroiditis (HT), a common autoimmune endocrine disease, is unknown, studies suggest a potential association with genetic factors and environmental conditions inducing excessive iodine intake. Additionally, HT patients have a high risk of papillary thyroid cancer (PTC), which is probably related to the chronic inflammation and autoimmune pathologic process occurring in HT, as it is thought to be associated with neoplastic transformation. Methods: Bioinformatics approaches can identify differentially expressed genes (DEGs) and analyze DEG functions in diseases. R software was used in this study to identify DEGs in HT and PTC using data in Gene Expression Omnibus (GEO). The online tools DAVID, Reactome, and AmiGO were employed for annotation, visualization, and integration of DEGs related to HT and PTC, and the STRING database and Cytoscape software were applied to predict and visualize protein-protein networks (PPIs) for DEG-encoded proteins. Coexpressed DEGs in HT and PTC were validated by reverse transcription PCR (RT-PCR). Results: In total, 326, 231, and 210 DEGs in HT specimens and samples of central PTC and PTC invasive areas, respectively, were detected. According to the PPI network, PTPN6, HLA-A, C3AR1, LCK and ITGB2 are hub genes among HT-DEGs, whereas FN1, CDH2, SERPINA1, and CYR61 are PTC-DEG hub genes. The shared DEGs LTF and CCL21 were validated by RT-PCR. Both bioinformatics and RT-PCR analyses showed LTF and CCL21 to be upregulated in HT tissues and downregulated in PTC tissues. Conclusions: We identified that expression of LTF and CCL21 are significantly different in HT and PTC, suggesting an underlying association between HT and PTC.
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Affiliation(s)
- Chang Liu
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yu Pan
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Qinyu Li
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yifan Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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27
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D'Andréa G, Lassalle S, Guevara N, Mograbi B, Hofman P. From biomarkers to therapeutic targets: the promise of PD-L1 in thyroid autoimmunity and cancer. Theranostics 2021; 11:1310-1325. [PMID: 33391536 PMCID: PMC7738901 DOI: 10.7150/thno.50333] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 08/30/2020] [Indexed: 12/12/2022] Open
Abstract
The programmed cell death-1/programmed cell death ligand-1 (PD-1/PD-L1) immune checkpoint proteins hold promise as diagnostic, prognostic, and therapeutic targets for precision oncology. By restoring antitumor T cell surveillance, the high degree of effectiveness of the immune checkpoint inhibitors (ICIs) has revolutionized cancer treatment. However, the majority of patients (65-80 %) treated with ICIs experience significant side effects, called immune-related adverse events (irAEs), resulting in autoimmune damage to various organs. Therefore, broadening the clinical applicability of these treatments to all cancer types requires an improved understanding of the mechanisms linking cancer immune evasion and autoimmunity. The thyroid is the endocrine gland the most frequently involved in autoimmunity and cancer, the growing incidence of which is raising serious public health issues worldwide. In addition, the risk of developing thyroid cancer is increased in patients with autoimmune thyroid disease and thyroid dysfunction is one of the most common irAEs, especially with PD‑1/PD-L1 blockade. Therefore, we chose the thyroid as a model for the study of the link between autoimmunity, irAEs, and cancer. We provide an update into the current knowledge of the PD‑1/PD-L1 axis and discuss the growing interest of this axis in the diagnosis, prognosis, and management of thyroid diseases within the context of autoimmunity and cancer, while embracing personalized medicine.
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Affiliation(s)
- Grégoire D'Andréa
- ENT and Head and Neck surgery department, Institut Universitaire de la Face et du Cou, CHU de Nice, University Hospital, Côte d'Azur University, Nice, France
- Côte d'Azur University, CNRS, INSERM, Institute for Research on Cancer and Aging, FHU OncoAge, Nice, France
| | - Sandra Lassalle
- Côte d'Azur University, CNRS, INSERM, Institute for Research on Cancer and Aging, FHU OncoAge, Nice, France
- Laboratory of Clinical and Experimental Pathology, Côte d'Azur University and Biobank, Pasteur Hospital, University Côte d'Azur, FHU OncoAge, Nice, France
| | - Nicolas Guevara
- ENT and Head and Neck surgery department, Institut Universitaire de la Face et du Cou, CHU de Nice, University Hospital, Côte d'Azur University, Nice, France
| | - Baharia Mograbi
- Côte d'Azur University, CNRS, INSERM, Institute for Research on Cancer and Aging, FHU OncoAge, Nice, France
- Antoine Lacassagne Cancer Center, FHU OncoAge, Nice, France
| | - Paul Hofman
- Côte d'Azur University, CNRS, INSERM, Institute for Research on Cancer and Aging, FHU OncoAge, Nice, France
- Antoine Lacassagne Cancer Center, FHU OncoAge, Nice, France
- Laboratory of Clinical and Experimental Pathology, Côte d'Azur University and Biobank, Pasteur Hospital, University Côte d'Azur, FHU OncoAge, Nice, France
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Abstract
PURPOSE OF REVIEW To summarize the recent developments in considering Hashimoto's thyroiditis as a risk factor for thyroid cancer. RECENT FINDINGS Modern approaches to understanding the co-occurrence of Hashimoto's thyroiditis and thyroid cancer have consistently found increased prevalence of both conditions, separately as well as of their coexistence. The inflammatory process in Hashimoto's thyroiditis is understood as a potential risk factor for thyroid cancer development. This has also provided a better understanding of the limitations in the current diagnostic and follow-up armamentarium for both conditions, resulting in international guidelines from the clinical and scientific societies. Other recent developments call for a paradigm shift in guidelines on thyroid carcinomas when lymphocytic infiltration is present, which potentially should always be considered the case at least in areas of sufficient iodine intake. SUMMARY The literature of Hashimoto's thyroiditis as a risk factor for thyroid cancer is reviewed over the last year to highlight new developments in the understanding of their association and future clinical implications.
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Affiliation(s)
- Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej, Denmark
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29
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Dias Lopes NM, Mendonça Lens HH, Armani A, Marinello PC, Cecchini AL. Thyroid cancer and thyroid autoimmune disease: A review of molecular aspects and clinical outcomes. Pathol Res Pract 2020; 216:153098. [PMID: 32825964 DOI: 10.1016/j.prp.2020.153098] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/24/2020] [Accepted: 06/29/2020] [Indexed: 12/24/2022]
Abstract
Thyroid cancer (TC) is the most prevalent malignant neoplasm that affects the endocrine system. Hashimoto's thyroiditis (HT), also known as chronic lymphocytic thyroiditis, is the most common autoimmune thyroid disease (AITD) that, together with Graves' disease (GD), represent the main autoimmune diseases that affect the thyroid gland. Some studies suggest a greater risk of AITD and the development of TC, while others, investigate its relationship with TC progression and patient prognosis. In this review, we have analyzed published data on the molecular aspects related to the association between AITD and TC, addressing their influence on TC progression, diagnosis, and prognosis of the patients. MEDLINE database (PubMed) platform was used as a search engine and the original articles related to the topic were selected using the keywords combination "thyroid cancer and Hashimoto thyroiditis" or "thyroid carcinoma and thyroid autoimmune disease". After the selection, we categorized the main findings of the papers into four topics: antitumor immunity, tumor progression, diagnosis, and prognosis. Although most of the studies have pointed out the presence of AITD as a factor that increases the risk of TC, few molecular mechanisms to support this conclusion have been described. Additionally, little information is available to explain, pathophysiologically, the effects of autoimmunity in TC diagnosis, progression, and prognosis.
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Affiliation(s)
- Natália Medeiros Dias Lopes
- Laboratory of Molecular Pathology, Department of Pathological Sciences, State University of Londrina (UEL), Londrina, PR, Brazil
| | - Hannah Hamada Mendonça Lens
- Laboratory of Molecular Pathology, Department of Pathological Sciences, State University of Londrina (UEL), Londrina, PR, Brazil
| | - André Armani
- Department of Surgical Clinic, State University of Londrina (UEL), Londrina, PR, Brazil
| | - Poliana Camila Marinello
- Laboratory of Molecular Pathology, Department of Pathological Sciences, State University of Londrina (UEL), Londrina, PR, Brazil
| | - Alessandra Lourenço Cecchini
- Laboratory of Molecular Pathology, Department of Pathological Sciences, State University of Londrina (UEL), Londrina, PR, Brazil.
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False-Positive Malignant Diagnosis of Nodule Mimicking Lesions by Computer-Aided Thyroid Nodule Analysis in Clinical Ultrasonography Practice. Diagnostics (Basel) 2020; 10:diagnostics10060378. [PMID: 32517227 PMCID: PMC7345888 DOI: 10.3390/diagnostics10060378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/17/2022] Open
Abstract
This study aims to test computer-aided diagnosis (CAD) for thyroid nodules in clinical ultrasonography (US) practice with a focus towards identifying thyroid entities associated with CAD system misdiagnoses. Two-hundred patients referred to thyroid US were prospectively enrolled. An experienced radiologist evaluated the thyroid nodules and saved axial images for further offline blinded analysis using a commercially available CAD system. To represent clinical practice, not only true nodules, but mimicking lesions were also included. Fine needle aspiration biopsy (FNAB) was performed according to present guidelines. US features and thyroid entities significantly associated with CAD system misdiagnosis were identified along with the diagnostic accuracy of the radiologist and the CAD system. Diagnostic specificity regarding the radiologist was significantly (p < 0.05) higher than when compared with the CAD system (88.1% vs. 40.5%) while no significant difference was found in the sensitivity (88.6% vs. 80%). Focal inhomogeneities and true nodules in thyroiditis, nodules with coarse calcification and inspissated colloid cystic nodules were significantly (p < 0.05) associated with CAD system misdiagnosis as false-positives. The commercially available CAD system is promising when used to exclude thyroid malignancies, however, it currently may not be able to reduce unnecessary FNABs, mainly due to the false-positive diagnoses of nodule mimicking lesions.
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31
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Sipos JA. The Thyroid Nodule Conundrum: Evaluate or Leave it Alone? J Clin Endocrinol Metab 2020; 105:5607891. [PMID: 31665335 DOI: 10.1210/clinem/dgz124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/18/2019] [Indexed: 02/13/2023]
Affiliation(s)
- Jennifer A Sipos
- Division of Endocrinology, The Ohio State University Wexner Medical Center, Columbus, Ohio
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32
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Ren Y, Kyriazidis N, Faquin WC, Soylu S, Kamani D, Saade R, Torchia N, Lubitz C, Davies L, Stathatos N, Stephen AE, Randolph GW. The Presence of Hürthle Cells Does Not Increase the Risk of Malignancy in Most Bethesda Categories in Thyroid Fine-Needle Aspirates. Thyroid 2020; 30:425-431. [PMID: 32013786 PMCID: PMC7476384 DOI: 10.1089/thy.2019.0190] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: Hürthle cell/oncocytic change is commonly reported on thyroid fine-needle aspiration (FNA) and may be considered an "atypical cell" by clinicians. This study aims to delineate the association between Hürthle cells in preoperative cytology and subsequent pathology of the indexed thyroid nodule and to report rates of malignancy. Methods: Retrospective review of records of 300 patients with Hürthle cell/oncocytic change on FNA and final surgical pathology at a tertiary referral center between 2000 and 2013 was performed and compared with a multi-institutional FNA cohort. The degree of Hürthle cell presence was correlated with histopathologic diagnoses. Results: In the Hürthle cell FNA group, Bethesda System for Reporting Thyroid Cytopathology (BSRTC) categories were as follows: I (nondiagnostic) 14 (4.7%); II (benign) 113 (37.7%); III (atypia of undetermined significance/follicular lesion of undetermined significance) 33 (11%); IV (follicular neoplasm/suspicious for a follicular neoplasm) 125 (41.6%); V (suspicious for malignancy) 12 (4%); and VI (malignant) 3 (1%). When categorized based on the degree of Hürthle cell change, 59 (29%) were classified as mild, 13 (6%) moderate, and 131 (65%) as predominant. When comparing the results with a multi-institutional FNA cohort (all with surgical confirmation), the presence of Hürthle cells was found to be associated with a lower risk of malignancy in all BSRTC categories, with a statistically significant difference in the BSRTC IV and V groups. The sole exception was when Hürthle cell presence was classified as predominant (defined as >75% of the cellular population); the rate of malignancy was significantly elevated in FNAs interpreted as benign/Bethesda II. Conclusions: Although Hürthle cells have been considered by clinicians as an "atypical cell," their presence does not increase the risk of malignancy within BSRTC categories overall. However, when predominant Hürthle cell change is present, the risk of malignancy is increased in the benign cytology/BSRTC category II.
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Affiliation(s)
- Yin Ren
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Natalia Kyriazidis
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - William C. Faquin
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Selen Soylu
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Dipti Kamani
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Rayan Saade
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Nicole Torchia
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Carrie Lubitz
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts
| | - Louise Davies
- VA Outcomes Group, White River Junction Department of Veterans Affairs Medical Center, White River Junction, Vermont
| | - Nikolaos Stathatos
- Department of Medicine, Thyroid Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Antonia E. Stephen
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
- Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Gregory W. Randolph
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
- Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Address correspondence to: Gregory W. Randolph, MD, FACS, FACE, Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114
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Sulaieva O, Selezniov O, Shapochka D, Belemets N, Nechay O, Chereshneva Y, Tsomartova D, Ivanova M. Hashimoto's thyroiditis attenuates progression of papillary thyroid carcinoma: deciphering immunological links. Heliyon 2020; 6:e03077. [PMID: 31938743 PMCID: PMC6953714 DOI: 10.1016/j.heliyon.2019.e03077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/08/2019] [Accepted: 12/16/2019] [Indexed: 12/22/2022] Open
Abstract
Although some studies have investigated the clinicopathologic relationships between papillary thyroid carcinoma (PTC) and Hashimoto's thyroiditis (HT), there is still no clear understanding of differences in tumor immune microenvironment for PTC with coexisting HT and HT effect on PTC progression. The aim of this study was to clarify immune-mediated mechanisms of coexisting HT, which might influence PTC progression. 30 patients with histologically confirmed conventional-type PTC and 30 patients with PTC and coexisting HT were enrolled in the study. To analyze the role of immune-mediated links between PTC and HT, immunohistochemical investigation was conducted to count the number of different immune cells including T-cytotoxic cells (CD8), plasma cells (CD138), Treg cells (FOXP3), mast cells (MCT), and M2 macrophages (CD163). It was shown that despite the high number of immune cells in the intact thyroid tissues of PTC patients with coexisting HT there were no significant differences in M2 macrophages, mast cells and Treg counts inside PTC with or without HT. PTC with HT was associated with a higher number of CD8+ cells (P < 0.001) reflecting the ability of immune system to generate and recruit T-cytotoxic cells in tumor area, which can explain the protective effect of HT on PTC progression. Lymph node metastases development was associated with an increased number of mast cells, M2 macrophages and Treg along with a decreased plasma cells count regardless of coexisting HT. However, we did not find significant differences in T-cytotoxic cells quantity in node-positive and node-negative patients with or without HT, which encourages further investigation of immune escape mechanisms in PTC.
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Affiliation(s)
| | | | | | - Nataliia Belemets
- Ukrainian Research and Practical Centre for Endocrine Surgery, Kiev, Ukraine
| | - Oleksandr Nechay
- Ukrainian Research and Practical Centre for Endocrine Surgery, Kiev, Ukraine
| | - Yelizaveta Chereshneva
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation
| | - Dibakhan Tsomartova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation
| | - Marina Ivanova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation
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Ragusa F, Fallahi P, Elia G, Gonnella D, Paparo SR, Giusti C, Churilov LP, Ferrari SM, Antonelli A. Hashimotos' thyroiditis: Epidemiology, pathogenesis, clinic and therapy. Best Pract Res Clin Endocrinol Metab 2019; 33:101367. [PMID: 31812326 DOI: 10.1016/j.beem.2019.101367] [Citation(s) in RCA: 206] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Hashimoto's thyroiditis (HT), the most frequent autoimmune thyroid disorders (AITDs), is the leading cause of hypothyroidism in the iodine-sufficient areas of the world. About 20-30% of patients suffers from HT, whose cause is thought to be a combination of genetic susceptibility and environmental factors that causes the loss of immunological tolerance, with a consequent autoimmune attack to the thyroid tissue and appearance of the disease. The pathologic features of lymphocytic infiltration, especially of T cells, and follicular destruction are the histological hallmark of autoimmune thyroiditis (AIT), that lead to gradual atrophy and fibrosis. An important role in the immune-pathogenesis of AITDs is due to chemokines and cytokines. In about 20% of patients, AITDs are associated with other organ specific/systemic autoimmune disorders. Many studies have demonstrated the relationship between papillary thyroid cancer and AITD. The treatment of hypothyroidism, as result of AIT, consists in daily assumption of synthetic levothyroxine.
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Affiliation(s)
- Francesca Ragusa
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Poupak Fallahi
- Department of Translational Research of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
| | - Giusy Elia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Debora Gonnella
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | | | - Claudia Giusti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Leonid P Churilov
- Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, Russia.
| | | | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
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Guo L, Chen B, Zhang L, Deng Y, Li H, Shi QD. Hashimoto's thyroiditis-induced cryptogenic organizing pneumonia: A case report. Exp Ther Med 2019; 18:4609-4616. [PMID: 31807148 PMCID: PMC6878873 DOI: 10.3892/etm.2019.8143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 09/19/2019] [Indexed: 11/05/2022] Open
Abstract
A 49-year-old female patient developed chest tightness and shortness of breath without apparent cause and presented to a local hospital. Chest radiography indicated increased thickening of the lung texture, increased multiple patchy densities in the lower lobes of the bilateral lungs and a slightly enlarged thyroid. The patient was treated for pulmonary infection with antibiotics but the symptoms persisted. A repeated CT scan revealed ground-glass attenuation of the bilateral lungs with multiple flaky exudates and visible bronchogenic signs. The symptoms did not improve after broadening anti-microbial coverage. Bronchoscopy and biopsy confirmed cryptogenic organizing pneumonia (COP). Thyroid ultrasound and thyroid function tests jointly confirmed the diagnosis of Hashimoto's thyroiditis (HT). After receiving corticosteroid treatment, the patient's condition improved and she was discharged. This case demonstrates that COP may present in combination with Hashimoto's thyroiditis (HT) and may possibly even be caused by HT. Early confirmation of diagnosis and treatment will help to improve the prognosis of such patients.
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Affiliation(s)
- Litao Guo
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Bo Chen
- Department of Critical Care Medicine, Shangluo Central Hospital, Shangluo, Shaanxi 726000, P.R. China
| | - Lei Zhang
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Yuan Deng
- Department of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Hao Li
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Qin Dong Shi
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
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Ferrari SM, Fallahi P, Galdiero MR, Ruffilli I, Elia G, Ragusa F, Paparo SR, Patrizio A, Mazzi V, Varricchi G, Marone G, Antonelli A. Immune and Inflammatory Cells in Thyroid Cancer Microenvironment. Int J Mol Sci 2019; 20:E4413. [PMID: 31500315 PMCID: PMC6769504 DOI: 10.3390/ijms20184413] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/30/2019] [Accepted: 09/05/2019] [Indexed: 12/22/2022] Open
Abstract
A hallmark of cancer is the ability of tumor cells to avoid immune destruction. Activated immune cells in tumor microenvironment (TME) secrete proinflammatory cytokines and chemokines which foster the proliferation of tumor cells. Specific antigens expressed by cancer cells are recognized by the main actors of immune response that are involved in their elimination (immunosurveillance). By the recruitment of immunosuppressive cells, decreasing the tumor immunogenicity, or through other immunosuppressive mechanisms, tumors can impair the host immune cells within the TME and escape their surveillance. Within the TME, cells of the innate (e.g., macrophages, mast cells, neutrophils) and the adaptive (e.g., lymphocytes) immune responses are interconnected with epithelial cancer cells, fibroblasts, and endothelial cells via cytokines, chemokines, and adipocytokines. The molecular pattern of cytokines and chemokines has a key role and could explain the involvement of the immune system in tumor initiation and progression. Thyroid cancer-related inflammation is an important target for diagnostic procedures and novel therapeutic strategies. Anticancer immunotherapy, especially immune checkpoint inhibitors, unleashes the immune system and activates cytotoxic lymphocytes to kill cancer cells. A better knowledge of the molecular and immunological characteristics of TME will allow novel and more effective immunotherapeutic strategies in advanced thyroid cancer.
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Affiliation(s)
- Silvia Martina Ferrari
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Poupak Fallahi
- Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Maria Rosaria Galdiero
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80138 Naples, Italy; (M.R.G.); (G.V.); (G.M.)
- WAO Center of Excellence, 80138 Naples, Italy
| | - Ilaria Ruffilli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Giusy Elia
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Francesca Ragusa
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Sabrina Rosaria Paparo
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Armando Patrizio
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Valeria Mazzi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Gilda Varricchi
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80138 Naples, Italy; (M.R.G.); (G.V.); (G.M.)
- WAO Center of Excellence, 80138 Naples, Italy
| | - Gianni Marone
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80138 Naples, Italy; (M.R.G.); (G.V.); (G.M.)
- WAO Center of Excellence, 80138 Naples, Italy
- Institute of Experimental Endocrinology and Oncology “Gaetano Salvatore” (IEOS), National Research Council (CNR), 80131 Naples, Italy
| | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
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Baek HJ, Kim DW, Ryu KH, Shin GW, Park JY, Lee YJ, Choo HJ, Park HK, Ha TK, Kim DH, Jung SJ, Park JS, Moon SH, Ahn KJ. Thyroid Imaging Reporting and Data System for Detecting Diffuse Thyroid Disease on Ultrasonography: A Single-Center Study. Front Endocrinol (Lausanne) 2019; 10:776. [PMID: 31781043 PMCID: PMC6857518 DOI: 10.3389/fendo.2019.00776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/24/2019] [Indexed: 11/17/2022] Open
Abstract
Objective: This study aimed to compare the ultrasonography (US) features of diffuse thyroid disease (DTD) and normal thyroid parenchyma (NTP), and to propose a structured imaging reporting system for detecting DTD. Methods: This retrospective study assessed the findings for 270 consecutive patients who underwent thyroid US before thyroid surgery. The following US data were analyzed: DTD-specific features, parenchymal echotexture and echogenicity, anteroposterior diameter, glandular margin, and parenchymal vascularity. Univariate and multivariate analyses with generalized estimating equations were performed to investigate the relationship between US features and DTD. The fitted probability of DTD was analyzed by using a regression equation. Results: Of the 270 patients, there were NTP (n = 193), Hashimoto thyroiditis (n = 24), non-Hashimoto lymphocytic thyroiditis (n = 51), Graves' disease (n = 1), and diffuse hyperplasia (n = 1). The following US features were significantly associated with DTD: decreased or increased parenchymal echogenicity, coarse parenchymal echotexture, increased anteroposterior diameter, lobulated glandular margin, and increased parenchymal vascularity. Of these, coarse parenchymal echotexture was the most significant independent predictor of DTD. The numbers of abnormal US features were positively correlated with the fitted probability and risk of DTD. The diagnostic indices were highest when the chosen cut-off criterion was category III with the largest Az value (0.867, 95% confidence interval: 0.820-0.905), yielding a sensitivity of 68.8%, specificity of 92.2%, positive predictive value of 77.9%, negative predictive value of 88.1%, and accuracy of 85.6% (p < 0.001). Conclusions: Our sonographic reporting and data system may be useful for detecting DTD.
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Affiliation(s)
- Hye Jin Baek
- Department of Radiology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, South Korea
| | - Dong Wook Kim
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
- *Correspondence: Dong Wook Kim
| | - Kyeong Hwa Ryu
- Department of Radiology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, South Korea
| | - Gi Won Shin
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Jin Young Park
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Yoo Jin Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Hye Jung Choo
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Ha Kyoung Park
- Department of General Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Tae Kwun Ha
- Department of General Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Do Hun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Soo Jin Jung
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Ji Sun Park
- Department of Nuclear Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Sung Ho Moon
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Ki Jung Ahn
- Department of Radiation Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
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