Lateral lymph node metastasis in papillary thyroid cancer: Is there a difference between PTC and PTMC?

Papillary thyroid carcinoma (PTC) and papillary thyroid microcarcinoma (PTMC) are generally characterized as less invasive forms of thyroid cancer with favorable prognosis. However, once lateral cervical lymph node metastasis takes place, the prognosis may be significantly impacted. The purpose of this study was to evaluate whether there is a difference in the pattern of lateral lymph node metastasis between PTC and PTMC. A retrospective analysis was performed for PTC and PTMC patients that underwent central area dissection and unilateral lateral neck lymph node dissection (II-V area) between January 2020 and December 2021. Compared with PTMC group, the PTC group exhibited higher incidence of capsule invasion, extrathyroid invasion and lymphatic vessel invasion. Both the number and rate of central lymph nodes metastasis were elevated in the PTC group. While the number of lateral cervical lymph node metastasis was higher, the metastasis rate did not demonstrate significant difference. No significant differences were identified in the lymph node metastasis patterns between the 2 groups. The determination of the extent of lateral neck lymph node dissection solely based on the tumor size may be unreliable, as PTC and PTMC showed no difference in the number and pattern of lateral neck metastasis. Additional clinical data are warranted to reinforce this conclusion. For patients categorized as unilateral, bilateral, or contralateral cervical lymph node metastasis (including level I, II, III, IV, or V) or retropharyngeal lymph node metastasis who require unilateral lateral neck dissection, the size of the primary tumor may not need to be a central consideration when assessing and deciding the extent of lateral neck dissection.

Analysis of the influence factors of cervical lymph node metastasis in Papillary thyroid carcinoma: A retrospective observational study.

Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, and surgery is crucial for curing PTC. PTC patients often experience lymph node metastasis (LNM) in the neck, and central lymph node metastasis (CLNM) significantly affects the recurrence rate of PTC. Therefore, the thoroughness of the surgery is particularly important for the treatment of PTC. However, there is still controversy regarding the choice of surgical approach. This study retrospectively analyzed the clinical data of 69 PTC patients treated at our hospital from December 2019 to April 2022 and clinically analyzed the high-risk factors for neck LNM. In this study, the patients aged ≤ 55 years were examined in which the number of patients with CLNM were 42 cases (80.77%), tumor diameter >2 cm were 15 cases (100%), the multifocal carcinoma were 38 cases (88.37%) and the involvement of membrane were 38 cases (80.85%), the number of patients whose had lateral cervical lymph node metastasis (LLNM), respectively 43 cases (82.69%), 14 cases (93.33%), 39 cases (90.7%) and 40 cases (85.11%),all of these factors were associated with cervical LNM (P < .05), but was not correlation with sex, double lobe carcinoma, extra glandular invasion and hashimoto (P > .05). The patient's age and number of cancers were independent risk factors for LNM in the central region of the neck (P < .05), while the patient's age, tumor size and number of cancers were significant risk factors for LNM in the lateral cervical region (P < .05). We concluded that cervical LNM was related with the high-risk factors of patient's age, tumor size, multifocal carcinoma in PTC. Especially, modified radical cervical dissection or selective cervical dissection was suggested in the PTC patients who were younger than 42.5 years old, with tumor diameter larger than 2 cm and multifocal carcinoma.

Endoscopic total parathyroidectomy via anterior chest approach with forearm autotransplantation for secondary hyperparathyroidism: a comparison of surgical results with open total parathyroidectomy with autotransplantation.

Objective: This paper aimed to evaluate the clinical value of performing an endoscopic total parathyroidectomy through anterior chest approach with autotransplantation (EACtPTx+AT) in treating secondary hyperparathyroidism (SHPT) to summarize and share the clinical experience. Methods: 24 patients with SHPT were retrospectively analyzed:11 patients underwent open total parathyroidectomy with autotransplantation (OtPTx+AT Group) and 13 patients underwent endoscopic parathyroidectomy through anterior chest approach with autotransplantation (EACtPTx+AT Group). Comparing the two groups regarding the following factors: (1) operating conditions, such as the blood loss during the operation, the length of time spent on the operating table, the number of parathyroid glands removed, postoperative drainage volume and hospital stay. (2) clinical efficacy, parathyroid hormone (PTH) and serum calcium (Ca) levels. (3) postoperative complications. Results: First, there were no significant differences in the number of parathyroid gland resection, operation time, intraoperative blood loss and hospital stay between the two groups. While there were significant differences in postoperative drainage volume between the two groups. Second, the two groups preoperative PTH and preoperative serum calcium decreased significantly compared with those of the two groups after surgery and there was a statistically significant difference. Thirdly, there was no postoperative bleeding, hoarseness or choking in the two groups and no conversion to open surgery case in EACtPTx+AT group. Conclusion: Endoscopic treatment of SHPT using the anterior chest approach with forearm autotransplantation significantly improves clinical symptoms and lowers levels of PTH and serum calcium after the operation. The results confirm the operation's safety and effectiveness.

Long non­coding RNA DSCAM­AS1 functions as an oncogene in thyroid cancer via regulating miR­211.

Long non-coding RNA Down syndrome cell adhesion molecule-antisense 1 (DSCAM-AS1) has been reported to play key roles in the progression and initiation of several cancer types. However, the various functional roles of DSCAM-AS1 in thyroid cancer tumorigenesis remain largely elusive. In the present study, the expression of DSCAM-AS1 was examined in thyroid cancer tissues and cell lines. Cell Counting Kit-8, wound healing, Transwell and clonogenic assays were conducted to detect cell proliferation, migration, invasion and colony formation, respectively. The association of DSCAM-AS1 with microRNA 211 (miR-211) was determined by luciferase reporter assay. It was found that the expression of DSCAM-AS1 was upregulated in thyroid cancer cells and tissues. Furthermore, enhanced DSCAM-AS1 expression was positively associated with lymph node metastasis and tumor-node-metastasis stage. Functional experiments demonstrated that DSCAM-AS1 knockdown inhibited the migration, proliferation and invasion of TPC-1 cells. Mechanistically, DSCAM-AS1 could bind to miR-211. Prevention of miR-211 by a miR-211 inhibitor reversed the effect of DSCAM-AS1 depletion in thyroid cancer tumorigenesis. Briefly, the current findings suggested that knockdown of DSCAM-AS1 suppressed the tumorigenesis of thyroid cancer via regulating miR-211, suggesting that DSCAM-AS1 may be a favorable therapeutic target for thyroid cancer.

Circular RNA PVT1 promotes progression of thyroid cancer by competitively binding miR-384.

Plasmacytoma variant translocation 1 circular RNA (circPVT1) is involved in the initiation and development of several types of cancer. However, the underlying molecular role of circPVT1 in tumorigenesis of thyroid cancer remains to be elucidated. In the present study, relative expression of circPVT1 was markedly upregulated in thyroid cancer compared with adjacent normal tissue. circPVT1 expression was associated with clinical stage and lymph node metastasis. Furthermore, Cell Counting Kit-8, colony formation and Transwell chamber assays demonstrated that knockdown of circPVT1 decreased proliferation, migration and invasion of thyroid cancer cells in vitro. Moreover, circPVT1 directly interacted with microRNA (miR)-384, as shown by bioinformatics prediction and dual luciferase and RNA pull-down assay. miR-384 inhibition partially reversed the circPVT1 knockdown-mediated inhibitory effect on proliferation, migration and invasion of thyroid cancer cells. In summary, these findings demonstrated that circPVT1 may be a potential therapeutic target for thyroid cancer.

Predictors for malignancy risk in subcentimeter thyroid nodules categorized as atypia/follicular lesion of undetermined significance by fine needle aspiration.

Little work has been done on the prediction of malignancy risk in patients with subcentimeter thyroid nodule (TN) categorized as atypia/follicular lesion of undetermined significance (AUS/FLUS). We performed a retrospective analysis on the medical records of subcentimeter TNs whose initial fine-needle aspiration (FNA) diagnosis was AUS/FLUS at our center between November 2013 and August 2018. Univariate analysis and multivariate logistic regression analysis were used to select independent factors associated with malignancy. Of the 324 patients who were classified as AUS/FLUS on initial FNA, 153 patients underwent surgical procedures and showed an associated malignancy rate of 45.10% (69/153). The malignancy rates in AUS/FLUS settings with and without repeat FNA were 38.30% (18/47), and 48.11% (51/106), respectively, p = 0.260. Multivariate logistic regression analysis revealed that age < 55 (OR 3.015, 95% CI 1.196-7.596), microcalcification (OR 9.162, 95% CI 3.332-25.916) and taller than wide shape (OR 10.785, 95% CI 4.108-28.319) were three independent predictors for malignancy. The malignancy rates in the patients with one or none of predictor and patients with two or three above predictors were 20.5% (17/83) and 74.3% (52/70), respectively, p < 0.001 (OR 11.216, 95% CI 5.266-23.885). In conclusion, our study showed that for subcentimeter TNs with AUS/FLUS category, patient's age, taller than wide shape and microcalcification were three independent predictive factors for malignancy, which was helpful for decision-making of surgery or observation in such patient population.

Effects of MiR-107 on The Chemo-drug Sensitivity of Breast Cancer Cells.

BACKGROUND: A growing body of evidence indicates that aberrant expression of miR-107 plays a core role in cancers. This study aims to demonstrate the function of miR-107 and its roles in chemo-drug resistance in breast cancer cells. METHODOLOGY: CCK-8 assays were carried out to test the effect of miR-107 mimics on the proliferation of MCF-7 cells. The apoptosis level of each group was detected by flow cytometry. miR-107 level, mRNA levels of Bcl-2/Bax and TRIAP1 were detected by quantitative real-time Polymerase Chain Reaction (qRT-PCR) analysis. Protein levels of Bcl-2/Bax, p-Akt/Akt in MCF-7 cells were detected by using Western Blot. Lastly, the dual luciferase reporter gene assay system was used to confirm interaction between miR-107 and its target gene TRIAP1. RESULTS: CCK-8 assays indicated that miR-107 mimics augmented Taxol-induced cell viability inhibition. Flow cytometry showed that miR-107 mimics augmented Taxol-induced elevation of cell apoptosis. qRT-PCR analysis revealed that miR-107 mimics inhibited the mRNA expression of Bcl-2 and induced the mRNA level of Bax. Western Blotting indicated that miR-107 mimics inhibited the expression of proteins Bcl-2 and p-Akt, and induced the expression of Bax, while showing no significant effects on Akt. The relative luciferase activity revealed that oncogene TRIAP1 is a potential target gene of miR-107. CONCLUSIONS: miR-107 plays a role in regulating chemo-drug sensitivity in mammary cancer cell by targeting TRIAP1.

Doxorubicin combined with celecoxib inhibits tumor growth of medullary thyroid carcinoma in xenografted mice.

The aim of the present study was to investigate the antitumor effect of celecoxib (CXB) combined with doxorubicin (DOX) on the subcutaneous xenograft tumor of medullary thyroid carcinoma in nude mice, and to analyze the possible mechanism of action. Nude mice with xenografted medullary thyroid carcinoma (MTC) were randomly divided into the control, CXB, DOX and DOX plus CXB groups, and the drug treatment was administered for three weeks. It was found that the tumor inhibition rates and the apoptosis index in the treatment groups were higher than in the control group (P<0.01), and that these values were higher in the combination group compared with the single-drug group (P<0.01). DOX alone upregulated the cyclooxygenase-2 and multidrug-resistance 1 expression levels, and the combination of CXB and DOX or CXB alone notably decreased the expression level of the two proteins compared with no treatment. The results of the present study provide evidence that a combination of DOX and CXB is a potential drug candidate for the treatment of MTC.

Antitumor activity of celecoxib, a selective cyclooxygenase-2 inhibitor, in medullary thyroid carcinoma.

The purpose of this study was to investigate the mechanisms of the antitumor effect of celecoxib (CXB) in the treatment of human medullary thyroid carcinoma (MTC). Human MTC TT cells were cultured with different concentrations (0, 20, 40, 60 µmol/l) of CXB following 0-72 h in vitro. An MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) assay was used to determine the growth inhibition of MTC in vitro. Flow cytometry was performed to analyze the cell cycle of TT cells. Levels of prostaglandin E2 (PGE2) were measured by enzyme-linked immunosorbent assay (ELISA) method. The expression profile of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) was measured by western blot analysis. In the present study, it was identified that CXB inhibited TT cell proliferation and induced apoptosis in a dose- and time-dependent manner. The cell cycle was arrested at G0/G1 and the percentage of cells in S phase was markedly decreased. The expression levels of PGE2 were inhibited by CXB. CXB effectively downregulated the expression of COX-2 and VEGF in a dose- and time-dependent manner. These data demonstrated that CXB inhibited the proliferation of MTC TT cells in vitro and thus may be effective as an antitumor therapy for human MTC.