1
|
Shen W, Zhang S, Li Q. Expression and Clinical Significance of Thyroid-stimulating hormone receptor in the Subtypes of Papillary thyroid carcinomas. Pak J Med Sci 2023; 39:198-202. [PMID: 36694763 PMCID: PMC9842975 DOI: 10.12669/pjms.39.1.6096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/13/2022] [Accepted: 10/27/2022] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate the expression of TSH receptors (TSHR) in various subtypes of Papillary thyroid carcinomas (PTC) by immunohistochemistry. Methods Retrospective analyses were carried out to the clinical data of 108 PTC patients randomly admitted into the Department of Thyroidthyroid surgery thyroid surgery and Breast Surgery, The Second Hospital of Hebei Medical University from March 2020 to December 2020. The archived paraffin blocks of the 108 cases as well as 18 contiguous normal thyroid tissues (control group) were taken from the Department of Pathology of The Second Hospital of Hebei Medical University. The pathological types of all PTC tissues were detected and the expression of TSHR was determined. Results TSHR expression was 86.11% positive in PTC tissues; with 85.00% positive in classical group; with 75.86% positive in micro group; with 84.61% positive in follicular group; with 83.33% positive in oncocytic group; with 50.00% positive in invasive group. TSHR expression was 100% in normal thyroid tissues. So TSHR expression in normal thyroid tissues is significantly higher than that in PTC; TSHR expression in microcarcinoma is stronger than in the other subtypes; there is no significant difference among the other subtypes. Conclusions TSH suppression works better on microcarcinoma than on the other subtypes. And the effects on non-invasive subtypes are better than on invasive subtypes.
Collapse
Affiliation(s)
- Wei Shen
- Wei Shen, Department of Thyroid and Breast Surgery, The Second Hospital of Hebei Medical University, 215 Peace West Road, Shijiazhuang 050000, Hebei, P.R. China
| | - Shanshan Zhang
- Shanshan Zhang, Department of Thyroid and Breast Surgery, The Second Hospital of Hebei Medical University, 215 Peace West Road, Shijiazhuang 050000, Hebei, P.R. China
| | - Qinghuai Li
- Qinghuai Li, Department of Thyroid and Breast Surgery, The Second Hospital of Hebei Medical University, 215 Peace West Road, Shijiazhuang 050000, Hebei, P.R. China
| |
Collapse
|
2
|
Miao H, Zhong J, Xing X, Sun J, Wu J, Wu C, Yuan Y, Zhou X, Wang H. A nomogram based on the risk factors of cervical lymph node metastasis in papillary thyroid carcinoma coexistent with Hashimoto's thyroiditis. Clin Hemorheol Microcirc 2023; 85:235-247. [PMID: 37718783 DOI: 10.3233/ch-221673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
OBJECTIVE The purpose of this study was to explore the risk factors of cervical lymph node metastasis(LNM) in papillary thyroid carcinoma(PTC) coexistent with Hashimoto's thyroiditis(HT). METHODS The clinical data of patients who underwent thyroid operation between November 2016 and January 2020 in our hospital were analyzed retrospectively. The association between sonographic features and the risk factors of cervical LNM in PTC coexistent with HT was analyzed and a nomogram based on the risk factors was built. RESULTS Age, US features as calcification, blood flow type, distance between thyroid nodule and fibrous capsule were risk factors of cervical LNM(P < 0.05).Size, SWVmax and SWVmean of thyroid nodule, SWVratio between thyroid nodule and thyroid gland were higher in PTCs with LNM than those without LNM(P < 0.05). The ROC curve showed that the cutoff value of SWVratio for predicting LNM was 1.29 (Sensitivity = 0.806, Specificity = 0.775, AUC = 0.823, P < 0.001). Based on the risk factors above, a relevant nomogram prediction model was established. The model verification showed that the C-index of the modeling set was 0.814, indicating that the nomogram model had good predicted accuracy. CONCLUSION Based on the risk factors above, a relevant nomogram prediction model was established. The model verification showed that the C-index of the modeling set was 0.814, indicating that the nomogram model had good predicted accuracy. The nomogram based on the risk factors above had good prediction ability, which could optimize thyroidectomy and cervical lymph node dissection and improving prognosis.
Collapse
Affiliation(s)
- Huanhuan Miao
- In-Patient Ultrasound Department, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jingwen Zhong
- In-Patient Ultrasound Department, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuesha Xing
- In-Patient Ultrasound Department, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiawei Sun
- In-Patient Ultrasound Department, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiaqi Wu
- In-Patient Ultrasound Department, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chengwei Wu
- In-Patient Ultrasound Department, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yan Yuan
- Department of Ultrasound, Heilongjiang Red Cross Sengong General Hospital, Harbin, China
| | - Xianli Zhou
- In-Patient Ultrasound Department, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongbo Wang
- In-Patient Ultrasound Department, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| |
Collapse
|
3
|
Dolidze DD, Shabunin AV, Mumladze RB, Vardanyan AV, Covantsev SD, Shulutko AM, Semikov VI, Isaev KM, Kazaryan AM. A Narrative Review of Preventive Central Lymph Node Dissection in Patients With Papillary Thyroid Cancer - A Necessity or an Excess. Front Oncol 2022; 12:906695. [PMID: 35847927 PMCID: PMC9278848 DOI: 10.3389/fonc.2022.906695] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/03/2022] [Indexed: 02/05/2023] Open
Abstract
ObjectiveThis review article summarises the latest evidence for preventive central lymph node dissection in patients with papillary thyroid cancer taking into account the possible complications and risk of recurrence.BackgroundPapillary thyroid cancer is the most frequent histological variant of malignant neoplasms of the thyroid gland. It accounts for about 80-85% of all cases of thyroid cancer. Despite good postoperative results and an excellent survival rate in comparison with many other malignant diseases, tumor metastases to the cervical lymph nodes are frequent. Most researchers agree that the presence of obvious metastases in the lymph nodes requires careful lymph node dissection. It was suggested to perform preventive routine lymphadenectomy in all patients with malignant thyroid diseases referred to surgery.MethodsIt was performed the literature review using the “papillary thyroid cancer”, “central lymph node dissection”, “hypocalcemia”, “recurrent laryngeal nerve paresis”, “metastasis”, “cancer recurrence” along with the MESH terms. The reference list of the articles was carefully reviewed as a potential source of information. The search was based on Medline, Scopus, Google Scholar, eLibrary engines. Selected publications were analyzed and their synthesis was used to write the review and analyse the role of preventive central lymph node dissection in patients with papillary thyroid cancer.ConclusionsThe necessity of preventive central lymph node dissection in patients with differentiated papillary thyroid carcinoma is still controversial. There is much evidence that it increases the frequency of transient hypocalcemia. Due to the fact that this complication is temporary, its significance in clinical practice is debatable. It can also be assumed that an extant of surgery in the neck area is associated with an increased risk of recurrent laryngeal nerve injury. However, most studies indicate that this injury is associated more with thyroidectomy itself than with lymph node dissection. Recurrent laryngeal nerve dysfunction is also a temporary complication in the vast majority of cases. At the same time, a large amount of data shows that central lymph node dissection reduces the risk of thyroid cancer recurrence in two times.
Collapse
Affiliation(s)
- David D. Dolidze
- Department of Surgery, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
- Department of Surgery, S.P. Botkin City Clinical Hospital, Moscow, Russia
| | - Alexey V. Shabunin
- Department of Surgery, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
- Department of Surgery, S.P. Botkin City Clinical Hospital, Moscow, Russia
| | - Robert B. Mumladze
- Department of Surgery, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
- Department of Surgery, S.P. Botkin City Clinical Hospital, Moscow, Russia
| | - Arshak V. Vardanyan
- Department of Surgery, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
- Department of Surgery, S.P. Botkin City Clinical Hospital, Moscow, Russia
| | | | - Alexander M. Shulutko
- Department of Faculty Surgery №2, I.M.Sechenov First Moscow State Medical University, Moscow, Russia
| | - Vasiliy I. Semikov
- Department of Faculty Surgery №2, I.M.Sechenov First Moscow State Medical University, Moscow, Russia
| | - Khalid M. Isaev
- Department of Surgery, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Airazat M. Kazaryan
- Department of Faculty Surgery №2, I.M.Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Gastrointestinal Surgery, Østfold Hospital Trust, Grålum, Norway
- Department of Surgery, Fonna Hospital Trust, Odda, Norway
- Intervention Centre, Oslo University Hospital – Rikshospitalet, Oslo, Norway
- Department of Surgery №1, Yerevan State Medical University after M.Heratsi, Yerevan, Armenia
- *Correspondence: Airazat M. Kazaryan,
| |
Collapse
|
4
|
Liu Y, Lv H, Zhang S, Shi B, Sun Y. The Impact of Coexistent Hashimoto's Thyroiditis on Central Compartment Lymph Node Metastasis in Papillary Thyroid Carcinoma. Front Endocrinol (Lausanne) 2021; 12:772071. [PMID: 34867817 PMCID: PMC8635140 DOI: 10.3389/fendo.2021.772071] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/21/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Hashimoto's thyroiditis (HT) is the most prevalent inflammatory disorder of the thyroid gland. Current studies have reported the coexistence rate between HT and papillary thyroid carcinoma (PTC) is quite high. The objective of this study was to evaluate the impact of HT on the predictive factors of central compartment lymph node metastasis (CLNM) in PTC. METHODS A retrospective investigation was performed on PTC patients. They were subclassified into HT and non-HT groups. The results of preoperative neck ultrasound (US) examinations were reviewed. The clinical characteristics and the predictive value for CLNM were explored and compared between the two groups. RESULTS A total of 756 patients were included in this study. There were more female patients (86.1%) in the PTC coexistent with the HT group than non-HT group. The patients with HT group had higher preoperative serum level of TSH. There was statistically significant difference between the HT patients and non-HT patients in nodular vascularization. Univariate and multivariate analyses showed that male, age ≤45 years old, tumor diameter >1 cm, and presence of suspicious central compartment lymph node on US, irregular nodular shape, multifocal carcinoma were independent predictive factors of CLNM in PTC patients. It was showed that male, age ≤45 years old, tumor diameter >1 cm, multifocality, and presence of suspicious central lymph node on US were risk factors for CLNM in non-HT patients. Only tumor diameter >1 cm and presence of suspicious central lymph node on US were independently correlated with CLNM in HT patients. The sensitivity of the multivariate model was 63.5%, and specificity was 88.9% for prediction CLNM in HT patients. For non-HT patients, the AUC was 80.6%, the sensitivity of the multivariate model was 64.5%, and specificity was 85.2. CONCLUSION PTC combined with HT is more common in women, and TSH level in HT group is higher than that in patients with PTC alone. Regardless of that HT is not a related risk factor of CLNM in PTC, our result suggested that different predictive systems should be used for HT and non-HT patients respectively to have a more accurate evaluation of CLNM in clinic.
Collapse
Affiliation(s)
- Yang Liu
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Hongjun Lv
- Department of Endocrinology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Shaoqiang Zhang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Bingyin Shi
- Department of Endocrinology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yushi Sun
- Department of Endocrinology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Yushi Sun,
| |
Collapse
|
5
|
Ye J, Feng JW, Wu WX, Hu J, Hong LZ, Qin AC, Shi WH, Jiang Y. Papillary Thyroid Microcarcinoma: A Nomogram Based on Clinical and Ultrasound Features to Improve the Prediction of Lymph Node Metastases in the Central Compartment. Front Endocrinol (Lausanne) 2021; 12:770824. [PMID: 35095755 PMCID: PMC8790095 DOI: 10.3389/fendo.2021.770824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 12/21/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Accurate preoperative identification of central lymph node metastasis (CLNM) is essential for surgical protocol establishment for patients with papillary thyroid microcarcinoma (PTMC). We aimed to develop a clinical and ultrasound characteristics-based nomogram for predicting CLNM. METHODS Our study included 399 patients who were pathologically diagnosed with PTMC between January 2011 and June 2018. Clinical and ultrasound features were collected for univariate and multivariate analyses to determine risk factors of CLNM. A nomogram comprising the prognostic model to predict the CLNM was established, and internal validation in the cohort was performed. The Cox regression model was used to determine the risk factors for recurrence-free survival (RFS) and cumulative hazard was calculated to predict prognosis. RESULTS Three variables of clinical and US features as potential predictors including sex (odd ratio [OR] = 1.888, 95% confidence interval [CI], 1.160-3.075; P =0.011), tumor size (OR = 1.933, 95% CI, 1.250-2.990; P =0.003) and ETE (OR = 6.829, 95% CI, 3.250-14.350; P <0.001) were taken into account. The predictive nomogram was established by involving all the factors above used for preoperative prediction of CLNM in patients with PTMC. The nomogram showed excellent calibration in predicting CLNM, with area under curves (AUC) of 0.684 (95% CI, 0.635 to 0.774). Furthermore, tumor size, multifocality, presence of ETE, vascular invasion, and CLNM were the significant factors related to the RFS. CONCLUSION Through this easy-to-use nomogram by combining clinical and US risk factor, the possibility of CLNM can be objectively quantified preoperatively. This prediction model may serve as a useful clinical tool to help clinicians determine an individual's risk of CLNM in PTMC, thus make individualized treatment plans accordingly.
Collapse
Affiliation(s)
- Jing Ye
- Department of Thyroid Surgery, The Third Affiliated Hospital of Soochow University, Changzhou First People’s Hospital, Changzhou, China
| | - Jia-Wei Feng
- Department of Thyroid Surgery, The Third Affiliated Hospital of Soochow University, Changzhou First People’s Hospital, Changzhou, China
| | - Wan-Xiao Wu
- Department of Thyroid Surgery, The Third Affiliated Hospital of Soochow University, Changzhou First People’s Hospital, Changzhou, China
| | - Jun Hu
- Department of Thyroid Surgery, The Third Affiliated Hospital of Soochow University, Changzhou First People’s Hospital, Changzhou, China
| | - Li-Zhao Hong
- Department of Thyroid Surgery, The Third Affiliated Hospital of Soochow University, Changzhou First People’s Hospital, Changzhou, China
| | - An-Cheng Qin
- The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Wei-Hai Shi
- The Affiliated Hospital of Nanjing Medical University, Changzhou Second People’s Hospital, Changzhou, China
| | - Yong Jiang
- Department of Thyroid Surgery, The Third Affiliated Hospital of Soochow University, Changzhou First People’s Hospital, Changzhou, China
- *Correspondence: Yong Jiang,
| |
Collapse
|