To evaluate the effectiveness and safety of radiofrequency ablation (RFA) for the treatment of symptomatic distant metastasis of differentiated thyroid carcinoma.

The medical records of 12 patients who underwent RFA for the palliative treatment of 18 symptomatic distant metastases from thyroid cancer between January 2008 and December 2020 were analyzed. All patients were assessed for their degree of discomfort and underwent periodical evaluations as outpatients, including clinical examination, imaging, and serologic markers.

Among the 18 tumors treated, nine were soft tissue, and nine were bone metastases. The mean size of the treated tumors was 5.3 cm (range, 1.7-10.7 cm). All patients complained of pain, discomfort and/or bulging of the metastatic mass before RFA. After RFA, 11 out of the 18 patients with metastatic tumors (61.1%) reported a subjective improvement in symptoms. Nine out of 18 tumors decreased in size, with a mean size reduction ratio of 43% ± 22%. Although symptom improvement was achieved in 61.1% of the tumors, after a mean follow-up duration of 37.4 months, five patients experienced progression of the tumor, four patients had a stable tumor status, and three patients died from pneumonia. There were no major adverse events related to RFA during the treatment or follow-up period.

RFA can be used as palliative therapy to relieve the symptoms caused by metastatic tumors; however, it has a limited role in improving the overall prognosis in patients with distant metastasis from thyroid cancer.

Thyroid cancer (TC) is commonly recognized as the most prevalent type of malignancy affecting the endocrine system. This study aimed to assess the incidence of TC and its trends in the Iranian population.

The incidence rate of TC in Iran was determined using data from the Iranian National Population-based Cancer Registry (INPCR). The INPCR registered all new cancer cases through various diagnostic methods, including pathology reports, clinical and paraclinical data, and death registry reports.

From 2014 to 2018, a total of 27,530 cases of TC were recorded. Among these cases, 21,932 (79.7%) were female, and 5,598 (20.3%) were male. The age-standardized incidence rate (ASR) of TC was 6.17 (95% confidence interval [CI]: 6.09-6.25) per 100,000 person-years, showing an upward trend from 4.61 (95% CI: 4.45-4.77) per 100,000 population in 2014 to 8.17 (95% CI: 7.97-8.37) in 2018. The ASR of TC in women was nearly 3.7 times higher than that in men (9.79 vs. 2.59 per 100,000 person-years). The ASR of TC was highest in younger age groups among women (40-50 years) compared to men, who had higher rates in older age groups (65-75 years). Papillary thyroid carcinoma (PTC), including its follicular variant, was the predominant histological type of TC in the Iranian population, accounting for 82.19% (n = 22,627) of cases, followed by follicular thyroid carcinoma (FTC) (n = 859; 3.12%).

Our data suggest that thyroid cancer rate has increased in Iran though comprehending the underlying reasons for this phenomenon requires further research.

This study aims to compare variations in 18 trace elements (Al, Na, K, Mg, Ca, Ti, Ba, Sn, Cr, Mn, Fe, Cu, Zn, Se, Mo, Cd, Sr, and Tl) between benign and malignant thyroid tissues. Post-operative thyroid tissue samples were collected from 106 patients (34 benign, 72 malignant), and elemental concentrations were quantified using inductively coupled plasma mass spectrometry. Spearman's correlation analysis revealed positive correlations among these trace elements. Notably, the malignant group exhibited significantly higher concentrations in eight elements (Mg, Al, Fe, Cr, Ti, Sr, Sn, and Ba) compared to the benign group, while levels of six elements (Na, Mn, Cu, Zn, Cd, and Mo) were significantly lower. Orthogonal partial least squares discriminant analysis distinguished three elements (Al, Ti, Sn) for the malignant group and six elements (Na, Mn, Cu, Zn, Cd, and Mo) for the benign group. Multivariate logistic regression further revealed associations between thyroid cancer and levels of Al, Cr, Ti, Sr, Sn, Ba, Mn, Cu, Zn, and Cd. Considering with each elemental biological funcions, these findings suggest that Cu, Mn, and particularly Zn may act as essential antitumor elements with synergistic effects, whereas elevated Ba, Cr, and Al levels are closely related to thyroid malignancies. However deficiencies and excesses of elements may be the consequences of malignant tissues. In conclusion, benign and malignant thyroid tumors exhibit different trace-element profiles.

Pediatric thyroid cancer incidence has been increasing globally, with environmental exposures being a hypothesized risk factor.

We evaluated the association between pediatric thyroid cancer risk and perinatal exposure to ambient fine particulate matter (PM) with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ) and outdoor artificial light at night (O-ALAN). Both are considered environmental carcinogens with evidence of thyroid function disruption, reported associations with thyroid cancer in adults, and concerns of distributive inequity. O-ALAN may also serve as a proxy for other outdoor air pollutants or urbanization.

We conducted a case-control study of papillary thyroid cancer nested within a California birth cohort that included 736 cases diagnosed at 0-19 y of age and born in 1982-2011 and 36,800 controls frequency-matched on birth year. We assigned individual-level exposures for residence at birth for ambient PM 2.5 concentrations from a validated, ensemble-based prediction model and O-ALAN using the New World Atlas of Artificial Night Sky Brightness. We calculated odds ratios (OR) and 95% confidence intervals (CI) using logistic regression adjusting for potential confounders and stratified by age and race/ethnicity.

We observed statistically significant associations between PM 2.5 exposure and papillary thyroid cancer risk overall (OR per 10 - μ g / m 3 increase in PM 2.5 = 1.07 , 95% CI: 1.01, 1.14), among the 15-19 y age group (OR = 1.08 ; 95% CI: 1.00, 1.16), and among Hispanic children (OR = 1.13 ; 95% CI: 1.02, 1.24). For O-ALAN, we observed statistically significantly increased odds of papillary thyroid cancer in higher exposure tertiles in comparison with the reference tertile in the overall population (tertile 2: OR = 1.25 , 95% CI: 1.04, 1.50; tertile 3: OR = 1.23 , 95% CI: 1.02, 1.50) and when modeled as a continuous variable (OR = 1.07 per 1  mcd / m 2 ). In age-stratified analyses, significant associations were observed among the 15-19 y age group, but not the 0-14 y age group. No significant differences were found by race/ethnicity.

This study provides new evidence suggesting associations between early-life exposure to PM 2.5 and O-ALAN and pediatric papillary thyroid cancer. Given that O-ALAN may also represent other air pollutants or broader urbanization patterns, further research and refinements to exposure metrics are needed to disentangle these factors. https://doi.org/10.1289/EHP14849.

Acromegaly is a rare condition, and often diagnosis is delayed by several years, for most patients. Acromegaly is characterized by short and long-term respiratory, cardiovascular and metabolic comorbidities, with possible impact on mortality. In the last two decades, life expectancy has progressively increased in part due to a reduction in biochemically active disease, multidisciplinary treatment approaches and a reduction in complications, and the availability of new drugs. Of note, a leading cause of mortality, cardiovascular comorbidity, has been replaced by cancer(s). As such, neoplasms more frequently observed (colon, thyroid, breast, prostate, and stomach) in patients with acromegaly are receiving increased attention. Chronic exposure to increased growth hormone serum levels may contribute to an increase in the occurrence and progression of cancers. Various efforts have been made to determine the pathogenetic mechanisms involved. However, there are no clear medical-related societal agreement(s) in relation to screening methods or timing regarding neoplasm(s) diagnosis in patients with acromegaly. Additionally, independent and dependent risk factor data in patients with acromegaly is lacking. International/national registries could help lay the groundwork to better study the impact of cancer(s) in patients with acromegaly and subsequently lead to and validate the most appropriate diagnostic and therapeutic path forward.

Current studies have reported a high association between the Hashimoto's thyroiditis (HT) and papillary thyroid cancer (PTC). However, studies on the characteristics of central lymph node metastasis (CLNM) in PTC patients with HT are scarce. Therefore, this study aims to evaluate the risk factors of CLNM in PTC and HT patients.

We retrospectively collected clinical data from 933 PTC patients with HT who underwent thyroid surgery. Of these, 653 patients were categorized into a training cohort for constructing the nomogram, and 280 patients formed a validation cohort to verify the performance of the model. Least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression analyses were used to select risk factors. A nomogram model for predicting CLNM was developed and internally validated. We subsequently evaluated thyroid function within 3 years after surgery and estimated the prevalence and incidence of postoperative complications between the CLNM ( +) and CLNM (-) groups.

LASSO regression revealed that 19 nonzero variables were associated with CLNM. Multivariate logistic regression analysis revealed that younger, patients of low body mass index (BMI), drinking, intranodular hyperechoic (IH) status, diameter ≥ 1 cm, multifocality, extrathyroidal extension (ETE), enlarged central lymph nodes (ECLNs) and lateral lymph node metastasis (LLNM) were at higher risk of CLNM (P < 0.05). A nomogram to predict CLNM in PTC patients with HT was constructed and internally validated on the basis of risk factors. The areas under the ROC curve (AUCs) of nomogram were 0.768 (95% CI, 0.723-0.812) and 0.773 (95% CI, 0.705-0.841) in training and validation groups, respectively. Moreover, the nomogram data showed a good discrimination and calibration ability to training and validation groups. Postoperative follow-up revealed that TGAb levels and the incidence of hypothyroidism were significantly greater in CLNM ( +) group than CLNM (-) group, respectively.

Our nomogram schedule developed and validated with a comprehensive set of preoperative risk factors showed a high benefit in predicting CLNM in PTC patients with HT. Postoperative follow-up of thyroid function allow to clarify the trend, as well as prevalence and incidence of common thyroid complications.

Background: In China, thyroid cancer (TC) is the most common cancer in females and the fifth most common cancer in males. TC overdiagnosis leads to overtreatment, lifelong medical care, and side effects. This study systematically quantifies the epidemiological profile of TC incidence in China, as well as estimating TC incidence attributable to overdiagnosis. Methods: Data were derived from the Cancer Incidence in Five Continents databases. Age-standardized incidence rates (ASIRs) per 100,000 person-years were calculated using the world standard population. Joinpoint regression and age-period-cohort models were conducted to examine temporal ASIR trends and period effects, respectively. We estimated TC incidence attributable to overdiagnosis among patients aged 15-84 years by comparing shapes of age-specific curves with those observed before diagnostic practices. Results: In 2013-2017, there were 37,862 and 117,979 new TC cases in males and females in China, respectively, with ASIRs of 6.9/100,000 and 21.1/100,000. Significant upward trends were observed from 1993 to 2017, with average annual percent changes being 14.7% for males and 16.2% for females. Incidence rate ratios of period effects markedly increased from 1.0 to 61.8 for males and from 1.0 to 42.9 for females from 1993 to 2017. Overdiagnosis accounted for 83.5% (31,455/37,685) and 88.7% (104,222/117,509) of cases in males and females in 2013-2017, respectively, yielding ASIRs of 5.9/100,000 and 19.1/100,000. ASIRs attributable to overdiagnosis in urban populations (6.9/100,000 for males and 21.7/100,000 for females) were significantly higher than in rural populations (1.3/100,000 and 6.4/100,000). Among the 25 included provinces, ASIRs attributable to overdiagnosis ranged from 0.3/100,000 in Sichuan to 18.5/100,000 in Shanghai in males and from 0.1/100,000 in Shanxi to 49.4/100,000 in Shanghai in females. The national ASIRs attributable to overdiagnosis increased from 2.6/100,000 in 2008-2012 to 5.9/100,000 in 2013-2017 for males and from 9.2/100,000 to 19.1/100,000 for females. Conclusions: The incidence rates of TC have considerably increased over the past 25 years in China. Rapidly increasing trends and considerable geographic variations in TC incidence attributable to overdiagnosis highlight the need to adjust TC screening strategies and clinical practices, optimize healthcare resource allocation, and monitor the impacts of TC overdiagnosis on population-level health.

Despite the rising incidence of differentiated thyroid cancer (DTC), mortality rates have remained relatively low yet crucial for effective patient management. This study aims to develop a deep neural network capable of predicting mortality in patients with differentiated thyroid cancer.

Leveraging data from the Surveillance, Epidemiology, and End Results (SEER) database, we developed Thy-DAMP (Deep Artificial Neural Network Model for Prediction of Thyroid Cancer) to forecast mortality in DTC patients. The dataset comprised demographic, histologic, and staging information. Following data normalization and feature encoding, the dataset was partitioned into training, testing, and validation subsets, with model hyperparameters fine-tuned via cross-validation.

Among the 63,513 patients, the mean age was 48.22 years (SD = 14.8), with 77.32% being female. Papillary carcinoma emerged as the predominant subtype, representing 62.94% of cases. The majority presented with stage I disease (73.96%). Thy-DAMP demonstrated acceptable performance metrics on both the test and validation sets. Sensitivity was 83.24% (95% CI 76.95-88.40%), specificity was 93.53% (95% CI 93.01-94.02%), and accuracy stood at 93.33% (95% CI 92.82-93.83%). The model exhibited a positive predictive value of 19.76% (95% CI 18.20-21.42%) and a negative predictive value of 99.66% (95% CI 99.53-99.75%). Additionally, Thy-DAMP demonstrated a positive likelihood ratio of 12.86 (95% CI 11.62-14.23), a negative likelihood ratio of 0.18 (95% CI 0.13-0.25), and an area under the receiver operating characteristic curve (AUROC) of 0.95. The model was externally validated on a separate dataset with nearly identical performance.

Thy-DAMP showcases considerable promise in accurately predicting mortality in DTC patients, leveraging limited set of patient data.

The severity of thyroid cancer is judged on the basis of histologic and clinical features. A limited number of studies have considered urinary metabolite signatures for its diagnosis, and no reliable urinary metabolite biomarkers have been proposed. This diagnostic method would be particularly valuable because of its non-invasive nature.

A nuclear magnetic resonance (NMR)-based metabolomics approach was used as the analytical platform to study the urine samples of patients with PTMC. Urine samples collected from 41 PTMC patients, 52 healthy subjects, and 13 patients with benign tumors were analyzed using 1H-NMR spectroscopy to identify metabolic changes. PLS-DA, or partial least squares discriminant analysis, was used to analyze the NMR spectra. A double cross-validation method and randomization tests were used to validate PLS-DA models.

Clear discriminations between PTMC patients and healthy controls, as well as between PTMC patients and patients with benign tumors were obtained. Collectively, pi-methyhistidine, trimethylamine, myo-inositol, acetate, suberate, azelate, mannitol, tau-methylhistine, ascorbate, 3-aminoisobutyric acid, 2-oxoglutarate, and methanol contributed to the discrimination. Apart from myo-inositol and methanol, all of these metabolites exhibited increased levels in the urine samples of PTMC patients as compared to that of patients with benign tumors.

The application of this NMR-based metabolomics approach allowed the detection of anomalous metabolic traits directly connected PTMC, potentially yielding a more sensitive and comprehensive diagnostic results for PTMC.

To evaluate the feasibility, safety and efficiency of the microwave ablation (MWA) of T1N0M0 papillary thyroid carcinoma (PTC) locating in dangerous region. This is a clinical retrospective study, and the data of patients who underwent thermal ablation for T1N0M0 PTC from June 2016 to March 2021 were reviewed. After ablation, the rates of technical success, as well as the changes in tumor size and volume, tumor disappearance, disease progression, and complications, were assessed. According to the tumor size, the patients were divided into T1a and T1b subgroups. There was a total of 94 cases enrolled in the present study. The mean age was 43.06 ± 11.51 years (22-65 years). The median follow-up time was 33 months (25-75% IQR 24-44; 12-85months). The technical success rate was 100%. Due to expanding ablation, the MD and volume of the ablation zone increased at the 1st and 3rd months and decreased from the 12th month after ablation (p < 0.05 for all). At the end of follow-up, the complete disappearance of ablation zone occurred in 78(78/94, 82.98%) cases, including 65 (65/75, 86.67%) cases in T1a subgroup and 13(13/19, 68.4%) cases in the T1b subgroup. There was no difference between the two subgroups (p = 0.121). 5 (5/94,5.3%) patients developed disease progression, and all of them were in T1a subgroup (5/75, 6.67%). There was not significantly different between two subgroups (p = 0.559). The complication rate was 15.96% (15/94). Recurrent laryngeal nerve (RLN) injury encountered in 11 (11/75, 14.7%) cases in the T1a subgroup and 4 (4/19, 21.1%) cases in the T1b subgroup. No significant difference between the two subgroups (p = 0.74). This preliminary study indicates that MWA is an effective treatment for T1N0M0 PTC locating in dangerous region.

This study aimed to develop a multimodal radiopathomics model utilising preoperative ultrasound (US) and fine-needle aspiration cytology (FNAC) to predict large-number cervical lymph node metastasis (CLNM) in patients with clinically lymph node-negative (cN0) papillary thyroid carcinoma (PTC).

This multicentre retrospective study included patients with PTC between October 2017 and June 2024 across seven institutions. Patients were categorised based on the presence or absence of large-number CLNM in training, validation, and external testing cohorts. A clinical model was developed based on the maximum diameter of thyroid nodules. Radiomics features were extracted from US images and pathomics features were extracted from FNAC images. Feature selection was performed using univariate analysis, correlation analysis, and least absolute shrinkage and selection operator regression. Six machine learning (ML) algorithms were employed to construct radiomics, pathomics, and radiopathomics models. Predictive performance was assessed using the area under the curve (AUC), and decision curve analysis (DCA).

A total of 426 patients with PTC (41.65 ± 12.47 years; 124 men) were included in this study, with 213 (50%) exhibiting large-number CLNM. The multimodal radiopathomics model demonstrated excellent predictive capabilities with AUCs 0.921, 0.873, 0.903; accuracies (ACCs) 0.852, 0.800, 0.833; sensitivities (SENs) 0.876, 0.867, 0.857; specificities (SPEs) 0.829, 0.733, 0.810, for the training, validation, and testing cohorts, respectively. It significantly outperformed the clinical model (AUCs 0.730, 0.698, 0.630; ACCs 0.690, 0.656, 0.627; SENs 0.686, 0.378, 0.556; SPEs 0.695, 0.933, 0.698), the radiomics model (AUCs 0.819, 0.762, 0.783; ACCs 0.752, 0.722, 0.738; SENs 0.657, 0.844, 0.937; SPEs 0.848, 0.600, 0.540), and the pathomics model (AUCs 0.882, 0.786, 0.800; ACCs 0.829, 0.756, 0.786; SENs 0.819, 0.889, 0.857; SPEs 0.838, 0.633, 0.714).

The multimodal radiopathomics model demonstrated significant advantages in the preoperative prediction of large-number CLNM in patients with cN0 PTC.

Question Accurate preoperative prediction of large-number CLNM in PTC patients can guide treatment plans, but single-modality diagnostic performance remains limited. Findings The radiopathomics model utilising preoperative US and FNAC images effectively predicted large-number CLNM in both validation and testing cohorts, outperforming single predictive models. Clinical relevance Our study proposes a multimodal radiopathomics model based on preoperative US and FNAC images, which can effectively predict large-number CLNM in PTC preoperatively and guide clinicians in treatment planning.

Postoperative nausea and vomiting (PONV) are common complications following thyroid cancer surgery, impacting patient well-being, prognosis, and potentially leading to severe complications. Frailty, a critical risk factor for postoperative complications, has not been thoroughly investigated concerning PONV in thyroid cancer patients. This study aimed to explore the correlation between frailty and PONV in thyroid cancer patients. A retrospective analysis was conducted on 908 patients who underwent radical thyroid cancer surgery at Jinan Central Hospital between January 2016 and September 2022. Patients were classified into the PONV group (626 patients) and the non-PONV group (282 patients). General and clinical data were collected for comparison. Independent risk factors for PONV were identified using univariate and multivariate logistic regression analyses. ROC curves evaluated the diagnostic efficiency of various indicators. A predictive model for PONV risk factors was developed, verified using ROC curves, and a scoring system was established. Age, Apfel score, modified frailty index (mFI) score, free fatty acids, uric acid, homocysteine (HCY), and fasting blood glucose were identified as independent risk factors for PONV through multivariable logistic regression analysis. The model achieved an area under the curve of 0.893 (0.871-0.915) in the ROC curve, with a sensitivity of 83.2%, specificity of 79.1%, and a maximum Youden index value of 0.623. mFI exhibited the strongest correlation with PONV post-radical thyroid cancer surgery, with a correlation coefficient of 0.523. The modified frailty index is a significant predictor of postoperative nausea and vomiting in patients undergoing thyroid cancer surgery.

Circular RNA ITCH (circ-ITCH) is implicated in papillary thyroid carcinoma (PTC) development. Nevertheless, the more detailed molecular mechanism remains uncovered. The transcriptional level of circ-ITCH was tested via quantitative real-time PCR. Transwell assay was introduced to assess the migrative and invasive abilities of cells. RNA interference technology was employed to reduce the level of circ-ITCH as well as JAZF1 in PTC cells. Western blot assay was utilized to reveal the content of JAZF1 and proteins related to epithelial-mesenchymal transformation (EMT) progression. Circ-ITCH was downregulated in PTC tissues as well as cells. Overexpression of circ-ITCH suppressed EMT, migration, invasion, facilitated apoptosis in PTC cells, while silencing circ-ITCH exhibited reversed effects. Additionally, miR-106a-5p was the target of circ-ITCH and negatively regulated through circ-ITCH. MiR-106a-5p mimic partly eliminated the influences of overexpressed circ-ITCH in PTC cells. Moreover, JAZF1 could interact with miR-106a-5p, then it was regulated via circ-ITCH. Silencing JAZF1 partially counteracted the role of circ-ITCH in PTC cells progress. This study uncovered that circ-ITCH suppressed the development of PTC cells at least partly by mediating miR-106a-5p/JAZF1 network.

Background: The global incidence of thyroid cancer has increased over the past several decades. While this increase is partially due to increased detection, environmental pollutants have also emerged as a possible contributing factor. Our goal was to perform a systematic review to assess the relationship between environmental air pollution and thyroid cancer. Methods: Systematic literature search was performed using PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus databases for original articles published prior to March 2024, investigating outdoor air pollution and thyroid cancer/nodules (PROSPERO CRD42024517624). Inclusion criteria included quantitative reporting of pollutant levels and effect size. Specific pollutants included ozone (O3), particulate matter less than 2.5 (PM2.5) or 10 microns in diameter (PM10), sulfur dioxide (SO2), nitric oxides (NOx), carbon monoxide (CO), and polyaromatic hydrocarbons (PAHs). Study design, sample size, pollution assessment method, covariates, and strength/direction of associations between pollutants and thyroid cancer/nodule detection were extracted, and descriptive synthesis was utilized to summarize pertinent findings. Risk of bias was assessed using the National Heart, Lung, and Blood Institute quality assessment tool. Results: Of 1294 identified studies, 11 met inclusion criteria. Over 6 million patients from diverse regions were represented across studies. Pollutants studied included O3 in 5 studies; PM2.5, PM10, SO2, and NOx in 3 studies; unspecified PM and CO in 2 studies; and PAHs in 1 study. Primary outcome was thyroid cancer diagnosis among 9 studies and thyroid nodule detection in 2. All studies examining NOx and O3 reported increased risks ranging from 1.03 to 1.5-fold and 1.1 to 1.3-fold, respectively. Both studies assessing PM2.5 reported 1.18 to 1.23-fold increased odds of thyroid cancer diagnosis, and the magnitude of association increased with increasing duration or concentration of PM2.5 Inconsistent results were observed for levels of CO, PM10, and SO2. Conclusion: While an emerging body of literature suggests a potential association between air pollution and thyroid cancer, the quality of evidence is limited by study design constraints, variability in exposure assessment, and inconsistent adjustment for potential confounding factors. The heterogeneity in study designs and methodologies present challenges in interpreting results, underscoring the need for standardized approaches in future research.

Introduction The internet is a crucial source of health information, including cancer-related topics, but the quality and reliability of these resources can vary, affecting patient decision-making. Objectives This study aimed to evaluate the quality of thyroid cancer-related websites in the Arabic language, using the DISCERN tool, and explore the content and sources provided by different types of websites. Methods A total of 78 websites were included after excluding 21 based on predefined criteria (e.g., duplicates, non-functional uniform resource locators (URLs)). The websites were categorized into commercial, non-profit, and individual types. Two independent reviewers assessed the websites using the DISCERN tool. Interrater agreement was measured using the k-score. A one-way analysis of variance (ANOVA) was used to compare DISCERN scores across website types, and Spearman's rank correlation was used to analyze the relationship between website ranking and DISCERN scores. Results Almost all websites included a definition of thyroid cancer. Additionally, 15 websites (19.2%) covered the definition, clinical presentation, risk factors, diagnosis, and treatment, while 14 websites (17.9%) offered only clinical presentation, diagnosis, and treatment, and 11 websites (14.1%) offered other combinations of similar content. However, there was a lack of information regarding prognosis and predictors of outcomes following thyroid cancer surgery. The average overall DISCERN score for the 78 websites was 42.65 ± 12.35. Statistically significant differences were found in DISCERN scores across website types, with non-profit websites scoring the highest (38.93 ± 14.12), followed by commercial (37.67 ± 10.34) and individual websites (28.63 ± 10.02). A significant negative correlation was also found between website rank and DISCERN scores (Spearman's r = -0.38, p < 0.0001). Conclusion The study found that non-profit websites provide higher-quality thyroid cancer information compared to commercial and individual sites. Website ranking also affects content quality, emphasizing the importance of patients assessing online resources critically. Health organizations are encouraged to improve the visibility and quality of trustworthy information.

Informative biomarkers play a vital role in guiding clinical decisions regarding management of cancers. We have previously demonstrated the potential of a deep convolutional neural network (CNN) for predicting cancer driver gene mutations from expert-curated histopathologic images in papillary thyroid carcinomas (PTCs). Recognizing the importance of whole slide image (WSI) analysis for clinical application, we aimed to develop an automated image preprocessing workflow that uses WSI inputs to categorize PTCs based on driver mutations.

Histopathology slides from The Cancer Genome Atlas (TCGA) repository were utilized for diagnostic purposes. These slides underwent an automated tile extraction and preprocessing pipeline to ensure analysis-ready quality. Next, the extracted image tiles were utilized to train a deep learning CNN model, specifically Google's Inception v3, for the classification of PTCs. The model was trained to distinguish between different groups based on BRAFV600E or RAS mutations.

The newly developed pipeline performed equally well as the expert-curated image classifier. The best model achieved Area Under the Curve (AUC) values of 0.86 (ranging from 0.847 to 0.872) for validation and 0.865 (ranging from 0.854 to 0.876) for the final testing subsets. Notably, it accurately predicted 90% of tumors in the validation set and 84.2% in the final testing set. Furthermore, the performance of our new classifier showed a strong correlation with the expert-curated classifier (Spearman rho = 0.726, p = 5.28 e-08), and correlated with the molecular expression-based classifier, BRS (BRAF-RAS scores) (Spearman rho = 0.418, p = 1.92e-13).

Utilizing WSIs, we implemented an automated workflow with deep CNN model that accurately classifies driver mutations in PTCs.

The treatment for papillary thyroid microcarcinoma (PTMC) is controversial. Central lymph node metastasis (CLNM) is one of the main predictors of recurrence and survival, accurate preoperative identification of CLNM is essential for surgical protocol establishment for PTMC. The objective of this study was to establish a nomogram to predict the possibility of CLNM in PTMC patients.

A total of 3023 PTMC patients were randomly divided into two groups by a ratio of 7 to 3, the training group (n = 2116) and validation group (n = 907). The LASSO regression model and multivariate logistic regression analysis were performed to examine risk factors associated with CLNM. A nomogram for predicting CLNM was established and internally validated. Meanwhile, we follow-up the serum thyroid function FT3, FT4, TSH, Tg, TGAb and TPOAb in 789 PTMC patients for 4 years after surgery and compared the differences between the CLNM (+) and CLNM (-) groups, respectively.

The LASSO regression model and multivariate logistic regression analysis showed that younger age, lower BMI, being male, location in the lower pole, calcification, 1 ≥ diameter ≥ 0.5 cm, multifocality lesions, extra thyroidal extension (ETE), enlargement of central lymph node (ECLN), lateral lymph node metastasis (LLNM) and higher carcinoembryonic antigen were the ultimate risk factors for determining CLNM. A nomogram for predicting CLNM was constructed based on the influencing factors and internally validated. By establishing the prediction model, the AUC of CLNM in the training and validation groups were 0.73 (95% CI, 0.70-0.76) and 0.75 (95% CI, 0.71-0.79) respectively. Results of the DCA showed that the model is clinically useful when deciding on intervention in the most range of the threshold probability. A 4-year follow-up of thyroid function showed that FT3 and FT4 remained at stable levels after 3 months postoperative and were higher in the CLNM (+) group than in the CLNM (-) group. Hypothyroidism appeared predominantly within 3 months after surgery. The overall incidence of the CLNM (+) group and CLNM (-) groups were 16.46% and 12.04%, respectively.

The nomogram model constructed in this study has a good predictive effect on CLNM in PTMC patients and provides a reasonable reference for clinical treatment.

Background/Objectives: The management of differentiated thyroid cancer (DTC) patients has undergone a major paradigm shift in past years, especially regarding the role of a careful postoperative disease assessment both in deciding for or against the use of iodine-131 therapy (i.e., patients' selection) and in selecting the correct goal of the treatment: ablative, adjuvant or therapeutic. Furthermore, diagnostic and risk-oriented uses of iodine isotopes (i.e., 123/124/131I) should always be considered during both postoperative assessment and follow-up of DTC patients to improve early staging and response assessment to initial treatments, respectively. The present review summarizes current (and real-life-related) evidence and the emerging perspectives on the therapeutic, diagnostic, and theragnostic use of radioiodine isotopes. Methods: A review of the pertinent literature was performed in PubMed, Web of Science, and Scopus without language restrictions or time limits and using one or more fitting search criteria and terms. Results: According to the literature evidence and real-life clinical practice, a risk-oriented postoperative iodine-131 therapy remains pivotal for most DTC patients and improves early disease staging through post-therapy functional imaging (i.e., theragnostic aim). Accordingly, the goal of iodine-131 therapy, the optimal strategy (empiric vs. dosimetric approach), the appropriate stimulation method [i.e., levothyroxine (L-T4) withdrawal vs. recombinant human thyrotropin (rhTSH) administration] and, finally, the suggested radioiodine activity to deliver for iodine-131 therapy (RIT) should be personalized, especially in metastatic DTC patients. Conclusions: The evidence related to the diagnostic and theragnostic use of iodine isotopes leads to a significant improvement in the postoperative risk stratification and staging of DTC patients in addition to a more accurate assessment of the response to initial treatments. In conclusion, radioiodine is really an oldie but goldie radiotracer. It has both a current fundamental role and a future perspective for the more careful management of DTC patients.

To analyze the evolving epidemiologic trends in thyroid disease, focusing on risk factors, underlying drivers of these changes, and their implications on clinical practice and research priorities.

Thyroid disease remains one of the most prevalent groups of disorders globally, and the shift in its frequency and distribution is multifactorial. The prevalence of hypothyroidism increases with age, although normal thyrotropin ranges appear to be age-dependent, raising concern for potentially inappropriate levothyroxine use. Hyperthyroidism and Graves' disease continue to be predominant in reproductive-age women but exhibit a milder phenotype at diagnosis. Thyroid nodules are increasingly found in asymptomatic patients, likely from more widespread use of neck and chest imaging. Thyroid cancer incidence has risen exponentially over the years, mostly driven by overdiagnosis of low-risk tumors; however, a small rise in incidence of higher risk tumors has been noted. Obesity appears to be a risk factor for thyroid cancer occurrence and more aggressive forms of the disease.

Understanding epidemiologic trends in thyroid disease is crucial for guiding clinical practice and research efforts, aiming to optimize patient outcomes while preventing unnecessary and potentially harmful interventions.

Objective The primary objective of this study is to comprehensively evaluate nodular thyroid lesions. By analyzing the morphological characteristics of surgically resected specimens and biopsies, the aim is to establish correlations between the patterns, corresponding clinical diagnoses and radiological findings. Furthermore, the study will investigate cases where there is a discrepancy between imaging and pathological assessments, with the goal of understanding the contributing factors to this discordance and improving diagnostic accuracy. Methodology This retrospective observational study utilized convenience sampling to recruit participants. Sample size was determined using GPower software (Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany). Statistical analysis was performed using Jamovi 2.3.28 (Jamovi Research, Vienna, Austria). The Chi-square test was employed to assess the association between the Thyroid Imaging Reporting and Data System (TIRADS) score and histopathological diagnosis. Receiver operating characteristic (ROC) analysis was conducted to identify the optimal TIRADS cut-off point for classifying nodules as malignant and to evaluate the diagnostic accuracy of TIRADS. Discordant cases between histopathological and radiological findings were analyzed to investigate potential discrepancies. Result Taking into consideration histopathology report as a gold standard, correlation of TIRADS with histopathology findings, TIRADS showed 73.08% sensitivity and 81.08% specificity, showing the strongest balance between sensitivity and specificity, as demonstrated by the Youden's Index and Metric Score. The area under the curve (AUC) remains constant at 0.805, suggesting a consistent overall discriminative ability of the TIRADS scale. Conclusion A primary advantage of this study is its exclusive focus on surgically resected nodules, which allows for definitive histological confirmation and thereby ensures the most accurate diagnostic assessment.

The American Thyroid Association guidelines primarily recommend central neck dissection for papillary thyroid carcinoma with advanced primary tumors or clinically positive neck nodes. However, the appropriate extent of dissection remains unclear. We aimed to compare the rate of locoregional recurrence between unilateral and bilateral central neck dissection in invasive papillary thyroid carcinoma.

Among 330 consecutive patients who underwent total thyroidectomy with central neck dissection for advanced papillary thyroid carcinoma, 212 underwent unilateral central neck dissection (UCND group) while 118 underwent bilateral central neck dissection (BCND group). We performed 1:1 propensity score matching, resulting in 99 matched pairs. Surgical outcomes and safety were compared between the two groups. Additionally, the impact of surgery on locoregional recurrence was compared using survival analysis.

During a follow-up of 47.8 ± 20.4 months, 29 (8.8%) patients experienced locoregional recurrence within the entire study cohort. Following propensity score matching, no significant difference in recurrence-free survival was observed between the two groups (log-rank p = 0.516). Multivariate analysis revealed that only T4 staging was an independent risk factor for locoregional recurrence (p = 0.006). The mean number of total and metastatic central lymph nodes retrieved were significantly greater in BCND group (14.1 vs. 9.3, p < 0.001 and 6.8 vs. 4.6, p = 0.005, respectively). There was no significant difference in postoperative stimulated thyroglobulin levels between the two groups (0.79 ng/mL vs. 1.44 ng/mL, p = 0.389).

The present study demonstrates no prognostic benefit in conducting bilateral central neck dissection. Unilateral central neck dissection may be the preferred choice for clinically invasive papillary thyroid carcinoma.

Thyroid-stimulating hormone (or thyrotropin) receptor (TSHR) could be a selective target for small molecule ligands to treat thyroid cancer (TC).

We report a novel, orally efficacious ligand for TSHR that exhibits proliferation inhibitory activity against human TC in vitro and in vivo, and inhibition of metastasis in vivo.

A35 (NCATS-SM4420; NCGC00241808) was selected from a sublibrary of >200 TSHR ligands. Cell proliferation assays including BrdU incorporation and WST-1, along with molecular docking studies were done. In vivo activity of A35 was assessed in TC cell-derived xenograft (CDX) models with immunocompromised (NSG) mice. Formalin-fixed, paraffin-embedded sections of tumor and lung tissues were observed for the extent of cell death and metastasis.

A35 was shown to stimulate cAMP production in some cell types by activating TSHR but not in TC cells, MDA-T32, and MDA-T85. A35 inhibited proliferation of MDA-T32 and MDA-T85 in vitro and in vivo, and pulmonary metastasis of MDA-T85F1 in mice. In vitro, A35 inhibition of proliferation was reduced by a selective TSHR antagonist. Inhibition of CDX tumor growth without decreases in mouse weights and liver function showed A35 to be efficacious without apparent toxicity. Lastly, A35 reduced levels of Ki67 in the tumors and metastatic markers in lung tissues.

We conclude that A35 is a TSHR-selective inhibitor of TC cell proliferation and metastasis, and suggest that A35 may be a promising lead drug candidate for the treatment of differentiated TC in humans.

To evaluate the efficacy and safety of thermal ablation in treating solitary low-risk T2N0M0 papillary thyroid cancer (PTC) and compare the outcomes of microwave ablation (MWA) and radiofrequency ablation (RFA).

This retrospective, single center study involved 34 patients (age: 40.0 ± 13.9 years; 28 female) who had low-risk T2N0M0 PTC with a maximum diameter >2 cm and ≤4 cm and underwent MWA (n = 15) or RFA (n = 19) from November 2016 to April 2023. The primary outcomes were the cumulative rate of disease progression and delayed surgery rates. In contrast, the secondary outcomes included changes in tumor size, cumulative rate of complete tumor disappearance, and complication rates.

The median follow-up period was 18.0 months (interquartile range [IQR]: 9.0-40.0 months). At 12 months, the median volume reduction rate of the ablation zone was 74.2% (IQR: 53.7%-86.0%). Disease progression was noted in two patients within 1 year, including one patient with local tumor progression post-RFA and one with a new tumor post-MWA, resulting in a constant cumulative disease progression rate of 8.8% (95% confidence interval [CI]: 0%-19.8%) throughout the remaining follow-up period. Both patients were subsequently treated with additional ablation and did not require surgery. The cumulative rates of complete tumor disappearance at 1, 3, and 5 years were 4.0% (95% CI: 0%-11.4%), 26.8% (95% CI: 2.7%-44.9%), and 51.2% (95% CI: 0%-79.1%), respectively. No significant differences were observed in the disease progression (P = 0.829) or complete tumor disappearance (P = 0.633) rates between the MWA and RFA groups. Complications occurred in 14.7% (5/34) of patients presenting with transient hoarseness. RFA had a higher but not statistically significant complication rate than MWA did (21.1% [4/19] vs. 6.7% [1/15]; P = 0.355).

Both MWA and RFA demonstrated promising short-term outcomes in terms of efficacy and safety in treating solitary low-risk T2N0M0 PTC, with no significant differences.

The study summarizes the potential use of immunotherapy for BRAF-mutated papillary thyroid cancer (PTC) by analyzing the immune profile of City of Hope PTC patient samples and comparing them to the thyroid dataset available in the TCGA database.

PTC cases with available formalin-fixed paraffin-embedded archived tumor tissue were identified. RNA was extracted from the tumor tissue and analyzed by NanoString to evaluate their immune gene expression profile. Immunohistochemistry was used to determine the expression of immune suppressive genes and lymphocytic infiltration into the tumor tissue. Thyroid cancer cell lines (MDA-T32, MDA-T68, MDA-T85, and MDA-T120) were used to determine the correlation between the BRAF inhibition and CD274 expression.

The study found that PTC cases with BRAF mutations had higher expression of immune checkpoint markers CD274 and CTLA4, as well as higher tumor-infiltrating lymphocytes, particularly CD4+T cells. Additionally, the study identified immunosuppressive markers expressed by tumor cells like CD73, CD276, and CD200 that could be targeted for immunotherapy. Further experiments using PTC cell lines lead to the conclusion that CD274 expression correlates with BRAF activity and that inhibitors of BRAF could potentially be used in combination with immunotherapy to treat PTC.

These findings suggest that PTC cases with BRAF mutations or high expression may be correlated with an immune hot signature and could benefit from immunotherapeutic strategies.

To investigate the association between age distribution and synchronous distant metastasis of papillary thyroid carcinoma.

Patients with PTC who were treated from January 2013 to December 2018 at a single institute in a cancer referral center in China were retrospectively reviewed. A logistic regression model with restricted cubic splines (RCS) was used to examine the association between age at diagnosis and synchronous distant metastasis.

A total of 111 patients (0.7%) were diagnosed with distant metastasis. The logistic regression model with RCS revealed a "U-shape" association between age and distant metastasis. The RCS curve suggested a U-shaped pattern. The multivariable regression analysis showed that patients in the age groups ≤21 years (OR 2.33, 95% CI 1.09-4.68, P = 0.022) and >55 years (OR 3.32, 95% CI 1.99-5.46, P < 0.001) had a significantly higher incidence of distant metastasis than patients in the age group of 22 to 55 years.

A U-shaped association was observed between age at diagnosis and synchronous distant metastasis in papillary thyroid carcinoma patients.

Thyroid cancer, the most prevalent cancer of the endocrine system and cervical region, has experienced a significant increase in incidence over recent decades. Nanomedicine has fundamentally revolutionized cancer treatment, particularly through the development of multifunctional nano-therapeutics. The progress in this field has been facilitated by the distinctive properties of nanomaterials, such as their capacity to perform several functions, be modified, and offer various detection methods. These features allow for non-invasive and practical diagnostic techniques through versatile imaging. Surface engineering plays a pivotal role in the design of multifunctional nano-systems for localized drug delivery against thyroid cancer. Nano-systems can be customized via surface modification techniques, such as functionalization with targeting ligands and inclusion of therapeutic drugs. This customization allows the nano-systems to specifically target cancer cells while reducing the impact on non-target cells. As a result, bovine serum albumin-coated nanostructures have emerged as powerful diagnostic and targeting nanosystems for thyroid cancer. This targeted strategy enhances the effectiveness of cancer treatment while reducing overall body toxicity. This comprehensive review aims to provide an extensive overview of the latest advancements in surface-engineered nanoparticle-based approaches for both diagnosing and treating thyroid cancer. It highlights the promising research endeavors aimed at creating novel and effective multifunctional nanomedicine for localized delivery to thyroid cancer sites. The review examines different nanomedicines that have been developed for cancer treatment and diagnosis. It also analyzes the current trends, future possibilities, and obstacles in this rapidly advancing sector. By synthesizing the current state of knowledge on surface-engineered multifunctional nano-systems, this review contributes to a better understanding of their potential applications in thyroid cancer treatment and paves the way for future research directions in this promising field of nanomedicine.

Thyroid cancer, a leading type of endocrine cancer, accounts for 3-4% of all cancer diagnoses. This study aims to analyse and compare thyroid cancer patterns in China and the Group twenty (G20) countries, and predict these trend for the upcoming two decades.

This observational longitudinal study utilised data from the Global Burden of Disease (GBD) study 2019. We used metrics including incidence, mortality, mortality-incidence ratio (MIR), age-standardised rate (ASR) and average annual percent change (AAPC) to examine thyroid cancer trends. Joinpoint regression analysis was used to identify periods manifesting notable changes. The association between sociodemographic index (SDI) and AAPC were investigated. The autoregressive integrated moving average (ARIMA) model was used to predict thyroid cancer trends from 2020 to 2040.

From 1990 to 2019, thyroid cancer incidence cases in China increased by 289.6%, with a higher AAPC of age-standardised incidence rate (ASIR) in men. Contrastingly, the G20 demonstrated a smaller increase, particularly among women over 50. Despite the overall age-standardised mortality rate (ASMR) was higher in the G20, the increase in mortality was less pronounced than in China. Age-standardised incidence rate increased across all age groups and genders, with a notable rise among men aged 15-49. ASMR decreased in specific age groups and genders, especially among women. Conversely, the ASMR significantly increased in group aged over 70. The MIR exhibited a declining trend, but this decrease was less noticeable in men and the group aged over 70. Joinpoint analysis pinpointed significant shifts in overall ASIR and ASMR, with the most pronounced increase in ASIR during 2003-2011 in China and 2003-2010 in the G20. Predictions suggested a continual ASIR uptrend, especially in the 50-69 age group, coupled with a predicted ASMR downturn among the elderly by 2040. Moreover, the proportion of thyroid cancer deaths attributable to high body mass index (BMI) escalated, with significant increase in Saudi Arabia and a rise to 7.4% in China in 2019.

Thyroid cancer cases in incidence and mortality are escalating in both China and the G20. The increasing trend may be attributed to factors beyond overdiagnosis, including environmental and genetic factors. These findings emphasise the necessity for augmenting prevention, control, and treatment strategies. They also highlight the significance of international collaboration in addressing the global challenge posed by thyroid cancer.

While males present with more adverse clinicopathologic features in papillary thyroid carcinoma (PTC), younger age has previously been shown to be a favorable prognostic factor. We examined the combined effect of male sex and young age on PTC outcomes.

We conducted a retrospective analysis of a prospectively maintained database of thyroid cancer surgery patients (2000-2020) at a single quaternary care institution. We included papillary thyroid carcinoma cases and excluded those with prior cancer-related thyroid surgery. We examined demographics, cancer stage, surgical outcomes, and complications by age and sex, analyzing groups below and above the age of 40 years.

A total of 680 patients with PTC were included. Females constituted 68% (age ≥40 years: 44% and <40 years: 24%) and males 32% (≥40 years: 24% and <40 years: 8%). A significant difference (p < 0.001) of N1 disease distribution was found between the groups. N1a metastasis was greater in patients younger than 40 regardless of sex ((M < 40 (15%), F < 40 (15%), M ≥ 40 (12%), and F ≥ 40 (9%)). While, M < 40 had greater N1b metastasis (36%) than all other groups (M ≥ 40 (28%), F < 40 (22%), and F ≥ 40 (10%)). There was no significant difference in the distribution of T stages between groups. Groups showed no differences in 30-day outcomes, recurrence at 1 year, reoperation, mortality, nerve injury, or hypocalcemia.

Young males with PTC face increased occurrence of nodal metastasis yet experience similar recurrence rates as their female and older counterparts. Subgroup analysis underscores the predictive role of sex and age in advanced PTC cases.

There is an ongoing debate about the reasons behind the increasing incidence of thyroid cancer in the last two to three decades. Here, we investigate how thyroid nodules were detected in a large series of consultations for thyroid nodular pathology.

In total, 576 patients were analyzed, with a total of 1014 nodules described.

In 347 (60.2%) cases, the diagnosis of a thyroid nodule was incidental, mostly during imaging tests for other reasons. Incidental diagnosis occurred among all ranges of nodule diameter and between palpable and non-palpable cases, even within a small proportion of symptomatic cases. In univariate analysis, incidental diagnosis was associated with smaller nodule diameter, non-palpable nodules, asymptomatic cases, older patient age, less advanced stages (T1-2), and conservative management. After multivariate analysis, older age, euthyroidism, and smaller diameter were statistically significant. Incidental diagnosis contributed to the diagnosis of 53.8% of the cases of cancer. Advanced T stages (T3-4) were more common in non-incidental diagnoses.

Our results indicate that incidental diagnosis of thyroid nodules is a significant contributor to thyroid cancer diagnosis in all ranges of nodule diameter, especially at earlier stages.

The effects of organochlorine pesticide (OCP) exposure on the development of human papillary thyroid cancer (PTC) are not well understood. A nested case-control study was conducted with data from the U.S. Department of Defense Serum Repository (DoDSR) cohort between 2000 and 2013 to assess associations of individual OCPs serum concentrations with PTC risk.

This study included 742 histologically confirmed PTC cases (341 females, 401 males) and 742 individually-matched controls with pre-diagnostic serum samples selected from the DoDSR. Associations between categories of lipid-corrected serum concentrations of seven OCPs and PTC risk were evaluated for classical PTC and follicular PTC using conditional logistic regression, adjusted for body mass index category and military branch to compute odds ratios (OR) and 95% confidence intervals (CIs). Effect modification by sex, birth cohort, and race was examined.

There was no evidence of associations between most of the OCPs and PTC, overall or stratified by histological subtype. Overall, there was no evidence of an association between hexachlorobenzene (HCB) and PTC, but stratified by histological subtype HCB was associated with significantly increased risk of classical PTC (third tertile above the limit of detection (LOD) vs. Collapse

Many studies have shown that Hashimoto's thyroiditis (HT) acts as a protective factor in differentiated thyroid cancer (DTC), but little is known about its effects on mortality. Therefore, this study was performed to reveal the prognosis of HT on mortality in patients with DTC.

This study included two types of research.

retrospective cohort study using the National Epidemiologic Survey of Thyroid cancer (NEST) in Korea and meta-analysis study with the NEST data and eight selected studies.

Of the 4,398 patients with DTC in NEST, 341 patients (7.8%) died during the median follow-up period of 15 years (interquartile range, 12.3 to 15.6). Of these, 91 deaths (2.1%) were related to DTC. HT was associated with a smaller tumor size and less aggressive DTC. In Cox regression analysis after adjusting for age and sex, patients with HT showed a significantly lower risk of all-cause death (hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.52 to 0.96) and DTC-related death (HR, 0.33; 95% CI, 0.14 to 0.77). The analysis with inverse probability of treatment weight data adjusted for age, sex, and year of thyroid cancer registration showed similar association. The meta-analysis showed that patients with HT showed a lower risk of all-cause mortality (risk ratio [RR], 0.24; 95% CI, 0.13 to 0.47) and thyroid cancer-related mortality (RR, 0.23; 95% CI, 0.13 to 0.40) in comparison with patients without HT.

This study showed that DTC co-presenting with HT is associated with a low risk of advanced DTC and presents a low risk for all-cause and DTC-related death.

The utilization of prophylactic central neck dissection (pCND) in cases of non-invasive clinical node-negative (cN0) papillary thyroid carcinoma (PTC) remains a topic of debate, with a dearth of long-term evidence.

We retrospectively reviewed 1181 cN0 PTC patients from 1997 to 2011. Of these, 641 underwent pCND (pCND + group) and 540 did not (pCND-group). Propensity score matching (PSM) was used to identify similar patients. Event-free survival and long-term complications including permanent hyperparathyroidism and permanent recurrent laryngeal nerve (RLN) paralysis were analyzed after PSM.

The pCND + group had more aggressive characteristics. In the matched cohort after PSM, the 5-year, 10-year, and 15-year EFS rates were 98.9 %, 98.2 %, and 97.1 % for the pCND + group, and 97.7 %, 97.1 %, and 97.1 % for the pCND-group, respectively. There was no statistically significant difference in EFS rates between the two groups (Log Rank P = 0.38). There was no statistically significant difference in the incidence of permanent hyperparathyroidism (3.3 % vs. 1.5 %, P = 0.08) and permanent RLN paralysis (1.7 % vs. 0.9 %, P = 0.13) between the pCND+ and pCND- groups.

Our study, with a median follow-up duration of 107 months, indicates that pCND does not lead to a significant reduction in nodal recurrence among non-invasive cN0 PTC patients.

The Ras association domain family 7 (RASSF7, also named HRC1), a potential tumor-related gene, located on human chromosome 11p15, has been identified as an important member of the N-terminal RASSF family. Whereas, the molecular biological mechanisms of RASSF7 in tumorigenesis remain to be further established. We perform a systematic review of the literature and assessment from PUBMED and MEDLINE databases in this article. RASSF7 plays a significant role in mitosis, microtubule growth, apoptosis, proliferation and differentiation. Many research literature shows that the RASSF7 could promote the occurrence and advance of human tumors by regulating Aurora B, MKK4, MKK7, JNK, YAP, MEK, and ERK, whereas, it might inhibit c-Myc and thus lead to the suppression of tumorigenesis. The pregulation of RASSF7 often occurs in various malignancies such as lung cancer, neuroblastoma, thyroid neoplasm, hepatocellular cancer, breast cancer and gastric cancer. The expression stage of RASSF7 is positively correlated with the tumor TNM stage. In this review, we primarily elaborate on the acknowledged structure and progress in the various biomechanisms and research advances of RASSF7, especially the potential relevant signaling pathways. We hope that RASSF7 , a prospective therapeutic target for human malignancies, could play an available role in future anti-cancer treatment.

Thyroid cancer, specifically differentiated thyroid carcinoma (DTC), is one of the most prevalent endocrine malignancies worldwide. Radioactive iodine therapy (RAIT) using I-131 has been a standard-of-care approach for DTC due to its ability to ablate remnant thyroid disease following surgery, thus reducing the risk of recurrence. It is also used for the treatment of iodine-avid metastases. RAIT dosimetry can be employed to determine the optimal treatment dose of I-131 to effectively treat cancer cells while safeguarding against undesirable radiation effects such as bone marrow toxicity or radiation pneumonitis. Conventional dosimetry protocols for RAIT, however, are complex and time-consuming, involving multiple days of imaging and blood sampling. This study explores the use of Artificial Intelligence (AI) in simplifying and optimizing RAIT. A retrospective analysis was conducted on 83 adult patients with DTC who underwent RAIT dosimetry at our institution between 1996 and 2023. The conventional MIRD-based dosimetry protocol involved imaging and blood sampling at 4, 24, 48, 72, and 96 h post-administration of a tracer activity of I-131. An AI system based on a deep-learning neural network was developed to predict the maximum permissible activity (MPA) for RAIT using only the data obtained from the initial 4, 24, and 48 h time points. The AI system predicted the MPA values with high accuracy, showing no significant difference compared to the results obtained from conventional MIRD-based analysis utilizing a paired t-test (p = 0.351, 95% CI). The developed AI system offers the potential to streamline the dosimetry process, reducing the number of imaging and blood sampling sessions while also optimizing resource allocation. Additionally, the AI approach can uncover underlying relationships in data that were previously unknown. Our findings suggest that AI-based dosimetry may be a promising method for patient-specific treatment planning in differentiated thyroid carcinoma, representing a step towards applying precision medicine for thyroid cancer. Further validation and implementation studies are warranted to assess the clinical applicability of the AI system.

Radiation exposure is a well-known risk factor for papillary thyroid cancer (PTC). South Korea has 24 nuclear reactors in operation; however, no molecular biological analysis has been performed on patients with PTC living near nuclear power plants.

We retrospectively included patients with PTC (n=512) divided into three groups according to their place of residence at the time of operation: inland areas (n=300), coastal areas far from nuclear power plants (n=134), and nuclear power plant areas (n=78). After propensity score matching (1:1:1) by age, sex, and surgical procedure, the frequency of representative driver mutations and gene expression profiles were compared (n=50 per group). Epithelial-mesenchymal transition (EMT), BRAF, thyroid differentiation, and radiation scores were calculated and compared.

No significant difference was observed in clinicopathological characteristics, including radiation exposure history and the frequency of incidentally discovered thyroid cancer, among the three groups. BRAFV600E mutation was most frequently detected in the groups, with no difference among the three groups. Furthermore, gene expression profiles showed no statistically significant difference. EMT and BRAF scores were higher in our cohort than in cohorts from Chernobyl tissue bank and The Cancer Genome Atlas Thyroid Cancer; however, there was no difference according to the place of residence. Radiation scores were highest in the Chernobyl tissue bank but exhibited no difference according to the place of residence.

Differences in clinicopathological characteristics, frequency of representative driver mutations, and gene expression profiles were not observed according to patients' region of residence in South Korea.

Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Dysregulated expression of miR-146b and androgen receptor (AR) has been shown to play critical roles in tumorigenesis in PTC. However, the mechanistic and clinical association between AR and miR-146b is not fully understood.

The purpose was to investigate miR-146b as the potential AR target miRNA and its involvement in advanced tumor characteristics of PTC.

Expression of AR and miR-146b were assessed in frozen and formalin-fixed paraffin-embedded tissue samples from PTC and adjacent normal thyroid specimens by quantitative real-time polymerase chain reaction, and their correlation was examined. Human thyroid cancer cell lines BCPAP and TPC-1 were used to evaluate the effect of AR on miR-146b signaling. Chromatin immunoprecipitation (ChIP) assays were performed to determine whether AR binds to the miR-146b promoter region.

Pearson correlation analysis confirmed significant inverse correlation between miR-146b and AR expression. Overexpressing AR BCPAP and TPC-1 cells showed relatively lower miR-146b expression. ChIP assay revealed that AR might bind to the androgen receptor element located on the promoter region of miRNA-146b gene, and overexpression of AR suppresses miR-146b-mediated tumor aggressiveness. The low AR/high miR-146b PTC patient group was associated with advanced tumor characteristics, including higher tumor stage, lymph node metastasis, and worse treatment response.

To sum up, miR-146b is a molecular target of AR transcriptional repression; therefore, AR suppresses miR-146b expression to reduce PTC tumor aggressiveness.

The purpose of this study was to investigate the preoperative prediction of large-number central lymph node metastasis (CLNM) in single thyroid papillary carcinoma (PTC) with negative clinical lymph nodes.

A total of 634 patients with clinically lymph node-negative single PTC who underwent thyroidectomy and central lymph node dissection at the First Affiliated Hospital of Anhui Medical University and the Nanchong Central Hospital between September 2018 and September 2021 were analyzed retrospectively. According to the CLNM status, the patients were divided into two groups: small-number (≤5 metastatic lymph nodes) and large-number (>5 metastatic lymph nodes). Univariate and multivariate analyses were used to determine the independent predictors of large-number CLNM. Simultaneously, a nomogram based on risk factors was established to predict large-number CLNM.

The incidence of large-number CLNM was 7.7%. Univariate and multivariate analyses showed that age, tumor size, and calcification were independent risk factors for predicting large-number CLNM. The combination of the three independent predictors achieved an AUC of 0.806. Based on the identified risk factors that can predict large-number CLNM, a nomogram was developed. The analysis of the calibration map showed that the nomogram had good performance and clinical application.

In patients with single PTC with negative clinical lymph nodes large-number CLNM is related to age, size, and calcification in patients with a single PTC with negative clinical lymph nodes. Surgeons and radiologists should pay more attention to patients with these risk factors. A nomogram can help guide the surgical decision for PTC.

Guidelines recommend total thyroidectomy (TT) to facilitate radioactive ablation and serological follow-up for intermediate- to high-risk papillary thyroid carcinoma (PTC). However, the association between surgical extent and tumor recurrence in these patients has not been well validated. We aimed to examine the association between the extent of surgery and recurrence in patients with completely resected unilateral intermediate- to high-risk PTC.

Patients with completely resected unilateral PTC from 2000 to 2017 in a single institute were reviewed. Those who had extrathyroidal extension (ETE) or lymph node metastasis (LNM, cN1 or pN1 > 5 lymph nodes involved) were included for analysis. Cox proportional hazards models were applied to measure the association between surgical extent and recurrence-free survival (RFS) while adjusting for patient demographic, clinicopathological and treatment variables.

A total of 4550 patients (mean[SD] age, 43.0[11.7] years; 3379 women[74.3%]) were included. Of these patients, 2262(49.7%), 656(14.4%), 1032(22.7%), and 600 (13.2%) underwent lobectomy, TT, lobectomy + neck dissection (ND) and TT + ND, respectively. With a median follow-up period of 68 months, after multivariate adjustment, lobectomy was associated with a compromised RFS compared with other surgical extents (HR[95%CI], TT 0.537[0.333-0.866], P = 0.011, lobectomy + ND 0.531[0.392-0.720] P < 0.0001, TT + ND 0.446[0.286-0.697] P < 0.0001). RFS was similar between the two extents with ND (lobectomy + ND, HR [95%CI], 1.196 [0.759-1.885], P = 0.440).

Lobectomy alone is associated with an elevated recurrence risk in patients with unilateral intermediate- to high-risk PTC compared with larger surgical extents. However, lobectomy and ND may provide similar tumor control compared with the conventional approach of TT and ND.