Tumor desmoplasia outperforms preoperative serum calcitonin as surgical biomarker in sporadic medullary thyroid cancer

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-06-08 DOI:10.1002/hed.27827

Andreas Machens MD, Kerstin Lorenz MD, Claudia Bensch MD, Claudia Wickenhauser MD, Henning Dralle MD

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Abstract

Background

Conceptually, thyroid tumor desmoplasia may be better suited for excluding node metastases in sporadic MTC than preoperative serum calcitonin levels.

Methods

This analysis included 181 patients with unilateral sporadic MTC graded on the 7-grade desmoplasia scale after thyroidectomy and neck dissection.

Results

When thyroid tumor desmoplasia reached 1% and ≥50%, node metastases increased from 0% to 7% (median of 0 metastases) and 83% (median of 7.5 metastases), microscopic lymphatic invasion from 0% to 3% and 35%, extrathyroid extension from 0% to 5% and 22%, and extranodal growth from 0% to 0% and 44%, whereas biochemical cure declined from 100% to 95% and 25%.

Thyroid tumor diameters and basal calcitonin overlapped widely among the seven desmoplasia groups, precluding differentiation by thyroid tumor size or serum calcitonin levels.

Conclusions

Thyroid tumor desmoplasia, unlike serum calcitonin levels, discriminates extremely well between node-negative and node-positive sporadic MTC, opening new avenues for precision surgery.

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作为散发性甲状腺髓样癌的手术生物标志物，肿瘤脱落细胞的作用优于术前血清降钙素。

背景：甲状腺肿瘤脱落细胞可能比术前血清降钙素水平更适合用于排除散发性 MTC 的结节转移：从概念上讲，甲状腺肿瘤脱落细胞可能比术前血清降钙素水平更适合用于排除散发性MTC的结节转移：这项分析纳入了181例单侧散发性MTC患者，这些患者在甲状腺切除术和颈部切除术后按7级脱钙标度进行了分级：当甲状腺肿瘤脱鳞达到1%和≥50%时，结节转移从0%增加到7%（转移中位数为0）和83%（转移中位数为7.5），显微淋巴侵袭从0%增加到3%和35%，甲状腺外扩展从0%增加到5%和22%，结节外生长从0%增加到0%和44%，而生化治愈率从100%下降到95%和25%。甲状腺肿瘤直径和基础降钙素在7个脱钙组中广泛重叠，因此无法根据甲状腺肿瘤大小或血清降钙素水平进行区分：甲状腺肿瘤脱落细胞与血清降钙素水平不同，能很好地区分结节阴性和结节阳性的散发性 MTC，为精准手术开辟了新途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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