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Wen J, Liu H, Lin Y, Liang Z, Wei L, Zeng Q, Wei S, Zhang L, Yang W. Correlation analysis between BRAF V600E mutation and ultrasonic and clinical features of papillary thyroid cancer. Heliyon 2024; 10:e29955. [PMID: 38726195 PMCID: PMC11078776 DOI: 10.1016/j.heliyon.2024.e29955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 05/12/2024] Open
Abstract
Purpose The study investigates the value of the BRAFV600E mutation in determining the aggressiveness of papillary thyroid cancer (PTC) and its correlation with ultrasound features. Methods The study selected 176 patients with BRAFV600E mutation and 80 without the mutation who underwent surgery at Guangxi Medical University Cancer Hospital. Clinical and pathological data were collected, focusing on BRAFV600E mutations and associated ultrasonic features. Correlation analysis, as well as univariate and multivariate logistic regression analysis, were conducted to identify independent risk factors for BRAFV600E mutation. The results were verified using a nomogram model. Results The analysis results indicate that the BRAFV600E mutation correlates with tumor size, nodule size, taller-than-wide shape, margin, and shape of papillary thyroid cancer. The receiver operating characteristic curve was used to analyze the diagnostic effect of these features on BRAFV600E mutation. The results showed that nodule size had the most significant area under the curve (AUC = 0.665). Univariate and multivariate logistic regression analyses revealed that taller-than-wide shape ≥1, ill-defined margin, irregular shape, nodule size (≤1.40 cm), TT4 (>98.67 nmol/L), and FT3 (<4.14 pmol/L) were independent risk factors for BRAFV600E mutation. While considering all these factors in the nomogram, the Concordance index (C-index) remained high at 0.764. This suggests that the model has a good predictive effect. Conclusion Ultrasound features including nodule size, taller-than-wide shape ≥1, ill-defined margins, irregular shape, higher TT4 levels, and lower FT3 levels were associated with papillary thyroid cancer aggressiveness and BRAFV600E mutation.
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Affiliation(s)
- Jiahao Wen
- Department of Ultrasound, Guangxi Medical University Cancer Hospital, Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Haizhou Liu
- Department of Research, Guangxi Medical University Cancer Hospital, Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
- Guangxi Cancer Molecular Medicine Engineering Research Center, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Yanyan Lin
- Department of Research, Guangxi Medical University Cancer Hospital, Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Zixuan Liang
- Department of Ultrasound, Guangxi Medical University Cancer Hospital, Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Lili Wei
- Department of Ultrasound, Guangxi Medical University Cancer Hospital, Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Qi Zeng
- Department of Ultrasound, Guangxi Medical University Cancer Hospital, Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Shanshan Wei
- Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Litu Zhang
- Department of Research, Guangxi Medical University Cancer Hospital, Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
- Guangxi Cancer Molecular Medicine Engineering Research Center, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Weiping Yang
- Department of Ultrasound, Guangxi Medical University Cancer Hospital, Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
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Pereira-Macedo J, Freire B, Macedo-Oliveira C, Mendes J, Carvalho M, Rocha-Neves J, Fonseca S, Vinagreiro M, Lemos R, Silva N, Sampaio F. Hyperfunctioning papillary thyroid carcinoma - a case report and literature review. Acta Chir Belg 2024; 124:147-152. [PMID: 37133354 DOI: 10.1080/00015458.2023.2210699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/29/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Malignant hyperfunctioning thyroid nodules are rare and more likely to occur in follicular cancer types rather than papillary variants. The authors present a case of a papillary thyroid carcinoma associated with a hyperfunctioning nodule. METHODS A single adult patient submitted to total thyroidectomy with the presence of thyroid carcinoma within hyperfunctioning nodules was selected. Additionally, brief literature was conducted. RESULTS An asymptomatic 58-year-old male was subjected to routine blood analysis and a TSH level of <0.003 mIU/L was found. Ultrasonography revealed a 21 mm solid, hypoechoic, and heterogenous nodule with microcalcifications in the right lobe. A fine needle aspiration guided by ultrasound resulted in a follicular lesion of undetermined significance. A 99mTc thyroid scintigram was followed and identified a right-sided hyperfunctioning nodule. Another cytology was performed and a papillary thyroid carcinoma was derived as a result. The patient underwent a total thyroidectomy. Postoperative histology confirmed the diagnosis and a tumor-free margin with no vascular or capsular invasions. CONCLUSION Hyperfunctioning malignant nodules are a rare association, although a careful approach should be led since major clinical implications arise. Selective fine needle aspiration in all suspicious ≥1 cm nodules should be considered.
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Affiliation(s)
- Juliana Pereira-Macedo
- Department of General Surgery, Hospitalar Centre of Médio-Ave, Vila Nova de Famalicão, Portugal
- CINTESIS@RISE, University of Porto, Porto, Portugal
- Faculty of Medicine of University of Porto, Porto, Portugal
| | - Bárbara Freire
- Department of General Surgery, Hospitalar Centre of Médio-Ave, Vila Nova de Famalicão, Portugal
| | - Carlos Macedo-Oliveira
- Department of General Surgery, Hospitalar Centre of Médio-Ave, Vila Nova de Famalicão, Portugal
| | - João Mendes
- Department of General Surgery, Hospitalar Centre of Médio-Ave, Vila Nova de Famalicão, Portugal
- Portuguese Institute of Oncology of Porto, Porto, Portugal
| | - Márcia Carvalho
- Department of General Surgery, Hospitalar Centre of Médio-Ave, Vila Nova de Famalicão, Portugal
- Portuguese Institute of Oncology of Porto, Porto, Portugal
| | - João Rocha-Neves
- Department of Angiology and Vascular Surgery, Centro Hospitalar, Universitário de São João, Porto, Portugal
- Department of Surgery and Physiology, Universidade do Porto, Porto, Portugal
- Department of Biomedicine - Unit of Anatomy, Universidade do Porto, Porto, Portugal
| | - Sofia Fonseca
- Department of General Surgery, Hospitalar Centre of Médio-Ave, Vila Nova de Famalicão, Portugal
| | - Margarida Vinagreiro
- Department of General Surgery, Hospitalar Centre of Médio-Ave, Vila Nova de Famalicão, Portugal
| | - Ricardo Lemos
- Department of General Surgery, Hospitalar Centre of Médio-Ave, Vila Nova de Famalicão, Portugal
| | - Nair Silva
- Department of General Surgery, Hospitalar Centre of Médio-Ave, Vila Nova de Famalicão, Portugal
| | - Francisco Sampaio
- Department of General Surgery, Hospitalar Centre of Médio-Ave, Vila Nova de Famalicão, Portugal
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Paz-Cruz E, Cadena-Ullauri S, Guevara-Ramírez P, Ruiz-Pozo VA, Tamayo-Trujillo R, Simancas-Racines D, Zambrano AK. Thyroid cancer in Ecuador: A genetic variants review and a cross-sectional population-based analysis before and after COVID-19 pandemic. Heliyon 2024; 10:e23964. [PMID: 38226262 PMCID: PMC10788530 DOI: 10.1016/j.heliyon.2023.e23964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/17/2023] [Accepted: 12/20/2023] [Indexed: 01/17/2024] Open
Abstract
Objectives The purpose of this study is to describe the genetic variants present in the Ecuadorian population and the incidence and mortality patterns of thyroid cancer in Ecuador from 2016 to 2021. Methods The present research constitutes a nationwide cross-sectional study encompassing all reported cases of thyroid cancer (C-73) in Ecuador from 2016 to 2021. Incidence rates were calculated based on the annual population at risk, considering factors such as ethnicity, sex, age group, and the geographic location of the incidence. All data was collected from the Hospital Discharge Statistics and the Statistical Registry of General Deaths Databases. Results Between 2016 and 2021, a total of 20,297 hospital admissions and 921 deaths attributed to thyroid cancer were reported in Ecuador. The incidence of thyroid cancer remained relatively stable from 2016 to 2019. However, there was a notable decrease in 2020, followed by an increase in 2021. Notably, thyroid cancer prevalence rates were found to be higher in highlands regions. Moreover, two genetic variants, the BRAFV600E and KITL678F, have been identified in the Ecuadorian population. It is noteworthy that women exhibited a higher susceptibility to thyroid cancer, being five times more likely than men to develop this condition. Conclusion Ecuador exhibits one of the highest global incidences of thyroid cancer. Consequently, describing the genetic variants and epidemiological characteristics of thyroid cancer is imperative for enhancing healthcare access and formulating evidence-based public health policies. This research contributes towards a comprehensive understanding of thyroid cancer in the Ecuadorian context, aiming to improve targeted interventions and health outcomes.
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Affiliation(s)
- Elius Paz-Cruz
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE. Mariana de Jesús Ave, no number, Quito, Pichincha, 170129, Ecuador
| | - Santiago Cadena-Ullauri
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE. Mariana de Jesús Ave, no number, Quito, Pichincha, 170129, Ecuador
| | - Patricia Guevara-Ramírez
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE. Mariana de Jesús Ave, no number, Quito, Pichincha, 170129, Ecuador
| | - Viviana A. Ruiz-Pozo
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE. Mariana de Jesús Ave, no number, Quito, Pichincha, 170129, Ecuador
| | - Rafael Tamayo-Trujillo
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE. Mariana de Jesús Ave, no number, Quito, Pichincha, 170129, Ecuador
| | - Daniel Simancas-Racines
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC). Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE. Mariana de Jesús Ave, no number, Quito, Pichincha, 170129, Ecuador
| | - Ana Karina Zambrano
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE. Mariana de Jesús Ave, no number, Quito, Pichincha, 170129, Ecuador
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Alzahrani AS. Clinical use of Molecular Data in Thyroid Nodules and Cancer. J Clin Endocrinol Metab 2023; 108:2759-2771. [PMID: 37200449 DOI: 10.1210/clinem/dgad282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/20/2023]
Abstract
Over the past 3 decades, advances in the molecular genetics of thyroid cancer (TC) have been translated into diagnostic tests, prognostic markers, and therapeutic agents. The main drivers in differentiated TC pathogenesis are single-point mutations and gene fusions in components of the Mitogen-activated protein kinase (MAPK) and phosphoinositide-3-kinase-protein kinase B/Akt (PI3K/Akt) pathways. Other important genetic alterations in the more advanced types of TC include TERT promoter, TP53, EIF1AX, and epigenetic alterations. Using this knowledge, several molecular tests have been developed for cytologically indeterminate thyroid nodules. Currently, 3 commercially available tests are in use including a DNA/RNA-based test (ThyroSeq v.3), an RNA-based test (Afirma Gene Sequencing Classifier), and a hybrid DNA/miRNA test, ThyGeNEXT/ThyraMIR. These tests are mostly used to rule out malignancy in Bethesda III and IV thyroid nodules because they all have high sensitivities and negative predictive values. Their common use, predominantly in the United States, has resulted in a significant reduction in unnecessary thyroid surgeries for benign nodules. Some of these tests also provide information on the underlying molecular drivers of TC; this may support decision making in initial TC management planning, although this practice has not yet been widely adopted. More importantly, molecular testing is essential in patients with advanced disease before using specific mono-kinase inhibitors (eg, selpercatinib for RET-altered TC) because these drugs are ineffective in the absence of a specific molecular target. This mini-review discusses the utilization of molecular data in the clinical management of patients with thyroid nodules and TC in these different clinical situations.
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Affiliation(s)
- Ali S Alzahrani
- Department of Medicine and Department of Molecular Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh 11211, Saudi Arabia
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Wang K, Li H, Zhao J, Yao J, Lu Y, Dong J, Bai J, Liao L. Potential diagnostic of lymph node metastasis and prognostic values of TM4SFs in papillary thyroid carcinoma patients. Front Cell Dev Biol 2022; 10:1001954. [PMID: 36568979 PMCID: PMC9773885 DOI: 10.3389/fcell.2022.1001954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
Background: Although the prognosis of papillary thyroid carcinoma (PTC) is relatively good, it causes around 41,000 deaths per year, which is likely related to recurrence and metastasis. Lymph node metastasis (LNM) is an important indicator of PTC recurrence and transmembrane 4 superfamily (TM4SF) proteins regulate metastasis by modulating cell adhesion, migration, tissue differentiation, and tumor invasion. However, the diagnostic and prognostic values of TM4SF in PTC remain unclear. Methods: This study aimed to identify TM4SF genes with predictive value for LNM and prognostic value in PTC using bioinformatic analysis. We screened the differentially expressed genes (DEGs) of the TM4SF family in PTC using data from TCGA, constructed a PPI network using STRING, and evaluated the predictive role of TM4SF1 in LNM via a binary logistic regression analysis and ROC curve. We assessed the association between TM4SF1 expression and DNA methylation, and determined the functional and mechanistic role of TM4SF1 in promoting LNM via GSEA, KEGG, and GO. We estimated the relationship between each TM4SF gene and overall survival (OS, estimated by Kaplan-Meier analysis) in patients with PTC and established a predictive model of prognostic indicators using a LASSO penalized Cox analysis to identify hub genes. Finally, we explored the correlation between TM4SFs and TMB/MSI. Results: We identified 21 DEGs from the 41 TM4SFs between N0 (without LNM) and N1 (with LNM) patients, with TM4SF1, TM4SF4, UPK1B, and CD151 being highly expressed in the N1 group; several DEGs were observed in the TNM, T, and N cancer stages. The "integrins and other cell-surface receptors" pathway was the most significantly enriched functional category related to LNM and TM4SFs. TM4SF1 was identified as an indicator of LNM (AUC= 0.702). High levels of TM4SF1 might be related to Wnt/β-catenin pathway and epithelial-mesenchymal transition (EMT) process in PTC. The higher expression of TM4SF1 was also related to DNA promoter hypomethylation. CD9, TM4SF4, TSPAN2, and TSPAN16 were associated with OS in PTC patients and TSPAN2 has great potential to become a prognostic marker of PTC progression. For the prognostic model, the riskscore = (-0.0058)*CD82+(-0.4994)*+(0.1584)*TSPAN11+(1.7597)*TSPAN19+(0.2694)*TSPAN2 (lambda.min = 0.0149). The AUCs for 3-year, 5-year, and 10-year OS were 0.81, 0.851, and 0.804. TSPAN18, TSPAN31, and TSPAN32 were associated with both TMB and MSI in PTC patients. Conclusion: Our findings identified TM4SF1 as a potential diagnostic marker of LNM and TSPAN2 as a prognostic factor for patients with PTC. Our study provides a novel strategy to assess prognosis and predict effective treatments in PTC.
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Affiliation(s)
- Kun Wang
- Department of Endocrinology and Metabology, Liaocheng People’s Hospital, Liaocheng, Shandong, China,Department of Endocrinology and Metabology, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Haomin Li
- Department of Endocrinology and Metabology, Liaocheng People’s Hospital, Liaocheng, Shandong, China
| | - Junyu Zhao
- Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Jinming Yao
- Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Yiran Lu
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jianjun Dong
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jie Bai
- Department of Endocrinology and Metabology, Liaocheng People’s Hospital, Liaocheng, Shandong, China,*Correspondence: Jie Bai, ; Lin Liao,
| | - Lin Liao
- Department of Endocrinology and Metabology, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China,*Correspondence: Jie Bai, ; Lin Liao,
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