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1.
Int J Hyperthermia ; 40(1): 2160880, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36599433

RESUMO

PURPOSE: Maintaining an optimal thyroid stimulating hormone (TSH) level is important in the postoperative management of papillary thyroid carcinoma (PTC). However, there is little evidence for TSH target levels in patients undergoing radiofrequency ablation (RFA). This study aimed to determine the optimal TSH level for management in low-risk patients who underwent RFA. METHODS: This retrospective propensity score-matched cohort study included patients with low-risk PTC who underwent RFA from January 2014 to December 2018. The patients were categorized into two groups based on the range of TSH levels: low (≤2 mU/L) and high (>2 mU/L) TSH levels. Local tumor progression and disease-free survival (DFS) were compared between the low TSH and high TSH groups, using propensity score analyses based on patient- and tumor-level characteristics. Univariate analyses were performed to select risk factors for tumor progression. RESULTS: Overall, our study included 516 patients with low-risk PTC who underwent RFA with a long-term follow-up of 5-years. During follow-up, the overall incidence rate of local tumor progression was 4.8% (25/516), with no significant difference between the matched groups (7/106 [6.6%] vs. 5/53 [9.4%], p = 0.524). DFS did not differ between the two groups (p = 0.5). Moreover, TSH level was not regarded as a significant predictor of tumor progression after Cox analysis; primary tumor size was the only relevant risk factor. CONCLUSION: This large propensity-matched study revealed no association between TSH levels and tumor progression. Thus, for patients with low-risk PTC who underwent RFA, the optimalTSH level is recommended at the euthyroid range.


Assuntos
Carcinoma Papilar , Ablação por Radiofrequência , Neoplasias da Glândula Tireoide , Humanos , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Estudos de Coortes , Estudos Retrospectivos , Tireotropina , Carcinoma Papilar/cirurgia , Ultrassonografia de Intervenção
2.
BMC Med Imaging ; 23(1): 3, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36609236

RESUMO

BACKGROUND: Intraductal papillary carcinoma (IDPC) is a rare but fatal disease. Preoperative ultrasound diagnosis of IDPC remains challenging and meaningful. The aim of the study was to determine an effective ultrasound model to predict intraductal papillary carcinoma (IDPC) in patients with partially cystic breast lesions on ultrasound. METHODS: We reviewed female patients with breast nodules who underwent biopsy or surgery between 2004 and 2019, and pathological results were used as the reference standard. We finally included 21 IDPC patients with partially cystic lesions on preoperative ultrasound matched to 40 patients with intraductal papilloma. The association of ultrasound features with IDPC was analysed. RESULTS: Posterior echo enhancement (P < 0.001), tumour size (P = 0.002), irregular shape (P = 0.003), wide base (P = 0.003), solid-mainly component (P = 0.013), rich Doppler flow (P < 0.001) and multiple lesions (P = 0.044) were associated with IDPC by univariate analysis. Based on univariate analysis, variables were included in the regression analysis to obtain independent factors. The regression analysis showed that microcalcification, multiple lesions, posterior echo enhancement, wide base of solid components and rich colour Doppler flow were predictors for IDPC (P < 0.001). The collective model of the independent factors (microcalcification, multiple lesions, posterior echo enhancement, wide base of solid components and rich colour Doppler flow) could predict IDPC with an area under the curve (AUC) of 0.99 (95% CI 0.95-1.00). The collective model had a better net benefit demonstrated by the decision curve. CONCLUSION: Ultrasonic features may be an applicable model for predicting IDPC with partially cystic breast lesions on ultrasound and has a better potential to facilitate decision-making preoperatively.


Assuntos
Doenças Mamárias , Neoplasias da Mama , Calcinose , Carcinoma Intraductal não Infiltrante , Carcinoma Papilar , Feminino , Humanos , Mama/diagnóstico por imagem , Mama/patologia , Doenças Mamárias/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Calcinose/patologia , Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/cirurgia , Carcinoma Papilar/patologia
3.
Medicina (Kaunas) ; 59(1)2023 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-36676734

RESUMO

Background and Objectives: Papillary thyroid carcinoma (PTC) is one of the most common malignancies of the endocrine system. In order to improve the ability to predict tumor behavior, several studies have been conducted to search for surrogate prognostic immunohistochemical tumor markers. Objective: To evaluate the correlation between the intensity of different immunohistochemical marker staining in PTC and the risk for extrathyroidal extension and metastases. Materials and Methods: The study comprised patients who underwent hemi- or total thyroidectomy. Thyroid tissues were immunohistochemically stained for different tumor proliferative markers: Minichromosome maintenance proteins 2 (MCM2), Ki-67 labeling index, E-Cadherin, Neuropilin-1 and Metallothionein. The correlation between the intensity of each marker staining and the final diagnosis (benign neoplasm and PTC) and the correlation between the intensity of each staining and tumor extrathyroidal extension and metastases were evaluated. Results: The study included 66 patients. Staining for Metallothionein, E-Cadherin and MCM2 significantly differed between benign neoplasm (n = 22) and thyroid-confined PTC (n = 21) (p = 0.002, 0.004 and 0.005, respectively), between benign neoplasm and PTC with extrathyroidal extension (n = 11) (p = 0.001, 0.006 and 0.01, respectively), and between benign neoplasm and PTC with metastases (n = 12) (p = 0.01, <0.001 and 0.037, respectively). No staining correlated with extrathyroidal extension. The intensity of E-Cadherin staining was significantly lower in PTC with metastases than thyroid confined PTC and PTC with extrathyroidal extension (p = 0.028 and 0.021, respectively). Conclusions: Immunohistochemical staining for Metallothionein, E-Cadherin and MCM2 significantly distinguished between benign thyroid tumor and PTC. E-Cadherin staining significantly and inversely correlated with the presence of metastases.


Assuntos
Carcinoma Papilar , Carcinoma , Neoplasias da Glândula Tireoide , Humanos , Câncer Papilífero da Tireoide , Carcinoma/patologia , Carcinoma Papilar/metabolismo , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/genética , Caderinas , Biomarcadores Tumorais , Estudos Retrospectivos
4.
Anal Cell Pathol (Amst) ; 2023: 2768344, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36691406

RESUMO

Introduction: This study aimed to examine the incidence of incidental papillary microcarcinoma (PMC) and papillary thyroid carcinoma (PTC) in patients with benign multinodular goiter (MNG) and to compare their relationship with some prognostic factors from a new perspective. Methods: Bilateral total thyroidectomy (BTT) was used to evaluate the data of 716 patients who underwent a surgery for MNG. The prognostic data for these tumors and the relationship between patients with bilateral and multifocal tumors were evaluated using statistical tests. Results: Papillary carcinomas were detected in 201 patients, PMC in 134 of them, and PTCs in 67. Bilaterality was more common in patients with PTCs than in those with PMC. The incidence of bilaterality in male patients with PTC was statistically more common. The presence of intra-tumoral lymphocytes was higher in multifocal PTC cases than in unifocal PTC cases. Conclusion: The results revealed that the number of PMC s was high in incidental tumors, and patients with PTC with male sex, bilaterality, multifocality, and tumor capsule invasion were associated with poor prognosis.


Assuntos
Carcinoma Papilar , Bócio , Neoplasias da Glândula Tireoide , Humanos , Masculino , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/patologia , Carcinoma Papilar/epidemiologia , Carcinoma Papilar/patologia , Estudos Retrospectivos
5.
J Transl Med ; 21(1): 9, 2023 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-36624452

RESUMO

BACKGROUNDS: Papillary thyroid cancer (PTC), which is often driven by acquired somatic mutations in BRAF genes, is the most common pathologic type of thyroid cancer. PTC has an excellent prognosis after treatment with conventional therapies such as surgical resection, thyroid hormone therapy and adjuvant radioactive iodine therapy. Unfortunately, about 20% of patients develop regional recurrence or distant metastasis, making targeted therapeutics an important treatment option. Current in vitro PTC models are limited in representing the cellular and mutational characteristics of parental tumors. A clinically relevant tool that predicts the efficacy of therapy for individuals is urgently needed. METHODS: Surgically removed PTC tissue samples were dissociated, plated into Matrigel, and cultured to generate organoids. PTC organoids were subsequently subjected to histological analysis, DNA sequencing, and drug sensitivity assays, respectively. RESULTS: We established 9 patient-derived PTC organoid models, 5 of which harbor BRAFV600E mutation. These organoids have been cultured stably for more than 3 months and closely recapitulated the histological architectures as well as mutational landscapes of the respective primary tumors. Drug sensitivity assays of PTC organoid cultures demonstrated the intra- and inter-patient specific drug responses. BRAFV600E inhibitors, vemurafenib and dabrafenib monotherapy was mildly effective in treating BRAFV600E-mutant PTC organoids. Nevertheless, BRAF inhibitors in combination with MEK inhibitors, RTK inhibitors, or chemotherapeutic agents demonstrated improved efficacy compared to BRAF inhibition alone. CONCLUSIONS: These data indicate that patient-derived PTC organoids may be a powerful research tool to investigate tumor biology and drug responsiveness, thus being useful to validate or discover targeted drug combinations.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Humanos , Câncer Papilífero da Tireoide/tratamento farmacológico , Câncer Papilífero da Tireoide/genética , Neoplasias da Glândula Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Proteínas Proto-Oncogênicas B-raf/genética , Radioisótopos do Iodo/uso terapêutico , Carcinoma Papilar/tratamento farmacológico , Carcinoma Papilar/genética , Mutação/genética , Inibidores de Proteínas Quinases/farmacologia , Inibidores de Proteínas Quinases/uso terapêutico , Organoides/patologia
7.
J Invest Surg ; 36(1): 2154416, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36519315

RESUMO

Background: To evaluate the clinical effectiveness of lateral cervical region (LCR) lymphadenectomy as a preventative procedure for stage CN0 papillary thyroid cancer (PTC).Methods: From December 2019 to October 2021, 108 patients with CN0 stage PTC hospitalized to our general surgery department were recruited. After analysis, the clinical data of these patients were separated into two groups: 57 cases were in the Surgical + lymphatic dissection group and 51 instances were in the surgical group. Total thyroidectomy with central node dissection (TTCD) was carried out on the surgical group, whereas intraoperative ultrasound (IOUS) for prophylactic LCR lymph nodes dissection was carried out on the basis of TTCD in the Surgical + lymphatic dissection group. The postoperative complications, cervical lymph node metastases and recurrent reoperation were analyzed in both groups.Results: In the Surgical + lymphatic dissection group, the rate of lymph node metastasis (LNM) identified by IOUS in the LCR of PTC was 29.82% (17/57). In the central group with >2 lymph node metastases compared to the central group with < 2 lymph node metastases, the rate of LCR LNM was considerably greater (20% vs. 43%). Between the two groups, there was no statistically significant difference in the frequency of postoperative complications (P > 0.05). At the 1-year postoperative follow-up, the recurrence rate in the surgical group was 13.73%, whereas there was no recurrence in the Surgical + lymphatic dissection group.Conclusions: The recurrence/reoperation rate of PTC in individuals with stage CN0 can be decreased by IOUS guided prophylactic lymph node dissection in the LCR.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Humanos , Câncer Papilífero da Tireoide/cirurgia , Câncer Papilífero da Tireoide/patologia , Estudos Prospectivos , Metástase Linfática/patologia , Carcinoma Papilar/cirurgia , Carcinoma Papilar/patologia , Esvaziamento Cervical/efeitos adversos , Esvaziamento Cervical/métodos , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/efeitos adversos , Tireoidectomia/métodos , Excisão de Linfonodo/efeitos adversos , Linfonodos/cirurgia , Resultado do Tratamento , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Retrospectivos , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/prevenção & controle , Recidiva Local de Neoplasia/patologia
8.
World J Surg ; 47(2): 403-411, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36525062

RESUMO

BACKGROUND: This study aimed to investigate the time trends of surgical outcomes in patients who underwent bilateral axillo-breast approach robotic thyroidectomy (BABA RT) over the last 14 years. METHODS: From February 2008 to September 2021, we conducted a retrospective medical chart review of 5,011 consecutive patients who underwent BABA RT at three Seoul National University-affiliated hospitals. The patients were divided into three groups based on the main model of the da Vinci robotic surgical system to evaluate trends in surgical treatment strategies and outcomes after BABA RT. RESULTS: Of the 5,011 patients (4,706 malignant and 305 benign), the most common histological subtype was papillary thyroid carcinoma (n = 4,584; 97.4%). The mean tumor size significantly increased from 0.8 cm to 1.2 cm (p < 0.05). The mean numbers of metastatic and harvested lymph nodes from the central neck dissection and the lateral neck dissection showed a significant difference and tendency to increase (from 0.9 to 1.6, 4.7 to 6.2, p < 0.05, and from 0.6 to 3.9, 5.3 to 17.9, p < 0.05), respectively, throughout the study period. Permanent hypoparathyroidism decreased from 3.4 to 2.9%. The rate of transient and permanent vocal cord palsy decreased from 15.2 to 2.7% and from 0.7 to 0.2%, respectively. CONCLUSION: With advancements in robotic surgical systems and improvements in the BABA RT technique, surgical indications have expanded to include more advanced thyroid diseases, and surgical outcomes have improved over the last 14 years.


Assuntos
Carcinoma Papilar , Procedimentos Cirúrgicos Robóticos , Neoplasias da Glândula Tireoide , Humanos , Tireoidectomia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias da Glândula Tireoide/patologia , Estudos Retrospectivos , Carcinoma Papilar/cirurgia , Carcinoma Papilar/etiologia , Mama/patologia , Esvaziamento Cervical/métodos , Axila/patologia , Duração da Cirurgia
9.
Anticancer Res ; 43(1): 255-258, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36585182

RESUMO

BACKGROUND/AIM: Squamous cell carcinoma (SCC) of the thyroid is a rare variant of the primary thyroid neoplasm, and some of such cases may involve dedifferentiation from papillary thyroid carcinoma (PTC). CASE REPORT: We herein present a case of 76-year-old male who initially presented with dysphagia and weight loss. His imaging studies revealed a hypopharyngeal mass and bilateral thyroid nodules. Upon surgical resection, the right pyriform sinus mass showed typical histomorphology of a moderately differentiated SCC, whereas the right peritracheal mass revealed histomorphology of a conventional PTC. The right pyriform sinus SCC demonstrated positive immunoreactivity of PAX8, supporting its thyroid origin. One of two paratracheal lymph nodes was positive for metastatic SCC and PTC, respectively. CONCLUSION: This report highlights a rare case of SCC arising from PTC dedifferentiation. The clinical course, imaging and histopathological evaluation, and a review of literature are presented. Due to its rarity, this could present as a clinical dilemma. Improving awareness of this rare entity with the clinic-histopathological correlation will lead to correct diagnosis and optical treatment.


Assuntos
Carcinoma Papilar , Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias da Glândula Tireoide , Masculino , Humanos , Idoso , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/patologia , Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia
10.
Comput Biol Med ; 152: 106377, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36493736

RESUMO

Thyroid cancer is a predominant form of endocrine malignancy, which destabilizes the metabolic rate of the body. The rapid increase in the incidence rate of thyroid cancer in recent years has aroused great concern to be investigated and diagnosed at an early stage. This study aimed to analyze the pathogenic mutations in thyroid cancer to identify their potential inhibitors for therapeutic targets. RAS genes are the most common oncogenes, which encode proteins that play an essential role in cell signaling and have been frequently mutated in different cancer types. The mutation in these genes causes abnormal cell growth and fails to respond to death signals. In this study, we identified the most significant mutations in the RAS genes; thus, the highly pathogenic mutations were curated from thyroid cancer patients and analyzed for their pathogenicity effect. The physicochemical analysis predicted mutation in wild-type KRAS protein had adapted negative charge on single base substitution of G12D that may easily cause loss of interactions and result in critical differences in the structure and function of the protein. Furthermore, the native KRAS protein was mutated and screened against a library of druggable compounds from the ZINC drug repository. The molecular docking analysis revealed that G12D mutant KRAS protein form best-docked complex with Naldemedine with the highest binding affinity. The dynamic simulation results further justified the stability of Naldemedine as a potential inhibitor with high efficiency in MMPBSA value of -45.4867 kcal/mol of being treated as a potential drug for papillary thyroid carcinoma. Further in vivo and in vitro validation of Naldemedine and its efficiency as a drug for the targeted pathogenic KRAS mutation is required.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Humanos , Câncer Papilífero da Tireoide/tratamento farmacológico , Câncer Papilífero da Tireoide/genética , Simulação de Acoplamento Molecular , Proteínas Proto-Oncogênicas p21(ras)/genética , Proteínas Proto-Oncogênicas p21(ras)/metabolismo , Proteínas Proto-Oncogênicas p21(ras)/uso terapêutico , Carcinoma Papilar/genética , Carcinoma Papilar/metabolismo , Carcinoma Papilar/patologia , Neoplasias da Glândula Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/genética , Mutação
11.
Int J Exp Pathol ; 104(1): 43-51, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36576071

RESUMO

The aim of this study was to evaluate the clinicopathological significance of autocrine motility factor receptor (AMFR) expression in a variety of human invasive micropapillary carcinomas (IMPC). AMFR expression was compared in 111 samples of a variety of human IMPCs which had intrinsic non-micropapillary components and with 26 cases of control pulmonary adenocarcinoma (CPA, carcinoma without an IMPC component) by immunohistochemistry (IHC). In the 137 cases analysed, AMFR expression was significantly elevated in the IMPC components compared to the non-IMPC components (p = .005) and normal tissues (p < .001). AMFR expression was also higher in the IMPC samples compared to their intrinsic non-IMPC components (p = .0234). Between the 69 cases of lung IMPC and 26 cases of CPA, AMFR expression was notably higher in the IMPC components than in the CPA components (p = .0455). However, there was no significant difference between the non-IMPC components in the lung and the CPA components (p = .4584). Moreover, in breast cancer, elevated AMFR expression was not significantly correlated with mixed type or pure type IMPC (p = .5969) or with age, gender, T stage, or lymph node metastasis (LNM). Between IMPC and CPA of the lung, there was no statistical significance in age, T stage, and LNM, where AMFR expression was higher in IMPC (p = .0071). Thus this study demonstrated that AMFR was overexpressed in a variety of human IMPC components compared with non-micropapillary components. This suggests that AMFR expression is a potential new prognostic indicator for different types of human IMPC, which might thus be a new therapeutic target.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Carcinoma Papilar , Carcinoma , Humanos , Feminino , Receptores do Fator Autócrino de Motilidade , Neoplasias da Mama/patologia , Metástase Linfática , Pulmão/patologia , Carcinoma Ductal de Mama/metabolismo , Carcinoma Ductal de Mama/patologia
12.
Eur J Radiol ; 159: 110667, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36574742

RESUMO

PURPOSE: Although angiogenesis is crucial for the occurrence and development of solid tumors, the prognostic value of vascularity remains unclear in papillary thyroid cancer (PTC), due to the lack of effective techniques to evaluate vascularity. Contrast-enhanced ultrasound (CEUS) is an effective technique to evaluate vascularity. This study aimed to investigate whether vascularity depicted by CEUS was associated with structural recurrence in classic PTC. METHODS: 512 consecutive patients who underwent total thyroidectomy and central lymph node dissection for classic PTC larger than 1 cm between January 2015 and December 2018 and who were followed up for 12 months or longer were retrospectively enrolled. For this study, iso- and hyperenhancement were considered hypervascularity, whereas hypovascularity referred to hypoenhancement. Kaplan-Meier cumulative event curves for structural recurrence were compared using the log-rank test. The multivariate Cox proportional hazard regression analysis was used to estimate hazard ratios (HRs) of hypervascularity depicted by CEUS for structural recurrence. RESULTS: 61 (11.9 %) of 512 patients had structural recurrence. Hypervascular PTCs had a shorter recurrence-free survival rate than hypovascular PTCs (P < 0.001). In the multivariate analysis, hypervascularity (HR, 2.069; 95 % confidence interval [CI]: 1.087, 3.937), larger size (HR, 1.279; 95 % CI: 1.011, 1.618), multifocality (HR, 1.976; 95 % CI: 1.150, 3.396), extrathyroidal extension (HR, 2.276; 95 % CI: 1.026, 5.046), and lymph node metastasis (HR, 3.631; 95 % CI: 1.515, 8.701) were independently associated with structural recurrence. CONCLUSION: Hypervascularity depicted by CEUS was independently associated with structural recurrence in patients with classic PTC.


Assuntos
Carcinoma Papilar , Carcinoma , Neoplasias da Glândula Tireoide , Humanos , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia , Estudos Retrospectivos , Carcinoma/patologia , Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/cirurgia , Prognóstico , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/patologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-36503171

RESUMO

Differentiated thyroid cancer (DTC) is the most frequent endocrine neoplasm, with an increase in recent decades. Papillary carcinoma is the most frequent histological subtype and a large number of cases are related to tumors of small size and with little clinical repercussion, detected incidentally or as a consequence of the availability of diagnostic techniques. The "good prognosis" of the majority of cases has maintained for years the controversy in the approach to these patients, especially in two basic aspects of the therapeutic protocol: surgery and the administration of radioiodine. While in metastatic and high-risk patients, the administration of 131I therapy is widely accepted, in intermediate-low risk patients its use is highly questioned. In this paper we review the available evidence on radioiodine therapy in low-risk patients.


Assuntos
Adenocarcinoma , Carcinoma Papilar , Neoplasias da Glândula Tireoide , Humanos , Radioisótopos do Iodo/uso terapêutico , Neoplasias da Glândula Tireoide/radioterapia , Neoplasias da Glândula Tireoide/patologia , Adenocarcinoma/tratamento farmacológico , Carcinoma Papilar/radioterapia
14.
Dis Markers ; 2022: 9541080, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36510497

RESUMO

Quercetin, a flavonoid with anti-inflammatory and anticancer properties, is expected to be an innovative anticancer therapeutic agent for papillary thyroid carcinoma (PTC). However, the downstream signaling pathways that mediate quercetin-dependent anticancer properties remain to be deciphered. Herein, potential targets of quercetin were screened with several bioinformatic avenues including PharmMapper, Gene Expression Omnibus (GEO) database, protein-protein interaction (PPI) network, and molecular docking. Besides, western blot, CCK-8 transwell analysis of migration and invasion, flow cytometric analysis, and colony formation assays were performed to investigate the underlying mechanism. We found four core nodes (MMP9, JUN, SPP1, and HMOX1) by constructing a PPI network with 23 common targets. Through functional enrichment analysis, we confirmed that the above four target genes are enriched in the TNF, PI3K-AKT, and NF-κB signaling pathways, which are involved in the inflammatory microenvironment and inhibit the development and progression of tumors. Furthermore, molecular docking results demonstrated that quercetin shows strong binding efficiency with the proteins encoded by these 4 key proteins. Finally, quercetin displayed strong antitumor efficacy in PTC cell lines. In this research, we demonstrated the application of network pharmacology in evaluating the mechanisms of action and molecular targets of quercetin, which regulates a variety of proteins and signaling pathways in PTC. These data might explain the mechanism underlying the anticancer effects of quercetin in PTC.


Assuntos
Carcinoma Papilar , Medicamentos de Ervas Chinesas , Neoplasias da Glândula Tireoide , Humanos , Quercetina/farmacologia , Câncer Papilífero da Tireoide/tratamento farmacológico , Farmacologia em Rede , Simulação de Acoplamento Molecular , Fosfatidilinositol 3-Quinases , Neoplasias da Glândula Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/genética , Microambiente Tumoral
15.
J Cancer Res Ther ; 18(Supplement): S498-S500, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36511015

RESUMO

Synchronous or metachronous associations of multiple malignancies are seen commonly in syndromic cases. Double malignancies with thyroid carcinomas are common with papillary thyroid carcinoma (PTC) than with other differentiated thyroid cancers. The presence of double malignancy should be ruled out before treatment as it may need different and multiple treatment modalities. We report a case of a columnar cell variant of PTC with invasive breast carcinoma in 56-year-old female patient. The columnar cell variant of PTC is rare and show inconspicous classical nuclear features of conventional PTC.


Assuntos
Neoplasias da Mama , Carcinoma Papilar , Neoplasias da Glândula Tireoide , Feminino , Humanos , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/patologia , Carcinoma Papilar/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Células Epiteliais/patologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia
16.
Tunis Med ; 100(7): 547-550, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36571744

RESUMO

INTRODUCTION: pMCT is defined as a variant of papillary carcinoma that measures≤1 cm in diameter and which is characterized by an excellent prognosis. Recently, a proposal has been advanced to use the designation of papillary mirotumour (pMT) for pMCTs with no risk factors . AIM: In this study, we aimed to reclassify pMCTs according to the Porto proposal(Pp) criteria. METHODS: We have retrospectively collected cases of pMCT diagnosed in our pathology department over a period of 10years(2012-2022). Clinical and pathological parameters have been retrieved from the patient's medical records and pathological reports. We have evaluated all cases following the criteria of Pp. Cases that fulfilled all the criteria have been reclassified as pMT. We have briefly compared the clinical outcomes in both groups. RESULTS: 29 cases of pMCT was found. Mean age of patients was 46,6 years-old (17-67) with a female predominance (sex ratio=0,45). 23 cases of pMCT were incidentally discovered. The tumor was located in the right thyroid lobe in 15cases. The mean size of the tumor was 5,2mm. Multifocality was observed in 5 cases. A total of 17 cases could be classified as pMT according to the Pp. Only one patient developed pulmonary metastasis and local recurrence; however it was related to the papillary carcinoma firstly diagnosed in his contralateral lobe. Clinical outcome was also good in the group of papillary microcarcinoma (pMC) with no recurrence or distant metastasis. CONCLUSION: According to the Pp,>50% of pMCT could be reclassified as pMT which could reduce the psychological impact and overtreatment. Further studies with large sample size and molecular analysis are however needed in order to definitively validate and generalize the use of Porto proposal.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Humanos , Feminino , Masculino , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/patologia , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/patologia , Prognóstico , Tireoidectomia
17.
World J Surg Oncol ; 20(1): 393, 2022 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-36510208

RESUMO

PURPOSE: To summarize the treatment experience of single-center children with PTC and to explore the influence of initial surgery on the recurrence/metastasis of papillary thyroid carcinoma (PTC) in children. METHODS: A retrospective analysis of PTC case data of children (≤ 18 years old) who were admitted to and received surgical treatment in the First Affiliated Hospital of Kunming Medical University from January 2012 to December 2020. RESULTS: A total of 64 children with PTC were included, including 45 cases (70.31%) with a single lesion, and 19 cases (29.69%) with multiple lesions (≥ 2 lesions). Fifteen patients relapsed. Univariate analysis found that gender, thyroidectomy scope, central lymph node dissection, and lateral lymph node dissection were risk factors affecting reoperation; multi-factor analysis showed that central lymph node dissection was an independent risk factor affecting reoperation. According to Kaplan-Meier analysis, central lymph node dissection, total thyroidectomy (TT), lobectomy (LT), and disease-free survival (DFS) were statistically significant (p = 0.000, p = 0.000). CONCLUSION: At the time of diagnosis of PTC in children, the rate of lymph node metastasis in the central and lateral cervical regions is high. The vast majority of children with PTC should be treated with TT, and LT is chosen for a small number of patients. CND should be routinely lined.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Criança , Humanos , Adolescente , Câncer Papilífero da Tireoide/cirurgia , Câncer Papilífero da Tireoide/patologia , Carcinoma Papilar/cirurgia , Carcinoma Papilar/patologia , Neoplasias da Glândula Tireoide/patologia , Estudos Retrospectivos , Esvaziamento Cervical , Tireoidectomia , Linfonodos/patologia , Fatores de Risco , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/cirurgia , Recidiva Local de Neoplasia/patologia
18.
World J Surg Oncol ; 20(1): 394, 2022 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-36510206

RESUMO

INTRODUCTION: Non-total thyroidectomy (non-TTx) is a widely accepted operative procedure for low-risk papillary thyroid carcinoma (PTC). PTC patients preoperatively diagnosed with unifocal disease are often revealed as having multifocal foci by microscopy. The present study determined whether or not patients with clinically unifocal, but pathologically multifocal non-high-risk PTC treated with non-TTx have an increased risk of a poor prognosis compared to those with pathologically unifocal PTC. MATERIALS AND METHODS: PTC patients diagnosed as unifocal preoperatively who underwent non-TTx were multifocal in 61 and unifocal in 266 patients microscopically. Oncologic event rates were compared between pathologically multifocal and unifocal PTC patients. RESULTS: Pathological multifocality was associated with positive clinical lymph node metastasis (cN1) (odds ratio [OR] 4.01, 95% confidence interval [CI]: 1.91-8.04) and positive pathological lymph node metastasis (pN1) in > 5 nodes (OR 3.68, 95% CI: 1.60-8.49). No patients died from PTC. There was no significant difference in the disease-free survival rate, remnant thyroid disease-free survival rate, lymph node disease-free survival rate, or distant disease-free survival rate between the two groups. Recurrence in pathologically multifocal PTC patients was locoregional in all cases and able to be salvaged by reoperation. Cox proportional hazard model analyses showed no significant difference in recurrence rates with regard to pathological multifocality and cN or number of pNs. CONCLUSION: The prognosis of PTC with pathological multifocality treated by non-TTx was not inferior to that of unifocal PTC. Immediate completion thyroidectomy is not necessary when microscopic foci are proven.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Humanos , Câncer Papilífero da Tireoide/cirurgia , Metástase Linfática , Estudos Retrospectivos , Carcinoma Papilar/patologia , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia , Prognóstico , Fatores de Risco , Recidiva Local de Neoplasia/cirurgia , Recidiva Local de Neoplasia/patologia
19.
Front Endocrinol (Lausanne) ; 13: 1030045, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36506061

RESUMO

Background: The presence of central lymph node metastasis (CLNM) is crucial for surgical decision-making in clinical N0 (cN0) papillary thyroid carcinoma (PTC) patients. We aimed to develop and validate machine learning (ML) algorithms-based models for predicting the risk of CLNM in cN0 patients. Methods: A total of 1099 PTC patients with cN0 central neck from July 2019 to March 2022 at our institution were retrospectively analyzed. All patients were randomly split into the training dataset (70%) and the validation dataset (30%). Eight ML algorithms, including the Logistic Regression, Gradient Boosting Machine, Extreme Gradient Boosting (XGB), Random Forest (RF), Decision Tree, Neural Network, Support Vector Machine and Bayesian Network were used to evaluate the risk of CLNM. The performance of ML models was evaluated by the area under curve (AUC), sensitivity, specificity, and decision curve analysis (DCA). Results: We firstly used the LASSO Logistic regression method to select the most relevant factors for predicting CLNM. The AUC of XGB was slightly higher than RF (0.907 and 0.902, respectively). According to DCA, RF model significantly outperformed XGB model at most threshold points and was therefore used to develop the predictive model. The diagnostic performance of RF algorithm was dependent on the following nine top-rank variables: size, margin, extrathyroidal extension, sex, echogenic foci, shape, number, lateral lymph node metastasis and chronic lymphocytic thyroiditis. Conclusion: By incorporating clinicopathological and sonographic characteristics, we developed ML-based models, suggesting that this non-invasive method can be applied to facilitate individualized prediction of occult CLNM in cN0 central neck PTC patients.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Humanos , Câncer Papilífero da Tireoide , Metástase Linfática , Carcinoma Papilar/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Estudos Retrospectivos , Teorema de Bayes , Fatores de Risco , Aprendizado de Máquina
20.
Front Endocrinol (Lausanne) ; 13: 1054882, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36578953

RESUMO

Background: X-linked inhibitor of apoptosis (XIAP) is the most potent caspase inhibitory IAP family member and its over-expression is implicated in aggressive behavior of various solid tumors, including papillary thyroid carcinoma (PTC). BRAFV600E mutation is the most common oncogenic event in PTC and is also known to be associated with aggressive clinico-pathological characteristics. In this study, we investigated the prevalence of XIAP expression in more than 1600 PTCs from Middle Eastern ethnicity and its prognostic value to predict disease-free survival (DFS), in combination with the BRAFV600E mutation. Methods: Clinical data, XIAP expression by immunohistochemistry and BRAF mutation status were analyzed in 1640 Saudi PTC patients seen at our institute between 1988 - 2020. Results: BRAFV600E mutation was found in 910 of 1640 patients (55.5%) and was significantly correlated with older age, extrathyroidal extension, bilaterality, multifocality and lymph node metastasis, but was not an independent predictor of DFS. XIAP was over-expressed in 758 of 1640 (46.2%) and was associated with aggressive clinico-pathological features. It was also found to be an independent prognostic marker for DFS (HR = 1.28, 95% CI = 1.02 - 1.60, P = 0.0342). XIAP overexpression was correlated with presence of BRAFV600E mutation in PTC patients. Interestingly, we found the ability to predict shorter DFS was 2.7-fold higher in PTCs with over-expression of XIAP and BRAFV600E mutation compared to patients with high XIAP and wild-type BRAFV600E status (HR = 2.74, 95% CI = 2.19 - 3.44, p < 0.0001). Conclusion: XIAP expression is an independent predictor of prognosis in Middle Eastern PTC patients. Combination of XIAP expression and BRAFV600E mutation can synergistically improve the DFS prediction in PTC patients, which may help clinicians to establish the most appropriate initial care and long-term surveillance strategies.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Humanos , Câncer Papilífero da Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Intervalo Livre de Doença , Carcinoma Papilar/genética , Carcinoma Papilar/patologia , Proteínas Inibidoras de Apoptose Ligadas ao Cromossomo X/genética
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