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
    超声造影(CEUS)已被确立为评估微血管形成的诊断工具,对于理解肿瘤发展中的血管生成至关重要。
    目的:本研究评估了CEUS作为TIRADS的辅助工具在增强基于超声的甲状腺癌诊断中的有效性。
    方法:一年以上,133例患者中有157个结节,以甲状腺实性结节为主,使用超声和CEUS检查,并接受甲状腺切除术,允许将超声检查结果与病理报告进行比较。
    结果:在31.21%(49/157)的病例中发现了甲状腺癌。显著的CEUS高风险特征包括不均匀增强,增强缺陷,和完全增强(AUC分别为0.818、0.767、0.864)。表现出任何这些特征的结节在CEUS中被归类为高风险。与CEUS结合使用时,TIRADS的诊断性能得到改善,AUC从0.707增加到0.840,灵敏度提高。
    结论:CEUS与TIRADS的结合显着提高了诊断甲状腺癌的准确性和特异性。这种组合被证明是一种更有效的风险分层和诊断方法,强调CEUS作为甲状腺癌评估辅助工具的价值。
    Contrast-enhanced ultrasonography (CEUS) has been established as a diagnostic tool for assessing microvascularization, essential for understanding angiogenesis in neoplastic development.
    OBJECTIVE: This study assesses the effectiveness of CEUS as a supplementary tool to TIRADS in enhancing the ultrasound-based diagnosis of thyroid cancer.
    METHODS: Over one year, 157 nodules in 133 patients, with predominantly solid thyroid nodules, were examined using ultrasound and CEUS and underwent thyroidectomy, allowing for a comparison of ultrasound findings with pathological reports.
    RESULTS: Thyroid cancer was identified in 31.21% (49/157) of cases. Significant CEUS high-risk features included inhomogeneous enhancement, enhancement defects, and complete hypoenhancement (AUC 0.818, 0.767, 0.864 respectively). Nodules exhibiting any of these features were classified as high-risk in CEUS. The diagnostic performance of TIRADS improved when combined with CEUS, with AUC increasing from 0.707 to 0.840 and improved sensitivity.
    CONCLUSIONS: The integration of CEUS with TIRADS significantly enhances the diagnostic accuracy and specificity in identifying thyroid cancer. This combination proves to be a more effective method for risk stratification and diagnosis, highlighting the value of CEUS as an adjunctive tool in thyroid cancer evaluation.
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  • 文章类型: Journal Article
    近年来,对电离辐射对暴露个体的影响的关注导致需要规范和量化诊断和治疗技术的使用。最近的地缘政治事件也增加了人们对电离辐射不安全的看法,我们越来越多的患者不愿在我们的核医学服务中接受某些类型的扫描,尽管频率较低,放射学服务。本文旨在总结电离辐射在我们日常生活中的存在程度,以及诊断和治疗程序如何影响我们的健康。特别是从它们对甲状腺的影响来看,人体对辐射最敏感的器官之一.
    In recent years, concern about the effects of ionizing radiation on exposed individuals has led to the need to regulate and quantify the use of diagnostic and therapeutic techniques. Geopolitical events in recent times have also increased the population\'s perception of insecurity regarding ionizing radiation, and we increasingly face patients reluctant to undergo certain types of scans in our nuclear medicine services and, albeit less frequently, in radiology services. This article aims to summarise the extent to which ionizing radiation is present in our daily lives and how diagnostic and therapeutic procedures can affect our health, particularly from the perspective of their effects on the thyroid gland, one of the body\'s most radiation-sensitive organs.
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  • 文章类型: Case Reports
    支气管裂隙囊肿是在胎儿发育过程中形成的先天性异常,起源于第二个支气管裂隙。它们通常表现为颈部一侧的无痛肿块,并且在感染时可能会出现症状。这些囊肿可以形成一个可能促进感染的空腔,在极少数情况下,促进原发性肿瘤的扩散。在肱囊肿中发现异位甲状腺组织是不寻常的,并且从该组织发展而来的乳头状甲状腺癌甚至很少见。每当医生发现一例包含甲状腺肿瘤的颈外侧囊肿,而甲状腺中没有已知的原发性,对于它是否是具有未检测到的原发性肿瘤的转移性疾病,总是存在困惑,或者是起源于异位甲状腺组织的癌。这是一例甲状腺乳头状癌的病例报告,该乳头状癌是在分支囊肿内无意中发现的。到目前为止,只有五个类似的案例被记录在案。患者进行了完整的甲状腺切除术和选择性的颈淋巴结清扫术后,没有潜在的原发性甲状腺肿瘤的迹象。综合评价。本文触及分支囊肿内甲状腺组织的发育,并研讨颈侧肿瘤的病因。囊肿切除术和甲状腺全切除术后,此类患者的预后似乎良好。本文还强调了对手术切除的良性样本进行常规组织病理学检查的重要性。
    Branchial cleft cysts are congenital anomalies that form during fetal development and originate from the second branchial cleft. They typically manifest as painless masses on the side of the neck and can become symptomatic when infected. These cysts can create a cavity that may foster infection and, in rare instances, facilitate the spread of primary tumors. It is unusual to find ectopic thyroid tissue within a brachial cyst and it is even rarer to see papillary thyroid carcinoma developing from this tissue. Whenever physicians find a case of lateral neck cyst containing thyroid neoplasm without a known primary in the thyroid, there is always a confusion about whether it is a case of metastatic disease with an undetected primary tumor, or is a carcinoma originating from ectopic thyroid tissue. This is a case report of a papillary thyroid cancer that was unintentionally discovered inside a branchial cyst. So far, only five cases akin to this have been documented. There was no sign of an underlying primary thyroid tumor after the patient had a complete thyroidectomy and selected neck dissection, according to a comprehensive evaluation. This article touches on the development of thyroid tissue within branchial cysts and discusses the etiology of lateral neck tumors. The outcome for such patients appears to be favorable after cyst excision and total thyroidectomy. This article also emphasizes the importance of doing routine histopathological examinations on surgically removed samples that look benign.
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  • 文章类型: Journal Article
    通过减少对诊断性甲状腺切除术的需求并降低成本,对细胞学上不确定的甲状腺结节进行分子检测已证明是有益的。目前,在临床上适当的情况下,美国甲状腺协会和美国内分泌外科医师协会在实践中建议使用它。此外,越来越多的证据表明,分子检测可以提供预后信息,并可以检测可靶向的遗传改变,这可能扩大难治性晚期甲状腺癌的治疗选择.
    Molecular testing for cytologically indeterminate thyroid nodules has demonstrated benefit by reducing the need for diagnostic thyroidectomies and reducing costs. Its use is currently recommended in practice guidelines from the American Thyroid Association and the American Association of Endocrine Surgeons when clinically appropriate. Moreover, there is growing evidence that molecular testing may provide prognostic information and can detect targetable genetic alterations which may expand treatment options for refractory advanced thyroid cancers.
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  • 文章类型: Journal Article
    甲状腺癌是最常见的内分泌恶性肿瘤。随着成像利用率的提高,对小的认识有所增加,否则会被诊断出来的惰性癌症。历史上,所有甲状腺癌患者的手术建议是甲状腺全切除术.然而,在过去的20年里,有许多研究评估了低风险甲状腺癌的干预措施的降级,从甲状腺全切除术过渡到甲状腺叶切除术或主动监测。这里,我们回顾了这些治疗方案的现有文献和建议.
    Thyroid cancer is the most common endocrine malignancy. With increasing imaging utilization, there has been an increase in the recognition of small, indolent cancers that would otherwise go undiagnosed. Historically, the surgical recommendation for all patients with thyroid cancer was a total thyroidectomy. However, over the last 20 years, there have been numerous studies evaluating the de-escalation of interventions for low-risk thyroid cancers, transitioning from total thyroidectomy to thyroid lobectomy or active surveillance when indicated. Here, we review the current literature and recommendations with each of these treatment options.
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  • 文章类型: Journal Article
    甲状腺结节广泛流行,经常偶然发现。偶发甲状腺结节的恶性率低,无论诊断如何,总体结局都是有利的。甲状腺结节患者应进行TSH水平评估,然后对甲状腺和颈部淋巴结进行超声检查。重要的是要识别可疑甲状腺恶性肿瘤的超声特征,并根据主要社会指南进行活检。Bethesda甲状腺细胞病理学报告系统以及分子检测可以帮助指导有关甲状腺结节的管理决策。手术切除等新兴技术对于需要介入治疗的甲状腺结节是安全有效的。
    Thyroid nodules are widely prevalent, and often discovered incidentally. Malignancy rates are low for incidental thyroid nodules, and overall outcomes are favorable regardless of diagnosis. Patients with thyroid nodules should be evaluated with TSH levels followed by ultrasound of the thyroid and cervical lymph nodes. It is important to recognize sonographic features suspicious for thyroid malignancy and obtain biopsies when indicated according to major society guidelines. The Bethesda System for Reporting Thyroid Cytopathology along with molecular testing can help guide management decisions regarding thyroid nodules. Surgical resection and other emerging technologies are safe and effective for the treatment of thyroid nodules needing intervention.
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  • 文章类型: Journal Article
    外泌体,作为肿瘤微环境中的关键实体,通过不同分子的转移来协调细胞间的通讯,其中非编码RNA(ncRNAs)如miRNA,lncRNAs,和circRNAs起着至关重要的作用。这些ncRNAs,被赋予监管职能,被选择性地掺入到外泌体中。新的证据强调了外泌体ncRNAs在调节甲状腺癌(TC)的关键致癌过程中的重要性,包括扩散,转移,上皮-间质转化(EMT),血管生成,和免疫编辑。外来体的独特组成保护其货物免受酶和化学降解,确保其完整性并促进其在血浆中的特异性表达。这将外泌体ncRNAs定位为TC中新型诊断和预后生物标志物的有希望的候选者。此外,外泌体在TC治疗领域的潜力日益得到认可.这篇综述旨在阐明外泌体ncRNAs与TC之间的复杂关系,培养对他们机械参与的更深入理解。通过这样做,它努力推进对TC中外泌体ncRNAs的探索,最终为基于外泌体及其ncRNA含量的创新诊断和治疗策略铺平道路。
    Exosomes, as pivotal entities within the tumor microenvironment, orchestrate intercellular communication through the transfer of diverse molecules, among which non-coding RNAs (ncRNAs) such as miRNAs, lncRNAs, and circRNAs play a crucial role. These ncRNAs, endowed with regulatory functions, are selectively incorporated into exosomes. Emerging evidence underscores the significance of exosomal ncRNAs in modulating key oncogenic processes in thyroid cancer (TC), including proliferation, metastasis, epithelial-mesenchymal transition (EMT), angiogenesis, and immunoediting. The unique composition of exosomes shields their cargo from enzymatic and chemical degradation, ensuring their integrity and facilitating their specific expression in plasma. This positions exosomal ncRNAs as promising candidates for novel diagnostic and prognostic biomarkers in TC. Moreover, the potential of exosomes in the therapeutic landscape of TC is increasingly recognized. This review aims to elucidate the intricate relationship between exosomal ncRNAs and TC, fostering a deeper comprehension of their mechanistic involvement. By doing so, it endeavors to propel forward the exploration of exosomal ncRNAs in TC, ultimately paving the way for innovative diagnostic and therapeutic strategies predicated on exosomes and their ncRNA content.
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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
    由于肥胖的患病率上升及其对癌症发病率的潜在影响,肥胖指标与甲状腺癌(TC)风险之间的关系已引起越来越多的关注。我们进行了全面的荟萃分析,以调查各种效应指标之间的这种关联。
    直到2022年7月,对数据库进行了全面搜索,以确定评估肥胖与TC发展之间关联的队列研究。采用随机效应模型进行Meta分析。进行亚组分析以探索异质性。使用Begg测试评估发表偏倚。
    系统文献检索确定了27项报告比值比(OR)的合格研究,相对风险(RR),或危险比(HR)作为效果度量。汇集研究,无论效果如何,肥胖指标与TC风险之间存在显著正相关,产生1.16的效应估计值(95%CI1.12-1.21)。OR/RR研究的综合效应估计值为1.10(95CI1.04-1.17),而HR研究得出的效应估计值为1.20(95CI1.13-1.26)。亚组分析揭示了不同年龄组之间的关联,肥胖指数,和地区,有一些基于效果度量的变化。Meta回归仅在HR研究中将随访持续时间确定为混杂因素。
    27项具有不同设计和人群的研究的综合强调了肥胖与TC风险之间的强烈正相关,为肥胖增加在TC发展中的潜在作用提供了令人信服的证据。
    在线版本包含补充材料,可在10.1007/s40200-024-01425-3获得。
    UNASSIGNED: The relationship between adiposity indicators and thyroid cancer (TC) risk has garnered increasing attention due to the rising prevalence of obesity and its potential impact on cancer incidence. We conducted a comprehensive meta-analysis to investigate this association across various effect measures.
    UNASSIGNED: Until July 2022, a comprehensive search of databases was conducted to identify cohort studies that assessed the association between adiposity and the development of TC. Meta-analysis was performed using random effects models. Subgroup analyses were conducted to explore heterogeneity. Publication bias was assessed using Begg\'s tests.
    UNASSIGNED: A systematic literature search identified 27 eligible studies reporting odds ratios (OR), relative risks (RR), or hazard ratios (HR) as effect measures. Pooling the studies irrespective of the effect measure, a significant positive association between adiposity indicators and TC risk was observed, yielding an effect estimate of 1.16 (95% CI 1.12-1.21). The combined effect estimate for OR/RR studies was 1.10 (95%CI 1.04-1.17), while HR studies yielded an effect estimate of 1.20 (95%CI 1.13-1.26). Subgroup analyses revealed associations across different age groups, obesity indices, and regions, with some variations based on effect measure. Meta-regression identified follow-up duration as a confounding factor only in HR studies.
    UNASSIGNED: The synthesis of 27 studies with diverse designs and populations underscores a robust positive association between adiposity and TC risk, providing compelling evidence for the potential role of increased adiposity in TC development.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s40200-024-01425-3.
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