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Xia B, Yu B, Wang X, Ma Y, Liu F, Gong Y, Zou X, Lei J, Su A, Wei T, Zhu J, Lu Q, Li Z. Conspicuousness and recurrence related factors of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules. BMC Surg 2021; 21:317. [PMID: 34344330 PMCID: PMC8336359 DOI: 10.1186/s12893-021-01312-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 07/27/2021] [Indexed: 02/08/2023] Open
Abstract
Objective Microwave ablation (MWA) is a minimally invasive technique for the treatment of benign thyroid nodules. The purpose of this study was to evaluate efficacy and safety of ultrasound-guided MWA in the treatment of benign thyroid nodules, and to find out the recurrence related factors, so as to provide reference for future clinical work. Methods This study retrospectively analyzed the patients who received ultrasound-guided MWA for benign thyroid nodules in our hospital from October 2018 to March 2020. A total of 214 patients were included in the study. We assessed thyroid volume changes (represented by volume reduction ratio VRR), the energy per 1 mL reduction in nodular volume (represented by energy volume ratio ΔE), the serum levels of free triiodide thyroid hormone (FT3), free thyroxine (FT4), thyrotropin (TSH) and complications after MWA treatment. Results There were a total of 306 nodules in 214 patients, including 183 (85.51%) females and 31 (14.49%) males. The median diameter and volume of the nodule were 33 mm and 8.01 mL. The VRR at 1 month, 3 months, 6 months and 12 months were 40.79%, 60.37%, 74.59% and 85.60%, respectively. In addition, MWA had a better ablation effect for small nodules (initial volume ≤ 10 mL). In recurrent studies, we found that ΔE was an independent risk factor for benign thyroid nodules (P < 0.05). Conclusions Ultrasound-guided MWA is effective and safe in the treatment of benign thyroid nodules. In addition, it has little damage to surrounding tissues and no effect on thyroid function. Especially, the nodules with smaller initial volume, the treatment is better. On the other hand, the energy per 1 mL reduction ΔE in nodular volume may be associated with nodular recurrence, which requires further follow-up for longer periods. At this stage, we consider that ultrasound-guided MWA can be used as one of the main clinical treatment methods for benign thyroid nodules.
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Affiliation(s)
- Baoying Xia
- Department of Thyroid, Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Boyang Yu
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaofei Wang
- Department of Thyroid, Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yu Ma
- Department of Thyroid, Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Feng Liu
- Department of Thyroid, Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yanping Gong
- Department of Thyroid, Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiuhe Zou
- Department of Thyroid, Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jianyong Lei
- Department of Thyroid, Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Anping Su
- Department of Thyroid, Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Tao Wei
- Department of Thyroid, Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jingqiang Zhu
- Department of Thyroid, Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qiang Lu
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Zhihui Li
- Department of Thyroid, Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Ertek S. Molecular economy of nature with two thyrotropins from different parts of the pituitary: pars tuberalis thyroid-stimulating hormone and pars distalis thyroid-stimulating hormone. Arch Med Sci 2021; 17:189-195. [PMID: 33488871 PMCID: PMC7811323 DOI: 10.5114/aoms/102476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 01/01/2019] [Indexed: 11/19/2022] Open
Abstract
Thyrotropin (TSH) is classically known to be regulated by negative feedback from thyroid hormones and stimulated by thyrotropin-releasing hormone (TRH) from the hypothalamus. At the end of the 1990s, studies showed that thyrotroph cells from the pars tuberalis (PT) did not have TRH receptors and their TSH regulation was independent from TRH stimulation. Instead, PT-thyrotroph cells were shown to have melatonin-1 (MT-1) receptors and melatonin secretion from the pineal gland stimulates TSH-β subunit formation in PT. Electron microscopy examinations also revealed some important differences between PT and pars distalis (PD) thyrotrophs. PT-TSH also have low bioactivity in the peripheral circulation. Studies showed that they have different glycosylations and PT-TSH forms macro-TSH complexes in the periphery and has a longer half-life. Photoperiodism affects LH levels in animals via decreased melatonin causing increased TSH-β subunit expression and induction of deiodinase-2 (DIO-2) in the brain. Mammals need a light stimulus carried into the suprachiasmatic nucleus (which is a circadian clock) and then transferred to the pineal gland to synthesize melatonin, but birds have deep brain receptors and they are stimulated directly by light stimuli to have increased PT-TSH, without the need for melatonin. Photoperiodic regulations via TSH and DIO 2/3 also have a role in appetite, seasonal immune regulation, food intake and nest-making behaviour in animals. Since humans have no clear seasonal breeding period, such studies as recent ''domestication locus'' studies in poultry are interesting. PT-TSH that works like a neurotransmitter in the brain may become an important target for future studies about humans.
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Affiliation(s)
- Sibel Ertek
- Department of Endocrinology and Metabolic Diseases, Memorial Ankara Hospital, Ankara, Turkey
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Alshoabi SA, Binnuhaid AA. Diagnostic accuracy of ultrasonography versus fine-needle-aspiration cytology for predicting benign thyroid lesions. Pak J Med Sci 2019; 35:630-635. [PMID: 31258566 PMCID: PMC6572947 DOI: 10.12669/pjms.35.3.292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and Objective Thyroid nodules (TNs) are abnormal growths of thyroid cells that form masses within the thyroid gland. TNs are common, and the importance lies in need to exclude thyroid cancer. This study was intended to evaluate the diagnostic accuracy of ultrasonography for differentiating benign from malignant thyroid lesions in comparison with fine-needle aspiration cytology (FNA cytology). Methods This study involved 133 patients with thyroid lesions. All patients underwent thyroid ultrasonography and ultrasound (US)-guided-FNA cytology and results were compared. Results Out of 133 patients included in this study, the mean age was 41.2±15 years, and 113 (85%) were female. Thyroid lesions were benign in 126 cases (94.7%) and malignant in nine cases (5.3%). Among 124 patients with thyroid lesions diagnosed as benign with US, 122 (98.38%) were confirmed to be benign with FNA cytology, and only 2 (1.6%) were proved to be malignant. Among nine patients with thyroid lesions diagnosed as malignant by US, 5 (55.6%) were confirmed to be malignant by FNA cytology, and 4 (44.4%) were proved to be benign. The US diagnosed benign thyroid lesions with a sensitivity, specificity, positive predictive value, and negative predictive value of 98.38%, 71.42%, 98.38%, and 55.55%, respectively. The results revealed strong compatibility between diagnosis of benign thyroid lesions by the US and proved diagnosis by FNA cytology (p<0.001). Conclusion B-mode ultrasonography is a valuable tool in differentiating benign from malignant thyroid lesions. It can almost always predict the benign nature of thyroid lesions with excellent diagnostic accuracy.
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Affiliation(s)
- Sultan Abdulwadoud Alshoabi
- Sultan Abdulwadoud Alshoabi, MBBS, MD, Department of Diagnostic Radiologic Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah, Saudi Arabia
| | - Abdulkhaleq Ayedh Binnuhaid
- Abdulkhaleq Ayedh Binnuhaid, MBBS, MD, Department of Specialized Surgery, Radiology Section, Faculty of Medicine, Hadhramout University, Hadhramout, Republic of Yemen
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Dąbrowska AM, Tarach JS, Kurowska M, Nowakowski A. Thyroid diseases in patients with acromegaly. Arch Med Sci 2014; 10:837-45. [PMID: 25276172 PMCID: PMC4175760 DOI: 10.5114/aoms.2013.36924] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 05/24/2012] [Accepted: 06/14/2012] [Indexed: 01/09/2023] Open
Abstract
Acromegaly often involves the presence of different pathologies of the thyroid gland. Long-lasting stimulation of the follicular epithelium by growth hormone (GH) and insulin-like growth factor 1 (IGF-1) can cause disorders in thyroid function, an increase in its mass and the development of goitre. Acromegalic patients present most frequently with non-toxic multinodular goitre. Nodules are more prevalent in patients with active acromegaly. It has been suggested that then thyroid size increases and it can be reduced through treatment with somatostatin analogues. The relationship between thyroid volume and the level of IGF-1 and the duration of the disease is unclear. Each acromegalic patient requires a hormonal and imaging evaluation of the thyroid when the diagnosis is made, and an accurate evaluation during further observation and treatment. Although the data concerning the co-occurrence of acromegaly and thyroid cancer still remain controversial, it is particularly important to diagnose the patient early and to rule out thyroid cancer.
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Affiliation(s)
| | | | - Maria Kurowska
- Chair and Department of Endocrinology, Medical University of Lublin, Poland
| | - Andrzej Nowakowski
- Chair and Department of Endocrinology, Medical University of Lublin, Poland
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