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Serial stimulated thyroglobulin measurements are more specific for detecting distant metastatic differentiated thyroid cancer before radioiodine therapy

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Chinese Journal of Cancer Research 2017年第3期29卷 213-222页

作者： Teng Zhao Jun Liang Tianjun Li Wen Gao yansong lin Department of Nuclear Medicine Peking Union Medical College Hospital Department of Thyroid and Neck Surgery Beijing Chaoyang Hospital Capital Medical University Department of Oncology Peking University Cancer Hospital &Institute Department of Oncology the Affiliated Hospital of Qingdao University

Objective: Preablative stimulated thyroglobulin (ps-Tg) has the potential to be used in identifying distant metastatic differentiated thyroid carcinoma (DM-DTC), but its single level can be affected by remnant thyroid tissue and thyrotropin (TSH). The objective of this retrospective study was to evaluate the value of serial ps-Tg measurements in identifying DM-DTC specifically. Methods: A total of 317 DTC patients with serial measurements of ps-Tg, TSH and anti-Tg antibody were divided into M1 (n=72) and M0 (n=245) according to the presence of distant metastasis (DM) or not. The initial psTg measurement, with a corresponding TSH exceeding 30 mu IU/mL, was marked as Tg1, and ps-Tg measured right before radioactive iodine (RAI) therapy was defined as Tg2, with a median interval of 8 days. Delta Tg denotes Tg2-Tg1, and Delta TSH denotes TSH2-TSH1. Tg1, Tg2, Delta Tg, and Delta Tg/Delta TSH were tested for efficacy in identifying DM-DTC using receiver operating characteristic (ROC) curve analysis, and further compared with chest computed tomography (CT) and posttreatment whole-body RAI scan (RxWBS). Results: Compared with single ps-Tg measurement (Tg1 or Tg2), both Delta Tg and Delta Tg/Delta TSH were more narrowly distributed around zero in the M0 group, which made their distribution in the M1 group more distinguished in a relatively dispersed way. Delta Tg/Delta TSH manifested a higher accuracy (88.64%) and specificity (90.20%) in identifying DM-DTC than Tg1 or Tg2 measurements, with a much higher specificity than chest CT (90.20% vs. 66.00%) and a much higher sensitivity than RxWBS (83.33% vs. 61.11%). Conclusions: Serial ps-Tg measurements even over as short an interval as 8 days hold incremental value in identifying DM-DTC. Delta Tg/Delta TSH is a specific early biochemical marker for DM-DTC.

关键词： Neoplasm metastasis thyroid cancer thyroglobulin iodine radioisotopes

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Internal radiation therapy:a neglected aspect of nuclear medicine in the molecular era

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The Journal of Biomedical Research 2015年第5期29卷 345-355页

作者： yansong lin Department of Nuclear Medicine Peking Union Medical College Hospital

With increasing evidence, internal radiation therapy, also known as brachytherapy, has become a neglected aspect of nuclear medicine in the molecular era. In this paper, recent developments regarding internal radiation ther- apy, including developments in radioiodine-13l （131^I） and thyroid, radioimmunotherapy （RIT） for non-Hodgkin lym- phoma （NHL）, and radiopharmaceuticals for bone metastases. Relevant differences and status of their applications in China were mentioned as well. These molecular mediated internal radiation therapies are gaining increasing importance by providing palliative and curative treatments for an increasing number of diseases and becoming one of the important parts of molecular nuclear medicine.

关键词： brachytherapy radioisotope neoplasm radioiodine hyperthyroidism

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The preclinical pharmacological study of dopamine transporter imaging agent ^(18)F-FP-β-CIT

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Nuclear Science and Techniques 2007年第4期18卷 223-226页

作者： LI Xiaominx CHEN Zhengping WANG Songpei TANG Jie lin yansong ZHU Zhaohui2 FANG Ping Jiangsu Institute of Nuclear Medicine Key Laboratory of Nuclear Medicine Ministry of Health Wuxi 214063 China PET Center Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing 100730 China

The paper is to study pharmacologic characteristics of 18F-FP-β-CIT (18F-N-(3-fluoropropyl)-2β-carbomethoxy-3β- (4-iodophenyl)nortropane) as an imaging agent for dopamine transporter. The radiochemical purity of 18F-FP-β-CIT in aqueous solution was over 95% after standing at room temperature for 4h. Biodistribution displayed rapid uptake in rat brain (1.375 %ID/organ at 5min and 0.100 %ID/organ at 180 min) and the striatal uptake was 1.444, 0.731, 0.397, 0.230 and 0.146 %ID/g at 5, 30, 60, 120 and 180 min, respectively. The values of striatum/cerebellum, striatum /frontal cortex and striatum / hippocampus in rat's brain at 30 min were 3.38, 2.17 and 2.40 respectively. The uptake in striatum can be blocked by β-CFT, suggesting that 18F-FP-β-CIT binds to DAT peculiarly. The compound was rapidly cleared from monkey's blood. The striatal uptake was bilaterally decreased in the left-sided lesioned PD rats, compared with normal control. Brain PET imaging studies in normal monkey showed that 18F-FP-β-CIT was concentrated in striatum. The test of undue toxicity showed that the dose received by mice was 1250 times as by human, which indicates that 18F-FP-β-CIT is very safe. So 18F-FP-β-CIT is a promising PET imaging agent for DAT with safety and validity.

关键词：帕金森病多巴胺输送放射性核素生物分布

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Discrepancies between Nonalcoholic and Metabolic-associated Fatty Liver Disease by Multiple Steatosis Assessment

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Journal of Clinical and Translational Hepatology 2022年第6期10卷 1013-1026页

作者： Congxiang Shao Junzhao Ye Xin Li yansong lin Shiting Feng Bing Liao Wei Wang Xiaorong Gong Bihui Zhong Department of Gastroenterology of the First Affiliated Hospital Sun Yat-sen UniversityGuangzhouGuangdongChina Department of Gastroenterology Affiliated Dongguan People’s HospitalSouthern Medical University(Dongguan People’s Hospital)DongguanGuangdongChina Department of Radiology of the First Affiliated Hospital Sun Yat-sen Univer-sityGuangzhouGuangdongChina Department of Pathology of the First Affiliated Hospital Sun Yat-sen UniversityGuangzhouGuangdongChina Department of Medical Ultrasonics of the First Affiliated Hospital Sun Yat-sen UniversityGuangzhouGuangdongChina Department of Gastroenterology First Affiliated HospitalGuangzhou Medical UniversityGuangzhouGuangdongChina

Background and Aims:The redefinition of metabolic-as-sociated fatty liver disease(MAFLD)from nonalcoholic fat-ty liver disease(NAFLD)has caused a revolution in clinical practice,and the characteristics of patients with steatosis but not MAFLD remain *** aims were to compare the diagnosis rate of MAFLD in NAFLD using different steato-sis methods and explore the features of non-MAFLD-NAFLD and ***:A cross-sectional study enrolling consecutive individuals was conducted at three medical centers in southern China from January 2015 to September *** was evaluated by liver biopsy or magnetic resonance imaging-based proton density fat frac-tion(MRI-PDFF),ultrasound,controlled attenuation param-eter(CAP),and fatty liver index(FLI).Fibrosis was assessed by the NAFLD fibrosis score,transient elastography,or shear wave ***:The study enrolled 14,985 Chi-nese *** agreement of MAFLD and NAFLD diagnoses were 83%for FLI,95%for ultrasound,94%for both CAP and MRI-PDFF,and 95%for liver *** body mass index,blood pressure and lipid levels among non-MAFLD-NAFLD pa-tients were similar metabolic parameters(p>0.05 for all),but not the alanine aminotransferase and the proportion of pa-tients with insulin resistance,which were significantly higher in non-MAFLD-NAFLD with significant ***:The new MAFLD definition ruled out 5-17%of NAFLD *** and MAFLD-NAFLD involved more severe metabolic abnormalities than MAFLD and ***-MAFLD-NAFLD patients with significant fibrosis had more se-vere liver injury and increased glycemic dysregulation within the normal *** should be paid to its progression.

关键词： Controlled attenuation parameter Fatty liver index Liver biopsy Metabolic-associated fatty liver disease Magnetic resonance imaging-based proton density fat fraction

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Comments on National guidelines for diagnosis and treatment of thyroid cancer 2022 in China (English version)

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Chinese Journal of Cancer Research 2022年第5期34卷 447-450页

作者： Hao Wang Jian Wang Xiang Wang Yiming Zhu Yuqing Sun Xin Zhang Xiaorong Hou Kun Zheng Shaoyan Liu yansong lin Department of Clinical Oncology Qingdao Municipal HospitalQingdao UniversityQingdao 266012China Department of Head and Neck Surgical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Medical Oncology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Radiation Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Nuclear Medicine State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine Beijing 100730China Department of Radiation Oncology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

Thyroid cancer (TC) is the most common endocrine system cancer, of note, the overall survival of TC in China is suboptimal when comparing with the developed countries such as US (84.3%vs.98.3%), posing a great challenge among professionals involved in this *** of its diagnosis and treatment not only provides the basis for all the care givers to promote the entire level of TC management, but also is helpful in shortening the distance between China and other developed countries. A multidisciplinary team (MDT)should be involved in the comprehensive clinical management of TC, particularly for those advanced or refractory TC, which needs cooperation among members from ultrasonography, radiology, pathology, surgery.

关键词： diagnosis cancer treatment

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National guidelines for diagnosis and treatment of thyroid cancer 2022 in China(English version)

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Chinese Journal of Cancer Research 2022年第3期34卷 131-150页

作者：无 Shaoyan Liu yansong lin Yiming Zhu lin Gui Xiaorong Hou Ziren Kong Yuanlin Piao Yuqing Sun Hao Wang Jian Wang Bo Zhang Ye Zhang Kun Zheng National Health Commission of the People's Republic of China National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical Sciences National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College(Beijing)&Hebei Cancer HospitalChinese Academy of Medical Sciences(Langfang) Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Peking Union Medical College Hospital State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Qingdao Municipal Hospital School of MedicineQingdao University China Japan Friendship Hospital

Contents 1. Overview 2. Diagnosis and management 2.1 Screening for high-risk group 2.2 Clinical manifestations 2.2.1 Symptoms 2.2.2 Signs 2.2.3 Invasion and metastasis 2.3 Laboratory examination 2.3.1 Routine examination 2.3.2 Special examination 2.4 Imaging 2.4.1 Ultrasonography 2.4.2 Computed tomography (CT)2.4.3 Magnetic resonance imaging (MRI)2.4.4 Positron emission tomography (PET)-CT。

关键词： diagnosis metastasis CT

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Risk stratification for radioactive iodine refractoriness using molecular alterations in distant metastatic differentiated thyroid cancer

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Chinese Journal of Cancer Research 2024年第1期36卷 25-35页

作者： Zhuanzhuan Mu Xin Zhang Dongquan Liang Jugao Fang Ge Chen Wenting Guo Di Sun Yuqing Sun Zhentian Kai Lisha Huang Jun Liang yansong lin Department of Nuclear Medicine State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College(PUMC)HospitalChinese Academy of Medical Sciences&PUMCBeijing 100730China Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine Beijing 100730China Pepperdine University Graduate School of Education and Psychology Los Angeles 90045USA Department of Head and Neck Surgery Affiliated Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China Department of General Surgery State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College(PUMC)HospitalChinese Academy of Medical Sciences&PUMCBeijing 100730China Central Laboratory State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College(PUMC)HospitalChinese Academy of Medical Sciences&PUMCBeijing 100730China Department of Bioinformatics Zhejiang Shaoxing Topgen Biomedical Technology Co.LtdShanghai 201321China Department of Medicine Zhejiang Shaoxing Topgen Biomedical Technology Co.LtdShanghai 201321China Department of Oncology Peking University International HospitalBeijing 102206China

Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness and the underlying genetic characteristics has not been extensively ***: Adult patients with distant metastatic DTC were enrolled and assigned to undergo next-generation sequencing of a customized 26-gene panel(Thyro Lead). Patients were classified into RAIR-DTC or non-RAIR groups to determine the differences in clinicopathological and molecular characteristics. Molecular risk stratification(MRS) was constructed based on the association between molecular alterations identified and RAI refractoriness, and the results were classified as high, intermediate or low ***: A total of 220 patients with distant metastases were included, 63.2% of whom were identified as RAIRDTC. Genetic alterations were identified in 90% of all the patients, with BRAF(59.7% vs. 17.3%), TERT promoter(43.9% vs. 7.4%), and TP53 mutations(11.5% vs. 3.7%) being more prevalent in the RAIR-DTC group than in the non-RAIR group, except for RET fusions(15.8% vs. 39.5%), which had the opposite pattern. BRAF and TERT promoter are independent predictors of RAIR-DTC, accounting for 67.6% of patients with RAIR-DTC. MRS was strongly associated with RAI refractoriness(Plinical outcomes and directing precision-based therapeutic interventions.

关键词： Differentiated thyroid cancer distant metastases genetic alterations RAI refractoriness molecular risk stratification

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分化型甲状腺癌的碘-131治疗现状和进展

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中华耳鼻咽喉头颈外科杂志 2019年第1期54卷 62-68页

作者：林岩松中国医学科学院北京协和医院核医学科 100730

作为分化型甲状腺癌(differentiated thyroid carcinoma,DTC)术后重要的靶向治疗手段,碘-131(^131I)治疗有效降低了部分中危DTC患者的潜在复发风险,以及存在摄碘病灶的高危DTC患者复发、死亡的风险。近年来,随着临床证据的增加,^131I治... 详细信息

作为分化型甲状腺癌(differentiated thyroid carcinoma,DTC)术后重要的靶向治疗手段,碘-131(^131I)治疗有效降低了部分中危DTC患者的潜在复发风险,以及存在摄碘病灶的高危DTC患者复发、死亡的风险。近年来,随着临床证据的增加,^131I治疗的目的、治疗前评估及风险分层系统、动态评估体系、甲状腺在DTC^131I诊治中的意义、分子病理特征及分子影像学在DTC诊治中的意义等方面取得了一定的进展,本文就上述问题加以综述。

关键词：碘放射性同位素分化型甲状腺癌

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有关放射性碘难治性分化型甲状腺癌靶向治疗的思考与初探

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中华核医学与分子影像杂志 2023年第8期43卷 449-451页

作者：林岩松中国医学科学院、北京协和医学院北京协和医院核医学科、疑难重症及罕见病国家重点实验室、核医学分子靶向诊疗北京市重点实验室北京100730

尽管分化型甲状腺癌(differentiated thyroid cancer,DTC)保留了部分滤泡细胞的特征,使得放射性碘(radioactive iodine,RAI)成为术后一线治疗手段,但高达2/3的局部晚期或转移性DTC在初始或治疗中逐渐呈现RAI难治性(RAI-refractory,RAIR)状态。RAIR-DTC治疗手段相对有限,患者的10年生存率仅10%,是甲状腺癌死亡病因最主要占比人群[1]。相对明确的RAIR-DTC概念于2012年被提出,从病灶的核医学分子影像学特征可以将RAIR分成4种情形:(1)病灶在清除残留甲状腺组织(简称清甲)成功后,首次RAI治疗即不摄碘;(2)起初摄碘,逐渐不摄碘;(3)部分病灶摄碘,部分病灶不摄碘;(4)病灶虽然摄碘但仍呈现临床进展[2]。

关键词：分化型甲状腺癌甲状腺组织放射性碘临床进展死亡病因靶向治疗核医学滤泡细胞

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有关分化型甲状腺癌核医学相关诊治的指南更新

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中华核医学与分子影像杂志 2018年第3期38卷 172-177页

作者：林岩松中国医学科学院、北京协和医学院北京协和医院核医学科 100730

分化型甲状腺癌（DTC）因其发病率逐年增高而引人关注，伴随着诊断治疗手段的不断完善以及分子生物学等技术在DTC中的深入研究，有关其诊断及治疗指南也不断更新，作者就美国甲状腺协会（ATA）《甲状腺结节及甲状腺癌诊治指南》及美国... 详细信息

分化型甲状腺癌（DTC）因其发病率逐年增高而引人关注，伴随着诊断治疗手段的不断完善以及分子生物学等技术在DTC中的深入研究，有关其诊断及治疗指南也不断更新，作者就美国甲状腺协会（ATA）《甲状腺结节及甲状腺癌诊治指南》及美国国立综合癌症网络（NCCN）指南中的更新，针对复发风险分层系统、甲状腺球蛋白（Tg）、分子病理特征、核医学显像及实时动态评估体系在DTC ^131I治疗前评估及治疗后随访中的意义进行简要解读。

关键词：甲状腺肿瘤核医学实践指南

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