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Song X, Skog S, Wei L, Qin J, Yang R, Li J, Zhou J, He E, Zhou J. Nomogram model of serum thymidine kinase 1 combined with ultrasonography for prediction of central lymph node metastasis risk in patients with papillary thyroid carcinoma pre-surgery. Front Endocrinol (Lausanne) 2024; 15:1366219. [PMID: 38887267 PMCID: PMC11180742 DOI: 10.3389/fendo.2024.1366219] [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: 01/05/2024] [Accepted: 05/02/2024] [Indexed: 06/20/2024] Open
Abstract
Objective The aim of this study was to develop a nomogram, using serum thymidine kinase 1 protein (STK1p) combined with ultrasonography parameters, to early predict central lymph node metastasis (CLNM) in patients with papillary thyroid carcinoma (PTC) pre-surgery. Methods Patients with PTC pre-surgery in January 2021 to February 2023 were divided into three cohorts: the observation cohort (CLNM, n = 140), the control cohort (NCLNM, n = 128), and the external verification cohort (CLNM, n = 50; NCLNM, n = 50). STK1p was detected by an enzyme immunodot-blot chemiluminescence analyzer and clinical parameters were evaluated by ultrasonography. Results A suitable risk threshold value for STK1p of 1.7 pmol/L was selected for predicting CLNM risk by receiver operating characteristic (ROC) curve analysis. Multivariate analysis identified the following six independent risk factors for CLNM: maximum tumor size >1 cm [odds ratio (OR) = 2.406, 95% confidence interval (CI) (1.279-4.526), p = 0.006]; capsule invasion [OR = 2.664, 95% CI (1.324-5.360), p = 0.006]; irregular margin [OR = 2.922; 95% CI (1.397-6.111), p = 0.004]; CLN flow signal [OR = 3.618, 95% CI (1.631-8.027), p = 0.002]; tumor-foci number ≥2 [OR = 4.064, 95% CI (2.102-7.859), p < 0.001]; and STK1p ≥1.7 pmol/L [OR = 7.514, 95% CI (3.852-14.660), p < 0.001]. The constructed nomogram showed that the area under the ROC curve for the main dataset was 0.867 and that for the validation dataset was 0.830, exhibiting effectivity, and was recalculated to a total score of approximately 383. Through monitoring the response post-surgery, all patients were assessed as tumor-free at 12 months post-surgery, which was significantly associated with a reduction in STK1p to disease-free levels. Conclusion We demonstrate for the first time that a novel nomogram including STK1p combined with ultrasonography can assist in the clinical prevention of CLNM, by facilitating timely, individualized prophylactic CLNM dissection, thereby reducing the risk of secondary surgery and the probability of recurrence.
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Affiliation(s)
- Xiaolong Song
- Radioimmunoassay Center, Department of Clinical Laboratory, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Sven Skog
- Department of Medicine, Shenzhen Ellen-Sven Precision Medicine Institute, Shenzhen, China
| | - Long Wei
- Radioimmunoassay Center, Department of Clinical Laboratory, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Jinlv Qin
- Radioimmunoassay Center, Department of Clinical Laboratory, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Ru Yang
- Radioimmunoassay Center, Department of Clinical Laboratory, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Jin Li
- Department of Medicine, Shenzhen Ellen-Sven Precision Medicine Institute, Shenzhen, China
| | - Ji Zhou
- Department of Medicine, Shenzhen Ellen-Sven Precision Medicine Institute, Shenzhen, China
| | - Ellen He
- Department of Medicine, Shenzhen Ellen-Sven Precision Medicine Institute, Shenzhen, China
| | - Jianping Zhou
- Radioimmunoassay Center, Department of Clinical Laboratory, Shaanxi Provincial People’s Hospital, Xi’an, China
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Xu H, Wu W, Zhao Y, Liu Z, Bao D, Li L, Lin M, Zhang Y, Zhao X, Luo D. Analysis of preoperative computed tomography radiomics and clinical factors for predicting postsurgical recurrence of papillary thyroid carcinoma. Cancer Imaging 2023; 23:118. [PMID: 38098119 PMCID: PMC10722708 DOI: 10.1186/s40644-023-00629-9] [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: 07/17/2023] [Accepted: 10/19/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Postsurgical recurrence is of great concern for papillary thyroid carcinoma (PTC). We aim to investigate the value of computed tomography (CT)-based radiomics features and conventional clinical factors in predicting the recurrence of PTC. METHODS Two-hundred and eighty patients with PTC were retrospectively enrolled and divided into training and validation cohorts at a 6:4 ratio. Recurrence was defined as cytology/pathology-proven disease or morphological evidence of lesions on imaging examinations within 5 years after surgery. Radiomics features were extracted from manually segmented tumor on CT images and were then selected using four different feature selection methods sequentially. Multivariate logistic regression analysis was conducted to identify clinical features associated with recurrence. Radiomics, clinical, and combined models were constructed separately using logistic regression (LR), support vector machine (SVM), k-nearest neighbor (KNN), and neural network (NN), respectively. Receiver operating characteristic analysis was performed to evaluate the model performance in predicting recurrence. A nomogram was established based on all relevant features, with its reliability and reproducibility verified using calibration curves and decision curve analysis (DCA). RESULTS Eighty-nine patients with PTC experienced recurrence. A total of 1218 radiomics features were extracted from each segmentation. Five radiomics and six clinical features were related to recurrence. Among the 4 radiomics models, the LR-based and SVM-based radiomics models outperformed the NN-based radiomics model (P = 0.032 and 0.026, respectively). Among the 4 clinical models, only the difference between the area under the curve (AUC) of the LR-based and NN-based clinical model was statistically significant (P = 0.035). The combined models had higher AUCs than the corresponding radiomics and clinical models based on the same classifier, although most differences were not statistically significant. In the validation cohort, the combined models based on the LR, SVM, KNN, and NN classifiers had AUCs of 0.746, 0.754, 0.669, and 0.711, respectively. However, the AUCs of these combined models had no significant differences (all P > 0.05). Calibration curves and DCA indicated that the nomogram have potential clinical utility. CONCLUSIONS The combined model may have potential for better prediction of PTC recurrence than radiomics and clinical models alone. Further testing with larger cohort may help reach statistical significance.
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Affiliation(s)
- Haijun Xu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Wenli Wu
- Medical Imaging Center, Liaocheng Tumor Hospital, Liaocheng, 252000, China
| | - Yanfeng Zhao
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Zhou Liu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - Dan Bao
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Lin Li
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Meng Lin
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Ya Zhang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - Xinming Zhao
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Dehong Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China.
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Kwon O, Lee S, Bae JS. Risk factors associated with high-risk nodal disease in patients considered for active surveillance of papillary thyroid microcarcinoma without extrathyroidal extension. Gland Surg 2023; 12:1179-1190. [PMID: 37842526 PMCID: PMC10570983 DOI: 10.21037/gs-23-256] [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: 06/16/2023] [Accepted: 08/31/2023] [Indexed: 10/17/2023]
Abstract
Background Active surveillance (AS) has become an alternative treatment approach for papillary thyroid microcarcinoma (PTMC). The purpose of this study is to uncover the clinicopathological factors associated with high-risk nodal disease in order to select proper candidates for AS of PTMC. Methods We retrospectively reviewed 5,329 patients with PTMC without extrathyroidal extension (ETE) who underwent thyroidectomy with central compartment neck dissection (CCND) between 2007 and 2021 at Seoul St. Mary's Hospital. Patients with more than five metastatic lymph nodes (MLNs) (higher-risk N1 disease) and/or lateral neck node metastases (N1b disease) were defined as having high-risk nodal disease. The clinicopathological factors associated with high-risk nodal disease were analyzed. Results A total of 415 (7.8%) patients had higher-risk N1 disease. These patients were younger on average, included a higher proportion of males, and had a larger tumor size and more frequent capsular invasion and multifocality compared with other patients. For the tumor size, a cutoff value of 0.65 cm was the best predictor of nodal risk groups. In a multivariate analysis, the independent risk factors associated with higher-risk N1 disease were younger age, male sex, tumor size >0.65 cm, and the presence of capsular invasion and/or multifocality. A total of 246 (4.6%) patients had N1b disease at initial diagnosis. In a multivariate analysis, the independent risk factors associated with N1b disease were younger age, male sex, tumor size >0.65 cm, and the presence of capsular invasion and/or multifocality. Conclusions Young age, male sex, tumor size >0.65 cm, and presence of capsular invasion and/or multifocality can be considered risk factors for high-risk nodal disease in PTMC. Therefore, cautious observation is necessary for AS of patients with these characteristics.
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Affiliation(s)
- Ohjoon Kwon
- Department of Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sohee Lee
- Department of Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ja Seong Bae
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Zhao W. A nomogram prediction for the metastasis of central lymph node in papillary thyroid carcinoma: One-center retrospective report. Asian J Surg 2023; 46:3916-3917. [PMID: 37055249 DOI: 10.1016/j.asjsur.2023.03.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 03/30/2023] [Indexed: 04/15/2023] Open
Affiliation(s)
- Wei Zhao
- Department of Ultrasound Medicine, The Fourth Hospital of Daqing, Heilongjiang Province, Daqing, 163000, China.
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Sorrenti S, Lauro A, Pironi D, Calò PG, Ulisse S. Editorial: Differential diagnoses of thyroid neoplasms: Molecular and histological features and the impact on follow-up. Front Oncol 2023; 13:1125887. [PMID: 36798815 PMCID: PMC9927641 DOI: 10.3389/fonc.2023.1125887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 01/19/2023] [Indexed: 02/04/2023] Open
Affiliation(s)
| | - Augusto Lauro
- Department of Surgery, “Sapienza” University of Rome, Rome, Italy
| | - Daniele Pironi
- Department of Surgery, “Sapienza” University of Rome, Rome, Italy
| | - Pietro Giorgio Calò
- Department of Surgical Sciences, University of Cagliari, Monserrato, Cagliari, Italy
| | - Salvatore Ulisse
- Department of Surgery, “Sapienza” University of Rome, Rome, Italy,*Correspondence: Salvatore Ulisse,
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Ulisse S, Baldini E, Pironi D, Gagliardi F, Tripodi D, Lauro A, Carbotta S, Tarroni D, D’Armiento M, Morrone A, Forte F, Frattaroli F, Persechino S, Odorisio T, D’Andrea V, Lori E, Sorrenti S. Is Melanoma Progression Affected by Thyroid Diseases? Int J Mol Sci 2022; 23:ijms231710036. [PMID: 36077430 PMCID: PMC9456309 DOI: 10.3390/ijms231710036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/25/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
Clinical and epidemiological evidence indicate a relationship between thyroid diseases and melanoma. In particular, the hypothyroidism condition appears to promote melanoma spread, which suggests a protective role of thyroid hormones against disease progression. In addition, experimental data suggest that, in addition to thyroid hormones, other hormonal players of the hypothalamic–pituitary–thyroid (HPT) axis, namely the thyrotropin releasing hormone and the thyrotropin, are likely to affect melanoma cells behavior. This information warrants further clinical and experimental studies in order to build a precise pattern of action of the HPT hormones on melanoma cells. An improved knowledge of the involved molecular mechanism(s) could lead to a better and possibly personalized clinical management of these patients.
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Affiliation(s)
- Salvatore Ulisse
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
- Correspondence:
| | - Enke Baldini
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Daniele Pironi
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Federica Gagliardi
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Domenico Tripodi
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Augusto Lauro
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Sabino Carbotta
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Danilo Tarroni
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Matteo D’Armiento
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy
| | - Flavio Forte
- Urology Department, M.G. Vannini Hospital, 00177 Rome, Italy
| | - Flaminia Frattaroli
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Severino Persechino
- Department of Neurosciences, Mental Health and Sensory Organs, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Teresa Odorisio
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell’Immacolata, IDI-IRCCS, 00167 Rome, Italy
| | - Vito D’Andrea
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Eleonora Lori
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
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Liu R, Cao Z, Pan M, Wu M, Li X, Yuan H, Liu Z. A novel prognostic model for papillary thyroid cancer based on epithelial-mesenchymal transition-related genes. Cancer Med 2022; 11:4703-4720. [PMID: 35608185 PMCID: PMC9741981 DOI: 10.1002/cam4.4836] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/08/2022] [Accepted: 05/04/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The frequent incidence of postsurgical recurrence issues in papillary thyroid cancer (PTC) patients is a primary concern considering the low cancer-related mortality. Previous studies have demonstrated that epithelial-mesenchymal transition (EMT) activation is closely related to PTC progression and invasion. In this study, we aimed to develop a novel EMT signature and ancillary nomogram to improve personalized prediction of progression-free interval (PFI). METHODS First, we carried out a differential analysis of PTC samples and pairwise normal thyroid samples to explore the differentially expressed genes (DEGs). The intersection of the DEGs with EMT-related genes (ERGs) were identified as differentially expressed EMT-related genes (DE-ERGs). We determined PFI-related DE-ERGs by Cox regression analysis and then established a novel gene classifier by LASSO regression analysis. We validated the signature in external datasets and in multiple cell lines. Further, we used uni- and multivariate analyses to identify independent prognostic characters. RESULTS We identified 244 prognosis-related DE-ERGs. The 244 DE-ERGs were associated with several pivotal oncogenic processes. We also constructed a novel 10-gene signature and relevant prognostic model for recurrence prediction of PTC. The 10-gene signature had a C-index of 0.723 and the relevant nomogram had a C-index of 0.776. The efficacy of the signature and nomogram was satisfying and closely correlated with relevant clinical parameters. Furthermore, the signature also had a unique potential in differentiating anaplastic thyroid cancer (ATC) samples. CONCLUSIONS The novel EMT signature and nomogram are useful and convenient for personalized management for thyroid cancer.
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Affiliation(s)
- Rui Liu
- Department of General Surgery, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople's Republic of China
| | - Zhen Cao
- Department of General Surgery, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople's Republic of China
| | - Meng Pan
- State Key Laboratory of Medical Molecular Biology & Department of ImmunologyInstitute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical CollegeBeijingPeople's Republic of China
| | - Mengwei Wu
- Department of General Surgery, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople's Republic of China
| | - Xiaobin Li
- Department of General Surgery, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople's Republic of China
| | - Hongwei Yuan
- Department of General Surgery, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople's Republic of China
| | - Ziwen Liu
- Department of General Surgery, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople's Republic of China
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Prognostic Impact of Microscopic Extra-Thyroidal Extension (mETE) on Disease Free Survival in Patients with Papillary Thyroid Carcinoma (PTC). Cancers (Basel) 2022; 14:cancers14112591. [PMID: 35681573 PMCID: PMC9179642 DOI: 10.3390/cancers14112591] [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: 03/28/2022] [Revised: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 02/01/2023] Open
Abstract
Background: This study assessed the risk of reduced disease-free survival (DFS) and poor clinical outcome in patients with papillary thyroid carcinomas (PTC) with microscopic extra-thyroidal extension (mETE), as compared to PTC patients without mETE. Methods: Retrospective analysis of a prospective database of patients treated by total thyroidectomy and radioactive iodine (RAI) with a five-year follow-up and tumors < 40 mm. In total, 303 patients were analyzed: 30.7% presented tumors with mETE, and 69.3% without. mETE was defined as extra-thyroidal invasion without skeletal muscle involvement. The primary outcome, DFS, was defined as the interval between initial treatment and any subsequent PTC-related treatment. The second outcome was the clinical status at five years. Results: In univariate analyses, the five-year DFS was significantly lower for tumors with mETE (62.4% versus 88.1%, p < 0.001). In multivariate analysis, mETE and massive lymph node involvement (LNI) were independent prognostic factors, associated respectively with a hazard ratio of 2.55 (95% CI 1.48−4.40) and 8.94 (95% CI 4.92−16.26). mETE was significantly associated with a pejorative clinical outcome at five years, i.e., biochemical/indeterminate response and structural persistence (Respectively OR 1.83 (95% CI 0.83; 4.06) and OR 4.92 (95% CI 1.87; 12.97)). Conclusion: Our results suggest that mETE is an independent poor prognosis factor of reduced DFS and predictive of poor clinical outcome.
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9
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Cantisani V, De Silvestri A, Scotti V, Fresilli D, Tarsitano MG, Polti G, Guiban O, Polito E, Pacini P, Durante C, Grani G, Isidori AM, Giannetta E, Sorrenti S, Trimboli P, Catalano C, Cirocchi R, Lauro A, D'Andrea V. US-Elastography With Different Techniques for Thyroid Nodule Characterization: Systematic Review and Meta-analysis. Front Oncol 2022; 12:845549. [PMID: 35371974 PMCID: PMC8966910 DOI: 10.3389/fonc.2022.845549] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/16/2022] [Indexed: 12/25/2022] Open
Abstract
Background Thyroid nodules are frequent in adult population and thyroid cancer incidence has increased dramatically over the past three decades. The aim of this systematic review and meta-analysis was to evaluate the US-Elastosonography (USE) diagnostic performance in assessing the thyroid nodules malignancy risk. Methods PubMed and Embase databases were searched from January 2011 to July 2021. We extracted data from selected studies and calculated the overall diagnostic accuracy of qualitative USE, semi-quantitative USE and quantitative USE. Summary receiver operating characteristic (ROC) curve was elaborated to show the results. All statistical tests were performed using Metadisc and Medcal software package. Results Finally 72 studies with 13,505 patients and 14,015 thyroid nodules (33% malignant) undergoing elastography were included. The pooled sensitivity, specificity and AUC were 84%, 81%, and 0.89 respectively for qualitative USE; 83%, 80%, and 0.93 for semi-quantitative USE and 78%, 81% and 0.87, for quantitative USE. The qualitative and semiquantitative USE present very similar diagnostic accuracy values and both better than the quantitative USE. Conclusions USE is a useful imaging tool for thyroid nodule characterization. In accordance with recent guidelines and meta-analyses, the USE could be used daily in thyroid nodule malignancy risk stratification. Systematic Review Registration PROSPERO: CRD42021279257.
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Affiliation(s)
- Vito Cantisani
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Annalisa De Silvestri
- Servizio di Epidemiologia Clinica e Biometria Direzione Scientifica-Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico san Matteo, Pavia, Italy
| | - Valeria Scotti
- Servizio di Epidemiologia Clinica e Biometria Direzione Scientifica-Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico san Matteo, Pavia, Italy
| | - Daniele Fresilli
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Maria Grazia Tarsitano
- Department of Clinical and Surgical Science, "Magna Graecia" University, Catanzaro, Italy
| | - Giorgia Polti
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Olga Guiban
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Eleonora Polito
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Patrizia Pacini
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Cosimo Durante
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Giorgio Grani
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Andrea M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Elisa Giannetta
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, Hospital "Policlinico Umberto I", "Sapienza" University of Rome, Rome, Italy
| | - Pierpaolo Trimboli
- Clinic for Endocrinology and Diabetology, Lugano Regional Hospital, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Carlo Catalano
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Roberto Cirocchi
- Department of Surgery and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - Augusto Lauro
- Department of Surgical Sciences, Hospital "Policlinico Umberto I", "Sapienza" University of Rome, Rome, Italy
| | - Vito D'Andrea
- Department of Surgical Sciences, Hospital "Policlinico Umberto I", "Sapienza" University of Rome, Rome, Italy
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10
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Thyroid Diseases and Breast Cancer. J Pers Med 2022; 12:jpm12020156. [PMID: 35207645 PMCID: PMC8876618 DOI: 10.3390/jpm12020156] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 01/27/2023] Open
Abstract
Epidemiological studies aimed at defining the association of thyroid diseases with extra-thyroidal malignancies (EM) have aroused considerable interest in the possibility of revealing common genetic and environmental factors underlying disease etiology and progression. Over the years, multiple lines of evidence indicated a significant relationship between thyroid carcinomas and other primary EM, especially breast cancer. For the latter, a prominent association was also found with benign thyroid diseases. In particular, a meta-analysis revealed an increased risk of breast cancer in patients with autoimmune thyroiditis, and our recent work demonstrated that the odds ratio (OR) for breast cancer was raised in both thyroid autoantibody-positive and -negative patients. However, the OR was significantly lower for thyroid autoantibody-positive patients compared to the negative ones. This is in agreement with findings showing that the development of thyroid autoimmunity in cancer patients receiving immunotherapy is associated with better outcome and supports clinical evidence that breast cancer patients with thyroid autoimmunity have longer disease-free interval and overall survival. These results seem to suggest that factors other than oncologic treatments may play a role in the initiation and progression of a second primary malignancy. The molecular links between thyroid autoimmunity and breast cancer remain, however, unidentified, and different hypotheses have been proposed. Here, we will review the epidemiological, clinical, and experimental data relating thyroid diseases and breast cancer, as well as the possible hormonal and molecular mechanisms underlying such associations.
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11
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Zhao Y, Shi W, Dong F, Wang X, Lu C, Liu C. Risk prediction for central lymph node metastasis in isolated isthmic papillary thyroid carcinoma by nomogram: A retrospective study from 2010 to 2021. Front Endocrinol (Lausanne) 2022; 13:1098204. [PMID: 36733797 PMCID: PMC9886574 DOI: 10.3389/fendo.2022.1098204] [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: 11/14/2022] [Accepted: 12/12/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Isthmic papillary thyroid carcinoma (IPTC) is an aggressive thyroid cancer associated with a poor prognosis. Guidelines elaborating on the extent of surgery for IPTC are yet to be developed. This study aims to construct and validate a model to predict central lymph node metastasis (CLNM) in patients with IPTC, which could be used as a risk stratification tool to determine the best surgical approach for patients. METHODS Electronic medical records for patients diagnosed with isolated papillary thyroid carcinoma who underwent surgery at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2010 to December 2021 were reviewed. All patients who underwent thyroidectomy with central neck dissection (CND) for isolated IPTC were included. We conducted univariate and multivariate logistic regression analyses to assess risk factors for ipsilateral and contralateral CLNM and the number of CLNM in IPTC patients. Based on the analysis, the nomogram construction and internal validations were performed. RESULTS A total of 147 patients with isolated IPTC were included. The occurrence of CLNM was 53.7% in the patients. We identified three predictors of ipsilateral CLNM, including age, gender, and size. For contralateral CLNM, three identified predictors were age, gender, and capsular invasion. Predictors for the number of CLNM included age, gender, capsular invasion, tumor size, and chronic lymphocytic thyroiditis (CLT). The concordance index(C-index) of the models predicting ipsilateral CLNM, contralateral CLNM, 1-4 CLNM, and ≥5 CLNM was 0.779 (95%CI, 0.704, to 0.854), 0.779 (95%CI, 0.703 to 0.855), 0.724 (95%CI, 0.629 to 0.818), and 0.932 (95%CI, 0.884 to 0.980), respectively. The corresponding indices for the internal validation were 0.756 (95%CI, 0.753 to 0.758), 0.753 (95%CI, 0.750 to 0.756), 0.706 (95%CI, 0.702 to 0.708), and 0.920 (95%CI, 0.918 to 0.922). Receiver operating characteristic (ROC) curves, calibration, and decision curve analysis (DCA) results confirmed that the three nomograms could precisely predict CLNM in patients with isolated IPTC. CONCLUSION We constructed predictive nomograms for CLNM in IPTC patients. A risk stratification scheme and corresponding surgical treatment recommendations were provided accordingly. Our predictive models can be used as a risk stratification tool to help clinicians make individualized surgical plans for their patients.
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Affiliation(s)
- Yu Zhao
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Shi
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Dong
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiuhua Wang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chong Lu
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Chunping Liu, ; Chong Lu,
| | - Chunping Liu
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Chunping Liu, ; Chong Lu,
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12
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Shen K, Xiao S, Wu X, Zhang G. Preoperative prognostic risk stratification model for papillary thyroid carcinoma based on clinical and ultrasound characteristics. Front Endocrinol (Lausanne) 2022; 13:1025739. [PMID: 36277684 PMCID: PMC9585272 DOI: 10.3389/fendo.2022.1025739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The preoperative risk stratification for patients with papillary thyroid carcinoma (PTC) plays a crucial role in guiding individualized treatment. We aim to construct a predictive model that aids in distinguishing between patients with low-risk and high-risk PTC based on preoperative clinical and ultrasound characteristics. MATERIALS AND METHODS Patients who underwent open surgery and were diagnosed with PTC via a postoperative pathological report between January 2020 and December 2020 were retrospectively reviewed. Data including basic information, preoperative ultrasound characteristics, thyroid function, and postoperative pathology characteristics were obtained. Univariate logistic regression analysis and least absolute shrinkage and selection operator regression analysis were performed to screen candidate variables. Finally, the preoperative predictive model for PTC was established based on the results of the multivariate logistic regression analysis. RESULTS A total of 1,875 patients with PTC were enrolled. Eight variables (sex, age, number of foci, maximum tumor diameter on ultrasound, calcification, capsule, lymph node status on ultrasound, and thyroid peroxidase (TPO) antibody level) significantly associated with risk stratification were included in the predictive model. A nomogram was constructed for clinical utility. The model showed good discrimination, and the area under the curve was 0.777 [95% confidence interval (CI): 0.752-0.803] and 0.769 (95% CI: 0.729-0.809) in the training set and validation set, respectively. The calibration curve exhibited a rather good consistency with the perfect prediction. Furthermore, decision curve analysis and clinical impact curve showed that the model had good efficacy in predicting the prognostic risk of PTC. CONCLUSIONS The nomogram model based on preoperative indicators for predicting the prognostic stratification of PTC showed a good predictive value. This could aid surgeons in deciding on individualized precision treatments.
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13
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Wen Q, Wang Z, Traverso A, Liu Y, Xu R, Feng Y, Qian L. A radiomics nomogram for the ultrasound-based evaluation of central cervical lymph node metastasis in papillary thyroid carcinoma. Front Endocrinol (Lausanne) 2022; 13:1064434. [PMID: 36531493 PMCID: PMC9748155 DOI: 10.3389/fendo.2022.1064434] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE To develop and validate a radiomics nomogram based on ultrasound (US) to predict central cervical lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC). METHODS PTC patients with pathologically confirmed presence or absence of central cervical LN metastasis in our hospital between March 2021 and November 2021 were enrolled as the training cohort. Radiomics features were extracted from the preoperative US images, and a radiomics signature was constructed. Univariate and multivariate logistic regression analyses were used to screen out the independent risk factors, and a radiomics nomogram was established. The performance of the model was verified in the independent test cohort of PTC patients who underwent thyroidectomy and cervical LN dissection in our hospital from December 2021 to March 2022. RESULTS In the independent test cohort, the radiomics model based on long-axis cross-section and short-axis cross-section images outperformed the radiomics models based on either one of these sections (the area under the curve (AUC), 0.69 vs. 0.62 and 0.66). The radiomics signature consisted of 4 selected features. The US radiomics nomogram included the radiomics signature, age, gender, BRAF V600E mutation status, and extrathyroidal extension (ETE) status. In the independent test cohort, the AUC of the receiver operating curve(ROC) of this nomogram was 0.76, outperformingthe clinical model and the radiomics model (0.63 and 0.69, respectively), and also much better than preoperative US examination (AUC, 0.60). Decision curve analysis indicated that the radiomics nomogram was clinically useful. CONCLUSIONS This study presents an efficient and useful US radiomics nomogram that can provide comprehensive information to assist clinicians in the individualized preoperative prediction of central cervical LN metastasis in PTC patients.
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Affiliation(s)
- Quan Wen
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhixiang Wang
- Department of Radiation Oncology (Maastro), GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Alberto Traverso
- Department of Radiation Oncology (Maastro), GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Yujiang Liu
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ruifang Xu
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ying Feng
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- *Correspondence: Linxue Qian, ; Ying Feng,
| | - Linxue Qian
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- *Correspondence: Linxue Qian, ; Ying Feng,
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Papillary Thyroid Cancer Prognosis: An Evolving Field. Cancers (Basel) 2021; 13:cancers13215567. [PMID: 34771729 PMCID: PMC8582937 DOI: 10.3390/cancers13215567] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/04/2021] [Accepted: 11/04/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Over the last couple of decades, the prognostic stratification systems of differentiated thyroid cancer (DTC) patients have been revised several times in an attempt to achieve a tailored clinical management reflecting the single patients’ needs. Such revisions are likely to continue in the near future, since the prognostic value of a number of promising clinicopathological features and new molecular biomarkers are being evaluated. Here, we will review the current staging systems of thyroid cancer patients and discuss the most relevant clinicopathological parameters and new molecular markers that are potentially capable of refining the prognosis. Abstract Over the last few years, a great advance has been made in the comprehension of the molecular pathogenesis underlying thyroid cancer progression, particularly for the papillary thyroid cancer (PTC), which represents the most common thyroid malignancy. Putative cancer driver mutations have been identified in more than 98% of PTC, and a new PTC classification into molecular subtypes has been proposed in order to resolve clinical uncertainties still present in the clinical management of patients. Additionally, the prognostic stratification systems have been profoundly modified over the last decade, with a view to refine patients’ staging and being able to choose a clinical approach tailored on single patient’s needs. Here, we will briefly discuss the recent changes in the clinical management of thyroid nodules, and review the current staging systems of thyroid cancer patients by analyzing promising clinicopathological features (i.e., gender, thyroid auto-immunity, multifocality, PTC histological variants, and vascular invasion) as well as new molecular markers (i.e., BRAF/TERT promoter mutations, miRNAs, and components of the plasminogen activating system) potentially capable of ameliorating the prognosis of PTC patients.
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Dong X, Jin C, Chen D, Chen Y, Ye ZQ, Zhang X, Huang X, Zhang W, Gu DN. Genomic Instability-Related LncRNA Signature Predicts the Prognosis and Highlights LINC01614 Is a Tumor Microenvironment-Related Oncogenic lncRNA of Papillary Thyroid Carcinoma. Front Oncol 2021; 11:737867. [PMID: 34604079 PMCID: PMC8481916 DOI: 10.3389/fonc.2021.737867] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/30/2021] [Indexed: 12/20/2022] Open
Abstract
Background Genomic instability (GI) is among the top ten characteristics of malignancy. Long non-coding RNAs (lncRNAs) are promising cancer biomarkers that are reportedly involved in GI. So far, the clinical value of GI-related lncRNAs (GIlncs) in papillary thyroid cancer (PTC) has not been clarified. Methods Integrative analysis of lncRNA expression and somatic mutation profiles was performed to identify GIlncs. Analysis of differentially expressed lncRNAs in the group with high- and low- cumulative number of somatic mutations revealed significant GIlncs in PTC. Univariate and multivariate Cox proportional hazard regression analyses were performed to identify hub-GIlncs. Results A computational model based on four lncRNAs (FOXD2-AS1, LINC01614, AC073257.2, and AC005082.1) was identified as a quantitative index using an in-silicon discovery cohort. GILS score was significantly associated with poor prognosis, as validated in the TCGA dataset and further tested in our local RNA-Seq cohort. Moreover, a combination of clinical characteristics and the composite GILS-clinical prognostic nomogram demonstrates satisfactory discrimination and calibration. Furthermore, the GILS score and FOXD2-AS1, LINC01614, AC073257.2, and AC005082.1 were also associated with driver mutations and multiple clinical-pathological variables, respectively. Moreover, RNA-Seq confirmed the expression patterns of FOXD2-AS1, LINC01614, AC073257.2, and AC005082.1 in PTC and normal thyroid tissues. Biological experiments demonstrated that downregulated or overexpressed LINC01614 affect PTC cell proliferation, migration, and invasion in vitro. Activation of the stromal and immune cell infiltration was also observed in the high LINC01614 group in the PTC microenvironment. Conclusion In summary, we identified a signature for clinical outcome prediction in PTC comprising four lncRNAs associated with GI. A better understanding of the GI providing an alternative evaluation of the progression risk of PTC. Our study also demonstrated LINC01614 as a novel oncogenic lncRNA and verified its phenotype in PTC.
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Affiliation(s)
- Xubin Dong
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Cong Jin
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Danxiang Chen
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yizuo Chen
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhi-Qiang Ye
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaohua Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoli Huang
- Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wei Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dian-Na Gu
- Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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16
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Baldini E, Tuccilli C, Pironi D, Catania A, Tartaglia F, Di Matteo FM, Palumbo P, Arcieri S, Mascagni D, Palazzini G, Tripodi D, Maturo A, Vergine M, Tarroni D, Lori E, Ferent IC, De Vito C, Fallahi P, Antonelli A, Censi S, D’Armiento M, Barollo S, Mian C, Morrone A, D’Andrea V, Sorrenti S, Ulisse S. Expression and Clinical Utility of Transcription Factors Involved in Epithelial-Mesenchymal Transition during Thyroid Cancer Progression. J Clin Med 2021; 10:jcm10184076. [PMID: 34575184 PMCID: PMC8469282 DOI: 10.3390/jcm10184076] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 12/12/2022] Open
Abstract
The transcription factors involved in epithelial–mesenchymal transition (EMT-TFs) silence the genes expressed in epithelial cells (e.g., E-cadherin) while inducing those typical of mesenchymal cells (e.g., vimentin). The core set of EMT-TFs comprises Zeb1, Zeb2, Snail1, Snail2, and Twist1. To date, information concerning their expression profile and clinical utility during thyroid cancer (TC) progression is still incomplete. We evaluated the EMT-TF, E-cadherin, and vimentin mRNA levels in 95 papillary TC (PTC) and 12 anaplastic TC (ATC) tissues and correlated them with patients’ clinicopathological parameters. Afterwards, we corroborated our findings by analyzing the data provided by a case study of the TGCA network. Compared with normal tissues, the expression of E-cadherin was found reduced in PTC and more strongly in ATC, while the vimentin expression did not vary. Among the EMT-TFs analyzed, Twist1 seems to exert a prominent role in EMT, being significantly associated with a number of PTC high-risk clinicopathological features and upregulated in ATC. Nonetheless, in the multivariate analysis, none of the EMT-TFs displayed a prognostic value. These data suggest that TC progression is characterized by an incomplete EMT and that Twist1 may represent a valuable therapeutic target warranting further investigation for the treatment of more aggressive thyroid cancers.
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Affiliation(s)
- Enke Baldini
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Chiara Tuccilli
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Daniele Pironi
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Antonio Catania
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Francesco Tartaglia
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Filippo Maria Di Matteo
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Piergaspare Palumbo
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Stefano Arcieri
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Domenico Mascagni
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Giorgio Palazzini
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Domenico Tripodi
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Alessandro Maturo
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Massimo Vergine
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Danilo Tarroni
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Eleonora Lori
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Iulia Catalina Ferent
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00161 Rome, Italy;
| | - Poupak Fallahi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (P.F.); (A.A.)
| | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (P.F.); (A.A.)
| | - Simona Censi
- Department of Medicine, University of Padua, 35128 Padua, Italy; (S.C.); (S.B.); (C.M.)
| | - Matteo D’Armiento
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy; (M.D.); (A.M.)
| | - Susy Barollo
- Department of Medicine, University of Padua, 35128 Padua, Italy; (S.C.); (S.B.); (C.M.)
| | - Caterina Mian
- Department of Medicine, University of Padua, 35128 Padua, Italy; (S.C.); (S.B.); (C.M.)
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy; (M.D.); (A.M.)
| | - Vito D’Andrea
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Salvatore Sorrenti
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Salvatore Ulisse
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
- Correspondence:
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17
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Heng Y, Feng S, Yang Z, Cai W, Qiu W, Tao L. Features of Lymph Node Metastasis and Structural Recurrence in Papillary Thyroid Carcinoma Located in the Upper Portion of the Thyroid: A Retrospective Cohort Study. Front Endocrinol (Lausanne) 2021; 12:793997. [PMID: 35145480 PMCID: PMC8823057 DOI: 10.3389/fendo.2021.793997] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This study aims to reveal the features of lymph node metastasis (LNM) and recurrence in papillary thyroid carcinoma (PTC) tumors located in the upper portion of the thyroid. METHODS A total of 1075 PTC patients were retrospectively reviewed, including 314 patients with a tumor in the upper portion of the thyroid. Another 103 PTC patients with upper portion diagonsis from three clinical centers were included for external validation. RESULTS The results showed no difference between the patients with a tumor in the upper portion of the thyroid and those with a tumor in the non-upper portion in terms of overall LNM rates. However, patients with a tumor in the upper portion were significantly more prone to LLNM and exhibited a significantly worse recurrence outcome than those with a tumor in other subregions. Multivariate analysis showed that four factors-age no more than 40, maximum tumor diameter no less than1.0 cm, the presence of thyroid capsular invasion, and tumor with ipsilateral nodular goiter-were independent risk factors for LLNM of the tumor in the upper thyroid. A predictive risk-scoring model was established based on these factors. CONCLUSIONS Patients with PTC located in the upper portion may have an exclusive lymphatic drainage pathway to the lateral neck region and are more prone to suffer from LLNM and tumor recurrence than those with a tumor located in other subregions. A new postoperative strategy selection flow chart was established based on our newly created risk-scoring model that can effectively predict the individualized possibility of LLNM for PTC patients with a tumor in the upper portion.
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Affiliation(s)
- Yu Heng
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Siqi Feng
- Department of General Surgery, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Zheyu Yang
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei Cai
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- *Correspondence: Lei Tao, ; Wei Cai, ; Weihua Qiu,
| | - Weihua Qiu
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- *Correspondence: Lei Tao, ; Wei Cai, ; Weihua Qiu,
| | - Lei Tao
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- *Correspondence: Lei Tao, ; Wei Cai, ; Weihua Qiu,
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