Patient-reported oral function and psychological well-being outcomes of papillary thyroid cancer patients (PTC) after surgery: a cross-sectional study.

BACKGROUND: This study was performed to evaluate the differences in oral function and psychological well-being between patients with PTC after the gasless transoral endoscopic thyroidectomy vestibular approach (gasless-TOETVA) and patients with PTC after open surgery. METHODS: PTC patients who underwent radical surgery from May 2021 to August 2022 were included in this study. Postoperative data on oral function and psychological well-being, including the Oral Health Impact profile-14 (OHIP-14) and State-Trait Anxiety Inventory Form Y, were collected and analyzed. RESULTS: 212 patients were included in the analysis. Among them, 102 patients who received gasless-TOETVA were assigned to the gasless-TOETVA group, while the remaining 110 patients who underwent open surgery were categorized as the open group. Although the OHIP-14 score in the gasless-TOETVA group was higher than that of the open group from 6 months to 1 year after surgery (p = 0.012), the difference in OHIP-14 scores between the two groups disappeared 1 year after surgery (p = 0.155). There were no differences between the gasless-TOETVA group and the open group in state-anxiety scores. However, the gasless-TOETVA group had significantly lower trait-anxiety scores than the open group at all follow-up time periods. Furthermore, within the gasless-TOETVA group, patients who were more than 1 year post-surgery showed significantly increased trait-anxiety scores compared to those of patients who were less than 1 year post-surgery (Δ = 3.4; p = 0.032). In contrast, the open group showed a decreasing trend in trait-anxiety scores, but there was no statistically significant difference between patients who had surgery less than 1 year ago and those who had surgery more than 1 year ago (Δ = - 2.2; p = 0.094). CONCLUSION: Gasless TOETVA had a temporary impact on oral function, but it did not alleviate the state of anxiety. Furthermore, we observed a significant increase in trait-anxiety scores among PTC patients who underwent gasless-TOETVA after 1 year.

Cucurbitacin E elicits apoptosis in laryngeal squamous cell carcinoma by enhancing reactive oxygen species-regulated mitochondrial dysfunction and endoplasmic reticulum stress.

Laryngeal squamous cell carcinoma (LSCC) is a prevalent head and neck neoplasm with escalating global morbidity and mortality rates. Despite the increasing burden of LSCC, the drugs currently approved for its treatment are limited. Therefore, it is necessary to identify novel and promising drugs that target LSCC. Cucurbitacin E (CuE) is a naturally oxygenated tetracyclic triterpenoid that suppresses several cancers. However, its anti-LSCC activity and the molecular mechanisms of action remain unclear. This study explored its impact on LSCC, revealing cell viability attenuation and apoptosis enhancement in vitro. Further investigations indicated that CuE significantly decreased mitochondrial membrane potential, thereby promoting cytochrome c release, increasing cleaved-Caspase 3 and cleaved-PARP levels, and triggering mitochondria-dependent apoptosis. Concurrently, exposure of LSCC cells to CuE enhanced endoplasmic reticulum (ER) stress, mobilized the protein kinase RNA-like endoplasmic reticulum kinase/initiation factor 2a/ATF4/C-EBP homologous protein pathway, and induced LSCC cell apoptosis. Finally, CuE markedly elevated intracellular reactive oxygen species (ROS) levels. When ROS were eliminated with N-acetylcysteine, CuE-mediated mitochondrial dysfunction, ER stress, and cell apoptosis were nearly abolished. Similar outcomes were observed in murine LSCC models. Together, these results highlight that CuE suppresses proliferation while triggering apoptosis in LSCC cells via ROS-regulated mitochondrial dysfunction and the ER stress pathway. Hence, CuE may serve as a promising candidate for LCSS treatment.

Synergistic induction of autophagy in gastric cancer by targeting CDK4/6 and MEK through AMPK/mTOR pathway.

KRAS is a commonly mutated oncogene in human gastric cancer and is often associated with drug resistance and poor prognosis. Co-clinical trial of combined MEK-CDK4/6 inhibition in KRAS mutated cancers demonstrated therapeutic efficacy in patient-derived xenografts and safety in patients. Here, present research focuses on targeting CDK4/6 and MEK synergistically block the proliferation of KRAS-mutated gastric cancer cells in vitro and in vivo and induced autophagy through the AMPK/mTOR pathway. Furthermore, autophagy inhibitor combined with targeting CDK4/6 and MEK therapy had significant antitumor effects on KRAS mutant gastric cancer cells. Clinical trials are needed to determine the mechanism behind this finding and its clinical utility. In conclusion, our results demonstrate autophagy inhibitor combined targeting MEK and CDK4/6 that concurrently block multiple metabolic processes may be an effective therapeutic approach for gastric cancer.

The new progress in cancer immunotherapy.

The cross talk between immune and non-immune cells in the tumor microenvironment leads to immunosuppression, which promotes tumor growth and survival. Immunotherapy is an advanced treatment that boosts humoral and cellular immunity rather than using chemotherapy or radiation-based strategy associated with non-specific targets and toxic effects on normal cells. Immune checkpoint inhibitors and T cell-based immunotherapy have already exhibited significant effects against solid tumors and leukemia. Tumor cells that escape immune surveillance create a major obstacle to acquiring an effective immune response in cancer patients. Tremendous progress had been made in recent years on a wide range of innate and adaptive immune checkpoints which play a significant role to prevent tumorigenesis, and might therefore be potential targets to suppress tumor cells growth. This review aimed to summarize the underlying molecular mechanisms of existing immunotherapy approaches including T cell and NK-derived immune checkpoint therapy, as well as other intrinsic and phagocytosis checkpoints. Together, these insights will pave the way for new innate and adaptive immunomodulatory targets for the development of highly effective new therapy in the future.

En bloc resection of total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach in papillary thyroid carcinoma.

Introduction: The current study presents a preliminary exploration of en bloc resection via a gasless transoral approach in papillary thyroid carcinoma. Objective: This study aimed to summarize and explore the efficacy and safety of en bloc resection of total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach in patients with papillary thyroid carcinoma. Methods: This study was conducted between January 2021 and December 2021. It involved 30 patients with bilateral papillary thyroid carcinoma who had undergone en bloc resection of the total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach using a three-trocar and four-instrument technique at The First Affiliated Hospital of the University of Science and Technology of China. The key steps and difficulties of the operation were summarized, and the clinicopathological characteristics and surgical complications of patients were analyzed. Results: All operations were successful without conversion to open surgery. The pathological diagnosis was bilateral papillary thyroid carcinoma. The mean maximum tumor diameter was 0.85 ± 0.51 cm (range 0.3-2.5 cm). There was no case of gross capsular invasion. The mean number of harvested central compartment lymph nodes was 11.36 ± 5.36. Central compartment lymph node metastases were found in 16 patients (53.3%) with a mean of 1.53 ± 2.39. On the other hand, lymphocytic thyroiditis was observed in 12 cases (40%), and microscopic capsular invasion was observed in five cases (16.6%). All patients had normal parathyroid hormone levels after the operation. However, one patient developed hoarseness after the operation due to injury of the recurrent laryngeal nerve branch, but there was no numbness of the mandible and lower lip or infection of the oral incision. Conclusion: The study revealed that the three-trocar and four-instrument technique can be used in the en bloc resection of total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach without disconnecting the thyroid isthmus. As a result, the operation is considered effective and safe. Therefore, this technique may be a better surgical method for patients with bilateral thyroid cancer and cosmetic needs.

Efficacy and safety of anlotinib-based chemotherapy for locally advanced or metastatic anaplastic thyroid carcinoma.

PURPOSE: Anaplastic thyroid carcinoma (ATC) is one of the most lethal malignancies with no effective treatment. In this study, we investigated the efficacy and safety of anlotinib-based chemotherapy as first-line therapy for ATC. METHODS: Locally advanced or metastatic (LA/M) ATC patients who never received antitumor treatment of any sort were eligible for this study. The patients received 2-6 cycles anlotinib12mg on days 1-14 per 21 days. Chemotherapy regimens consisted of paclitaxel, capecitabine, or paclitaxel plus carboplatin/capecitabine. The end points including Objective Response Rate (ORR), Disease Control Rate (DCR), Progression-Free Survival (PFS), and Disease Specification Survival (DCS) were analyzed. RESULTS: A total of 25 patients were enrolled. 1 patient achieved a Complete Response (CR) and 14 patients achieved Partial Response (PR). The best ORR was 60.0%, and the DCR was 88.0%. The median PFS was 25.1 weeks, and the median DCS was 96.0 weeks. Approximately 56% (14 patients) had at least one Adverse Event (AE) of any grade. Most AEs were well tolerated. The most common AEs was palmar-plantar erythrodysesthesia syndrome (28.0%). CONCLUSIONS: Anlotinib-based chemotherapy as first-line therapy is a safe and effective intervention for the treatment of LA/M ATC patients.

Case Report: Acute cerebral infarction caused by left atrial and right ventricular myxoma received emergency operation.

Cardiac myxoma is a rare etiology of ischemic stroke, especially in young people. We report a case of multiple myxomas in left atrium and right ventricle inducing acute cerebral infarction. No significant abnormalities were detected in the patient's preoperative laboratory examination. Following emergency surgery, the patient's prognosis was satisfactory, providing valuable empirical insight for the surgical management of acute cerebral infarction in individuals diagnosed with cardiac myxoma. Our objective is to heighten awareness regarding the evaluation and treatment of patients with acute cerebral infarction subsequent to early diagnosis of cardiac myxoma.

Effects of fear of cancer recurrence on subjective physical and mental health in breast cancer patients: The intermediary role of heart rate variability.

BACKGROUND: Fear of cancer recurrence (FCR) and psychological distress are common psychological problems in breast cancer (BC) patients and ultimately affecting their health-related quality of life (HRQoL). Heart rate variability (HRV) can reflect the activity of the parasympathetic nervous system. However, the pathways through which HRV influences between FCR and HRQoL are unclear. This study preliminarily explored the intermediary role of HRV in FCR and HRQoL in BC patients. METHODS: A total of 101 BC patients participated in this study. HRV parameters were measured by a 5-min dynamic electrocardiogram. FCR, psychological distress and HRQoL were evaluated by the Fear of disease progression simplified scale (FOP-Q-SF), Distress thermometer and SF-36 concise health survey. The intermediary effect model was established to test the intermediary effect of high frequency-HRV (HF-HRV) on FCR and HRQoL. RESULTS: FCR and psychological distress were negatively correlated with HRV in the time domain, negatively correlated with HF-HRV in the frequency domain, and positively correlated with low frequency/high frequency (LF/HF). HF-HRV had a partial mediating effect on the FCR and physical health and mental health, with effects of 30.23% and 9.53%, respectively. CONCLUSION: FCR and psychological distress are correlated with HRV parameters in the time domain and the frequency domain, and we preliminarily believe that parasympathetic nerves play an important intermediary role between FCR and subjective physical and mental health. This may provide intervention information for improving the HRQoL of BC patients.

FTO mediated ERBB2 demethylation promotes tumor progression in esophageal squamous cell carcinoma cells.

N6-methyladenosine (m6A) is the most prevalent and internal modification that occurs in the messenger RNAs of eukaryotes. However, knowledge of the impact of these modifications on gene expression regulation remains limited. By using the in vitro MeRIP-seq and RNA-seq assays, we discovered that the mRNA demethylase FTO was significantly up-regulated in esophageal squamous cell carcinoma (ESCC) tissues and cells. Knockdown of FTO drastically suppressed the proliferation, migration, and invasion of ESCC cells. Furthermore, by using transcriptome-wide m6A-seq and RNA-seq assays, we identified ERBB2 is the target of FTO, which acts in concert in ESCC tumorigenesis and metastasis. Moreover, loss and gain functional studies suggested that the m6A reader YTHDF1 stabilizes ERBB2 mRNA via decoding the m6A modification. All these results uncovered a new signaling cascade, including FTO, YTHDF1, and ERBB2, which finely regulates the ESCC progression.

Corrigendum: Novel Trocars and Suspension System Applicated in Gasless Transoral Endoscopic Thyroidectomy Vestibular Approach Oral Endoscopic Surgery.

[This corrects the article DOI: 10.3389/fonc.2021.694133.].

Novel Trocars and Suspension System Application in Gasless Transoral Endoscopic Thyroidectomy Vestibular Approach Oral Endoscopic Surgery.

In the current study, we reported our initial experience of gasless transoral endoscopic thyroidectomy vestibular approach (TOETVA) by novel trocars and a suspension system. Between February 2019 to September 2020, thyroid cancer patients with indicated central lymph node metastasis by imaging examination who had received gasless TOETVA by our designed trocars and suspension system in The First Affiliated Hospital of University of Science and Technology of China were reviewed. A total of 95 thyroid cancer patients that received gasless TOETVA were included in this analysis. Of note, 73 cases underwent one-sided lobectomy and the remaining 22 cases underwent total thyroidectomy. All thyroid cancer patients underwent central lymph node dissection (CND). The average total examined lymph nodes number was 8.55 ± 5.67 per individual. No serious complications occurred during or after the operation besides one patient who had a short-term recurrent laryngeal nerve (RLN) deficit and one patient who had delayed postoperative bleeding. In conclusion, the use of novel trocars and a suspension system can effectively improve the safety and efficacy of TOETVA.

Knockdown of eIF3a attenuated cell growth in K1 human thyroid cancer cells.

BACKGROUND: In ribosome establishment and the initiation of translation, eukaryotic translation initiation factor (eIF) 3a is a pivotal functional subunit of the eIF3 complex. In various cancer types, abnormal eIF3a expression plays an important role in tumorigenesis. OBJECTIVE: We aimed to explore the role of eIF3a in human thyroid cancer (TC). MATERIAL AND METHODS: The expression of eIF3a was determined in TC tissues by qRT-PCR and immunohistochemistry (IHC) assay, respectively. In addition, the expression of eIF3a in K1 and BCPAP cells were detected by qRT-PCR. Cell proliferation, cell cycle, and cell apoptosis were assessed after eIF3a knockdown in K1 in cell line. RESULTS: The expression of eIF3a mRNA was high in TC tissues and cancer cell lines. Moreover, eIF3a expression in TC tissues indicated that high eIF3a level was associated with tumor grade. In addition, eIF3a knockdown resulted in a significantly decrease in cell proliferation and increased the apoptosis of K1 cells. Cell cycle was arrested in both the S and G2/M phase. The levels of phosphorylated ERK1/2 and surviving were decreased after eIF3a knockdown. CONCLUSION: Our study suggested that eIF3a contributed to TC cell proliferation. It may be a promising target for gene therapy in human thyroid cancer.

Isolation and Detection of Murine iNKT Cells in Different Organs.

The invariant NKT (iNKT) cells are innate-like lymphocytes that share phenotypic and functional characteristics with NK cells and T cells, playing an important role in both human and mouse physiology and disease and bridging the gap between the innate and adaptive immune responses. The frequency and subtypes of iNKT cells in major immune organs are different, which also determines the regional immune characteristics of iNKT cells. Here, we report a protocol about the isolation of iNKT cells in the thymus, spleen, and liver of C57BL/6, CD1d-/-, and Jα18-/- mice.

Pulling-Force Spinning Top for Serum Separation Combined with Paper-Based Microfluidic Devices in COVID-19 ELISA Diagnosis.

The spread of Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), resulting in a global pandemic with around four million deaths. Although there are a variety of nucleic acid-based tests for detecting SARS-CoV-2, these methods have a relatively high cost and require expensive supporting equipment. To overcome these limitations and improve the efficiency of SARS-CoV-2 diagnosis, we developed a microfluidic platform that collected serum by a pulling-force spinning top and paper-based microfluidic enzyme-linked immunosorbent assay (ELISA) for quantitative IgA/IgM/IgG measurements in an instrument-free way. We further validated the paper-based microfluidic ELISA analysis of SARS-CoV-2 receptor-binding domain (RBD)-specific IgA/IgM/IgG antibodies from human blood samples as a good measurement with higher sensitivity compared with traditional IgM/IgG detection (99.7% vs 95.6%) for early illness onset patients. In conclusion, we provide an alternative solution for the diagnosis of SARS-CoV-2 in a portable manner by this smart integration of pulling-force spinning top and paper-based microfluidic immunoassay.

BRD4 modulates vulnerability of triple-negative breast cancer to targeting of integrin-dependent signaling pathways.

PURPOSE: Stemming from a myriad of genetic and epigenetic alterations, triple-negative breast cancer (TNBC) is tied to poor clinical outcomes and aspires for individualized therapies. Here we investigated the therapeutic potential of co-inhibiting integrin-dependent signaling pathway and BRD4, a transcriptional and epigenetic mediator, for TNBC. METHODS: Two independent patient cohorts were subjected to bioinformatic and IHC examination for clinical association of candidate cancer drivers. The efficacy and biological bases for co-targeting these drivers were interrogated using cancer cell lines, a protein kinase array, chemical inhibitors, RNAi/CRISPR/Cas9 approaches, and a 4 T1-Balb/c xenograft model. RESULTS: We found that amplification of the chromosome 8q24 region occurred in nearly 20% of TNBC tumors, and that it coincided with co-upregulation or amplification of c-Myc and FAK, a key effector of integrin-dependent signaling. This co-upregulation at the mRNA or protein level correlated with a poor patient survival (p < 0.0109 or p < 0.0402, respectively). Furthermore, we found that 14 TNBC cell lines exhibited high vulnerabilities to the combination of JQ1 and VS-6063, potent pharmacological antagonists of the BRD4/c-Myc and integrin/FAK-dependent pathways, respectively. We also observed a cooperative inhibitory effect of JQ1 and VS-6063 on tumor growth and infiltration of Ly6G+ myeloid-derived suppressor cells in vivo. Finally, we found that JQ1 and VS-6063 cooperatively induced apoptotic cell death by altering XIAP, Bcl2/Bcl-xl and Bim levels, impairing c-Src/p130Cas-, PI3K/Akt- and RelA-associated signaling, and were linked to EMT-inducing transcription factor Snail- and Slug-dependent regulation. CONCLUSION: Based on our results, we conclude that the BRD4/c-Myc- and integrin/FAK-dependent pathways act in concert to promote breast cancer cell survival and poor clinical outcomes. As such, they represent promising targets for a synthetic lethal-type of therapy against TNBC.

Usefulness of Lateral Thoracic Adipofascial Flaps After Breast-conserving Surgery in Small-to Moderate-sized Breasts.

BACKGROUND: Women with small- to moderate-sized breasts present a specific challenge to performing oncoplastic volume-displacement techniques for reconstructing breast defects after breast-conserving surgery (BCS). In such cases, the lateral thoracic wall region serves as a versatile reconstruction donor site. Therefore, in the present study, we aimed to investigate the effectiveness and feasibility of employing lateral thoracic adipofascial (LTA) flaps to reconstruct breast defects following BCS. PATIENTS AND METHODS: A total of 58 female patients who underwent BCS between February 2016 and April 2017 were analyzed. Of these, 33 patients were reconstructed with LTA flaps, and the other 25 patients received BCS only and were assigned as the control group. All patients were followed up, and we assessed surgery-related complications, breast appearance, and disease recurrence. RESULTS: The mean weight of the resected breast tissue was 65.9 g (range, 35-100 g). The mean volume of LTA flaps was 309.5 cm3 (range, 112.6-588 cm3). This oncoplastic technique was performed with minimal complications in all patients. Two patients exhibited partial adipose liquefaction (6.1%), and 2 patients manifested wound infections. CONCLUSIONS: The LTA flaps were reliable and useful for reconstructing breast defects after BCS when the resected volume was confined to between 50 and 100 g, particularly in patients with small- to moderate-sized breasts. This is optimal for patients with lesions located in the upper-outer quadrant.

Fasting serum glucose, thyroid-stimulating hormone, and thyroid hormones and risk of papillary thyroid cancer: A case-control study.

BACKGROUND: This study was to investigate the association of fasting serum glucose (FSG), thyroid-stimulating hormone (TSH), and thyroid hormones with papillary thyroid cancer (PTC). METHODS: A total of 649 participants were included in this case-control study. The associations of FSG, TSH, free triiodothyronine (FT3) and free thyroxine (FT4) with PTC were estimated using an unconditional logistic regression. RESULTS: Compared with the lowest quintile of TSH levels, odds ratios (ORs) and 95% confidence intervals (CIs) for association between PTC risk and highest quintile of TSH levels were 1.67 (95% CI, 0.99-2.83). However, this risk correlation was more significant in PTC cases with ≤1.0 cm tumor size (adjusted OR, 1.95; 95% CI, 1.08-3.54; adjusted P-trend, 0.05). The PTC risk was also inversely associated with the serum FT3 level in all participants (adjusted P-trend, 0.001), but positively associated with the serum FT4 (adjusted P-trend, 0.001) and FSG (adjusted P-trend, 0.01) levels. Among the participants without diabetes, the individuals with high FSG levels and abnormal TSH concentration had an increased PTC risk (adjusted OR, 3.38; 95% CI, 1.78-6.42). CONCLUSION: The current study provides evidence for the association of FSG, TSH, and thyroid hormones (FT3 and FT4) with PTC risk. However, larger relative studies are needed.

A novel polysaccharide from Rhizoma panacis japonica exerts anti-inflammatory effects via STAT3 signal pathway.

We report a novel water-soluble polysaccharide from Rhizoma panacis japonica, namely, PJ-1 with anti-inflammatory activity. We first obtained a polysaccharide from this herb by eluting with water. After fully characterizing PJ-1 with a series of chromatographic technologies, we evaluated its biological activity by stimulating Raw 264.7 cells to express inflammatory cytokines and found that PJ-1 effectively enhanced the production of anti-inflammatory factors such as IL-10. We further identified its anti-inflammatory effect in a mouse model of sepsis induced by a lipopolysaccharide. The treatment of PJ-1 evidently suppressed the secretion of major inflammatory cytokines and increased the survival rate of mice. Particularly, we verified the STAT3 signal pathway responsible for the anti-inflammatory activity. Thus, PJ-1, which has remarkable anti-inflammatory effect and mechanism of action, may be a promising candidate as an anti-inflammatory agent.

Clinical behaviors of rare variants of papillary thyroid carcinoma are associated with survival: a population-level analysis.

OBJECTIVE: This study was to evaluate the risk factors of survival in patients with columnar cell variant (CCV) and encapsulated variant (ECV). MATERIALS AND METHODS: The Surveillance, Epidemiology, and End Results database (1988-2013) was used to compare the characteristics of CCV and ECV with those of classic papillary thyroid carcinoma (PTC). Survival was analyzed by the Kaplan-Meier method, the log-rank test, and Cox multivariate regression. Multivariate logistic regression was used to further analyze lymph node metastases and distant metastasis. There were 765 CCV, 529 ECV, and 39,035 PTC patients. ECV tumors were similar to PTC in terms of overall survival, disease-specific survival, age, sex, and distant metastasis. RESULTS: Compared with PTC, CCV tumors tended to be larger, with a higher incidence rate among males and in patients ≥65 years of age. CCV was associated with higher rates of extrathyroidal extension, multifocality, lymph node examinations, and lymph node and distant metastases (p<0.0001). Significant differences were found in 10-year overall survival (97.14% vs 89.15%, p<0.0001) and disease-specific survival (99.08% vs 93.07%, p<0.0001) between PTC and CCV. In CCV, distant metastasis (hazard ratio 5.125, p<0.0001) and lymph nodal metastasis (hazard ratio 2.152, p=0.032) predicted a poor prognosis. After adjustment, distant metastasis was independently associated with age ≥65 years, and lymph nodal metastasis was independently associated with female sex (odds ratio [OR] 0.341 [0.234-0.496]), extrathyroidal extension (OR 2.453 [1.368-4.397]), multifocality (OR 2.168 [1.318-3.569]), size >20 mm, ≤40 mm (OR 1.851 [1.170-2.928]), and size >40 mm (OR 1.847 [1.088-3.136]). CONCLUSION: ECV appears to have a similar prognosis to PTC, while CCV has a worse prognosis than classic PTC. Treatment with external beam radiotherapy and radioactive implants should be conducted carefully in patients with CCV.

MiRNA-221/222 in thyroid cancer: A meta-analysis.

OBJECTIVES: A meta-analysis was performed to observe whether a difference in miRNA-221/222 expression exists in thyroid cancer with normal thyroid or BTLs (benign thyroid lesions) and, under this premise, assess its diagnostic efficacy for thyroid cancer. METHODS: Systematic electronic literature searches were conducted to include PubMed, the Cochrane Central Register of Controlled Trials, and Web of Science. The combined fold change (FC) was calculated, and pooled estimates of sensitivity, specificity, diagnostic odds ratio (DOR) and summary receiver operating characteristic (SROC) curves were calculated. RESULTS: Twenty-seven articles were included in this meta-analysis. The combined FC of miRNA-221/222 were 13.85 and 13.75 in thyroid cancer with normal control. For miRNA-221/222, the pooled sensitivity was 0.79 (95% CI = 0.73-0.85), specificity was 0.84 (95% CI = 0.76-0.90) and AUC (area under the curve) value was 0.88 (0.85-0.91). For miRNA-221, the pooled sensitivity was 0.82 (95% CI = 0.76-0.86) and specificity was 0.84 (95%CI = 0.74-0.91). For miRNA-222, the pooled sensitivity was 0.78 (95%CI = 0.68-0.85) and specificity was 0.83 (95% CI = 0.70-0.92). CONCLUSION: Differences in expression levels of miRNA-221/222 can provide clues for exploring the etiology of thyroid cancer. In addition, miRNA-221/222 were promising molecular biomarkers that may significantly improve the diagnostic accuracy of thyroid cancer.