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de Carlos Artajo J, Irigaray Echarri A, García Torres J, Pineda Arribas JJ, Ernaga Lorea A, Eguílaz Esparza N, Zubiría Gortázar JM, Anda Apiñániz E. Clinical characteristics and prognosis of familial nonmedullary thyroid carcinoma. ENDOCRINOL DIAB NUTR 2022; 69:262-270. [PMID: 35353680 DOI: 10.1016/j.endien.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/30/2021] [Accepted: 04/30/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Familial non-medullary thyroid carcinoma (FNMTC) is defined by the presence of 2 or more first-degree family members with differentiated thyroid carcinoma (DTC). The aim of this study is to compare clinicopathological features and prognosis of FNMTC and sporadic carcinoma (SC). MATERIALS AND METHODS Retrospective study of DTC included in the hospital database during the period 1990-2018. RESULTS A total of 927 patients were analyzed, 61 of them were FNMTC, with a mean follow-up of 9.7 ± 6.5 years. The prevalence of FNMTC was 6.6%, with a lower TNM staging presentation (P = 0.003) consequence of a higher proportion of tumors smaller than 2 cm (P = 0.003), combined with a greater multifocality (P = 0.034) and papillary histologic subtype (P = 0.022) compared to SC. No significant differences in age at diagnosis (P = 0.347), gender (P = 0.406), neither in other aggressiveness markers (bilaterality, extrathyroidal extension, lymph node involvement and metástasis) were detected. Rate of persistence/recurrence (P = 0.656), disease-free survival (P = 0.929) and mortality caused by the tumor itself (P = 0.666) were comparable. Families with ≥3 affected relatives, had smaller tumors (P = 0.005), more multifocality (P = 0.040) and bilaterality (P = 0.002), as well as a higher proportion of males (P = 0.020). Second generation patients present earlier FNMTC compared to those of the first generation (P = 0.001). CONCLUSION In our study FNMTC presents a lower TNM staging, higher multifocality and papillary variant, with similar aggressiveness and prognosis compared to SC.
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Affiliation(s)
| | - Ana Irigaray Echarri
- Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Javier García Torres
- Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | | | - Ander Ernaga Lorea
- Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Nerea Eguílaz Esparza
- Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | | | - Emma Anda Apiñániz
- Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
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Yang T, Huang L, Chen C, Luo H, Jiang Y. Comparison Between Clinicopathological Characteristics, BRAF V600E and TERT Promoter Mutation of Familial Non-Medullary Thyroid Carcinomas, and Sporadic Case. Front Oncol 2021; 11:616974. [PMID: 34926235 PMCID: PMC8672032 DOI: 10.3389/fonc.2021.616974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/05/2021] [Indexed: 12/09/2022] Open
Abstract
Background It has been debated whether familial non-medullary thyroid carcinoma (FNMTC) is more aggressive and has a worse prognosis than sporadic non-medullary thyroid carcinoma (SNMTC). Our aim was to compare the invasiveness and prognosis of FNMTC and SNMTC by their biological behavior and molecular changes. Method and Material Our group mainly compared 106 patients with FNMTC whom have complete clinicopathological data during 2011–2019 in West China Hospital, Sichuan University, and 212 randomly selected cases with SNMTC were included to compare their biological behavior, recurrence and mortality, and molecular expression of BRAF V600E and TERT promoter. At the same time, FNMTC cases were divided into four subgroups, namely, two affected members group, three or more affected members, parent/offspring group, and sibling group, and they were compared with SNMTC separately to analyze the difference in their invasiveness and prognosis. Results We found that the mean tumor size of FNMTC (0.96 ± 0.53cm) was smaller than that of SNMTC (1.15 ± 0.72 cm) (p = 0.020), while no significant difference in the incidence of other clinicopathological factors, including bilateral growth, capsular invasion, with thyroid nodular goiter or not, multifocality, lymph node metastasis, extrathyroidal extension, iodine 131 treatments, T stage, and American Joint Committee on Cancer (AJCC) stage, was observed between FNMTC and SNMTC (p > 0.05), between each FNMTC subgroup (p > 0.05), and between each FNMTC subgroup and SNMTC (p > 0.05). There was no significant difference in recurrence, mortality, and BRAF V600E and TERT promoter mutation between FNMTC and SNMTC, among which 50/60 (83.33%) of FNMTC patients had BRAF V600E mutation and 1/32 (3.13%) had TERT promoter mutation, while the mutation rates of SNMTC were 93/108 (86.11%) and 3/64 (4.69%) (p > 0.05). Conclusion There was no significant difference in invasiveness and prognosis between FNMTC and SNMTC by biological behavior, patient survival, and molecular level comparison.
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Affiliation(s)
- Tian Yang
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Longsheng Huang
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Chang Chen
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
| | - Han Luo
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yong Jiang
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Yong Jiang,
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Papillary Thyroid Cancer Affecting Multiple Family Members: A Case Report and Literature Review of Familial Nonmedullary Thyroid Cancer. Case Rep Endocrinol 2021; 2021:3472000. [PMID: 34691791 PMCID: PMC8536453 DOI: 10.1155/2021/3472000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/07/2021] [Indexed: 11/18/2022] Open
Abstract
Familial nonmedullary thyroid cancer (FNMTC) represents 5–10% of NMTC cases. Many controversies are associated with the FNMTC, namely, the minimum required number of affected family members to define the condition, aggressiveness, prognosis, and treatment and screening recommendations. Moreover, the genetic basis of the FNMTC has not yet been identified. We report a family diagnosed with FNMTC and present a comprehensive literature review of the condition. The index case was a 26-year-old male who was diagnosed with locally advanced papillary thyroid cancer (PTC). Then, his family members became worried and asked for a neck ultrasound. Four of his six siblings, in addition to his father, were diagnosed with PTC. In addition, two of his cousins were diagnosed. The patient underwent total thyroidectomy with bilateral neck dissection, and he received 2 doses of radioactive iodine (100 mCi each). Furthermore, one of his siblings required a second surgery with repeated radioactive iodine therapy. The index case genetic screening and whole-exome sequencing did not show any abnormalities. Future genetic and clinical research should focus on kindred with 3 or more affected individuals for better identification of the FNMTC susceptibility genes and to better guide management and screening recommendations.
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de Carlos Artajo J, Irigaray Echarri A, García Torres J, Pineda Arribas JJ, Ernaga Lorea A, Eguílaz Esparza N, Zubiría Gortázar JM, Anda Apiñániz E. Clinical characteristics and prognosis of familial nonmedullary thyroid carcinoma. ENDOCRINOL DIAB NUTR 2021; 69:S2530-0164(21)00192-0. [PMID: 34503933 DOI: 10.1016/j.endinu.2021.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/30/2021] [Accepted: 04/30/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Familial non-medullary thyroid carcinoma (FNMTC) is defined by the presence of 2or more first-degree family members with differentiated thyroid carcinoma (DTC). The aim of this study is to compare clinicopathological features and prognosis of FNMTC and sporadic carcinoma (SC). MATERIALS AND METHODS Retrospective study of DTC included in the hospital database during the period 1990-2018. RESULTS A total of 927 patients were analyzed, 61 of them were FNMTC, with a mean follow-up of 9.7±6.5 years. The prevalence of FNMTC was 6.6%, with a lower TNM staging presentation (P=.003) consequence of a higher proportion of tumors smaller than 2 centimeters (P=.003), combined with a greater multifocality (P=.034) and papillary histologic subtype (P=.022) compared to SC. No significant differences in age at diagnosis (P=.347), gender (P=.406), neither in other aggressiveness markers (bilaterality, extrathyroidal extension, lymph node involvement and metástasis) were detected. Rate of persistence/recurrence (P=.656), disease-free survival (P=.929) and mortality caused by the tumor itself (P=.666) were comparable. Families with ≥3 affected relatives, had smaller tumors (P=.005), more multifocality (P=.040) and bilaterality (P=.002), as well as a higher proportion of males (P=.020). Second generation patients present earlier FNMTC compared to those of the first generation (P=.001). CONCLUSION In our study FNMTC presents a lower TNM staging, higher multifocality and papillary variant, with similar aggressiveness and prognosis compared to SC.
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Affiliation(s)
| | - Ana Irigaray Echarri
- Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - Javier García Torres
- Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | | | - Ander Ernaga Lorea
- Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - Nerea Eguílaz Esparza
- Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | | | - Emma Anda Apiñániz
- Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
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Orois A, Mora M, Halperin I, Oriola J. Familial non medullary thyroid carcinoma: Beyond the syndromic forms. ENDOCRINOL DIAB NUTR 2021; 68:260-269. [PMID: 34266638 DOI: 10.1016/j.endien.2020.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/17/2020] [Indexed: 10/20/2022]
Abstract
Familial non-medullary thyroid cancer is defined as the presence of non-medullary thyroid cancer in two or more first-degree relatives, in the absence of other predisposing factors. It represents up to 9% of differentiated thyroid cancers, and only a minority appears in well-known hereditary syndromes that associate thyroid cancer among many other clinical manifestations. However, in more than 95% of cases, thyroid cancer appears isolated, and its genetic causes have yet to be elucidated. We review here the current knowledge of the genetic basis of this pathology, as well as its clinical characteristics. Understanding the genetic mechanisms implied would help to comprehend the metabolic pathways involved, with the consequent potential therapeutic application. In addition, it would allow genetic counseling and to focus our efforts on patients at risk of developing this disorder.
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Affiliation(s)
- Aida Orois
- Servicio de Endocrinología y Nutrición, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain; Servicio de Endocrinología y Nutrición, ICMDM, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - Mireia Mora
- Servicio de Endocrinología y Nutrición, ICMDM, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Irene Halperin
- Servicio de Endocrinología y Nutrición, ICMDM, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Josep Oriola
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain; Servicio de Bioquímica y Genética Molecular, CDB, Hospital Clínic de Barcelona, Barcelona, Spain
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Prognostic analysis of recurrence in children and adolescents with differentiated thyroid cancer. Chin Med J (Engl) 2021; 133:2281-2286. [PMID: 32941235 PMCID: PMC7546846 DOI: 10.1097/cm9.0000000000000910] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: The standard treatment for pediatric differentiated thyroid carcinoma (DTC) still requires consideration because of a lack of clinical evidence. The purpose of this study was to summarize the clinical experiences and explore the risk factors for post-operative recurrence through a retrospective analysis to develop better clinical strategies for pediatric DTC. Methods: This study retrospectively analyzed children and adolescents with DTC who were treated between January 1999 and December 2014 at the Cancer Hospital, Chinese Academy of Medical Sciences. Clinicopathological results and outcomes were collected. A log-rank test of Kaplan-Meier curves and the Cox regression model were used to determine the factors associated with recurrence. Results: Data of 150 patients were collected in this study. During the follow-up, there was only one disease-related death. The recurrence rates at 3, 5, and 10 years were 13.6%, 18.7%, and 28.6%, respectively. There was a significant difference in the rate of recurrence according to age (P < 0.001), extrathyroidal extension (P < 0.001), lymph node metastasis (P = 0.023), and invasion of the trachea and esophageal wall (P = 0.004). Cox regression analysis demonstrated that age (P = 0.006) and extrathyroidal extension (P = 0.013) were significant dependent factors of post-operative recurrence. Conclusions: The prognosis of DTC in children and adolescents is favorable. A close follow-up is recommended because of the high recurrence rate. A comparatively higher recurrence rate was observed in the younger age group, and new age-based divisions may be needed to conveniently evaluate the possibility of recurrence.
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Orois A, Mora M, Halperin I, Oriola J. Familial non medullary thyroid carcinoma: Beyond the syndromic forms. ACTA ACUST UNITED AC 2020; 68:260-269. [PMID: 33191196 DOI: 10.1016/j.endinu.2020.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/25/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022]
Abstract
Familial non-medullary thyroid cancer is defined as the presence of non-medullary thyroid cancer in two or more first-degree relatives, in the absence of other predisposing factors. It represents up to 9% of differentiated thyroid cancers, and only a minority appears in well-known hereditary syndromes that associate thyroid cancer among many other clinical manifestations. However, in more than 95% of cases, thyroid cancer appears isolated, and its genetic causes have yet to be elucidated. We review here the current knowledge of the genetic basis of this pathology, as well as its clinical characteristics. Understanding the genetic mechanisms implied would help to comprehend the metabolic pathways involved, with the consequent potential therapeutic application. In addition, it would allow genetic counseling and to focus our efforts on patients at risk of developing this disorder.
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Affiliation(s)
- Aida Orois
- Servicio de Endocrinología y Nutrición, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, España; Servicio de Endocrinología y Nutrición, ICMDM, Hospital Clínic de Barcelona, Barcelona, España.
| | - Mireia Mora
- Servicio de Endocrinología y Nutrición, ICMDM, Hospital Clínic de Barcelona, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Facultad de Medicina, Universidad de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - Irene Halperin
- Servicio de Endocrinología y Nutrición, ICMDM, Hospital Clínic de Barcelona, Barcelona, España
| | - Josep Oriola
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Facultad de Medicina, Universidad de Barcelona, Barcelona, España; Servicio de Bioquímica y Genética Molecular, CDB, Hospital Clínic de Barcelona, Barcelona, España
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Sezer H, Demirkol MO, Yazici D, Kapran Y, Alagöl MF. The clinicopathologic characteristics of familial and sporadic papillary thyroid carcinoma in Turkish patients. Turk J Med Sci 2020; 50:360-368. [PMID: 31999407 PMCID: PMC7164763 DOI: 10.3906/sag-1907-94] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 01/29/2020] [Indexed: 01/05/2023] Open
Abstract
Background/aim The aim of this study is to investigate clinicopathologic features of familial papillary thyroid carcinoma (fPTC) and compare them with sporadic papillary thyroid carcinoma (sPTC) in Turkish patients. A retrospective analysis of the papillary thyroid carcinoma (PTC) cases, with or without family history with a follow-up around 10 years was performed. Materials and methods A series of patients with fPTC (82 fPTC families with 146 affected individuals) were compared with patients with sPTC (n = 112). The clinicopathologic features [(age, gender, histologic subtype, tumour size, bilaterality, multifocality, extrathyroidal extension (ETE), lymph node metastasis (LNM)] and treatment procedures (lymph node dissection, radioactive iodine ablation), and the outcomes like recurrences in the neck region, distant metastasis, and the need for reoperation were compared between the groups. Results When the groups were compared, there was no significant difference in age (P = 0.449), and tumour size (P = 0.898) between familial and sporadic PTC patients. fPTC group had a significantly higher risk of male gender (P=0.001), bilaterality (P = 0.004), multifocality (P = 0.011), LNM (P = 0.013), ETE (P = 0.040), and distant metastasis (P ≤ 0.0001) than the sPTC group. However, recurrence rate was similar between the 2 groups (P = 0.436). Conclusion The results of this study confirms a more aggressive nature in fPTC patients, in terms of bilaterality, multifocality, ETE, LNM, and distant metastasis, compared to sPTC patients in Turkish population.
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Affiliation(s)
- Havva Sezer
- Department of Endocrinology and Metabolism, Faculty of Medicine, Koç University, İstanbul, Turkey
| | - Mehmet Onur Demirkol
- Department of Nuclear Medicine, Faculty of Medicine, Koç University, İstanbul, Turkey
| | - Dilek Yazici
- Department of Endocrinology and Metabolism, Faculty of Medicine, Koç University, İstanbul, Turkey
| | - Yersu Kapran
- Department of Pathology, Faculty of Medicine, Koç University, İstanbul, Turkey
| | - Mahmut Faruk Alagöl
- Department of Endocrinology and Metabolism, Faculty of Medicine, Koç University, İstanbul, Turkey
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