This study was conducted to explore possible correlation between smoking habit and thyroid volume and function in Jeddah. A total of 226 volunteers i.e. 128 male and 98 female were screened at Radiology Department Kin...This study was conducted to explore possible correlation between smoking habit and thyroid volume and function in Jeddah. A total of 226 volunteers i.e. 128 male and 98 female were screened at Radiology Department King Abdul-Aziz University Hospital. They were categorized as smokers and non- smokers;the number of smokers was 99 cases i.e. 48 Cigarette smokers and 51 Shisha smokers, and the non-smokers were 127 cases. The information was gathered via a questionnaire distributed at the radiology department. Ultrasonography of thyroid and thyroid function test were performed for 166 participants;and data were analyzed Using SPSS version 22 and Microsoft excel. The study was carried out based on random selection and findings revealed that most of the cases were in the age group between 20 to 30 years old, high body mass index (BMI) was 33.1 kg/m2 in persons above 60 years old and the highest percentage smokers in the age group from 20 to 30 years (40.02%). Ultrasonography of thyroid showed 96 (58%) normal cases, 46 (28%) abnormal “solid” cases and 24 (14%) abnormal “cyst” cases. A lower proportion of cigarette and shisha smokers (15.4% and 5.6% respectively) had an enlarged thyroid gland compared to no cigarettes or shisha smokers (47.9% and 47.3% respectively). The difference between these frequencies was statistically significant (Chi-square = 9.446 and 11.424, p = 0.002 and p = 0.001 for cigarette and shisha smoking respectively). Consequently, it can be concluded from this research that there are no direct significant values correlating smoking habit to thyroid volume or function. However, it is always recommended not smoke due to other well-known threats.展开更多
Objective To assess the effect of different levels of salt iodine content on thyroid volume(ThV) distribution using data from the 1999, 2011, and 2014 Chinese national iodine deficiency disorder(IDD) surveys. Methods ...Objective To assess the effect of different levels of salt iodine content on thyroid volume(ThV) distribution using data from the 1999, 2011, and 2014 Chinese national iodine deficiency disorder(IDD) surveys. Methods Probability proportion to size(PPS) sampling method was used to obtain a representative national sample of 34,547, 38,932, and 47,188 Chinese children aged 8-10 years in 1999, 2011, and 2014 Chinese national IDD surveys, respectively. The iodine content in household iodized salt and urinary iodine concentration were measured and thyroid ultrasound examination was performed. The data were analyzed by SAS software using histograms and box plots. The skewness and kurtosis were calculated for testing the normality of ThV. Results The median iodine content in household iodized salt dropped from 42.30 mg/kg in 1999 to 25.00 mg/kg in 2014. The median urinary iodine concentration of children aged 8-10 years decreased from 306.0 μg/L in 1999 to 197.9 μg/L in 2014. The median and interquartile range(IQR) of ThV in 1999, 2011, and 2014 surveys were 3.44 m L and 1.50 m L, 2.60 m L and 1.37 m L, 2.63 m L and 1.25 m L, respectively. The skewness and kurtosis of ThV distribution in 1999, 2011, and 2014 surveys were 1.34 and 5.84, 0.98 and 3.54, 1.27 and 5.49, respectively. Conclusion With reduced salt iodization levels, the median urinary iodine concentration and median ThV of children decreased significantly, and the symmetry of the ThV distribution improved.展开更多
Purpose:The present work examines the associations of dietary habits,sedentarism,physical activity(PA)levels and sleep habits,with thyroid function in young euthyroid adults.Methods:A total of 105 young euthyroid adul...Purpose:The present work examines the associations of dietary habits,sedentarism,physical activity(PA)levels and sleep habits,with thyroid function in young euthyroid adults.Methods:A total of 105 young euthyroid adults participated in this cross-sectional study.Thyroid function was determined in fasting conditions(>6 h).Dietary habits were measured by a food frequency questionnaire and three non-consecutive 24 h recalls,and different dietary intake and patterns were then estimated.The time spent in sedentary,PA levels and sleep habits were objectively measured using a wrist-worn accelerometer.Results:Energy and carbohydrate intake were positively associated with thyroid stimulating hormone(TSH)(β=0.222;R^(2)=0.102;P=0.022 andβ=0.425;R^(2)=0.129;P=0.007,respectively)whereas fat intake was negatively associated with TSH(β=-0.428;R^(2)=0.137;P=0.004).Energy intake was also positively associated with free triiodothyronine(β=0.277;R^(2)=0.137;P=0.004).Further,adherence to the Mediterranean diet was negatively related to TSH and free thyroxine(FT4)(β=-0.221;R^(2)=0.113;P=0.020 andβ=-0.268;R^(2)=0.071;P=0.007,respectively).Vigorous-intensity and overall PA were negatively associated with FT4(β=-0.227;R^(2)=0.052;P=0.022 andβ=-0.204;R^(2)=0.042;P=0.041,respectively).In contrast,no associations were found between sleep parameters and thyroid function.Conclusions:Lifestyle factors such as dietary intake and PA levels seems to be related to thyroid function even in young euthyroid adults.展开更多
BACKGROUND Patients rarely develop complicated infections in thyroid cysts.Here,we describe a patient with chronic infected unilateral giant thyroid cyst related to diabetes mellitus(DM).CASE SUMMARY A 66-year-old mal...BACKGROUND Patients rarely develop complicated infections in thyroid cysts.Here,we describe a patient with chronic infected unilateral giant thyroid cyst related to diabetes mellitus(DM).CASE SUMMARY A 66-year-old male was admitted due to an evident neck lump for 5 d after approximately 40 years of gradually progressive neck mass and 7 years of DM.Doppler ultrasound and computed tomography scan showed a giant lump in the left thyroid gland lobe.He was diagnosed with a large thyroid nodule complicated by tracheal dislocation and had surgical indications.Surgical exploration revealed evident inflammatory edema and exudation between the left anterior neck muscles,the nodule and glandular tissue.Fortunately,inflammatory lesions did not affect major neck vessels.Finally,a left partial thyroidectomy was performed.Macroscopic observation showed that the cystic thyroid mass consisted of extensive cystic wall calcification and was rich in massive rough sand-like calculi content and purulent matter.Postoperative pathology confirmed benign thyroid cyst with chronic infection.CONCLUSION The progression of this chronic infectious unilateral giant thyroid cyst may have been related to DM,and identifying blood vessels involvement can prevent serious complications during operation.展开更多
BACKGROUND A fish spike stuck in the throat is a common ear,nose,and throat(ENT)emergency.However,it is very rare for a fish spike to reach the thyroid tissue through the throat,which is very dangerous and can lead to...BACKGROUND A fish spike stuck in the throat is a common ear,nose,and throat(ENT)emergency.However,it is very rare for a fish spike to reach the thyroid tissue through the throat,which is very dangerous and can lead to pharyngeal fistula,cervical abscess,mediastinal abscess,and thyroid abscess.Proper and timely management can help reduce complications,especially in elderly patients.CASE SUMMARY In the case presented here,the causative factor was dentures,but improper management aggravated the condition.In the case presented here,an elderly woman with a history of accidentally swallowing fish bones for 20 d had a sensation of foreign bodies in her throat.Eventually,computed tomography(CT)of the neck showed that the left side of the thyroid gland had a dense shadow in the form of a stripe.CONCLUSION If a fishbone foreign body is not visible during endoscopic examination but the patient has significant symptoms,the surgeon should be aware that the fishbone may be lodged in the thyroid.To avoid a misdiagnosis,ultrasound,CT,and other tests can be used to clarify the diagnosis.T The first step in treating a fish bone in the thyroid gland is to determine the position of the foreign body and the extent of the infection,and to develop a personalized surgical plan for its removal.At the same time,scientific information should be made available to the general public so that people know that if a fish bone is accidentally lodged,they should not force it to be swallowed or be spit out by inducing vomiting,which are incorrect methods and may aggravate the condition or even cause it to migrate outside the cavity,leading to serious complications,as in this reported case.展开更多
As a common hyperglycemic disease,type 1 diabetes mellitus(T1DM)is a complicated disorder that requires a lifelong insulin supply due to the immunemediated destruction of pancreaticβcells.Although it is an organ-spec...As a common hyperglycemic disease,type 1 diabetes mellitus(T1DM)is a complicated disorder that requires a lifelong insulin supply due to the immunemediated destruction of pancreaticβcells.Although it is an organ-specific autoimmune disorder,T1DM is often associated with multiple other autoimmune disorders.The most prevalent concomitant autoimmune disorder occurring in T1DM is autoimmune thyroid disease(AITD),which mainly exhibits two extremes of phenotypes:hyperthyroidism[Graves'disease(GD)]and hypothyroidism[Hashimoto's thyroiditis,(HT)].However,the presence of comorbid AITD may negatively affect metabolic management in T1DM patients and thereby may increase the risk for potential diabetes-related complications.Thus,routine screening of thyroid function has been recommended when T1DM is diagnosed.Here,first,we summarize current knowledge regarding the etiology and pathogenesis mechanisms of both diseases.Subsequently,an updated review of the association between T1DM and AITD is offered.Finally,we provide a relatively detailed review focusing on the application of thyroid ultrasonography in diagnosing and managing HT and GD,suggesting its critical role in the timely and accurate diagnosis of AITD in T1DM.展开更多
BACKGROUND Diabetes and thyroiditis are closely related.They occur in combination and cause significant damage to the body.There is no clear treatment for type-2 diabetes mellitus(T2DM)with Hashimoto's thyroiditis...BACKGROUND Diabetes and thyroiditis are closely related.They occur in combination and cause significant damage to the body.There is no clear treatment for type-2 diabetes mellitus(T2DM)with Hashimoto's thyroiditis(HT).While single symptomatic drug treatment of the two diseases is less effective,combined drug treatment may improve efficacy.AIM To investigate the effect of a combination of vitamin D,selenium,and hypoglycemic agents in T2DM with HT.METHODS This retrospective study included 150 patients with T2DM and HT treated at The Central Hospital of Shaoyang from March 2020 to February 2023.Fifty patients were assigned to the control group,test group A,and test group B according to different treatment methods.The control group received low-iodine diet guidance and hypoglycemic drug treatment.Test group A received the control treatment plus vitamin D treatment.Test group B received the group A treatment plus selenium.Blood levels of markers of thyroid function[free T3(FT3),thyroid stimulating hormone(TSH),free T4(FT4)],autoantibodies[thyroid peroxidase antibody(TPOAB)and thyroid globulin antibody(TGAB)],blood lipid index[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triacylglycerol(TG)],blood glucose index[fasting blood glucose(FBG),and hemoglobin A1c(HbA1c)]were measured pre-treatment and 3 and 6 months after treatment.The relationships between serum 25-hydroxyvitamin D3[25(OH)D3]level and each of these indices were analyzed.RESULTS The levels of 25(OH)D3,FT3,FT4,and LDL-C increased in the order of the control group,test group A,and test group B(all P<0.05).The TPOAB,TGAB,TC,TG,FBG,HbA1c,and TSH levels increased in the order of test groups B,A,and the control group(all P<0.05).All the above indices were compared after 3 and 6 months of treatment.Pre-treatment,there was no divergence in serum 25(OH)D3 level,thyroid function-related indexes,autoantibodies level,blood glucose,and blood lipid index between the control group,test groups A and B(all P>0.05).The 25(OH)D3 levels in test groups A and B were negatively correlated with FT4 and TGAB(all P<0.05).CONCLUSION The combination drug treatment for T2DM with HT significantly improved thyroid function,autoantibody,and blood glucose and lipid levels.展开更多
BACKGROUND The occurrence of thyroid cancer(TC)has increased in recent decades.Exposure to outdoor artificial light at night(ALN)is associated with an increased risk of cancer.AIM To investigated the impact of ALN,as ...BACKGROUND The occurrence of thyroid cancer(TC)has increased in recent decades.Exposure to outdoor artificial light at night(ALN)is associated with an increased risk of cancer.AIM To investigated the impact of ALN,as a significant environmental pollutant,on TC incidence worldwide.METHODS The assessment involved analyzing satellite ALN data in conjunction with TC incidence data[adjusted standardized rate(ASR)],while considering the quality of cancer registries(QCR),gross domestic product(GDP)per person,and health expenditure per person(HEP)for each country.RESULTS Results indicated a correlation between higher ASR and ALN exposure percentages,particularly in countries with higher GDP or HEP quartiles(all P<0.05).Significant differences in ASR were observed across QCR levels,both high and low quality(all P<0.05),but not in countries without registry activity.However,when evaluating ASR against ALN exposure percentages while considering GDP/HEP quartiles or QCR levels,no significant associations were found(all P>0.10).CONCLUSION The findings suggest a potential link between higher GDP and adverse health conditions,serving as possible risk factors for TC,rather than a direct association with ALN.Limitations include the use of cross-sectional data,temporal misalign ment,and reliance on ALN as a socioeconomic proxy.It is proposed that light pollution might be connected to a lifestyle conducive to carcinogenesis.Additionally,the presence of higher GDP/HEP could enhance access to diagnostic resources,potentially facilitating TC diagnosis and inclusion in cancer registries.展开更多
This research concentrates to model an efficient thyroid prediction approach,which is considered a baseline for significant problems faced by the women community.The major research problem is the lack of automated mod...This research concentrates to model an efficient thyroid prediction approach,which is considered a baseline for significant problems faced by the women community.The major research problem is the lack of automated model to attain earlier prediction.Some existing model fails to give better prediction accuracy.Here,a novel clinical decision support system is framed to make the proper decision during a time of complexity.Multiple stages are followed in the proposed framework,which plays a substantial role in thyroid prediction.These steps include i)data acquisition,ii)outlier prediction,and iii)multi-stage weight-based ensemble learning process(MS-WEL).The weighted analysis of the base classifier and other classifier models helps bridge the gap encountered in one single classifier model.Various classifiers aremerged to handle the issues identified in others and intend to enhance the prediction rate.The proposed model provides superior outcomes and gives good quality prediction rate.The simulation is done in the MATLAB 2020a environment and establishes a better trade-off than various existing approaches.The model gives a prediction accuracy of 97.28%accuracy compared to other models and shows a better trade than others.展开更多
Introduction: Since its creation in 2017 by the European community, the EU-TIRADS classification has enjoyed an excellent reputation in several countries around the world. Indeed, several studies conducted in these co...Introduction: Since its creation in 2017 by the European community, the EU-TIRADS classification has enjoyed an excellent reputation in several countries around the world. Indeed, several studies conducted in these countries testify to the effectiveness of this tool for the management of nodular thyroid pathology. However, in Benin, the contribution of this classification has not yet been evaluated. It is therefore to overcome this inadequacy that we undertook this study. Objective: Participate in improving the diagnostic and therapeutic management of thyroid nodules at the CNHU HKM in Cotonou and at the CHUZ in Suru-Léré. Methods: This is a cross-sectional study with retrospective data collection spread over a period of 3 years 5 months, from January 2019 to May 2022 and carried out jointly in the Endocrinology Metabolism Nutrition and ORL-CCF departments of the CNHU HKM of Cotonou and in the ORL-CCF department of the CHUZ of Suru-Léré. The study population consisted of patients who consulted the University Clinic of Endocrinology Metabolism Nutrition, the University Clinic of ORL-CCF of the CNHU-HKM and the University Clinic of ORL-CCF of the CHUZ of Suru-Léré for thyroid nodule and who have had surgery. The study data was collected from patients hospitalization records using a survey form. Results: On ultrasound, according to the EU-TIRADS classification, 56.8% of nodules presented a low risk of malignancy (EU-TIRADS 3) compared to respectively 19.8%;23% and 2.5% of nodules with zero (EU-TIRADS 2), intermediate (EU-TIRADS 4) and high (EU-TIRADS 5) risk of malignancy. Regarding the performance of this classification, it is sensitive in 37.5% of cases and has a specificity of 78.5% with a PPV (Positive Predictive Value) and a NPV (Negative Predictive Value) respectively of 6.6 % and 91.6%. Furthermore, the bivariate correlations revealed that the size of the nodule was significantly associated with the malignancy of the nodule (p = 0.014) and the calculated value of the Yule’s Q coefficient (0.375) reflects a moderate intensity of the connection between the EU-TIRADS and histology. Conclusion: the EU-TIRADS classification, due to its excellent NPV, is of great interest for the management of thyroid nodules at the CNHU-HKM of Cotonou and at the CHUZ of Suru-Léré. In view of this, particular emphasis must be placed on its regular and rigorous use.展开更多
Heavy Menstrual Bleeding is one of the common Gynaecological issues. There are several causes. Some of the women presented with these issues found to have underling thyroid abnormality which was not discovered earlier...Heavy Menstrual Bleeding is one of the common Gynaecological issues. There are several causes. Some of the women presented with these issues found to have underling thyroid abnormality which was not discovered earlier. This research tries to find the prevalence of the Thyroid Disorder among the women present with Heavy menstrual bleeding in Sri Lankan women.展开更多
Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, d...Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, dietary and environmental factors. Histopathological patterns of surgically treated thyroid diseases play an important role in early diagnosis and management of these diseases. There is, however, limited published data regarding histopathological reports on thyroid disease in our local setting. This study aimed to determine the histopathological patterns and highlight early postoperative complications among patients with surgically treated thyroid diseases at Bugando Medical Centre (BMC). Methods: This was a longitudinal study involving all patients with surgically treated thyroid diseases seen at BMC over a period of 6 months from October 2019 to March 2020. Results: A total of 84 patients were studied. Females outnumbered males by a female to male ratio of 11:1. The median age of patients was 44 [IQR, 35 - 54] years old, the youngest was 14 years old and the oldest was 76 years old. Colloid goiter was the most common non-neoplastic lesion accounting for 34 (44.7%) patients. Among the neoplastic lesions, follicular adenoma was the most commonly encountered benign pathologies (n = 16;21.1%), while papillary carcinoma was the most commonly encountered malignancy (n = 4;50%). Following thyroidectomy, 12 (14.3%) patients developed early complications, of which hemorrhage sometimes requiring blood transfusion was the leading intra/postoperative complications accounting for 4 (33.3%) patients. Other complications include temporary recurrent laryngeal nerve palsy 2 (16.7%), surgical site infection 2 (16.7%) and tracheomalacia, bronchospasm, thyroid abscess and respiratory obstruction in 1 (8.3%) patient each, respectively. In this study, malignant thyroid lesion (p Conclusion: This study demonstrated that colloid goiter was the most common non-neoplastic lesion, and on the neoplastic category, follicular adenoma was the most common benign lesion, while papillary carcinoma was the most frequent malignant lesion.展开更多
Objective:To explore the effect of cognitive behavioral therapy on self-care in thyroid cancer patients.Methods:A total of 144 thyroid cancer patients treated at the Affiliated Hospital of Hebei University from Januar...Objective:To explore the effect of cognitive behavioral therapy on self-care in thyroid cancer patients.Methods:A total of 144 thyroid cancer patients treated at the Affiliated Hospital of Hebei University from January 2022 to August 2023 were selected as research subjects.Using the random number table method,they were divided into a control group and an experimental group,each consisting of 72 cases.The control group received routine nursing intervention,while the experimental group received cognitive behavioral therapy based on standard nursing practices.The self-care ability(self-concept,self-efficacy,self-care skills,health knowledge level),coping style(confrontation,avoidance,and surrender),and quality of life(psychological function,social function,material life,physical function)of both groups before and after the intervention were compared.Results:In comparison to the pre-intervention period,the experimental group exhibited significantly higher self-care ability,quality of life,and confrontation scores after the intervention,as opposed to the control group.Additionally,the avoidance and surrender scores were lower in the experimental group than in the control group,with these differences proving to be statistically significant(P<0.01).Conclusion:The application of cognitive behavioral therapy can enhance the self-care ability of thyroid cancer patients,aid in better disease coping,and improve their overall quality of life.This approach is deserving of further promotion.展开更多
Objective:To investigate the effect of TSH inhibition therapy in the postoperative management of patients with differentiated thyroid cancer.Methods:Seventy patients diagnosed with differentiated thyroid cancer were s...Objective:To investigate the effect of TSH inhibition therapy in the postoperative management of patients with differentiated thyroid cancer.Methods:Seventy patients diagnosed with differentiated thyroid cancer were selected for the study.TSH inhibition therapy was administered to the research group,while thyroxine replacement therapy was provided to the control group during the postoperative management phase.This allowed for a comparative analysis between the two groups.Results:In comparison with the control group,the research group exhibited significant decreases in serum TSH,T3,and T4 levels after treatment,while FT4 and FT3 levels significantly increased(P<0.05).Additionally,significant decreases in Tg,VEGF,TSGF,CD44V6,and sIL-2R levels were observed in the research group after treatment(P<0.05).No significant differences were found in pre-treatment thyroid function between the two groups(P>0.05).Conclusion:The application of TSH inhibition therapy in the postoperative management of patients with differentiated thyroid cancer demonstrates promising outcomes.展开更多
Objective:To analyze the effect of thyroid-stimulating hormone(TSH)suppression therapy on sex hormone levels in patients undergoing postoperative treatment for thyroid cancer.Methods:A total of 40 patients undergoing ...Objective:To analyze the effect of thyroid-stimulating hormone(TSH)suppression therapy on sex hormone levels in patients undergoing postoperative treatment for thyroid cancer.Methods:A total of 40 patients undergoing postoperative thyroid cancer treatment were selected for data analysis.TSH suppression therapy was implemented during the postoperative period.Patients were grouped according to the TSH level:TSH<0.1,0.1≤TSH<0.5,and TSH≥0.5.Results:Among male patients,there were no significant differences in sex hormone levels at different dosing times and TSH levels(P>0.05).For female patients,testosterone levels at different dosing times showed no significant differences under the same circumstances(P>0.05).The comparison of testosterone levels at different TSH levels over 5 years of TSH suppression therapy did not yield significant differences(P>0.05).However,the comparison of testosterone levels within 5 years of TSH suppression therapy yielded significant differences(P<0.05),with the lowest levels observed at 0.1≤TSH<0.5.Conclusion:The use of TSH suppression therapy in postoperative thyroid cancer treatment minimally affects sex hormone levels in male patients.However,it has a significant impact on female patients.Therefore,preoperative sex hormone testing is recommended,and postoperative monitoring should include regular sex hormone testing.展开更多
<span style="font-family:Verdana;">Rationale and Objectives: Accurately establishing the diagnosis and staging of cervical and thyroid cancers is essential in medical practice in determining tumor exte...<span style="font-family:Verdana;">Rationale and Objectives: Accurately establishing the diagnosis and staging of cervical and thyroid cancers is essential in medical practice in determining tumor extension and dissemination and involves the most accurate and effective therapeutic approach. For accurate diagnosis and staging of cervical and thyroid cancers, we aim to create a diagnostic method, optimized by the algorithms of artificial intelligence and validated by achieving accurate and favorable results by conducting a clinical trial, during which we will use the diagnostic method optimized by artificial intelligence (AI) algorithms, to avoid errors, to increase the understanding on interpretation computer tomography (CT) scan, magnetic resonance imaging (MRI) of the doctor and improve therapeutic planning. Materials and Methods: The optimization of the computer assisted diagnosis (CAD) method will consist in the development and formation of artificial intelligence models, using algorithms and tools used in segmental volumetric constructions to generate 3D images from MRI/CT. We propose a comparative study of current developments in “DICOM” image processing by volume rendering technique, the use of the transfer function for opacity and color, shades of gray from “DICOM” images projected in a three-dimensional space. We also use artificial intelligence (AI), through the technique of Generative Adversarial Networks (GAN), which has proven to be effective in representing complex data distributions, as we do in this study. Validation of the diagnostic method, optimized by algorithm of artificial intelligence will consist of achieving accurate results on diagnosis and staging of cervical and thyroid cancers by conducting a randomized, controlled clinical trial, for a period of 17 months. Results: We will validate the CAD method through a clinical study and, secondly, we use various network topologies specified above, which have produced promising results in the tasks of image model recognition and by using this mixture. By using this method in medical practice, we aim to avoid errors, provide precision in diagnosing, staging and establishing the therapeutic plan in cancers of the cervix and thyroid using AI. Conclusion: The use of the CAD method can increase the quality of life by avoiding intra and postoperative complications in surgery, intraoperative orientation and the precise determination of radiation doses and irradiation zone in radiotherapy.</span>展开更多
BACKGROUND In recently diagnosed patients with thyroid cancer,papillary thyroid cancer(PTC),as the most common histological subtype,accounts for 90%of all cases.Although PTC is known as a relatively adolescent maligna...BACKGROUND In recently diagnosed patients with thyroid cancer,papillary thyroid cancer(PTC),as the most common histological subtype,accounts for 90%of all cases.Although PTC is known as a relatively adolescent malignant disease,there still is a high possibility of recurrence in PTC patients with a poor prognosis.Therefore,new biomarkers are necessary to guide more effective stratification of PTC patients and personalize therapy to avoid overtreatment or inadequate treatment.Accumulating evidence demonstrates that microRNAs(miRNAs)have broad application prospects as diagnostic biomarkers in cancer.AIM To explore novel markers consisting of miRNA-associated signatures for PTC prognostication.METHODS We obtained and analyzed the data of 497 PTC patients from The Cancer Genome Atlas.The patients were randomly assigned to either a training or testing cohort.RESULTS We discovered 237 differentially expressed miRNAs in tumorous thyroid tissues compared with normal tissues,which contained 172 up-regulated and 65 downregulated miRNAs.The evaluation of differently expressed miRNAs was conducted using our risk score model.We then successfully generated a fourmiRNA potential prognostic signature[risk score=(-0.001×hsa-miR-181a-2-3p)+(0.003×hsa-miR-138-5p)+(-0.018×hsa-miR-424-3p)+(0.284×hsa-miR-612)],which reliably distinguished patients from high and low risk with a significant difference in the overall survival(P<0.01)and was effective in predicting the five-year disease survival rate with the area under the receiver operating characteristic curve of 0.937 and 0.812 in the training and testing cohorts,respectively.Additionally,there was a trend indicated that high-risk patients had shorter relapse-free survival,although statistical significance was not reached(P=0.082)in our sequencing cohort.CONCLUSION Our results indicated a four-miRNA signature that has a robust predictive effect on the prognosis of PTC.Accordingly,we would recommend more radical therapy and closer follow-ups for highrisk groups.展开更多
Thyroid cancer is the most common endocrine malignancy.While there has been no appreciable increase in the observed mortality of well-differentiated thyroid cancer,there has been an overall rise in its incidence world...Thyroid cancer is the most common endocrine malignancy.While there has been no appreciable increase in the observed mortality of well-differentiated thyroid cancer,there has been an overall rise in its incidence worldwide over the last few decades.Patients with papillary thyroid carcinoma(PTC)and clinical evidence of central(cN1)and/or lateral lymph node metastases require total thyroidectomy plus central and/or lateral neck dissection as the initial surgical treatment.Nodal status in PTC patients plays a crucial role in the prognostic evaluation of the recurrence risk.The 2015 guidelines of the American Thyroid Association(ATA)have more accurately determined the indications for therapeutic central and lateral lymph node dissection.However,prophylactic central neck lymph node dissection(pCND)in negative lymph node(cN0)PTC patients is controversial,as the 2009 ATA guidelines recommended that CND“should be considered”routinely in patients who underwent total thyroidectomy for PTC.Although the current guidelines show clear indications for therapeutic CND,the role of pCND in cN0 patients with PTC is still debated.In small solitary papillary carcinoma(T1,T2),pCND is not recommended unless there are high-risk prediction factors for recurrence and diffuse nodal spread(extrathyroid extension,mutation in the BRAF gene).pCND can be considered in cN0 disease with advanced primary tumors(T3 or T4)or clinical lateral neck disease(cN1b)or for staging and treatment planning purposes.The role of the preoperative evaluation is fundamental to minimizing the possible detrimental effect of overtreatment of the types of patients who are associated with low disease-related morbidity and mortality.On the other hand,it determines the choice of appropriate treatment and determines if close monitoring of patients at a higher risk is needed.Thus,pCND is currently recommended for T3 and T4 tumors but not for T1 and T2 tumors without high-risk prediction factors of recurrence.展开更多
Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this stu...Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this study,we aimed to explore the microbial community in thyroid tissues and its contribution to papillary thyroid cancer(PTC).In parallel,we performed microbial profiling and transcriptome sequencing in the tumor and adjacent normal tissues of a large cohort of 340 PTC and benign thyroid nodule(BTN)patients.Distinct microbial signatures were identified in PTC,BTN,and their adjacent nontumor tissues.Intra-thyroid tissue bacteria were verified by means of bacteria staining,fluorescence in situ hybridization,and immunoelectron microscopy.We found that 17 bacterial taxa were differentially abundant in PTC compared with BTN,which included enrichment in PTC of the pathobionts Rhodococcus,Neisseria,Streptococcus,Halomonas,and Devosia,and depletion of the beneficial bacteria Amycolatopsis.These differentially abundant bacteria could differentiate PTC tumor tissues(PTC-T)from BTN tissues(BTN-T)with an area under the curve(AUC)of 81.66%.Microbial network analysis showed increased correlation strengths among the bacterial taxa in PTC-T in comparison with BTN-T.Immunefunction-corresponding bacteria(i.e.,Erwinia,Bacillus,and Acinetobacter)were found to be enriched in PTC with Hashimoto’s thyroiditis.Moreover,our integrative analysis revealed that the PTC-enriched bacteria had a positive association with key PTC-oncogenic pathway-related genes,including BRAF,KRAS,IRAK4,CTNNB1,PIK3CA,MAP3K7,and EGFR.In conclusion,our results suggest that intratumor bacteria dysbiosis is associated with the thyroid tumorigenesis and oncogenic signaling pathways of PTC.展开更多
文摘This study was conducted to explore possible correlation between smoking habit and thyroid volume and function in Jeddah. A total of 226 volunteers i.e. 128 male and 98 female were screened at Radiology Department King Abdul-Aziz University Hospital. They were categorized as smokers and non- smokers;the number of smokers was 99 cases i.e. 48 Cigarette smokers and 51 Shisha smokers, and the non-smokers were 127 cases. The information was gathered via a questionnaire distributed at the radiology department. Ultrasonography of thyroid and thyroid function test were performed for 166 participants;and data were analyzed Using SPSS version 22 and Microsoft excel. The study was carried out based on random selection and findings revealed that most of the cases were in the age group between 20 to 30 years old, high body mass index (BMI) was 33.1 kg/m2 in persons above 60 years old and the highest percentage smokers in the age group from 20 to 30 years (40.02%). Ultrasonography of thyroid showed 96 (58%) normal cases, 46 (28%) abnormal “solid” cases and 24 (14%) abnormal “cyst” cases. A lower proportion of cigarette and shisha smokers (15.4% and 5.6% respectively) had an enlarged thyroid gland compared to no cigarettes or shisha smokers (47.9% and 47.3% respectively). The difference between these frequencies was statistically significant (Chi-square = 9.446 and 11.424, p = 0.002 and p = 0.001 for cigarette and shisha smoking respectively). Consequently, it can be concluded from this research that there are no direct significant values correlating smoking habit to thyroid volume or function. However, it is always recommended not smoke due to other well-known threats.
文摘Objective To assess the effect of different levels of salt iodine content on thyroid volume(ThV) distribution using data from the 1999, 2011, and 2014 Chinese national iodine deficiency disorder(IDD) surveys. Methods Probability proportion to size(PPS) sampling method was used to obtain a representative national sample of 34,547, 38,932, and 47,188 Chinese children aged 8-10 years in 1999, 2011, and 2014 Chinese national IDD surveys, respectively. The iodine content in household iodized salt and urinary iodine concentration were measured and thyroid ultrasound examination was performed. The data were analyzed by SAS software using histograms and box plots. The skewness and kurtosis were calculated for testing the normality of ThV. Results The median iodine content in household iodized salt dropped from 42.30 mg/kg in 1999 to 25.00 mg/kg in 2014. The median urinary iodine concentration of children aged 8-10 years decreased from 306.0 μg/L in 1999 to 197.9 μg/L in 2014. The median and interquartile range(IQR) of ThV in 1999, 2011, and 2014 surveys were 3.44 m L and 1.50 m L, 2.60 m L and 1.37 m L, 2.63 m L and 1.25 m L, respectively. The skewness and kurtosis of ThV distribution in 1999, 2011, and 2014 surveys were 1.34 and 5.84, 0.98 and 3.54, 1.27 and 5.49, respectively. Conclusion With reduced salt iodization levels, the median urinary iodine concentration and median ThV of children decreased significantly, and the symmetry of the ThV distribution improved.
基金funded by the Spanish Ministry of Economy and Competitiveness via the Fondo de Investigación Sanitaria del Instituto de Salud CarlosⅢ(PI13/01393)by the Retos de la Sociedad program(DEP2016-79512-R)+7 种基金European Regional Development Funds(ERDF)the Spanish Ministry of Education(FPU13/04365 and FPU19/01609)the Fundación Iberoamericana de Nutrición(FINUT)the Redes Temáticas de Investigación Cooperativa RETIC(Red SAMID RD16/0022)the Astra Zeneca Health Care Foundationthe University of Granada Plan Propio de Investigación 2016-Excellence actions:Unit of Excellence on Exercise and Health(UCEES)-and Plan Propio de Investigación 2018-the Programa Contratos-Puente and Contratos Perfeccionamiento de Doctoresthe Junta de Andalucía,Consejería de Conocimiento,Investigacióny Universidades(ERDF,ref.SOMM17/6107/UGR)the Fundación Alfonso Martín Escudero(grant awarded to GSD)。
文摘Purpose:The present work examines the associations of dietary habits,sedentarism,physical activity(PA)levels and sleep habits,with thyroid function in young euthyroid adults.Methods:A total of 105 young euthyroid adults participated in this cross-sectional study.Thyroid function was determined in fasting conditions(>6 h).Dietary habits were measured by a food frequency questionnaire and three non-consecutive 24 h recalls,and different dietary intake and patterns were then estimated.The time spent in sedentary,PA levels and sleep habits were objectively measured using a wrist-worn accelerometer.Results:Energy and carbohydrate intake were positively associated with thyroid stimulating hormone(TSH)(β=0.222;R^(2)=0.102;P=0.022 andβ=0.425;R^(2)=0.129;P=0.007,respectively)whereas fat intake was negatively associated with TSH(β=-0.428;R^(2)=0.137;P=0.004).Energy intake was also positively associated with free triiodothyronine(β=0.277;R^(2)=0.137;P=0.004).Further,adherence to the Mediterranean diet was negatively related to TSH and free thyroxine(FT4)(β=-0.221;R^(2)=0.113;P=0.020 andβ=-0.268;R^(2)=0.071;P=0.007,respectively).Vigorous-intensity and overall PA were negatively associated with FT4(β=-0.227;R^(2)=0.052;P=0.022 andβ=-0.204;R^(2)=0.042;P=0.041,respectively).In contrast,no associations were found between sleep parameters and thyroid function.Conclusions:Lifestyle factors such as dietary intake and PA levels seems to be related to thyroid function even in young euthyroid adults.
文摘BACKGROUND Patients rarely develop complicated infections in thyroid cysts.Here,we describe a patient with chronic infected unilateral giant thyroid cyst related to diabetes mellitus(DM).CASE SUMMARY A 66-year-old male was admitted due to an evident neck lump for 5 d after approximately 40 years of gradually progressive neck mass and 7 years of DM.Doppler ultrasound and computed tomography scan showed a giant lump in the left thyroid gland lobe.He was diagnosed with a large thyroid nodule complicated by tracheal dislocation and had surgical indications.Surgical exploration revealed evident inflammatory edema and exudation between the left anterior neck muscles,the nodule and glandular tissue.Fortunately,inflammatory lesions did not affect major neck vessels.Finally,a left partial thyroidectomy was performed.Macroscopic observation showed that the cystic thyroid mass consisted of extensive cystic wall calcification and was rich in massive rough sand-like calculi content and purulent matter.Postoperative pathology confirmed benign thyroid cyst with chronic infection.CONCLUSION The progression of this chronic infectious unilateral giant thyroid cyst may have been related to DM,and identifying blood vessels involvement can prevent serious complications during operation.
文摘BACKGROUND A fish spike stuck in the throat is a common ear,nose,and throat(ENT)emergency.However,it is very rare for a fish spike to reach the thyroid tissue through the throat,which is very dangerous and can lead to pharyngeal fistula,cervical abscess,mediastinal abscess,and thyroid abscess.Proper and timely management can help reduce complications,especially in elderly patients.CASE SUMMARY In the case presented here,the causative factor was dentures,but improper management aggravated the condition.In the case presented here,an elderly woman with a history of accidentally swallowing fish bones for 20 d had a sensation of foreign bodies in her throat.Eventually,computed tomography(CT)of the neck showed that the left side of the thyroid gland had a dense shadow in the form of a stripe.CONCLUSION If a fishbone foreign body is not visible during endoscopic examination but the patient has significant symptoms,the surgeon should be aware that the fishbone may be lodged in the thyroid.To avoid a misdiagnosis,ultrasound,CT,and other tests can be used to clarify the diagnosis.T The first step in treating a fish bone in the thyroid gland is to determine the position of the foreign body and the extent of the infection,and to develop a personalized surgical plan for its removal.At the same time,scientific information should be made available to the general public so that people know that if a fish bone is accidentally lodged,they should not force it to be swallowed or be spit out by inducing vomiting,which are incorrect methods and may aggravate the condition or even cause it to migrate outside the cavity,leading to serious complications,as in this reported case.
文摘As a common hyperglycemic disease,type 1 diabetes mellitus(T1DM)is a complicated disorder that requires a lifelong insulin supply due to the immunemediated destruction of pancreaticβcells.Although it is an organ-specific autoimmune disorder,T1DM is often associated with multiple other autoimmune disorders.The most prevalent concomitant autoimmune disorder occurring in T1DM is autoimmune thyroid disease(AITD),which mainly exhibits two extremes of phenotypes:hyperthyroidism[Graves'disease(GD)]and hypothyroidism[Hashimoto's thyroiditis,(HT)].However,the presence of comorbid AITD may negatively affect metabolic management in T1DM patients and thereby may increase the risk for potential diabetes-related complications.Thus,routine screening of thyroid function has been recommended when T1DM is diagnosed.Here,first,we summarize current knowledge regarding the etiology and pathogenesis mechanisms of both diseases.Subsequently,an updated review of the association between T1DM and AITD is offered.Finally,we provide a relatively detailed review focusing on the application of thyroid ultrasonography in diagnosing and managing HT and GD,suggesting its critical role in the timely and accurate diagnosis of AITD in T1DM.
基金Supported by Science and Technology Plan Project of Shaoyang City,No.2022GX4139.
文摘BACKGROUND Diabetes and thyroiditis are closely related.They occur in combination and cause significant damage to the body.There is no clear treatment for type-2 diabetes mellitus(T2DM)with Hashimoto's thyroiditis(HT).While single symptomatic drug treatment of the two diseases is less effective,combined drug treatment may improve efficacy.AIM To investigate the effect of a combination of vitamin D,selenium,and hypoglycemic agents in T2DM with HT.METHODS This retrospective study included 150 patients with T2DM and HT treated at The Central Hospital of Shaoyang from March 2020 to February 2023.Fifty patients were assigned to the control group,test group A,and test group B according to different treatment methods.The control group received low-iodine diet guidance and hypoglycemic drug treatment.Test group A received the control treatment plus vitamin D treatment.Test group B received the group A treatment plus selenium.Blood levels of markers of thyroid function[free T3(FT3),thyroid stimulating hormone(TSH),free T4(FT4)],autoantibodies[thyroid peroxidase antibody(TPOAB)and thyroid globulin antibody(TGAB)],blood lipid index[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triacylglycerol(TG)],blood glucose index[fasting blood glucose(FBG),and hemoglobin A1c(HbA1c)]were measured pre-treatment and 3 and 6 months after treatment.The relationships between serum 25-hydroxyvitamin D3[25(OH)D3]level and each of these indices were analyzed.RESULTS The levels of 25(OH)D3,FT3,FT4,and LDL-C increased in the order of the control group,test group A,and test group B(all P<0.05).The TPOAB,TGAB,TC,TG,FBG,HbA1c,and TSH levels increased in the order of test groups B,A,and the control group(all P<0.05).All the above indices were compared after 3 and 6 months of treatment.Pre-treatment,there was no divergence in serum 25(OH)D3 level,thyroid function-related indexes,autoantibodies level,blood glucose,and blood lipid index between the control group,test groups A and B(all P>0.05).The 25(OH)D3 levels in test groups A and B were negatively correlated with FT4 and TGAB(all P<0.05).CONCLUSION The combination drug treatment for T2DM with HT significantly improved thyroid function,autoantibody,and blood glucose and lipid levels.
文摘BACKGROUND The occurrence of thyroid cancer(TC)has increased in recent decades.Exposure to outdoor artificial light at night(ALN)is associated with an increased risk of cancer.AIM To investigated the impact of ALN,as a significant environmental pollutant,on TC incidence worldwide.METHODS The assessment involved analyzing satellite ALN data in conjunction with TC incidence data[adjusted standardized rate(ASR)],while considering the quality of cancer registries(QCR),gross domestic product(GDP)per person,and health expenditure per person(HEP)for each country.RESULTS Results indicated a correlation between higher ASR and ALN exposure percentages,particularly in countries with higher GDP or HEP quartiles(all P<0.05).Significant differences in ASR were observed across QCR levels,both high and low quality(all P<0.05),but not in countries without registry activity.However,when evaluating ASR against ALN exposure percentages while considering GDP/HEP quartiles or QCR levels,no significant associations were found(all P>0.10).CONCLUSION The findings suggest a potential link between higher GDP and adverse health conditions,serving as possible risk factors for TC,rather than a direct association with ALN.Limitations include the use of cross-sectional data,temporal misalign ment,and reliance on ALN as a socioeconomic proxy.It is proposed that light pollution might be connected to a lifestyle conducive to carcinogenesis.Additionally,the presence of higher GDP/HEP could enhance access to diagnostic resources,potentially facilitating TC diagnosis and inclusion in cancer registries.
文摘This research concentrates to model an efficient thyroid prediction approach,which is considered a baseline for significant problems faced by the women community.The major research problem is the lack of automated model to attain earlier prediction.Some existing model fails to give better prediction accuracy.Here,a novel clinical decision support system is framed to make the proper decision during a time of complexity.Multiple stages are followed in the proposed framework,which plays a substantial role in thyroid prediction.These steps include i)data acquisition,ii)outlier prediction,and iii)multi-stage weight-based ensemble learning process(MS-WEL).The weighted analysis of the base classifier and other classifier models helps bridge the gap encountered in one single classifier model.Various classifiers aremerged to handle the issues identified in others and intend to enhance the prediction rate.The proposed model provides superior outcomes and gives good quality prediction rate.The simulation is done in the MATLAB 2020a environment and establishes a better trade-off than various existing approaches.The model gives a prediction accuracy of 97.28%accuracy compared to other models and shows a better trade than others.
文摘Introduction: Since its creation in 2017 by the European community, the EU-TIRADS classification has enjoyed an excellent reputation in several countries around the world. Indeed, several studies conducted in these countries testify to the effectiveness of this tool for the management of nodular thyroid pathology. However, in Benin, the contribution of this classification has not yet been evaluated. It is therefore to overcome this inadequacy that we undertook this study. Objective: Participate in improving the diagnostic and therapeutic management of thyroid nodules at the CNHU HKM in Cotonou and at the CHUZ in Suru-Léré. Methods: This is a cross-sectional study with retrospective data collection spread over a period of 3 years 5 months, from January 2019 to May 2022 and carried out jointly in the Endocrinology Metabolism Nutrition and ORL-CCF departments of the CNHU HKM of Cotonou and in the ORL-CCF department of the CHUZ of Suru-Léré. The study population consisted of patients who consulted the University Clinic of Endocrinology Metabolism Nutrition, the University Clinic of ORL-CCF of the CNHU-HKM and the University Clinic of ORL-CCF of the CHUZ of Suru-Léré for thyroid nodule and who have had surgery. The study data was collected from patients hospitalization records using a survey form. Results: On ultrasound, according to the EU-TIRADS classification, 56.8% of nodules presented a low risk of malignancy (EU-TIRADS 3) compared to respectively 19.8%;23% and 2.5% of nodules with zero (EU-TIRADS 2), intermediate (EU-TIRADS 4) and high (EU-TIRADS 5) risk of malignancy. Regarding the performance of this classification, it is sensitive in 37.5% of cases and has a specificity of 78.5% with a PPV (Positive Predictive Value) and a NPV (Negative Predictive Value) respectively of 6.6 % and 91.6%. Furthermore, the bivariate correlations revealed that the size of the nodule was significantly associated with the malignancy of the nodule (p = 0.014) and the calculated value of the Yule’s Q coefficient (0.375) reflects a moderate intensity of the connection between the EU-TIRADS and histology. Conclusion: the EU-TIRADS classification, due to its excellent NPV, is of great interest for the management of thyroid nodules at the CNHU-HKM of Cotonou and at the CHUZ of Suru-Léré. In view of this, particular emphasis must be placed on its regular and rigorous use.
文摘Heavy Menstrual Bleeding is one of the common Gynaecological issues. There are several causes. Some of the women presented with these issues found to have underling thyroid abnormality which was not discovered earlier. This research tries to find the prevalence of the Thyroid Disorder among the women present with Heavy menstrual bleeding in Sri Lankan women.
文摘Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, dietary and environmental factors. Histopathological patterns of surgically treated thyroid diseases play an important role in early diagnosis and management of these diseases. There is, however, limited published data regarding histopathological reports on thyroid disease in our local setting. This study aimed to determine the histopathological patterns and highlight early postoperative complications among patients with surgically treated thyroid diseases at Bugando Medical Centre (BMC). Methods: This was a longitudinal study involving all patients with surgically treated thyroid diseases seen at BMC over a period of 6 months from October 2019 to March 2020. Results: A total of 84 patients were studied. Females outnumbered males by a female to male ratio of 11:1. The median age of patients was 44 [IQR, 35 - 54] years old, the youngest was 14 years old and the oldest was 76 years old. Colloid goiter was the most common non-neoplastic lesion accounting for 34 (44.7%) patients. Among the neoplastic lesions, follicular adenoma was the most commonly encountered benign pathologies (n = 16;21.1%), while papillary carcinoma was the most commonly encountered malignancy (n = 4;50%). Following thyroidectomy, 12 (14.3%) patients developed early complications, of which hemorrhage sometimes requiring blood transfusion was the leading intra/postoperative complications accounting for 4 (33.3%) patients. Other complications include temporary recurrent laryngeal nerve palsy 2 (16.7%), surgical site infection 2 (16.7%) and tracheomalacia, bronchospasm, thyroid abscess and respiratory obstruction in 1 (8.3%) patient each, respectively. In this study, malignant thyroid lesion (p Conclusion: This study demonstrated that colloid goiter was the most common non-neoplastic lesion, and on the neoplastic category, follicular adenoma was the most common benign lesion, while papillary carcinoma was the most frequent malignant lesion.
文摘Objective:To explore the effect of cognitive behavioral therapy on self-care in thyroid cancer patients.Methods:A total of 144 thyroid cancer patients treated at the Affiliated Hospital of Hebei University from January 2022 to August 2023 were selected as research subjects.Using the random number table method,they were divided into a control group and an experimental group,each consisting of 72 cases.The control group received routine nursing intervention,while the experimental group received cognitive behavioral therapy based on standard nursing practices.The self-care ability(self-concept,self-efficacy,self-care skills,health knowledge level),coping style(confrontation,avoidance,and surrender),and quality of life(psychological function,social function,material life,physical function)of both groups before and after the intervention were compared.Results:In comparison to the pre-intervention period,the experimental group exhibited significantly higher self-care ability,quality of life,and confrontation scores after the intervention,as opposed to the control group.Additionally,the avoidance and surrender scores were lower in the experimental group than in the control group,with these differences proving to be statistically significant(P<0.01).Conclusion:The application of cognitive behavioral therapy can enhance the self-care ability of thyroid cancer patients,aid in better disease coping,and improve their overall quality of life.This approach is deserving of further promotion.
文摘Objective:To investigate the effect of TSH inhibition therapy in the postoperative management of patients with differentiated thyroid cancer.Methods:Seventy patients diagnosed with differentiated thyroid cancer were selected for the study.TSH inhibition therapy was administered to the research group,while thyroxine replacement therapy was provided to the control group during the postoperative management phase.This allowed for a comparative analysis between the two groups.Results:In comparison with the control group,the research group exhibited significant decreases in serum TSH,T3,and T4 levels after treatment,while FT4 and FT3 levels significantly increased(P<0.05).Additionally,significant decreases in Tg,VEGF,TSGF,CD44V6,and sIL-2R levels were observed in the research group after treatment(P<0.05).No significant differences were found in pre-treatment thyroid function between the two groups(P>0.05).Conclusion:The application of TSH inhibition therapy in the postoperative management of patients with differentiated thyroid cancer demonstrates promising outcomes.
文摘Objective:To analyze the effect of thyroid-stimulating hormone(TSH)suppression therapy on sex hormone levels in patients undergoing postoperative treatment for thyroid cancer.Methods:A total of 40 patients undergoing postoperative thyroid cancer treatment were selected for data analysis.TSH suppression therapy was implemented during the postoperative period.Patients were grouped according to the TSH level:TSH<0.1,0.1≤TSH<0.5,and TSH≥0.5.Results:Among male patients,there were no significant differences in sex hormone levels at different dosing times and TSH levels(P>0.05).For female patients,testosterone levels at different dosing times showed no significant differences under the same circumstances(P>0.05).The comparison of testosterone levels at different TSH levels over 5 years of TSH suppression therapy did not yield significant differences(P>0.05).However,the comparison of testosterone levels within 5 years of TSH suppression therapy yielded significant differences(P<0.05),with the lowest levels observed at 0.1≤TSH<0.5.Conclusion:The use of TSH suppression therapy in postoperative thyroid cancer treatment minimally affects sex hormone levels in male patients.However,it has a significant impact on female patients.Therefore,preoperative sex hormone testing is recommended,and postoperative monitoring should include regular sex hormone testing.
文摘<span style="font-family:Verdana;">Rationale and Objectives: Accurately establishing the diagnosis and staging of cervical and thyroid cancers is essential in medical practice in determining tumor extension and dissemination and involves the most accurate and effective therapeutic approach. For accurate diagnosis and staging of cervical and thyroid cancers, we aim to create a diagnostic method, optimized by the algorithms of artificial intelligence and validated by achieving accurate and favorable results by conducting a clinical trial, during which we will use the diagnostic method optimized by artificial intelligence (AI) algorithms, to avoid errors, to increase the understanding on interpretation computer tomography (CT) scan, magnetic resonance imaging (MRI) of the doctor and improve therapeutic planning. Materials and Methods: The optimization of the computer assisted diagnosis (CAD) method will consist in the development and formation of artificial intelligence models, using algorithms and tools used in segmental volumetric constructions to generate 3D images from MRI/CT. We propose a comparative study of current developments in “DICOM” image processing by volume rendering technique, the use of the transfer function for opacity and color, shades of gray from “DICOM” images projected in a three-dimensional space. We also use artificial intelligence (AI), through the technique of Generative Adversarial Networks (GAN), which has proven to be effective in representing complex data distributions, as we do in this study. Validation of the diagnostic method, optimized by algorithm of artificial intelligence will consist of achieving accurate results on diagnosis and staging of cervical and thyroid cancers by conducting a randomized, controlled clinical trial, for a period of 17 months. Results: We will validate the CAD method through a clinical study and, secondly, we use various network topologies specified above, which have produced promising results in the tasks of image model recognition and by using this mixture. By using this method in medical practice, we aim to avoid errors, provide precision in diagnosing, staging and establishing the therapeutic plan in cancers of the cervix and thyroid using AI. Conclusion: The use of the CAD method can increase the quality of life by avoiding intra and postoperative complications in surgery, intraoperative orientation and the precise determination of radiation doses and irradiation zone in radiotherapy.</span>
基金Supported by the Foundation of Wenzhou Municipal Science and Technology Bureau,No.Y20190209 and No.Y2020739the Hospital Research Incubation Program,No.FHY2019075。
文摘BACKGROUND In recently diagnosed patients with thyroid cancer,papillary thyroid cancer(PTC),as the most common histological subtype,accounts for 90%of all cases.Although PTC is known as a relatively adolescent malignant disease,there still is a high possibility of recurrence in PTC patients with a poor prognosis.Therefore,new biomarkers are necessary to guide more effective stratification of PTC patients and personalize therapy to avoid overtreatment or inadequate treatment.Accumulating evidence demonstrates that microRNAs(miRNAs)have broad application prospects as diagnostic biomarkers in cancer.AIM To explore novel markers consisting of miRNA-associated signatures for PTC prognostication.METHODS We obtained and analyzed the data of 497 PTC patients from The Cancer Genome Atlas.The patients were randomly assigned to either a training or testing cohort.RESULTS We discovered 237 differentially expressed miRNAs in tumorous thyroid tissues compared with normal tissues,which contained 172 up-regulated and 65 downregulated miRNAs.The evaluation of differently expressed miRNAs was conducted using our risk score model.We then successfully generated a fourmiRNA potential prognostic signature[risk score=(-0.001×hsa-miR-181a-2-3p)+(0.003×hsa-miR-138-5p)+(-0.018×hsa-miR-424-3p)+(0.284×hsa-miR-612)],which reliably distinguished patients from high and low risk with a significant difference in the overall survival(P<0.01)and was effective in predicting the five-year disease survival rate with the area under the receiver operating characteristic curve of 0.937 and 0.812 in the training and testing cohorts,respectively.Additionally,there was a trend indicated that high-risk patients had shorter relapse-free survival,although statistical significance was not reached(P=0.082)in our sequencing cohort.CONCLUSION Our results indicated a four-miRNA signature that has a robust predictive effect on the prognosis of PTC.Accordingly,we would recommend more radical therapy and closer follow-ups for highrisk groups.
文摘Thyroid cancer is the most common endocrine malignancy.While there has been no appreciable increase in the observed mortality of well-differentiated thyroid cancer,there has been an overall rise in its incidence worldwide over the last few decades.Patients with papillary thyroid carcinoma(PTC)and clinical evidence of central(cN1)and/or lateral lymph node metastases require total thyroidectomy plus central and/or lateral neck dissection as the initial surgical treatment.Nodal status in PTC patients plays a crucial role in the prognostic evaluation of the recurrence risk.The 2015 guidelines of the American Thyroid Association(ATA)have more accurately determined the indications for therapeutic central and lateral lymph node dissection.However,prophylactic central neck lymph node dissection(pCND)in negative lymph node(cN0)PTC patients is controversial,as the 2009 ATA guidelines recommended that CND“should be considered”routinely in patients who underwent total thyroidectomy for PTC.Although the current guidelines show clear indications for therapeutic CND,the role of pCND in cN0 patients with PTC is still debated.In small solitary papillary carcinoma(T1,T2),pCND is not recommended unless there are high-risk prediction factors for recurrence and diffuse nodal spread(extrathyroid extension,mutation in the BRAF gene).pCND can be considered in cN0 disease with advanced primary tumors(T3 or T4)or clinical lateral neck disease(cN1b)or for staging and treatment planning purposes.The role of the preoperative evaluation is fundamental to minimizing the possible detrimental effect of overtreatment of the types of patients who are associated with low disease-related morbidity and mortality.On the other hand,it determines the choice of appropriate treatment and determines if close monitoring of patients at a higher risk is needed.Thus,pCND is currently recommended for T3 and T4 tumors but not for T1 and T2 tumors without high-risk prediction factors of recurrence.
基金supported by the National Natural Science Foundation of China(81772850 and 82273300)。
文摘Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this study,we aimed to explore the microbial community in thyroid tissues and its contribution to papillary thyroid cancer(PTC).In parallel,we performed microbial profiling and transcriptome sequencing in the tumor and adjacent normal tissues of a large cohort of 340 PTC and benign thyroid nodule(BTN)patients.Distinct microbial signatures were identified in PTC,BTN,and their adjacent nontumor tissues.Intra-thyroid tissue bacteria were verified by means of bacteria staining,fluorescence in situ hybridization,and immunoelectron microscopy.We found that 17 bacterial taxa were differentially abundant in PTC compared with BTN,which included enrichment in PTC of the pathobionts Rhodococcus,Neisseria,Streptococcus,Halomonas,and Devosia,and depletion of the beneficial bacteria Amycolatopsis.These differentially abundant bacteria could differentiate PTC tumor tissues(PTC-T)from BTN tissues(BTN-T)with an area under the curve(AUC)of 81.66%.Microbial network analysis showed increased correlation strengths among the bacterial taxa in PTC-T in comparison with BTN-T.Immunefunction-corresponding bacteria(i.e.,Erwinia,Bacillus,and Acinetobacter)were found to be enriched in PTC with Hashimoto’s thyroiditis.Moreover,our integrative analysis revealed that the PTC-enriched bacteria had a positive association with key PTC-oncogenic pathway-related genes,including BRAF,KRAS,IRAK4,CTNNB1,PIK3CA,MAP3K7,and EGFR.In conclusion,our results suggest that intratumor bacteria dysbiosis is associated with the thyroid tumorigenesis and oncogenic signaling pathways of PTC.
