1
|
Ghosh R, Auh S, Gubbi S, Veeraraghavan P, Cochran C, Shobab L, Urken ML, Burman KD, Wartofsky L, Klubo-Gwiezdzinska J. Association of Free Thyroxine With Progression-Free Survival in Intermediate and High-Risk Differentiated Thyroid Cancer. J Clin Endocrinol Metab 2025; 110:e1473-e1480. [PMID: 39115341 PMCID: PMC12012765 DOI: 10.1210/clinem/dgae537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Indexed: 04/24/2025]
Abstract
CONTEXT Supraphysiologic T4 doses are used in intermediate- and high-risk patients with differentiated thyroid cancer (IR/HR-DTC) to suppress tumor progression by TSH. However, preclinical data suggest that T4 can also act as a growth stimulus for cancer, but there is no clinical evidence supporting this claim. OBJECTIVE We analyzed the association between free T4 (FT4) and progression-free survival (PFS) in patients with IR/HR-DTC. METHODS This longitudinal cohort study, approved by multi-institutional review board, included patients with IR/HR-DTC treated uniformly with total thyroidectomy, radioiodine, and TSH suppression therapy, with at least 3 TSH and FT4 values available. Association between FT4 and PFS at landmarks 6, 12, and 18 months was assessed by Kaplan-Meier survival curves, whereas competing risks were assessed through Cox proportional hazards model. RESULTS From 739 screened patients, 382 met the inclusion criteria and were characterized by a median age of 46 (34-59) years, 64.1% women, and treated with a median radioiodine dosage of 159 (110-410) mCi. During follow up of 7.1 (3.4-12.7) years, 34.6% experienced disease progression. Elevated FT4, observed in 29.3% of patients, was not associated with worse PFS (hazard ratio [HR], 0.9; CI, 0.54-1.5; P = .69), whereas age (HR, 1.02; CI, 1.004-1.04; P = .01), tumor size (HR, 1.15; CI, 1.04-1.28; P = .01) and metastases to the lateral neck lymph nodes (HR, 2.9; CI, 1.7-4.74; P < .001), bones (HR, 4.87; CI, 1.79-13.3; P = .002), and brain (HR, 5.56; CI; 2.54-12.2; P < .001) were associated with shorter PFS. CONCLUSION Contrary to preclinical evidence, elevated FT4 levels do not affect PFS in patients with IR/HR-DTC.
Collapse
Affiliation(s)
- Raisa Ghosh
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20814, USA
| | - Sungyoung Auh
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20814, USA
| | - Sriram Gubbi
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20814, USA
| | - Padmasree Veeraraghavan
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20814, USA
| | - Craig Cochran
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20814, USA
| | - Leila Shobab
- Department of Endocrinology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Mark L Urken
- Institute of Head, Neck and Thyroid Cancer, Mount Sinai Beth Israel Medical Center, New York, NY 10003, USA
| | - Kenneth D Burman
- Department of Endocrinology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Leonard Wartofsky
- Department of Endocrinology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Joanna Klubo-Gwiezdzinska
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20814, USA
| |
Collapse
|
2
|
Jia X, Li J, Jiang Z. Association between thyroid disorders and extra-thyroidal cancers, a review. Clin Transl Oncol 2024; 26:2075-2083. [PMID: 38491294 DOI: 10.1007/s12094-024-03434-3] [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: 02/03/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
Thyroid hormone has been shown to have both tumor-promoting and tumor-suppressing actions, which has led to significant debate over its involvement in the development of cancer. Proliferation, apoptosis, invasiveness, and angiogenesis are all aspects of cancer that are affected by the thyroid hormones T3 and T4, according to research conducted in animal models and in vitro experiments. The effects of thyroid hormones on cancer cells are mediated by many non-genomic mechanisms, one of which involves the activation of the plasma membrane receptor integrin αvβ3. Typically, abnormal amounts of thyroid hormones are linked to a higher occurrence of cancer. Both benign and malignant thyroid disorders were found to be associated with an increased risk of extra-thyroidal malignancies, specifically colon, breast, prostate, melanoma, and lung cancers. The purpose of this review was to shed light on this link to define which types of cancer are sensitive to thyroid hormones and, as a result, are anticipated to respond favorably to treatment of the thyroid hormone axis.
Collapse
Affiliation(s)
- Xin Jia
- Department of Nursing, Zhengzhou Health Vocational College, Zhengzhou, 410005, China
| | - Jingru Li
- Department of Nursing, Zhengzhou Health Vocational College, Zhengzhou, 410005, China.
| | - Zongliang Jiang
- Department of Nursing, Zhengzhou Health Vocational College, Zhengzhou, 410005, China
| |
Collapse
|
3
|
Hu X, Wang X, Liang Y, Chen X, Zhou S, Fei W, Yang Y, Que H. Cancer Risk in Hashimoto's Thyroiditis: a Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2022; 13:937871. [PMID: 35903279 PMCID: PMC9318815 DOI: 10.3389/fendo.2022.937871] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/09/2022] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Research data suggest that patients with Hashimoto's thyroiditis may increase the risk of cancer. However, existing research is inconsistent with this view. Therefore, to investigate the effect of Hashimoto's thyroiditis on the risk of developing cancer, we conducted this study. METHODS We searched the PubMed and Embase databases from database establishment until March 2022. After rigorous literature screening by two authors, 23 studies that met the inclusion criteria were identified, and the required data were independently extracted. RESULTS We retrieved 3591 records, and after the screening, 11 case-control studies and 12 cohort studies were included in the analysis. Data analysis suggested that patients with Hashimoto's thyroiditis had an increased risk of developing breast cancer, urogenital cancer, digestive organs cancer, hematologic cancer, and a low risk of respiratory cancers. CONCLUSIONS This systematic review and meta-analysis showed that patients with HT may have a significantly increased risk of thyroid cancer, breast cancers, lung cancer, digestive system cancer, urogenital cancers, blood cancers, and prolactinoma people without HT. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier CRD 42022320741.
Collapse
Affiliation(s)
- Xiaojie Hu
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xuanyu Wang
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yue Liang
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xin Chen
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Siyuan Zhou
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenting Fei
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuxin Yang
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huafa Que
- Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Huafa Que,
| |
Collapse
|
4
|
Zervoudis S, Iatrakis G, Markja A, Tsatsaris G, Bothou A, von Tempelhoff GF, Balafouta M, Tsikouras P. Risk Factors of Synchronous Breast and Thyroid Cancer: a Controlled Multicenter Study and Review of the Literature. Mater Sociomed 2021; 33:298-303. [PMID: 35210954 PMCID: PMC8812374 DOI: 10.5455/msm.2021.33.298-303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/16/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Breast cancer (BC) is one of the most common cancers diagnosed in women in the United States. Thyroid cancer (TC) is also one of the fastest increasing cancer types in the United States, with most cases being papillary thyroid carcinomas. OBJECTIVE To identify possible risk factors for the synchronous or metachronous co-occurrence of breast and thyroid cancers. METHODS We carried out a study, which consisted of data from four gynecological clinics: two in Greece (Athens, Alexandroupolis, Ioannina) and one in Germany, collected from June 2017 to June 2020. The patients were divided into two groups: the first group consisted of 58 patients with breast cancer and a personal history of thyroid cancer. The second group (control group) included 50 patients with the same characteristics as to age, parity, type of pregnancy, treatment for sterility, polycystic ovaries, regularity of the menstrual cycle, breast density, BMI, family history of cancer, blood group rhesus and histological results of breast cancer. The data we collected were analyzed using version 20 of the SPSS statistical package. The Chi-square test was used for statistical analysis and a p-value<0.005 was considered statistically significant. RESULTS The only factors that seem to be related with the association of breast and thyroid cancer were: history of abortion and multiparity. CONCLUSION In our study there is a higher chance of developing breast cancer after diagnosing thyroid cancer and vice versa. More than genetic mutations, a possible hormonal pathway of these two malignancies is possible. The hormonal change in women who had many children or abortions could be a risk factor to develop both cancers. More studies are necessary to confirm our findings.
Collapse
Affiliation(s)
- Stefanos Zervoudis
- Breast Unit, REA Maternity Hospital, Athens, Greece
- Department of Midwifery, University of West Attica, Athens, Greece
| | | | - Anisa Markja
- Department of Midwifery, University of West Attica, Athens, Greece
| | | | - Anastasia Bothou
- Department of Midwifery, University of West Attica, Athens, Greece
| | | | | | - Pana Tsikouras
- Democritus University of Thrace, Alexandroupolis, Greece
| |
Collapse
|
5
|
Association of Polygenetic Risk Scores Related to Immunity and Inflammation with Hyperthyroidism Risk and Interactions between the Polygenetic Scores and Dietary Factors in a Large Cohort. J Thyroid Res 2021; 2021:7664641. [PMID: 34567510 PMCID: PMC8457978 DOI: 10.1155/2021/7664641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/14/2021] [Indexed: 12/13/2022] Open
Abstract
Graves's disease and thyroiditis induce hyperthyroidism, the causes of which remain unclear, although they are involved with genetic and environmental factors. We aimed to evaluate polygenetic variants for hyperthyroidism risk and their interaction with metabolic parameters and nutritional intakes in an urban hospital-based cohort. A genome-wide association study (GWAS) of participants with (cases; n = 842) and without (controls, n = 38,799) hyperthyroidism was used to identify and select genetic variants. In clinical and lifestyle interaction with PRS, 312 participants cured of hyperthyroidism were excluded. Single nucleotide polymorphisms (SNPs) associated with gene-gene interactions were selected by hyperthyroidism generalized multifactor dimensionality reduction. Polygenic risk scores (PRSs) were generated by summing the numbers of selected SNP risk alleles. The best gene-gene interaction model included tumor-necrosis factor (TNF)_rs1800610, mucin 22 (MUC22)_rs1304322089, tribbles pseudokinase 2 (TRIB2)_rs1881145, cytotoxic T-lymphocyte-associated antigen 4 (CTLA4)_rs231775, lipoma-preferred partner (LPP)_rs6780858, and human leukocyte antigen (HLA)-J_ rs767861647. The PRS of the best model was positively associated with hyperthyroidism risk by 1.939-fold (1.317-2.854) after adjusting for covariates. PRSs interacted with age, metabolic syndrome, and dietary inflammatory index (DII), while hyperthyroidism risk interacted with energy, calcium, seaweed, milk, and coffee intake (P < 0.05). The PRS impact on hyperthyroidism risk was observed in younger (<55 years) participants and adults without metabolic syndrome. PRSs were positively associated with hyperthyroidism risk in participants with low dietary intakes of energy (OR = 2.74), calcium (OR = 2.84), seaweed (OR = 3.43), milk (OR = 2.91), coffee (OR = 2.44), and DII (OR = 3.45). In conclusion, adults with high PRS involved in inflammation and immunity had a high hyperthyroidism risk exacerbated under low intakes of energy, calcium, seaweed, milk, or coffee. These results can be applied to personalized nutrition in a clinical setting.
Collapse
|
6
|
Osorio C, Ballestas J, Barrios D, Arévalo A, Montaño S, Pérez N, Guardo Y, Oviedo H, Zambrano V, Redondo K, Herrera F. Clinical characteristics associated with the finding of thyroid cancer originating from hot nodules in patients with hyperthyroidism: a case report and systematic review of the literature. REVISTA COLOMBIANA DE CIRUGÍA 2021. [DOI: 10.30944/20117582.790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Coexistence between thyroid cancer and hyperthyroidism is rare, and most of the nodular lesions from which a malignant tumor is documented in this group of patients correspond to cold nodules. Justified by the increasing number of reports in the literature about malignant tumors diagnosed from hot nodules, a systematic review was carried out to determine possible factors associated with the diagnosis of thyroid cancer from hot nodules in patients with hyperthyroidism. The results suggest that the clinical diagnosis of toxic nodular goiter, nodular lesions of diameter > 10 mm and a histological type compatible with a follicular carcinoma, are factors that on their own increase the risk of making the diagnosis of cancer from a hot nodule.
Collapse
|
7
|
The impact of thyroid tumor features on lymph node metastasis in papillary thyroid carcinoma patients in head and neck department at KAMC: A retrospective cross-sectional study. Ann Med Surg (Lond) 2021; 64:102217. [PMID: 33854770 PMCID: PMC8027685 DOI: 10.1016/j.amsu.2021.102217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 11/25/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) is the most prevalent type of thyroid cancer. It is one of the most common types of malignancy of the thyroid that spreads to cervical lymph nodes. Lymph node metastasis (LNM) is an important factor when determining recurrence risk, and determining the extent of lymph node involvement can guide treatment. Our main objective is to evaluate the association between the size of the tumor and the number of lymph node metastases in patients with PTC. Methods: We conducted an electronic retrospective chart review of 125 patients with PTC followed in the Head and Neck Department at KAMC from 2009 to 2020. Twenty-two patients included in our study were pathologically and clinically diagnosed and confirmed to have LNM of PTC. Results: The study included 22 PTC patients who had undergone lymph node dissections. Patients had a median age of 38.8 years (IQR = 32.2–54.5), and the median tumor size was 20.5 mm. The most commonly affected level of the neck was IV (76.2%). Distant metastasis M1 was seen in only two patients (9.1%). Tumors sizes >30mm (75%) had ≥5 LNM. Most cases were the classic subtype PTC. For the site of the tumor, the site had a significant impact on the number of LNM (p = 0.004). Multifocality had a high impact on LNM (p = 0.019). Conclusions: This study showed no association between the size of PTC and the number of LNMs. The bilaterality of PTC was significantly associated with a high number of LNMs. Lymph nodes in level IV were the most common metastasis site for PTC. Bilateral and multifocal PTC were significantly associated with a higher number of lymph nodes metastasis. The size of the tumor was not significantly related to the number of lymph node metastasis.
Collapse
|
8
|
Hu L, Wu Y. Papillary thyroid carcinoma presenting as a functioning thyroid nodule: report of 2 rare cases. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2020; 13:2895-2906. [PMID: 33284874 PMCID: PMC7716118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/27/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Autonomously functioning thyroid nodules (AFTNs) are generally benign, whereas papillary thyroid carcinomas (PTCs) are mostly non-functioning. Graves' disease (GD) is the most common cause of hyperthyroidism (HD), followed by hyperfunctional adenoma or Plummer's disease. GD with AFTNs is called Marine-Lenhart syndrome, a relatively rare syndrome. In clinical practice, the presence of HD, AFTNs and PTC at the same time is extremely rare. CASE PRESENTATION Case 1: A 55-year-old middle-aged woman with a preoperative diagnosis of GD and HD with right AFTNs. Case 2: A 43-year-old middle-aged woman with a preoperative diagnosis of non-GD and HD with right AFTNs and right PTC. Case 1: Histology showed a 4 cm adenoma with a 1.0 cm PTC in the right lobe and a 0.3 cm PTC in the left lobe. The rest of the thyroid showed typical pathologic GD changes. The postoperative diagnosis was atypical Marine-Lenhart syndrome with bilateral PTC. Case 2: Histology showed a 0.4 cm PTC surrounded by nodular goiter. The postoperative diagnosis was toxic nodular goiter with PTC. CONCLUSION This paper covers the relationships among PTC, HD and AFTNs, explains some common and uncommon clinical diagnoses, and reports two rare cases with these three diagnoses. Our ultimate purpose is to remind doctors that when handling nodules or HD, PTC as a diagnosis cannot be excluded. Instead, it is better to perform total or near-total thyroidectomy and intraoperative frozen biopsy or preoperative biopsy examinations to avoid omitting PTC, which needs reoperation.
Collapse
Affiliation(s)
- Liang Hu
- Department of Thyroid Surgery, The First Hospital Affiliated to Zhejiang University, School of Medicine No. 79 Qingchun Road, Hangzhou 310000, P. R. China
| | - Yijun Wu
- Department of Thyroid Surgery, The First Hospital Affiliated to Zhejiang University, School of Medicine No. 79 Qingchun Road, Hangzhou 310000, P. R. China
| |
Collapse
|
9
|
Varadharajan K, Choudhury N. A systematic review of the incidence of thyroid carcinoma in patients undergoing thyroidectomy for thyrotoxicosis. Clin Otolaryngol 2020; 45:538-544. [PMID: 32149464 DOI: 10.1111/coa.13527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 02/01/2020] [Accepted: 02/29/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Hyperthyroidism (HT) has been associated with no insignificant rates of thyroid malignancy. There are no current specific guidelines that suggest routine preoperative imaging for thyroid nodules in patients with Grave's disease. We therefore performed a systematic review assessing rates of thyroid malignancy in patients undergoing surgery for different causes of HT: Grave's disease (GD), toxic adenoma (TA) and toxic multinodular goitre (TMNG). METHODS Major databases (MEDLINE, PubMed and the Cochrane library) were searched to identify eligible studies. RESULTS After searching and appraising, 33 papers were found to be eligible for analysis. The mean overall rate of malignancy was 8.5% (range 0.8%-32.4%). The mean rates based on histological subtype were as follows: papillary thyroid cancer (PTC), 3.1% (range 0%-13.2%); micropapillary carcinoma (mPTC), 5.1% (range 0%-16.9%); and follicular thyroid cancer (FTC), 0.8% (range 0%-4.4%). In those patients who had preoperative imaging, mean malignancy rates were higher in patients with pre-identified nodules (19.8%) compared to those without any nodules (8.7%). Mean rates were lower in patients with GD/diffuse goitre (5.9%) compared to patients with TA (6.5%) and TMNG (12%). CONCLUSION Hyperthyroidism is associated with notable rates of thyroid cancer, although the mechanisms for this are not clear. The presence of nodules increases this risk. This review raises the question for considering preoperative assessment of nodules in all patients undergoing surgery for HT, in order to correctly assess and evaluate any patients with suspected concurrent thyroid malignancy, before proceeding with surgery.
Collapse
|
10
|
Mekraksakit P, Rattanawong P, Karnchanasorn R, Kanitsoraphan C, Leelaviwat N, Poonsombudlert K, Kewcharoen J, Dejhansathit S, Samoa R. PROGNOSIS OF DIFFERENTIATED THYROID CARCINOMA IN PATIENTS WITH GRAVES DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract 2019; 25:1323-1337. [PMID: 31412224 DOI: 10.4158/ep-2019-0201] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: It is still controversial whether differentiated thyroid carcinoma (DTC) in patients with Graves disease (GD) can be more aggressive than non-Graves DTC. We conducted a systematic review and meta-analysis to examine the association between GD and prognosis in patients with DTC. Methods: We comprehensively searched the databases of MEDLINE and EMBASE from inception to March 2019. We included published studies that compared the risk of mortality and prognosis between DTC patients with GD and those with non-GD. Data from each study were combined using the random-effects model. Results: Twenty-five studies from February 1988 to May 2018 were included (987 DTC patients with GD and 2,064 non-Graves DTC patients). The DTC patients with GD had a significantly higher risk of associated multifocality/multicentricity (odds ratio, 1.45; 95% confidence interval, 1.04 to 2.02; I2, 6.5%; P = .381) and distant metastasis at the time of cancer diagnosis (odds ratio, 2.19; 95% confidence interval, 1.08 to 4.47; I2, 0.0%; P = .497), but this was not associated with DTC-related mortality and recurrence/persistence during follow-up. Conclusion: Our meta-analysis demonstrates a statistically significant increased risk of multifocality/multicentricity and distant metastasis at the time of cancer diagnosis in DTC patients with GD than those without GD. Abbreviations: CI = confidence interval; DTC = differentiated thyroid carcinoma; GD = Graves disease; LN = lymph node; OR = odds ratio; PTC = papillary thyroid carcinoma; TC = thyroid carcinoma; TSAb = thyroid-stimulating antibody; TSH = thyroid-stimulating hormone.
Collapse
|
11
|
Jia Q, Li X, Liu Y, Li L, Kwong JSW, Ren K, Jiang Y, Sun X, Tian H, Li S. Incidental thyroid carcinoma in surgery-treated hyperthyroid patients with Graves' disease: a systematic review and meta-analysis of cohort studies. Cancer Manag Res 2018; 10:1201-1207. [PMID: 29872340 PMCID: PMC5973324 DOI: 10.2147/cmar.s164210] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The association between Graves' disease (GD) and thyroid carcinoma remains controversial. This study aimed to investigate incidental thyroid carcinoma (ITC) in surgery-treated hyperthyroid patients with and without GD. MATERIALS AND METHODS We searched PubMed and EMBASE for cohort studies investigating ITC in surgery-treated hyperthyroid patients without prediagnosed thyroid carcinoma in accordance with the Meta-Analysis of Observational Studies in Epidemiology guidelines. The last search was updated to January 23, 2018. All statistical tests were performed using Review Manager 5.3 and STATA version 12.0. RESULTS Eleven cohort studies involving 10,743 GD and 3,336 non-GD patients were included. The pooled prevalence of ITC was 7.0% (95% confidence interval [CI] 4.5-9.6), and was comparable in surgery-treated GD and non-GD hyperthyroid patients (GD vs non-GD: pooled odds ratio [OR], 1.0; 95% CI: 0.68-1.46; P=0.98). In the subgroup analysis, toxic adenoma and toxic nodular goiter showed no difference when comparing with GD (pooled OR, 0.53; 95% CI: 0.21-1.36; P=0.18 and pooled OR, 1.01; 95% CI: 0.65-1.57; P=0.95, respectively). CONCLUSION Our study demonstrated that GD was not associated with increased risk of ITC in surgery-treated hyperthyroid patients.
Collapse
Affiliation(s)
- Qingyi Jia
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China
| | - Xiaodan Li
- Department of Gastroenterology, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China
| | - Ying Liu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China
| | - Ling Li
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China
| | - Joey SW Kwong
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Department of Clinical Epidemiology and Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Kaiyun Ren
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China
| | - Yong Jiang
- Department of Pathology, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China
| | - Xin Sun
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China
| | - Haoming Tian
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China
| | - Sheyu Li
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China
| |
Collapse
|
12
|
Romitti M, Wajner SM, Ceolin L, Ferreira CV, Ribeiro RVP, Rohenkohl HC, Weber SDS, Lopez PLDC, Fuziwara CS, Kimura ET, Maia AL. MAPK and SHH pathways modulate type 3 deiodinase expression in papillary thyroid carcinoma. Endocr Relat Cancer 2016; 23:135-46. [PMID: 26825960 DOI: 10.1530/erc-15-0162] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Type 3 deiodinase (DIO3, D3) is reactivated in human neoplasias. Increased D3 levels in papillary thyroid carcinoma (PTC) have been associated with tumor size and metastatic disease. The objective of this study is to investigate the signaling pathways involved in DIO3 upregulation in PTC. Experiments were performed in human PTC cell lines (K1 and TPC-1 cells) or tumor samples. DIO3 mRNA and activity were evaluated by real-time PCR and ion-exchange column chromatography respectively. Western blot analysis was used to determine the levels of D3 protein. DIO3 gene silencing was performed via siRNA transfection. DIO3 mRNA levels and activity were readily detected in K1 (BRAF(V6) (0) (0E)) and, at lower levels, in TPC-1 (RET/PTC1) cells (P<0.007 and P=0.02 respectively). Similarly, DIO3 mRNA levels were higher in PTC samples harboring the BRAF(V600E) mutation as compared with those with RET/PTC1 rearrangement or negative for these mutations (P<0.001). Specific inhibition of BRAF oncogene (PLX4032, 3 μM), MEK (U0126, 10-20 μM) or p38 (SB203580, 10-20 μM) signaling was associated with decreases in DIO3 expression in K1 and TPC-1 cells. Additionally, the blockage of the sonic hedgehog (SHH) pathway by cyclopamine (10 μM) resulted in markedly decreases in DIO3 mRNA levels. Interestingly, siRNA-mediated DIO3 silencing induced decreases on cyclin D1 expression and partial G1 phase cell cycle arrest, thereby downregulating cell proliferation. In conclusion, sustained activation of the MAPK and SHH pathways modulate the levels of DIO3 expression in PTC. Importantly, DIO3 silencing was associated with decreases in cell proliferation, thus suggesting a D3 role in tumor growth and aggressiveness.
Collapse
Affiliation(s)
- Mírian Romitti
- Thyroid SectionEndocrine Division, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, RS, BrazilExperimental Research CenterHospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Cell and Developmental BiologyInstitute of Biomedical Sciences, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Simone Magagnin Wajner
- Thyroid SectionEndocrine Division, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, RS, BrazilExperimental Research CenterHospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Cell and Developmental BiologyInstitute of Biomedical Sciences, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Lucieli Ceolin
- Thyroid SectionEndocrine Division, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, RS, BrazilExperimental Research CenterHospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Cell and Developmental BiologyInstitute of Biomedical Sciences, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Carla Vaz Ferreira
- Thyroid SectionEndocrine Division, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, RS, BrazilExperimental Research CenterHospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Cell and Developmental BiologyInstitute of Biomedical Sciences, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Rafaela Vanin Pinto Ribeiro
- Thyroid SectionEndocrine Division, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, RS, BrazilExperimental Research CenterHospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Cell and Developmental BiologyInstitute of Biomedical Sciences, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Helena Cecin Rohenkohl
- Thyroid SectionEndocrine Division, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, RS, BrazilExperimental Research CenterHospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Cell and Developmental BiologyInstitute of Biomedical Sciences, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Shana de Souto Weber
- Thyroid SectionEndocrine Division, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, RS, BrazilExperimental Research CenterHospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Cell and Developmental BiologyInstitute of Biomedical Sciences, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Patrícia Luciana da Costa Lopez
- Thyroid SectionEndocrine Division, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, RS, BrazilExperimental Research CenterHospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Cell and Developmental BiologyInstitute of Biomedical Sciences, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Cesar Seigi Fuziwara
- Thyroid SectionEndocrine Division, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, RS, BrazilExperimental Research CenterHospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Cell and Developmental BiologyInstitute of Biomedical Sciences, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Edna Teruko Kimura
- Thyroid SectionEndocrine Division, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, RS, BrazilExperimental Research CenterHospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Cell and Developmental BiologyInstitute of Biomedical Sciences, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ana Luiza Maia
- Thyroid SectionEndocrine Division, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, RS, BrazilExperimental Research CenterHospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Cell and Developmental BiologyInstitute of Biomedical Sciences, Universidade de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|