thyroid cancer

甲状腺癌
  • 文章类型: Journal Article
    免疫系统在甲状腺癌(THCA)的发展和治疗中起着重要作用。然而,免疫细胞与THCA的相关性尚未得到系统研究。
    这项研究使用了两个样本的孟德尔随机化(MR)研究,以确定免疫细胞特征与THCA之间的因果关系。基于大量公开的遗传数据样本,我们探讨了731种免疫细胞特征与THCA风险之间的因果关系.将731种免疫表型分为7组,包括B细胞面板(n=190),cDC面板(n=64),T细胞组的成熟期(n=79),单核细胞面板(n=43),髓系细胞组(n=64),TBNK面板(n=124),和Treg面板(n=167)。对结果的敏感性进行了分析,并排除异质性和水平多效性。
    FDR校正后,免疫表型对THCA的影响无统计学意义。值得一提的是,然而,有一些未经调整的低P值表型。单核细胞CD62L对THCA风险的比值比(OR)为0.953(95%CI=0.930~0.976,P=1.005×10-4),ThCA风险的Treg%CD4的静息估计为0.975(95%CI=0.961-0.989,P=7.984×10-4)。此外,THCA与以下5种免疫表型的风险降低相关:CD39上的CD25+Treg上的CD4(OR=0.871,95%CI=0.812~0.935,P=1.274×10-4),活化的TregAC(OR=0.884,95%CI=0.820~0.953,P=0.001),激活和静息Treg%CD4Treg(OR=0.872,95CI=0.811〜0.937,P=2.109×10-4),CD28-CD25+CD8brAC(OR=0.867,95%CI=0.809~0.930,P=6.09×10-5),CD28-CD127-CD25++CD8brAC(OR=0.875,95CI=0.814~0.942,P=3.619×10-4)。THCA与IgD+CD24+分泌Treg%CD4Treg(OR=1.143,95%CI=1.064~1.229,P=2.779×10-4)和CD19的风险增加相关(OR=1.118,95%CI=1.041~1.120,P=0.002)。
    这些发现表明了免疫细胞与THCA之间通过遗传手段的因果关系。我们的研究结果可能为未来的临床研究提供指导。
    UNASSIGNED: The immune system plays an important role in the development and treatment of thyroid cancer(THCA).However, the correlation between immune cells and THCA has not been systematically studied.
    UNASSIGNED: This study used a two-sample Mendelian randomization (MR) study to determine the causal relationship between immune cell characteristics and THCA. Based on a large sample of publicly available genetic data, we explored the causal relationship between 731 immune cell characteristics and THCA risk. The 731 immunophenotypes were divided into 7 groups, including B cell panel(n=190),cDC panel(n=64),Maturation stages of T cell panel(n=79),Monocyte panel(n=43),Myeloid cell panel(n=64),TBNK panel(n=124),and Treg panel(n=167). The sensitivity of the results was analyzed, and heterogeneity and horizontal pleiotropy were excluded.
    UNASSIGNED: After FDR correction, the effect of immunophenotype on THCA was not statistically significant. It is worth mentioning, however, that there are some unadjusted low P-values phenotypes. The odds ratio (OR) of CD62L on monocyte on THCA risk was estimated to be 0.953 (95% CI=0.930~0.976, P=1.005×10-4),and which was estimated to be 0.975(95% CI=0.961-0.989, P=7.984×10-4) for Resting Treg%CD4 on THCA risk. Furthermore, THCA was associated with a reduced risk of 5 immunophenotype:CD25 on CD39+ CD4 on Treg (OR=0.871, 95% CI=0.812~0.935, P=1.274×10-4), activated Treg AC (OR=0.884, 95% CI=0.820~0.953, P=0.001), activated & resting Treg % CD4 Treg (OR=0.872, 95%CI=0.811~0.937,P=2.109×10-4),CD28- CD25++ CD8br AC(OR=0.867,95% CI=0.809~0.930,P=6.09×10-5),CD28-CD127-CD25++CD8brAC(OR=0.875,95%CI=0.814~0.942,P=3.619×10-4).THCA was associated with an increased risk of Secreting Treg % CD4 Treg (OR=1.143, 95% CI=1.064~1.229, P=2.779×10-4) and CD19 on IgD+ CD24+ (OR=1.118, 95% CI=1.041~1.120, P=0.002).
    UNASSIGNED: These findings suggest the causal associations between immune cells and THCA by genetic means. Our results may have the potential to provide guidance for future clinical research.
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  • 文章类型: Journal Article
    甲状腺癌被认为是内分泌癌症的主要形式。癌症复发的可能性和远处转移的发展取决于癌症的病理和阶段。伊朗目前缺乏有关甲状腺癌的特定国家数据,这可能会导致临床医生偏离最佳治疗方案。建立这种登记册的主要目标是确定发生率,识别风险因素,并评估伊朗人群中甲状腺癌的治疗结果。最终,本方案研究的首要目标是通过根据本登记系统的结果实施适当的干预措施,降低甲状腺癌患者的死亡率和发病率.
    该研究将纳入所有18岁及以上根据病理标准诊断为原发性甲状腺癌的个体。数据将从各种甲状腺临床中心收集。参与中心包括Shariati医院内分泌科诊所,Shariati医院核医学中心的甲状腺诊所,以及Kerman和Bushehr的病理学和核医学中心。患者记录包括门诊就诊的信息。
    注册中心旨在加强治疗方法和后续方案,同时作为开展临床的基础,流行病学,以及基于可靠证据数据的基础科学研究。
    UNASSIGNED: Thyroid cancer is recognized as the predominant form of endocrine cancer. The likelihood of cancer recurrence and the development of distant metastases varies depending on the cancer\'s pathology and stage. Iran currently lacks country-specific data on thyroid cancer, which can potentially result in clinicians deviating from the optimal treatment. The primary objectives of establishing such a registry are to determine the incidence, identify risk factors, and evaluate treatment outcomes for thyroid cancer within the Iranian population. Ultimately, the overarching goal of this protocol study is to reduce mortality and morbidity rates among thyroid cancer patients by implementing appropriate interventions based on the findings derived from this registration system.
    UNASSIGNED: The study will enroll all individuals aged 18 years and older who have received a diagnosis of primary thyroid carcinoma based on pathology criteria. Data will be collected from various thyroid clinic centers. The participating centers include the Endocrinology Clinic at Shariati Hospital, the Thyroid Clinic in the Nuclear Medicine Center at Shariati Hospital, as well as pathology and nuclear medicine centers in Kerman and Bushehr. Patient records comprise information on outpatient visits to the clinic.
    UNASSIGNED: The registry aims to enhance treatment approaches and follow-up protocols while serving as a foundation for conducting clinical, epidemiological, and basic science studies based on robust evidence-based data.
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  • 文章类型: Journal Article
    先前的观察性研究显示,补充维生素治疗甲状腺疾病的结果相互矛盾。维生素与甲状腺疾病之间的因果关系尚不清楚。因此,我们进行了一项双样本双向孟德尔随机化(MR)研究,以探讨循环维生素水平与甲状腺疾病的相关性.
    我们使用全基因组关联研究(GWAS)数据进行了双向MR分析。循环维生素水平的遗传工具变量包括维生素A,B9,B12,C,D,E,甲状腺疾病的遗传工具变量包括自身免疫性甲状腺功能亢进,自身免疫性甲状腺功能减退症,甲状腺结节(TNs),甲状腺癌(TC)。逆方差加权乘法随机效应(IVW-RE)主要用于MR分析,使用加权中位数(WM)和MREgger作为辅助方法评估循环维生素水平与甲状腺疾病之间的关系.敏感性和多能性通过Cochran'sQ检验进行评估,MR-PRESSO,径向MR,MR-Egger回归和留一法分析。
    MR阳性证据表明循环维生素C水平是自身免疫性甲状腺功能减退症的保护因素(ORIVW-RE=0.69,95CI:0.58-0.83,p=1.05E-04)。反向MR证据表明,自身免疫性甲状腺功能亢进的遗传易感性与循环维生素A水平降低有关(ORIVW-RE=0.97,95%CI:0.95-1.00,p=4.38E-02),TNs的遗传易感性与循环维生素D水平升高相关(ORIVW-RE=1.02,95%CI:1.00-1.03,p=6.86E-03).在其他循环维生素水平与甲状腺疾病之间未检测到因果关系和反向因果关系。
    我们的研究结果提供了遗传证据,支持循环维生素水平与甲状腺疾病之间的双向因果关系。这些发现为临床应用维生素防治甲状腺疾病提供了信息。
    UNASSIGNED: Previous observational studies have shown conflicting results of vitamins supplementation for thyroid diseases. The causal relationships between vitamins and thyroid diseases are unclear. Therefore, we conducted a two-sample bidirectional Mendelian randomization (MR) study to explore association of circulating vitamin levels with thyroid diseases.
    UNASSIGNED: We performed a bidirectional MR analysis using genome-wide association study (GWAS) data. Genetic tool variables for circulating vitamin levels include vitamins A, B9, B12, C, D, and E, Genetic tool variables of thyroid diseases include autoimmune hyperthyroidism, autoimmune hypothyroidism, thyroid nodules (TNs), and Thyroid cancer (TC). Inverse-variance weighted multiplicative random effects (IVW-RE) was mainly used for MR Analysis, weighted median (WM) and MR Egger were used as supplementary methods to evaluate the relationships between circulating vitamin levels and thyroid diseases. Sensitivity and pluripotency were evaluated by Cochran\'s Q test, MR-PRESSO, Radial MR, MR-Egger regression and leave-one-out analysis.
    UNASSIGNED: Positive MR evidence suggested that circulating vitamin C level is a protective factor in autoimmune hypothyroidism (ORIVW-RE=0.69, 95%CI: 0.58-0.83, p = 1.05E-04). Reverse MR Evidence showed that genetic susceptibility to autoimmune hyperthyroidism is associated with reduced level of circulating vitamin A(ORIVW-RE = 0.97, 95% CI: 0.95-1.00, p = 4.38E-02), genetic susceptibility of TNs was associated with an increased level of circulating vitamin D (ORIVW-RE = 1.02, 95% CI: 1.00-1.03, p = 6.86E-03). No causal and reverse causal relationship was detected between other circulating vitamin levels and thyroid diseases.
    UNASSIGNED: Our findings provide genetic evidence supporting a bi-directional causal relationship between circulating vitamin levels and thyroid diseases. These findings provide information for the clinical application of vitamins prevention and treatment of thyroid diseases.
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  • 文章类型: Journal Article
    The incidence of new cases of thyroid cancer worldwide is around 10.1/100.000 in woman dan 3.1/100.000 in men. Women with thyroid cancer are advised to avoid pregnancy while undergoing radioablation due to teratogenicity. Therefore, it is crucial to utilize contraception to avoid pregnancy during treatment. The purpose of this study was to determine the characteristics of contraceptive use patterns in women with thyroid cancer of reproductive age who underwent radioablation at Hasan Sadikin Hospital Bandung.Cross-sectional study conducted at Hasan Sadikin Hospital Bandung in May 2023. The research sample was all female thyroid cancer of reproductive age who underwent radioablation at the Nuclear Medicine polyclinic of Dr. Hasan Sadikin Bandung in January-December 2022 by purposive sampling. Data obtained from patient medical records and primary data from patients. A total of 450 patients fulfilled inclusion criteria, but only 329 analyzed with complete data. Majority of the patient was in age group 35-49 years (58.1%), parity >1 (55.9%), last education high school (39.2%), married (81.8%), type of papillary thyroid carcinoma (79.9%), sources of information about contraception from doctors (71.7%), and 75.4% use contraception. The most widely used type of contraception was intrauterine device (IUD), accounting for 28.6% patients. Approximately 75.4% patient use contraception. The most widely used type of contraception is the IUD. Contraception counselling is important for increasing contraceptive use rates among women with thyroid cancer. Further research in the form of analytical research is needed to assess the factors that influence contraceptive use in women with thyroid cancer of reproductive age.
    L\'incidence des nouveaux cas de cancer de la thyroïde dans le monde est d\'environ 10,1/100 000 chez la femme et 3,1/100 000 chez l\'homme. Il est conseillé aux femmes atteintes d\'un cancer de la thyroïde d\'éviter une grossesse lorsqu\'elles subissent une radioablation en raison de la tératogénicité. Il est donc crucial d’utiliser une contraception pour éviter une grossesse pendant le traitement. Le but de cette étude était de déterminer les caractéristiques des modes d\'utilisation des contraceptifs chez les femmes atteintes d\'un cancer de la thyroïde en âge de procréer qui ont subi une radioablation à l\'hôpital Hasan Sadikin de Bandung. Étude transversale menée à l\'hôpital Hasan Sadikin de Bandung en mai 2023. L\'échantillon de recherche était entièrement cancer de la thyroïde chez la femme en âge de procréer qui a subi une radioablation à la polyclinique de médecine nucléaire du Dr Hasan Sadikin Bandung en janvier-décembre 2022 par échantillonnage raisonné. Données obtenues à partir des dossiers médicaux des patients et des données primaires des patients. Au total, 450 patients remplissaient les critères d\'inclusion, mais seulement 329 ont été analysés avec des données complètes. La majorité des patients appartenaient à la tranche d\'âge 35-49 ans (58,1%), parité >1 (55,9%), dernier diplôme d\'études secondaires (39,2%), mariés (81,8%), type de carcinome papillaire de la thyroïde (79,9%), sources d\'information sur la contraception auprès des médecins (71,7 %) et 75,4 % utilisent la contraception. Le type de contraception le plus utilisé était le dispositif intra-utérin (DIU), représentant 28,6 % des patientes. Environ 75,4 % des patientes utilisent une contraception. Le moyen de contraception le plus utilisé est le DIU. Les conseils en matière de contraception sont importants pour augmenter les taux d’utilisation des contraceptifs chez les femmes atteintes d’un cancer de la thyroïde. Des recherches supplémentaires sous forme de recherches analytiques sont nécessaires pour évaluer les facteurs qui influencent l\'utilisation de la contraception chez les femmes atteintes d\'un cancer de la thyroïde en âge de procréer.
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  • 文章类型: Journal Article
    目的:甲状腺癌正在上升,但是相关的重要预后和长期生存率非常好。因此,接受治疗的患者的生活质量和心理健康是重要的考虑因素。治疗通常包括手术和放射性碘(放射性碘)消融。本研究旨在探讨放射性碘消融治疗对健康相关生活质量的潜在影响。焦虑和抑郁症状,治疗后6个月的营养状况。
    方法:本研究包括136例诊断为甲状腺癌的患者。根据患者佩戴的剂量计估算唾液腺的吸收剂量。患者健康相关的生活质量,使用标准化问卷(包括SF-36,医院焦虑和抑郁(HAD)量表)评估治疗前和治疗后6个月的心理状态和营养状况.统计分析包括对潜在混杂因素进行调整的随机效应逻辑回归和线性回归。
    结果:虽然放射性碘暴露与焦虑或抑郁症状之间没有显著关联,或营养状况,观察到与唾液腺剂量相关的SF-36作用物理分显著增加(β=6.54,95CI2.71;1Gy增加10.36).
    结论:研究结果表明,与身体健康相关的生活质量得到改善,即减轻疼痛和功能障碍,甲状腺癌患者放射性碘治疗后6个月。放射性碘暴露与心理健康相关的生活质量之间没有显着关联。焦虑或抑郁评分和营养状况。这项研究没有提供任何证据表明放射性碘治疗对患者健康相关的生活质量有潜在的不利影响。
    OBJECTIVE: Thyroid cancers are on the rise, but the associated vital prognosis and long-term survival rates are very good. Therefore, treated patients\' quality of life and psychological well-being are important considerations. The treatment usually involves surgery and radioactive iodine (radioiodine) ablation. This study aims to investigate potential effects of radioiodine ablation therapy on health-related quality of life, anxiety and depression symptoms, and nutritional status at 6 months post-therapy.
    METHODS: This study included 136 patients diagnosed with thyroid cancer. Absorbed doses to the salivary glands were estimated from dosimeters worn by patients. Patient health-related quality of life, psychological status and nutritional status were assessed before and 6 months after therapy using standardized questionnaires (including SF-36, Hospital Anxiety and Depression (HAD) scale). Statistical analyses included random-effects logistic and linear regressions adjusted for potential confounders.
    RESULTS: While no significant association was found between radioiodine exposure and anxiety or depression symptoms, or nutritional status, a significant increase in the SF-36 role physical sub- score was observed in relation with the salivary gland dose (β= 6.54, 95%CI 2.71;10.36 for a 1-Gy increase).
    CONCLUSIONS: The findings suggest an improved physical health-related quality of life, namely reduced pain and functional impairment, 6 months after radioiodine therapy in thyroid cancer patients. No significant association was found between radioiodine exposure and mental health-related quality of life, anxiety or depression scores nor nutritional status. This study does not provide any evidence that radioiodine therapy has a potentially adverse effect on patient health-related quality of life.
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  • 文章类型: Journal Article
    目的:复发或肿瘤转移和耐药性仍然是甲状腺癌治疗的主要挑战。需要确定甲状腺癌的新药物靶标。
    方法:进行了基于汇总数据的孟德尔随机化(SMR)和共定位分析,以评估基因甲基化之间的关联,表达式,蛋白质水平与甲状腺癌。我们还进行了蛋白质-蛋白质相互作用(PPI)网络,基因本体论(GO)和京都基因和基因组百科全书(KEGG)分析,以进一步探索已识别基因在甲状腺癌中的潜在作用。
    结果:SDCCAG8和VCAM1基因与甲状腺癌风险相关,而TCN2基因具有三级证据。SDCCAG8基因与甲状腺乳头状癌的风险相关。在循环蛋白质的水平上,遗传预测的较高水平的SDCCAG8(OR=0.46,95%CI0.34-0.64)和VCAM1(OR=0.21,95%CI0.10-0.45)与甲状腺癌风险呈负相关;较高水平的TCN2与甲状腺癌风险增加相关(OR=1.30,95%CI1.15-1.47);较高水平的SDCCAG8(OR=0.40,95%CI)与乳头状癌风险0.28相关.生物信息学分析表明SDCCAG8、VCAM1和TCN2可能在免疫相关通路中发挥作用。
    结论:SDCCAG8、VCAM1和TCN2基因与甲状腺癌风险相关,多组学水平的证据表明。SDCCAG8、VCAM1和TCN2在免疫相关通路中具有潜在的作用。我们的发现可能会提高对甲状腺癌发病机制的理解,并发现该疾病的新潜在药物靶标。
    OBJECTIVE: Recurrence or tumor metastasis and drug resistance remain the major challenge in the treatment of thyroid cancer. It is needed to identify novel drug targets for thyroid cancer.
    METHODS: Summary data-based Mendelian randomization (SMR) and colocalization analysis were performed to evaluate the associations between gene methylation, expression, protein levels with thyroid cancer. We additionally performed protein-protein interaction (PPI) network, gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) analyses to further explore the potential roles of identified genes in thyroid cancer.
    RESULTS: SDCCAG8 and VCAM1 genes were associated with risk of thyroid cancer with tier 1 evidence, while TCN2 gene was with tier 3 evidence. SDCCAG8 gene was associated with risk of papillary thyroid cancer with tier 1 evidence. At the level of circulating proteins, genetically predicted higher levels of SDCCAG8 (OR = 0.46, 95% CI 0.34-0.64) and VCAM1 (OR = 0.21, 95% CI 0.10-0.45) were inversely associated with thyroid cancer risk; higher level of TCN2 was associated with an increased risk of thyroid cancer (OR = 1.30, 95% CI 1.15-1.47); and the higher level of SDCCAG8 (OR = 0.40, 95% CI 0.28-0.58) was associated with a decreased risk of papillary thyroid cancer. The bioinformatics analysis showed that SDCCAG8, VCAM1 and TCN2 might play roles in immune-related pathways.
    CONCLUSIONS: SDCCAG8, VCAM1 and TCN2 genes were associated with thyroid cancer risk with evidence at multi-omics levels. There were potential roles of SDCCAG8, VCAM1 and TCN2 in immune-related pathways. Our findings might improve the understanding of the pathogenesis of thyroid cancer and discovery of novel potential drug targets for this disease.
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  • 文章类型: Journal Article
    背景:我们调查了甲状腺癌患者甲状腺切除术前或后的运动习惯与2型糖尿病(T2DM)的关系。
    方法:使用韩国国家健康信息数据库,对2010年至2016年间接受甲状腺切除术治疗甲状腺癌的69,526例甲状腺癌患者进行了观察性队列研究。根据自我报告的问卷,定期运动被定义为每周至少1天的中期或剧烈运动。根据甲状腺切除术前后的运动习惯将患者分为四组:持续性非运动者,新的锻炼者,锻炼辍学,和运动维护者。
    结果:在4.5年的中位随访期间,2,720例(3.91%)患者发展为T2DM。在甲状腺切除术之前或之后进行定期运动的患者中,每1000人年的T2DM发生率低于持续非运动者(持续非运动者组的10.77,8.28在新的锻炼者组中,运动辍学组8.59,和运动保持者组的7.61)。与持续不锻炼者组相比,新的锻炼者组(危险比[HR]0.87,95%置信区间[CI]0.78-0.97),运动退出组(HR0.81,95%CI0.72-0.91),运动维持者组(HR0.84,95%CI0.76-0.93)发生T2DM的风险较低.与持续非运动者相比,运动维持者组的运动<1,500MET-分钟/周与T2DM的事件风险较低相关(<500:HR0.80,95%CI0.67-0.96,P=0.002;500至<1,000:HR0.81,95%CI0.71-0.93,P<0.001;1,000至<1,500:HR0.81,95%CI0.69-0.94,
    结论:甲状腺切除术前或后定期运动与甲状腺癌患者发生T2DM的风险较低相关。
    BACKGROUND: We investigated the association between exercise habits before or after thyroidectomy and incident type 2 diabetes mellitus (T2DM) in patients with thyroid cancer.
    METHODS: An observational cohort study of 69,526 thyroid cancer patients who underwent thyroidectomy for the treatment of thyroid cancer between 2010 and 2016 was performed using the Korean National Health Information Database. Regular exercise was defined as mid-term or vigorous exercise at least 1 day in a week based on a self-reported questionnaire. Patients were divided into four groups according to exercise habits before and after thyroidectomy: persistent non-exercisers, new exercisers, exercise dropouts, and exercise maintainers.
    RESULTS: During a median follow-up of 4.5 years, 2,720 (3.91%) patients developed T2DM. The incidence of T2DM per 1,000 person years was lower in patients who performed regular exercise before or after thyroidectomy than in persistent non-exercisers (10.77 in persistent non-exerciser group, 8.28 in new exerciser group, 8.59 in exercise dropout group, and 7.61 in exercise maintainer group). Compared with the persistent non-exerciser group, the new exerciser group (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.78-0.97), the exercise dropout group (HR 0.81, 95% CI 0.72-0.91), and the exercise maintainer group (HR 0.84, 95% CI 0.76-0.93) had lower risks of incident T2DM. Exercising < 1,500 MET-minutes/week in the exercise maintainer group was associated with a lower risk of incident T2DM compared with persistent non-exercisers (< 500: HR 0.80, 95% CI 0.67-0.96, P = 0.002; 500 to < 1,000: HR 0.81, 95% CI 0.71-0.93, P < 0.001; 1,000 to < 1,500: HR 0.81, 95% CI 0.69-0.94, P < 0.001).
    CONCLUSIONS: Regular exercise before or after thyroidectomy was associated with a lower risk of incident T2DM in patients with thyroid cancer.
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  • 文章类型: Journal Article
    OBJECTIVE: The study aimed to assess the predictive significance of inflammatory parameters as potential markers for malignancy in individuals with thyroid nodules.
    METHODS: Nine hundred and ninety-one patients with thyroid nodules who had undergone thyroid fine-needle aspiration biopsy were included and classified according to the Bethesda system. Neutrophil lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) values obtained from hemogram parameters were determined for each patient. The study examined the correlation between the Bethesda classification and NLR/SII levels. In addition, a comparison was made between the inflammatory parameters of the benign and malignant Bethesda groups.
    RESULTS: Five hundred and seventy-three patients were classified as Bethesda 2 (benign), 34 as Bethesda 6 (malignant). A correlation was observed between the Bethesda classification and NLR and SII levels (r: 0.230, p < 0.001; r: 0.207 p < 0.001, respectively). NLR and SII values were significantly higher in the malignant group (p < 0.001). The cutoff value for SII in predicting benign and malignant thyroid nodules was 489.86 × 103/mm3 with a sensitivity of 88.2% and a specificity of 63.7%. The cutoff value for NLR for the same prediction was 2.06 with a sensitivity of 82.4% and a specificity of 83.4%.
    CONCLUSIONS: The findings of this study indicate that SII and NLR may be valuable prognostic markers for predicting the malignancy of thyroid nodules.
    OBJECTIVE: Evaluar parámetros inflamatorios como posibles marcadores de malignidad en individuos con nódulos tiroideos.
    UNASSIGNED: Se incluyeron 991 pacientes con nódulos tiroideos que se sometieron a biopsia por aspiración con aguja fina y se clasificaron según el sistema de Bethesda. Se determinaron los valores de la relación neutrófilo-linfocito (NLR) y el índice de inflamación inmunitaria sistémica (SII). El estudio exploró la correlación entre la clasificación de Bethesda y los valores de NLR/SII, y comparó los parámetros inflamatorios de los grupos benignos y malignos de Bethesda.
    RESULTS: Se clasificaron 573 pacientes como Bethesda 2 (benigno) y 34 como Bethesda 6 (maligno). Se observó una correlación entre la clasificación de Bethesda y los valores de NLR y SII (r: 0.230; r: 0.207). Los valores de NLR y SII fueron mayores en el grupo maligno (p < 0.001). El valor de corte para SII en la predicción de nódulos tiroideos benignos y malignos fue de 489.86 × 103/mm3, con una sensibilidad del 88.2% y una especificidad del 63.7%; para NLR fue de 2.06, con una sensibilidad del 82.4% y una especificidad del 83.4%.
    CONCLUSIONS: El SII y el NLR pueden ser valiosos marcadores pronósticos para predecir la malignidad de los nódulos tiroideos.
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  • 文章类型: Journal Article
    目的:评估种族和2010年平价医疗法案(ACA)对高分化甲状腺癌患者的疾病表现和总生存期的影响。
    方法:在国家癌症数据库(NCDB)中对2004年至2018年期间接受部分或全甲状腺切除术伴或不伴术后放射性碘(RAI)的患者(n=51,078)进行了横断面研究。
    方法:用Cox比例风险回归分析评估累积生存期(CS)。
    结果:诊断时的疾病表现存在显着差异,黑色,亚洲/太平洋岛民(API),与白人患者相比,西班牙裔患者在诊断时更可能患有转移性疾病(p<0.001)和更高的TNM分期(p<0.001)。与白人患者相比,黑人患者的死亡风险显着增加(HR1.147,95CI1.021-1.289),但API患者的CS改善(HR0.730,95%CI0.608-0.877)。ACA的传播与较低的死亡风险相关,无论患者是否生活在未扩大医疗补助的州(HR0.866,95%CI0.823-0.910)或是否生活在扩大州(HR0.818,95%CI0.758-0.884).
    结论:种族差异显著影响了美国甲状腺癌的诊断和治疗,但随着时间的推移有所改善。随着时间的推移,扩张和非扩张状态都改善了生存结果,并建议分析ACA的长期影响和解决健康不平等的能力仍然是必要的。
    方法:三级喉镜,2024.
    OBJECTIVE: To assess the impact of race and the Affordable Care Act (ACA) of 2010 on disease presentation and overall survival for patients with well-differentiated thyroid carcinoma.
    METHODS: Cross-sectional study of patients (n = 51,078) who underwent partial or total thyroidectomy with or without postoperative radioactive iodine (RAI) for well-differentiated thyroid carcinoma between 2004 and 2018 in the National Cancer Database (NCDB).
    METHODS: Cumulative survival (CS) was assessed with Cox proportional hazard regression analyses.
    RESULTS: There were significant disparities in disease presentation at the time of diagnosis, with Black, Asian/Pacific Islander (API), and Hispanic patients were more likely to have metastatic disease (p < 0.001) and higher TNM stage (p < 0.001) at the time of diagnosis compared to White patients. Black patients had significantly increased risk of death (HR 1.147, 95%CI 1.021-1.289) but API patients had improved CS (HR 0.730, 95% CI 0.608-0.877) compared to White patients. Passage of the ACA was associated with lower risk of mortality, regardless of whether patients lived in states that did not expand Medicaid (HR 0.866, 95% CI 0.823-0.910) or whether they lived in expansion states (HR 0.818, 95% CI 0.758-0.884).
    CONCLUSIONS: Racial disparities significantly impact thyroid carcinoma diagnosis and treatment in the United States but have improved over time. Both expansion and non-expansion states had improved survival outcomes over time, and suggesting analysis of the ACA\'s long-term impact and ability to address health inequities is still warranted.
    METHODS: Level 3 Laryngoscope, 2024.
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  • 文章类型: Journal Article
    背景:EU-甲状腺成像报告和数据系统(EU-TIRADS)允许选择性细针穿刺细胞学(FNAC)。2017年,EU-TIRADS作为瑞典西部全国甲状腺癌标准化护理包的一部分实施,人口约170万。这项研究的目的是调查EU-TIRADS试图减少甲状腺结节转诊患者不必要的FNAC数量的临床价值。
    方法:研究队列包括所有因以下原因转诊至Sahlgrenska大学医院的患者:在2018年至2022年期间,新发现或生长的甲状腺结节或甲状腺超声检查和选择性细胞学检查的PET阳性发现。关于EU-TIRADS分类的医疗记录,回顾性收集相应的FNAC结果和组织病理学诊断.遵守EU-TIRADS指南,我们对接受手术的患者使用选择性FNAC和恶性肿瘤(ROM)的发生率进行了评估.
    结果:总计,对990例患者的1246个甲状腺结节进行了评估。EU-TIRADS2-5n(%)的分布为:63(5);462(37);443(36);278(22)。在7%的被调查患者中省略了FNAC。尽管未达到EU-TIRADS标准或没有PET阳性发现,但仍在124个结节(10%)中进行了FNAC。接受“不必要”FNAC的患者的ROM为33%和1/50。
    结论:在甲状腺结节的常规管理中实施EU-TIRADS导致选择性使用FNAC,但临床影响有限.这项研究通过在临床实践中实施EU-TIRADS提供了有关诊断改进的价值和幅度的实际数据。
    OBJECTIVE: The European Thyroid Imaging Reporting and Data System (EU-TIRADS) allows for selective fine needle aspiration cytology (FNAC). In 2017, EU-TIRADS was implemented as part of a nationwide standardized care bundle for thyroid cancer in Western Sweden with a population of approximately 1.7 million. The objective of this study was to investigate the clinical value of EU-TIRADS attempting to reduce the number of unnecessary FNACs in referred patients with thyroid nodules.
    METHODS: The study cohort consisted of all patients referred to Sahlgrenska University Hospital due to a palpable, newly detected or growing thyroid nodules or a positron emission tomography-positive finding for examination with thyroid ultrasound and selective cytology between 2018 and 2022. Medical records on EU-TIRADS classification, corresponding FNAC results, and histopathologic diagnosis were retrospectively collected. Adherence to the EU-TIRADS guidelines, use of selective FNAC, and rate of malignancy in patients who underwent surgery were assessed.
    RESULTS: In total, 1246 thyroid nodules in 990 patients were evaluated. The distributions of EU-TIRADS 2 to 5 (number [percentage]) for all examined nodules were 63 (5%), 462 (37%), 443 (36%), and 278 (22%), respectively. FNAC was omitted in 7% of the investigated patients. FNAC was performed in 124 nodules (10%) despite not fulfilling the EU-TIRADS criteria or absence of positron emission tomography-positive findings. The rate of malignancy was 33% and 1/50 in patients who underwent \"unnecessary\" FNAC.
    CONCLUSIONS: Implementation of EU-TIRADS in routine management of thyroid nodules led to the selective use of FNAC; however, the clinical impact was limited. This study provides real-world data on the value and magnitude of diagnostic improvement by implementing EU-TIRADS in clinical practice.
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