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Expressions of mitochondria-related genes in pregnant women with subclinical hypothyroidism, and expressions of miRNAs in maternal and cord blood. 线粒体相关基因在亚临床甲状腺功能减退孕妇中的表达,以及miRNA在母体和脐血中的表达。
IF 2.2 Q3 Medicine Pub Date : 2023-09-18 DOI: 10.1186/s13044-023-00180-6
Julie Kristine Guldberg Stryhn, Jacob Larsen, Palle Lyngsie Pedersen, Peter Haulund Gæde

Background: Subclinical hypothyroidism in pregnancy and definition by upper thyrotropin (TSH) cutoff are controversial. As mitochondria are influenced by thyroid hormones, the purpose in this study was to measure expression of mitochondria-related genes in euthyroid and subclinical hypothyroid pregnant women to obtain more knowledge of potential metabolic consequences of maternal subclinical hypothyroidism. In addition, we wished to test if applied TSH-cutoff significantly changed our results of expressed gene-levels. Moreover, we aimed to identify potential microRNA-biomarkers for subclinical hypothyroidism - markers that could be traced to offspring as well.

Methods: From a cohort of at-term pregnant women undergoing planned cesarean section, 77 women had expression levels of the mitochondria-related genes Peroxisome Proliferator-activated Receptor-γ coactivator-1β (PGC-1β), mitochondrial Transcription Factor A (TFAM), Superoxide Dismutase 2 (SOD2) and Nuclear Respiratory Factor 2 (NRF-2) determined by qPCR from blood sampled in prior to delivery. Two TSH-cutoff levels defining subclinical hypothyroidism (> 3.0 and > 3.7 mIU/L) were applied for the procession of results, generating two data analyses of the same cohort. In 22 pairwise maternal-cord samples (subclinical hypothyroid/euthyroid-rate 0.5, TSH-cutoff > 3.0 mIU/L), microRNA-expressions (miRNA) were analyzed.

Results: All gene expressions were lower in the subclinical hypothyroid group regardless of applied TSH-cutoff, but insignificant except for PGC-1β at TSH cutoff > 3.0 mIU/L. Two miRNAs (hsa-let-7d-3p and hsa-miR-345-5p) were upregulated in blood from women and offspring (cord blood) with subclinical hypothyroidism.

Conclusions: A trend towards decreased mitochondrial gene expressions in subclinical hypothyroidism were demonstrated. The miRNAs hsa-let-7d-3p and hsa-miR-345-5p might be potential markers of maternal subclinical hypothyroidism. However, larger studies are needed to verify the findings.

背景:妊娠期亚临床甲状腺功能减退症和促甲状腺激素(TSH)上限的定义存在争议。由于线粒体受到甲状腺激素的影响,本研究的目的是测量甲状腺功能正常和亚临床甲状腺功能减退孕妇线粒体相关基因的表达,以了解母体亚临床甲状腺机能减退的潜在代谢后果。此外,我们希望测试应用TSH截断是否显著改变了我们表达基因水平的结果。此外,我们旨在确定亚临床甲状腺功能减退症的潜在微小RNA生物标志物,这些标志物也可以追溯到后代。方法:从计划剖宫产的足月孕妇队列中,77名妇女的线粒体相关基因过氧化物酶体增殖因子激活受体-γ共激活因子-1β(PGC-1β)、线粒体转录因子a(TFAM)、,通过qPCR从分娩前采集的血液中测定超氧化物歧化酶2(SOD2)和核呼吸因子2(NRF-2)。定义亚临床甲状腺功能减退症的两个TSH临界水平(> 3.0和 > 3.7mIU/L)用于结果处理,生成同一队列的两个数据分析。在22个成对的母体脐带样本中(亚临床甲状腺功能减退/甲状腺功能正常率0.5,TSH临界值 > 3.0mIU/L)、微小RNA表达(miRNA)。结果:亚临床甲状腺功能减退组的所有基因表达均较低,无论TSH阈值如何,但除PGC-1β外,其他基因表达均不显著 > 3.0 mIU/L。两种miRNA(hsa-let-7d-3p和hsa-miR-345-5p)在患有亚临床甲状腺功能减退症的妇女和后代(脐带血)的血液中上调。结论:亚临床甲状腺功能减退症患者线粒体基因表达呈下降趋势。miRNA hsa-let-7d-3p和hsa-miR-345-5p可能是母体亚临床甲状腺功能减退的潜在标志物。然而,还需要更大规模的研究来验证这些发现。
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引用次数: 0
Impact of thyroid hormone treatment on maternal pregnancy outcomes in women with subclinical hypothyroidism without TPOAb: a retrospective cross-sectional study. 甲状腺激素治疗对无TPOAb的亚临床甲状腺功能减退患者妊娠结局的影响:一项回顾性横断面研究
IF 2.2 Q3 Medicine Pub Date : 2023-09-11 DOI: 10.1186/s13044-023-00171-7
Georgiana Sitoris, Flora Veltri, Emna Jelloul, Pierre Kleynen, Serge Rozenberg, Kris G Poppe

Background: Evidence on the impact of thyroid hormone treatment (LT4) on maternal pregnancy outcomes in women with subclinical hypothyroidism (SCH) without thyroid peroxidase antibodies (TPOAb) positivity is scarce.

Methods: Single centre, cross-sectional study in 1460 women screened for TSH, free T4 and TPOAb at median 13 (11-17) weeks of gestation during the period 2013-2014. Exclusion criteria were twin- and assisted reproduction pregnancies, TPO positivity, overt thyroid dysfunction, and treatment with LT4 before screening. The impact of LT4 on maternal pregnancy outcomes was investigated in a group of 53 women with SCH (TSH > 3.74 mIU/L) in which LT4 was initiated at median 13 (10-22) weeks (treated group). The control group included 18 women with SCH (TSH > 3.74 mIU/L). The prevalence of pregnancy complications in these two groups was compared with that in a euthyroid reference (REF) group of 1389 women (TSH ≤ 3.74 mIU/L).

Results: The prevalence of pre-eclampsia and gestational diabetes (GDM) was higher in the control group vs the REF group (16.7% vs 5.0% and 27.8% vs 18.9%; p = 0.017 and p = 0.016, respectively), but comparable in the treated group vs the REF group (7.6% vs 5.0% and 22.6% vs 18.9%; p = 0.918 and 0.676, respectively). The prevalence of iron-deficiency anaemia was lower in the treated vs the REF group (17.0% vs 32.5%; p = 0.017).

Conclusion: Pregnant women with untreated SCH and without TPOAb positivity had a higher prevalence of pre-eclampsia and GDM compared with euthyroid women, while this was not the case in women with treated SCH, even when it was initiated after the first trimester.

背景:甲状腺激素治疗(LT4)对无甲状腺过氧化物酶抗体(TPOAb)阳性的亚临床甲状腺功能减退(SCH)患者妊娠结局影响的证据很少。方法:对2013-2014年期间1460名中位妊娠13(11-17)周进行TSH、游离T4和TPOAb筛查的女性进行单中心横断面研究。排除标准为双胎和辅助生殖妊娠、TPO阳性、明显甲状腺功能障碍和筛查前接受LT4治疗。在一组53名SCH (TSH > 3.74 mIU/L)妇女中,研究了LT4对孕产妇妊娠结局的影响,其中LT4在中位13(10-22)周(治疗组)开始。对照组患者18例,TSH > 3.74 mIU/L。将两组妊娠并发症发生率与正常甲状腺参考(REF)组1389例(TSH≤3.74 mIU/L)进行比较。结果:对照组子痫前期和妊娠期糖尿病(GDM)患病率高于REF组(16.7% vs 5.0%, 27.8% vs 18.9%;p = 0.017和p = 0.016),但治疗组与REF组具有可比性(7.6% vs 5.0%和22.6% vs 18.9%;P = 0.918, 0.676)。治疗组缺铁性贫血的患病率低于REF组(17.0% vs 32.5%;p = 0.017)。结论:与甲状腺功能正常的孕妇相比,未经治疗的SCH和TPOAb阳性的孕妇有更高的先兆子痫和GDM的患病率,而接受治疗的SCH妇女则不是这种情况,即使在妊娠早期开始治疗也是如此。
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引用次数: 0
Thyroid Research celebrates its 15th year of publication achieving its first Journal impact factor. 甲状腺研究庆祝其出版的第15年,实现其第一个期刊影响因子。
IF 2.2 Q3 Medicine Pub Date : 2023-09-01 DOI: 10.1186/s13044-023-00179-z
Simone de Leo, Bijay Vaidya
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引用次数: 0
Severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinic. 甲状腺功能减退的严重程度与内分泌门诊患者的生活质量受损呈负相关。
IF 2.2 Q3 Medicine Pub Date : 2023-09-01 DOI: 10.1186/s13044-023-00178-0
Camilla B Larsen, Kristian Hillert Winther, Per Karkov Cramon, Åse Krogh Rasmussen, Ulla Feldt-Rasmussen, Mogens Groenvold, Jakob Bue Bjorner, Laszlo Hegedüs, Torquil Watt, Steen Joop Bonnema

Purpose: We investigated the association between health-related quality of life (HRQL) and the severity of hypothyroidism at diagnosis in patients referred to a secondary hospital clinic.

Methods: Sixty-seven adult patients referred from primary care were enrolled. All patients had newly diagnosed hypothyroidism due to autoimmune thyroiditis and were treated with levothyroxine (LT4). The dose was adjusted according to thyroid function tests aiming at a normal plasma thyrotropin. Patients were stratified according to the severity of hypothyroidism in two different ways: the conventional approach (subclinical or overt hypothyroidism) and a novel approach according to the change (decrease or increase) in plasma level of free triiodothyronine index (FT3I) following LT4 treatment. The ThyPRO-39 questionnaire was used for measurement of HRQL at referral to the Endocrine Outpatient Clinic (higher score corresponds to worse HRQL).

Results: Free thyroxine index (FT4I) at diagnosis correlated positively with the scores on the Hypothyroid Symptoms and Tiredness scales (p = 0.018 for both). In accordance, patients with subclinical hypothyroidism (n = 36) scored higher on Hypothyroid Symptoms (p = 0.029) than patients with overt hypothyroidism (n = 31). The difference in HRQL was more pronounced if patients were stratified according to the dynamics in FT3I following LT4 treatment. Thus, patients who showed a decrease in FT3I following treatment (n = 24) scored significantly worse for Anxiety (p = 0.032) and Emotional Susceptibility (p = 0.035) than patients with an increase in FT3I (n = 43).

Conclusion: Patients referred to an endocrine clinic with mild hypothyroidism had an impaired HRQL, compared to patients with more severe hypothyroidism. The most likely explanation of this finding is a lower threshold for seeking medical consultation and secondary care referral if HRQL is deteriorated. The dynamics in plasma FT3I following treatment may be more sensitive for such a discrimination in HRQL than a stratification according to the thyroid function tests at diagnosis.

目的:我们调查与健康相关的生活质量(HRQL)与转介到二级医院诊所诊断的甲状腺功能减退患者的严重程度之间的关系。方法:纳入67例从初级保健转介的成年患者。所有患者均为新诊断的自身免疫性甲状腺炎引起的甲状腺功能减退,并接受左旋甲状腺素(LT4)治疗。剂量根据甲状腺功能测试调整,目标是血浆促甲状腺素正常。根据甲状腺功能减退的严重程度,采用两种不同的方法对患者进行分层:常规方法(亚临床或明显甲状腺功能减退)和根据LT4治疗后血浆游离三碘甲状腺原氨酸指数(FT3I)水平的变化(降低或增加)的新方法。采用ThyPRO-39问卷测量转诊至内分泌门诊的HRQL(评分越高HRQL越差)。结果:诊断时游离甲状腺素指数(FT4I)与甲状腺功能减退和疲劳量表得分呈正相关(p = 0.018)。与此同时,亚临床甲状腺功能减退患者(n = 36)在甲状腺功能减退症状上的得分高于显性甲状腺功能减退患者(n = 31) (p = 0.029)。如果根据LT4治疗后FT3I的动态对患者进行分层,HRQL的差异更为明显。因此,治疗后FT3I水平下降的患者(n = 24)在焦虑(p = 0.032)和情绪敏感性(p = 0.035)方面的得分明显低于FT3I水平升高的患者(n = 43)。结论:转介内分泌诊所的轻度甲状腺功能减退患者的HRQL受损,与更严重的甲状腺功能减退患者相比。这一发现最可能的解释是,如果HRQL恶化,寻求医疗咨询和二级保健转诊的门槛较低。治疗后血浆FT3I的动态变化可能比诊断时根据甲状腺功能检查进行分层更敏感。
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引用次数: 0
Correlation of the ultrasound thyroid imaging reporting and data system with cytology findings among patients in Uganda. 乌干达患者甲状腺超声成像报告和数据系统与细胞学检查结果的相关性。
IF 2.2 Q3 Medicine Pub Date : 2023-09-01 DOI: 10.1186/s13044-023-00169-1
Hamdi Mohamed Isse, Robert Lukande, Senai Goitom Sereke, Fualal Jane Odubu, Rita Nassanga, Samuel Bugeza

Background: Ultrasonography is a noninvasive modality for the initial assessment of thyroid nodules. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) has demonstrated good performance in differentiating malignant thyroid nodules. However, the combination of ACR TI-RADS categories and cytology has not been studied extensively, in Uganda. The study aims to correlate ACR TI-RADS with cytology among patients referred for US-guided fine-needle aspiration at Mulago National Referral Hospital.

Methods: This was a hospital-based cross-sectional study that recruited 132 patients with thyroid nodules. Spearman's correlation was used to establish a relationship between TI-RADS and cytology findings. The diagnostic accuracy of TI-RADS was assessed using sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios.

Results: Of 132 study participants, 90% (n = 117) were females, and the mean age was 41 ± 13 years. One hundred sixty-one thyroid nodules were analyzed. More than half of the thyroid nodules (54.7%, n = 87) were solid or almost solid, 96.9% (n = 154) were shaped wider than tall, 57.2% (n = 91) had smooth margins, 83.7% (n = 133) were hyperechoic or isoechoic, and 88.7% (n = 141) had no echogenic foci. TI-RADS 3 was the most common at 42.9% (n = 69). The proportions of malignancy for TI-RADS 4 and TI-RADS 5 were 73.3% and 85.7%, respectively. The correlation between ACR TI-RADS and the Bethesda system of thyroid classification scores was r = 0.577. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of ACR TI-RADS were 90.9%, 98.5%, 90%, 99.3%, 62.3, and 0.1, respectively.

Conclusion: We found that ACR TI-RADS classification is an appropriate and noninvasive method for assessing thyroid nodules in routine practice. It can safely reduce the number of unnecessary fine-needle aspiration in a significant proportion of benign thyroid lesions. Thyroid nodules classified as TI-RADS 3 should be followed routinely. ACR TI-RADS should be standardized as the screening tool in resource-limited areas.

背景:超声检查是一种对甲状腺结节进行初步评估的非侵入性方法。美国放射学会甲状腺成像报告和数据系统(ACR TI-RADS)在鉴别恶性甲状腺结节方面表现良好。然而,在乌干达,ACR TI-RADS分类和细胞学的结合尚未得到广泛研究。该研究旨在将在穆拉戈国家转诊医院接受美国引导细针抽吸的患者中的ACR TI-RADS与细胞学相关联。方法:这是一项基于医院的横断面研究,招募了132名甲状腺结节患者。Spearman相关性用于建立TI-RADS与细胞学检查结果之间的关系。TI-RADS的诊断准确性通过敏感性、特异性、阳性和阴性预测值以及阳性和阴性似然比进行评估。结果:在132名研究参与者中,90%(n = 117)为女性,平均年龄41岁 ± 13年。对161个甲状腺结节进行了分析。超过一半的甲状腺结节(54.7% = 87)为固体或几乎固体,96.9%(n = 154)比高宽57.2%(n = 边缘光滑者占83.7%(n = 133)为高回声或等回声,88.7%(n = 141)无回声灶。TI-RADS 3最常见,为42.9%(n = 69)。TI-RADS 4和TI-RADS 5的恶性肿瘤比例分别为73.3%和85.7%。ACR TI-RADS与Bethesda甲状腺分类评分系统的相关性为r = ACR TI-RADS的敏感性、特异性、阳性和阴性预测值以及阳性和阴性似然比分别为90.9%、98.5%、90%、99.3%、62.3和0.1。结论:我们发现ACR TI-RADS分类是一种在常规实践中评估甲状腺结节的合适且无创的方法。它可以安全地减少在相当大比例的甲状腺良性病变中不必要的细针抽吸次数。分类为TI-RADS 3的甲状腺结节应进行常规随访。ACR TI-RADS应作为资源有限地区的筛查工具进行标准化。
{"title":"Correlation of the ultrasound thyroid imaging reporting and data system with cytology findings among patients in Uganda.","authors":"Hamdi Mohamed Isse, Robert Lukande, Senai Goitom Sereke, Fualal Jane Odubu, Rita Nassanga, Samuel Bugeza","doi":"10.1186/s13044-023-00169-1","DOIUrl":"10.1186/s13044-023-00169-1","url":null,"abstract":"<p><strong>Background: </strong>Ultrasonography is a noninvasive modality for the initial assessment of thyroid nodules. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) has demonstrated good performance in differentiating malignant thyroid nodules. However, the combination of ACR TI-RADS categories and cytology has not been studied extensively, in Uganda. The study aims to correlate ACR TI-RADS with cytology among patients referred for US-guided fine-needle aspiration at Mulago National Referral Hospital.</p><p><strong>Methods: </strong>This was a hospital-based cross-sectional study that recruited 132 patients with thyroid nodules. Spearman's correlation was used to establish a relationship between TI-RADS and cytology findings. The diagnostic accuracy of TI-RADS was assessed using sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios.</p><p><strong>Results: </strong>Of 132 study participants, 90% (n = 117) were females, and the mean age was 41 ± 13 years. One hundred sixty-one thyroid nodules were analyzed. More than half of the thyroid nodules (54.7%, n = 87) were solid or almost solid, 96.9% (n = 154) were shaped wider than tall, 57.2% (n = 91) had smooth margins, 83.7% (n = 133) were hyperechoic or isoechoic, and 88.7% (n = 141) had no echogenic foci. TI-RADS 3 was the most common at 42.9% (n = 69). The proportions of malignancy for TI-RADS 4 and TI-RADS 5 were 73.3% and 85.7%, respectively. The correlation between ACR TI-RADS and the Bethesda system of thyroid classification scores was r = 0.577. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of ACR TI-RADS were 90.9%, 98.5%, 90%, 99.3%, 62.3, and 0.1, respectively.</p><p><strong>Conclusion: </strong>We found that ACR TI-RADS classification is an appropriate and noninvasive method for assessing thyroid nodules in routine practice. It can safely reduce the number of unnecessary fine-needle aspiration in a significant proportion of benign thyroid lesions. Thyroid nodules classified as TI-RADS 3 should be followed routinely. ACR TI-RADS should be standardized as the screening tool in resource-limited areas.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10472606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10265211","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
Ultrasound characteristics of follicular and parafollicular thyroid neoplasms: diagnostic performance of artificial neural network. 甲状腺滤泡及滤泡旁肿瘤的超声特征:人工神经网络的诊断性能。
IF 2.2 Q3 Medicine Pub Date : 2023-08-28 DOI: 10.1186/s13044-023-00168-2
Michael Cordes, Theresa Ida Götz, Stephan Coerper, Torsten Kuwert, Christian Schmidkonz

Background: Ultrasound is the first-line imaging modality for detection and classification of thyroid nodules. Certain features observable by ultrasound have recently been equated with potential malignancy. This retrospective cohort study was conducted to test the hypothesis that radiomics of the four categorical divisions (medullary [MTC], papillary [PTC], or follicular [FTC] carcinoma and follicular thyroid adenoma [FTA]) demonstrate distinctive sonographic characteristics. Using an artificial neural network model for proof of concept, these sonographic features served as input.

Methods: A total of 148 patients were enrolled for study, all with confirmed thyroid pathology in one of the four named categories. Preoperative ultrasound profiles were obtained via standardized protocols. The neural network consisted of seven input neurons; three hidden layers with 50, 250, and 100 neurons, respectively; and one output layer.

Results: Radiomics of contour, structure, and calcifications differed significantly according to nodule type (p = 0.025, p = 0.032, and p = 0.0002, respectively). Levels of accuracy shown by artificial neural network analysis in discriminating among categories ranged from 0.59 to 0.98 (95% confidence interval [CI]: 0.57-0.99), with positive and negative predictive ranges of 0.41-0.99 and 0.78-0.97, respectively.

Conclusions: Our data indicate that some MTCs, PTCs, FTCs, and FTAs have distinctive sonographic characteristics. However, a significant overlap of these characteristics may impede an explicit classification. Further prospective investigations involving larger patient and nodule numbers and multicenter access should be pursued to determine if neural networks of this sort are beneficial, helping to classify neoplasms of the thyroid gland.

背景:超声是甲状腺结节检测和分类的一线影像学手段。超声观察到的某些特征最近被认为是潜在的恶性肿瘤。本回顾性队列研究旨在验证四种类型(髓样癌(MTC)、乳头状癌(PTC)、滤泡癌(FTC)和滤泡甲状腺腺瘤(FTA))的放射组学表现出不同超声特征的假设。使用人工神经网络模型进行概念验证,这些超声特征作为输入。方法:共纳入148例患者进行研究,所有患者均确诊为四类甲状腺病理之一。术前超声资料通过标准化方案获得。该神经网络由7个输入神经元组成;三个隐藏层,分别有50、250和100个神经元;还有一个输出层。结果:不同类型结节的轮廓、结构、钙化放射组学差异有统计学意义(p = 0.025, p = 0.032, p = 0.0002)。人工神经网络分析的分类判别准确率范围为0.59 ~ 0.98(95%置信区间[CI]: 0.57 ~ 0.99),阳性预测范围为0.41 ~ 0.99,阴性预测范围为0.78 ~ 0.97。结论:我们的数据表明,一些MTCs、ptc、FTCs和FTAs具有独特的超声特征。然而,这些特征的显著重叠可能会妨碍明确的分类。进一步的前瞻性研究涉及更多的患者和结节数量和多中心访问,以确定这种类型的神经网络是否有益,有助于甲状腺肿瘤的分类。
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引用次数: 0
Clinicopathological profile and management of thyroid carcinoma: a Sub-Saharan country experience. 甲状腺癌的临床病理概况和管理:撒哈拉以南国家的经验。
IF 2.2 Q3 Medicine Pub Date : 2023-08-25 DOI: 10.1186/s13044-023-00173-5
Moawia Mohammed Ali Elhassan, Mohamed Dafalla Awadalla Gismalla, Sahar Abdelrahman Hamid Mohamed, Areeg Faggad

Background: In Sudan, there is limited knowledge on the epidemiology, clinical characteristics and pathological patterns of thyroid cancer. To address this shortcoming, we studied the clinical, pathological and treatment patterns of thyroid cancer at the National Cancer Institute ‒ University of Gezira (NCI-UG), Sudan.

Methods: We performed a retrospective health facility-based study of patients with thyroid cancer who were treated at NCI-UG from January 2009 to December 2017.

Results: A total of 139 patients with thyroid cancer were identified during the study period. Tumors were more common among women (69%). Goiter was the main presenting symptom (85%). The most common type of thyroid cancer was follicular carcinoma (41%), followed by papillary carcinoma (24%), then anaplastic carcinoma (20%). The mean age of the women was 56.3 years (SD ± 14.7), compared to 52.5 years (SD ± 16.6) for the men. The frequencies of stage I, II, III, and IV were 17%, 22%, 16%, and 45%, respectively. Different types of thyroidectomies were performed in 79% of the cases, lobectomy in 4%, and no surgery in 17%. Only 28% of the cases received radioactive iodine. Palliative chemotherapy and radiotherapy were prescribed to 17% and 37% of the cases, respectively.

Conclusion: Thyroid cancer is more prevalent among women and most patients present at later stages. The dominance of follicular type suggests that the majority of this population is iodine-deficient.

背景:在苏丹,对甲状腺癌的流行病学、临床特征和病理模式的了解有限。为了解决这一缺陷,我们研究了苏丹国家癌症研究所-格齐拉大学(NCI-UG)甲状腺癌的临床、病理和治疗模式。方法:我们对2009年1月至2017年12月在NCI-UG接受治疗的甲状腺癌患者进行了一项基于医疗机构的回顾性研究。结果:研究期间共发现139例甲状腺癌患者。肿瘤在女性中更为常见(69%)。甲状腺肿大是主要症状(85%)。甲状腺癌最常见的类型是滤泡癌(41%),其次是乳头状癌(24%),然后是间变性癌(20%)。女性的平均年龄为56.3岁(SD±14.7),男性为52.5岁(SD±16.6)。I期、II期、III期和IV期的发生率分别为17%、22%、16%和45%。不同类型的甲状腺切除术占79%,肺叶切除术占4%,未手术的占17%。只有28%的病例接受了放射性碘治疗。姑息性化疗和放疗分别适用于17%和37%的病例。结论:甲状腺癌在女性中更为普遍,且大多数患者出现在晚期。卵泡型的优势表明,大多数人是缺碘的。
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引用次数: 0
Sonographic changes in the thyroid gland after sclerotherapy with doxycycline can be mistaken for thyroid cancer. 强力霉素硬化治疗后甲状腺超声变化可被误认为甲状腺癌。
IF 2.2 Q3 Medicine Pub Date : 2023-08-17 DOI: 10.1186/s13044-023-00177-1
Steven Raeymaeckers, Maurizio Tosi, Bastiaan Sol, Johan De Mey

Background: The literature considers sclerotherapy to be a safe and effective treatment for benign thyroid cysts. No subsequent diagnostic problems have been reported as a complication. We report the occurrence of focal inflammation after said therapy, mimicking a thyroid malignancy.

Case presentation: We report a case of a young male with a solitary strongly suspicious lesion in the thyroid. The patient had undergone prior sclerotherapy of a thyroid cyst with Doxycycline. The lesion appeared to be a focal area of inflammation and thus iatrogenic in nature. Systemic use of doxycycline is known to sometimes cause a non-immune chemical thyroiditis, dubbed as black thyroid due to the intense black discoloration of the thyroid. It might be that the instillation of doxycycline was responsible for a similar, more localized area of thyroiditis.

Conclusions: For the work-up of a solitary suspicious thyroid lesion, the medical history of the patient should always be considered. In case of prior ipsilateral sclerotherapy, a reactive inflammatory response may mimic thyroid malignancy. A fine needle aspiration should be performed to exclude thyroid cancer. Treatment is not necessary; the process appears to be self-limiting as evidenced in the follow-up of this case.

背景:文献认为硬化疗法是一种安全有效的治疗良性甲状腺囊肿的方法。没有后续诊断问题被报道为并发症。我们报告局灶性炎症的发生后,上述治疗,模仿甲状腺恶性肿瘤。病例介绍:我们报告一例年轻男性与一个孤立的强烈可疑病变在甲状腺。患者曾接受多西环素甲状腺囊肿硬化治疗。病变似乎是炎症的焦点区域,因此在本质上是医源性的。众所周知,系统使用强力霉素有时会引起非免疫性化学甲状腺炎,由于甲状腺呈强烈的黑色变色,被称为黑色甲状腺。这可能是多西环素的灌注负责一个类似的,更局部的区域甲状腺炎。结论:对单发可疑甲状腺病变的检查,应充分考虑患者的病史。在先前同侧硬化治疗的情况下,反应性炎症反应可能模仿甲状腺恶性肿瘤。应进行细针抽吸以排除甲状腺癌。治疗是不必要的;这一过程似乎是自我限制的,这在本病例的后续行动中得到了证明。
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引用次数: 0
Challenges in the care of patients with RET-altered thyroid cancer: a multicountry mixed-methods study. ret改变甲状腺癌患者护理的挑战:一项多国混合方法研究
IF 2.2 Q3 Medicine Pub Date : 2023-08-14 DOI: 10.1186/s13044-023-00166-4
Suzanne Murray, Vivek Subbiah, Steven I Sherman, Sophie Péloquin, Anthony Sireci, Christian Grohé, Patrick Bubach, Patrice Lazure

Background: The discovery of driver oncogenes for thyroid carcinomas and the identification of genomically targeted therapies to inhibit those oncogenes have altered the treatment algorithm in thyroid cancer (TC), while germline testing for RET mutations has become indicated for patients with a family history of RET gene mutations or hereditary medullary TC (MTC). In the context of an increasing number of selective RET inhibitors approved for use, this paper aims to describe challenges and barriers affecting providers' ability to deliver optimal care for patients with RET-altered TC across the patient healthcare journey.

Methods: A mixed-method educational and behavioral needs assessment was conducted in Germany (GER), Japan (JPN), the United Kingdom (UK), and the United States (US) prior to RET-selective inhibitor approval. Participants included medical oncologists (MO), endocrinologists (EN) and clinical pathologists (CP) caring for patients affected with TC. Data collection tools were implemented in three languages (English, German, Japanese). Qualitative data were coded and thematically analyzed in NVivo. Quantitative data were analyzed via frequency and crosstabulations in SPSS. The findings presented here were part of a broader study that also investigated lung cancer challenges and included pulmonologists.

Results: A total of 44 interviews and 378 surveys were completed. Suboptimal knowledge and skills were self-identified among providers, affecting (1) assessment of genetic risk factors (56%, 159/285 of MOs and ENs), (2) selection of appropriate genetic biomarkers (59%, 53/90 of CPs), (3) treatment plan initiation (65%, 173/275 of MOs and ENs), (4) management of side effects associated with multitargeted tyrosine kinase inhibitors (78%, 116/149 of MOs and ENs), and (5) transfer of patients into palliative care services (58%, 160/274 of MOs and ENs). Interviews underscored the presence of systemic barriers affecting the use of RET molecular tests and selective inhibitors, in addition to suboptimal knowledge and skills necessary to manage the safety and efficacy of targeted therapies.

Conclusion: This study describes concrete educational needs for providers involved in the care of patients with RET-altered thyroid carcinomas. Findings can be used to inform the design of evidence-based education and performance improvement interventions in the field and support integration into practice of newly approved RET-selective inhibitors.

背景:甲状腺癌驱动癌基因的发现和抑制这些癌基因的基因组靶向治疗的发现改变了甲状腺癌(TC)的治疗方法,而RET突变的种系检测已成为具有RET基因突变或遗传性髓样TC (MTC)家族史的患者的适应症。在越来越多的选择性RET抑制剂被批准使用的背景下,本文旨在描述影响提供者在患者医疗保健过程中为RET改变的TC患者提供最佳护理的能力的挑战和障碍。方法:在批准ret选择性抑制剂之前,在德国(GER)、日本(JPN)、英国(UK)和美国(US)进行了一项混合方法的教育和行为需求评估。参与者包括治疗TC患者的内科肿瘤学家(MO)、内分泌学家(EN)和临床病理学家(CP)。数据收集工具以三种语言(英语、德语、日语)实施。在NVivo中对定性数据进行编码和主题分析。定量数据采用SPSS软件进行频率和交叉统计分析。这里的发现是一项更广泛的研究的一部分,该研究还调查了肺癌的挑战,包括肺病学家。结果:共完成44次访谈,378次问卷调查。服务提供者自我认为知识和技能不佳,影响(1)遗传风险因素评估(56%,MOs和ENs的159/285),(2)选择合适的遗传生物标志物(59%,CPs的53/90),(3)治疗计划启动(65%,MOs和ENs的173/275),(4)多靶向酪氨酸激酶抑制剂相关副作用管理(78%,MOs和ENs的116/149),以及(5)将患者转移到缓和护理服务(58%,MOs和ENs的160/274)。访谈强调了影响RET分子测试和选择性抑制剂使用的系统性障碍,以及管理靶向治疗的安全性和有效性所需的次优知识和技能。结论:本研究描述了参与ret改变甲状腺癌患者护理的提供者的具体教育需求。研究结果可用于为现场循证教育和绩效改善干预措施的设计提供信息,并支持将新批准的ret选择性抑制剂整合到实践中。
{"title":"Challenges in the care of patients with RET-altered thyroid cancer: a multicountry mixed-methods study.","authors":"Suzanne Murray,&nbsp;Vivek Subbiah,&nbsp;Steven I Sherman,&nbsp;Sophie Péloquin,&nbsp;Anthony Sireci,&nbsp;Christian Grohé,&nbsp;Patrick Bubach,&nbsp;Patrice Lazure","doi":"10.1186/s13044-023-00166-4","DOIUrl":"https://doi.org/10.1186/s13044-023-00166-4","url":null,"abstract":"<p><strong>Background: </strong>The discovery of driver oncogenes for thyroid carcinomas and the identification of genomically targeted therapies to inhibit those oncogenes have altered the treatment algorithm in thyroid cancer (TC), while germline testing for RET mutations has become indicated for patients with a family history of RET gene mutations or hereditary medullary TC (MTC). In the context of an increasing number of selective RET inhibitors approved for use, this paper aims to describe challenges and barriers affecting providers' ability to deliver optimal care for patients with RET-altered TC across the patient healthcare journey.</p><p><strong>Methods: </strong>A mixed-method educational and behavioral needs assessment was conducted in Germany (GER), Japan (JPN), the United Kingdom (UK), and the United States (US) prior to RET-selective inhibitor approval. Participants included medical oncologists (MO), endocrinologists (EN) and clinical pathologists (CP) caring for patients affected with TC. Data collection tools were implemented in three languages (English, German, Japanese). Qualitative data were coded and thematically analyzed in NVivo. Quantitative data were analyzed via frequency and crosstabulations in SPSS. The findings presented here were part of a broader study that also investigated lung cancer challenges and included pulmonologists.</p><p><strong>Results: </strong>A total of 44 interviews and 378 surveys were completed. Suboptimal knowledge and skills were self-identified among providers, affecting (1) assessment of genetic risk factors (56%, 159/285 of MOs and ENs), (2) selection of appropriate genetic biomarkers (59%, 53/90 of CPs), (3) treatment plan initiation (65%, 173/275 of MOs and ENs), (4) management of side effects associated with multitargeted tyrosine kinase inhibitors (78%, 116/149 of MOs and ENs), and (5) transfer of patients into palliative care services (58%, 160/274 of MOs and ENs). Interviews underscored the presence of systemic barriers affecting the use of RET molecular tests and selective inhibitors, in addition to suboptimal knowledge and skills necessary to manage the safety and efficacy of targeted therapies.</p><p><strong>Conclusion: </strong>This study describes concrete educational needs for providers involved in the care of patients with RET-altered thyroid carcinomas. Findings can be used to inform the design of evidence-based education and performance improvement interventions in the field and support integration into practice of newly approved RET-selective inhibitors.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10424354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10006219","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: 1
Histopathological features of asymmetric lacrimal gland enlargement in patients with thyroid eye disease. 甲状腺眼病患者不对称泪腺肿大的组织病理学特征。
IF 2.2 Q3 Medicine Pub Date : 2023-08-14 DOI: 10.1186/s13044-023-00174-4
Pav Gounder, Huw Oliphant, Valerie Juniat, Michael Koenig, Dinesh Selva, Saul N Rajak

Purpose: Lacrimal gland enlargement can be a feature of thyroid eye disease (TED). Unilateral or asymmetric lacrimal gland enlargement is poorly described and may impede diagnosis. We present the histological and clinical findings of four patients with asymmetric lacrimal gland enlargement.

Methods: A retrospective case note review was performed for patients over two tertiary orbital clinics (Royal Adelaide Hospital, South Australia and the Sussex Eye Hospital, Brighton, United Kingdom) presenting with an asymmetrical lacrimal gland enlargement with a background of TED that underwent biopsy to exclude alternate diagnoses. Baseline data was collected for each patient and histopathological images and reports were reviewed.

Results: All four patients were hyperthyroid at time of lacrimal gland biopsy. Biopsy demonstrated nonspecific, lymphoid aggregates, typically of B cell type, with no diagnostic findings to support lymphocyte clonality or IgG4-related disease. One biopsy specimen demonstrated evidence of some fibrosis.

Conclusion: Asymmetrical lacrimal gland enlargement can occur as part of the TED spectrum but may require biopsy to exclude alternate pathology. Histology demonstrates a non-specific lymphocytic infiltrate.

目的:泪腺肿大可能是甲状腺眼病(TED)的一个特征。单侧或不对称的泪腺肿大描述不佳,可能妨碍诊断。我们报告了4例不对称泪腺肿大患者的组织学和临床表现。方法:对两家三级眼眶诊所(南澳大利亚皇家阿德莱德医院和英国布莱顿苏塞克斯眼科医院)的患者进行回顾性病例回顾,这些患者表现为不对称泪腺肿大,伴有TED背景,并进行活检以排除其他诊断。收集每位患者的基线数据,并回顾组织病理学图像和报告。结果:4例患者泪腺活检时均为甲状腺功能亢进。活检显示非特异性淋巴样聚集体,典型的B细胞型,没有诊断结果支持淋巴细胞克隆或igg4相关疾病。一个活检标本显示有一些纤维化的证据。结论:不对称的泪腺肿大可以作为TED频谱的一部分发生,但可能需要活检来排除其他病理。组织学显示非特异性淋巴细胞浸润。
{"title":"Histopathological features of asymmetric lacrimal gland enlargement in patients with thyroid eye disease.","authors":"Pav Gounder, Huw Oliphant, Valerie Juniat, Michael Koenig, Dinesh Selva, Saul N Rajak","doi":"10.1186/s13044-023-00174-4","DOIUrl":"10.1186/s13044-023-00174-4","url":null,"abstract":"<p><strong>Purpose: </strong>Lacrimal gland enlargement can be a feature of thyroid eye disease (TED). Unilateral or asymmetric lacrimal gland enlargement is poorly described and may impede diagnosis. We present the histological and clinical findings of four patients with asymmetric lacrimal gland enlargement.</p><p><strong>Methods: </strong>A retrospective case note review was performed for patients over two tertiary orbital clinics (Royal Adelaide Hospital, South Australia and the Sussex Eye Hospital, Brighton, United Kingdom) presenting with an asymmetrical lacrimal gland enlargement with a background of TED that underwent biopsy to exclude alternate diagnoses. Baseline data was collected for each patient and histopathological images and reports were reviewed.</p><p><strong>Results: </strong>All four patients were hyperthyroid at time of lacrimal gland biopsy. Biopsy demonstrated nonspecific, lymphoid aggregates, typically of B cell type, with no diagnostic findings to support lymphocyte clonality or IgG4-related disease. One biopsy specimen demonstrated evidence of some fibrosis.</p><p><strong>Conclusion: </strong>Asymmetrical lacrimal gland enlargement can occur as part of the TED spectrum but may require biopsy to exclude alternate pathology. Histology demonstrates a non-specific lymphocytic infiltrate.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10426099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10015057","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
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Thyroid Research
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