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Destek S, Demirbolat İ, Yabacı A, Kalemoglu M, Kartal M, Ersoy EY, Gul VO, Kayıran Z, Aysan ME. Randomized Placebo Controlled Clinical Study of Dill ( Anethum Graveolens L.) in Thyroiditis and Nodular Goiter Patients. J Med Food 2025. [PMID: 40329862 DOI: 10.1089/jmf.2024.0263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2025] Open
Abstract
Thyroid nodules are common and affect half of the general population by the age of 60 years. The cause is believed to be due to hypothyroidism, mutational changes, and autoimmunity leading to thyroid carcinoma. Dill, a traditional herbal remedy, has been used to treat thyroid dysfunctions such as hyperthyroidism and hypothyroidism. This study evaluates the effects of dill (Anethum graveolens L.) on patients with thyroiditis and nodular goiter. A study was conducted on patients with benign thyroid nodules. They were divided into two groups; placebo (=35) and dill group (n = 33). Dried and ground dill was put into hydroxypropyl methylcellulose capsules and patients were given three capsules per day for 90 days. Various tests were conducted at the beginning and end of the study, including thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-Tg), and C-reactive protein (CRP) analysis, and thyroid nodule dimensions were measured by ultrasound. Statistical analysis was performed. After 90 days of treatment with dill extract, patients showed significant reductions in TSH, FT4, anti-TPO, and CRP levels, as well as a decrease in thyroid nodule sizes as demonstrated by ultrasonography. The dill-treated group had significantly decreased TSH (P = .020), FT4 (P = .001), anti-TPO (P = .004), CRP (P = .003) levels, and nodule sizes (P = .001) at the beginning and end of the study. Compared to the control group, the dill group had significantly decreased TSH (P = .009), fT4 (P < .001), anti-TPO (P = .001), CRP (P < .001) levels and nodule sizes (P < .001), which reached normal values. A. graveolens suppressed inflammation of the thyroid gland, reduced nodule size, and normalized TSH levels. Dill supplementation should be recommended for the treatment of thyroid nodules in selected patients.
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Affiliation(s)
- Sabahattin Destek
- Department of General Surgery, Üsküdar University School of Medicine, Istanbul, Turkey
| | - İlker Demirbolat
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Kent University, Istanbul, Turkey
| | - Ayşegül Yabacı
- Department of Biostatistics, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Murat Kalemoglu
- Department of General Surgery, Üsküdar University School of Medicine, Istanbul, Turkey
| | - Murat Kartal
- Faculty of Pharmacy, Phytotherapy Research Center, Bezmialem Vakıf University, Istanbul, Turkey
| | - Emine Yeliz Ersoy
- Department of General Surgery, Faculty of Medicine, Bezmialem Vakıf University, Istanbul Turkey
| | - Vahit Onur Gul
- General Surgery Department Cankaya, Koru Hospital , Ankara, Turkey
| | - Zulal Kayıran
- Nutrition and Dietetics Center, Bezmialem Vakıf University, Istanbul, Turkey
| | - Mustafa Erhan Aysan
- Department of General Surgery, Faculty of Medicine, Bezmialem Vakıf University, Istanbul Turkey
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Meng C, Yang P, Wang Y, Liu S, Wu X, Wang S. Prevalence and Related Factors of Thyroid Nodules in Physical Examination Population in a Level-A Hospital in Jinan. J Multidiscip Healthc 2024; 17:3753-3762. [PMID: 39108774 PMCID: PMC11302421 DOI: 10.2147/jmdh.s443884] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/22/2024] [Indexed: 01/04/2025] Open
Abstract
BACKGROUND To investigate the prevalence of thyroid nodules among medical staff and health check-up population in a Level-A hospital (Primary-level hospital) in Jinan City and analyze its influencing factors. METHODS A total of 5812 cases from the two groups were screened. t-test and χ2 tests were used to analyze the differences in the prevalence of thyroid nodules. Multivariate Logistic regression analysis was used to explore the influencing factors. RESULTS The average age of medical staff was (36.20±9.11) years old, and the total prevalence was 48.5%. The average age of the healthcare population was (57.89±12.51) years old, and the total prevalence rate was 63.9%, with statistical significance between the two groups (P<0.001 for all). A stratified analysis of the two groups showed that the prevalence increased with age, and the prevalence among medical workers of all ages was higher than that of the health population younger than 50 years of age. Multivariate Logistic regression analysis showed that female sex (OR=1.646,95% CI: 1.315-2.060), older age (OR=1.384,95% CI: 1.265-1.514), and high BMI (OR = 1.199, 95% CI: 1.065-1.350) were risk factors for the disease among medical staff. In the health population, female sex (OR=0.799,95% CI: 0.644-0.992) and high TSH levels (OR = 0.918, 95% CI: 0.874-0.964) were protective factors, while older age (OR=1.634,95% CI: 1.525-1.751) was a risk factor. CONCLUSION There are certain differences in the prevalence of thyroid nodules between the two groups. Age and occupation are important influencing factors. While age is uncontrollable, active regulation of emotional status caused by occupational factors has important clinical guiding significance for reducing the prevalence of thyroid nodules and reducing the social medical burden.
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Affiliation(s)
- Chao Meng
- Department of General Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Ping Yang
- Department of Integrated Chinese and Western Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Yanan Wang
- Department of Endocrinology, Central Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Siyan Liu
- Department of Endocrinology, Central Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Xueyan Wu
- Department of Endocrinology, Central Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Shaolian Wang
- Department of Endocrinology, Central Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
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Li X, Chen Z, Wu L, Tu P, Mo Z, Xing M. Prevalence of thyroid nodule and relationship with physiological and psychosocial factors among adults in Zhejiang Province, China: a baseline survey of a cohort study. BMC Public Health 2024; 24:1854. [PMID: 38992649 PMCID: PMC11238450 DOI: 10.1186/s12889-024-19375-z] [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: 05/04/2024] [Accepted: 07/04/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Thyroid nodules have attracted much attention due to their high incidence and potential for malignant transformation. Compared with the clinical assessment and diagnosis of thyroid nodules, there are relatively few studies on the epidemiological risk factors for thyroid nodules. The aim of this study was to investigate the prevalence of thyroid nodule among adults in Zhejiang province and to explore their relationship with physiological and psychosocial factors. METHODS The data used in this study were obtained from the baseline survey of the Zhejiang Provincial Cohort Study on Environment and Health. From June 2022 to December 2023, a total of 21,712 participants from five representative cities in Zhejiang were recruited for the baseline survey. Based on the inclusion and exclusion criteria, 15,595 adults were included in the analysis. The data were collected via self-report questionnaires and physical examinations. Multivariate logistic regression analysis was subsequently performed. RESULTS The detection rate of thyroid nodules was 50.98% among adults in Zhejiang province. Age, gender, education level, BMI, tea and alcohol consumption all had a statistically significant association with thyroid nodules (p < 0.05). After adjusting for sociodemographic factors, results of logistic regression analysis showed that good life satisfaction (OR = 0.854, 95% CI: 0.780-0.934) had a lower risk of thyroid nodules, however, poor life satisfaction (OR = 1.406, 95% CI: 1.014-1.951), social isolation (OR = 1.294, 95% CI: 1.089-1.538) and a family history of thyroid nodules (OR = 1.334, 95% CI: 1.064-1.672) had a greater risk of thyroid nodules. CONCLUSION The detection rate of thyroid nodules in adults of Zhejiang province was an increasing trend compared with that in previous years. In addition to the sensitive thyroid nodule screening technology, influencing factors mentioned in this study might also represent credible candidates for this increase. As variable influence factors, weight management, good interpersonal relationships and life satisfaction should be the focus of health interventions.
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Affiliation(s)
- Xueqing Li
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Zhijian Chen
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Lizhi Wu
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Pengchen Tu
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Zhe Mo
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Mingluan Xing
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
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Zhang L, Wong C, Li Y, Huang T, Wang J, Lin C. Artificial intelligence assisted diagnosis of early tc markers and its application. Discov Oncol 2024; 15:172. [PMID: 38761260 PMCID: PMC11102422 DOI: 10.1007/s12672-024-01017-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024] Open
Abstract
Thyroid cancer (TC) is a common endocrine malignancy with an increasing incidence worldwide. Early diagnosis is particularly important for TC patients, because it allows patients to receive treatment as early as possible. Artificial intelligence (AI) provides great advantages for complex healthcare systems by analyzing big data based on machine learning. Nowadays, AI is widely used in the early diagnosis of cancer such as TC. Ultrasound detection and fine needle aspiration biopsy are the main methods for early diagnosis of TC. AI has been widely used in the detection of malignancy in thyroid nodules by ultrasound images, cytopathology images and molecular markers. It shows great potential in auxiliary medical diagnosis. The latest clinical trial has shown that the performance of AI models matches with the diagnostic efficiency of experienced clinicians, and more efficient AI tools will be developed in the future. Therefore, in this review, we summarized the recent advances in the application of AI algorithms in assessing the risk of malignancy in thyroid nodules. The objective of this review was to provide a data base for the clinical use of AI-assisted diagnosis in TC, as well as to provide new ideas for the next generation of AI-assisted diagnosis in TC.
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Affiliation(s)
- Laney Zhang
- Yale School of Public Health, New Haven, CT, USA
| | - Chinting Wong
- Department of Nuclear Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yungeng Li
- Department of Nuclear Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | | | - Jiawen Wang
- Department of Nuclear Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Chenghe Lin
- Department of Nuclear Medicine, The First Hospital of Jilin University, Changchun, Jilin, China.
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Liu T, Yang F, Qiao J, Mao M. Deciphering the progression of fine-needle aspiration: A bibliometric analysis of thyroid nodule research. Medicine (Baltimore) 2024; 103:e38059. [PMID: 38758913 PMCID: PMC11098219 DOI: 10.1097/md.0000000000038059] [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: 02/21/2024] [Accepted: 04/08/2024] [Indexed: 05/19/2024] Open
Abstract
This study aims to dissect the evolution and pivotal shifts in Fine-Needle Aspiration (FNA) research for thyroid nodules over the past 2 decades, focusing on delineating key technological advancements and their impact on clinical practice. A comprehensive bibliometric analysis was conducted on 5418 publications from the Web of Science Core Collection database (2000-2023). Publications were rigorously selected based on their contributions to the advancement of FNA techniques and their influence on thyroid nodule management practices. Our analysis uncovered significant breakthroughs, most notably the incorporation of ultrasound and molecular diagnostics in FNA, which have markedly elevated diagnostic accuracy. A pivotal shift was identified towards minimally invasive post-FNA treatments, such as Radiofrequency Ablation, attributable to these diagnostic advancements. Additionally, the emergence of AI-assisted cytology represents a frontier in precision diagnostics, promising enhanced disease identification. The geographical analysis pinpointed the United States, Italy, and China as key contributors, with the United States leading in both publication volume and citation impact. This bibliometric analysis sheds light on the transformative progression in FNA practices for thyroid nodules, characterized by innovative diagnostic technologies and a trend towards patient-centric treatment approaches. The findings underscore the need for further research into AI integration and global practice standardization. Future explorations should focus on the practical application of these advancements in diverse healthcare settings and their implications for global thyroid nodule management.
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Affiliation(s)
- Tengfei Liu
- Department of Head and Neck Thyroid Surgery, Xingtai People’s Hospital of Hebei Medical University, Xingtai, P.R. China
| | - Fei Yang
- Department of Otorhinolaryngology – Head and Neck Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, P.R. China
| | - Junli Qiao
- Department of Head and Neck Thyroid Surgery, Xingtai People’s Hospital of Hebei Medical University, Xingtai, P.R. China
| | - Mengxuan Mao
- Department of Head and Neck Thyroid Surgery, Xingtai People’s Hospital of Hebei Medical University, Xingtai, P.R. China
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Li W, Deng J, Xiong W, Zhong Y, Cao H, Jiang G. Knowledge, attitude, and practice towards thyroid nodules and cancer among patients: a cross-sectional study. Front Public Health 2023; 11:1263758. [PMID: 38026301 PMCID: PMC10654744 DOI: 10.3389/fpubh.2023.1263758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Aim This study aimed to explore the knowledge, attitude, and practice (KAP) towards thyroid nodules (TN) and thyroid cancer (TC) among patients. Subject and methods This cross-sectional study enrolled patients with TN or TC at the Second Affiliated Hospital of the University of South China between September 2022 and February 2023. A self-administered questionnaire was developed to collect demographic information of the participants, and their knowledge, attitude and practice (KAP) towards TN and TC. Results A total of 510 valid questionnaires were collected. Among the participants, 102 (20.00%) were male, and 197 (38.63%) had the diagnosis of TC. The knowledge, attitude and practice scores were 5.76 ± 3.09 (possible range: 0-12), 31.07 ± 2.73 (possible range: 9-45), and 18.97 ± 2.92 (possible range: 5-25), respectively. Multivariate logistic regression showed that age of above 50 years old (OR = 0.27, 95%CI: 0.12-0.64, p = 0.003), junior college or bachelor's degree and above (OR = 4.97, 95%CI: 1.74-14.20, p = 0.003), monthly income of 5,000-10,000 CNY (OR = 2.02, 95%CI: 1.09-3.74, p = 0.025) and > 10,000 CNY (OR = 5.67, 95%CI: 2.49-12.94, p < 0.001) were independently associated with knowledge. The good knowledge (OR = 3.87, 95%CI: 1.89-7.95, p < 0.001), high school or technical secondary school (OR = 0.52, 95%CI: 0.30-0.88, p = 0.016), and monthly income of 5,000-10,000 CNY (OR = 2.02, 95%CI: 1.13-3.63, p = 0.018) were independently associated with practice. Conclusion Patients demonstrated poor knowledge, moderate attitude, and proactive practice towards TN and TC.
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Affiliation(s)
- Wei Li
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- Department of Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jian Deng
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Wei Xiong
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Yangyan Zhong
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Hong Cao
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Guoqin Jiang
- Department of Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Canpolat AG, Taşkın DG, Deryol HY, Korkmaz FN, Erdoğan MF. Should we reconsider high-risk features in thyroid ultrasonography? REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230820. [PMID: 37909623 PMCID: PMC10610763 DOI: 10.1590/1806-9282.20230820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/15/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Round shape is generally considered to reduce the risk of malignancy according to recent guidelines. On the contrary, according to some reports, spherically shaped thyroid nodules are associated with a higher risk of malignancy. Thus, we aimed to evaluate the malignancy risk of solid round isoechoic nodules detected at thyroid ultrasonography and compare it with that of solid ovoid isoechoic nodules. METHODS Between 2017 and 2022, solitary solid round isoechoic nodules with diameters ³10 and £25 mm at thyroid ultrasonography were retrospectively selected and enrolled in the study. Age, size, nodule volume, serum thyrotropin levels, thyroid antibody levels, and cytopathological and histopathological results were recorded. RESULTS A total of 457 solitary solid isoechoechoic nodules from 457 patients (262 females and 195 males; median age, 59 [31-70] years) were selected, of which 203 were solid round isoechoic nodules, and 254 were solid ovoid isoechoic nodules. A total of 54 surgical operations were performed on 457 nodules, and 31 of them resulted in malignancy. From the 31 malignant results, 25 originated from solid round isoechoic nodules and the remaining 6 originated from solid ovoid isoechoic nodules (p<0.025). CONCLUSION We found that round nodules have higher malignancy rates than ovoid nodules. We think that ultrasonographic risk stratification systems used to target the most suitable nodules for the necessary biopsies can be dynamically updated, and sphericity can be added as a parameter in patient-based decision-making.
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Affiliation(s)
- Asena Gökçay Canpolat
- Ankara University, School of Medicine, Department of Endocrinology and Metabolism – Ankara, Turkey
| | - Dursun Göktürk Taşkın
- Ankara University, School of Medicine, Department of Internal Medicine – Ankara, Turkey
| | - Hilal Yıldırım Deryol
- Ankara Training and Research Hospital, Department of Endocrinology and Metabolism – Ankara, Turkey
| | - Fatma Nur Korkmaz
- Ankara University, School of Medicine, Department of Endocrinology and Metabolism – Ankara, Turkey
| | - Murat Faik Erdoğan
- Ankara University, School of Medicine, Department of Endocrinology and Metabolism – Ankara, Turkey
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Uludag M, Unlu MT, Kostek M, Aygun N, Caliskan O, Ozel A, Isgor A. Management of Thyroid Nodules. SISLI ETFAL HASTANESI TIP BULTENI 2023; 57:287-304. [PMID: 37900341 PMCID: PMC10600596 DOI: 10.14744/semb.2023.06992] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 10/31/2023]
Abstract
Thyroid nodules are common and the prevalence varies between 4 and 7% by palpation and 19-68% by high-resolution USG. Most thyroid nodules are benign, and the malignancy rate varies between 7 and 15% of patients. Thyroid nodules are detected incidentally during clinical examination or, more often, during imaging studies performed for another reason. All detected thyroid nodules should be evaluated clinically. The main test in evaluating thyroid function is thyroid stimulating hormone (TSH). If the serum TSH level is below the normal reference range, a radionuclide thyroid scan should be performed to determine whether the nodule is hyperfunctioning. If the serum TSH level is normal or high, ultrasonography (US) should be performed to evaluate the nodule. US is the most sensitive imaging method in the evaluation of thyroid nodules. Computed tomography (CT) and magnetic resonance imaging are not routinely used in the initial evaluation of thyroid nodules. There are many risk classification systems according to the USG characteristics of thyroid nodules, and the most widely used in clinical practice are the American Thyroid Association guideline and the American College of Radiology Thyroid Imaging Reporting and Data System. Fine needle aspiration biopsy (FNAB) is the gold standard method in the evaluation of nodules with indication according to USG risk class. In the cytological evaluation of FNAB, the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is the most frequently applied cytological classification. TBSRTC is a simplified, 6-category reporting system and was updated in 2023. The application of molecular tests to FNAB specimens, especially those diagnosed with Bethesda III and IV, is increasing to reduce the need for diagnostic surgery. Especially in Bethesda III and IV nodules, different methods are applied in the treatment of nodules according to the malignancy risk of each category, these are follow-up, surgical treatment, radioactive iodine treatment, and non-surgical ablation methods.
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Affiliation(s)
- Mehmet Uludag
- Division of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Mehmet Taner Unlu
- Division of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Mehmet Kostek
- Division of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Nurcihan Aygun
- Division of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Ozan Caliskan
- Division of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Alper Ozel
- Department of Radiology, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Adnan Isgor
- Department of General Surgery, Sisli Memorial Hospital, Istanbul, Türkiye
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Buitrago-Gómez N, García-Ramos A, Salom G, Cuesta-Castro DP, Aristizabal N, Hurtado N, Aros V, Quiñonez C, Ocampo-Chaparro J, Torres-Grajales JL, Duque JJ, Abreu-Lomba A. [Sociodemographic, clinical and ultrasound characterization of thyroid nodule pathology and its association with malignancy in a Colombian high-complexity center]. Semergen 2023; 49:102015. [PMID: 37327739 DOI: 10.1016/j.semerg.2023.102015] [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: 02/28/2023] [Revised: 04/05/2023] [Accepted: 05/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Thyroid nodules are among the most frequent conditions, with a 10% risk of malignancy. The objective is to describe the frequency of demographic, clinical, and ultrasonographic characteristics of thyroid nodule pathology in adults and to explore the relationship with tumor malignancy. METHODS An analytical, retrospective cross-sectional study in adults with thyroid nodules and nodular fine-needle aspiration performed in adult patients from a Colombian reference center between 2009-2019. Data were obtained from the clinical history, descriptive measures of the patient's demographic, clinical, and ultrasound variables were estimated, and their relationship with the malignancy of the tumor was explored. RESULTS A total of 445 patients and 515 nodules were included. The median age was 55 years (IQR 44-64), 86.8% of women, and 54.8% had a single lesion. Percentages of 80.2 and 19.8 were benign and malignant nodules, with a median of 15.7mm (IQR 11-25) and 12.7mm (IQR 8.5-18.3), respectively (p<0.001). Hypothyroidism and levothyroxine consumption were higher in those with malignant nodules (p<0.001). The echographic characteristics were statistically different between the nodules. In the malignant ones, there was a higher frequency of solid composition, hypoechogenicity, and irregular margins. In contrast, in the benign ones, the absence of echogenic focus stood out (p<0.001). CONCLUSION The ultrasound characteristics are essential to define the risk of malignancy of a thyroid nodule. Therefore, considering the most frequent ones can help in the most appropriate approach to primary care.
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Affiliation(s)
- N Buitrago-Gómez
- Departamento de Endocrinología, Universidad Pontificia Bolivariana, Medellín, Colombia.
| | - A García-Ramos
- Departamento de Endocrinología, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - G Salom
- Servicio de Radiología, Clínica Imbanaco, Grupo QuirónSalud, Cali, Colombia
| | - D P Cuesta-Castro
- Departamento de Epidemiología, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - N Aristizabal
- Servicio de Endocrinología, Clínica las Américas AUNA, Medellín, Colombia
| | - N Hurtado
- Departamento de Medicina, Universidad Libre, Cali, Colombia
| | - V Aros
- Servicio de Medicina Interna, Clínica Imbanaco, Grupo QuirónSalud, Cali, Colombia
| | - C Quiñonez
- Servicio de Medicina Interna, Clínica Imbanaco, Grupo QuirónSalud, Cali, Colombia
| | - J Ocampo-Chaparro
- Servicio de Medicina Familiar, Facultad de Salud, Universidad del Valle, Cali, Colombia
| | | | - J J Duque
- Servicio de Endocrinología, Clínica Central del Quindío, Armenia, Colombia
| | - A Abreu-Lomba
- Servicio de Endocrinología, Clínica Imbanaco, Grupo QuirónSalud, Cali, Colombia
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Xiang P, Ahmadi S, Coleman A, West W, Lobon I, Bikas A, Landa I, Marqusee E, Kim M, Alexander EK, Pappa T. Identifying and Predicting Diverse Patterns of Benign Nodule Growth. J Clin Endocrinol Metab 2023; 108:e458-e463. [PMID: 36625198 DOI: 10.1210/clinem/dgad007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/05/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
CONTEXT The natural history of benign thyroid nodules is typically characterized by slow growth and minimal risk of malignant transformation. Available data have, to date, been unable to elucidate the diversity of benign nodule growth patterns over time nor predictive of which patients follow which pattern. OBJECTIVE We aimed to better define the diverse patterns of benign nodule behavior and their predictors. METHODS We prospectively studied 389 consecutive patients with solitary, solid, cytologically benign thyroid nodules ≥1 cm and follow-up ultrasound for at least 4 years. Demographic, sonographic, biochemical data were collected at initial evaluation, and subsequent growth patterns were identified over the follow-up. Predictors of growth at initial evaluation and 3 years of follow-up were defined. RESULTS The mean (±SD) follow-up was 7.7 (±2.7) years. Three distinct growth patterns were identified: A) stagnant nodules with average growth rate < 0.2 mm/year; B) slow-growing nodules with a rate 0.2 to 1.0 mm/year; and C) fast-growing nodules increasing > 1.0 mm/year. Fast-growing nodules represented 17.2% of the cohort, and were more frequent in patients younger than 50 years (OR 2.2 [1.2-4.1], P = 0.016), and in larger nodules (2.0-2.9 cm, OR 3.5 [1.7-7.1], P = 0.001; >3.0 cm, OR 4.4 [1.8-10.4], P = 0.001 vs reference 1-1.9 cm). In a multiple regression model, nodule growth at 3 years at an average growth rate over 0.2 mm/year over 3 years since initial evaluation was an independent predictor of longer-term fast nodule growth, even after adjusting for age, biological sex, TSH level, and nodule size (P < 0.001). CONCLUSION The natural history of benign nodule growth is diverse, with over 80% of nodules demonstrating minimal to no growth long-term. Nearly 20% of cytologically benign nodules may exhibit a fast, continued growth pattern, which can be predicted by the 3-year growth rate pattern. These findings can help inform decision making for tailored benign nodule follow-up and monitoring.
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Affiliation(s)
- PingPing Xiang
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA
- Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210029, China
| | - Sara Ahmadi
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Alexandra Coleman
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - William West
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Isabel Lobon
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Athanasios Bikas
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Iñigo Landa
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Ellen Marqusee
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Matthew Kim
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Erik K Alexander
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Theodora Pappa
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA
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Borowczyk M, Dobosz P, Szczepanek-Parulska E, Budny B, Dębicki S, Filipowicz D, Wrotkowska E, Oszywa M, Verburg FA, Janicka-Jedyńska M, Ziemnicka K, Ruchała M. Follicular Thyroid Adenoma and Follicular Thyroid Carcinoma-A Common or Distinct Background? Loss of Heterozygosity in Comprehensive Microarray Study. Cancers (Basel) 2023; 15:638. [PMID: 36765597 PMCID: PMC9913827 DOI: 10.3390/cancers15030638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
Pre- and postsurgical differentiation between follicular thyroid adenoma (FTA) and follicular thyroid cancer (FTC) represents a significant diagnostic challenge. Furthermore, it remains unclear whether they share a common or distinct background and what the mechanisms underlying follicular thyroid lesions malignancy are. The study aimed to compare FTA and FTC by the comprehensive microarray and to identify recurrent regions of loss of heterozygosity (LOH). We analyzed formalin-fixed paraffin-embedded (FFPE) samples acquired from 32 Caucasian patients diagnosed with FTA (16) and FTC (16). We used the OncoScan™ microarray assay (Affymetrix, USA), using highly multiplexed molecular inversion probes for single nucleotide polymorphism (SNP). The total number of LOH was higher in FTC compared with FTA (18 vs. 15). The most common LOH present in 21 cases, in both FTA (10 cases) and FTC (11 cases), was 16p12.1, which encompasses many cancer-related genes, such as TP53, and was followed by 3p21.31. The only LOH present exclusively in FTA patients (56% vs. 0%) was 11p11.2-p11.12. The alteration which tended to be detected more often in FTC (6 vs. 1 in FTA) was 12q24.11-q24.13 overlapping FOXN4, MYL2, PTPN11 genes. FTA and FTC may share a common genetic background, even though differentiating rearrangements may also be detected.
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Affiliation(s)
- Martyna Borowczyk
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland
- Department of Medical Simulation, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | - Paula Dobosz
- Department of Genetics and Genomics, Central Clinical Hospital of the Ministry of Interior Affairs and Administration, 02-507 Warsaw, Poland
| | - Ewelina Szczepanek-Parulska
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Bartłomiej Budny
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Szymon Dębicki
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Dorota Filipowicz
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Elżbieta Wrotkowska
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Michalina Oszywa
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Frederik A. Verburg
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | | | - Katarzyna Ziemnicka
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland
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Xu C, Fang J, Li W, Sun C, Li Y, Lowe S, Bentley R, Chen S, He C, Li X, Wang B, Yin C, Li W, Li W. Construction and validation of BRAF mutation diagnostic model based on ultrasound examination and clinical features of patients with thyroid nodules. Front Genet 2022; 13:973272. [PMID: 36160023 PMCID: PMC9498827 DOI: 10.3389/fgene.2022.973272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: Fine Needle Aspiration (FNA) is currently the most popular method for identifying benign and malignant thyroid nodules. However, its diagnostic sensitivity is sometimes limited, which makes it necessary to apply genetic testing and other modalities as a secondary diagnostic method. The diagnostic accuracy of thyroid nodule can be improved by combining mutations in the B-Raf proto-oncogene serine/threonine kinase (BRAF) with FNA. Thus, this study was conducted to create a nomogram diagnostic model based on the clinical and ultrasonic characteristics of patients with BRAF mutations to aid in the identification of benign and malignant thyroid nodules using FNA.Methods: From April 2018 to December 2021, 275 patients with thyroid nodules who underwent ultrasonography and BRAF gene testing (137 positive and 138 negative) were included from Xianyang Central Hospital. The clinical and ultrasonic characteristics of the patients were used to develop a nomographic, diagnostic model of BRAF gene mutation, and to validate and evaluate the usefulness of the model.Results: Independent risk factors for BRAF mutations included: focal strong echogenicity (microcalcifications, OR = 3.04, 95%CI = 1.41–6.58, p = 0.005), hypoechogenicity (OR = 3.8, 95%CI = 1.14–12.61, p = 0.029), lymph node metastases (OR = 3.54, 95%CI = 1.43–8.75, p = 0.006), margin (lobulated, OR = 3.7, 95%CI = 1.66–8.23, p = 0.001; extrathyroidal invasion, OR = 2.81, 95%CI = 1.11–7.06, p = 0.029), and shape (vertical position, OR = 2.7, 95%CI = 1.11–6.59, p = 0.029). The area under the curve (AUC) of the receiver operating characteristic (ROC) curve of the BRAF mutation diagnostic model constructed on these factors was 0.806 (95% CI = 0.754–0.851), and 39.5% was set as the threshold probability of making a clinical decision. The results of the validation and clinical utility evaluation showed that our model had good predictive performance and clinical application value.Conclusion: Our nomogram diagnostic model based on clinical and ultrasound features of patients accurately predicted the possibility of BRAF gene mutations in patients with thyroid nodules.
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Affiliation(s)
- Chan Xu
- Department of Dermatology, Xianyang Central Hospital, Xianyang, China
- Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, China
| | - Jianqiang Fang
- Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, China
- Department of Ultrasound Interventional, Xianyang Central Hospital, Xianyang, China
| | - Wanying Li
- Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, Chicago, IL, United States
| | - Yaru Li
- Internal Medicine, Swedish Hospital, Chicago, IL, United States
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO, United States
| | - Rachel Bentley
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO, United States
| | - Shuya Chen
- Newham University Hospital, London, United Kingdom
| | - Cunyu He
- Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, China
| | - Xinxin Li
- Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, China
| | - Bing Wang
- Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, China
| | - Chengliang Yin
- Faculty of Medicine, Macau University of Science and Technology, Macau, China
- *Correspondence: Chengliang Yin, ; Wenle Li,
| | - Wenxian Li
- Beijing Life Biosciences Co., LTD, Beijing, China
| | - Wenle Li
- Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, China
- Department of Orthopaedics II, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Center for Molecular Imaging and Translational Medicine, Xiamen University, Xiamen, China
- *Correspondence: Chengliang Yin, ; Wenle Li,
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13
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Diagnostic Effectiveness of Dual Source Dual Energy Computed Tomography for Benign and Malignant Thyroid Nodules. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2257304. [PMID: 36034942 PMCID: PMC9402342 DOI: 10.1155/2022/2257304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/08/2022] [Accepted: 07/08/2022] [Indexed: 11/25/2022]
Abstract
Objective To evaluate the diagnostic effectiveness of dual source dual energy computed tomography (DS-DECT) for benign and malignant thyroid nodules. Methods Between January 2019 and December 2021, 60 patients with surgically and pathologically verified thyroid nodules treated at our institution were recruited. DS-DECT was administered to all patients. The iodine content of lesioned and normal tissues, the normalized iodine concentration (NIC) and standardized CT values of benign and malignant nodules, the consistency of examination results and pathological findings, and diagnostic effectiveness were all investigated. Results The diagnosis accuracy was the same as that of surgical pathology, producing a 100% accuracy for the 60 patients with thyroid nodules (42 were benign and 18 were malignant). The iodine content of lesioned solid tissue differed significantly from that of normal tissue, as did the iodine content of malignant and benign nodules (P < 0.05). In the arterial phase, no significant difference was found in NIC and standardized CT values between benign and malignant nodules (P > 0.05). The optimal critical NIC for differentiating benign and malignant nodules in the venous phase was 0.74 and the standardized CT value was 0.79 HU according to the receiver operating characteristics (ROC) curve. Malignant nodules were diagnosed when the NIC was <0.74 and the standardized CT value was <0.79 HU, with AUC values of 0.89 and 0.93, respectively, where the sensitivity and specificity of the differential diagnosis of NIC were 90.48% (38/42) and 88.89% (16/18), respectively, and those of the differential diagnosis of standardized CT value were 92.86% (39/ 42) and 94.44% (17/18), respectively. The diagnosis accuracy of DS-DECT was 100%, and the diagnostic results of morphological characteristics and pathological testing were consistent. The sensitivity and specificity of the NIC values and standardized CT values in the venous phase differential diagnosis of benign and malignant nodules were compatible with the morphological differential diagnosis. Conclusion DS-DECT is highly accurate in determining the benignity and malignancy of thyroid nodules and has a strong potential for clinical promotion to allow for prompt treatment.
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