RESUMEN

OBJECTIVE: This study investigated the significance of serum hypoxia-inducible factor (HIF)-1α/HIF-2 α and Chitinase 3-Like protein 1 (YKL-40) levels in the assessment of vascular invasion and prognostic outcomes in patients with Follicular Thyroid Cancer (FTC). METHODS: This prospective study comprised 83 patients diagnosed with FTC, who were subsequently categorized into a recurrence group (17 cases) and a non-recurrence group (66 cases). The pathological features of tumor vascular invasion were classified. Serum HIF-1α/HIF-2α and YKL-40 were quantified using a dual antibody sandwich enzyme-linked immunosorbent assay, while serum Thyroglobulin (Tg) levels were measured using an electrochemiluminescence immunoassay method. The Spearman test was employed to assess the correlation between serum factors, and the predictive value of diagnostic factors was determined using receiver operating characteristic curve analysis. A Cox proportional hazards regression model was utilized to analyze independent factors influencing prognosis. RESULTS: Serum HIF-1α, HIF-2α, YKL-40, and Tg were elevated in patients exhibiting higher vascular invasion. A significant positive correlation was observed between Tg and HIF-1α, as well as between HIF-1α and YKL-40. The cut-off values for HIF-1α and YKL-40 in predicting recurrence were 48.25 pg/mL and 60.15 ng/mL, respectively. Patients exceeding these cut-off values experienced a lower recurrence-free survival rate. Furthermore, serum levels surpassing the cut-off value, in conjunction with vascular invasion (v2+), were identified as independent risk factors for recurrence in patients with FTC. CONCLUSION: Serum HIF-1α/HIF-2α and YKL-40 levels correlate with vascular invasion in FTC, and the combination of HIF-1α and YKL-40 predicts recurrence in patients with FTC.

Asunto(s)

Adenocarcinoma Folicular , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico , Biomarcadores de Tumor , Proteína 1 Similar a Quitinasa-3 , Subunidad alfa del Factor 1 Inducible por Hipoxia , Invasividad Neoplásica , Valor Predictivo de las Pruebas , Humanos , Proteína 1 Similar a Quitinasa-3/sangre , Femenino , Masculino , Subunidad alfa del Factor 1 Inducible por Hipoxia/sangre , Persona de Mediana Edad , Pronóstico , Adulto , Adenocarcinoma Folicular/sangre , Adenocarcinoma Folicular/patología , Adenocarcinoma Folicular/mortalidad , Estudios Prospectivos , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/sangre , Biomarcadores de Tumor/sangre , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/mortalidad , Anciano , Recurrencia Local de Neoplasia/sangre , Recurrencia Local de Neoplasia/patología , Ensayo de Inmunoadsorción Enzimática , Valores de Referencia , Adulto Joven , Estadísticas no Paramétricas , Curva ROC

RESUMEN

Objective: This study aims to analyze the relationship between papillary thyroid carcinoma (PTC) and various factors. Methods: The study involved two groups-PTC patients and non-PTC controls. We utilized binary logistic regression and Least Absolute Shrinkage and Selection Operator (Lasso) regression for variable selection and risk factor analysis. Correlation analysis was performed using Spearman's rank correlation. The diagnostic value of thyroid stimulating hormone (TSH) levels for PTC was assessed using Receiver Operating Characteristic (ROC) curves. Results: PTC patients exhibited higher body mass index (BMI) (23.71 vs. 22.66, p<0.05) and TSH levels (3.38 vs. 1.59, p<0.05). Urinary iodine concentration (UIC) was an independent predictor of PTC (OR=1.005, p<0.05). The optimal TSH threshold for PTC diagnosis was 2.4 mIU/L [The Area Under the Curve (AUC)=67.3%, specificity=71.4%, sensitivity=70.1%]. TSH levels positively correlated with BMI (r=0.593, p<0.05) and UIC (r=0.737, p<0.05). Conclusions: UIC may be an independent predictor of PTC, and TSH levels have some diagnostic value for identifying PTC.

Asunto(s)

Cáncer Papilar Tiroideo , Pruebas de Función de la Tiroides , Neoplasias de la Tiroides , Tirotropina , Humanos , Masculino , Cáncer Papilar Tiroideo/diagnóstico , Cáncer Papilar Tiroideo/orina , Cáncer Papilar Tiroideo/sangre , Cáncer Papilar Tiroideo/epidemiología , Femenino , Factores de Riesgo , Neoplasias de la Tiroides/epidemiología , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/orina , Adulto , Tirotropina/sangre , Persona de Mediana Edad , Índice de Masa Corporal , Yodo/orina , Glándula Tiroides , Estudios de Casos y Controles , Curva ROC

RESUMEN

PURPOSE: The survival rate of patients with medullary thyroid carcinoma (MTC) who fail to achieve a biochemical cure after surgery is reduced. This study aimed to investigate the prognostic factors affecting the survival of MTC patients who do not achieve a biochemical cure after surgery. METHODS: Cox univariate and multivariate proportional hazard models were used to determine the influence of different variables on overall survival (OS). Pearson's chi-square test was used for categorical variables, and paired t-test was used for continuous variables. RESULTS: In our study of 277 MTC patients treated between 2012 and 2022, there were 96 with raised postoperative 1-month calcitonin (Ct) levels (0-9.52 pg/ml). The overall survival (OS) rates of patients with high postoperative 1-month Ct values at 1, 3, and 5 years were 97.9%, 94.6%, and 86.8%, respectively. The univariate analysis revealed that patients with a postoperative 1-month Ct > 441.9 pg/ml had a greater risk of mortality than patients with postoperative 1-month Ct values ranging from 9.52 to 73.4 pg/ml (p = 0.043). Subsequent analyses revealed that receiving targeted therapy did not improve the OS of patients with distant metastasis among those with high postoperative 1-month Ct values (p = 0.527). CONCLUSION: This study confirmed that MTC patients who did not achieve biochemical remission after surgery had an increased risk of death when the Ct level was > 441.9 pg/ml 1 month after surgery. Additionally, for MTC patients who have not achieved biochemical remission and have experienced disease progression or distant metastasis after surgery, the use of targeted therapy does not prolong survival.

Asunto(s)

Calcitonina , Carcinoma Neuroendocrino , Neoplasias de la Tiroides , Tiroidectomía , Humanos , Neoplasias de la Tiroides/cirugía , Neoplasias de la Tiroides/mortalidad , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/terapia , Masculino , Femenino , Calcitonina/sangre , Persona de Mediana Edad , Carcinoma Neuroendocrino/patología , Carcinoma Neuroendocrino/mortalidad , Carcinoma Neuroendocrino/cirugía , Carcinoma Neuroendocrino/terapia , Tasa de Supervivencia , Pronóstico , Estudios de Seguimiento , Adulto , Estudios Retrospectivos , Anciano , Biomarcadores de Tumor/sangre , Biomarcadores de Tumor/metabolismo , Terapia Molecular Dirigida/métodos , Adulto Joven , Periodo Posoperatorio , Adolescente

RESUMEN

Objective: Levothyroxine (LT4) monotherapy is the current recommended approach for treating pediatric patients post-total thyroidectomy (TT) based on the assumption that peripheral conversion of thyroxine (T4) to triiodothyronine (T3) normalizes thyroid hormone levels. In adults, approximately 15% of post-TT patients on LT4 monotherapy have altered T4:T3 ratios with ongoing debate in regard to the clinical impact with respect to health-related quality of life (hrQOL). The ability to normalize T3 and T4 levels on LT4 monotherapy for pediatric patients' post-TT is important but not previously described. This study reports data on T3 levels in athyreotic pediatric patients to determine if a similar cohort of patients exists on LT4 monotherapy targeting normalization of TSH (LT4 replacement) or suppression (LT4 suppression). Methods: Thyroid function tests (TFTs) were retrospectively extracted from medical charts for patients <19 years old who underwent TT for definitive treatment of Graves' disease (GD) or differentiated thyroid cancer (DTC) between 2010-2021. LT4 dosing was selected to normalize the TSH in GD patients (LT4 replacement) or suppress TSH in DTC patients (LT4 suppression). Pre- and post-surgical TSH, T3 and T4 levels were compared. Results: Of 108 patients on LT4 replacement (n=53) or LT4 suppression (n=55) therapy, 94% (102/108) of patients demonstrated T3 levels in the normal range post-TT. However, the majority of patients on LT4 replacement (44/53; 83%) and LT4 suppression (31/55; 56%) displayed post-TT T3 levels in the lower half of the normal range despite 50% (22/44) and 48% (15/31) of these patients, respectively, having post-TT fT4 levels above the upper limit of the normal range. Conclusion: A significant number of pediatric patients do not achieve similar T3 and T4:T3 levels pre- and post-TT. Future multi-center, prospective studies evaluating LT4 monotherapy in comparison to combined LT4/LT3 therapy are warranted to determine the potential clinical impact of altered T3 levels in athyreotic pediatric patients.

Asunto(s)

Pruebas de Función de la Tiroides , Tiroidectomía , Tiroxina , Triyodotironina , Humanos , Tiroxina/uso terapéutico , Tiroxina/sangre , Tiroxina/administración & dosificación , Triyodotironina/sangre , Masculino , Femenino , Niño , Adolescente , Estudios Retrospectivos , Enfermedad de Graves/tratamiento farmacológico , Enfermedad de Graves/sangre , Enfermedad de Graves/cirugía , Neoplasias de la Tiroides/tratamiento farmacológico , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/cirugía , Tirotropina/sangre , Terapia de Reemplazo de Hormonas/métodos

RESUMEN

PURPOSE: Although the potential association between autoimmune thyroiditis and papillary thyroid cancer (PTC) has been acknowledged, whether the clinicopathological features of PTC will be affected by thyroid autoantibodies remains unknown. PATIENTS AND METHODS: We conducted a case-control study to investigate the association of thyroid autoantibodies with clinicopathological characteristics of PTC in 15,305 patients (including 11,465 females and 3,840 males) from 3 medical centers in the central province of China. Logistic regression and restricted cubic spline models were performed to analyze the association of thyroid autoantibodies with clinicopathological features of PTC. RESULTS: In total, out of the 15,305 patients enrolled in this study, 10,087 (65.9%) had negative thyroid autoantibodies, while 5,218(34.1%) tested positive thyroid autoantibodies. Among these individuals, 1,530(10.0%) showed positivity for TPOAb only, 1,247(8.2%) for TGAb only and a further 2,441(15.9%) exhibited dual positivity for both TPOAb and TGAb combined. Thyroid autoantibodies level demonstrated significant correlations with certain aggressive features in PTC. Specifically, TGAb level displayed a direct correlation to an increased likelihood of multifocality, bilateral tumor, extrathyroidal extension, lymph node metastasis, as well as more than five affected lymph nodes. However, TPOAb level exhibited an inverse association with the risk associated with extrathyroidal extension, lymph node metastasis, and more than five affected lymph nodes. CONCLUSION: Elevated level of TGAb were positively correlated with the risk of aggressive features in PTC, while high level of TPOAb were inversely associated with the risk of extrathyroidal extension and lymph node metastasis.

Asunto(s)

Autoanticuerpos , Neoplasias de la Tiroides , Humanos , Femenino , Estudios de Casos y Controles , Masculino , Autoanticuerpos/inmunología , Autoanticuerpos/sangre , Persona de Mediana Edad , Neoplasias de la Tiroides/inmunología , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/sangre , Adulto , Pronóstico , Estudios de Seguimiento , Cáncer Papilar Tiroideo/inmunología , Cáncer Papilar Tiroideo/patología , Metástasis Linfática , Carcinoma Papilar/inmunología , Carcinoma Papilar/patología , Carcinoma Papilar/sangre , China/epidemiología , Biomarcadores de Tumor/inmunología , Biomarcadores de Tumor/sangre , Adulto Joven , Anciano

RESUMEN

BACKGROUND: Dietary flavonoids may have potential effects on hormone-related cancers (HRCs) due to their anti-cancer properties via regulating hormones and suppressing inflammation and oxidative stress. We aimed to examine the association of flavonoid intake with risks of HRCs and whether this association was mediated by blood biomarkers involved in biological mechanisms. METHODS: This prospective cohort study from UK Biobank included 187,350 participants free of cancer when the last dietary recall was completed. The dietary intakes of flavonoids and subclasses were assessed using 24-hour dietary recalls. Venous blood was collected at baseline and assayed for biomarkers of inflammation, hormones, and oxidative stress. Hazard ratios (HR) and 95 % confidential intervals (CI) for the associations between flavonoid intake and HRCs risk were estimated by the cause-specific Cox proportional hazards model. The role of blood biomarkers in the flavonoids-HRCs association was investigated through mediation analysis. RESULTS: Over a median follow-up of 9.5 years, 3,392 female breast cancer, 417 ovarian cancer, 516 endometrial cancer, 4,305 prostate cancer, 45 testicular cancer, and 146 thyroid cancer cases were documented. Compared to the lowest quintile, multivariable-adjusted HRs (95 % CIs) in the highest quintile of total flavonoid intake were 0.89 (0.80-0.99) for breast cancer, 0.68 (0.50-0.92) for ovarian cancer, and 0.88 (0.80-0.98) for female-specific cancers. For subclasses, intakes of flavonols and anthocyanidins were inversely associated with the risk of female-specific cancers (Ptrend <0.05). Anthocyanidin intake was positively related to prostate cancer risk, whereas isoflavone intake was inversely linked to thyroid cancer risk (Ptrend <0.05). Additionally, certain biomarkers of inflammation, hormones and oxidative stress jointly mediated the association of flavonoid intake with the risk of female-specific cancers and prostate cancer. CONCLUSIONS: Our findings highlighted the importance of dietary flavonoids for the prevention of HRCs in the general population, providing epidemiological evidence for dietary guidelines.

Asunto(s)

Dieta , Flavonoides , Humanos , Femenino , Flavonoides/administración & dosificación , Estudios Prospectivos , Masculino , Persona de Mediana Edad , Anciano , Neoplasias de la Próstata/prevención & control , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/epidemiología , Adulto , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/prevención & control , Neoplasias de la Mama/sangre , Modelos de Riesgos Proporcionales , Neoplasias Ováricas/prevención & control , Neoplasias Ováricas/epidemiología , Neoplasias Ováricas/sangre , Estrés Oxidativo/efectos de los fármacos , Neoplasias de la Tiroides/epidemiología , Neoplasias de la Tiroides/prevención & control , Neoplasias de la Tiroides/sangre , Neoplasias/prevención & control , Neoplasias/epidemiología , Reino Unido/epidemiología , Factores de Riesgo

RESUMEN

This study aimed to investigate the expression of microRNAs (miRNAs) -146b-3p, -221-5p, -222-3p, and -21a-3p and the methylation pattern of the thyroid-stimulating hormone receptor (TSHR) gene in blood plasma samples from papillary thyroid cancer (PTC) patients before and after thyroidectomy compared to healthy controls (HCs). This study included 103 participants, 46 PTC patients and 57 HCs, matched for gender and age. Significantly higher preoperative expression levels of miRNAs and TSHR methylation were determined in the PTC patients compared to HCs. Post-surgery, there was a notable decrease in these biomarkers. Elevated TSHR methylation was linked to larger tumor sizes and lymphovascular invasion, while increased miRNA-222-3p levels correlated with multifocality. Receiver operating characteristic (ROC) analysis showed AUCs below 0.8 for all candidate biomarkers. However, significant changes in the expression of all analyzed miRNAs and TSHR methylation levels indicate their potential to differentiate PTC patients from healthy individuals. These findings suggest that miRNAs and TSHR methylation levels may serve as candidate biomarkers for early diagnosis and monitoring of PTC, with the potential to distinguish PTC patients from healthy individuals. Further research is needed to validate these biomarkers for clinical application.

Asunto(s)

Biomarcadores de Tumor , Metilación de ADN , Regulación Neoplásica de la Expresión Génica , MicroARNs , Receptores de Tirotropina , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides , Humanos , MicroARNs/sangre , MicroARNs/genética , Femenino , Masculino , Cáncer Papilar Tiroideo/genética , Cáncer Papilar Tiroideo/sangre , Cáncer Papilar Tiroideo/diagnóstico , Cáncer Papilar Tiroideo/patología , Persona de Mediana Edad , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/genética , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/patología , Biomarcadores de Tumor/sangre , Biomarcadores de Tumor/genética , Adulto , Receptores de Tirotropina/genética , Estudios de Casos y Controles , Curva ROC

RESUMEN

OBJECTIVE: To investigate the clinical value of blood routine derivative biomarkers and thyroid function biomarkers in differentiating different thyroid diseases. METHODS: The differences of blood routine derived indexes neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), platelet-large cell rate (P-LCR) and thyroid function indexes between benign and malignant thyroid diseases were compared, and the differences of each index between different benign thyroid diseases were further compared. Univariate regression analysis model was used to analyze the clinical value of various indexes. Receiver operating characteristic curve (ROC) was used to calculate the area under the curve (AUC). RESULTS: There were statistically significant differences in PLR, NLR and P-LCR between patients with benign and malignant thyroid diseases (P < 0.05 for each). The results of univariate logistic regression analysis showed that P < 0.05 for all indicators except LMR, when PLR and NLR value increased by 1, the risk of thyroid malignancy decreased by 1 % and 21 %, when P-LCR value increased by 1, the risk of thyroid malignancy increased by 4 %. CONCLUSIONS: PLR, NLR and P-LCR are helpful to distinguish different benign thyroid diseases and to diagnose benign and malignant thyroid diseases.

Asunto(s)

Enfermedades de la Tiroides , Humanos , Femenino , Masculino , Enfermedades de la Tiroides/sangre , Enfermedades de la Tiroides/diagnóstico , Persona de Mediana Edad , Adulto , Recuento de Células Sanguíneas/métodos , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/patología , Curva ROC , Plaquetas/patología , Neutrófilos/patología , Neutrófilos/citología , Estudios Retrospectivos , Anciano , Linfocitos/patología

RESUMEN

INTRODUCTION: The thyroid cancer has the ninth larger incidence of cancer in the world. Investigations related to the exposure to metals have become important due to the sensibility of the thyroid gland to them. Studies reveal that carcinogenic progressions are associated to the deficiency of the essential trace elements. In this context, the zinc is highlighted, essential for the metabolism of the thyroidal hormone and has a potential relation with the pathogenesis of the thyroid cancer. The objective of this systematic review and meta-analysis is to evaluate the low serum zinc as a risk factor for thyroid cancer in adults. METHODS AND ANALYSIS: PubMed/MEDLINE, Scopus, Embase and LILACS databases will be searched for observational studies investigating the low serum zinc as a risk factor for thyroid cancer in adults. No language or publication period restrictions will be imposed. The primary outcome will be that the low serum zinc is a risk factor for thyroid cancer. Three independent reviewers will select the studies and extract data from the original publications. The risk-of-bias will be assessed by using the Newcastle-Ottawa Quality Assessment Scale (NOS). Data synthesis will be performed using the R software (V.4.3.1) and to assess heterogeneity, we will compute the I2 statistic and the results will be based on either random-effects or fixed-effects models, depending on the heterogeneity. The Grading of Recommendations, Development, and Evaluation (GRADE) system will be used to evaluate the reliability and quality of evidence. PROSPERO REGISTRATION NUMBER: International Prospective Register of Systematic Reviews (PROSPERO) CRD42023463747.

Asunto(s)

Neoplasias de la Tiroides , Zinc , Humanos , Metaanálisis como Asunto , Factores de Riesgo , Revisiones Sistemáticas como Asunto , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/epidemiología , Zinc/sangre

RESUMEN

Objectives: To explore the impact of lymph node diameter on the efficacy and safety of ultrasound-guided microwave ablation (MWA) in the treatment of cervical metastatic lymph nodes (CMLNs) from thyroid cancer. Methods: A total of 32 patients with 58 CMLNs from thyroid cancer underwent ultrasound-guided MWA and were included in the retrospective study. Patients were divided into three groups based on the mean largest diameter of the CMLNs: Group A (diameter ≤10mm), Group B (10mm < diameter ≤20mm), and Group C (diameter >20mm). The research involved comparing changes in cervical metastatic lymph nodes and serum thyroglobulin (sTg) levels, as well as the incidence of complications, before and after microwave ablation across three groups of patients. Results: The technical success rate of this study was 100% (32/32), and they showed no major complications. Compared with measurements taken before MWA, the mean largest diameter and volume of CMLNs, as well as the sTg level, showed significant reductions (p <0.05) at the last follow-up in all three patient groups. Group A and B exhibited higher lymph node volume reduction rates and complete disappearance rates compared to Group C. However, the recurrence rate in the three groups were in the following order: Group C > Group B > Group A. The occurrence rate of mild complications was Group A > Group C > Group B. Conclusion: MWA is a safe and effective method for treating CMLNs, with advantages for localized nodes but limitations for larger ones. Careful consideration and personalized plans are advised, based on comprehensive evidence assessment.

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Ganglios Linfáticos , Metástasis Linfática , Microondas , Neoplasias de la Tiroides , Humanos , Femenino , Masculino , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Neoplasias de la Tiroides/sangre , Microondas/uso terapéutico , Persona de Mediana Edad , Estudios Retrospectivos , Ganglios Linfáticos/patología , Ganglios Linfáticos/cirugía , Adulto , Anciano , Resultado del Tratamiento , Estudios de Seguimiento , Técnicas de Ablación/métodos

RESUMEN

BACKGROUND: To analyze the relationship between serum microRNA-221 and microRNA-451 expression and the pathological features and prognosis of patients with thyroid papillary carcinoma. METHODS: Cross-sectional study that included 120 patients with papillary thyroid cancer treated at the hospital and 120 healthy volunteers selected as the control group who underwent physical examination. The relative expression levels of microRNA-221 and microRNA-451 were compared between the thyroid papillary carcinoma group (prior to treatment) and the control group. Additionally, microRNA-221 and microRNA-451 expression levels were analyzed in patients with papillary thyroid carcinoma across different pathological characteristics. RESULTS: Serum microRNA-221 relative levels were significantly higher (p<0.001) in the papillary carcinoma group compared to the control group, while microRNA-451 levels were higher in the control group (p<0.001). In the papillary carcinoma group, microRNA-221 expression was significantly higher in patients with extracapsular invasion (p<0.001), lymphatic metastasis (p=0.003), and poor prognosis (p<0.001). Conversely, microRNA-451 expression was significantly lower (p<0.001) in patients with extracapsular invasion, lymphatic metastasis and poor prognosis. In the multivariate logistic regression analysis, morphological features suggestive of an aggressive clinical behavior (extracapsular invasion and lymphatic metastasis) were related to high expression of microRNA-221 and low expression of microRNA-451 in patients with thyroid papillary carcinoma (p<0.001). CONCLUSIONS: Serum microRNA-221 and microRNA-451 expression levels are significantly higher and lower, respectively, in patients with papillary thyroid carcinoma, particularly in patients with morphological features suggestive of an aggressive clinical behavior (extracapsular invasion and lymphatic metastasis) and, therefore, of a poor prognosis.

Asunto(s)

MicroARNs , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides , Humanos , MicroARNs/sangre , Masculino , Femenino , Cáncer Papilar Tiroideo/genética , Cáncer Papilar Tiroideo/sangre , Cáncer Papilar Tiroideo/patología , Pronóstico , Neoplasias de la Tiroides/genética , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/patología , Persona de Mediana Edad , Estudios Transversales , Adulto , Estudios de Casos y Controles , Anciano , Biomarcadores de Tumor/sangre , Biomarcadores de Tumor/genética , Metástasis Linfática

RESUMEN

As the most common endocrine cancer, thyroid cancer (TC) has sharply increased globally over the past three decades. The growing incidence of TC might be counted by genetics, radiation, iodine, autoimmune disease, and exposure to environmental endocrine-disrupting chemicals (EDCs). Polybrominated diphenyl ethers (PBDEs), being typical EDCs, have been widely utilized in plastics, electronics, furniture, and textiles as flame retardants since the 1980s, and research has indicated a significant correlation between their exposure and the risk of TC. Even so, PBDEs exposure impact on the metabolic signature for TC remains unexplored. In this study, eight congeners of PBDEs were determined in serum from 111 patents with papillary thyroid cancer (PTC) and 111 healthy participants based on case-control epidemiology using gas chromatography-atmospheric pressure chemical ionization-tandem mass spectrometry (GC-APCI-MS/MS). Based on the tertile distribution of total PBDEs concentrations in 59 participants, metabolomics analysis was further performed by ultra-high performance liquid chromatography coupled to hybrid quadrupole-Orbitrap MS. In the partial correlation analysis, the 29 identified metabolites were correlated with PBDEs exposure (P < 0.05). In addition, PBDEs disrupted the metabolism of glycerophospholipids, sphingolipids, taurine, and hypotaurine, indicating that neurotransmitters, oxidative stress, and inflammation are the vulnerable pathways affected in PTC. Furthermore, (±)-octopamine and 5-hydroxyindole, both of which modulate the actions of neurotransmitters, emerged as potential disturbed metabolite markers for TC following exposure to PBDEs. This study analyzed the impact of PBDEs on PTC in terms of the metabolic changes and further explored possible biomarkers, which helped us have a deep understanding of the possible mechanism of the effects of PBDEs on TC.

Asunto(s)

Éteres Difenilos Halogenados , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides , Humanos , Éteres Difenilos Halogenados/sangre , Estudios de Casos y Controles , Femenino , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/inducido químicamente , Masculino , Persona de Mediana Edad , Adulto , Cáncer Papilar Tiroideo/sangre , Contaminantes Ambientales/sangre , Exposición a Riesgos Ambientales , Cromatografía de Gases y Espectrometría de Masas , Anciano

RESUMEN

PURPOSE: Poorly differentiated thyroid carcinoma (PDTC) and anaplastic thyroid carcinoma (ATC) are rare, aggressive thyroid cancers with poor prognosis. At present, there are a limited number of research reports on PDTC and ATC. The study aimed to analysis the predictive value of hematologic parameters and clinicopathological features of PDTC and ATC. METHODS: This study retrospectively analyzed 67 patients at Tianjin Medical University Cancer Hospital from 2007 to 2019. We analyzed the clinicopathological features and survival outcomes of PDTC and ATC. RESULTS: This study showed that positive D-dimer, a high NLR, and a high PLR were more common in death patients. At the end of follow-up, 22 (32.8%) patients were alive at the time of study and 45 (67.2%) patients died from thyroid carcinoma. Disease-related death rates were 93.8% in ATC and 42.9% in the PDTC group. The median overall survival (OS) was 2.5 (0.3-84) months for patients with ATC, and 56 (3-113) months of PDTC patients. Univariate analysis showed that age at diagnosis and surgery were associations with OS in ATC patients, what's more, age at diagnosis, a high NLR, a high PLR, and positive D-dimer were associations with OS in PDTC patients. Multivariate analysis revealed that age at diagnosis was an independent association with OS in ATC patients. CONCLUSIONS: The hematologic parameters and clinicopathological features may provide predictive value of prognosis for patients with PTDC and ATC.

Asunto(s)

Valor Predictivo de las Pruebas , Carcinoma Anaplásico de Tiroides , Neoplasias de la Tiroides , Humanos , Masculino , Femenino , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/mortalidad , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/cirugía , Persona de Mediana Edad , Carcinoma Anaplásico de Tiroides/patología , Carcinoma Anaplásico de Tiroides/mortalidad , Carcinoma Anaplásico de Tiroides/sangre , Estudios Retrospectivos , Anciano , Adulto , Pronóstico , Tasa de Supervivencia , Anciano de 80 o más Años

RESUMEN

Papillary thyroid carcinoma (PTC) is a common endocrine cancer with a good prognosis. Radioactive iodine is thought to be useful for individuals who have had a total or almost total thyroidectomy, but its effects are still controversial. The effects of radioactive iodine-131 (I-131) treatment on oxidative and chromosomal damage in PTC patients were examined in this study, which was carried out with 16 patients newly diagnosed with PTC and 20 healthy control subjects with similar age and gender. Blood samples were taken from patients with PTC at five sampling times (before total thyroidectomy, after total thyroidectomy, and seven days, six months, and one year after treatment) and from control subjects. The cytokinesis block micronucleus cytome (CBMN-cyt) assay parameters in peripheral blood lymphocytes of patients with PTC and controls were evaluated and plasma 8-hydroxydeoxyguanosine (8-OHdG) levels were measured. Furthermore, genome instability and oxidative DNA damage in peripheral blood lymphocytes and plasma of patients with PTC were evaluated before total thyroidectomy (n=16), after total thyroidectomy (before I-131 treatment) (n=16), seven days (n=10), six months (n=5), and one year after treatment (n=5). The numbers of CBMN-cyt assay parameters (micronucleus; MN and nucleoplasmic bridges; NPB) and 8-OHdG levels in patients with PTC were determined to be significantly higher than in those of the control subjects and these values significantly decreased after total thyroidectomy (before I-131 treatment). While the number of MN, apoptotic, and necrotic cells increased after I-131 treatment, it significantly decreased after six months and one year after treatment. The results achieved in this study suggest that I-131 treatment may pose a threat to cells and that radioactive iodine therapy should be avoided (if possible) for patients with PTC after total thyroidectomy.

Asunto(s)

Daño del ADN , Radioisótopos de Yodo , Estrés Oxidativo , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides , Tiroidectomía , Humanos , Radioisótopos de Yodo/uso terapéutico , Radioisótopos de Yodo/efectos adversos , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/radioterapia , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/genética , Femenino , Masculino , Adulto , Persona de Mediana Edad , Cáncer Papilar Tiroideo/sangre , Cáncer Papilar Tiroideo/radioterapia , Estrés Oxidativo/efectos de los fármacos , Pruebas de Micronúcleos , Carcinoma Papilar/sangre , Carcinoma Papilar/patología , Carcinoma Papilar/radioterapia , Carcinoma/radioterapia , Carcinoma/sangre , Carcinoma/genética , Linfocitos/efectos de la radiación , Linfocitos/efectos de los fármacos , 8-Hidroxi-2'-Desoxicoguanosina/sangre , Desoxiguanosina/análogos & derivados , Desoxiguanosina/sangre , Estudios de Casos y Controles , Inestabilidad Genómica

RESUMEN

PURPOSE: Collecting venous blood samples from patients post administration of high therapeutic activities results in radiation exposure to staff collecting the blood. This study investigated the use of finger-tip capillary-blood collection as an alternative to the venous-blood collection method recommended by the European Association of Nuclear Medicine (EANM) dosimetry protocol for quantifying 131I concentration in the critical organ after therapeutic dose of 131I. METHODS: The study included differentiated thyroid cancer patients referred to a thyroid cancer centre at St James's Hospital, Ireland, for therapeutic and diagnostic oral administration of 131I. The 15 patients recruited for this study provided 30 venous and capillary paired-blood samples. The activity concentration of the blood samples was compared between the type of blood (venous vs capillary) and the geometry/volume of the blood (1.0 ml versus 0.03 ml). Other variables were also investigated including administered activities, dose to staff performing the sampling, duration of sampling and time since administration. RESULTS: Blood samples were taken at 2.0-91.9 h post administration using 0.2 ± 0.0 GBq (n = 2) or 4.0 ± 0.1 GBq (n = 28) 131I activities. There was no significant difference found between different blood sampling types (-1.0 ± 4.3 %, p = 0.223), different blood volumes (-3.2 ± 10.0 %, p = 0.070), or between their combination. No significant correlation was found between the percentage differences and investigated parameters. CONCLUSION: A high degree of accuracy was achieved with blood radioactivity quantified using capillary blood collection using the finger-prick method. Further validation of the method would be required prior to implementation, to investigate patient specific factors which may affect accuracy.

Asunto(s)

Recolección de Muestras de Sangre , Radioisótopos de Yodo , Radiometría , Radioisótopos de Yodo/uso terapéutico , Humanos , Recolección de Muestras de Sangre/métodos , Radiometría/métodos , Neoplasias de la Tiroides/radioterapia , Neoplasias de la Tiroides/sangre , Femenino

RESUMEN

BACKGROUND: This paper reports the diagnostic process of a case involving an 86-year-old male patient who was admitted with cough, sputum, and fever, accompanied by persistent leukocytosis. METHODS: Through a multidisciplinary team (MDT) discussion, the laboratory department identified elevated ferritin levels, prompting clinical consideration of potential malignancy. RESULTS: Further investigations confirmed the diagnosis of thyroid cancer with multiple lung metastases. CONCLUSIONS: This case highlights the potential value of ferritin in tumor diagnosis, offering new insights into the etiology of abnormal leukocyte elevation. Additionally, the active involvement of the laboratory department in MDT discussions proves to be crucial for diagnosing challenging cases.

Asunto(s)

Leucocitosis , Humanos , Leucocitosis/diagnóstico , Masculino , Anciano de 80 o más Años , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/sangre , Ferritinas/sangre , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundario , Grupo de Atención al Paciente

RESUMEN

This study aims to evaluate the prognostic significance of thyroid function-related indices in patients with differentiated thyroid cancer (DTC). This retrospective analysis included 90 patients diagnosed with DTC and treated at our hospital from January 2010 to January 2019. Patients were classified into 2 groups based on whole-body imaging results: 67 with a favorable prognosis and 23 with a poor prognosis. The study compared clinical data and thyroid function indices between these groups to assess their efficacy in prognostic prediction. Patients in the poor prognosis group had a higher occurrence of T3-4 stage cancer (P = .006) and ≥2 lymph node metastases (P = .019). Notably, levels of total thyroxine (TT4), thyroid-stimulating hormone (TSH), and thyroglobulin antibody (Tg-Ab) were significantly elevated in this group (P < .001 for each). Receiver operating characteristic analysis revealed substantial predictive accuracy for TT4, TSH, and Tg-Ab (area under curve of 0.747, 0.820, and 0.720, respectively). The columnar graphical model used for prediction demonstrated a high concordance index (C-index = 0.919), superior to single-indicator evaluations. Thyroid function indices, specifically TT4, TSH, and Tg-Ab, play a crucial role in the prognostic assessment of patients with DTC. The column-line diagram model effectively enhances prophetic prediction, aiding in clinical decision-making.

Asunto(s)

Pruebas de Función de la Tiroides , Neoplasias de la Tiroides , Tirotropina , Humanos , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/mortalidad , Neoplasias de la Tiroides/sangre , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Pronóstico , Tirotropina/sangre , Adulto , Tiroxina/sangre , Autoanticuerpos/sangre , Anciano , Curva ROC , Glándula Tiroides/patología , Glándula Tiroides/fisiopatología , Glándula Tiroides/diagnóstico por imagen , Metástasis Linfática , Estadificación de Neoplasias , Tiroglobulina/sangre

RESUMEN

INTRODUCTION: Some epidemiological data suggest that there may be an inverse relationship between cholesterol levels and the risk of thyroid cancer in the overall population. The present study was aimed to evaluate the lipid profile specifically in subjects with Bethesda category IV thyroid nodules, and compare whether there were any differences between those with benign and malignant nodules. METHODS: Single-centre, retrospective study on 204 subjects treated by partial or total thyroidectomy for excision of a Bethesda category IV thyroid nodule, who had undergone a blood lipid profile test in the 12 months prior to surgery. In addition to lipid measures, other demographic, clinical, biochemical and ultrasound data were collected. RESULTS: Seventy-five subjects (36.8%) were diagnosed with thyroid carcinoma in the definitive histopathological examination. Patients with thyroid cancer had lower levels of total cholesterol, LDL-cholesterol and non-HDL-cholesterol than subjects with benign thyroid diseases. There were no differences in HDL-cholesterol, triglycerides or total cholesterol/HDL-cholesterol ratio. There were no differences either between groups in other clinical, biochemical and ultrasound variables, including the use of lipid-lowering drugs. In multivariate analysis, only LDL-cholesterol was independently associated with malignancy. Subjects with follicular carcinoma showed the lowest cholesterol levels, while those with papillary carcinoma had intermediate values between the group with follicular carcinoma and the group with benign thyroid diseases. CONCLUSIONS: In subjects with cytologically indeterminate Bethesda category IV thyroid nodules, levels of total cholesterol, non-HDL-cholesterol and, particularly, LDL-cholesterol are lower among those with malignant nodules.

Asunto(s)

Colesterol , Neoplasias de la Tiroides , Nódulo Tiroideo , Humanos , Nódulo Tiroideo/sangre , Nódulo Tiroideo/patología , Nódulo Tiroideo/cirugía , Masculino , Estudios Retrospectivos , Femenino , Colesterol/sangre , Persona de Mediana Edad , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Adulto , Carcinoma Papilar/sangre , Carcinoma Papilar/patología , Carcinoma Papilar/cirugía , Adenocarcinoma Folicular/sangre , Adenocarcinoma Folicular/patología , Adenocarcinoma Folicular/cirugía , Tiroidectomía , Anciano

RESUMEN

BACKGROUND: Thyroid Imaging Reporting and Data Systems (TIRADSs) have demonstrated high performance in risk stratification of thyroid nodules (TNs). However, further improvements are needed in view of the ongoing project of an international TIRADS. Even if thyroid-stimulating hormone (TSH) measurement is traditionally used to assess the thyroid function, several papers have reported that higher TSH levels are associated with the presence of differentiated thyroid carcinoma (DTC). The present study aimed to investigate the role of TSH levels as improvement factor of American College of Radiology (ACR-), European Thyroid Association (EU-), and Korean Society (K-)TIRADS. METHODS: Patients undergoing thyroidectomy were reviewed and TNs were re-assessed according to TIRADSs. Different TSH subgroups were attained. Histology was the reference standard. DTC risk of relapse was assessed according to American Thyroid Association guidelines. RESULTS: The study series included 97 patients with 39.2% cancer prevalence. ACR-, EU-, and K-TIRADS indicated fine-needle aspiration cytology (FNAC) in 78.9%, 81.6%, and 92.1% of cases, respectively. All high-risk DTC had FNAC indication according to the three TIRADSs. The cancer rate was significantly lower in patients with TSH<0.4 mIU/L (P=0.04). The receiver operating characteristic (ROC) curve analysis showed that the best TSH cut-off to detect DTC patient was >1.3 mIU/L with Area Under the Curve (AUC)=0.70. Combining TSH data with TIRADS, the sensitivity of ACR-, EU-, and K-TIRADS increased to 92.1% 89.5%, and 94.7%, respectively. Conversely, the rate of unnecessary FNAC raised. At multivariate analysis, gender, TSH, and TIRADS were independent predictors of cancer. CONCLUSIONS: Even if TIRADSs are strongly reliable to stratify the risk of malignancy of TNs, measuring TSH can further improve our sensitivity in detecting DTC.

Asunto(s)

Neoplasias de la Tiroides , Nódulo Tiroideo , Tiroidectomía , Tirotropina , Humanos , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Tirotropina/sangre , Masculino , Femenino , Persona de Mediana Edad , Adulto , Nódulo Tiroideo/sangre , Nódulo Tiroideo/patología , Nódulo Tiroideo/diagnóstico , Nódulo Tiroideo/cirugía , Nódulo Tiroideo/diagnóstico por imagen , Biopsia con Aguja Fina , Anciano , Estudios Retrospectivos , Medición de Riesgo/métodos , Sensibilidad y Especificidad

RESUMEN

Lenvatinib (LEN), a multitarget tyrosine kinase inhibitor used in various cancer treatments, is mainly metabolized by cytochrome P450 3A (CYP3A) enzymes. The importance of therapeutic drug monitoring (TDM) in patients administered LEN has been proposed. Although some biomarkers of endogenous CYP3A activity have been reported, their utility in dosage adjustments has not been well evaluated. This study investigated the correlation between plasma LEN concentrations and endogenous urinary CYP3A biomarkers in clinical practice. Concentrations of plasma LEN (N = 225) and CYP3A biomarkers (cortisol, 6ß-hydroxycortisol, deoxycholic acid, and 1ß-hydroxydeoxycholic acid) in urine (N = 214) from 20 patients (hepatocellular carcinoma, N = 6; thyroid cancer, N = 3; endometrial cancer, N = 8; and renal cell carcinoma, N = 3) collected for consultation for up to 1 year were evaluated using liquid chromatography-tandem mass spectrometry. Moreover, plasma trough LEN concentrations were predicted using a three-compartment model with linear elimination for outpatients administered LEN before sample collection. Moderate correlations were observed between the quantified actual concentrations and the predicted trough concentrations of LEN, whereas there was no correlation with endogenous urinary CYP3A biomarkers. The utility of endogenous urinary CYP3A biomarkers could not be determined. However, TDM for outpatients administered orally available medicines may be predicted using a nonlinear mixed effect model (NONMEM). This study investigated the utility of endogenous urinary CYP3A biomarkers for personalized medicine and NONMEM for predicting plasma trough drug concentrations. These findings will provide important information for further clinical investigation and detailed TDM.

Asunto(s)

Biomarcadores , Citocromo P-450 CYP3A , Monitoreo de Drogas , Compuestos de Fenilurea , Quinolinas , Humanos , Compuestos de Fenilurea/orina , Compuestos de Fenilurea/farmacocinética , Compuestos de Fenilurea/sangre , Compuestos de Fenilurea/uso terapéutico , Compuestos de Fenilurea/administración & dosificación , Femenino , Quinolinas/orina , Quinolinas/uso terapéutico , Quinolinas/sangre , Quinolinas/administración & dosificación , Quinolinas/farmacocinética , Citocromo P-450 CYP3A/metabolismo , Anciano , Persona de Mediana Edad , Masculino , Biomarcadores/orina , Biomarcadores/sangre , Monitoreo de Drogas/métodos , Adulto , Anciano de 80 o más Años , Antineoplásicos/orina , Antineoplásicos/uso terapéutico , Antineoplásicos/sangre , Antineoplásicos/farmacocinética , Inhibidores de Proteínas Quinasas/orina , Inhibidores de Proteínas Quinasas/sangre , Inhibidores de Proteínas Quinasas/uso terapéutico , Inhibidores de Proteínas Quinasas/farmacocinética , Inhibidores de Proteínas Quinasas/administración & dosificación , Neoplasias/tratamiento farmacológico , Neoplasias/sangre , Neoplasias/orina , Espectrometría de Masas en Tándem/métodos , Neoplasias Endometriales/tratamiento farmacológico , Neoplasias Endometriales/orina , Neoplasias Endometriales/sangre , Carcinoma Hepatocelular/tratamiento farmacológico , Carcinoma Hepatocelular/sangre , Carcinoma Hepatocelular/orina , Cromatografía Liquida/métodos , Neoplasias de la Tiroides/tratamiento farmacológico , Neoplasias de la Tiroides/orina , Neoplasias de la Tiroides/sangre , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/sangre , Neoplasias Hepáticas/orina , Carcinoma de Células Renales/tratamiento farmacológico , Carcinoma de Células Renales/orina , Carcinoma de Células Renales/sangre