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Original Articles
Cost-Utility Analysis of Early Detection with Ultrasonography of Differentiated Thyroid Cancer: A Retrospective Study on a Korean Population
Han-Sang Baek, Jeonghoon Ha, Kwangsoon Kim, Ja Seong Bae, Jeong Soo Kim, Sungju Kim, Dong-Jun Lim, Chul-Min Kim
Received October 24, 2023  Accepted January 22, 2024  Published online April 9, 2024  
DOI: https://doi.org/10.3803/EnM.2023.1870    [Epub ahead of print]
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
There is debate about ultrasonography screening for thyroid cancer and its cost-effectiveness. This study aimed to evaluate the cost-effectiveness of early screening (ES) versus symptomatic detection (SD) for differentiated thyroid cancer (DTC) in Korea.
Methods
A Markov decision analysis model was constructed to compare the cost-effectiveness of ES and SD. The model considered direct medical costs, health outcomes, and different diagnostic and treatment pathways. Input data were derived from literature and Korean population studies. Incremental cost-effectiveness ratio (ICER) was calculated. Willingness-to-pay (WTP) threshold was set at USD 100,000 or 20,000 per quality-adjusted life year (QALY) gained. Sensitivity analyses were conducted to address uncertainties of the model’s variables.
Results
In a base case scenario with 50 years of follow-up, ES was found to be cost-effective compared to SD, with an ICER of $2,852 per QALY. With WTP set at $100,000, in the case with follow-up less than 10 years, the SD was cost-effective. Sensitivity analysis showed that variables such as lobectomy probability, age, mortality, and utility scores significantly influenced the ICER. Despite variations in costs and other factors, all ICER values remained below the WTP threshold.
Conclusion
Findings of this study indicate that ES is a cost-effective strategy for DTC screening in the Korean medical system. Early detection and subsequent lobectomy contribute to the cost-effectiveness of ES, while SD at an advanced stage makes ES more cost-effective. Expected follow-up duration should be considered to determine an optimal strategy for DTC screening.
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Diabetes, obesity and metabolism
Risk of Pancreatic Cancer and Use of Dipeptidyl Peptidase 4 Inhibitors in Patients with Type 2 Diabetes: A Propensity Score-Matching Analysis
Mee Kyoung Kim, Kyungdo Han, Hyuk-Sang Kwon, Soon Jib Yoo
Endocrinol Metab. 2023;38(4):426-435.   Published online July 20, 2023
DOI: https://doi.org/10.3803/EnM.2023.1737
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  • 134 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The effects of dipeptidyl peptidase 4 (DPP-4) inhibitors over the course of long-term treatment remain unclear, and concerns have been raised regarding the role of DPP-4 inhibitors in carcinogenesis in the pancreas. Earlier studies of pancreatic adverse events have reported conflicting results.
Methods
This study analyzed Korean National Health Insurance Service data from January 2009 to December 2012. Patients who had type 2 diabetes mellitus and took two or more oral glucose-lowering drugs (GLDs) were included. Patients prescribed DPP-4 inhibitors (n=51,482) or other GLDs (n=51,482) were matched at a 1:1 ratio using propensity score matching. The risk of pancreatic cancer was calculated using Kaplan-Meier curves and Cox proportional-hazards regression analysis.
Results
During a median follow-up period of 7.95 years, 1,051 new cases of pancreatic cancer were identified. The adjusted hazard ratio (HR) for DPP-4 inhibitor use was 0.99 (95% confidence interval [CI], 0.88 to 1.12) compared with the other GLD group. In an analysis limited to cases diagnosed with pancreatic cancer during hospitalization, the adjusted HR for the use of DPP-4 inhibitors was 1.00 (95% CI, 0.86 to 1.17) compared with patients who took other GLDs. Using the other GLD group as the reference group, no trend was observed for elevated pancreatic cancer risk with increased DPP-4 inhibitor exposure.
Conclusion
In this population-based cohort study, DPP-4 inhibitor use over the course of relatively long-term follow-up showed no significant association with an elevated risk of pancreatic cancer.

Citations

Citations to this article as recorded by  
  • Diabetes Duration, Cholesterol Levels, and Risk of Cardiovascular Diseases in Individuals With Type 2 Diabetes
    Mee Kyoung Kim, Kyu Na Lee, Kyungdo Han, Seung-Hwan Lee
    The Journal of Clinical Endocrinology & Metabolism.2024;[Epub]     CrossRef
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Thyroid
Clinicopathological Characteristics and Disease-Free Survival in Patients with Hürthle Cell Carcinoma: A Multicenter Cohort Study in South Korea
Meihua Jin, Eun Sook Kim, Bo Hyun Kim, Hee Kyung Kim, Yea Eun Kang, Min Ji Jeon, Tae Yong Kim, Ho-Cheol Kang, Won Bae Kim, Young Kee Shong, Mijin Kim, Won Gu Kim
Endocrinol Metab. 2021;36(5):1078-1085.   Published online October 28, 2021
DOI: https://doi.org/10.3803/EnM.2021.1151
  • 3,861 View
  • 110 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Hürthle cell carcinoma (HCC), a type of thyroid carcinoma, is rare in South Korea, and few studies have investigated its prognosis.
Methods
This long-term multicenter retrospective cohort study evaluated the clinicopathological features and clinical outcomes in patients with HCC who underwent thyroid surgery between 1996 and 2009.
Results
The mean age of the 97 patients included in the study was 50.3 years, and 26.8% were male. The mean size of the primary tumor was 3.2±1.8 cm, and three (3.1%) patients had distant metastasis at initial diagnosis. Ultrasonographic findings were available for 73 patients; the number of nodules with low-, intermediate-, and high suspicion was 28 (38.4%), 27 (37.0%), and 18 (24.7%), respectively, based on the Korean-Thyroid Imaging Reporting and Data System. Preoperatively, follicular neoplasm (FN) or suspicion for FN accounted for 65.2% of the cases according to the Bethesda category, and 13% had malignancy or suspicious for malignancy. During a median follow-up of 8.5 years, eight (8.2%) patients had persistent/recurrent disease, and none died of HCC. Older age, gross extrathyroidal extension (ETE), and widely invasive types of tumors were significantly associated with distant metastasis (all P<0.01). Gross ETE (hazard ratio [HR], 27.7; 95% confidence interval [CI], 2.2 to 346.4; P=0.01) and widely invasive classification (HR, 6.5; 95% CI, 1.1 to 39.4; P=0.04) were independent risk factors for poor disease-free survival (DFS).
Conclusion
The long-term prognosis of HCC is relatively favorable in South Korea from this study, although this is not a nation-wide data, and gross ETE and widely invasive cancer are significant prognostic factors for DFS. The diagnosis of HCC by ultrasonography and cytopathology remains challenging.

Citations

Citations to this article as recorded by  
  • Molecular Alterations and Comprehensive Clinical Management of Oncocytic Thyroid Carcinoma
    Lindsay A. Bischoff, Ian Ganly, Laura Fugazzola, Erin Buczek, William C. Faquin, Bryan R. Haugen, Bryan McIver, Caitlin P. McMullen, Kate Newbold, Daniel J. Rocke, Marika D. Russell, Mabel Ryder, Peter M. Sadow, Eric Sherman, Maisie Shindo, David C. Shonk
    JAMA Otolaryngology–Head & Neck Surgery.2024; 150(3): 265.     CrossRef
  • Oncocytic carcinoma of the thyroid: Conclusions from a 20‐year patient cohort
    Nelson R. Gruszczynski, Shahzeb S. Hasan, Ana G. Brennan, Julian De La Chapa, Adithya S. Reddy, David N. Martin, Prem P. Batchala, Edward B. Stelow, Eric M. Dowling, Katherine L. Fedder, Jonathan C. Garneau, David C. Shonka
    Head & Neck.2024;[Epub]     CrossRef
  • Hurthle cell carcinoma: a rare variant of thyroid malignancy – a case report
    Yuvraj Adhikari, Anupama Marasini, Nawaraj Adhikari, Laxman D. Paneru, Binit Upadhaya Regmi, Manita Raut
    Annals of Medicine & Surgery.2023; 85(5): 1940.     CrossRef
  • Hürthle Cell Carcinoma: Single Center Analysis and Considerations for Surgical Management Based on the Recent Literature
    Costanza Chiapponi, Milan J.M. Hartmann, Matthias Schmidt, Michael Faust, Christiane J. Bruns, Anne M. Schultheis, Hakan Alakus
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
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Thyroid
Whole-Exome Sequencing in Papillary Microcarcinoma: Potential Early Biomarkers of Lateral Lymph Node Metastasis
Mijin Kim, Chae Hwa Kwon, Min Hee Jang, Jeong Mi Kim, Eun Heui Kim, Yun Kyung Jeon, Sang Soo Kim, Kyung-Un Choi, In Joo Kim, Meeyoung Park, Bo Hyun Kim
Endocrinol Metab. 2021;36(5):1086-1094.   Published online October 28, 2021
DOI: https://doi.org/10.3803/EnM.2021.1132
  • 3,586 View
  • 109 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Early identification of patients with high-risk papillary thyroid microcarcinoma (PTMC) that is likely to progress has become a critical challenge. We aimed to identify somatic mutations associated with lateral neck lymph node (LN) metastasis (N1b) in patients with PTMC.
Methods
Whole-exome sequencing (WES) of 14 PTMCs with no LN metastasis (N0) and 13 N1b PTMCs was performed using primary tumors and matched normal thyroid tissues.
Results
The mutational burden was comparable in N0 and N1b tumors, as the median number of mutations was 23 (range, 12 to 46) in N0 and 24 (range, 12 to 50) in N1b PTMC (P=0.918). The most frequent mutations were detected in PGS1, SLC4A8, DAAM2, and HELZ in N1b PTMCs alone, and the K158Q mutation in PGS1 (four patients, Fisher’s exact test P=0.041) was significantly enriched in N1b PTMCs. Based on pathway analysis, somatic mutations belonging to the receptor tyrosine kinase-RAS and NOTCH pathways were most frequently affected in N1b PTMCs. We identified four mutations that are predicted to be pathogenic in four genes based on Clinvar and Combined Annotation-Dependent Depletion score: BRAF, USH2A, CFTR, and PHIP. A missense mutation in CFTR and a nonsense mutation in PHIP were detected in N1b PTMCs only, although in one case each. BRAF mutation was detected in both N0 and N1b PTMCs.
Conclusion
This first comprehensive WES analysis of the mutational landscape of N0 and N1b PTMCs identified pathogenic genes that affect biological functions associated with the aggressive phenotype of PTMC.

Citations

Citations to this article as recorded by  
  • What can we learn about acid-base transporters in cancer from studying somatic mutations in their genes?
    Bobby White, Pawel Swietach
    Pflügers Archiv - European Journal of Physiology.2024; 476(4): 673.     CrossRef
  • Comprehensive Long-Read Sequencing Analysis Discloses the Transcriptome Features of Papillary Thyroid Microcarcinoma
    Yanqiang Wang, Binbin Zou, Yanyan Zhang, Jin Zhang, Shujing Li, Bo Yu, Zhekun An, Lei Li, Siqian Cui, Yutong Zhang, Jiali Yao, Xiuzhi Shi, Jing Liu
    The Journal of Clinical Endocrinology & Metabolism.2024; 109(5): 1263.     CrossRef
  • Feasibility of whole‐exome sequencing in fine‐needle aspiration specimens of papillary thyroid microcarcinoma for the identification of novel gene mutations
    Liyuan Ma, Luying Gao, Ya Hu, Xiaoyi Li, Chunhao Liu, Jiang Ji, Xinlong Shi, Aonan Pan, Yuang An, Nengwen Luo, Yu Xia, Yuxin Jiang
    Clinical Genetics.2024; 105(5): 567.     CrossRef
  • Multi-omics analysis reveals a molecular landscape of the early recurrence and early metastasis in pan-cancer
    Dan-ni He, Na Wang, Xiao-Ling Wen, Xu-Hua Li, Yu Guo, Shu-heng Fu, Fei-fan Xiong, Zhe-yu Wu, Xu Zhu, Xiao-ling Gao, Zhen-zhen Wang, Hong-jiu Wang
    Frontiers in Genetics.2023;[Epub]     CrossRef
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Review Article
Thyroid
Active Surveillance as an Effective Management Option for Low-Risk Papillary Thyroid Microcarcinoma
Min Ji Jeon, Won Gu Kim, Tae Yong Kim, Young Kee Shong, Won Bae Kim
Endocrinol Metab. 2021;36(4):717-724.   Published online August 11, 2021
DOI: https://doi.org/10.3803/EnM.2021.1042
Correction in: Endocrinol Metab 2022;37(1):180
  • 4,676 View
  • 179 Download
  • 4 Web of Science
  • 3 Crossref
AbstractAbstract PDFPubReader   ePub   
Active surveillance (AS) for low-risk papillary thyroid microcarcinoma (PTMC) has been accepted worldwide as safe and effective. Despite the growing acceptance of AS in the management of low-risk PTMCs, there are barriers to AS in real clinical settings, and it is important to understand and establish appropriate AS protocol from initial evaluation to follow-up. PTMC management strategies should be decided upon after careful consideration of patient and tumor characteristics by a multidisciplinary team of thyroid cancer specialists. Patients should understand the risks and benefits of AS, participate in decision-making and follow structured monitoring strategies. In this review, we discuss clinical outcomes of AS from previous studies, optimal indications and follow-up strategies for AS, and unresolved questions about AS.

Citations

Citations to this article as recorded by  
  • Serum thyroglobulin testing after thyroid lobectomy in patients with 1–4 cm papillary thyroid carcinoma
    Ahreum Jang, Meihua Jin, Chae A Kim, Min Ji Jeon, Yu-Mi Lee, Tae-Yon Sung, Tae Yong Kim, Won Bae Kim, Young Kee Shong, Won Gu Kim
    Endocrine.2023; 81(2): 290.     CrossRef
  • Papillary Thyroid Microcarcinoma: Active Surveillance Against Surgery. Considerations of an Italian Working Group From a Systematic Review
    Giuseppina Orlando, Gregorio Scerrino, Alessandro Corigliano, Irene Vitale, Roberta Tutino, Stefano Radellini, Francesco Cupido, Giuseppa Graceffa, Gianfranco Cocorullo, Giuseppe Salamone, Giuseppina Melfa
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Prognosis of Patients with 1–4 cm Papillary Thyroid Cancer Who Underwent Lobectomy: Focus on Gross Extrathyroidal Extension Invading Only the Strap Muscles
    Ahreum Jang, Meihua Jin, Won Woong Kim, Min Ji Jeon, Tae-Yon Sung, Dong Eun Song, Tae Yong Kim, Ki-Wook Chung, Won Bae Kim, Young Kee Shong, Yu-Mi Lee, Won Gu Kim
    Annals of Surgical Oncology.2022; 29(12): 7835.     CrossRef
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Original Articles
Thyroid
Association between Iodine Intake, Thyroid Function, and Papillary Thyroid Cancer: A Case-Control Study
Kyungsik Kim, Sun Wook Cho, Young Joo Park, Kyu Eun Lee, Dong-Wook Lee, Sue K. Park
Endocrinol Metab. 2021;36(4):790-799.   Published online August 11, 2021
DOI: https://doi.org/10.3803/EnM.2021.1034
  • 4,713 View
  • 236 Download
  • 9 Web of Science
  • 12 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aimed to assess the effects of iodine intake, thyroid function, and their combined effect on the risk of papillary thyroid cancer (PTC) and papillary thyroid microcarcinoma (PTMC).
Methods
A case-control study was conducted including 500 community-based controls who had undergone a health check-up, and 446 overall PTC cases (209 PTC and 237 PTMC) from the Thyroid Cancer Longitudinal Study. Urinary iodine concentration (UIC), was used as an indicator of iodine intake, and serum for thyroid function. The risk of PTC and PTMC was estimated using unconditional logistic regression.
Results
Excessive iodine intake (UIC ≥220 μg/gCr) was associated with both PTC (odds ratio [OR], 18.13 95% confidence interval [CI], 8.87 to 37.04) and PTMC (OR, 8.02; 95% CI, 4.64 to 13.87), compared to adequate iodine intake (UIC, 85 to 219 μg/gCr). Free thyroxine (T4) levels ≥1.25 ng/dL were associated with PTC (OR, 1.97; 95% CI, 1.36 to 2.87) and PTMC (OR, 2.98; 95% CI, 2.01 to 4.41), compared to free T4 levels of 0.7 to 1.24 ng/dL. Individuals with excessive iodine intake and high free T4 levels had a greatly increased OR of PTC (OR, 43.48; 95% CI, 12.63 to 149.62), and PTMC (OR, 26.96; 95% CI, 10.26 to 70.89), compared to individuals with adequate iodine intake and low free T4 levels.
Conclusion
Excessive iodine intake using creatinine-adjusted UIC and high free T4 levels may have a synergistic effect on PTC and PTMC. Considering both iodine intake and thyroid function is important to assess PTC and PTMC risk.

Citations

Citations to this article as recorded by  
  • Association between urinary iodine concentration and the risk of papillary thyroid cancer by sex and age: a case–control study
    Yerin Hwang, Hyun-Kyung Oh, Jae Hoon Chung, Sun Wook Kim, Jung-Han Kim, Jee Soo Kim, Myung-Hee Shin
    Scientific Reports.2023;[Epub]     CrossRef
  • Association between iodine nutrition and cervical lymph node metastasis of papillary thyroid microcarcinoma
    Hengqiang Zhao, Jin Hu, Le Cui, Yiping Gong, Tao Huang
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Sex-specific Associations between Body Mass Index and Thyroid Cancer Incidence among Korean Adults
    Kyoung-Nam Kim, Kyungsik Kim, Sangjun Lee, Sue K. Park
    Cancer Epidemiology, Biomarkers & Prevention.2023; 32(9): 1227.     CrossRef
  • Nomogram Model Based on Iodine Nutrition and Clinical Characteristics of Papillary Thyroid Carcinoma to Predict Lateral Lymph Node Metastasis
    Junrong Wang, Yuzhang Gao, Yuxuan Zong, Weitong Gao, Xueying Wang, Ji Sun, Susheng Miao
    Cancer Control.2023;[Epub]     CrossRef
  • Content of Copper, Iron, Iodine, Rubidium, Strontium and Zinc in Thyroid Malignant Nodules and Thyroid Tissue adjacent to Nodules
    Vladimir Zaichick, Qiping Dong
    Journal of Clinical and Diagnostic Pathology.2022; 1(4): 7.     CrossRef
  • Distinguish Thyroid Malignant from Benign Alterations using Trace Element Contents in Nodular Tissue determined by Neutron Activation and Inductively Coupled Plasma Mass Spectrometry
    Vladimir Zaichick
    Journal of Clinical and Diagnostic Pathology.2022; 1(4): 18.     CrossRef
  • Seaweed and Iodine Intakes and SLC5A5 rs77277498 in Relation to Thyroid Cancer
    Tung Hoang, Eun Kyung Lee, Jeonghee Lee, Yul Hwangbo, Jeongseon Kim
    Endocrinology and Metabolism.2022; 37(3): 513.     CrossRef
  • Iodine nutrition and papillary thyroid cancer
    Xueqi Zhang, Fan Zhang, Qiuxian Li, Chuyao Feng, Weiping Teng
    Frontiers in Nutrition.2022;[Epub]     CrossRef
  • The relationship between urinary iodine concentration and papillary thyroid cancer: A systematic review and meta-analysis
    Xueqi Zhang, Fan Zhang, Qiuxian Li, Renaguli Aihaiti, Chuyao Feng, Deshi Chen, Xu Zhao, Weiping Teng
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Screening and validation of lymph node metastasis risk-factor genes in papillary thyroid carcinoma
    Qiaoyue Zhang, Jing Li, Hengyan Shen, Xinyu Bai, Tao Zhang, Ping Liu
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Diagnosis of Thyroid Malignancy using Levels of Chemical Element Contents in Nodular Tissue
    Vladimir Zaichick
    Journal of Health Care and Research.2022; 3(1): 16.     CrossRef
  • Associations of Habitual Mineral Intake with New-Onset Prediabetes/Diabetes after Acute Pancreatitis
    Claire F. Norbitt, Wandia Kimita, Juyeon Ko, Sakina H. Bharmal, Maxim S. Petrov
    Nutrients.2021; 13(11): 3978.     CrossRef
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Thyroid
Clinicopathological Characteristics and Recurrence-Free Survival of Rare Variants of Papillary Thyroid Carcinomas in Korea: A Retrospective Study
Mijin Kim, Sun Wook Cho, Young Joo Park, Hwa Young Ahn, Hee Sung Kim, Yong Joon Suh, Dughyun Choi, Bu Kyung Kim, Go Eun Yang, Il-Seok Park, Ka Hee Yi, Chan Kwon Jung, Bo Hyun Kim
Endocrinol Metab. 2021;36(3):619-627.   Published online June 10, 2021
DOI: https://doi.org/10.3803/EnM.2021.974
  • 4,677 View
  • 179 Download
  • 6 Web of Science
  • 5 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
We aimed to evaluate the clinicopathological features and biological behaviors of Korean thyroid cancer patients with rare variants of papillary thyroid carcinoma (PTC) to address the ambiguity regarding the prognostic consequences of these variants.
Methods
We retrospectively reviewed the medical records of 5,496 patients who underwent thyroid surgery for PTC, between January and December 2012, in nine tertiary hospitals. Rare PTC variants included tall cell (TCV), columnar cell (CCV), diffuse sclerosing (DSV), cribriform-morular (CMV), solid (SV), hobnail, and Warthin-like variants. Recurrence-free survival (RFS) was defined as the time from the date of thyroidectomy until recurrence.
Results
Rare variants accounted for 1.1% (n=63) of the PTC patients; with 0.9% TCV, 0.02% CCV, 0.1% DSV, 0.1% CMV, and 0.1% SV. The mean age of patients and primary tumor size were 42.1±13.1 years and 1.3±0.9 cm, respectively. Extrathyroidal extension and cervical lymph node metastasis were observed in 38 (60.3%) and 37 (58.7%) patients, respectively. Ultrasonographic findings revealed typical malignant features in most cases. During a median follow-up of 7 years, 6.3% of patients experienced a locoregional recurrence. The 5-year RFS rates were 71.4% in patients with DSV or SV, 95.9% for TCV, or CCV, and 100% for other variants. DSV emerged an independent risk factor associated with shorter RFS.
Conclusion
In this multicenter Korean cohort, rare variants accounted for 1.1% of all PTC cases, with TCV being the most frequent subtype. DSV emerged as a significant prognostic factor for RFS.

Citations

Citations to this article as recorded by  
  • Serum thyroglobulin testing after thyroid lobectomy in patients with 1–4 cm papillary thyroid carcinoma
    Ahreum Jang, Meihua Jin, Chae A Kim, Min Ji Jeon, Yu-Mi Lee, Tae-Yon Sung, Tae Yong Kim, Won Bae Kim, Young Kee Shong, Won Gu Kim
    Endocrine.2023; 81(2): 290.     CrossRef
  • Do Histologically Aggressive Subtypes of Papillary Thyroid Microcarcinoma have Worse Clinical Outcome than Non-Aggressive Papillary Thyroid Microcarcinoma Subtypes? A Multicenter Cohort Study
    Sayid Shafi Zuhur, Hunkar Aggul, Ugur Avci, Selvinaz Erol, Mazhar Müslüm Tuna, Serhat Uysal, Gulhan Akbaba, Faruk Kilinç, Merve Catak, Sakin Tekin, Ogun Irem Bilen, Beyza Olcay Öztürk, Ecem Bilgehan Erden, Gulsah Elbuken, Halise Cinar Yavuz, Pinar Kadiogl
    Hormone and Metabolic Research.2023; 55(05): 323.     CrossRef
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    Xing Zhao, Yijia Zhang, Pengyu Hao, Mingzhen Zhao, Xingbin Shen
    Oncologie.2023; 25(5): 581.     CrossRef
  • A Retrospective Cohort Study with Validation of Predictors of Differentiated Thyroid Cancer Outcomes
    Ayanthi Wijewardene, Anthony J. Gill, Matti Gild, Diana L. Learoyd, Anthony Robert Glover, Mark Sywak, Stan Sidhu, Paul Roach, Geoffrey Schembri, Jeremy Hoang, Bruce Robinson, Lyndal Tacon, Roderick Clifton-Bligh
    Thyroid.2022;[Epub]     CrossRef
  • Clinicopathological Implications of the BRAFV600E Mutation in Papillary Thyroid Carcinoma of Ukrainian Patients Exposed to the Chernobyl Radiation in Childhood: A Study for 30 Years After the Accident
    Liudmyla Zurnadzhy, Tetiana Bogdanova, Tatiana I. Rogounovitch, Masahiro Ito, Mykola Tronko, Shunichi Yamashita, Norisato Mitsutake, Michael Bolgov, Serhii Chernyshov, Sergii Masiuk, Vladimir A. Saenko
    Frontiers in Medicine.2022;[Epub]     CrossRef
Close layer
Review Article
Thyroid
Tumor Cells and Cancer-Associated Fibroblasts: A Synergistic Crosstalk to Promote Thyroid Cancer
Laura Fozzatti, Sheue-yann Cheng
Endocrinol Metab. 2020;35(4):673-680.   Published online November 9, 2020
DOI: https://doi.org/10.3803/EnM.2020.401
  • 10,893 View
  • 246 Download
  • 19 Web of Science
  • 18 Crossref
AbstractAbstract PDFPubReader   ePub   
Thyroid cancer is the most common endocrine malignancy. Although most thyroid cancer patients are successfully treated and have an excellent prognosis, a percentage of these patients will develop aggressive disease and, eventually, progress to anaplastic thyroid cancer. Since most patients with this type of aggressive thyroid carcinoma will die from the disease, new treatment strategies are urgently needed. Tumor cells live in a complex and dynamic tumor microenvironment composed of different types of stromal cells. Cancer-associated fibroblasts (CAFs) are one of the most important cell components in the tumor microenvironment of most solid tumors, including thyroid cancer. CAFs originate mainly from mesenchymal cells and resident fibroblasts that are activated and reprogrammed in response to paracrine factors and cytokines produced and released by tumor cells. Upon reprogramming, which is distinguished by the expression of different marker proteins, CAFs synthesize and secret soluble factors. The secretome of CAFs directly impacts different functions of tumor cells. This bi-directional interplay between CAFs and tumor cells within the tumor microenvironment ends up fostering tumor cancer progression. CAFs are therefore key regulators of tumor progression and represent an under-explored therapeutic target in thyroid cancer.

Citations

Citations to this article as recorded by  
  • FAPi-Based Agents in Thyroid Cancer: A New Step towards Diagnosis and Therapy? A Systematic Review of the Literature
    Priscilla Guglielmo, Pierpaolo Alongi, Lucia Baratto, Miriam Conte, Elisabetta Maria Abenavoli, Ambra Buschiazzo, Greta Celesti, Francesco Dondi, Rossella Filice, Joana Gorica, Lorenzo Jonghi-Lavarini, Riccardo Laudicella, Maria Librando, Flavia Linguanti
    Cancers.2024; 16(4): 839.     CrossRef
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    Ece Ozmen, Tevriz Dilan Demir, Gulnihal Ozcan
    Frontiers in Molecular Biosciences.2024;[Epub]     CrossRef
  • Co-cultivation of human granulosa cells with ovarian cancer cells leads to a significant increase in progesterone production
    Detlef Pietrowski, Martina Grgic, Isabella Haslinger, Julian Marschalek, Christian Schneeberger
    Archives of Gynecology and Obstetrics.2023; 307(5): 1593.     CrossRef
  • Secretome of Stromal Cancer-Associated Fibroblasts (CAFs): Relevance in Cancer
    Deepshikha Mishra, Debabrata Banerjee
    Cells.2023; 12(4): 628.     CrossRef
  • Head-to-Head Comparison of [68Ga]Ga-DOTA.SA.FAPi and [68Ga]Ga-DOTANOC Positron Emission Tomography/Computed Tomography Imaging for the Follow-Up Surveillance of Patients with Medullary Thyroid Cancer
    Sanjana Ballal, Madhav Prasad Yadav, Frank Roesch, Shobhana Raju, Swayamjeet Satapathy, Parvind Sheokand, Euy Sung Moon, Marcel Martin, Shipra Awarwal, Madhavi Tripathi, Chandrasekhar Bal
    Thyroid®.2023; 33(8): 974.     CrossRef
  • Head-to-head comparison of [68Ga]Ga-DOTA.SA.FAPi with [18F]F-FDG PET/CT in radioiodine-resistant follicular-cell derived thyroid cancers
    Sanjana Ballal, Madhav P. Yadav, Frank Roesch, Swayamjeet Satapathy, Euy Sung Moon, Marcel Martin, Nicky Wakade, Parvind Sheokand, Madhavi Tripathi, Kunal R. Chandekar, Shipra Agarwal, Ranjit Kumar Sahoo, Sameer Rastogi, Chandrasekhar Bal
    European Journal of Nuclear Medicine and Molecular Imaging.2023; 51(1): 233.     CrossRef
  • Identifying the cancer-associated fibroblast signature to predict the prognosis and immunotherapy response in patients with lung squamous cell carcinoma
    Yinhui Zhu, Yingqun Zhu, Sirui Chen, Qian Cai
    Computer Methods in Biomechanics and Biomedical Engineering.2023; : 1.     CrossRef
  • Roles and new Insights of Macrophages in the Tumor Microenvironment of Thyroid Cancer
    Qi Liu, Wei Sun, Hao Zhang
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • Rab22a Promotes Epithelial-Mesenchymal Transition in Papillary Thyroid Carcinoma by Activating PI3K/AKT/mTOR Signaling Pathway
    Xue Luo, Jinping Wang, Jinxi Lu, Xi Wang, Yuan Miao, Qingchang Li, Xiaoman Li, Liang Wang, Yong Xin Ma
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Close layer
Original Article
Clinical Study
Clinical Implication of World Health Organization Classification in Patients with Follicular Thyroid Carcinoma in South Korea: A Multicenter Cohort Study
Meihua Jin, Eun Sook Kim, Bo Hyun Kim, Hee Kyung Kim, Hyon-Seung Yi, Min Ji Jeon, Tae Yong Kim, Ho-Cheol Kang, Won Bae Kim, Young Kee Shong, Mijin Kim, Won Gu Kim
Endocrinol Metab. 2020;35(3):618-627.   Published online September 22, 2020
DOI: https://doi.org/10.3803/EnM.2020.742
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AbstractAbstract PDFPubReader   ePub   
Background
The study aimed to compare the prognostic value of the 4th edition of World Health Organization classification (WHO-2017) with the previous WHO classification (WHO-2004) for follicular thyroid carcinoma (FTC).
Methods
This multicenter retrospective cohort study included 318 patients with FTC from five tertiary centers who underwent thyroid surgery between 1996 and 2009. We evaluated the prognosis of patients with minimally invasive (MI), encapsulated angioinvasive (EA), and widely invasive (WI) FTC according to WHO-2017. Further, we evaluated the proportion of variation explained (PVE) and Harrell’s C-index to compare the predictability of disease-free survival (DFS) and disease-specific survival (DSS).
Results
In total, 227, 58, and 33 patients had MI-, EA-, and WI-FTC, respectively. During a median follow-up of 10.6 years, 46 (14.5%) patients had disease recurrence and 20 (6.3%) patients died from FTC. The 10-year DFS rates of patients with MI-, EA-, and WI-FTC were 91.1%, 78.2%, and 54.9%, respectively (P<0.001, PVE=7.1%, C-index=0.649). The corresponding 10-year DSS rates were 95.9%, 93.5%, and 73.5%, respectively (P<0.001, PVE=2.6%, C-index=0.624). The PVE and C-index values were higher using WHO-2017 than using WHO-2004 for the prediction of DFS, but not for DSS. In multivariate analysis, older age (P=0.02), gross extrathyroidal extension (ETE) (P=0.003), and distant metastasis (P<0.001) were independent risk factors for DSS.
Conclusion
WHO-2017 improves the predictability of DFS, but not DSS, in patients with FTC. Distant metastasis, gross ETE and older age (≥55 years) were independent risk factors for DSS.

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Close layer
Review Article
Thyroid
Recent Improvements in Genomic and Transcriptomic Understanding of Anaplastic and Poorly Differentiated Thyroid Cancers
Seong-Keun Yoo, Young Shin Song, Young Joo Park, Jeong-Sun Seo
Endocrinol Metab. 2020;35(1):44-54.   Published online March 19, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.1.44
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AbstractAbstract PDFPubReader   ePub   

Anaplastic thyroid cancer (ATC) is a lethal human cancer with a 5-year survival rate of less than 10%. Recently, its genomic and transcriptomic characteristics have been extensively elucidated over 5 years owing to advance in high throughput sequencing. These efforts have extended molecular understandings into the progression mechanisms and therapeutic vulnerabilities of aggressive thyroid cancers. In this review, we provide an overview of genomic and transcriptomic alterations in ATC and poorly-differentiated thyroid cancer, which are distinguished from differentiated thyroid cancers. Clinically relevant genomic alterations and deregulated signaling pathways will be able to shed light on more effective prevention and stratified therapeutic interventions for affected patients.

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Close layer
Original Articles
Clinical Study
Protein Expression of Cyclin B1, Transferrin Receptor, and Fibronectin Is Correlated with the Prognosis of Adrenal Cortical Carcinoma
Sun Joon Moon, Jung Hee Kim, Sung Hye Kong, Chan Soo Shin
Endocrinol Metab. 2020;35(1):132-141.   Published online March 19, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.1.132
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Adrenal cortical carcinoma (ACC) is a rare cancer with a variable prognosis. Several prognostic factors of ACC have been previously reported, but a proteomic analysis has not yet been performed. This study aimed to investigate prognostic biomarkers for ACC using a proteomic approach.

Methods

We used reverse-phase protein array data from The Cancer Proteome Atlas, and identified differentially expressed proteins in metastatic ACCs. Multivariate Cox regression analysis adjusted by age and staging was used for survival analysis, and the C-index and category-free net reclassification improvement (cfNRI) were utilized to evaluate additive prognostic value.

Results

In 46 patients with ACC, cyclin B1, transferrin receptor (TfR1), and fibronectin were significantly overexpressed in patients with distant metastasis. In multivariate models, high expression of cyclin B1 and TfR1 was significantly associated with mortality (hazard ratio [HR], 6.13; 95% confidence interval [CI], 1.02 to 36.7; and HR, 6.59; 95% CI, 1.14 to 38.2; respectively), whereas high fibronectin expression was not (HR, 3.92; 95% CI, 0.75 to 20.4). Combinations of high cyclin B1/high TfR1, high cyclin B1/high fibronectin, and high TfR1/high fibronectin were strongly associated with mortality ([HR, 13.72; 95% CI, 1.89 to 99.66], [HR, 9.22; 95% CI, 1.34 to 63.55], and [HR, 18.59; 95% CI, 2.54 to 135.88], respectively). In reclassification analyses, cyclin B1, TfR1, fibronectin, and combinations thereof improved the prognostic performance (C-index, 0.78 to 0.82–0.86; cfNRI, all P values <0.05).

Conclusion

In ACC patients, the overexpression of cyclin B1, TfR1, and fibronectin and combinations thereof were associated with poor prognosis.

Citations

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Close layer
Clinical Study
Quality of Life in Patients with Papillary Thyroid Microcarcinoma According to Treatment: Total Thyroidectomy with or without Radioactive Iodine Ablation
Jonghwa Ahn, Min Ji Jeon, Eyun Song, Tae Yong Kim, Won Bae Kim, Young Kee Shong, Won Gu Kim
Endocrinol Metab. 2020;35(1):115-121.   Published online March 19, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.1.115
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AbstractAbstract PDFPubReader   ePub   
Background

Recently, there has been some controversy regarding the role of radioactive iodine (RAI) ablation in the treatment of low-risk differentiated thyroid carcinoma (DTC), especially papillary thyroid microcarcinoma (PTMC). This study aimed to compare quality of life (QoL) parameters between patients with PTMC who underwent total thyroidectomy (TT) alone and those who underwent TT with RAI ablation.

Methods

In this cross-sectional study, patients with PTMC who underwent TT with/without RAI remnant ablation were prospectively enrolled between June 2016 and October 2017. All patients completed three questionnaires: the 12-item short-form health survey (SF-12), thyroid cancer-specific quality of life (THYCA-QoL) questionnaire, and fear of progression (FoP) questionnaire.

Results

The TT and TT with RAI groups comprised 107 and 182 patients, respectively. The TT with RAI group had significantly lower serum thyrotropin (TSH) levels than the TT group. However, after matching for TSH levels between the groups (n=100 in both groups), there were no significant differences in baseline characteristics. According to the SF-12, the score for general health was significantly lower in the TT with RAI group than in the TT group (P=0.047). The THYCA-QoL also showed a significant difference in the “felt chilly” score between groups (P=0.023). No significant differences in FoP scores were observed between the groups.

Conclusion

Patients with PTMC who underwent TT with RAI ablation experienced more health-related problems than those managed with TT alone. These findings support the idea that RAI ablation should be carefully considered in patients with low-risk DTCs.

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Close layer
Case Reports
A Case of Follicular Carcinoma Associated with Hashimoto's Thyroiditis Arising in a Thyroglossal Duct Remnant.
Jin Choi, Jun Cheol Lee, Sun Mi Park, Tae Joon Cha, Hark Rim, Young Sik Choi, Yo Han Park, Hee Kyung Chang
J Korean Endocr Soc. 1996;11(3):336-342.   Published online November 7, 2019
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AbstractAbstract PDF
Thyroglossal duct remnants are common congenital abnormalities of the thyroid development but malignant tumors arising in the thyroglossal duct remnants are rare, occuring in less than 1%. In the literature, about 160 cases of malignancy in the thyroglossal duct remnant have been reported. Among the various types of carcinoma being found from the thyroglossal duct remnants, most are papillary carcinoma(79.8%) and Mixed follicular-papillary carcinoma(9.5%). Others are squamous cell carcinoma(7.6%), follicular carcinoma(1.2%), and anaplastic carcinoma(0.6%). Hashimotos thyroiditis is a common autoimmune disease of the thyroid gland. Malignant tumors of the thyroid gland with Hashimotos thyroiditis are rare disorder except malignant lymphoma whose association with Hashimotos thyroiditis is well known. Malignant tumors associated with Hashimotos thyroiditis arising in a thyroglossal duct remnant are extremely rare. Recently the authors experienced a case of follicular carcinoma associated with Hashimotos thyroiditis arising in a thyroglossal duct remnant, which was removed by local excision and reported with literature review.
Close layer
A Case of Primary Parathyroid Carcinoma with full-brown Symptom.
Chang Soo Ryu, Deok Ki Kim, Kee Hyun Park, Shi Gyeong Seong, Dong Ho Kim, Sang Min Woo, In Sung Cho
J Korean Endocr Soc. 1996;11(2):221-226.   Published online November 7, 2019
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AbstractAbstract PDF
Primary hyperparathyroicism is a state of hypersecretion of PTH by the parathyroid. The etiology has not been established. The three possible etiologies of piimary hyperparathyroidism and incidences are adencena(83%), hyperplasia(15%), and carcinoma(1~2%). Parathyroid carcinoma usually presents in the fourth decades. The hallmark preoperative signs are hypercalcemia(serum calcium 15mg/dl). Palpable neck mass and bane and renal disease. Patients may present with multiple signs and syrnptoms, including recurrent nephrolithiasis, peptic ulcers, mental change, less frequently, extensive bone resorption. However, with greater awareness of the disease and wider use of screening tests, including blood calcium determinations, the diagnosis is frequently made in patients who have no symptoms and minimal, if any, signs of the disease ather than hypercalcemia and elevated levels of parathyroid Hormone. An 38-years-old woman was admitted to the hospital due to pain on the left knee joint. We experienced full-brown symptom pertaining to hyperpara- thyroidism. Thus we report a case herein and also discuss clinical anifestation, histologic features and treatment.
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A Case of Subsequent Papillary Carcinoma of the Thyroid gland and Hashimoto's Thyroiditis.
Sang Woong Han, Yong Seon So, Seok Hwan Kim, Ki Hyun Kwon, Tae Hyeung Kim, Jong Soon Kim, Kwang Hoe Kim, Byung Doo Lee
J Korean Endocr Soc. 1996;11(2):214-220.   Published online November 7, 2019
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The association of thyroid carcinoma and Hashimotos thyroiditis in same thyroid gland is controversial. Incidence of carcinoma who has Hashimotos thyroiditis has been reported from 0.5 to 22.5 per cent by Crile and by Hirabayashi et al. The reason that there are such great diffarences in the reported incidences of carcinoma in Hashimotos disease is the result of the way the material is reported. The carcinomas of the thyroid which occur in association with Hashirnotos thyroiditis are predominently papillary tumors of lower grade malignancy. Thyroid carcinoma need not be feared in patimts with Hashimotos thymiditis, if one examines the ghmd catefully. When patients with Hashimotos disease are treated with thyroxine, there is little or no tendency for Hashimotos disease propess to clinieally detectable carcinoma of the thymid, and the microcarcinoma does not appear. In this case, single thyroid nodule was detected in Hashiimotos disease patient who was treated with thyroxine. There was no significant volume change of thyroid nodule despite of TSH suppression therapy during six months. Therefore we perforrned FNABC twice, the results were highly suspicious thyroid malignancy and subtotoal thyroidectomy was performed. The final pathologic result was microscopic papillary carcinoma with background Hashlmotos thyroiditis. In conclusion, we experienced a case of subsequent microscopic papillary carcinoma of the thyroid in patient with Hashimotos thyroiditis who was TSH suppression therapy with thyroxine.
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Endocrinol Metab : Endocrinology and Metabolism