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Current Understanding of Papillary thyroid Carcinoma

International Journal of Otolaryngology and Head & Neck Surgery 2021年第3期10卷 184-221页

作者： Rodrigo Arrangoiz Jeronimo Garcialopez De Llano Maria Fernanda Mijares Gonzalo Fernandez-Christlieb Vanitha Vasudevan Amit Sastry Adrian Legaspi Jennifer Fernandez Frank de la Cruz Fernando Cordera Daniel Margain Center for Advanced Surgical Oncology Florida USA American British Cowdray Medical Center Mexico City Mexico Sociedad Quirurgica S.C. at the American British Cowdray Medical Center Mexico City

The term thyroid neoplasm incorporates tumors that originate from follicular cells and those that arise from parafollicular cells (C cells). Differentiated thyroid cancer, which originates from follicular cells, includes papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC), oncocytic cell carcinoma (Hürthle), poorly differentiated carcinoma, and anaplastic thyroid carcinoma (ATC). PTC tends to have an indolent clinical course with low morbidity and mortality. However, this entity has a broad range of biological and clinical behavior that can result in disease recurrence and death, depending on patient and tumor characteristics and the initial treatment approach. PTC is the most common form of well-differentiated thyroid cancer (WDTC) and based on the most recent statistics, accounts for approximately 89.4% of all thyroid malignancies. PTC appears as an irregular solid or cystic nodule in normal thyroid parenchyma. PTC has the propensity for lymphatic invasion, but it is less likely to have hematogenous spread. Around 11% of patients with PTC present with distant metastases outside the neck and mediastinum. This manuscript with review the current understanding of the epidemiology, pathology, molecular characteristics, prognostic factors, and dynamic risk stratification of PTC centered on an evidence-based and personalized approach.

关键词： thyroid cancer Papillary thyroid cancer Papillary thyroid Microcarcinoma thyroid Nodule thyroid cancer Treatment Molecular Studies for thyroid cancer

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The Reliability of Ultrasound Diagnosis in Differentiating Malignant from Benign thyroid Nodules Using TI-RADS Selection Followed by FNA

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Open Journal of Radiology 2021年第3期11卷 115-125页

作者： Abdullah S. Mirza Husain Alturkistani Elsayed Elbehery Abdulmalik Alruhaimi Ahmed A. Mirza Syed O. Ahsan Turki H. Alharbi Radiology and Diagnostic Imaging Department King Saud University Medical City Riyadh Saudi Arabia Department of Medical Laboratory Science King Abdulaziz University Jeddah Saudi Arabia

Context: Diagnostic imaging has increased the rate of thyroid nodules detection and improved utilization of fine-needle aspiration (FNA). Objective: This study aims to demonstrate the effects of the most reliable non-invasive technique on thyroid nodules. Methods: Between 2016 and 2020, 190 patients with 214 nodules visiting King Khalid University Hospital were randomly selected and retrospectively reviewed. Following the ACR TI-RADS recommendations for FNA and correlating cytology reports. Two expert radiologists with ultrasonographic imaging experience re-evaluated and reviewed the images. 88 nodules (41%) in 79 patients were excluded because the nodule size was smaller than the FNA recommended size. Results: Following the ACR TI-RADS for FNA recommended selection, 27 nodules (21.4%) out of the recommended 126 nodules were consistent with malignancy in cytology, with overall mean sensitivities, specificities, accuracies, precisions, and negative predictive values (NPV) of 96.4%, 40.7%, 48.7%, 28.4%, and 98.6% respectively. The nodules were subdivided into the TI-RADS 3, 4, and 5. Conclusion: In conclusion, ACR TI-RADS is feasible, reliable, and well structured, easily applicable in thyroid nodules reporting. ACR TI-RADS can eliminate many unnecessary FNAs, providing a decline in costs and complications. We recommend the ACR TI-RADS in our radiology department to eliminate reporting discrepancies and cut costs, thereby standardizing the reports, improving intra-user agreements, and improving overall patients’ health care.

关键词： thyroid cancer thyroid Nodules thyroid Ultrasound Ultrasound TIRADS

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Powerful quantifiers for cancer transcriptomics

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World Journal of Clinical Oncology 2020年第9期11卷 679-704页

作者： Dumitru Andrei Iacobas Personalized Genomics Laboratory CRI Center for Computational Systems BiologyRoy G Perry College of EngineeringPrairie View A&M UniversityPrairie ViewTX 77446United States

Every day,investigators find a new link between a form of cancer and a particular alteration in the sequence or/and expression level of a key gene,awarding this gene the title of“biomarker”.The clinician may choose from numerous available panels to assess the type of cancer based on the mutation or expression regulation(“transcriptomic signature”)of“driver”***,cancer is not a“onegene show”and,together with the alleged biomarker,hundreds other genes are found as mutated or/and regulated in cancer *** of the platform,a well-designed transcriptomic study produces three independent features for each gene:Average expression level,expression variability and coordination with expression of each other *** the average expression level is used in all studies to identify what genes were up-/down-regulated or turn on/off,the other two features are unfairly *** use all three features to quantify the transcriptomic change during the progression of the disease and recovery in response to a *** from our published microarray experiments on cancer nodules and surrounding normal tissue from surgically removed tumors prove that the transcriptomic topologies are not only different in histopathologically distinct regions of a tumor but also dynamic and unique for each human *** show also that the most influential genes in cancer nodules[the Gene Master Regulators(GMRs)]are significantly less influential in the normal *** such,“smart”manipulation of the cancer GMRs expression may selectively kill cancer cells with little consequences on the normal ***,we strongly recommend a really personalized approach of cancer medicine and present the experimental procedure and the mathematical algorithm to identify the most legitimate targets(GMRs)for gene therapy.

关键词： cancer biomarkers cancer nodule Gene therapy Kidney cancer Prostate cancer RNA gene thyroid cancer

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Characteristics of Patients Sponsored by the Internet Platforms of Medical Mutual Aid

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Yangtze Medicine 2021年第1期5卷 70-78页

作者： Xiaotong Li Feng Qian Department of Physiology School of Basic Medicine Health Science Center Yangtze University Jingzhou China

The morbidity and mortality of life-threatening diseases such as cancers are increasing year by year in China. Although the national medical insurance has been improved a lot, it still falls short of expecting “universal medical insurance”. To help the families of patients with cancer and other serious diseases to resolve the unaffordable medical cost, several internet platforms of “Peer to Peer Medical Mutual Aid” have gradually emerged recently. In the form of low threshold insurance combined with public support, these platforms provide subsidies to families of patients suffering from serious financial burden and then partly compensate them for the limit of national medical insurance. This article summarized the characteristics of declared patients sponsored by several medical mutual aid internet platforms. The results showed that the sponsored patients were mostly cancer patients (90.1%), aged 21 - 60 (88.4%), and the average amounts of financial support had a trend to decrease with the increase of age. In particular, the reported cases of thyroid cancer were increased dramatically recently, however, with a lowest average mutual aid fund. Given these data, it is urgent to list out a detailed rule for the use of national medical insurance on the treatment of cancer, to heighten the healthcare system for the occupational population, age from 21 to 60, and to establish the credit system for Medicare and Medicaid services.

关键词： Medical Insurance cancer thyroid cancer Internet Platform

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Active surveillance in low risk papillary thyroid carcinoma

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World Journal of Clinical Oncology 2020年第6期11卷 320-336页

作者： Fabian Pitoia Anabella Smulever Division of Endocrinology Hospital de ClínicasUniversity of Buenos AiresBuenos Aires 1120Argentina

In recent decades,while the incidence of thyroid cancer has increased exponentially around the world,mortality has remained *** vast majority of this increase is attributable to the identification of intrathyroidal papillary microcarcinomas,which exhibit slow growth rates with indolent courses.A diagnosis of thyroid cancer based upon the presence of these small tumors could be considered as an overdiagnosis,as the majority of these tumors would not likely result in death if left *** surgical resection was the classical standard therapy for papillary microcarcinomas,active surveillance(AS)has emerged over the last three decades as an alternative approach that is aimed to recognize a minority group of patients who will clinically progress and would likely benefit from rescue *** the encouraging results of AS,its implementation in clinical practice is strongly influenced by psychosocial *** aim of this review is to describe the epidemiology,clinical evolution,prognostic factors,and mortality of papillary thyroid *** also summarize the AS strategy according to published evidence,characterize the criteria for selecting patients for AS according to risk factors and environmental characteristics,as well as analyze the current limitations for AS implementation.

关键词： Active surveillance Low risk Papillary thyroid carcinoma Observation Papillary thyroid microcarcinoma thyroid cancer

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Solitary thyroid Nodule: Clinical, Sonography and Pathological Evaluation Risk of Malignancy

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International Journal of Otolaryngology and Head & Neck Surgery 2021年第5期10卷 441-476页

作者： Burkan Nasr M. Qubati S. Qubati Abdulhakim Al-Tamimi Yasser A. Rabo Anwar Aljounaeed Abdulfatah Al-Tam Mohmmed Al-Shujaa Mohmmed Al-Shehari Department of Surgery Saudi Hospital at Hajjah Hajjah Yemen Department of Surgery Aden University Aden Yemen Department of Surgery Sana&#224 University Sana&#224 Yemen Department of Pathology Taiz University Taiz Yemen Department of Pathology Thamar University Thamar Yemen Department of Surgery Thamar University Thamar Yemen Department of Surgery 21 September University Sana&#224 Yemen

Aim: To determined risk of increases Incidence of thyroid cancer in solitary thyroid nodules so Preoperative distinction between benign and malignant in solitary thyroid nodules is important and helps to avoid unnecessary surgery and its adverse effects, such as hypothyroidism, hypocalcemia, and recurrent nerve injury. Methods: Descriptive perspective analyzed data over a period of 6 years April 2015-April 2021 in Saudi Hospital at Hajjah, Yemen. 226 thyroid operations for 207 patients, 135 patient’s diagnosis as Solitary thyroid nodule and 72 patients as Multi nodular goiter. Patients with a clinically solitary thyroid nodule were included in the study group. Results: 135 cases of clinically detected solitary thyroid nodules, 126 female and 9 male patients, between 14 - 65 years age, median 41 years and mean 39.76 years, (94, 41) patients respectively Right side thyroid effect more than Left side, Fine needle aspiration cytology (FNAC) sensitivity, specificity and accuracy was (61%, 72%, 64%) respectively. Postoperative histopathology reported 100 (74%) patients as having benign thyroid nodules and 35 patients (26%) as having malignant thyroid nodules. Postoperative transient hypocalcemia was observed in 9 patients (7%), and temporary hoarseness was observed in 3 patients (2%). Conclusion: The incidence of malignancy in solitary thyroid nodules is high. Rapid growth by history and hard fixed nodule by examination and hypoechoic, micro calcification and cervical lymphadenopathy on thyroid Ultrasound frequently in malignant nodules. Male risk factors for thyroid cancer but age, number and size of nodules not included as risk factor. Fine needle aspiration cytology (FNAC) is more helpful for diagnosing if aspiration under Ultrasound guidance and reading by experience histopathologists. The type of surgery depends on preoperative evaluation, including history, examination, ultrasound, fine needle aspir

关键词： Solitary thyroid Nodule thyroid cancer Fine Needle Aspiration Cytology thyroid Ultrasound

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Electronic Synoptic Reporting of thyroid Nodules: Potential for Reduction in Number of Patients Undergoing thyroid Nodule Biopsies

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Open Journal of Radiology 2016年第3期6卷 233-242页

作者： Jimmy Tanche Wang Paul Babyn Gary Groot Rob Otani Department of Radiology University of Saskatchewan Faculty of Medicine Royal University of Hospital Saskatoon Canada Department of Surgery University of Saskatchewan Faculty of Medicine Royal University of Hospital Saskatoon Canada

Purpose: The objective of the study was to design and implement an electronic synoptic report for thyroid sonography that incorporates the thyroid imaging reporting and data system (TIRADS) and assess potential for reducing unnecessary fine needle aspiration biopsies (FNAB) of thyroid nodules. Methods: The electronic synoptic report was developed using a relational database based on elements from TIRADS and a multidisciplinary consensus statement for thyroid reporting. A retrospective analysis of 138 patients with previously reported thyroid sonographic exams was evaluated for the presence of these elements. The electronic synoptic report calculates the TIRADS score and generates a formal report. Using the TIRADS score the potential decrease in unnecessary FNAB was estimated. Results: Key TIRADS elements were variously reported ranging from 43% for the thyroid nodule’s architecture as solid or cystic. thyroid nodule echogenicity and calcification was commented in 27% and 23%, respectively. Other features of the TIRADS score were commented in 0% to 8% of the official reports. Estimated reduction for potentially reduced need for FNAB was 34.5%. Conclusions: This study is the first implementation of synoptic reporting using a relational database for sonography of thyroid nodules. Implementation of an electronic standardized synoptic reporting system may facilitate more accurate, and more comprehensive reporting for thyroid ultrasound scanning of thyroid nodules. The use of TIRADS was estimated to be able to potentially reduce the need for FNAB which was significant.

关键词： Synoptic Reporting thyroid Nodules thyroid cancer Fine Needle Aspiration Biopsy thyroid Imaging Reporting and Data System

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Reliability of thyroid Imaging Reporting and Data System(TIRADS)Classification in Differentiating Benign from Malignant thyroid Nodules

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Open Journal of Radiology 2013年第3期3卷 103-107页

作者： Boniface Moifo Emmanuel Oben Takoeta Joshua Tambe Francois Blanc Joseph Gonsu Fotsin Department of Radiology and Radiation Oncology Faculty of Medicine and Biomedical SciencesThe University of Yaounde IYaoundeCameroon Centre Hospitalier de Lagny Marne La ValleeFrance

Background: Ultrasonography (US) is the best diagnostic tool in the initial assessment of thyroid nodule. Giving its appropriateness and accessibility, ultrasound-based thyroid imaging reporting and data systems (TIRADS) classifications have been developed with main goal to standardize reporting and facilitate communication between practitioners, and to indicate when fine-needle aspiration biopsy (FNAB) should be performed. Objective: To determine the reliability of Russ’ modified TIRADS classification in predicting thyroid malignancy. Materials and Methods: It was a cross sectional study carried out at Centre Hospitalier de Lagny, Marne La Vallée (France). Consecutive records of patients with focal thyroid nodules on ultrasound (US) for which US-guided FNAB was performed and pathology results were available, from January 2007 to August 2012, were selected for review. The risk of malignancy of each TIRADS category was determined and correlation with pathology assessed. Statistical performances of some US features were also assessed. The threshold for statistical significance was set at 0.05. Results: A total of 430 records of patients were eligible. Twenty-three out of 430 (5.3%) nodules were malignant. The risk of malignancy of the TIRADS categories were as follows: TIRADS2 0%, TIRADS3 2.2%, TIRADS4A 5.9%, TIRADS4B 57.9%, TIRADS5 100% (Gamma statistic = 0.85;Spearman correlation = 0.30, Pearson’s R = 0.37, p Conclusion: Russ’ modified TIRADS classification is reliable in predicting thyroid malignancy. More evidence is nevertheless necessary for widespread adoption and use.

关键词： TIRADS thyroid Nodule thyroid cancer Ultrasonography Fine-Needle Biopsy

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Primary mucinous carcinoma of the thyroid: case report and review of the literature

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cancer Advances 2022年第23期5卷 1-4页

作者： Neng-Liang Zhang Jian-Hua Wang Wei Cheng Zheng-Jing Li Jie Tang Tao Wang Yi Chen Clinical Medical College of Dali University Dali 671000China Department of Oncology The First Affiliated Hospital of Dali UniversityDali 671000China Department of Surgery The First Affiliated Hospital of Dali UniversityDali 671000China

Primary mucinous carcinoma of the thyroid gland which is more difficult to diagnose than common thyroid cancer is an extremely rare *** is a malignant tumor that can secrete mucus.A 45-year-old Chinese man came to seek medical care because he found a lump in his right *** showed that there was a space-occupying lesion on the right thyroid gland which compressed the *** the operation of total thyroidectomy and lymph node dissection in the right central area,the pathological examination showed that tumor cells existed,showing a small nest-like and cribriform distribution *** were broad fibrous tissues,a large amount of mucus around the tumur cell that had no obvious amyloid *** tumor cells were positive for thyroid transcription factor-1 and paired box gene-8,while they were focally positive for *** the histological features and immunohistochemical profile and ruling out mucinous cancers originating from other *** patient was diagnosed with primary mucinous carcinoma of the thyroid *** patient is still alive at *** of primary mucinous carcinoma of the thyroid gland is usually *** best way to improve the prognosis of these patients maybe to do surgery of complete tumor+lymph node resection as soon as possible.

关键词： mucinous carcinoma thyroid cancer immunohistochemistry surgery

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