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Hu T, Zhou T, Zhang Y, Zhou L, Huang X, Cai Y, Qian S, Huang K, Luo D. The predictive value of the thyroid nodule benign and malignant based on the ultrasound nodule-to-muscle gray-scale ratio. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:51-58. [PMID: 37915163 DOI: 10.1002/jcu.23601] [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: 09/04/2023] [Revised: 10/14/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To investigate the efficacy of the ultrasonic nodule to muscle gray scale ratio as a predictive tool for distinguishing between benign and malignant thyroid nodules. METHODS A retrospective study was undertaken at the First People's Hospital of Hangzhou, affiliated with the Zhejiang University School of Medicine, analyzing ultrasound and pathological data of patients with thyroid nodules between May 2020 and December 2022. The study extracted ultrasound features of nodules and employed univariate and multivariate logistic regression analyses to identify independent risk factors for malignant tumors in the nodules. Subsequently, a predictive model for distinguishing benign and malignant thyroid nodules was developed. RESULTS A total of 466 patients were included in this retrospective study, of which 275 cases were malignant tumors. Univariate and multivariate logistic regression analyses showed that the nodular-muscle gray-scale ratio, nodule diameter, margin status, aspect ratio, and calcification were closely related to thyroid malignant tumors. The area under the curve (AUC) of training group was 0.832, with a sensitivity, specificity, and accuracy of 85.5%, 67.4%, and 76.6%, respectively. The AUC of the external validation group was 0.819, with a sensitivity, specificity, and accuracy of 76.4%, 74.5%, and 75.7%, respectively. The calibration and decision curves showed that the model had good diagnostic value. CONCLUSION The research findings indicate that ratio is significantly associated with the malignant nature of thyroid nodules. The application of a line chart model based on these parameters exhibits a high level of predictive performance.
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Affiliation(s)
- Tao Hu
- Zhejiang Chinese Medical University, Fourth Clinical Medical College, Hangzhou, China
| | - Tianhan Zhou
- The Department of General Surgery, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Yu Zhang
- The Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li Zhou
- The Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xuanwei Huang
- Zhejiang Chinese Medical University, Fourth Clinical Medical College, Hangzhou, China
| | - Yuan Cai
- Zhejiang Chinese Medical University, Fourth Clinical Medical College, Hangzhou, China
| | - Shuoying Qian
- Zhejiang Chinese Medical University, Fourth Clinical Medical College, Hangzhou, China
| | - Kaiyuan Huang
- Zhejiang Chinese Medical University, Fourth Clinical Medical College, Hangzhou, China
| | - Dingcun Luo
- The Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Wang Z, Gui Z, Wang Z, Huang J, He L, Dong W, Zhang D, Zhang T, Shao L, Shi J, Wu P, Ji X, Zhang H, Sun W. Clinical and ultrasonic risk factors for high-volume central lymph node metastasis in cN0 papillary thyroid microcarcinoma: A retrospective study and meta-analysis. Clin Endocrinol (Oxf) 2023; 98:609-621. [PMID: 36263602 DOI: 10.1111/cen.14834] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/21/2022] [Accepted: 10/18/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Papillary thyroid microcarcinoma (PTMC) comprises more than 50% of all newly detected cases of papillary thyroid carcinoma (PTC). High-volume lymph node metastasis (involving >5 lymph nodes) (hv-LNM) is associated with PTMC recurrence. In half of the clinically node-negative (cN0) PTMC patients, central lymph node metastasis (CLNM) is pathologically present. However, clinical risk factors for high-volume CLNM (hv-CLNM) in cN0 PTMC have not been defined well. Therefore, we aimed to obtain evidence for hv-CLNM risk factors in cN0 PTMC. DESIGN Data on patients who visited our hospital between January 2020 and December 2021 were collected; a preoperative diagnosis of cN0 and a postoperative pathological confirmation of PTMC were obtained. After filtering by inclusion versus exclusion criteria, the obtained data (N = 2268) were included in the meta-analysis. Relevant studies published as of 10 April 2022, were identified from the Web of Science, PubMed, WANFANG, and CNKI databases. These eligible studies were included in the meta-analysis and the association between clinicopathological factors and hv-CLNM in cN0 PTMC was assessed. SPSS and MetaXL were used for statistical analyses. RESULTS The meta-analysis included 10 previous studies (11,734 patients) and 2268 patients enroled in our hospital for a total of 14,002 subjects. The results of which suggested that younger age (<40, odds ratio [OR] = 3.28, 95% confidence interval [CI] = 2.75-3.92, p < .001 or <45 odds ratio [OR] = 2.93, 95% CI = 2.31-3.72, p < .001), male sex (OR = 2.81, 95% CI = 2.25-3.52, p < .001), tumour size >5 mm (OR = 1.85, 95% CI = 1.39-2.47, p < .001), multifocality (OR = 1.88, 95% CI = 1.56-2.26, p < .001), extrathyroidal extension (OR = 2.58, 95% CI = 2.02-3.30, p < .001), capsule invasion (OR = 2.02, 95% CI = 1.46-2.78, p < .001), microcalcification (OR = 3.25, 95% CI = 2.42-4.36, p < .001) and rich blood flow (OR = 1.65, 95% CI = 1.21-2.25, p = .002) were the significant factors related to an elevated hv-CLNM risk in cN0 PTMC patients. Hashimoto thyroiditis (OR = 0.76, 95% CI = 0.55-1.07, p = .114), irregular margin (versus regular margin, OR = 0.96, 95% CI = 0.68-1.33, p = .787) and hypoechoic (versus nonhypoechoic, OR = 1.27, 95% CI = 0.84-1.92, p = .261) showed no significant association with hv-CLNM. CONCLUSIONS Younger age, tumour size >5 mm, males, extrathyroidal extension, multifocality, microcalcification, capsular invasion, and rich blood flow were the significant clinicopathological risk factors for hv-CLNM risk in cN0 PTMC patients. These predictors may compensate for the sensitivity of imaging diagnosis in the preoperative period, thus helping in the effective identification of PTMCs with an invasive phenotype.
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Affiliation(s)
- Zhiyuan Wang
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Zhiqiang Gui
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Zhihong Wang
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Jiapeng Huang
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Liang He
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Wenwu Dong
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Dalin Zhang
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Ting Zhang
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Liang Shao
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Jinyuan Shi
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Pu Wu
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Xiaoyu Ji
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Hao Zhang
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Wei Sun
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China
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Sun YD, Zhang H, Zhu HT, Wu CX, Chen ML, Han JJ. A systematic review and meta-analysis comparing tumor progression and complications between radiofrequency ablation and thyroidectomy for papillary thyroid carcinoma. Front Oncol 2022; 12:994728. [PMID: 36530996 PMCID: PMC9748571 DOI: 10.3389/fonc.2022.994728] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/08/2022] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Papillary thyroid cancer (PTC) is the most frequent thyroid cancers worldwide. The efficacy and acceptability of radiofrequency ablation (RFA) in the treatment of PTC have been intensively studied. The aim of this study is to focus on extra detailed that may influent for PTC or papillary thyroid microcarcinoma (PTMC). MATERIALS AND METHODS We identified a total of 1,987 records of a primary literature searched in PubMed, Embase, Cochrane Library, and Google Scholar by key words, from 2000 to 2022. The outcome of studies included complication, costs, and local tumor progression. After scrutiny screening and full-text assessment, six studies were included in the systematic review. Heterogeneity was estimated using I2, and the quality of evidence was assessed for each outcome using the GRADE guidelines. RESULTS Our review enrolled 1,708 patients reported in six articles in the final analysis. There were 397 men and 1,311 women in the analysis. Two of these studies involved PTC and four focused on PTMC. There were 859 patients in the RFA group and 849 patients in the thyroidectomy group. By contrast, the tumor progression of RFA group was as same as that surgical groups [odds ratio, 1.31; 95% CI, 0.52-3.29; heterogeneity (I2 statistic), 0%, p = 0.85]. The risk of complication rates was significantly lower in the RFA group than that in the surgical group [odds ratio, 0.18; 95% CI, 0.09-0.35; heterogeneity (I2 statistic), 40%, p = 0.14]. CONCLUSIONS RFA is a safe procedure with a certain outcome for PTC. RFA can achieve a good efficacy and has a lower risk of major complications.
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Affiliation(s)
- Yuan-dong Sun
- Department of Interventional Radiology, Shandong Cancer Hospital and Institute Affiliated Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Hao Zhang
- Department of Interventional Radiology, Shandong Cancer Hospital and Institute Affiliated Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | | | - Chun-xue Wu
- Graduate School of Shandong First Medical University, Jinan, China
| | - Miao-ling Chen
- Graduate School of Shandong First Medical University, Jinan, China
| | - Jian-jun Han
- Department of Interventional Radiology, Shandong Cancer Hospital and Institute Affiliated Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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Zhang Z, Cao Z, Liu R, Li Z, Wu J, Liu X, Wu M, Xu X, Liu Z. Nomograms Based on Serum N-glycome for Diagnosis of Papillary Thyroid Microcarcinoma and Prediction of Lymph Node Metastasis. Curr Oncol 2022; 29:6018-6034. [PMID: 36135043 PMCID: PMC9497917 DOI: 10.3390/curroncol29090474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/10/2022] [Accepted: 08/20/2022] [Indexed: 11/16/2022] Open
Abstract
Non-invasive biomarkers for the diagnosis and prognosis of papillary thyroid microcarcinoma (PTMC) are still urgently needed. We aimed to characterize the N-glycome of PTMC, and establish nomograms for the diagnosis of PTMC and the prediction of lymph node metastasis (LNM). N-glycome of PTMC (LNM vs. non-LNM, capsular invasion (CI) vs. non-CI (NCI)) and matched healthy controls (HC) were quantitatively analyzed based on mass spectrometry. N-glycan traits associated with PTMC/LNM were used to create binomial logistic regression models and were visualized as nomograms. We found serum N-glycome differed between PTMC and HC in high-mannose, complexity, fucosylation, and bisection, of which, four N-glycan traits (TM, CA1, CA4, and A2Fa) were significantly associated with PTMC. The nomogram based on four traits achieved good performance for the identification of PTMC. Two N-glycan traits (CA4 and A2F0S0G) showed strong associations with LNM. The nomogram based on two traits showed relatively good performance in predicting LNM. We also found differences between CI and NCI in several N-glycan traits, which were not the same as that associated with LNM. This study reported serum N-glycosylation signatures of PTMC for the first time. Nomograms constructed from aberrant glycans could be useful tools for PTMC diagnosis and stratification.
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Affiliation(s)
- Zejian Zhang
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Zhen Cao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Rui Liu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Zepeng Li
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jianqiang Wu
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiaoli Liu
- Department of Hernia and Abdominal Wall Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100043, China
| | - Mengwei Wu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiequn Xu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- Correspondence: (X.X.); (Z.L.); Tel.: +86-010-69152620 (X.X.); +86-010-69152620 (Z.L.)
| | - Ziwen Liu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- Correspondence: (X.X.); (Z.L.); Tel.: +86-010-69152620 (X.X.); +86-010-69152620 (Z.L.)
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Gong Y, Yao X, Yu L, Wei P, Han Z, Fang J, Ao W, Xu C. Ultrasound grayscale ratio: a reliable parameter for differentiating between papillary thyroid microcarcinoma and micronodular goiter. BMC Endocr Disord 2022; 22:75. [PMID: 35331216 PMCID: PMC8952271 DOI: 10.1186/s12902-022-00994-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/18/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The present study aimed to quantify and differentiate the echo levels of papillary thyroid microcarcinomas (PTMCs) and micronodular goiters (MNGs) using the ultrasound grayscale ratio (UGSR) and to investigate the repeatability of UGSR. METHODS The ultrasound (US) data of 241 patients with 265 PTMCs and 141 patients with 168 MNGs confirmed by surgery and pathology were retrospectively analyzed. All patients had received outpatient ultrasonic examination and preoperative ultrasonic positioning. The RADinfo radiograph reading system was used to measure the grayscales of PTMC, MNG, and thyroid tissues at the same gain level, and the UGSR values of the PTMC, MNG, and thyroid tissue were calculated. The patients were divided into outpatient examination, preoperative positioning, and mean value groups, and the receiver operating characteristic (ROC) curves were calculated to obtain the optimal UGSR threshold to distinguish PTMC from MNG. The interclass correlation coefficient (ICC) was used to assess the consistency of UGSR measured in three groups. RESULTS The UGSR values of the PTMC and MNG were 0.56 ± 0.14 and 0.80 ± 0.19 (t = 5.84, P < 0.001) in the outpatient examination group, 0.55 ± 0.14 and 0.80 ± 0.19 (t = 18.74, P < 0.001) in the preoperative positioning group, and 0.56 ± 0.12 and 0.80 ± 0.18 (t = 16.49, P < 0.001) in the mean value group. The areas under the ROC curves in the three groups were 0.860, 0.856, and 0.875, respectively. When the UGSR values for the outpatient examination, preoperative positioning, and mean value groups were 0.649, 0.646, and 0.657, respectively, each group obtained its largest Youden index. A reliable UGSR value was obtained between the outpatient examination and preoperative positioning groups (ICC = 0.79, P = 0.68). CONCLUSION UGSR is a simple and repeatable method to distinguish PTMC from MNG, and hence, can be widely applicable.
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Affiliation(s)
- Yun Gong
- Department of Pediatrics, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang, Hangzhou, China
| | - Xiuzhen Yao
- Department of Ultrasound, Shanghai Putuo District People's Hospital, Shanghai, China
| | - Lifang Yu
- Department of Ultrasound, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261, Huansha Road, Shangcheng District, Zhejiang, 310006, Hangzhou, China
| | - Peiying Wei
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhijiang Han
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jianhua Fang
- Department of Ultrasound, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261, Huansha Road, Shangcheng District, Zhejiang, 310006, Hangzhou, China
| | - Weiqun Ao
- Department of Radiology, Tongde Hospital of Zhejiang Province, No.234, Gucui Road, Zhejiang, 310012, Hangzhou, China.
| | - Chenke Xu
- Department of Ultrasound, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261, Huansha Road, Shangcheng District, Zhejiang, 310006, Hangzhou, China.
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Seyrek NC, Baser H, Topaloglu O, Ozdemir D, Kilicarslan A, Ersoy R, Cakir B. Ultrasonographical, clinical and histopathological features of 1264 nodules with papillary thyroid carcinoma and microcarcinoma based on tumor size. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 64:533-541. [PMID: 34033293 PMCID: PMC10118958 DOI: 10.20945/2359-3997000000286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective We aimed to evaluate the patients diagnosed with papillary thyroid carcinoma (PTC) and papillary thyroid microcarcinoma (PTMC) in terms of clinical, ultrasonographical (US) and histopathological features and their relationships with tumor size. Methods We retrospectively evaluated 881 patients who underwent thyroid surgery in our clinic and diagnosed with PTC histopathologically were enrolled the study. Demographic characteristics, US findings and histopathological features were evaluated. Results In total, 1264 nodules were identified in the 881 patients. The incidentality rates were higher in the PTMC group and also in the ≤ 5 mm group. In total multifocality rate was 32.9%, and was significantly higher in PTMC group than the PTC group. PTC and > 5 mm PTMC groups compared to PTMC and ≤ 5 mm groups respectively, were more aggresive histopathological features. Conclusion Since the incidentality rates were found significantly more common in our patients with PTMC and those with ≤ 5 mm, ultrasonographic features of the nodules should be evaluated carefully and for cases which are suspicious with US, US-guided fine needle aspiration biopsy (FNAB) should be considered in order to make the correct treatment strategy. Also our study revealed that PTC and > 5 mm PTMC groups compared to PTMC and ≤ 5 mm groups respectively, have more aggresive histopathological features.
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Affiliation(s)
- Neslihan Cuhaci Seyrek
- Ankara Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey,
| | - Husniye Baser
- Ankara Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Oya Topaloglu
- Ankara Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Didem Ozdemir
- Ankara Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Aydan Kilicarslan
- Ankara Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Pathology, Ankara, Turkey
| | - Reyhan Ersoy
- Ankara Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Bekir Cakir
- Ankara Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
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Mao Y, Zhang F, He L, Luo F, Li L, Huo Y, Kang Z. Added value of circulating miRNA expression profiling to sonographic TI-RADS classification in the diagnosis of thyroid nodules. Exp Ther Med 2020; 20:1589-1595. [PMID: 32765676 PMCID: PMC7388447 DOI: 10.3892/etm.2020.8870] [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: 06/26/2019] [Accepted: 02/12/2020] [Indexed: 11/05/2022] Open
Abstract
Potential use of sonographic TI-RADS classification combined with circulating miRNA expression profiling in the diagnosis of thyroid nodules was explored. Retrospective analysis was performed on clinical data of 121 patients with thyroid nodules. The biopsy specimens of patients obtained through ultrasound-guided aspiration and blood specimens were evaluated in Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2018 to June 2019. In addition, the blood specimen test results of 121 healthy volunteers (control group) who underwent physical examination were retrospectively analyzed. Results of sonographic TI-RADS classification and circulating miRNA expression profiling were compared with the pathological results. Of the 212 nodules, 2 fell into TI-RADS category 2 and were diagnosed as benign. Malignant nodules accounted for 4.35, 37.14, 84.78, 93.33 and 96.77% of those nodules that fell into TI-RADS categories 3, 4a, 4b, 4c and 5, respectively. Of the 121 patients, 92.55% had with nodular goiter, 3.31% had inflammatory nodules, 2.48% toxic nodular goiter, 0.83% thyroid cysts and 0.83% thyroid tumors. A nodule that fell into a higher TI-RADS classification category had a higher risk of malignancy. The expression levels of miRNA146b, miRNA187, miRNA375, miRNA-222-3p and miRNA-151a-5p were higher, while the level of miRNA138 was lower, in patients with either benign or malignant thyroid nodules compaed to those in the control group. The expression levels of miRNA146b, miRNA187, miRNA375, miRNA-222-3p and miRNA-151a-5p were higher, while the level of miRNA138 was lower, in patients with malignant thyroid nodules than those in patients with benign thyroid nodule (P<0.05). The AUC of the combined diagnostic method was 0.973, which was significantly different from the AUCs of the individual diagnostic method (P<0.05). In conclusion, sonographic TI-RADS classification combined with circulating miRNA expression profiling can improve the diagnosis of thyroid nodules.
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Affiliation(s)
- Yu Mao
- Department of Endocrinology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450007, P.R. China
| | - Fengjiao Zhang
- Department of Endocrinology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450007, P.R. China
| | - Li He
- Department of Endocrinology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450007, P.R. China
| | - Fang Luo
- Department of Endocrinology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450007, P.R. China
| | - Lei Li
- Department of Endocrinology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450007, P.R. China
| | - Yajie Huo
- Department of Endocrinology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450007, P.R. China
| | - Zhiqiang Kang
- Department of Endocrinology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450007, P.R. China
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Li X, Zhou W, Zhan W. Clinical and ultrasonographic features of medullary thyroid microcarcinomas compared with papillary thyroid microcarcinomas: a retrospective analysis. BMC Med Imaging 2020; 20:49. [PMID: 32410587 PMCID: PMC7227110 DOI: 10.1186/s12880-020-00444-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 04/21/2020] [Indexed: 11/27/2022] Open
Abstract
Background To identify the sonographic features that help to differentiate medullary thyroid microcarcinomas (MTMCs) from papillary thyroid microcarcinomas (PTMCs). Methods A total of 46 MTMCs in 41 patients and 136 PTMCs in 104 patients that were proven by surgery and pathology were included in the study. Patient age and nodule size were analyzed by independent sample t-tests, and sex, multiplicity and cervical lymph node metastases were analyzed by χ2 or Fisher’s exact tests. Univariate analysis and multivariate logistic regression analysis were performed on the sonographic features of thyroid nodules, including location, shape, boundary, margin, peripheral halo ring, echogenicity, composition, calcifications and vascularization. Results Compared with the corresponding number of patients with PTMCs, more MTMC patients had cervical lymph node metastases (P = 0.040). There were no significant differences in age, sex, nodule size, multiplicity, location, boundary, margin, peripheral halo ring, echogenicity or microcalcifications between MTMCs and PTMCs (P > 0.05 for all). However, significant differences were found in shape (P = 0.000), composition (P = 0.032), macrocalcifications (P = 0.004) and vascularity (P = 0.000) between the two groups. Conclusions There were some overlapping sonographic features between MTMCs and PTMCs. However, MTMCs tended to have a > 50% solid composition, be ovoid to round nodules with macrocalcifications and be hypervascular. Cervical lymph node metastases were more common in MTMC patients.
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Affiliation(s)
- Xiaoyu Li
- Ultrasound Department, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Rd, Shanghai, 200025, China
| | - Wei Zhou
- Ultrasound Department, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Rd, Shanghai, 200025, China
| | - Weiwei Zhan
- Ultrasound Department, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Rd, Shanghai, 200025, China.
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Wang J, Wei W, Guo R. Ultrasonic elastography and conventional ultrasound in the diagnosis of thyroid micro-nodules. Pak J Med Sci 2019; 35:1526-1531. [PMID: 31777487 PMCID: PMC6861480 DOI: 10.12669/pjms.35.6.777] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: To investigate the clinical value of conventional ultrasound, ultrasound elastography and conventional ultrasound combined with ultrasound elastography in differential diagnosis of benign and malignant thyroid micro-nodules. Methods: Eighty-six patients who were found with thyroid micro-nodules with the maximum diameter no more than 10 mm in the physical examination in our hospital from June 2015 to December 2017 were selected, and 102 nodules were included. All patients were confirmed with thyroid micro-nodules by puncture or surgical pathology and underwent conventional ultrasound and ultrasound elastography. Taking the surgical pathological results as a control, the value of conventional ultrasound, ultrasound elastography and conventional ultrasound combined with ultrasound elastography in differential diagnosis of benign and malignant thyroid micro-nodules were compared. A receiver operating characteristic (ROC) curve was drawn, and the area under the ROC curve was calculated. Results: One hundred and two thyroid nodules were detected by surgical pathology, including 75 benign nodules (73.53%) and 27 malignant nodules (26.47%). The sensitivity and diagnostic accordance rate of ultrasound elastography were significantly higher than those of conventional ultrasound in the diagnosis of thyroid microcarcinoma, and the missed diagnosis rate of ultrasound elastography was significantly lower than that of conventional ultrasound; the difference was statistically significant (P<0.05). However, the difference between the two methods was not statistically significant in terms of diagnostic specificity and misdiagnosis rate (P>0.05). The areas under the ROC curve in the diagnosis of benign and malignant thyroid nodules by conventional ultrasound and ultrasound elastography were 0.735 and 0.743 respectively. Conclusion: Conventional ultrasound can be used as a routine examination technique in differential diagnosis of benign and malignant thyroid nodules, while ultrasound elastography can improve the sensitivity and diagnostic rate in the diagnosis of thyroid micro carcinoma. It can help to reduce the clinical missed diagnosis, which also can be be used as an effective supplement for conventional ultrasound.
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Affiliation(s)
- Jinming Wang
- Jinming Wang Department of Ultrasound, Binzhou People's Hospital, Shandong, 256610, China
| | - Wenbing Wei
- Wenbing Wei Department of Ultrasound, Binzhou People's Hospital, Shandong, 256610, China
| | - Rui Guo
- Rui Guo Department of Ultrasound, Binzhou People's Hospital, Shandong, 256610, China
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10
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Semiz-Oysu A, Demir M, Kulali F, Bukte Y, Oysu C. The Sonographic Findings of Papillary Thyroid Microcarcinomas. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2019. [DOI: 10.1177/8756479319847649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this research was to compare the sonographic features of papillary thyroid microcarcinomas (micro-PTCs) to those of macro-PTCs. Patients with known PTC were retrospectively reviewed and divided into micro- or macro-PTC groups, according to the largest nodule diameter, ≤10 mm or >10 mm, respectively. Eighty-nine nodules (62 macro-PTCs and 27 micro-PTCs) were evaluated. Contour irregularity was more common in micro-PTCs than macro-PTCs ( P < .05). No significant difference was found in the presence of hypoechogenicity, heterogeneity, microcalcifications, cystic component, and absence of peripheral halo between groups ( P > .05). Internal vascularity was detected in none of the micro-PTCs while being present in 13% of macro-PTCs ( P < .05). Micro-PTCs demonstrated similar sonographic findings as larger PTCs. In micro-PTCs, the presence of irregular contours, in a micro-nodule, should increase suspicion and consideration for biopsy, when clinically indicated. Internal nodular vascularity may not be present in micro-PTCs and therefore not decrease the suspicion of malignancy in the presence of other suspicious sonographic features.
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Affiliation(s)
- Aslihan Semiz-Oysu
- Umraniye Training and Research Hospital, Department of Radiology, University of Health Sciences, Istanbul, Turkey
| | - Mustafa Demir
- Umraniye Training and Research Hospital, Department of Radiology, University of Health Sciences, Istanbul, Turkey
| | - Fatma Kulali
- Umraniye Training and Research Hospital, Department of Radiology, University of Health Sciences, Istanbul, Turkey
| | - Yasar Bukte
- Umraniye Training and Research Hospital, Department of Radiology, University of Health Sciences, Istanbul, Turkey
| | - Cagatay Oysu
- Department of Otorhinolaryngology Head and Neck Surgery, Marmara University, Istanbul, Turkey
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Han Z, Lei Z, Li M, Luo D, Ding J. Differential diagnosis value of the ultrasound gray scale ratio for papillary thyroid microcarcinomas and micronodular goiters. Quant Imaging Med Surg 2018; 8:507-513. [PMID: 30050785 DOI: 10.21037/qims.2018.06.04] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background To investigate the differential diagnosis value of the ultrasound gray scale ratio (UGSR) for papillary thyroid microcarcinomas (PTMCs) and micronodular goiters (MNGs). Methods A retrospective analysis was performed using ultrasound images from 521 PTMC patients (561 PTMC lesions) and 405 MNG patients (515 MNG lesions). All cases were surgically and histologically confirmed. Gray scale values of the thyroid lesions and the surrounding normal thyroid tissue were measured. The thyroid lesion to normal thyroid tissue (UGSR) was calculated. Statistical analysis was performed with Mann-Whitney test. Receiver operating characteristic curve determined the optimal UGSR threshold for differentiating PTMCs and MNGs. Results In 561 PTMCs, the mean UGSR was 0.54 (SD: 0.16; range: 0.24-1.26). In 515 MNGs, the mean UGSR was 0.87 (SD: 0.22; range: 0.34-2.06), with significant difference between values of PTMCs and MNGs (P<0.001). The UGSR area under the curve to differentiate PTMCs and MNGs was 0.895. When the UGSR decreased, the UGSR to PTMC sensitivity decreased and the specificity increased. When the UGSR was chosen to be 0.99, 0.72, 0.63 or 0.34, the sensitivity was 98.4% and 87.0%, 73.8% and 5.9% respectively, and specificity was 25.1% and 80.4%, 90.1% and 100.0% respectively. When the UGSR was 0.72, the Youden index maximum was 0.674. Conclusions The UGSR allows potential differentiation PTMCs and MNGs.
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Affiliation(s)
- Zhijiang Han
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Zhikai Lei
- Department of Ultrasound, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Mingkui Li
- Department of Ultrasound, Zhejiang Xiaoshan Hospital, Hangzhou 311200, China.,Trying Doctor Group, Hangzhou 311200, China
| | - Dingcun Luo
- Department of Tumor Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Jinwang Ding
- Department of Tumor Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
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12
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Tang H, Zhang Y. Identification and bioinformatics analysis of overlapping differentially expressed genes in depression, papillary thyroid cancer and uterine fibroids. Exp Ther Med 2018; 15:4810-4816. [PMID: 29805500 PMCID: PMC5952074 DOI: 10.3892/etm.2018.6023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 10/26/2017] [Indexed: 01/04/2023] Open
Abstract
It is hypothesized that there may be common characteristics between the genetic regulatory networks of different diseases. To identify these potential similarities, analysis of overlapping differentially expressed genes (DEGs) in several diseases, which are believed to be associated in traditional Chinese medicine (TCM) was performed in the present study. The gene expression profiles associated with depression, papillary thyroid carcinoma (PTC) and uterine fibroids (UF) were preliminarily analyzed using Gene Expression Omnibus 2R tools. Gene Ontology enrichment analysis, Kyoto Encyclopedia of Genes and Genomes pathway analysis and protein-protein interaction network analysis of the overlapping DEGs in depression, PTC and UF was performed. The results indicated that multiple genes, including activating transcription factor 3 and WSC domain containing 2 and the phosphoinositide 3 kinase/protein kinase b signaling pathway and its downstream effectors may be common factors associated with depression, PTC and/or UF. The neuroendocrine functions of the hypothalamic-pituitary-ovarian axis and hypothalamic-pituitary-thyroid axis were also identified as being mutually associated with depression, PTC and/or UF. However, due to the limitations of DNA microassays, it is recommended that future studies take epigenetics into consideration. Further transcriptomic, methylomic and metabolomic analyses of depression, PTC and UF are also required to identify and elucidate the key associated biomarkers. In conclusion, the results of the current study shed light on the potential genetic interconnections between depression, PTC and UF, which may be beneficial for understanding their underlying coregulatory mechanisms and contributing to the development of homeotherapy based on bioinformatics prediction.
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Affiliation(s)
- Hanxiao Tang
- Department of Pharmacy, Affiliated Tongde Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310012, P.R. China
| | - Yongsheng Zhang
- The Diagnostic Institute of Chinese Medicine, School of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, P.R. China
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Zhu Y, Deng S, Zhang Y, Jiang Q. Comparative study of ultrasonic elastography and conventional ultrasound in diagnosis of malignant anus neoplasm. Exp Ther Med 2018; 15:2343-2346. [PMID: 29456640 PMCID: PMC5795467 DOI: 10.3892/etm.2018.5720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 12/12/2017] [Indexed: 12/26/2022] Open
Abstract
The application value of conventional ultrasound and ultrasonic elastography (UE) in preoperative diagnosis and combined diagnosis of malignant anus neoplasms was investigated. One hundred and twenty patients, whose mass was detected by digital rectal examination, were examined using UE and conventional ultrasound before operation, and the results were compared with those of histopathological examinations after operation, so that the accuracy and imaging features of UE as well as UE combined with conventional ultrasound in diagnosing malignant anus neoplasm were analyzed. Among the 120 patients, 77 were diagnosed with benign lesions and 43 were diagnosed with malignant lesions via pathological diagnosis for anal canal lesion surgery. Conventional ultrasound before operation showed that 53 patients were diagnosed with benign lesions and 26 with malignant lesions. Compared with that in the pathological diagnosis results, the diagnostic accordance rate in preoperative conventional ultrasound was 65.8%. Through UE diagnosis, 66 patients had benign lesions and 39 patients had malignant lesions. Compared with that in the pathological diagnosis results, the diagnostic accordance rate in preoperative UE was 87.5%. After the examination via UE combined with conventional ultrasound before operation, 71 patients were diagnosed with benign lesions and 40 patients were diagnosed with malignant lesions; compared with that in the pathological diagnosis results, the diagnostic accordance rate was 92.5%. In terms of mass qualitative diagnosis, the sensitivity and specificity of conventional ultrasound were 60.5 and 68.8%, respectively; those of UE were 90.7 and 85.7%, respectively, and those of UE combined with conventional ultrasound were 93.0 and 92.2%, respectively. According to the analysis results of receiver operating characteristic (ROC) curve, the area under curve (AUC) of malignant anus neoplasm diagnosed via UE was 0.732 [95% confidence interval (95% CI), 0.211-2.534], the AUC via conventional ultrasound was 0.695 (95% CI, 0.517-0.932), and that via UE combined with conventional ultrasound was 0.823 (95% CI, 0.146-4.643). In conclusion, examinations utilizing UE combined with conventional ultrasound can increase the preoperative diagnostic accordance rate in malignant anus neoplasm, which can be used as an effective method for preoperative diagnosis of malignant anus neoplasm.
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Affiliation(s)
- Yicheng Zhu
- Department of Ultrasound, Shanghai Pudong New Area People's Hospital, Shanghai 201299, P.R. China
| | - Shuhao Deng
- Department of Ultrasound, Shanghai Pudong New Area People's Hospital, Shanghai 201299, P.R. China
| | - Yuan Zhang
- Department of Ultrasound, Shanghai Pudong New Area People's Hospital, Shanghai 201299, P.R. China
| | - Quan Jiang
- Department of Ultrasound, Shanghai Pudong New Area People's Hospital, Shanghai 201299, P.R. China
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Wu G, Guo JJ, Ma ZY, Wang J, Zhou ZW, Wang Y. Correlation between calcification and bone sialoprotein and osteopontin in papillary thyroid carcinoma. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:2010-2017. [PMID: 25973097 PMCID: PMC4396203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 12/05/2014] [Indexed: 06/04/2023]
Abstract
The correlation between calcification and papillary thyroid carcinoma has received increasing attention. We investigated the ability of bone sialoprotein (BSP) and osteopontin (OPN) protein levels to diagnose papillary thyroid carcinoma (PTC), and explored the correlation between BSP and OPN protein levels and calcification in PTC. Archival PTC specimens from patients with PTC with calcification and lateral cervical lymph node metastasis (LNM) were included in this retrospective immunohistochemical study. The protein levels of BSP and OPN were analysed immunohistochemically using routinely prepared tissue sections. PTC specimens from 66 patients with PTC were reviewed retrospectively (25 patients with histological calcification seen in paraffin sections, 41 patients without calcification; 35 patients with lateral cervical LNM, 31 patients without LNM). The percentage of samples that had cells that demonstrated positive protein staining differed significantly between PTC specimens, benign thyroid nodules, and adjacent normal follicular epithelium (BSP: 87.88%, 55.00%, and 42.50%, respectively; OPN: 83.33%, 70.00% and 50.00%, respectively). There was a significant difference in the immunohistochemical score (IHS) for BSP and OPN protein staining between PTC specimens with and without calcification (P < 0.05). The level of BSP protein staining was found to be significantly correlated with the level of OPN protein staining in PTC specimens. We conclude that the strong correlation between BSP and OPN and PTC suggests a role for BSP and OPN in calcification and tumor progression of PTC. BSP and OPN might be useful tumour markers for the diagnosis of PTC with limited value, because both of them had low specificity.
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Affiliation(s)
- Gang Wu
- Depratment of General Surgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Jing-Jing Guo
- Depratment of General Surgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
- Depratment of General Surgery, Renhe HospitalBaoshan District, Shanghai 200431, China
| | - Zhen-Yu Ma
- Depratment of General Surgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Jie Wang
- Depratment of General Surgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Zhong-Wen Zhou
- Department of Pathology, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Yi Wang
- Department of Ultrasound, Huashan Hospital, Fudan UniversityShanghai 200040, China
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