1
|
Li LQ, Hilmi O, England J, Tolley N. An update on the management of thyroid nodules: rationalising the guidelines. J Laryngol Otol 2023; 137:965-970. [PMID: 36318928 DOI: 10.1017/s002221512200233x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Guidance for the management of thyroid nodules has evolved over time, from initial evaluation based predominantly on clinical grounds to now including the established role of ultrasound and fine needle aspiration cytology in their assessment. There is, however, significant variation in the management of thyroid nodules depending on which national guidelines are followed. In addition, there are certain clinical situations such as pregnancy and paediatric thyroid nodules that have differing evaluation priorities. OBJECTIVES This review aimed to provide an overview of currently accepted practices for the initial investigation and subsequent management of patients with thyroid nodules for the non-specialist. The review also addresses areas of variance between the systems in common clinical use, as well as newer, evolving technologies, including molecular testing in the evaluation of malignancy in thyroid nodules.
Collapse
Affiliation(s)
- L Q Li
- Department of Otorhinolaryngology Head and Neck Surgery, NHS Greater Glasgow and Clyde, Glasgow, Scotland
| | - O Hilmi
- Department of Otorhinolaryngology Head and Neck Surgery, NHS Greater Glasgow and Clyde, Glasgow, Scotland
| | - J England
- Department of Otorhinolaryngology Head and Neck Surgery, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | - N Tolley
- Department of Otorhinolaryngology Head and Neck Surgery, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
2
|
Denaro N, Romanò R, Alfieri S, Dolci A, Licitra L, Nuzzolese I, Ghidini M, Bareggi C, Bertaglia V, Solinas C, Garrone O. The Tumor Microenvironment and the Estrogen Loop in Thyroid Cancer. Cancers (Basel) 2023; 15:cancers15092458. [PMID: 37173925 PMCID: PMC10177023 DOI: 10.3390/cancers15092458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/31/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Thyroid cancer (TC) cells employ multiple signaling pathways, such as PI3K/AKT/mTOR and RAS/Raf/MAPK, fostering cell proliferation, survival and metastasis. Through a complex interplay with immune cells, inflammatory mediators and stroma, TC cells support an immunosuppressive, inflamed, pro-carcinogenic TME. Moreover, the participation of estrogens in TC pathogenesis has previously been hypothesized, in view of the higher TC incidence observed among females. In this respect, the interactions between estrogens and the TME in TC could represent a relevant, unexplored area of research. We thereby collectively reviewed the available evidence concerning the potential carcinogenic role of estrogens in TC, specifically focusing on their crosstalk with the TME.
Collapse
Affiliation(s)
- Nerina Denaro
- Medical Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Rebecca Romanò
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Salvatore Alfieri
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Alessia Dolci
- Endocrinology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Lisa Licitra
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
- Department of Hematology and Oncology, University of Milan, 20122 Milan, Italy
| | - Imperia Nuzzolese
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Michele Ghidini
- Medical Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Claudia Bareggi
- Medical Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Valentina Bertaglia
- Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, Italy
| | - Cinzia Solinas
- Medical Oncology, AOU Cagliari, Policlinico di Monserrato, 09042 Cagliari, Italy
| | - Ornella Garrone
- Medical Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| |
Collapse
|
3
|
Kitahara CM, Slettebø Daltveit D, Ekbom A, Engeland A, Gissler M, Glimelius I, Grotmol T, Trolle Lagerros Y, Madanat-Harjuoja L, Männistö T, Sørensen HT, Troisi R, Bjørge T. Maternal Health, Pregnancy and Offspring Factors, and Maternal Thyroid Cancer Risk: A Nordic Population-Based Registry Study. Am J Epidemiol 2023; 192:70-83. [PMID: 36130211 PMCID: PMC10144719 DOI: 10.1093/aje/kwac163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 01/11/2023] Open
Abstract
Thyroid cancer incidence is higher in women than men, especially during the reproductive years, for reasons that remain poorly understood. Using population-based registry data from 4 Nordic countries through 2015, we examined associations of perinatal characteristics with risk of maternal thyroid cancer. Cases were women diagnosed with thyroid cancer ≥2 years after last birth (n = 7,425, 83% papillary). Cases were matched to controls (n = 67,903) by mother's birth year, country, and county of residence. Odds ratios (ORs) were estimated using conditional logistic regression models adjusting for parity. Older age at first pregnancy, postpartum hemorrhage (OR = 1.18, 95% (confidence interval) CI: 1.08, 1.29), and benign thyroid conditions (ORs ranging from 1.64 for hypothyroidism to 10.35 for thyroid neoplasms) were associated with increased thyroid cancer risk, as were higher offspring birth weight (per 1-kg increase, OR = 1.17, 95% CI: 1.12, 1.22) and higher likelihood of offspring being large for gestational age (OR = 1.26, 95% CI: 1.11, 1.43). Unmarried/noncohabiting status (OR = 0.91, 95% CI: 0.84, 0.98), maternal smoking (OR = 0.75, 95% CI: 0.67, 0.84), and preterm birth (OR = 0.90, 95% CI: 0.83, 0.98) were associated with reduced risk. Several factors (e.g., older age at first pregnancy, maternal smoking, goiter, benign neoplasms, postpartum hemorrhage, hyperemesis gravidarum, and neonatal jaundice) were associated with advanced thyroid cancer. These findings suggest that some perinatal exposures may influence maternal thyroid cancer risk.
Collapse
Affiliation(s)
- Cari M Kitahara
- Correspondence to Dr. Cari M. Kitahara, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rm 7E-456, Bethesda, MD 20892 (e-mail: )
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Moretti C, Lazzarin N, Vaquero E, Dal Lago A, Campagnolo L, Valensise H. A practical approach to the management of thyroid dysfunction during pregnancy. Gynecol Endocrinol 2022; 38:1028-1034. [PMID: 36480916 DOI: 10.1080/09513590.2022.2154337] [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] [Indexed: 12/13/2022] Open
Abstract
Pregnancy has an important impact on the thyroid gland and its function. Thyroid activity changes as a consequence of the novel physiological state of pregnancy and requires a complex hormonal and metabolic adaptation, which is possible only in the presence of a perfectly functioning thyroid gland. In fact, thyroid function is crucial for the success of the implantation and the progression of pregnancy. Abnormal thyroid function is very common among childbearing age women, explaining the high incidence of thyroid diseases that occur during pregnancy. Aim of this work is to analyze the adaptive events that characterize the thyroid function during pregnancy, exploring their hormonal, metabolic and molecular mechanisms. Moreover, the interpretation of the laboratory data necessary to monitor the thyroid functioning during normal pregnancy or in the presence of thyroid abnormalities will be discussed.
Collapse
Affiliation(s)
- Costanzo Moretti
- Department of Systems' Medicine, University of Rome TorVergata, Rome, Italy
| | - Natalia Lazzarin
- Department of Obstetrics and Gynecology, Policlinico Casilino Hospital, Rome, Italy
| | - Elena Vaquero
- Department of Biomedicine and Prevention of Rome TorVergata, Rome, Italy
| | - Alessandro Dal Lago
- Department of Gender Parenting Child and Adolescent Medicine Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Luisa Campagnolo
- Department of Biomedicine and Prevention, University of Rome TorVergata, Rome, Italy
| | - Herbert Valensise
- Department of Obstetrics and Gynecology, Policlinico Casilino Hospital, Rome, Italy
- Department of Surgery, University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
5
|
Drui D, Briet C, Guerin C, Lugat A, Borson-Chazot F, Grunenwald S. SFE-AFCE-SFMN 2022 Consensus on the management of thyroid nodules : Thyroid nodules and pregnancy. ANNALES D'ENDOCRINOLOGIE 2022; 83:435-439. [PMID: 36270537 DOI: 10.1016/j.ando.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The SFE-AFCE-SFMN 2022 consensus deals with the management of thyroid nodules, a condition that is a frequent reason for consultation in endocrinology. In more than 90% of cases, patients are euthyroid, with benign non-progressive nodules that do not warrant specific treatment. The clinician's objective is to detect malignant thyroid nodules at risk of recurrence and death, toxic nodules responsible for hyperthyroidism or compressive nodules warranting treatment. The diagnosis and treatment of thyroid nodules requires close collaboration between endocrinologists, nuclear medicine physicians and surgeons, but also involves other specialists. Therefore, this consensus statement was established jointly by 3 societies: the French Society of Endocrinology (SFE), French Association of Endocrine Surgery (AFCE) and French Society of Nuclear Medicine (SFMN); the various working groups included experts from other specialties (pathologists, radiologists, pediatricians, biologists, etc.). The present section deals with the epidemiology and specificities of diagnosis and treatment of thyroid nodules in pregnant women.
Collapse
Affiliation(s)
- Delphine Drui
- Nantes Université, CHU Nantes, Service d'Endocrinologie-Diabétologie et Nutrition, Institut du Thorax, 44000 Nantes, France.
| | - Claire Briet
- Service d'Endocrinologie-Diabétologie Nutrition, et Centre de Référence des Maladies Rares de la Thyroïde et des Récepteurs Hormonaux, CHU Angers, Univ Angers, Inserm, CNRS, MITOVASC, 49000 Angers, France
| | - Carole Guerin
- Service de Chirurgie Générale, Endocrinienne et Métabolique, APHM, Aix Marseille Université, Marseille, France
| | - Alexandre Lugat
- Nantes Université, CHU Nantes, Service d'Oncologie Médicale, 44000 Nantes, France
| | - Francoise Borson-Chazot
- Fédération d'Endocrinologie, Groupement Hospitalier Est, Hospices Civils de Lyon; inserm U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Solange Grunenwald
- Service d'Endocrinologie et Maladies Métaboliques, CHU Larrey, Toulouse, France
| |
Collapse
|
6
|
The application value of CDFI and SMI combined with serological markers in distinguishing benign and malignant thyroid nodules. CLINICAL & TRANSLATIONAL ONCOLOGY : OFFICIAL PUBLICATION OF THE FEDERATION OF SPANISH ONCOLOGY SOCIETIES AND OF THE NATIONAL CANCER INSTITUTE OF MEXICO 2022; 24:2200-2209. [PMID: 35792982 DOI: 10.1007/s12094-022-02880-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/17/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study is to explore the application value of CDFI and SMI combined with serological markers in distinguishing benign and malignant thyroid nodules. METHOD A total of 192 patients with thyroid nodules admitted to our hospital from July 2019 to December 2020 were selected as subjects. Color Doppler blood flow imaging (CDFI) and supermicro blood flow imaging (SMI) methods are used to detect the blood flow of patients and the levels of serum thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), and thyroid stimulating hormone (TSH). The receiver operating characteristic curve (ROC curve) was used to observe the sensitivity and specificity of serological markers for distinguishing benign and malignant thyroid nodules, and combined with CDFI and SMI to observe the sensitivity and specificity for distinguishing benign and malignant thyroid nodules. RESULTS The levels of TgAb, TPOAb and TSH in benign thyroid nodules were lower than those of the malignant group, and the difference was statistically significant (P < 0.01). There was no statistically significant difference between benign and malignant thyroid nodules in the presence or absence of the capsule and the presence or absence of vocal halo (P > 0.05), while the differences in the nodule morphology, boundary, internal echo and internal calcification were statistically significant (P < 0.01). CONCLUSION CDFI and SMI combined with serological index detection have higher value in the differential diagnosis of thyroid cancer, which can significantly improve the sensitivity and specificity of differential diagnosis.
Collapse
|
7
|
Pappa T, Ahmadi S, Bikas A, Hwang S, Coleman A, Lobon I, Xiang P, Kim M, Marqusee E, Richman DM, Durfee SM, Asch EH, Benson CB, Frates MC, Landa I, Alexander EK. Thyroid Nodule Shape Independently Predicts Risk of Malignancy. J Clin Endocrinol Metab 2022; 107:1865-1870. [PMID: 35439309 PMCID: PMC9202719 DOI: 10.1210/clinem/dgac246] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Indexed: 01/28/2023]
Abstract
CONTEXT Predictive models of thyroid nodule cancer risk are presently based upon nodule composition, echogenicity, margins, and the presence of microcalcifications. Nodule shape has shown promise to be an additive factor helping determine the need for nodule biopsy. OBJECTIVE We sought to determine if calculation of a nodule's spherical shape independently associates with cancer risk. METHODS This prospective cohort study, conducted at a single large academic healthcare system in the United States, included patients with 1 or 2 clinically relevant thyroid nodules (predominantly solid and over 1 cm) presenting for diagnostic evaluation. Thyroid ultrasound, cytological evaluation with fine-needle biopsy, and/or histopathological examination on occasion of thyroid surgery were performed. We calculated the nodule's long to short ratio (spherical shape), and its association with tissue proven benign or malignant endpoints. RESULTS The long to short nodule ratio was significantly lower in malignant compared to benign nodules indicating greater risk of malignancy in more spherical nodules (1.63 ± 0.38 for malignant nodules vs 1.74 ± 0.47 for benign, P < 0.0001). The risk of malignancy continually increased as the long to short ratio approached a purely spherical ratio of 1.0 (ratio > 2.00, 14.6% cancer; ratio 1.51-2.00, 19.7%; ratio 1.00-1.50, 25.5%, P < 0.0001). In multiple regression analysis, younger age, male sex, and nodule's spherical shape were each independently associated with cancer risk. CONCLUSION The more a thyroid nodule is spherically shaped, as indicated by a long to short ratio approaching 1.0, the greater its risk of malignancy. This was independent of age, sex, and nodule size. Incorporating a nodule's sphericity in the risk stratification systems may improve individualized clinical decision making.
Collapse
Affiliation(s)
- Theodora Pappa
- Correspondence: Theodora Pappa, MD, PhD, Division of Endocrinology, Diabetes and Hypertension, 221 Longwood Avenue, Boston, MA 02115, USA.
| | | | - Athanasios Bikas
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, MA, USA
| | - Sally Hwang
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, MA, USA
| | - Alexandra Coleman
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, MA, USA
| | - Isabel Lobon
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, MA, USA
| | - Pingping Xiang
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, MA, USA
| | - Matthew Kim
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, MA, USA
| | - Ellen Marqusee
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, MA, USA
| | | | - Sara M Durfee
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Elizabeth H Asch
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Carol B Benson
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Mary C Frates
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Iñigo Landa
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, MA, USA
| | - Erik K Alexander
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, MA, USA
| |
Collapse
|
8
|
Li N, Zhang J, Meng X, Yao W. Clinical Application Value of High-Frequency Ultrasound Combined with Detection of Serum High Mobility Group Box 1, Soluble IL-2 Receptor, and Thyroglobulin Antibody in Diagnosing Thyroid Cancer. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:7851436. [PMID: 35392142 PMCID: PMC8983246 DOI: 10.1155/2022/7851436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/13/2022]
Abstract
Objective The aim of this study is to explore the clinical application value of high-frequency ultrasound combined with detection of serum high mobility group box (HMGB-1), soluble IL-2 receptor (SIL-2R), and thyroglobulin antibody (TgAb) in diagnosing thyroid cancer. Methods By means of retrospective study, 50 thyroid cancer patients treated in our hospital from January 2019 to January 2021 were selected as the thyroid cancer group, 50 patients with benign thyroid lesions were included in the benign lesion group, and 50 healthy individuals examined in our hospital in the same period were included in the control group. All study objects received high-frequency ultrasound examination, and at the same time, their serum HMGB-1, SIL-2R, and TgAb levels were measured. After that, the results of high-frequency ultrasound examination were analyzed, the diagnostic efficacy of different diagnosis methods was explored, and receiver operating characteristic (ROC) curves were plotted. Results According to the results of high-frequency ultrasound examination, there were significant differences in echogenicity surrounding and inside the lesion, calcification, blood flow distribution, and blood flow parameters between the thyroid cancer group and the benign lesion group (P < 0.001); the HMGB-1, SIL-2R, and TgAb levels were statistically different among the three groups (P < 0.001), and the level values of HMGB-1, SIL-2R, and TgAb of the thyroid cancer group were, respectively, (12.26 ± 1.32) ng/ml, (108.65 ± 9.75) pmol/L, and (690.65 ± 34.47) IU/mL; the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of high-frequency ultrasound combined with detection of serum HMGB-1, SIL-2R, and TgAb were, respectively, 98.0%, 95.0%, 90.7%, and 99.0%, and AUC (95%CI) = 0.965 (0.931-0.999). Conclusion High-frequency ultrasound combined with detection of serum HMGB-1, SIL-2R, and TgAb has a good value in diagnosing thyroid cancer, which should be promoted in practice.
Collapse
Affiliation(s)
- Ning Li
- Department of Ultrasound Medicine, Zibo Central Hospital, 255022 Zibo, Shandong Province, China
| | - Jiahui Zhang
- Department of Public Health, Zibo Central Hospital, 255022 Zibo, Shandong Province, China
| | - Xiaojiao Meng
- Department of Ultrasound Medicine, Zibo Central Hospital, 255022 Zibo, Shandong Province, China
| | - Wenliang Yao
- Department of Nuclear Medicine, Zibo Central Hospital, 255022 Zibo, Shandong Province, China
| |
Collapse
|
9
|
Jing QB, Tong HX, Tang WJ, Tian SD. Clinical Significance and Potential Regulatory Mechanisms of Serum Response Factor in 1118 Cases of Thyroid Cancer Based on Gene Chip and RNA-Sequencing Data. Med Sci Monit 2020; 26:e919302. [PMID: 31967986 PMCID: PMC6995247 DOI: 10.12659/msm.919302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Thyroid cancer (TC) is one of the most prevalent endocrine malignancies and there may be many unclarified molecular events and gene types involved in TC. The objective of this study was to assess the clinical implications and potential mechanisms of serum response factor (SRF) in TC. Material/Methods RNA-sequencing and gene chip data with TC expression were collected from The Cancer Genome Atlas/Genotype-Tissue Expression, Gene Expression Omnibus, ArrayExpress, Sequence Read Archive, and Oncomine. SRF expression of all TC and adjacent non-cancerous tissue were calculated using the t test, STATA, and Meta-DiSc. The related pathways of the potential SRF target genes and target miRNAs were explored. Dual-luciferase reporter assay was performed to validate the association between SRF and its putative miRNA. Results One RNA-sequencing and 15 gene chips were collected, and the pooled standardized mean difference of SRF was −1.00. Furthermore, the area under the curve of sROC of SRF in TC was 0.8251, indicating a dramatic decreased expression of SRF in TC tissues based on 1118 cases. The intersection of differentially expressed genes in TC, SRF co-expressed genes, and SRF potential target genes achieved from Cistrome Cancer led to 169 overlapped genes. miR-330-5p was predicted to target SRF, which was further confirmed by dual-luciferase reporter assay. Conclusions The reduction of SRF appears to play a crucial role in the origin of TC. These properties are accomplished by the target genes of SRF, as a transcription factor, or by the axes with the associated miRNAs.
Collapse
Affiliation(s)
- Qiang-Bin Jing
- Center of Medical Oncology, The First People's Hospital of Huaihua, Huaihua, Hunan, China (mainland)
| | - Hai-Xiao Tong
- Center of Medical Oncology, The First People's Hospital of Huaihua, Huaihua, Hunan, China (mainland)
| | - Wei-Jian Tang
- Center of Medical Oncology, The First People's Hospital of Huaihua, Huaihua, Hunan, China (mainland)
| | - Shao-Dong Tian
- Center of Medical Oncology, The First People's Hospital of Huaihua, Huaihua, Hunan, China (mainland)
| |
Collapse
|