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Increased thyroid stimulating hormone (TSH) as a possible risk factor for atherosclerosis in subclinical hypothyroidism. 促甲状腺激素(TSH)升高可能是亚临床甲状腺功能减退症导致动脉粥样硬化的危险因素。
IF 2.2 Q3 Medicine Pub Date : 2024-06-17 DOI: 10.1186/s13044-024-00199-3
Basil Mohammed Alomair, Hayder M Al-Kuraishy, Ali I Al-Gareeb, Majed Ayed Alshammari, Athanasios Alexiou, Marios Papadakis, Hebatallah M Saad, Gaber El-Saber Batiha

Primary hypothyroidism (PHT) is associated with an increased risk for the development of atherosclerosis (AS) and other cardiovascular disorders. PHT induces atherosclerosis (AS) through the induction of endothelial dysfunction, and insulin resistance (IR). PHT promotes vasoconstriction and the development of hypertension. However, patients with subclinical PHT with normal thyroid hormones (THs) are also at risk for cardiovascular complications. In subclinical PHT, increasing thyroid stimulating hormone (TSH) levels could be one of the causative factors intricate in the progression of cardiovascular complications including AS. Nevertheless, the mechanistic role of PHT in AS has not been fully clarified in relation to increased TSH. Therefore, in this review, we discuss the association between increased TSH and AS, and how increased TSH may be involved in the pathogenesis of AS. In addition, we also discuss how L-thyroxine treatment affects the development of AS.

原发性甲状腺功能减退症(PHT)与动脉粥样硬化(AS)和其他心血管疾病的发病风险增加有关。PHT通过诱导内皮功能障碍和胰岛素抵抗(IR)诱发动脉粥样硬化(AS)。PHT 会促进血管收缩并引发高血压。然而,甲状腺激素(THs)正常的亚临床 PHT 患者也有发生心血管并发症的风险。在亚临床 PHT 患者中,促甲状腺激素(TSH)水平的升高可能是导致包括强直性脊柱炎在内的心血管并发症进展的复杂致病因素之一。然而,PHT在强直性脊柱炎中与促甲状腺激素升高有关的机理作用尚未完全阐明。因此,在这篇综述中,我们讨论了促甲状腺激素增高与强直性脊柱炎之间的关联,以及促甲状腺激素增高可能如何参与强直性脊柱炎的发病机制。此外,我们还讨论了左旋甲状腺素治疗如何影响强直性脊柱炎的发病。
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引用次数: 0
Abstracts from the 72nd Annual Meeting of the British Thyroid Association. 第 72 届英国甲状腺协会年会论文摘要。
IF 2.2 Q3 Medicine Pub Date : 2024-06-14 DOI: 10.1186/s13044-024-00203-w
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引用次数: 0
Efficacy and safety of ultrasound-guided thermal ablation of graves' disease: a retrospective cohort study. 超声引导下热消融治疗巴塞杜氏病的有效性和安全性:一项回顾性队列研究。
IF 2.2 Q3 Medicine Pub Date : 2024-06-03 DOI: 10.1186/s13044-024-00198-4
Guangzhen Cai, Beilin Luo, Maolin Wang, Jiqin Su, Luping Lin, Guibin Li, Xiangru Chen, Zhishu Huang, Peiyi Lin, Shengwei Liu, Huidi Yan, Lixin Zhou

Background: Ultrasound-guided thermal ablation (TA) has emerged as a robust therapeutic approach for treating solid tumors in multiple organs, including the thyroid. Yet, its efficacy and safety profile in the management of Graves' Disease (GD) remains to be definitively established.

Methods: A retrospective study was conducted on 50 GD patients treated with TA between October 2017 and December 2021. Key metrics like thyroid volume, volume reduction rate (VRR), thyroid hormones, and basal metabolic rate (BMR) were evaluated using paired Wilcoxon tests.

Results: The intervention of ultrasound-guided TA yielded a statistically significant diminution in total thyroid volume across all postoperative follow-up intervals-1, 3, 6, and 12 months-relative to pre-intervention baselines (p < 0.001). The median VRR observed at these time points were 17.5%, 26.5%, 34.4%, and 39.8%, respectively. Euthyroid status was corroborated in 96% of patients at the one-year follow-up milestone. Transient tachycardia and dysphonia were observed in three patients, while a solitary case of skin numbness was noted. Crucially, no instances of enduring injury to the recurrent laryngeal nerve (RLN) were documented.

Conclusions: Our investigation substantiates ultrasound-guided TA as a pragmatic, well-tolerated, and safe therapeutic modality for GD. It effectively improves symptoms of hyperthyroidism, engenders a substantial reduction in thyroid volume, and restores thyroid hormone and BMR to physiological levels. Given its favorable safety profile, enhanced cosmetic outcomes, and minimally invasive nature, ultrasound-guided TA is a compelling alternative to thyroidectomy for GD patients.

背景:超声引导下热消融术(TA)已成为治疗包括甲状腺在内的多种器官实体瘤的一种强有力的治疗方法。然而,它在治疗巴塞杜氏病(GD)方面的疗效和安全性仍有待确定:对2017年10月至2021年12月期间接受TA治疗的50名GD患者进行了回顾性研究。采用配对 Wilcoxon 检验对甲状腺体积、体积缩小率(VRR)、甲状腺激素和基础代谢率(BMR)等关键指标进行评估:结果:与干预前的基线相比,超声引导下甲状腺肿大干预在术后随访的1、3、6和12个月期间均使甲状腺总体积出现了统计学意义上的显著缩小(p 结论:我们的研究证实了超声引导下甲状腺肿大干预的有效性:我们的研究证实,超声引导下甲状腺肿大切除术是一种实用、耐受性好且安全的广东治疗方式。它能有效改善甲状腺功能亢进的症状,使甲状腺体积大幅缩小,并将甲状腺激素和基础代谢率恢复到生理水平。鉴于其良好的安全性、更佳的美容效果和微创性,超声引导下甲状腺肿大切除术是甲状腺切除术的理想替代方案。
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引用次数: 0
Multi-element analysis of metals in human pathological and unchanged thyroid glands - pilot study. 人体病理甲状腺和未改变甲状腺中金属的多元素分析--试点研究。
IF 2.2 Q3 Medicine Pub Date : 2024-05-20 DOI: 10.1186/s13044-024-00197-5
Aleksandra Kuzan, Justyna Rewak-Soroczyńska, Marta Kardach, Emilia Królewicz, Krzysztof Kaliszewski, Rafał Wiglusz

Disturbances in the homeostasis of the elemental composition of thyroid tissue may have serious metabolic and health consequences. It is believed that the accumulation of some metals or the deficiency of others may even cause lethal tumours. Due to the fact that metallomics most often uses human serum to analyse macro and microelements as well as trace elements, it was decided to use material that is more difficult to obtain, but also adds credibility to the research - thyroid tissue samples biopsy. The experiments were conducted on 17 patients diagnosed with: nodular (10) and colloidal goitre (2), chronic thyroiditis (2), follicular adenoma (2) and papillary carcinoma (1). They were recruited by collecting a tumour fragment, control fragment and serum from each of them. The content of Ca, Cd, Co, Cr, Cu, Fe, Mg, Mn, Ni, Pb, Zn was examined using ICP-OES (Inductively Coupled Plasma - Optical Emission Spectrometers). Simultaneously, biochemical methods were used to determine the markers of inflammation, glycation and peroxidation: malondialdehyde, pentosidine, reactive free amine content, compounds with thiol groups and galectin 3 in the sera of the examined patients. Three statistically significant correlations were identified: Ca-Mg and Cu-Zn in control tissues (p < 0.05) and Cr-Mn in pathological tissues (p < 0.05). A comparison of individual groups of patients shows that there are some potentail tendencies to increase or decrease in the concentration of certain elements or markers of inflammation and glycation, therefore we discuss potential relationships between a given parameter and a thyroid disorder. The pilot study is an introduction to a deeper analysis aimed at tracing the pathomechanism of the development of thyroid diseases, so that the risk of developing these diseases can be effectively minimized.

甲状腺组织元素组成的平衡失调可能会对新陈代谢和健康造成严重后果。据认为,某些金属的积累或其他金属的缺乏甚至可能导致致命的肿瘤。由于金属组学通常使用人体血清来分析宏量和微量元素以及痕量元素,因此我们决定使用更难获得但也更可信的材料--甲状腺组织活检样本。实验对 17 名患者进行了诊断,他们分别患有结节性甲状腺肿(10 人)和胶样甲状腺肿(2 人)、慢性甲状腺炎(2 人)、滤泡性腺瘤(2 人)和乳头状癌(1 人)。研究人员收集了每个人的肿瘤片段、对照片段和血清。使用 ICP-OES(电感耦合等离子体-光学发射光谱仪)检测了 Ca、Cd、Co、Cr、Cu、Fe、Mg、Mn、Ni、Pb、Zn 的含量。与此同时,还使用生化方法测定了受检患者血清中的炎症、糖化和过氧化标记物:丙二醛、喷托苷、活性游离胺含量、硫醇基化合物和galectin 3。在统计学上发现了三种重要的相关性:对照组织中的钙镁和铜锌(p
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引用次数: 0
A case of hyalinizing trabecular tumor of the thyroid: diagnostic significance of PAX8-GLIS3 fusion. 一例甲状腺透明小梁瘤:PAX8-GLIS3融合的诊断意义
IF 2.2 Q3 Medicine Pub Date : 2024-05-06 DOI: 10.1186/s13044-024-00196-6
Shuto Hayashi, Nobuyuki Bandoh, Shogo Baba, Misaki Hayashi, Takashi Goto, Miki Takahara, Yasutaka Kato, Eriko Aimono, Hiroshi Nishihara

Background: Hyalinizing trabecular tumor (HTT) is an uncommon follicular cell-derived thyroid tumor classified as a low-risk neoplasm by the World Health Organization Classification of Tumors of Endocrine Organs, 5th edition. The PAX8-GLIS3 gene fusion is reportedly a pathognomonic genetic alteration of HTT.

Case presentation: A 43-year-old Japanese female was incidentally discovered to have an 8-mm, well-defined, hypoechoic mass in the left lobe of the thyroid gland by ultrasound examination. Contrast-enhanced computed tomography scan revealed a solid mass exhibiting slight homogeneous enhancement in the lower pole of the thyroid gland. The mass was diagnosed as atypia of undetermined significance by fine-needle aspiration cytology. The patient underwent left hemithyroidectomy with routine central compartment dissection. Histologic findings revealed tumor cells with elongated nuclei and intranuclear pseudoinclusions arranged with trabeculae architecture or small nests in hyalinized stroma. Weak membranous and cytoplasmic staining was found by MIB1 (Ki-67) immunostaining. The final diagnosis was HTT of the thyroid gland. Next-generation sequencing genetic analysis of a surgical specimen revealed no pathologic mutations, including BRAF, H/K/NRAS, or RET-PTC fusions. The PAX8-GLIS3 fusion was detected by RT-PCR.

Conclusions: A rare case of HTT was demonstrated through imaging, cytologic, histologic and molecular investigations. PAX8-GLIS3 fusion detected by RT-PCR and Sanger sequencing was confirmed to be a genetic hallmark of HTT.

背景:透明小梁瘤(HTT)是一种不常见的滤泡细胞源性甲状腺肿瘤,被世界卫生组织《内分泌器官肿瘤分类》第五版列为低风险肿瘤。据报道,PAX8-GLIS3 基因融合是 HTT 的一种标志性遗传改变:一名 43 岁的日本女性通过超声检查偶然发现甲状腺左叶有一个 8 毫米、界限清楚的低回声肿块。对比增强计算机断层扫描显示,甲状腺下极有一个实性肿块,呈轻度均匀强化。经细针穿刺细胞学检查,该肿块被诊断为意义不明的不典型性。患者接受了左侧甲状腺半切除术,并进行了常规的中央区解剖。组织学检查结果显示,肿瘤细胞核拉长,核内假包涵体呈小梁结构或小巢状排列在透明基质中。MIB1(Ki-67)免疫染色发现膜和细胞质染色较弱。最终诊断为甲状腺 HTT。对手术标本进行的新一代测序基因分析显示,没有发现病理突变,包括BRAF、H/K/NRAS或RET-PTC融合。RT-PCR检测到PAX8-GLIS3融合:结论:通过影像学、细胞学、组织学和分子学检查发现了一例罕见的 HTT 病例。通过RT-PCR和Sanger测序检测到的PAX8-GLIS3融合被证实是HTT的遗传特征。
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引用次数: 0
TERT RNAscope analysis of sub-centimetric papillary thyroid carcinomas and synchronous lymph node metastases 甲状腺亚中心乳头状癌和同步淋巴结转移的 TERT RNAscope 分析
IF 2.2 Q3 Medicine Pub Date : 2024-04-15 DOI: 10.1186/s13044-024-00195-7
Marie-Lisa Eich, W. Jeske, Uschi Zenz, Costanza Chiapponi, C. Alidousty, Sabine Merkelbach-Bruse, Reinhard Büttner, A. Schultheis
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引用次数: 0
Novel molecular typing reveals the risk of recurrence in patients with early-stage papillary thyroid cancer. 新型分子分型揭示了早期甲状腺乳头状癌患者的复发风险。
IF 2.2 Q3 Medicine Pub Date : 2024-04-01 DOI: 10.1186/s13044-024-00193-9
Mingyu Sun, Bingqing Zhao, Tao Chen, Lijun Yao, Xiaoxin Li, Shaojun Hu, Chengling Chen, Xinbao Gao, Chuangang Tang

Background: Papillary thyroid cancer (PTC) is an indolent disease with a favorable prognosis but characterized by a high recurrence rate. We aimed to improve precise stratification of recurrence risk in PTC patients with early stage using multi-gene signatures.

Patients and methods: The present study was performed using data from The Cancer Genome Atlas (TCGA) and multi-center datasets. Unsupervised consensus clustering was used to obtain the optimal molecular subtypes and least absolute shrinkage and selection operator (LASSO) analysis was performed to identify potential genes for the construction of recurrence signature. Kaplan-Meier survival analysis and the log-rank test was used to detect survival differences. Harrells concordance index (C-index) was used to assess the performance of the DNA damage repair (DDR) recurrence signature.

Results: Through screening 8 candidate gene sets, the entire cohort was successfully stratified into two recurrence-related molecular subtypes based on DDR genes: DDR-high subtype and DDR-low subtype. The recurrence rate of DDR-high subtype was significantly lower than DDR-low subtype [HR = 0.288 (95%CI, 0.084-0.986), P = 0.047]. Further, a two-gene DDR recurrence signature was constructed, including PER1 and EME2. The high-risk group showed a significantly worse recurrence-free survival (RFS) than the low-risk group [HR = 10.647 (95%CI, 1.363-83.197), P = 0.024]. The multi-center data demonstrated that proportion of patients with low expression of PER1 and EME2 was higher in the recurrence group than those in the non-recurrence group.

Conclusions: These findings could help accurately and reliably identify PTC patients with high risk of recurrence so that they could receive more radical and aggressive treatment strategies and more rigorous surveillance practices.

背景:甲状腺乳头状癌(PTC甲状腺乳头状癌(PTC)是一种轻度疾病,预后良好,但复发率高。我们的目的是利用多基因图谱对早期PTC患者的复发风险进行精确分层:本研究使用了癌症基因组图谱(TCGA)和多中心数据集的数据。采用无监督共识聚类获得最佳分子亚型,并进行最小绝对收缩和选择算子(LASSO)分析,以确定构建复发特征的潜在基因。卡普兰-梅耶生存分析和对数秩检验用于检测生存差异。Harrells 一致性指数(C-index)用于评估DNA损伤修复(DDR)复发特征的性能:结果:通过筛选8个候选基因集,根据DDR基因将整个队列成功分层为两个与复发相关的分子亚型:DDR-高亚型和DDR-低亚型:高DDR亚型和低DDR亚型。DDR-高亚型的复发率明显低于DDR-低亚型[HR = 0.288 (95%CI, 0.084-0.986), P = 0.047]。此外,还构建了包括PER1和EME2在内的双基因DDR复发特征。高风险组的无复发生存期(RFS)明显低于低风险组[HR = 10.647 (95%CI, 1.363-83.197), P = 0.024]。多中心数据显示,复发组中PER1和EME2低表达的患者比例高于非复发组:这些发现有助于准确、可靠地识别复发风险高的 PTC 患者,使他们能够接受更彻底、更积极的治疗策略和更严格的监测措施。
{"title":"Novel molecular typing reveals the risk of recurrence in patients with early-stage papillary thyroid cancer.","authors":"Mingyu Sun, Bingqing Zhao, Tao Chen, Lijun Yao, Xiaoxin Li, Shaojun Hu, Chengling Chen, Xinbao Gao, Chuangang Tang","doi":"10.1186/s13044-024-00193-9","DOIUrl":"10.1186/s13044-024-00193-9","url":null,"abstract":"<p><strong>Background: </strong>Papillary thyroid cancer (PTC) is an indolent disease with a favorable prognosis but characterized by a high recurrence rate. We aimed to improve precise stratification of recurrence risk in PTC patients with early stage using multi-gene signatures.</p><p><strong>Patients and methods: </strong>The present study was performed using data from The Cancer Genome Atlas (TCGA) and multi-center datasets. Unsupervised consensus clustering was used to obtain the optimal molecular subtypes and least absolute shrinkage and selection operator (LASSO) analysis was performed to identify potential genes for the construction of recurrence signature. Kaplan-Meier survival analysis and the log-rank test was used to detect survival differences. Harrells concordance index (C-index) was used to assess the performance of the DNA damage repair (DDR) recurrence signature.</p><p><strong>Results: </strong>Through screening 8 candidate gene sets, the entire cohort was successfully stratified into two recurrence-related molecular subtypes based on DDR genes: DDR-high subtype and DDR-low subtype. The recurrence rate of DDR-high subtype was significantly lower than DDR-low subtype [HR = 0.288 (95%CI, 0.084-0.986), P = 0.047]. Further, a two-gene DDR recurrence signature was constructed, including PER1 and EME2. The high-risk group showed a significantly worse recurrence-free survival (RFS) than the low-risk group [HR = 10.647 (95%CI, 1.363-83.197), P = 0.024]. The multi-center data demonstrated that proportion of patients with low expression of PER1 and EME2 was higher in the recurrence group than those in the non-recurrence group.</p><p><strong>Conclusions: </strong>These findings could help accurately and reliably identify PTC patients with high risk of recurrence so that they could receive more radical and aggressive treatment strategies and more rigorous surveillance practices.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10983671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the progression to abnormal thyrotropin in euthyroid preconception women: a population-based study. 评估甲状腺功能正常的孕前妇女甲状腺素异常的进展情况:一项基于人群的研究。
IF 2.2 Q3 Medicine Pub Date : 2024-03-11 DOI: 10.1186/s13044-024-00192-w
Rili Gao, Xinyi Lyu, Ying Yang, Jinrong Fu, Chuanyu Zhao, Haixia Guan, Xu Ma

Background: Abnormal preconception thyrotropin levels were associated with fecundability and adverse fetomaternal outcomes, however, little is known regarding the natural change of serum thyrotropin in euthyroid preconception women. Thus, we performed a population-based study to evaluate the progression to abnormal thyrotropin in euthyroid preconception women.

Methods: This retrospective cohort study used data from the National Free Prepregnancy Checkups Project (NFPCP) collected between 2010 and 2020. Female Han Chinese participants aged 20-49 years who had two repeated NFPCP participations with a time interval of 1.5-3.0 years, confirmed non-pregnant status within this duration, and normal thyrotropin levels during their first participation were included for the analysis of thyrotropin abnormalities during the second NFPCP examination. Data were analyzed between June 1 and October 1, 2023.

Results: This study included 186,095 euthyroid women of reproductive age (mean ± SD, 26.72 ± 4.70 years) whose preconception thyrotropin levels were between 0.37 and 4.87 mIU/L. The median follow-up time was 2.13 (IQR, 1.85-2.54) years. A total of 8,497 (4.57%) women developed abnormal thyrotropin, including 4,118 (2.21%) subnormal thyrotropin and 4,379 (2.35%) supranormal thyrotropin. Compared with the reference group (thyrotropin 1.01-2.00 mIU/L), the lower baseline thyrotropin group had greater risk of developing subnormal thyrotropin, and the higher baseline thyrotropin group had greater risk of developing supranormal thyrotropin. Moreover, the restricted cubic spline analysis revealed a U-shaped dose-response association of baseline thyrotropin levels or thyrotropin multiples of the median (MOM) levels against risk of subnormal thyrotropin in the follow-up, and a J-shaped dose-response association against risk of supranormal thyrotropin levels in the follow-up. We further found that baseline thyrotropin outside of 1.43-1.93 mIU/L or baseline thyrotropin MOM outside 0.59-1.36 would hava a higher risk of developing of abnormal thyrotropin.

Conclusions: Both low and high baseline thyrotropin were associated with a significantly increased risk of developing abnormal thyrotropin outcomes. The optimal preconception baseline thyrotropin levels may be between 1.43 mIU/L and 1.93 mIU/L or baseline thyrotropin MoM between 0.59 and 1.36 to minimize progression toward abnormal thyrotropin after 1.5-3.0 years. These findings may help with counseling of preconception thyroid function monitoring.

背景:孕前甲状腺素水平异常与受孕率和不良的胎儿-产妇结局有关,但人们对甲状腺功能正常的孕前妇女血清甲状腺素的自然变化知之甚少。因此,我们进行了一项基于人群的研究,以评估甲状腺功能正常的孕前妇女甲状腺素异常的进展情况:这项回顾性队列研究使用了 2010 年至 2020 年间收集的国家免费孕前检查项目(NFPCP)数据。研究纳入了年龄在20-49岁之间、两次重复参加国家免费孕前优生健康检查且间隔时间在1.5-3.0年之间、在此期间确认未孕且在第一次参加时甲状腺素水平正常的汉族女性参与者,以分析她们在第二次参加国家免费孕前优生健康检查时的甲状腺素异常情况。数据分析时间为 2023 年 6 月 1 日至 10 月 1 日:该研究共纳入了 186,095 名甲状腺功能正常的育龄妇女(平均 ± SD,26.72 ± 4.70 岁),她们的孕前促甲状腺素水平在 0.37 至 4.87 mIU/L 之间。随访时间中位数为 2.13 年(IQR,1.85-2.54)。共有8,497名(4.57%)妇女出现甲状腺素异常,其中4,118名(2.21%)妇女甲状腺素亚正常,4,379名(2.35%)妇女甲状腺素超常。与参照组(甲状腺素 1.01-2.00 mIU/L)相比,基线甲状腺素较低的一组出现甲状腺素亚正常的风险更高,而基线甲状腺素较高的一组出现甲状腺素超常的风险更高。此外,限制性立方样条分析显示,基线甲状腺素水平或甲状腺素中位数倍数(MOM)水平与随访期间甲状腺素亚正常风险呈 "U "形剂量-反应关系,而与随访期间甲状腺素超正常风险呈 "J "形剂量-反应关系。我们还发现,基线甲状腺素在1.43-1.93 mIU/L之外或基线甲状腺素MOM在0.59-1.36之外的人,甲状腺素异常的发病风险较高:结论:甲状腺素基线过低和过高都会显著增加甲状腺素异常的风险。最佳的孕前促甲状腺激素基线水平可能介于 1.43 mIU/L 和 1.93 mIU/L 之间,或基线促甲状腺激素摩尔值介于 0.59 和 1.36 之间,以尽量减少 1.5-3.0 年后促甲状腺激素异常的进展。这些发现可能有助于为孕前甲状腺功能监测提供咨询。
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引用次数: 0
When to settle for SETTLE! A lesson learned from our cases. 何时和解?从我们的案件中汲取的教训。
IF 2.2 Q3 Medicine Pub Date : 2024-03-04 DOI: 10.1186/s13044-023-00189-x
Bangalore Rammohan Nagarjun, Shailee Mehta, Jahnavi Gandhi, Priti Trivedi, Priyank Rathod

Spindle epithelial tumor with thymic like elements (SETTLE) is a biphasic tumor composed of epithelial and spindle cell components. It is an uncommon indolent tumor arising in the thyroid gland and most commonly affects the children and young adults. This entity is mostly overlooked because of its rarity and diagnostic difficulty on morphology. We discuss two cases of SETTLE with varied presentation, diagnostic challenges and lessons learnt from them.SETTLE should be considered as a differential especially when dealing with a thyroid lesion in young and adolescent. The article discusses the histologic details and common mimickers to be borne in mind aiding in arrival at the final diagnosis on biopsy specimens.

具有胸腺样成分的纺锤形上皮性肿瘤(SETTLE)是一种由上皮细胞和纺锤形细胞成分组成的双相肿瘤。它是一种不常见的发生在甲状腺的疏松性肿瘤,最常见于儿童和青壮年。由于其罕见性和形态学诊断上的困难,这一实体瘤大多被忽视。我们讨论了两例表现各异的SETTLE病例、诊断难题以及从中汲取的经验教训。SETTLE应被视为鉴别诊断的一种,尤其是在处理青少年甲状腺病变时。文章讨论了组织学细节以及活检标本中需要注意的常见假象,以帮助得出最终诊断。
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引用次数: 0
Ultrasound radiomics signature for predicting central lymph node metastasis in clinically node-negative papillary thyroid microcarcinoma. 预测临床结节阴性甲状腺乳头状微癌中央淋巴结转移的超声放射组学特征。
IF 2.2 Q3 Medicine Pub Date : 2024-02-19 DOI: 10.1186/s13044-024-00191-x
Jie Liu, Jingchao Yu, Yanan Wei, Wei Li, Jinle Lu, Yating Chen, Meng Wang

Background: Whether prophylactic central lymph node dissection is necessary for patients with clinically node-negative (cN0) papillary thyroid microcarcinoma (PTMC) remains controversial. Herein, we aimed to establish an ultrasound (US) radiomics (Rad) score for assessing the probability of central lymph node metastasis (CLNM) in such patients.

Methods: 480 patients (327 in the training cohort, 153 in the validation cohort) who underwent thyroid surgery for cN0 PTMC at two institutions between January 2018 and December 2020 were included. Radiomics features were extracted from the US images. Least absolute shrinkage and selection operator logistic regression were utilized to generate a Rad score. A nomogram consisting of the Rad score and clinical factors was then constructed for the training cohort. Both cohorts assessed model performance using discrimination, calibration, and clinical usefulness.

Results: Based on the six most valuable radiomics features, the Rad score was calculated for each patient. A multivariate analysis revealed that a higher Rad score (P < 0.001), younger age (P = 0.006), and presence of capsule invasion (P = 0.030) were independently associated with CLNM. A nomogram integrating these three factors demonstrated good calibration and promising clinical utility in the training and validation cohorts. The nomogram yielded areas under the curve of 0.795 (95% confidence interval [CI], 0.745-0.846) and 0.774 (95% CI, 0.696-0.852) in the training and validation cohorts, respectively.

Conclusions: The radiomics nomogram may be a clinically useful tool for the individual prediction of CLNM in patients with cN0 PTMC.

背景:临床结节阴性(cN0)甲状腺乳头状微小癌(PTMC)患者是否有必要进行预防性中央淋巴结清扫仍存在争议。在此,我们旨在建立一个超声(US)放射组学(Rad)评分,用于评估此类患者发生中央淋巴结转移(CLNM)的概率。方法:纳入2018年1月至2020年12月期间在两家机构接受甲状腺手术治疗cN0 PTMC的480例患者(训练队列327例,验证队列153例)。从 US 图像中提取放射组学特征。利用最小绝对收缩和选择算子逻辑回归生成Rad评分。然后为训练队列构建了一个由 Rad 评分和临床因素组成的提名图。两个队列都通过辨别、校准和临床实用性评估了模型的性能:根据六个最有价值的放射组学特征,计算出了每位患者的 Rad 评分。多变量分析表明,Rad 评分越高(P 结论:放射组学提名图可能是一种有效的诊断方法:放射组学提名图可能是预测 cN0 PTMC 患者 CLNM 的临床有用工具。
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引用次数: 0
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Thyroid Research
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