Endocrinology and Metabolism

Original Articles

Value of the Inflammatory Burden Index in the Diagnosis and Prognosis of Subacute Thyroiditis: Sumei Wang, Jing Lu, Rui Guo, Xueyang Wang, Bijun Tong, Yan Shen, Hongxiang Xie; Received September 4, 2025 Accepted January 23, 2026 Published online May 6, 2026; DOI: https://doi.org/10.3803/EnM.2025.2642 [Epub ahead of print]

224 View
12 Download

Abstract PDF: Background
This study sought to assess the utility of the inflammatory burden index (IBI) in differentiating subacute thyroiditis (SAT) from Graves’ disease (GD) and to investigate its association with recovery time, hepatic function impairment, recurrence, and permanent hypothyroidism in patients with SAT.
Methods
Clinical and laboratory data from 357 adult patients with SAT, 412 patients with GD, and 633 healthy controls were retrospectively analyzed. Determinants influencing recovery time, hepatic function impairment, recurrence, and permanent hypothyroidism in patients with SAT were systematically evaluated.
Results
The IBI in the SAT cohort was markedly higher than that observed in both patients with GD and healthy controls. Receiver operating characteristic curve analysis indicated that the optimal IBI cutoff value for distinguishing SAT from GD was 9.13, yielding a diagnostic sensitivity of 90.76%, a specificity of 88.35%, and an area under the curve (AUC) of 0.944 (95% confidence interval, 0.927 to 0.961). The AUC for IBI was markedly superior to those for erythrocyte sedimentation rate (ESR), C-reactive protein, systemic immune-inflammation index, and other complete blood count-derived indices. Among patients with painless SAT, the IBI was markedly elevated compared with that in thyroid-stimulating hormone receptor antibody (TRAb)-negative GD patients. Stepwise multiple logistic regression identified ESR, IBI, free thyroxine, and thyroid-stimulating hormone as independent predictive factors for SAT. IBI was not associated with recovery time in patients with SAT. However, higher IBI values were observed in patients requiring glucocorticoid therapy due to an insufficient response to non-steroidal anti-inflammatory drugs. Furthermore, no significant associations were identified between IBI and hepatic function impairment, recurrence, or permanent hypothyroidism in patients with SAT.
Conclusion
IBI, as a simple and practical inflammatory biomarker, could potentially serve as a valuable diagnostic tool for differentiating SAT, particularly in diagnostically challenging cases. Moreover, it may have clinical relevance in guiding therapeutic decision- making for patients with SAT.

Thyroid
Unexpected Cancellation of Radioactive Iodine Treatment after Thyroid Hormone Withdrawal: Lessons from a Case Series: Hye-Seon Oh, Won Gu Kim, Won Bae Kim, Jin-Sook Ryu, Min Ji Jeon, Tae Yong Kim; Endocrinol Metab. 2026;41(2):300-307. Published online April 8, 2026; DOI: https://doi.org/10.3803/EnM.2025.2798

726 View
21 Download

Abstract PDF Supplementary Material PubReader ePub: Background
Radioactive iodine treatment (RAIT) is an essential therapy for differentiated thyroid cancer. However, unforeseen complications arising during thyroid hormone withdrawal (THW) can lead to Cancellation of the scheduled treatment. This study aimed to identify cases in which THW-RAIT was discontinued due to THW-related complications and to explore potentially preventable causes to improve patient management.
Methods
Among 4,174 patients who underwent THW-RAIT between 2012 and 2024, 39 did not complete the planned treatment. After excluding Cancellations unrelated to THW, 11 (0.26%) patients with unexpected THW-related medical issues were analyzed.
Results
The median age of the included patients was 61 years (range, 23 to 70), and 10 were male. The reasons for THW-RAIT Cancellation were hyponatremia (n=1), abnormal liver function (n=1), renal dysfunction (n=3), and combined liver and renal dysfunction (n=6). The patient with hyponatremia was taking a thiazide diuretic. Most cases of liver dysfunction were associated with prior use of herbal medications, whereas renal dysfunction was linked to diuretic or nonsteroidal anti-inflammatory drug use, pre-existing conditions such as single kidney or diabetic nephropathy, or inadequate oral intake during low-iodine preparation. Two cases of concurrent liver and renal dysfunction were attributed to rhabdomyolysis following intense exercise or heavy physical labor.
Conclusion
Enhanced patient education, comprehensive pre-treatment assessment, and careful avoidance of high-risk medications are essential to prevent THW-related complications and minimize disruptions in RAIT.

Thyroid
Impact of Tumor Bilaterality and Multifocality in Predicting Recurrence of Papillary Thyroid Carcinoma: A Retrospective Cohort Study: Eunji Kim, Jun Hyun Park, Ji-Young Park, Jin Hyang Jung, Sang-Woo Lee; Endocrinol Metab. 2026;41(2):288-299. Published online March 4, 2026; DOI: https://doi.org/10.3803/EnM.2025.2607

820 View
41 Download

Abstract PDF Supplementary Material PubReader ePub: Background
This study investigated the prognostic value of bilaterality and multifocality in papillary thyroid carcinoma (PTC) recurrence, aiming to inform optimal surgical strategies.
Methods
In this retrospective cohort, 1,966 patients who underwent total thyroidectomy for PTC (2011–2014) were categorized into four groups according to tumor multifocality and bilaterality confirmed by postoperative histopathology: group 1, unilateral solitary; group 2, unilateral multifocal; group 3, bilateral solitary; group 4, bilateral multifocal. Clinicopathologic features and clinical outcomes were compared across these groups.
Results
Group 4 exhibited the highest prevalence of BRAFV600E positivity, nodal metastases, and recurrence. Both bilaterality and multifocality were associated with more aggressive clinicopathologic characteristics. Recurrence risk increased with the number of tumor foci, with the odds ratio (OR) significantly elevated for more than five foci. Satellite pattern was strongly linked to recurrence (OR, 19.49; P<0.001). While tumor multifocality (≥5 foci) and bilaterality were associated with recurrence in univariate analyses, these associations were not independent after adjustment. Kaplan-Meier analysis demonstrated the lowest recurrence-free survival (RFS) in group 4. Patients with bilateral disease had significantly lower RFS than those with unilateral disease (P=0.003), whereas multifocality did not significantly affect RFS compared to solitary disease (P=0.095).
Conclusion
Tumor bilaterality, multifocality (≥5 foci), and satellite pattern were associated with aggressive features and higher recurrence risk. Although not independent predictors, these factors may serve as useful surrogate markers of aggressive disease biology and help guide personalized surgical strategies in patients with PTC.

Review Article

Miscellaneous Big Data Articles (National Health Insurance Service Database)
Nationwide Big Data Studies of Endocrine Diseases Using the Korean National Health Information Database: Research Trends and Standardization of Operational Definitions: Sun Wook Cho, Jung Hee Kim, Kyoung Jin Kim, Beom-Jun Kim, Mee Kyoung Kim, Eun Jung Rhee; Endocrinol Metab. 2026;41(1):86-104. Published online February 26, 2026; DOI: https://doi.org/10.3803/EnM.2026.2953

1,277 View
42 Download
1 Web of Science
1 Crossref

Abstract PDF PubReader ePub

The Korean National Health Information Database (NHID) is a large-scale dataset created through linkage of National Health Insurance claims with nationwide health screening records. Because it is released in a cohort-based format, the NHID enables longitudinal follow-up and allows investigation of rare endocrine conditions with low population prevalence. Mortality data, including both dates and causes of death, are additionally obtained through linkage with Statistics Korea. Over recent years, use of the NHID has expanded rapidly, establishing it as a major resource for epidemiological research in endocrinology. Nevertheless, because the database was originally developed for administrative and screening purposes rather than for research, investigators face several methodological limitations, particularly the need to construct and validate robust operational definitions of diseases. In this review, we describe the key features of the Korean NHID, summarize operational definitions of endocrine disorders that have been applied in prior research, and provide an overview of recent endocrine studies conducted using this database.

Citations

Citations to this article as recorded by

Age-specific loss of life expectancy after hip fracture in Asian adults: A nationwide population-based cohort study
Kyoung Jin Kim, Su Jin Kwon, Seunghyun Lee, Seong Hee Ahn, So Young Park, Ha-Young Kim, Kyoung Min Kim
Bone.2026; 208: 117896. CrossRef

Namgok Lecture 2025

Mineral, bone & muscle
Current Knowledge on Atypical Parathyroid Tumors and Emerging Strategies for Risk Stratification: Hye-Sun Park, Milim Kim, Jong Ju Jeong, Namki Hong, Yumie Rhee; Endocrinol Metab. 2026;41(1):14-25. Published online January 7, 2026; DOI: https://doi.org/10.3803/EnM.2025.2846

1,413 View
66 Download

Abstract PDF PubReader ePub: Atypical parathyroid tumors (APTs) are an uncommon subset of parathyroid neoplasms that carry substantial clinical relevance because of their histological and clinical resemblance to parathyroid cancer. Despite this importance, the diagnosis of APTs remains persistently challenging, even for experienced pathologists. Their histopathological features overlap extensively with those of parathyroid cancer, and at present, no specific immunohistochemical markers are available that can reliably distinguish between these entities. Moreover, the clinical manifestations of APTs are indistinguishable from those of parathyroid adenomas or true parathyroid cancer. A major concern is the uncertain malignant potential of APTs, which contributes to difficulties in prognostic prediction and the absence of standardized surveillance guidelines. Although most published studies suggest a benign clinical course for the majority of APTs, these conclusions are frequently limited by relatively short follow-up durations. This limitation is underscored by several case reports describing recurrence or metastatic disease in patients initially diagnosed with APTs, subsequently prompting reclassification as parathyroid cancer. Recent advances in molecular technologies, particularly RNA sequencing and genomic profiling, have facilitated novel approaches to risk assessment and prognostic evaluation in APTs. This review aims to provide a comprehensive overview of the diagnosis, clinical manifestations, and current molecular strategies used to assess the malignant potential of APTs.

Review Article

Thyroid
Diagnostic Challenges, Prognostic Assessment, and Treatment Strategies in High-Grade Differentiated Thyroid Carcinoma: Chan Kwon Jung, Agnes Stephanie Harahap; Endocrinol Metab. 2025;40(6):830-850. Published online December 11, 2025; DOI: https://doi.org/10.3803/EnM.2025.2725

1,901 View
95 Download

Abstract PDF PubReader ePub: High-grade differentiated thyroid carcinoma (HGDTC) is a recently codified entity in the 2022 World Health Organization Classification of Endocrine Tumors, defined by a mitotic count of ≥5 mitoses per 2 mm² and/or tumor necrosis in a carcinoma that retains papillary, follicular, or oncocytic differentiation without anaplastic morphology. Although uncommon, HGDTC presents significant diagnostic and therapeutic challenges. This review summarizes current evidence regarding histopathologic recognition, molecular features, prognostic determinants, and evolving treatment paradigms. Particular attention is given to pattern-specific pitfalls such as high-grade papillary thyroid carcinoma, the diffuse sclerosing subtype, and the prognostic influence of the invasion phenotype (encapsulated versus infiltrative). Subcentimeter papillary carcinomas exhibiting increased mitotic activity alone should not be overinterpreted as HGDTC. An integrated, stepwise approach is proposed to enhance diagnostic reproducibility, refine risk stratification, and optimize multidisciplinary management in clinical practice.

Original Articles

Thyroid Big Data Articles (National Health Insurance Service Database)
A Comparative Evaluation of Three Time-to-Event Models Predicting 5-Year Osteoporosis Risk in Thyroid Cancer Survivors: A Nationwide Cohort Study: Young Bin Cho, Kyoung Sik Park; Endocrinol Metab. 2026;41(1):174-184. Published online December 3, 2025; DOI: https://doi.org/10.3803/EnM.2025.2478

1,194 View
31 Download

Abstract PDF Supplementary Material PubReader ePub: Background
Osteoporosis is a common complication among thyroid cancer survivors; however, predictive tools for this condition remain inadequate. This study aimed to develop time-to-event prediction models for assessing osteoporosis risk in thyroid cancer patients.
Methods
Using the Korean National Health Insurance Service claims database, we identified 3,089 patients newly diagnosed with thyroid cancer between 2004 and 2014. Patients were randomly divided into training and test datasets in a 7:3 ratio. Three time-toevent models were constructed: random survival forest, Boruta-Cox proportional hazards, and least absolute shrinkage and selection operator (LASSO)-penalized Cox models, with feature selection and five-fold cross-validation. Model performance was evaluated using time-dependent area under the curve, Harrell’s concordance index (C-index), and risk stratification analysis.
Results
Among thyroid cancer survivors with a median follow-up of 4.2 years, the 5-year cumulative incidence of osteoporosis was 21%. The Boruta-Cox proportional hazards model achieved the highest C-index of 0.72 (95% confidence interval [CI], 0.68 to 0.75), outperforming the random survival forest (0.68 [95% CI, 0.65 to 0.71]) and the LASSO-penalized Cox model (0.64 [95% CI, 0.61 to 0.68]). Risk stratification analysis showed that all three models significantly distinguished between low- and high-risk groups (P<0.001).
Conclusion
This study constructed well-performing prediction models for estimating osteoporosis risk in thyroid cancer survivors, demonstrating their utility in risk stratification.

Thyroid
Investigating Birth and Thyroid Outcomes of Maternal-Fetal Environmental Exposures (IBM-E): A Cohort Protocol for Dietary Iodine and Endocrine Disruptors: Yun Ji Jung, Jeong Eun Shin, Ju-hee Yoon, Suhra Kim, Hayan Kwon, Sungbo Shim, Dong Yeob Shin, Minseo Gim, Younglim Kho, JoonHo Lee; Endocrinol Metab. 2025;40(6):940-949. Published online September 25, 2025; DOI: https://doi.org/10.3803/EnM.2025.2475

1,662 View
79 Download

Abstract PDF Supplementary Material PubReader ePub: Background
Endocrine-disrupting chemicals (EDCs) are environmental pollutants that may impair maternal and fetal health by disrupting hormonal systems, including the thyroid. Both iodine deficiency and excess are associated with thyroid dysfunction and adverse obstetrical outcomes. However, the combined impacts of EDCs and iodine exposure on maternal-fetal thyroid homeostasis remain undetermined. We established the Investigating Birth and Thyroid Outcomes of Maternal-Fetal Environmental Exposures (IBM-E) cohort to prospectively assess the effects of maternal exposures to dietary iodine and EDCs on thyroid function, pregnancy complications, and offspring growth and development.
Methods
In this prospective observational study, we aim to enroll 556 pregnant women between 2024 and 2027 at a tertiary hospital in Korea. Maternal blood and urine samples will be collected at six time points, spanning from early pregnancy through 15 months postpartum, with infant samples collected at three time points. EDCs will be quantified using ultra-high performance liquid chromatography-tandem mass spectrometry. Thyroid function and urinary iodine concentration will be measured in both mothers and infants.
Results
As of the current interim analyses of 193 mothers and 229 neonates, 15.0% of mothers had thyroid dysfunction and 11.4% developed preeclampsia. Preterm birth occurred in 23.8% of cases, and 16.6% of neonates were small for gestational age.
Conclusion
The IBM-E cohort is designed to enable the longitudinal assessment of gestational environmental exposures and their potential impacts on maternal and fetal thyroid function, as well as pregnancy and neonatal outcomes. The findings of this study may inform preventive strategies and guide policy development in perinatal environmental health.

Thyroid
High TRAb Titer at Diagnosis Predicts Persistent Positivity and Relapse in Graves’ Disease after Prolonged Antithyroid Therapy: Zimiao Chen, Jinglu Xu, Wenrui Kang, Yang Zhang, Rujun Chen, Xiaohua Gong; Endocrinol Metab. 2025;40(6):950-960. Published online September 16, 2025; DOI: https://doi.org/10.3803/EnM.2025.2405

4,595 View
117 Download
1 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
The association between high thyrotropin receptor antibody (TRAb) titers at diagnosis and long-term outcomes following prolonged antithyroid drug (ATD) therapy in Graves’ disease (GD) remains unclear. This study examined TRAb dynamics and outcomes in high-titer patients receiving prolonged ATD.
Methods
In this retrospective cohort (2018–2021), 1,148 of 3,052 newly diagnosed GD patients met inclusion criteria (≥18-month ATD course, TRAb negativity before withdrawal, and ≥12-month follow-up). Initial TRAb levels were defined as low-titer (<5.25 IU/L, 3×upper normal limit [UNL]), intermediate-titer (5.25–10.5 IU/L), and high-titer (>10.5 IU/L, 6×UNL). Outcomes included TRAb dynamics, treatment duration, and relapse.
Results
High-titer patients required longer therapy (50 months vs. 30 months vs. 22 months, P<0.001) and slower thyroid-stimulating hormone normalization (6 months vs. 4 months vs. 2 months, both P<0.001). TRAb negativity at 24/48 months occurred in 91.85%/99.26% (low-titer), 52.38%/75.24% (intermediate-titer), and 12.70%/52.68% (high-titer) (P<0.001). High-titer patients showed fluctuant (46.20%) or smoldering (28.89%) trends. Remission rates declined with higher TRAb titer (60.45% vs. 42.70% vs. 30.47%, P<0.001). High-titer patients showed increased risk of persistent TRAb positivity (2.17-fold; 95% confidence interval [CI], 1.55 to 3.05) and relapse (1.66-fold; 95% CI, 1.45 to 3.22). Thresholds of 10.90 IU/L and 16.01 IU/L predicted positivity and relapse, respectively. Definitive therapy post-relapse was more common in high-titer patients (38.29% vs. 16.98% in low-titer, P<0.001).
Conclusion
High TRAb titers strongly predict persistent TRAb positivity and relapse after ATD withdrawal. Cut-off at 10.90 and 16.01 IU/L may guide prognosis and treatment.

Citations

Citations to this article as recorded by

Peripartum Management of Refractory Graves’ Thyrotoxicosis
Sonam Tshering, Ashutosh Kapoor, Sophie Buckley, Fareeha Rizvi
Cureus.2026;[Epub] CrossRef

Review Articles

Thyroid
The Initial Risk Stratification System for Differentiated Thyroid Cancer: Key Updates in the 2024 Korean Thyroid Association Guideline: Shinje Moon, Young Shin Song, Kyong Yeun Jung, Eun Kyung Lee, Jeongmin Lee, Dong-Jun Lim, Chan Kwon Jung, Young Joo Park, on Behalf of the Korean Thyroid Association Clinical Guideline Committee; Endocrinol Metab. 2025;40(3):357-384. Published online June 24, 2025; DOI: https://doi.org/10.3803/EnM.2025.2465

8,261 View
248 Download
5 Web of Science
8 Crossref

Abstract PDF Supplementary Material PubReader ePub

In 2024, the Korean Thyroid Association (KTA) introduced a revised Risk Stratification System (K-RSS) for differentiated thyroid cancer, building upon the modified RSS (M-RSS) proposed by the American Thyroid Association in 2015. The K-RSS emphasizes the cumulative impact of coexisting clinical and pathological features, acknowledging that multiple intermediate-risk factors collectively indicate a higher recurrence risk. Histologic classification follows the 2022 World Health Organization classification, consolidating encapsulated follicular-patterned thyroid carcinomas, including invasive encapsulated follicular variant papillary thyroid carcinoma, follicular thyroid carcinoma, and oncocytic carcinoma of the thyroid gland, and stratifying them by the extent of capsular and vascular invasion. High-grade thyroid carcinoma is newly included. Updated criteria for tumor size and extrathyroidal extension (ETE) represent another significant change. BRAF^V600E-mutated papillary thyroid carcinomas measuring 1 to 2 cm are now considered lower risk than previously classified in the M-RSS, while encapsulated follicular-patterned tumors larger than 4 cm are considered higher risk. Both minimal ETE and gross ETE confined to the strap muscles have been downgraded to low and intermediate risk, respectively. These changes are accompanied by updates regarding molecular profiling and surgical margin status. Collectively, these updates aim to minimize overtreatment in low-risk patients, while ensuring intensified management for those at higher risk.

Citations

Citations to this article as recorded by

Development and validation of a machine learning model for predicting high-risk distant metastatic recurrence in differentiated thyroid cancer
Fei Yang, Jie Zhang, Tengfei Liu, Zhijun Zhao
Frontiers in Medicine.2026;[Epub] CrossRef
Impact of Tumor Bilaterality and Multifocality in Predicting Recurrence of Papillary Thyroid Carcinoma: A Retrospective Cohort Study
Eunji Kim, Jun Hyun Park, Ji-Young Park, Jin Hyang Jung, Sang-Woo Lee
Endocrinology and Metabolism.2026; 41(2): 288. CrossRef
Positive prognostic implications of SPHK1 expression in patients with papillary thyroid carcinoma undergoing radioactive iodine therapy
Kyung Won Park, Ja Seong Bae, Dong-Jun Lim, Chan Kwon Jung
Scientific Reports.2026;[Epub] CrossRef
Overdiagnosis and Overtreatment of Thyroid Cancer and Precision Mitigation Strategies—An Integrated Analysis Based on Evidence-Based Medicine and Risk Stratification Models
云菲李
Advances in Clinical Medicine.2026; 16(04): 4980. CrossRef
Who Really Needs RAI Ablation Therapy for Low-to-Intermediate Risk Differentiated Thyroid Cancer? Insights from the IoN Trial
Young Joo Park
Clinical Thyroidology®.2025; 37(9): 323. CrossRef
From Classification to Personalization: Advances in Thyroid Cancer Risk Stratification Systems
Mijin Kim, Bo Hyun Kim
Endocrinology and Metabolism.2025; 40(5): 689. CrossRef
Thyroglobulin Cutoffs after Total Thyroidectomy Without Radioiodine in Low- to Intermediate-Risk Thyroid Cancer: A Multicenter Cohort Study
Mijin Kim, Eun Kyung Lee, Kyeong Jin Kim, Soo Myoung Shin, Jinsun Jang, Je Yoon Shin, Meihua Jin, Ja Seong Bae, Kwangsoon Kim, Won Gu Kim, Min Ji Jeon, Seung Heon Kang, Hee Kyung Kim, Jee Hee Yoon, Yea Eun Kang, Hwa Young Ahn, Young Joo Park, Bo Hyun Kim
Thyroid®.2025;[Epub] CrossRef
Diagnostic Challenges, Prognostic Assessment, and Treatment Strategies in High-Grade Differentiated Thyroid Carcinoma
Chan Kwon Jung, Agnes Stephanie Harahap
Endocrinology and Metabolism.2025; 40(6): 830. CrossRef

Thyroid
2025 Korean Thyroid Association Management Guidelines for Radioactive Iodine Therapy in Patients with Hyperthyroidism: Kyeong Jin Kim, Eyun Song, Mijin Kim, Hyemi Kwon, Eu Jeong Ku, Hyun Woo Kwon, Jee Hee Yoon, Eun Kyung Lee, Won Woo Lee, Young Joo Park, Dong-Jun Lim, Sun Wook Kim, Ho-Cheol Kang, Jae Hoon Chung, Tae Yong Kim, Sin Gon Kim, Dong Gyu Na, Jee Soo Kim; Endocrinol Metab. 2025;40(3):342-356. Published online June 24, 2025; DOI: https://doi.org/10.3803/EnM.2025.2464

13,057 View
450 Download
1 Web of Science
1 Crossref

Abstract PDF PubReader ePub

Hyperthyroidism is a condition marked by excessive thyroid hormone production, most commonly due to Graves’ disease. Treatment options include antithyroid drugs (ATD), radioactive iodine (RAI) therapy, and thyroidectomy. To develop standardized clinical recommendations for RAI therapy with a focus on safety, efficacy, and monitoring, the Korean Thyroid Association formed a task force to create evidence-based guidelines. Six key clinical questions were identified through expert consensus, and a systematic literature review from 2013 to 2022 was conducted. Clinical indications for RAI therapy were categorized into three groups: strongly recommended, may be considered, and not recommended. A fixed dose of 10 to 15 mCi is recommended. Although a strict low-iodine diet is unnecessary, iodine-rich foods should be avoided for at least 1 week before treatment. ATD should be stopped 3 to 7 days before RAI and may be resumed in select cases. Prophylactic glucocorticoids are recommended for patients with mildly active thyroid eye disease and may be considered for others at risk. Thyroid function should be monitored at 4–6 weeks post-treatment, every 2–3 months until stabilized, and then every 6–12 months. These guidelines highlight recent advances and underscore the importance of individualized treatment based on clinical features, comorbidities, and patient preferences in Korea.

Citations

Citations to this article as recorded by

Outcome of MRI-Guided Single-Dose Iodine-131 for Graves’ Hyperthyroidism with Large Goiter
Shangcheng Yan, Xiansheng Chen, Bing Yan, Xin Li, Zhen Cao, Pan Zhang, Yajun Wang, Wenmei Guo, Ziwen Liu
Annals of Nuclear Medicine.2026;[Epub] CrossRef

Thyroid
2025 Korean Thyroid Association Clinical Management Guideline on Active Surveillance for Low-Risk Papillary Thyroid Carcinoma: Eun Kyung Lee, Min Joo Kim, Seung Heon Kang, Bon Seok Koo, Kyungsik Kim, Mijin Kim, Bo Hyun Kim, Ji-hoon Kim, Shinje Moon, Kyorim Back, Young Shin Song, Jong-hyuk Ahn, Hwa Young Ahn, Ho-Ryun Won, Won Sang Yoo, Min Kyoung Lee, Jeongmin Lee, Ji Ye Lee, Kyong Yeun Jung, Chan Kwon Jung, Yoon Young Cho, Dong-Jun Lim, Sun Wook Kim, Young Joo Park, Dong Gyu Na, Jee Soo Kim; Endocrinol Metab. 2025;40(3):307-341. Published online June 24, 2025; DOI: https://doi.org/10.3803/EnM.2025.2461

12,420 View
534 Download
5 Web of Science
8 Crossref

Abstract PDF PubReader ePub

The increasing detection of papillary thyroid microcarcinoma (PTMC) has raised concerns regarding overtreatment. For low-risk PTMC, either immediate surgery or active surveillance (AS) can be considered. To facilitate the implementation of AS, the Korean Thyroid Association convened a multidisciplinary panel and developed the first Korean guideline. AS is recommended for adults with pathologically confirmed Bethesda V–VI PTMC who have no clinical evidence of lymph node or distant metastasis, gross extrathyroidal extension, invasion of the trachea or recurrent laryngeal nerve, or aggressive histology. A baseline assessment requires high-resolution neck ultrasound performed by experienced operators to exclude extrathyroidal extension, tracheal or recurrent laryngeal nerve invasion, and lymph node metastasis; contrast-enhanced neck computed tomography is optional. Patient characteristics, including age, comorbidities, and the capacity for long-term follow-up, should be thoroughly assessed. Shared decision-making should carefully weigh the benefits and risks of surgery versus AS, considering expected oncologic outcomes, potential complications, quality of life, anxiety, medical costs, and patient preference. Follow-up involves neck ultrasound and thyroid function tests every 6 months for 2 years and annually thereafter. Disease progression, defined as significant tumor growth or newly detected nodal or distant metastasis, warrants surgery. Despite remaining uncertainties, this guideline provides a structured framework to ensure oncologic safety and supports patient-centered AS.

Citations

Citations to this article as recorded by

Feasibility and Safety of Active Surveillance in Subcapsular Thyroid Nodules with High Suspicion for Malignancy
Yan Hu, Wei Zhou, Lu Zhang, Weiwei Zhan
Ultrasound in Medicine & Biology.2026; 52(4): 816. CrossRef
Combined Ultrasound and MRI Assessment in Patients Undergoing Reoperation for Recurrent Papillary Thyroid Carcinoma: Oncological Outcomes and Surgical Safety
Zimei Tang, Jie Liu, Rong Wang, Gang Tian, Anwen Ren, Jiexiao Li, Yiran Wang, Wen Yang, Peng Sun, Tao Huang, Ximeng Zhang, Jie Ming
Current Oncology.2026; 33(2): 98. CrossRef
Multidisciplinary team diagnosis and treatment of well-differentiated thyroid carcinoma: current landscape and future prospects
Yuanyuan Li, Peijie Wang, Jiaxin Cao, Haiyan Liu
The Oncologist.2026;[Epub] CrossRef
Controlled minimally invasive surgical interventions for the treatment of patients with thyroid carcinoma
David D. Dolidze, Zurab A. Bagatelia, Suren G. Laboyan, Arshak V. Vardanyan, Konstantin S. Titov, Ivan N. Lebedinsky, Georgi Genadi Melkonyan, Dmitriy V. Matveev, Nodar N. Gogitidze, Andrei Y. Lukin, Armen R. Oganyan, David G. Gogolashvili, Anastasia V. B
Journal of Experimental and Clinical Surgery.2026; 19(1): 45. CrossRef
Overdiagnosis and Overtreatment of Thyroid Cancer and Precision Mitigation Strategies—An Integrated Analysis Based on Evidence-Based Medicine and Risk Stratification Models
云菲李
Advances in Clinical Medicine.2026; 16(04): 4980. CrossRef
Active surveillance for low-risk papillary thyroid carcinoma: Integrating guidelines, emerging evidence, and directions
Zijing Wu, Kaiang Zhang, Huixian Zhou, Leyi Wan, Jingyuan Zhong, Chunhua Li, Lianggeng Gong, Yun Peng
iScience.2026; 29(6): 115832. CrossRef
Optimal cutoff value of fine-needle aspiration thyroglobulin of metastatic lymph node in thyroid cancer patients
Yang Yang, Xianfeng Jiang
European Journal of Surgical Oncology.2025; 51(11): 110428. CrossRef
Low-risk thyroid cancer: surgery or active surveillance—an application of shared decision-making: a narrative review
Min Joo Kim, Eun Kyung Lee, Sun Wook Cho, Yoo Hyung Kim, Kyu Eun Lee, Su-jin Kim, Woochul Kim, Eun-Jae Chung, Jungirl Seok, Yul Hwangbo, Young Ki Lee, Jinsun Jang, Junsun Ryu, Yuh-Seog Jung, Chang Hwan Ryu, Jae Hoon Moon, June Young Choi, Hyeong Won Yu, K
Journal of the Korean Medical Association.2025; 68(9): 573. CrossRef

Original Articles

Thyroid
Comparison of Ultrasensitive and Highly Sensitive Assay to Predict Stimulated Thyroglobulin Levels Using Unstimulated Levels in Differentiated Thyroid Cancer Patients: Jinsun Jang, Hyun Joo Kim, Seunggyun Ha, Kyong Yeun Jung, Gyeongseo Jung, Sun Wook Cho, Do Joon Park, Gi Jeong Cheon, Young Joo Park; Endocrinol Metab. 2025;40(5):759-771. Published online June 5, 2025; DOI: https://doi.org/10.3803/EnM.2025.2302

4,005 View
89 Download
2 Web of Science
2 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Thyroglobulin (Tg) measurement is an essential aspect of monitoring for differentiated thyroid cancer (DTC) patients. This study compared the performances of ultrasensitive Tg (ultraTg) and highly sensitive Tg (hsTg) assays in predicting stimulated Tg levels without thyroid-stimulating hormone stimulation.
Methods
Overall, 268 DTC patients who had undergone total thyroidectomy and either radioiodine treatment or I-123 diagnostic scanning were included. Unstimulated and stimulated Tg levels were measured using hsTg (BRAHMS Dynotest Tg-plus) and ultraTg (RIAKEY Tg immunoradiometric assay) assays. Correlations of each assay with the ability of unstimulated Tg levels to predict stimulated Tg ≥1 ng/mL were analyzed.
Results
hsTg and ultraTg showed a strong correlation (R=0.79, P<0.01); the correlation was weaker in Tg antibody-positive patients (R=0.52). UltraTg demonstrated higher sensitivity in predicting stimulated Tg ≥1 ng/mL compared with hsTg. The optimal cut-off for ultraTg was 0.12 ng/mL (sensitivity, 72.0%; specificity, 67.2%). hsTg at 0.105 ng/mL had lower sensitivity (39.8%) but higher specificity (91.5%). Eight discordant cases with low hsTg (<0.2 ng/mL) but elevated ultraTg (>0.23 ng/mL) were identified; three developed structural recurrence within 3.4 to 5.8 years. Two patients had an excellent response according to hsTg but an indeterminate or biochemical incomplete response according to ultraTg.
Conclusion
UltraTg demonstrated higher sensitivity in predicting positive stimulated Tg levels and potential recurrence compared with hsTg. However, its lower specificity may lead to more frequent classifications of biochemical incomplete response. UltraTg may be beneficial in clinically suspicious cases where hsTg falls below the cut-off, but its broader applicability requires further investigation.

Citations

Citations to this article as recorded by

Unstimulated Highly Sensitive Thyroglobulin <0.2 ng/mL: Insufficient to Predict Stimulated Thyroglobulin <1 ng/mL?
Tae Yong Kim
Endocrinology and Metabolism.2025; 40(5): 687. CrossRef
Post-thyroidectomy ultrasonography versus thyroglobulin as a surveillance tool for locoregional recurrence in patients with differentiated thyroid carcinoma: A single centre 10-year study
Abhishek Mahajan, Vineeth Kurki, Pranjal Rai, Nilesh Sable, Ujjwal Agarwal, Richa Vaish, Nivedita Chakrabarty, Shreya Shukla, Anil D’Cruz, Prathamesh Pai, Kumar Prabhash, Vanita Noronha, Vijay Patil, Nandini Menon, Sarbani Ghosh Laskar, Asawari Patil, Mun
Frontiers in Endocrinology.2025;[Epub] CrossRef

Thyroid
Risk Stratification of Thyroid Nodules Diagnosed as Follicular Neoplasm on Core Needle Biopsy: Byeong-Joo Noh, Won Jun Kim, Jin Yub Kim, Ha Young Kim, Jong Cheol Lee, Myoung Sook Shim, Yong Jin Song, Kwang Hyun Yoon, In-Hye Jung, Hyo Sang Lee, Wooyul Paik, Dong Gyu Na; Endocrinol Metab. 2025;40(4):610-622. Published online May 28, 2025; DOI: https://doi.org/10.3803/EnM.2024.2256

2,458 View
75 Download
1 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
This study assessed risk stratification and diagnostic performance for malignancy in thyroid nodules diagnosed as follicular neoplasm (FN) based on core needle biopsy (CNB) subcategories.
Methods
A total of 313 consecutive nodules (>1 cm) diagnosed as FN on CNB with corresponding surgical histology were included. FN subcategories were classified retrospectively for nodules diagnosed before 2022 (retrospective dataset) and prospectively for nodules diagnosed since 2022 (prospective dataset). CNB subcategories were determined using histologic criteria based on architectural uniformity and nuclear atypia, as modified from the 2019 Korean CNB pathology guideline. The diagnostic performance of CNB subcategories, nodule size, and ultrasound risk stratification systems (RSSs) for malignancy was assessed.
Results
CNB subcategory IVb showed a significantly higher malignancy risk compared to other subcategories in both datasets (34.5%–83.7% vs. 4.2%–13.6%, P<0.001). It was also identified as an independent predictor of malignancy in both datasets (P< 0.001), whereas nodule size and all ultrasound RSSs were not predictive of malignancy, including noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) (P≥0.079). CNB subcategory IVb demonstrated higher sensitivity for malignancy and a lower surgical rate for benign nodules compared to the nodule size criterion (>2 cm). The combined criterion of CNB subcategory IVb or nodule size >3 cm identified all malignant tumors, excluding NIFTP, in the prospective dataset.
Conclusion
CNB subcategory IVb effectively stratifies malignancy risk in thyroid nodules and outperforms nodule size (>2 cm) and ultrasound RSSs in diagnostic performance. Non-IVb nodules ≤3 cm can be safely managed with ultrasound surveillance instead of immediate surgery.

Citations

Citations to this article as recorded by

Advantages of thyroid core needle biopsy: an emerging selective first-line biopsy modality
Jae Ho Shin, Yeseul Kim, Min Kyoung Lee, Jung Hwan Baek, So Lyung Jung
Ultrasonography.2026; 45(3): 205. CrossRef

Thyroid
Comprehensive Proteomics and Machine Learning Analysis to Distinguish Follicular Adenoma and Follicular Thyroid Carcinoma from Indeterminate Thyroid Nodules: Hee-Sung Ahn, Eyun Song, Chae A Kim, Min Ji Jeon, Yu-Mi Lee, Tea-Yon Sung, Dong Eun Song, Jiyoung Yu, Ji Min Shin, Yeon-Sook Choi, Kyunggon Kim, Won Gu Kim; Endocrinol Metab. 2025;40(4):623-636. Published online April 10, 2025; DOI: https://doi.org/10.3803/EnM.2024.2208

4,426 View
144 Download

Abstract PDF Supplementary Material PubReader ePub: Background
The preoperative diagnosis of follicular thyroid carcinoma (FTC) is challenging because it cannot be readily distinguished from follicular adenoma (FA) or benign follicular nodular disease (FND) using the sonographic and cytological features typically employed in clinical practice.
Methods
We employed comprehensive proteomics and machine learning (ML) models to identify novel diagnostic biomarkers capable of classifying three subtypes: FTC, FA, and FND. Bottom-up proteomics techniques were applied to quantify proteins in formalin-fixed, paraffin-embedded (FFPE) thyroid tissues. In total, 202 FFPE tissue samples, comprising 62 FNDs, 72 FAs, and 68 FTCs, were analyzed.
Results
Close spectrum-spectrum matching quantified 6,332 proteins, with approximately 9% (780 proteins) differentially expressed among the groups. When applying an ML model to the proteomics data from samples with preoperative indeterminate cytopathology (n=183), we identified distinct protein panels: five proteins (CNDP2, DNAAF5, DYNC1H1, FARSB, and PDCD4) for the FND prediction model, six proteins (DNAAF5, FAM149B1, RPS9, TAGLN2, UPF1, and UQCRC1) for the FA model, and seven proteins (ACTN4, DSTN, MACROH2A1, NUCB1, SPTAN1, TAGLN, and XRCC5) for the FTC model. The classifiers’ performance, evaluated by the median area under the curve values of the random forest models, was 0.832 (95% confidence interval [CI], 0.824 to 0.839) for FND, 0.826 (95% CI, 0.817 to 0.835) for FA, and 0.870 (95% CI, 0.863 to 0.877) for FTC.
Conclusion
Quantitative proteome analysis combined with an ML model yielded an optimized multi‐protein panel that can distinguish FTC from benign subtypes. Our findings indicate that a proteomic approach holds promise for the differential diagnosis of FTC.

Review Article

Thyroid
Ultrasound Imaging Criteria and Protocols for Active Surveillance of Low-Risk Thyroid Cancer: A Review of International Consensus Guidelines: Ji Ye Lee, Dong Gyu Na; Endocrinol Metab. 2025;40(2):185-194. Published online March 27, 2025; DOI: https://doi.org/10.3803/EnM.2024.2319

5,343 View
213 Download
2 Web of Science
3 Crossref

Abstract PDF PubReader ePub

Given the indolent nature and favorable outcomes of papillary thyroid microcarcinoma (PTMC), active surveillance (AS) has been adopted as an alternative management option to immediate surgery. However, the meticulous selection of patients based on individual and tumor-specific characteristics, as well as ultrasound (US) findings, is crucial in AS. Regular US monitoring is performed during AS to detect indicators of tumor progression, such as growth, the emergence of new US features suggestive of gross extrathyroidal extension, and lymph node metastasis. Thus, imaging-based evaluations play a pivotal role in guiding the decision to continue AS or proceed with surgical intervention. This review introduces the Korean Society of Thyroid Radiology (KSThR) guideline for the standardized US imaging of patients with low-risk PTMC under AS, which provide practical recommendations for tumor assessment during the initiation and follow-up phases of AS. This review compared the key features of the KSThR guideline with those of major international guidelines and identified the similarities and differences in imaging methodologies and follow-up strategies. The primary objective of this review is to support the broader implementation of AS and improve outcomes for patients with low-risk PTMC by emphasizing imaging protocols.

Citations

Citations to this article as recorded by

Shared Decision-Making for Determining Treatment Strategies in Low-Risk Thyroid Cancer: Protocol of a Multicenter Cluster-Randomized Trial (MAeSTro-SDM)
Eun Kyung Lee, Min Joo Kim, Yul Hwangbo, Jae Hoon Moon, Sun Wook Cho, Young Jun Chai, June Young Choi, Yuh-Seog Jung, Kyu Eun Lee, Eun-Jae Chung, Kyungsik Kim, Su-jin Kim, Woochul Kim, Yoo Hyung Kim, Young Ki Lee, Jinsun Jang, Young Shin Song, Ka Hee Yi,
Journal of Korean Medical Science.2026;[Epub] CrossRef
New Trends in Thyroid Malignancy: Minimally Invasive Thermal Ablation Percutaneous Techniques for T1 Papillary Thyroid Carcinomas
Pierre Yves Marcy
Current Oncology.2025; 32(8): 442. CrossRef
Ultrasound for Active Surveillance of Low-Risk Thyroid Carcinoma
Sang Yull Kang, Hyeong Eun Jeong, Ha Rim Ahn, Hyun Jo Youn
Journal of Surgical Ultrasound.2025; 12(2): 23. CrossRef

Original Articles

Thyroid
Medullary Thyroid Carcinoma Detected by Routine Health Screening Had Better Clinical Outcome and Survival: Ji Hyun Yoo, Da Eun Leem, Bo Ram Kim, Tae Hyuk Kim, Sun Wook Kim, Jae Hoon Chung; Endocrinol Metab. 2025;40(3):414-420. Published online March 5, 2025; DOI: https://doi.org/10.3803/EnM.2024.2214

2,979 View
79 Download

Abstract PDF Supplementary Material PubReader ePub: Background
The benefits of early detection in medullary thyroid carcinoma (MTC) are not well established. This study investigates the impact of early detection of MTC on clinical outcomes.
Methods
This retrospective study evaluated 144 patients diagnosed with MTC at Samsung Medical Center between 1995 and 2019, classified as asymptomatic (mostly detected through routine health check-ups, including ultrasonography, calcitonin, or carcinoembryonic antigen levels) and symptomatic. Initial treatment response, final clinical outcomes, and cancer-specific survival were compared.
Results
MTC was diagnosed in 104 (72.2%) asymptomatic and 40 (27.8%) symptomatic patients. The symptomatic group showed a significantly larger primary tumor size, more frequent lateral neck lymph node metastasis, more advanced tumor, node, metastasis (TNM) staging, and higher pre- and postoperative serum calcitonin levels. For initial treatment response, the proportion of excellent responders was significantly higher in the asymptomatic group (71.2% vs. 40.0%), while that of patients with biochemical incomplete response (37.5% vs. 26.9%) and structural incomplete response (22.5% vs. 1.9%) was significantly higher in the symptomatic group (all P<0.001). For the final clinical outcomes, the rate of patients with no evidence of disease was higher in the asymptomatic group (67.3% vs. 30.0%), while the rate of patients with structurally identifiable disease was higher in the symptomatic group (45.0% vs. 7.7%) (P<0.001 for both). The symptomatic group had significantly poorer cancer-specific survival than the asymptomatic group (log-rank P=0.023).
Conclusion
Compared with late diagnosis through symptomatic presentation, early diagnosis in asymptomatic patients results in significantly better initial treatment response, final clinical outcomes, and cancer-specific survival in patients with MTC.

Thyroid
Microvascular Ultrasonography Vascularity Index as a Rapid and Simplified Assessment Tool for Differentiating Graves’ Disease from Destructive Thyroiditis and Managing Thyrotoxicosis: Han-Sang Baek, Chaiho Jeong, Jeonghoon Ha, Dong-Jun Lim; Endocrinol Metab. 2025;40(3):394-404. Published online February 25, 2025; DOI: https://doi.org/10.3803/EnM.2024.2206

3,363 View
90 Download
1 Web of Science
2 Crossref

Abstract PDF PubReader ePub

Background
Thyrotoxicosis presents significant diagnostic challenges in distinguishing Graves’ disease (GD) from destruction-induced thyrotoxicosis (DT) using ultrasound imaging. We evaluated a new technology, microvascular ultrasonography (MVUS) to effectively differentiate between GD and DT, and observe the MVUS changes during follow-up.
Methods
A total of 264 consecutive patients were prospectively enrolled into two cohorts from August 2022 to March 2024 at one tertiary referral hospital: cohort 1 comprised patients initially presenting with thyrotoxicosis (n=185; 98 with GD and 87 with DT). Cohort 2 included patients either with GD considering antithyroid drug discontinuation or with DT in the follow-up phase after treatment (n=77). Ultrasound imaging was conducted using the MVUS technique, and the vascularity index (MVUS-VI) was automatically calculated as the percentage ratio of color pixels to total grayscale pixels within a specified region of interest.
Results
Diagnostic accuracy highlighted MVUS-VI as the most accurate diagnostic tool, achieving a sensitivity of 79.6%, specificity of 84.3%, with an area under the curve of 0.856 (95% confidence interval, 0.800 to 0.911). Presence of thyroid peroxidase antibody or thyroglobulin antibody affected MVUS-VI’s performance, requiring a higher cut-off value for specificity in this subgroup. Follow-up in cohort 2 (n=77) demonstrated significant normalization in thyroid function and reductions in MVUS-VI from an initial 32.6%±23.4% to 20.8%±13.5% at follow-up (P<0.001).
Conclusion
MVUS-VI provides a rapid, non-invasive diagnostic alternative to traditional methods in differentiating GD from DT, thus aiding in the management of patients with thyrotoxicosis.

Citations

Citations to this article as recorded by

Update on newer ultrasound systems to study the microvasculature
Orlando Catalano, Antonio Pio Masciotra
La radiologia medica.2025; 130(8): 1283. CrossRef
Diagnostic Approach and Therapeutic Strategies for Ambiguous Thyrotoxicosis
Mijin Kim
The Korean Journal of Medicine.2025; 100(5): 241. CrossRef

Thyroid
Prognostic Impact of Primary Tumor Size in Papillary Thyroid Carcinoma without Lymph Node Metastasis: Chae A Kim, Hye In Kim, Na Hyun Kim, Tae Yong Kim, Won Bae Kim, Jae Hoon Chung, Min Ji Jeon, Tae Hyuk Kim, Sun Wook Kim, Won Gu Kim; Endocrinol Metab. 2025;40(3):405-413. Published online February 25, 2025; DOI: https://doi.org/10.3803/EnM.2024.2199

5,376 View
116 Download

Abstract PDF PubReader ePub: Background
We aimed to investigate the prognostic significance of primary tumor size in patients with pT1–T3a N0 M0 papillary thyroid carcinoma (PTC), minimizing the impact of confounding factors.
Methods
A multicenter retrospective study included 5,759 patients with PTC. Those with lymph node metastasis, gross extrathyroidal extension (ETE), and aggressive variants were excluded. Patients were categorized by primary tumor size (≤1, 1.1–2, 2.1–4, and >4 cm) and subdivided based on the presence of microscopic ETE (mETE).
Results
The median age was 48.0 years, and 87.5% were female. The median primary tumor size was 0.7 cm, with mETE identified in 43.7%. The median follow-up was 8.0 years, with an overall recurrent/persistent disease rate of 2.8%. Multivariate analysis identified male sex, larger tumor size, and the presence of mETE as significant prognostic risk factors. The 10-year recurrent/persistent disease rates for tumors ≤1, 1.1–2, 2.1–4, and >4 cm were 2.5%, 4.7%, 11.1%, and 6.0%, respectively. The 2.1–4 cm group had a significantly higher hazard ratio (HR), with the >4 cm group had the highest HR than the ≤1 cm group. Patients with mETE had a higher recurrent/persistent disease rate (4.5%) than those without, with rates by tumor size being 2.6%, 5.6%, 16.7%, and 8.2%.
Conclusion
Larger tumor size and the presence of mETE significantly increased the risk of recurrent/persistent disease in PTC. Patients with pT2–T3a N0 M0 PTC (>2 cm) had a recurrent/persistent disease risk exceeding 5%, warranting vigilant management.

Thyroid
Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP): Jae Hoon Moon, Eun Kyung Lee, Wonjae Cha, Young Jun Chai, Sun Wook Cho, June Young Choi, Sung Yong Choi, A Jung Chu, Eun-Jae Chung, Yul Hwangbo, Woo-Jin Jeong, Yuh-Seog Jung, Kyungsik Kim, Min Joo Kim, Su-jin Kim, Woochul Kim, Yoo Hyung Kim, Chang Yoon Lee, Ji Ye Lee, Kyu Eun Lee, Young Ki Lee, Hunjong Lim, Do Joon Park, Sue K. Park, Chang Hwan Ryu, Junsun Ryu, Jungirl Seok, Young Shin Song, Ka Hee Yi, Hyeong Won Yu, Eleanor White, Katerina Mastrocostas, Roderick J. Clifton-Bligh, Anthony Glover, Matti L. Gild, Ji-hoon Kim, Young Joo Park; Endocrinol Metab. 2025;40(2):236-246. Published online February 18, 2025; DOI: https://doi.org/10.3803/EnM.2024.2136

6,365 View
168 Download
5 Web of Science
4 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making.
Methods
This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes.
Conclusion
This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Citations

Citations to this article as recorded by

Shared Decision-Making for Determining Treatment Strategies in Low-Risk Thyroid Cancer: Protocol of a Multicenter Cluster-Randomized Trial (MAeSTro-SDM)
Eun Kyung Lee, Min Joo Kim, Yul Hwangbo, Jae Hoon Moon, Sun Wook Cho, Young Jun Chai, June Young Choi, Yuh-Seog Jung, Kyu Eun Lee, Eun-Jae Chung, Kyungsik Kim, Su-jin Kim, Woochul Kim, Yoo Hyung Kim, Young Ki Lee, Jinsun Jang, Young Shin Song, Ka Hee Yi,
Journal of Korean Medical Science.2026;[Epub] CrossRef
Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP) (Endocrinol Metab 2025;40:236-46, Jae Hoon Moon et al.)
Eun Kyung Lee, Jae Hoon Moon, Young Joo Park
Endocrinology and Metabolism.2025; 40(4): 655. CrossRef
Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP) (Endocrinol Metab 2025;40:236-46, Jae Hoon Moon et al.)
Hoonsung Choi
Endocrinology and Metabolism.2025; 40(4): 653. CrossRef
Habitat imaging combined with multimodal analysis for preoperative risk stratification of papillary thyroid carcinoma
Jia-Wei Feng, You-Long Zhu, Lu Zhang, Yu-Xin Yang, An-Cheng Qin, Shui-Qing Liu, Yong Jiang
Insights into Imaging.2025;[Epub] CrossRef

Thyroid
Prognostic Indicators and Comparative Treatment Outcomes in High-Risk Thyroid Cancer with Laryngotracheal Invasion: Eman A. Toraih, Jessan A. Jishu, Mohammad H. Hussein, Aly A. M. Shaalan, Manal S. Fawzy, Emad Kandil; Endocrinol Metab. 2025;40(2):201-215. Published online January 22, 2025; DOI: https://doi.org/10.3803/EnM.2024.2033

3,794 View
107 Download
1 Web of Science
1 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Laryngotracheal invasion occurs in a subset of patients with well-differentiated thyroid cancer (WDTC) and is associated with a poor prognosis. We aimed to analyze patterns and predictors/outcomes related to this high-risk manifestation.
Methods
This population-based analysis utilized the Surveillance, Epidemiology, and End Results (SEER) registry (2000 to 2015) to identify WDTC patients. Temporal trends and geographic variation in invasion rates were assessed. Logistic regression and propensity score matching were employed to identify predictors of secondary malignancy, mortality, and treatment impact on overall and thyroid cancer (TC)-specific survival.
Results
Of 131,721 WDTC patients, 1,662 (1.3%) had tracheal invasion and 976 (0.7%) had laryngeal invasion at diagnosis. Tracheal and laryngeal invasion rates declined from 3.7%–0.7% and 1.5%–0.6%, respectively, from 2000 to 2015. Compared to 98,835 noninvasive cases, patients with laryngotracheal invasion were older and more often male, Asian, and Hispanic (all P<0.001). This group had larger tumors with higher rates of nodal (N1: 61.8% vs. 15.1%) and distant metastases (M1: 9.3% vs. 0.4%). Age ≥55 years (hazard ratio [HR], 1.19; P=0.004) and metastases (HR, 1.75; P<0.001) increased TC-specific mortality, whereas the converse pattern was found for Asian race (HR, 0.63; P=0.002) and surgery (HR, 0.35; P<0.001). In rigorously matched groups to control confounding, adding radioactive iodine to surgery reduced mortality by 30% (P<0.001). However, external beam radiation and systemic therapy did not improve survival over surgery alone.
Conclusion
Laryngotracheal invasion is present in 0.7% to 1.3% of cases, conferring over double the mortality risk. Radioactive iodine with surgery improves outcomes in this aggressive WDTC subset.

Citations

Citations to this article as recorded by

Thyroid cancer in Chinese military flight personnel: Characteristics and management advances
Yan Wang, Jing Liu, Chun-Xia Zhang, Guo-Li Gu
World Journal of Clinical Oncology.2026;[Epub] CrossRef

Diabetes, obesity and metabolism
Tirzepatide and Cancer Risk in Individuals with and without Diabetes: A Systematic Review and Meta-Analysis: A.B.M. Kamrul-Hasan, Muhammad Shah Alam, Deep Dutta, Thanikai Sasikanth, Fatema Tuz Zahura Aalpona, Lakshmi Nagendra; Endocrinol Metab. 2025;40(1):112-124. Published online January 15, 2025; DOI: https://doi.org/10.3803/EnM.2024.2164

72,082 View
764 Download
14 Web of Science
16 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Data on the carcinogenic potential of tirzepatide from randomized controlled trials (RCTs) are limited. Furthermore, no meta-analysis has included all relevant RCTs to assess the cancer risk associated with tirzepatide.
Methods
RCTs involving patients receiving tirzepatide in the intervention arm and either a placebo or any active comparator in the control arm were searched through electronic databases. The primary outcome was the overall risk of any cancer, and secondary outcomes were the risks of specific types of cancer in the tirzepatide versus the control groups.
Results
Thirteen RCTs with 13,761 participants were analyzed. Over 26 to 72 weeks, the tirzepatide and pooled control groups had identical risks of any cancer (risk ratio, 0.78; 95% confidence interval, 0.53 to 1.16; P=0.22). The two groups had comparable cancer risks in patients with and without diabetes. In subgroup analyses, the risks were also similar in the tirzepatide versus placebo, insulin, and glucagon-like peptide-1 receptor agonist groups. The overall cancer risk was also comparable for different doses of tirzepatide compared to the control groups; only a 10-mg tirzepatide dose had a lower risk of any cancer than placebo. Furthermore, compared to the control groups (pooled or separately), tirzepatide did not increase the risk of any specific cancer types. Despite greater increments in serum calcitonin with 10- and 15-mg tirzepatide doses than with placebo, the included RCTs reported no cases of papillary thyroid carcinoma.
Conclusion
Tirzepatide use in RCTs over 26 to 72 weeks did not increase overall or specific cancer risk.

Citations

Citations to this article as recorded by

Tirzepatide and Obesity: A Narrative Review
Arya Singh, Rahnuma Ahmad, Kona Chowdhury, Mahendra Narwaria, Mainul Haque
Advances in Human Biology.2026; 16(2): 290. CrossRef
Tirzepatide and Cardiovascular Outcomes: A Narrative Review of Mechanisms, Efficacy and Implications for Heart Failure Management
Hamza A. Abdul‐Hafez, Ameer Awashra, Sosana Bdir, Sarah Saife, Qasem Salah, Mohammed Barbarawi, Thabet Swaileh, Ahmed Emara, Mohamed S. Elgendy, Abdalhakim Shubietah
Endocrinology, Diabetes & Metabolism.2026;[Epub] CrossRef
Glucagon-like peptide 1 receptor agonists and cancer risk: the good, the bad and the unknown
Edoardo Mannucci, Ilaria Dicembrini
Nature Reviews Clinical Oncology.2026;[Epub] CrossRef
Incretin-Based Therapy and Thyroid Cancer Risk: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Naseem Eisa, Omar Barood
AACE Endocrinology and Diabetes.2026;[Epub] CrossRef
GLP-1/GIP agonists and cancer: mechanisms, evidence, and nutrition implications
Sedat Arslan, Ayca Aydin
Academia Oncology.2026;[Epub] CrossRef
Dietary and pharmacological energy restriction and exercise for healthspan extension
Maria Lastra Cagigas, Isabella De Ciutiis, Andrius Masedunskas, Luigi Fontana
Trends in Endocrinology & Metabolism.2025; 36(6): 521. CrossRef
GLP-1 receptor agonists in the context of cancer: the road ahead
Isabelle R. Miousse
American Journal of Physiology-Cell Physiology.2025; 328(6): C1822. CrossRef
Treatment of type 2 diabetes mellitus - a current view of the different drug classes and strategies for their use
Jan Brož
Vnitřní lékařství.2025; 71(3): 144. CrossRef
Repurposing glucose-lowering drugs for cancer therapy
Michaela Luconi, Giulia Cantini, Clara Crescioli
Trends in Cancer.2025; 11(7): 691. CrossRef
Impact of 1-Year Tirzepatide Use on Glycemic and Metabolic Profile in Overweight to Obese People with Type 1 Diabetes: A Systematic Review and Meta-Analysis
Deep Dutta, Abul Bashar Mohammad Kamrul-Hasan, Ritin Mohindra, Nishant Raizada
Diabetes Technology and Obesity Medicine.2025;[Epub] CrossRef
Obesity and Pancreatic Diseases: From Inflammation to Oncogenesis and the Impact of Weight Loss Interventions
Mariana Souto, Tiago Cúrdia Gonçalves, José Cotter
Nutrients.2025; 17(14): 2310. CrossRef
Weight loss interventions and obesity‐associated cancers in people with type 2 diabetes and overweight/obesity: A real‐world observational study
Testimony Ipaye, Jonathan Goldney, Thomas J. Wilkinson, Francesco Zaccardi, Thomas Yates, Melanie J. Davies, Karen Brown, Dimitris Papamargaritis
Diabetes, Obesity and Metabolism.2025; 27(12): 6914. CrossRef
GLP-1 receptor agonists and cancer: current clinical evidence and translational opportunities for preclinical research
Estefania Valencia-Rincón, Rajani Rai, Vishal Chandra, Elizabeth A. Wellberg
Journal of Clinical Investigation.2025;[Epub] CrossRef
The efficacy and safety of dual GIP/GLP1 receptor agonists (tirzepatide) in diabetes and obesity: a systematic review and network meta-analysis
Karolina Hoffmann, Michał Michalak, Manfredi Rizzo, Viviana Maggio, Anna Paczkowska
Expert Opinion on Drug Safety.2025; : 1. CrossRef
Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan
Dario Tuccinardi, Davide Masi, Mikiko Watanabe, Valeria Zanghi Buffi, Francesco De Domenico, Sabrina Berti, Valentina Cipriani, Melania Manco, Silvia Manfrini, Uberto Pagotto
Journal of Endocrinological Investigation.2025; 48(12): 2761. CrossRef
The gynecologic tumor risk related to GLP-1 receptor agonists and SGLT2 inhibitors use: a network meta-analysis of 91 randomized controlled trials
Ping-Tao Tseng, Bing-Yan Zeng, Chih-Wei Hsu, Cheuk-Kwan Sun, Mein-Woei Suen, Andre F. Carvalho, Brendon Stubbs, Yen-Wen Chen, Tien-Yu Chen, Wei-Te Lei, Po-Huang Chen, Jiann-Jy Chen, Yow-Ling Shiue, Bing-Syuan Zeng, Kuan-Pin Su, Chih-Sung Liang
Journal of Hematology & Oncology.2025;[Epub] CrossRef

Thyroid Big Data Articles (National Health Insurance Service Database)
Risk of Osteoporotic Fractures among Patients with Thyroid Cancer: A Nationwide Population-Based Cohort Study: Eu Jeong Ku, Won Sang Yoo, Yu Been Hwang, Subin Jang, Jooyoung Lee, Shinje Moon, Eun Kyung Lee, Hwa Young Ahn; Endocrinol Metab. 2025;40(2):225-235. Published online January 15, 2025; DOI: https://doi.org/10.3803/EnM.2024.2101

5,491 View
142 Download
3 Web of Science
5 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
The associations between thyroid cancer and skeletal outcomes have not been thoroughly investigated. We aimed to investigate the risk of osteoporotic fractures in patients with thyroid cancer compared to that in a matched control group.
Methods
This retrospective cohort study included 2,514 patients with thyroid cancer and 75,420 matched controls from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC, 2006–2019). The rates of osteoporotic fractures were analyzed, and associations with the levothyroxine dose were evaluated.
Results
Patients with thyroid cancer had a significantly lower risk of fracture than did the control group (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.69 to 0.94; P=0.006). Patients diagnosed with thyroid cancer after the age of 50 years (older cancer group) had a significantly lower risk of fracture than did those in the control group (HR, 0.72; 95% CI, 0.6 to 0.85; P<0.001), especially those diagnosed with spinal fractures (HR, 0.66; 95% CI, 0.51 to 0.85; P=0.001). Patients in the older cancer group started osteoporosis treatment earlier than did those in the control group (65.5±7.5 years vs. 67.3±7.6 years, P<0.001). Additionally, a lower dose of levothyroxine was associated with a reduced risk of fractures.
Conclusion
In the clinical setting, the risk of fracture in women diagnosed with thyroid cancer after the age of 50 years was lower than that in the control group, which was caused by more proactive osteoporosis treatment in postmenopausal women with thyroid cancer.

Citations

Citations to this article as recorded by

Increased risk of osteoporosis among thyroid cancer survivors: the influence of postoperative levothyroxine therapy in a nationwide cohort study
Young Bin Cho, Kyoung Sik Park
Annals of Surgical Treatment and Research.2026; 110(2): 84. CrossRef
A Comparative Evaluation of Three Time-to-Event Models Predicting 5-Year Osteoporosis Risk in Thyroid Cancer Survivors: A Nationwide Cohort Study
Young Bin Cho, Kyoung Sik Park
Endocrinology and Metabolism.2026; 41(1): 174. CrossRef
Japanese cancer survivors have a higher risk of fragility fractures over ten years
Takaomi Kobayashi, Yuichiro Nishida, Takuma Furukawa, Chisato Shimanoe, Mikako Horita, Hinako Nanri, Yasuki Higaki, Tadatsugu Morimoto, Keitaro Tanaka, Megumi Hara
Scientific Reports.2026;[Epub] CrossRef
Assessing the risk of osteoporotic fracture recurrence using CT-based radiomics and machine learning
Xiaoyang Zheng, Caihong Zhu, Rui Zhang, Hongyu Sun
Current Problems in Surgery.2025; 72: 101876. CrossRef
Prospective evidence for the gut–bone axis in osteoporotic fractures: Insights from genetic prediction and metabolite mediators
Binjie Zhu, Xinghao Yu, Huimin Lu, Mingzhu Su, Xiaomin Li, Jianhua Jin, Yongmin Yan, Yi Jin
Bone.2025; 201: 117651. CrossRef

Thyroid
Deep Learning Technology for Classification of Thyroid Nodules Using Multi-View Ultrasound Images: Potential Benefits and Challenges in Clinical Application: Jinyoung Kim, Min-Hee Kim, Dong-Jun Lim, Hankyeol Lee, Jae Jun Lee, Hyuk-Sang Kwon, Mee Kyoung Kim, Ki-Ho Song, Tae-Jung Kim, So Lyung Jung, Yong Oh Lee, Ki-Hyun Baek; Endocrinol Metab. 2025;40(2):216-224. Published online January 13, 2025; DOI: https://doi.org/10.3803/EnM.2024.2058

9,794 View
287 Download
9 Web of Science
8 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
This study aimed to evaluate the applicability of deep learning technology to thyroid ultrasound images for classification of thyroid nodules.
Methods
This retrospective analysis included ultrasound images of patients with thyroid nodules investigated by fine-needle aspiration at the thyroid clinic of a single center from April 2010 to September 2012. Thyroid nodules with cytopathologic results of Bethesda category V (suspicious for malignancy) or VI (malignant) were defined as thyroid cancer. Multiple deep learning algorithms based on convolutional neural networks (CNNs) —ResNet, DenseNet, and EfficientNet—were utilized, and Siamese neural networks facilitated multi-view analysis of paired transverse and longitudinal ultrasound images.
Results
Among 1,048 analyzed thyroid nodules from 943 patients, 306 (29%) were identified as thyroid cancer. In a subgroup analysis of transverse and longitudinal images, longitudinal images showed superior prediction ability. Multi-view modeling, based on paired transverse and longitudinal images, significantly improved the model performance; with an accuracy of 0.82 (95% confidence intervals [CI], 0.80 to 0.86) with ResNet50, 0.83 (95% CI, 0.83 to 0.88) with DenseNet201, and 0.81 (95% CI, 0.79 to 0.84) with EfficientNetv2_ s. Training with high-resolution images obtained using the latest equipment tended to improve model performance in association with increased sensitivity.
Conclusion
CNN algorithms applied to ultrasound images demonstrated substantial accuracy in thyroid nodule classification, indicating their potential as valuable tools for diagnosing thyroid cancer. However, in real-world clinical settings, it is important to aware that model performance may vary depending on the quality of images acquired by different physicians and imaging devices.

Citations

Citations to this article as recorded by

Molecular intelligence and immune reconnaissance in thyroid cancer: a new paradigm for diagnosis, risk stratification, and therapeutic precision
Marcio J. Concepción-Zavaleta, Jenyfer M. Fuentes-Mendoza, Alfredo Cruz-Quintá, Argelia V. Cadena-Guerrero, Ximena Barrón, Luis Concepción-Urteaga, Cristian D. Armas, José Paz-Ibarra, Juan Eduardo Quiroz-Aldave
Expert Review of Anticancer Therapy.2026; 26(5): 585. CrossRef
Deep Learning for Ultrasound Classification to Identify Noninvasive Follicular Thyroid Neoplasms with Papillary–Like Nuclear Features
I-Hung Chien, Yi-Chiung Hsu, Shih-Ping Cheng
Journal of Imaging Informatics in Medicine.2026;[Epub] CrossRef
Knowledge-Prompted Trustworthy Disentangled Learning for Thyroid Ultrasound Segmentation With Limited Annotations
Wenxu Wang, Weizhen Wang, Qianjin Feng, Yu Zhang, Zhenyuan Ning
IEEE Transactions on Image Processing.2026; 35: 983. CrossRef
Integrating Robotic Bilateral Axillo-Breast Approach Thyroidectomy with Molecular Diagnostics and Artificial Intelligence in Thyroid Cancer Care
Qiang Deng, Xiaoping Men, Duo Jin, Yuzhuo Bai
Biomolecules & Therapeutics.2026; 34(1): 45. CrossRef
Improving Non-Invasive Prediction of Thyroid Nodule Malignancy: A Machine Learning-Based Clinical Approach
Maja Reiner, Hanna Drobińska, Michał Miciak, Michał Kisiel, Szymon Biernat, Krzysztof Kaliszewski
Cancer Management and Research.2026; Volume 18: 1. CrossRef
An early evaluation of MedSigLIP in thyroid cytology: a comparative frozen-encoder benchmark against ImageNet-pretrained encoders
Mehmet Poyrazer, Rıdvan Erten
Frontiers in Endocrinology.2026;[Epub] CrossRef
Deep Learning for the Diagnosis and Treatment of Thyroid Cancer: A Review
Rili Gao, Shangqing Mai, Song Wang, Wuqiang Hu, Zhangqi Chang, Guozhi Wu, Haixia Guan
Endocrine Practice.2025; 31(12): 1608. CrossRef
Artificial Intelligence for Thyroid Ultrasound: Clinical Performance, Pitfalls, and Practice Integration
Junseok Kang, Jihyun Ahn, Jeong Hun Hah
Clinical Ultrasound.2025; 10(2): 59. CrossRef

Thyroid
Triiodothyronine Is Associated with Incidence/Resolution of Steatotic Liver Disease: Longitudinal Study in Euthyroid Korean: Hye In Kim, Jun Young Kim, Jung Hwan Cho, Ji Min Han, Sunghwan Suh, Ji Cheol Bae, Tae Hyuk Kim, Sun Wook Kim, Jong Ryeal Hahm, Jae Hoon Chung; Endocrinol Metab. 2025;40(1):135-145. Published online December 4, 2024; DOI: https://doi.org/10.3803/EnM.2024.2040

3,150 View
82 Download
1 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
The positive relationship between triiodothyronine (T3) and steatotic liver disease (SLD) demonstrated only in crosssectional study. We aimed to evaluated whether total T3 (TT3) is associated with the development/resolution of SLD in longitudinal design.
Methods
This retrospective, longitudinal, population-based cohort study included 1,665 South Korean euthyroid adults with ≥4 thyroid function test. We explored the impact of mean TT3 during follow-up on development/resolution of either SLD (diagnosed by ultrasound) or modified metabolic dysfunction-associated steatotic liver disease (MASLD) using Cox proportional hazards regression models.
Results
During about median 5 years follow-up, 807/1,216 (66.3%) participants among participants without SLD at baseline developed SLD, and 253/318 (79.5%) participants among participants with SLD at baseline SLD resolved fatty liver. Mean TT3 rather than thyroid stimulating hormone or mean free thyroxine was significantly related with development (adjusted hazard ratio [HR], 1.01; 95% confidence interval [CI], 1.00 to 1.02; P=0.002) and resolution (adjusted HR, 0.97; 95% CI, 0.96 to 0.99; P=0.005) of SLD. Compared with low mean TT3 group, high mean TT3 group was positively associated with development of SLD (adjusted HR, 1.20; 95% CI, 1.05 to 1.38; P=0.008) and inversely associated with resolution of SLD (adjusted HR, 0.66; 95% CI, 0.51 to 0.85; P=0.001). The statistical significance remained for development (adjusted HR, 1.29; 95% CI, 1.10 to 1.51; P=0.001) and resolution (adjusted HR, 0.71; 95% CI, 0.54 to 0.94; P=0.018) of modified MASLD.
Conclusion
In Korean euthyroid adults, TT3 level was associated with development and resolution of either SLD or modified MASLD.

Citations

Citations to this article as recorded by

Association Between Thyroid Dysfunction and Non-Alcoholic Fatty Liver Disease: A Systematic Review
Tanya ., Aryan Kler, Sunil Singh Bains
International Journal of Health Sciences and Research.2025; : 171. CrossRef

Thyroid
Association of the Preoperative Controlling Nutritional Status (CONUT) Score with Clinicopathological Characteristics in Patients with Papillary Thyroid Carcinoma: Doohwa Kim, Myungsoo Im, Soree Ryang, Mijin Kim, Yun Kyung Jeon, Sang Soo Kim, Bo Hyun Kim; Endocrinol Metab. 2024;39(6):856-863. Published online November 15, 2024; DOI: https://doi.org/10.3803/EnM.2024.2006

3,168 View
83 Download
3 Web of Science
3 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
The Controlling Nutritional Status (CONUT) score is an immunonutritional test tool based on serum albumin, total cholesterol, and lymphocyte counts. It has been studied as a simple prognostic predictor for various carcinomas. This study aimed to investigate the association between preoperative CONUT scores and the clinicopathological characteristics in papillary thyroid carcinoma (PTC) patients.
Methods
This study included 2,403 PTC patients who underwent total thyroidectomy between 2012 and 2016 at a single tertiary medical center. The CONUT scores were calculated based on preoperative blood tests. The clinicopathological characteristics were retrospectively reviewed. The patients were categorized by the CONUT score (relatively low, 0–2; relatively high, 3–5).
Results
Among the 2,997 PTC patients who underwent total thyroidectomy at Pusan National University Hospital between 2012 and 2016, those without preoperative blood test were excluded (n=149). Finally 2,403 patients were analyzed after excluding 439 patients taking lipid-lowering drugs and six patients without available T stage data after surgery. Based on the CONUT score, the relatively high score group had a lower body mass index (23.7±3.3 kg/m² vs. 21.9±2.9 kg/m², P<0.001), more advanced T stage (T stage 3/4, 5.9% vs. 11.4%, P=0.045), and higher extrathyroidal extension (2.1% vs. 7.6%, P=0.005).
Conclusion
Patients included in this large, single-center study all had a preoperative CONUT score of 0–5, but this study demonstrated that higher preoperative CONUT scores were significantly associated with advanced T stage and extrathyroidal extension. The CONUT score, which can be easily used in clinical practice, is thought to be helpful in predicting the aggressiveness of PTC.

Citations

Citations to this article as recorded by

Nutritional-immunological assessment by CONUT score predicts surgical outcomes in tuberculous empyema: development of a multivariate risk model
Liangliang Chen, Wenfeng Yu, Likui Fang, Jing Zhen, Fangming Zhong, Guocan Yu, Pengfei Zhu
Journal of Cardiothoracic Surgery.2026;[Epub] CrossRef
Prognostic Impact of the Pretreatment Controlling Nutritional Status (CONUT) Score in Anaplastic Thyroid Cancer: A Retrospective Cohort Study
Sun-Kyung Park, Nam Kyung Kim, Jun Sung Lee, Hyeok Jun Yun, Yong Sang Lee, Hye Sun Lee, Seok-Mo Kim, Young Song
Cancers.2025; 17(20): 3344. CrossRef
Machine learning-based prediction of clinical outcomes in cervical cancer using routine hematological indices: development and web implementation
Gaigai Bai, Fanghua Chen, Junjun Qiu, Keqin Hua
Frontiers in Oncology.2025;[Epub] CrossRef

Thyroid
A Neglected Point: Frailty in Older Adults with Differentiated Thyroid Cancer: Meric Coskun, Esra Cataltepe, Hacer Dogan Varan, Eda Ceker, Yasemin Bektas, Yasemin Kuscu, Mehmet Muhittin Yalcin, Mujde Akturk, Fusun Balos Toruner, Mehmet Ayhan Karakoc, Alev Eroglu Altinova; Endocrinol Metab. 2024;39(6):899-907. Published online November 5, 2024; DOI: https://doi.org/10.3803/EnM.2024.2046

3,473 View
72 Download

Abstract PDF PubReader ePub: Background
This study investigated the risk of frailty in older adults with differentiated thyroid cancer (DTC) and the effect of thyroid- stimulating hormone (TSH) levels on frailty.
Methods
This single-center, cross-sectional study included 70 DTC patients aged ≥60 years with stable TSH levels during the previous year while receiving levothyroxine. Frailty was assessed using the fried frailty phenotype (FFP). Anterior thigh muscle thickness was measured by ultrasound, and the sonographic thigh adjustment ratio (STAR) index was calculated. Muscle strength was measured using a hand dynamometer. Physical activity was determined by the physical activity scale for the elderly (PASE).
Results
The median (interquartile range) age and follow-up time were 65 years (62 to 71) and 11 years (7.0 to 14.2), respectively. The median TSH level was 1.10 μIU/mL (0.49 to 1.62), and 58.6% of patients were prefrail/frail. Muscle mass and strength were reduced in 35.7% and 17.2% of patients, respectively. TSH levels were lower in those with prefrailty/frailty (P=0.002), low muscle mass (P=0.014), and low strength (P=0.037) than in their normal counterparts. TSH levels correlated negatively with FFP (P= 0.001) and positively with the STAR index (P=0.034). TSH below 1.325 μIU/mL was associated with an increased frailty risk (area under the curve=0.719; P=0.001). Low TSH, female sex, low handgrip strength, and low PASE leisure time scores emerged as independent predictors of frailty (P<0.05).
Conclusion
Older adults with lower TSH levels due to DTC are at high frailty risk and have low muscle mass and strength. Therefore, TSH targets should be set based on a comprehensive evaluation with consideration of the risk-benefit ratio.

Thyroid
Distinct Impacts of Clinicopathological and Mutational Profiles on Long-Term Survival and Recurrence in Medullary Thyroid Carcinoma: Moon Young Oh, Kyong Yeun Jung, Hoonsung Choi, Young Jun Chai, Sun Wook Cho, Su-jin Kim, Kyu Eun Lee, Eun-Jae Chung, Do Joon Park, Young Joo Park, Han-Kwang Yang; Endocrinol Metab. 2024;39(6):877-890. Published online November 5, 2024; DOI: https://doi.org/10.3803/EnM.2024.2027

5,563 View
129 Download
3 Web of Science
4 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Medullary thyroid carcinoma (MTC) has a poorer prognosis than differentiated thyroid cancers; however, comprehensive data on the long-term outcomes of MTC remain scarce. This study investigated the extended clinical outcomes of MTC and aimed to identify prognostic factors.
Methods
Patients diagnosed with MTC between 1980 and 2020 were retrospectively reviewed. Their clinical characteristics, longterm clinical outcomes, and prognostic factors for recurrence and mortality were analyzed.
Results
The study included 226 patients (144 women, 82 men). The disease-specific survival (DSS) rates for all MTC patients at 5-, 10-, 20-, and 30-year intervals were 92.7%, 89.4%, 74.3%, and 68.1%, respectively. The recurrence-free survival (RFS) rates were 71.1%, 56.1%, 40.2%, and 32.1% at these intervals. DSS was comparable between the groups from 1980–2009 and 2010–2020 (P=0.995); however, the 1980–2009 group had significantly lower RFS rates (P=0.031). The 2010–2020 group exhibited greater extents of surgical and lymph node dissection (P=0.003) and smaller tumors (P=0.003). Multivariate analysis identified extrathyroidal extension as the strongest prognostic factor for both RFS and DSS. Age >55 years and tumor size of ≥2 cm were also significant prognostic factors for DSS, while hereditary disease and lymph node metastasis were significant for RFS. Survival analysis after propensity-score matching of rearranged during transfection (RET)-negative and non-screened RET-positive groups showed comparable DSS but longer RFS in the RET-negative group.
Conclusion
Extrathyroidal extension was identified as the strongest prognostic factor for RFS and DSS. Older age and larger tumor size were associated with decreased DSS, while RET mutation and lymph node metastasis significantly impacted RFS.

Citations

Citations to this article as recorded by

Clinical characteristics and risk analysis of lymph node metastasis in patients with cN0 differentiated thyroid carcinoma
Meng Wei, Kaipeng Hu, Gaolin Qiu, Qing Lin, Jincan Qian, Yao Lu, Rui Wang
Scientific Reports.2026;[Epub] CrossRef
The impact of microscopic extrathyroidal extension on the prognosis of medullary thyroid carcinoma: A multicenter cohort study
Beyza Olcay Ozturk, Umran Keskin, Serhat Uysal, Aysa Hacioglu, Seda Karsli, Burak Andac, Umit Nur Ozbay, Hulyanur Sodan, Sebnem Burhan, Coskun Ates, Ugur Avci, Faruk Kilinc, Selvinaz Erol, Merve Catak, Zafer Pekkolay, Gulhan Akbaba, Goknur Yorulmaz, Sakin
Endocrinología, Diabetes y Nutrición.2025; 72(10): 501633. CrossRef
The impact of microscopic extrathyroidal extension on the prognosis of medullary thyroid carcinoma: A multicenter cohort study
Beyza Olcay Ozturk, Umran Keskin, Serhat Uysal, Aysa Hacioglu, Seda Karsli, Burak Andac, Umit Nur Ozbay, Hulyanur Sodan, Sebnem Burhan, Coskun Ates, Ugur Avci, Faruk Kilinc, Selvinaz Erol, Merve Catak, Zafer Pekkolay, Gulhan Akbaba, Goknur Yorulmaz, Sakin
Endocrinología, Diabetes y Nutrición (English ed.).2025; 72(10): 501633. CrossRef
MEDULLARY THYROID CARCINOMA (MTC): A CURRENT REVIEW OF EPIDEMIOLOGY, DIAGNOSIS, AND THERAPY
Szymon Zysiak, Julia Wawerska, Dawid Głaz, Maksymilian Głaz, Natalia Kamińska, Jędrzej Zaguła, Magdalena Stolarczyk, Aleksandra Jagura-Sukiennik, Mateusz Stronczyński, Kacper Wicha
International Journal of Innovative Technologies in Social Science.2025;[Epub] CrossRef

Thyroid
Prevalence of Subclinical Hypothyroidism in a Non-Diabetic Young Female Population and Its Impact on Diabetes and Cardiometabolic Risk: Nawoda Hewage, Udaya Wijesekara, Rasika Perera; Endocrinol Metab. 2024;39(6):864-876. Published online November 5, 2024; DOI: https://doi.org/10.3803/EnM.2024.2015

4,683 View
100 Download
2 Crossref

Abstract PDF PubReader ePub

Background
We evaluated the influence of subclinical hypothyroidism (SCH) on insulin resistance (IR), cardiometabolic risk, and obesity in childbearing-age women without diabetes.
Methods
This cross-sectional investigation included 282 women, aged 18 to 35 years, from rural and suburban Sri Lanka. Anthropometric and biochemical parameters, including IR and lipid/thyroid profiles, were recorded. Data were compared between SCH and euthyroidism (EU) for controls (normal weight) and cases (overweight/obese).
Results
The overall rates of SCH, EU, IR, and metabolic syndrome (MetS) were 40.42%, 59.57%, 73.40%, and 24.46%, respectively. Both controls and cases included individuals with SCH; overall, 168 participants (59.57%) had EU, while 114 (40.42%) exhibited SCH. IR was significantly associated with SCH in both weight groups (P<0.05). Among those with SCH, the odds ratios (ORs) for IR were >2 (95% confidence interval [CI], 0.45 to 3.87) in controls and >6 (95% CI, 3.52 to 8.41) in cases. Similarly, the ORs for MetS were >1 (95% CI, 0.38 to 4.16) in controls and >11 (95% CI, 8.73 to 15.01) in cases. Dyslipidemia and hypertriglyceridemia were significantly more prevalent in the SCH group (P<0.05). Women with SCH exhibited higher mean values for all obesity indices compared to their EU counterparts, surpassing normal thresholds (P<0.05). Among obesity measures, visceral adiposity index (VAI) demonstrated the highest area under the curve and sensitivity for assessing SCH and cardiovascular disease (CVD) risk.
Conclusion
SCH must be identified and managed in young women to help prevent diabetes and cardiometabolic disorders. VAI may aid in precisely detecting SCH and CVD.

Citations

Citations to this article as recorded by

Increased Serum Lipopolysaccharide Levels are Related to a Higher Prevalent Risk of Subclinical Hypothyroidism
Xuan An, Xiaoyi Wang, Jin Zhang, Mingtong Xu, Muchao Wu, Suraiya Saleem
International Journal of Endocrinology.2025;[Epub] CrossRef
Incidence of Subclinical Hypothyroidism in Obese Adults and Its Metabolic Implications: A Prospective Cohort Study
Umer Jameel, Obaidullah Durrani, Ahmad Munib, Amanullah Khan
Cureus.2025;[Epub] CrossRef

Review Article

Thyroid
Long-Term Antithyroid Drug Therapy in Smoldering or Fluctuating-Type Graves’ Hyperthyroidism with Potassium Iodide: Ken Okamura; Endocrinol Metab. 2024;39(6):827-838. Published online October 16, 2024; DOI: https://doi.org/10.3803/EnM.2024.2079

7,983 View
191 Download
2 Web of Science
2 Crossref

Abstract PDF PubReader ePub

Graves’ hyperthyroidism is characterized by stimulation of the thyroid gland by thyroid-stimulating hormone receptor antibodies (TRAbs). Antithyroid drug (ATD) continuation is recommended as long as the thyroid gland is stimulated. Goiter size, thyroidal ¹²³I uptake, serum thyroglobulin level, and TRAb positivity are reliable markers of thyroid stimulation. Attention must also be paid to the responsiveness of the thyroid gland due to the high prevalence of painless thyroiditis and spontaneous hypothyroidism during treatment. TRAbs disappeared at <5 years entering remission in 36.6% of patients (smooth-type), while re-elevation of TRAb activity occurred in 37.7% (fluctuating-type) and remained positive for >5 years in 21.1% (smoldering-type). Seven percent of patients remained positive for TRAbs for >30 years, requiring life-long ATD treatment. Remission occurred after median 6.8 years (interquartile range, 4.0 to 10.9) of ATD treatment in 55% of patients. However, late relapse may occur after stressful events (dormant type). In apparently intractable Graves’ disease (GD) with a large goiter (>40 g), ¹³¹I therapy should be considered. For initial and long-term ATD treatment, we must choose effective, safe, and economical drugs such as 100 mg potassium iodide (KI), although KI sensitivity varies in patients with GD. Thionamide, which has notorious side effects, is added only during the KI-resistant period.

Citations

Citations to this article as recorded by

Therapeutic effectiveness of iodine-rich herbs in treating Graves’ hyperthyroidism: a retrospective cohort study from a single center
Yiwen Lai, Mengfei Yang, Jing Li, Di Gan, Qingyang Liu, Yingna Wang, Tianshu Gao
Frontiers in Endocrinology.2025;[Epub] CrossRef
High TRAb Titer at Diagnosis Predicts Persistent Positivity and Relapse in Graves’ Disease after Prolonged Antithyroid Therapy
Zimiao Chen, Jinglu Xu, Wenrui Kang, Yang Zhang, Rujun Chen, Xiaohua Gong
Endocrinology and Metabolism.2025; 40(6): 950. CrossRef

Original Article

Thyroid
In Vitro Investigation of HIF-1α as a Therapeutic Target for Thyroid-Associated Ophthalmopathy: Jeongmin Lee, Jinsoo Lee, Hansang Baek, Dong-Jun Lim, Seong-Beom Lee, Jung-Min Lee, Sang-Ah Jang, Moo Il Kang, Suk-Woo Yang, Min-Hee Kim; Endocrinol Metab. 2024;39(5):767-776. Published online October 16, 2024; DOI: https://doi.org/10.3803/EnM.2024.1952

4,207 View
114 Download
3 Web of Science
2 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Thyroid-associated ophthalmopathy (TAO) involves tissue expansion and inflammation, potentially causing a hypoxic microenvironment. Hypoxia-inducible factor (HIF)-1α is crucial in fibrosis and adipogenesis, which are observed in TAO progression. We investigated the effects of hypoxia on orbital fibroblasts (OFs) in TAO, focusing on the role of HIF-1α in TAO progression.
Methods
OFs were isolated from TAO and non-TAO patients (as controls). In addition to HIF-1α, adipogenic differentiation markers including peroxisome proliferator-activated receptor γ (PPARγ) and CCAAT/enhancer binding protein (CEBP) were measured by Western blot, and phenotype changes were evaluated by Oil Red O staining under both normoxia and hypoxia. To elucidate the effect of HIF-1α inhibition, protein expression changes after HIF-1α inhibitor treatment were evaluated under normoxia and hypoxia.
Results
TAO OFs exhibited significantly higher HIF-1α expression than non-TAO OFs, and the difference was more distinct under hypoxia than under normoxia. Oil Red O staining showed that adipogenic differentiation of TAO OFs was prominent under hypoxia. Hypoxic conditions increased the expression of adipogenic markers, namely PPARγ and CEBP, as well as HIF-1α in TAO OFs. Interleukin 6 levels also increased in response to hypoxia. The effect of hypoxia on adipogenesis was reduced at the protein level after HIF-1α inhibitor treatment, and this inhibitory effect was sustained even with IGF-1 stimulation in addition to hypoxia.
Conclusion
Hypoxia induces tissue remodeling in TAO by stimulating adipogenesis through HIF-1α activation. These data could provide insights into new treatment strategies and the mechanisms of adipose tissue remodeling in TAO.

Citations

Citations to this article as recorded by

Hypoxia-Inducible Factor 1-α in Autoimmune Diseases—Insights from the Paradigm of Hashimoto’s Thyroiditis: A Narrative Review
Nika Srb, Andrea Milostić-Srb, Lea Sarić, Dubravka Holik, Matej Šapina, Rajko Fureš, Jasminka Talapko, Ivana Škrlec, Darko Katalinić, Borna Kovačić
Medical Sciences.2026; 14(1): 61. CrossRef
Integrative transcriptomic profiling and machine learning reveal hypoxia-associated molecular signatures for precision diagnosis in thyroid eye disease
Weijin Qian, Tianyi Zhu, Jin Liu, Yining Wei, Li Yang, Lianfei Fang, Jing Sun, Yinwei Li, Sijie Fang, Huifang Zhou
Human Genomics.2025;[Epub] CrossRef

Review Article

Thyroid
Thyroid Hormone-Mediated Selective Autophagy and Its Implications in Countering Metabolic Dysfunction-Associated Steatotic Liver Disease: Rohit A. Sinha; Endocrinol Metab. 2024;39(5):686-692. Published online October 14, 2024; DOI: https://doi.org/10.3803/EnM.2024.2068

5,334 View
119 Download
5 Web of Science
5 Crossref

Abstract PDF PubReader ePub

The influence of thyroid hormone (TH) on liver metabolism has attracted the attention of pharmacologists seeking new treatments for metabolic dysfunction-associated steatotic liver disease (MASLD), an increasingly common metabolic disorder. In this context, the selective induction of autophagy by TH in preclinical models has been identified as a promising mechanism. In this process, TH clears intrahepatic fat through lipophagy while protecting against inflammation and mitochondrial damage in hepatocytes via mitophagy. Furthermore, TH-induced aggrephagy may represent a protective mechanism to mitigate the development of MASLD-associated hepatocellular carcinoma. Considering the defects in autophagy observed during the progression of human MASLD, the induction of autophagy by TH, its metabolites, and its analogs represent a novel strategy to combat hepatic damage across the MASLD spectrum.

Citations

Citations to this article as recorded by

The many pathways driving liver inflammation in MASH
Herbert Tilg, Timon E. Adolph, Stefano Romeo, Rohit Loomba
Cell Metabolism.2026;[Epub] CrossRef
Decoding the association of polycystic ovary syndrome with metabolic-associated fatty liver: insights into CK18 and LC3II/ATG7/P62 autophagy axis and adjunct therapeutics of metformin and levothyroxine
Sameeah Mejbel Hamad Algenabi, Anwar Nather Seiwan, Maha Hussein Hashem Sabra, Doaa I. Mohamed, Lobna Fouad Abd ElAziz Bassyouni, Dalia Alaa El-Din Aly El-Waseef, Samar F. Ezzat, Omnyah A. El-Kharashi, Hanaa F. Abd El-Kareem, Hyfa A. Alzahrani, Fawzyah Ob
RSC Medicinal Chemistry.2026;[Epub] CrossRef
Nuclear receptors in metabolic, inflammatory, and oncologic diseases: mechanisms, therapeutic advances, and future directions
Mohammed A. Abdel-Rasol, Wael M. El-Sayed
European Journal of Medical Research.2025;[Epub] CrossRef
Human genetics of steatotic liver disease: insights into insulin resistance and lipid metabolism
Rosellina M. Mancina, Luca Valenti, Stefano Romeo
Nature Metabolism.2025; 7(11): 2199. CrossRef
Repurposing levothyroxine for managing metabolic dysfunction-associated steatotic liver disease
Leonidas H. Duntas, Stergios A. Polyzos, Ulrike Gottwald-Hostalek, Bogumila Urgatz, Paul M. Yen
Endocrine.2025; 90(3): 1043. CrossRef

Original Articles

Thyroid
Small Multi-Gene DNA Panel Can Aid in Reducing the Surgical Resection Rate and Predicting the Malignancy Risk of Thyroid Nodules: Moon Young Oh, Hye-Mi Choi, Jinsun Jang, Heejun Son, Seung Shin Park, Minchul Song, Yoo Hyung Kim, Sun Wook Cho, Young Jun Chai, Woosung Chung, Young Joo Park; Endocrinol Metab. 2024;39(5):777-792. Published online October 14, 2024; DOI: https://doi.org/10.3803/EnM.2024.2034

4,920 View
113 Download
3 Web of Science
4 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
We explored the utility of a small multi-gene DNA panel for assessing molecular profiles of thyroid nodules and influencing clinical decisions by comparing outcomes between tested and untested nodules.
Methods
Between April 2022 and May 2023, we prospectively performed fine-needle aspiration (FNA) with gene testing via DNA panel of 11 genes (BRAF, RAS [NRAS, HRAS, KRAS], EZH1, DICER1, EIF1AX, PTEN, TP53, PIK3CA, TERT promoter) in 278 consecutive nodules (panel group). Propensity score-matching (1:1) was performed with 475 nodules that consecutively underwent FNA without gene testing between January 2021 and December 2021 (control group).
Results
In the panel group, positive call rate for mutations was 41.7% (BRAF 16.2%, RAS 12.6%, others 11.5%, double mutation 1.4%) for all nodules, and 40.0% (BRAF 4.3%, RAS 19.1%, others 15.7%, double mutation 0.9%) for indeterminate nodules. Benign call rate was 69.8% for all nodules, and 75.7% for indeterminate nodules. In four nodules, additional TP53 (in addition to BRAF or EZH1) or PIK3CA (in addition to BRAF or TERT) mutations were co-detected. Sensitivity, specificity, positive predictive value, and negative predictive value were 80.0%, 53.3%, 88.1%, 38.1% for all nodules, and 78.6%, 45.5%, 64.7%, 62.5% for indeterminate nodules, respectively. Panel group exhibited lower surgical resection rates than the control group for all nodules (27.0% vs. 52.5%, P<0.001), and indeterminate nodules (23.5% vs. 68.2%, P<0.001). Malignancy risk was significantly different between the panel and control groups (81.5% vs. 63.9%, P=0.008) for all nodules.
Conclusion
Our panel aids in managing thyroid nodules by providing information on malignancy risk based on mutations, potentially reducing unnecessary surgery in benign nodules or patients with less aggressive malignancies.

Citations

Citations to this article as recorded by

Integrative multi-omics refines the molecular subtypes of thyroid cancers and enhances cancer-progression prediction: a retrospective cohort study
Yoo Hyung Kim, Joseph Wang, Jae-Kyung Won, Youngsoo Kim, Sun Wook Cho, Dohyun Han, Young Joo Park
International Journal of Surgery.2026;[Epub] CrossRef
Great Debate: Molecular Testing and Extent of Surgery in Well-Differentiated Thyroid Cancer
Cord Sturgeon, Ashok R. Shaha, Linwah Yip
Annals of Surgical Oncology.2025; 32(7): 4597. CrossRef
Prediction of malignancy risk in Bethesda III nodules: development and validation of multiple machine learning models
Wentian Li, Jiayu Zhu, Ying Wang, Jingxiu Li, Zhonghui Li, Cuicui Wang, Jingli Xue, Peng Zhou, Qingqing He
Frontiers in Endocrinology.2025;[Epub] CrossRef
Inside the Matrix: Integrated Cytology and Molecular Testing of Thyroid FNAC Samples Using a Commercial Synthetic 3D Scaffold
Diana Raluca Streinu, Dana Liana Stoian, Octavian Constantin Neagoe, Mihnea Derban, Paula Diana Ciordas, Catalin Marian
International Journal of Molecular Sciences.2025; 26(22): 11100. CrossRef

Thyroid Big Data Articles (National Health Insurance Service Database)
Rising Incidence and Comorbidities of Endogenous Hypothyroidism in Republic of Korea from 2004 to 2018: A Nationwide Population Study: Chae Won Chung, Hwa Young Ahn, Sun Wook Cho, Ka Hee Yi; Endocrinol Metab. 2024;39(6):891-898. Published online September 23, 2024; DOI: https://doi.org/10.3803/EnM.2024.1996

5,217 View
91 Download
2 Web of Science
2 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Hypothyroidism, a prevalent endocrine disorder, results from insufficient thyroid hormone production or release, affecting metabolism. However, disparities in comorbidities and treatment trajectories may exist between endogenous and exogenous hypothyroidism.
Methods
Data from the Korean National Health Insurance Service from 2004 to 2018. Endogenous hypothyroidism was defined as cases with two or more diagnostic codes for hypothyroidism coupled with a history of thyroid hormone intake exceeding 60 days. To eliminate iatrogenic hypothyroidism, individuals with diagnosis codes for thyroid cancer, treatment codes for thyroid surgery, or radiotherapy were excluded. Hypothyroidism-related comorbidities were defined as new occurrences of the corresponding diagnosis code after the diagnosis of hypothyroidism during the entire study period.
Results
The age-standardized incidence of endogenous hypothyroidism among men was 0.2 per 1,000 person-years in 2004, increasing to 0.8 in 2018. Among women, the incidence increased from 1.6 per 1,000 person-years in 2004 to 3.7 in 2018. When comparing age groups of 20s–50s and 60s–90s, both sexes in the 60s–90s demonstrated a more rapid increase in incidence than those in the 20s–50s age range. Patients with endogenous hypothyroidism demonstrated a higher incidence of mood disorders across all age groups and cerebrovascular disease in individuals ≥60 years old, regardless of sex.
Conclusion
In Republic of Korea, endogenous hypothyroidism incidence has been increased in recent years. The incidence of endogenous hypothyroidism is increasing more rapidly in men than in women, especially in the elderly. Patients with endogenous hypothyroidism seem to have a heightened risk for cerebrovascular disease and mood disorders.

Citations

Citations to this article as recorded by

Nationwide Big Data Studies of Endocrine Diseases Using the Korean National Health Information Database: Research Trends and Standardization of Operational Definitions
Sun Wook Cho, Jung Hee Kim, Kyoung Jin Kim, Beom-Jun Kim, Mee Kyoung Kim, Eun Jung Rhee
Endocrinology and Metabolism.2026; 41(1): 86. CrossRef
Comorbidities of hypothyroidism
Gabriela Brenta, Ulrike Gottwald-Hostalek
Current Medical Research and Opinion.2025; 41(3): 421. CrossRef

Thyroid
Adequate Dose of Levothyroxine for Thyroid-Stimulating Hormone Suppression after Total Thyroidectomy in Patients with Differentiated Thyroid Cancer: Hyun Jin Ryu, Min Sun Choi, Hyunju Park, Tae Hyuk Kim, Jae Hoon Chung, So Young Park, Sun Wook Kim; Endocrinol Metab. 2024;39(4):615-621. Published online August 7, 2024; DOI: https://doi.org/10.3803/EnM.2023.1896

12,514 View
184 Download
7 Web of Science
6 Crossref

Abstract PDF PubReader ePub

Background
The adequate dose of levothyroxine (LT4) for patients who have undergone total thyroidectomy (TT) for differentiated thyroid cancer (DTC) is uncertain. We evaluated the LT4 dose required to achieve mild thyroid-stimulating hormone (TSH) suppression in DTC patients after TT.
Methods
The electronic medical records of patients who underwent TT for DTC and received mild TSH suppression therapy were reviewed. Linear regression analysis was performed to evaluate the association between LT4 dose (μg/kg) and an ordinal group divided by body mass index (BMI). We also evaluated the trend in LT4 doses among groups divided by BMI and age.
Results
In total, 123 patients achieved mild TSH suppression (0.1 to 0.5 mIU/L). The BMI variable was divided into three categories: <23 kg/m² (n=46), ≥23 and <25 kg/m² (n=30), and ≥25 kg/m² (n=47). In the linear regression analysis, BMI was negatively associated with the LT4 dose after adjusting for age and sex (P<0.001). The LT4 doses required to achieve mild TSH suppression based on the BMI categories were 1.86, 1.71, and 1.71 μg/kg, respectively (P for trend <0.001). Further analysis with groups divided by age and BMI revealed that a higher BMI was related to a lower LT4 dose, especially in younger patients aged 20 to 39 (P for trend=0.011).
Conclusion
The study results suggest an appropriate LT4 dose for mild TSH suppression after TT based on body weight in patients with DTC. Considering body weight, BMI, and age in estimating LT4 doses might help to achieve the target TSH level promptly.

Citations

Citations to this article as recorded by

A paper-based fluorescent aptasensor utilizing click chemistry strategy for portable detection of thyroid stimulating hormone
Changxin Huangfu, Yanting Duan, Chenyue Zhan, Ruimin Liang, Jiajie Xu, Minghua Ge
Microchemical Journal.2026; 225: 118035. CrossRef
Effects of 131I and TSH suppression therapy on METTL3, METTL14 levels and recurrence in thyroid cancer
Li-Guo Yang
American Journal of Cancer Research.2025; 15(1): 42. CrossRef
Developing a machine learning-based predictive model for levothyroxine dosage estimation in hypothyroid patients: a retrospective study
Tran Thi Ngan, Dang Huong Tra, Ngo Thi Quynh Mai, Hoang Van Dung, Nguyen Van Khai, Pham Van Linh, Nguyen Thi Thu Phuong
Frontiers in Endocrinology.2025;[Epub] CrossRef
Tailoring TSH suppression in differentiated thyroid carcinoma: evidence, controversies, and future directions
Xinxin Song, Xin Zhi, Linxue Qian
Endocrine.2025; 89(1): 1. CrossRef
Risk of Osteoporotic Fractures among Patients with Thyroid Cancer: A Nationwide Population-Based Cohort Study
Eu Jeong Ku, Won Sang Yoo, Yu Been Hwang, Subin Jang, Jooyoung Lee, Shinje Moon, Eun Kyung Lee, Hwa Young Ahn
Endocrinology and Metabolism.2025; 40(2): 225. CrossRef
Levothyroxine Dosing for Thyroid-Stimulating Hormone Suppression in Patients with Differentiated Thyroid Cancer after Total Thyroidectomy
Mijin Kim
Endocrinology and Metabolism.2024; 39(4): 576. CrossRef

Thyroid
Prognosis of Poorly Differentiated Thyroid Carcinoma: A Systematic Review and Meta-Analysis: Ji Young Kim, Jae Kyung Myung, Soyun Kim, Kyung Tae, Yun Young Choi, Soo Jin Lee; Endocrinol Metab. 2024;39(4):590-602. Published online June 27, 2024; DOI: https://doi.org/10.3803/EnM.2024.1927

14,218 View
291 Download
8 Web of Science
7 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Poorly differentiated thyroid carcinoma (PDTC) accounts for a small portion of thyroid carcinomas but contributes to a significant proportion of thyroid carcinoma-associated deaths. The clinicopathological prognostic factors and clinical outcomes of PDTC remain unclear. We aimed to evaluate the clinical outcomes of patients with PDTC after curative treatment.
Methods
A comprehensive search was performed up to September 2023. We included studies investigating treatment outcomes in patients with PDTC who underwent initial surgery. The 5-year disease-free survival (DFS) and overall survival (OS) were extracted. In this meta-analysis, the enrolled PDTC histological criteria included 3rd, 4th, and 5th World Health Organization (WHO) and Memorial Sloan Kettering Cancer Center (MSKCC) classification. A random-effects model was used for the pooled proportion analysis. Meta-regression analysis was conducted to evaluate the prognostic factors.
Results
Twenty retrospective studies published between 2007 and 2023, including 1,294 patients, met all inclusion criteria. Studies that diagnosed PDTC based on various histological criteria including 3rd WHO (n=5), 4th WHO (n=12), 5th WHO (n=2), and MSKCC (n=1) were included. Overall, 5-year DFS and 5-year OS were 49.4% (95% confidence interval [CI], 42.3 to 56.4) and 73.8% (95% CI, 66.5 to 79.9), with moderate heterogeneity of 58% and 55%, respectively. In meta-regression analysis, extrathyroidal extension (ETE) was a prognostic factor for OS.
Conclusion
The meta-analysis of DFS and OS in patients with PDTC show the moderate heterogeneity with a variety of histological criteria. ETE appears to have a significant impact on OS, regardless of histological criteria.

Citations

Citations to this article as recorded by

Differentiated high-grade thyroid carcinoma (DHGTC): clinicopathological analysis of a new entity in a chilean center
Marlín Solórzano, Ignacio Fuentes, José Miguel González, Nicole Lustig, Lorena Mosso, Joel Falcón, Catalina Ruiz, Joaquín Viñambres, Rodolfo Cabello, Hernán González, Pablo H Montero, Francisco Cruz, Rodrigo Jaimovich, Juan Carlos Quintana, Antonieta Sola
Endocrine.2026;[Epub] CrossRef
Poorly differentiated thyroid carcinoma in identical twins: a report of two cases and review of the literature
Amal El Masri, Celine El Moughrabi, Anas El Zouhbi, Anthony Shebly, Hala Kassouf, Mustafa Natout, Yusef Hazimeh, Mustapha El Lakis
Thyroid Research.2026;[Epub] CrossRef
Clinical and prognostic characteristics of poorly differentiated thyroid carcinomas
B.B. Guda, A.V. Tymkiv, M.V. Ostafiychuk, I.I. Komisarenko, I.V. Gamezardashvili, M.D. Melnik
INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine).2026; 22(2): 111. CrossRef
Multilayered Insights into Poorly Differentiated, BRAFV600E-Positive, Thyroid Carcinoma in a Rapidly Developing Goiter with Retrosternal Extension: From En “Y” Cervicotomy to SPECT/CT-Positive Lung Metastases
Oana-Claudia Sima, Anca-Pati Cucu, Dana Terzea, Claudiu Nistor, Florina Vasilescu, Lucian-George Eftimie, Mihai-Lucian Ciobica, Mihai Costachescu, Mara Carsote
Diagnostics.2025; 15(16): 2049. CrossRef
GDF15 is associated with thyroid cancer progression and may modulate thyroid cancer cell senescence in a p53-dependent manner
Jingyu Ma, Zishuo Liu, Rui Hua, Changyuan Ding, Zhenpeng Yang, Weili Liang, Bin Lv
Frontiers in Endocrinology.2025;[Epub] CrossRef
Multimodal spectrum of approach in poorly differentiated thyroid carcinoma (an updated analysis)
Mihai Costachescu, Nina Ionovici , Dana Cristina Terzea , Florina Vasilescu , Lucian-George Eftimie , Alexandra-Ioana Trandafir , Ana-Maria Gheorghe , Oana-Claudia Sima , Claudiu Nistor , Mara Carsote
Romanian Journal of Morphology and Embryology.2025; 66(3): 431. CrossRef
Aggressive Types of Malignant Thyroid Neoplasms
Maria Boudina, Eleana Zisimopoulou, Persefoni Xirou, Alexandra Chrisoulidou
Journal of Clinical Medicine.2024; 13(20): 6119. CrossRef

Review Articles

Mineral, Bone & Muscle
Parathyroid Gland Generation from Pluripotent Stem Cells: Mayuko Kano; Endocrinol Metab. 2024;39(4):552-558. Published online June 10, 2024; DOI: https://doi.org/10.3803/EnM.2024.1989

6,975 View
148 Download
3 Web of Science
3 Crossref

Abstract PDF PubReader ePub

Patients with permanent hypoparathyroidism require lifelong treatment. Current replacement therapies sometimes have adverse effects (e.g., hypercalciuria and chronic kidney disease). Generating parathyroid glands (PTGs) from the patient’s own induced pluripotent stem cells (PSCs), with transplantation of these PTGs, would be an effective treatment option. Multiple methods for generating PTGs from PSCs have been reported. One major trend is in vitro differentiation of PSCs into PTGs. Another is in vivo generation of PSC-derived PTGs by injecting PSCs into PTG-deficient embryos. This review discusses current achievements and challenges in present and future PTG regenerative medicine.

Citations

Citations to this article as recorded by

Perspectives on the Parathyroid–Thymus Interconnection—A Literature Review
Maria-Paula Comănescu, Otilia Boișteanu, Delia Hînganu, Marius Valeriu Hînganu, Roxana Grigorovici, Alexandru Grigorovici
International Journal of Molecular Sciences.2025; 26(13): 6000. CrossRef
Parathyroid glands exhibit reduced parenchymatic chief cells and increased extracellular collagen as a response to a long-term low-phosphorus diet in pigs
Michael Oster, Henry Reyer, Frieder Hadlich, Siriluck Ponsuksili, Petra Wolf, Klaus Wimmers, Jonas Keiler
Animal Nutrition.2025; 22: 471. CrossRef
Adipose-Derived Stem Cells Pretreated With Phototherapy Promote HUVECs Migration and Angiogenesis by Mediating EYA1 Activation
D Zhang, Y Zhang, J Wen, B Wu, Y Chen, Y Song, C Liang
Physiological Research.2025; : 809. CrossRef

Thyroid
Metabolic Reprogramming in Thyroid Cancer: Sang-Hyeon Ju, Minchul Song, Joung Youl Lim, Yea Eun Kang, Hyon-Seung Yi, Minho Shong; Endocrinol Metab. 2024;39(3):425-444. Published online June 10, 2024; DOI: https://doi.org/10.3803/EnM.2023.1802

14,086 View
265 Download
19 Web of Science
20 Crossref

Abstract PDF PubReader ePub

Thyroid cancer is a common endocrine malignancy with increasing incidence globally. Although most cases can be treated effectively, some cases are more aggressive and have a higher risk of mortality. Inhibiting RET and BRAF kinases has emerged as a potential therapeutic strategy for the treatment of thyroid cancer, particularly in cases of advanced or aggressive disease. However, the development of resistance mechanisms may limit the efficacy of these kinase inhibitors. Therefore, developing precise strategies to target thyroid cancer cell metabolism and overcome resistance is a critical area of research for advancing thyroid cancer treatment. In the field of cancer therapeutics, researchers have explored combinatorial strategies involving dual metabolic inhibition and metabolic inhibitors in combination with targeted therapy, chemotherapy, and immunotherapy to overcome the challenge of metabolic plasticity. This review highlights the need for new therapeutic approaches for thyroid cancer and discusses promising metabolic inhibitors targeting thyroid cancer. It also discusses the challenges posed by metabolic plasticity in the development of effective strategies for targeting cancer cell metabolism and explores the potential advantages of combined metabolic targeting.

Citations

Citations to this article as recorded by

Proteomics combined with ultrasound radiomics predicts central lymph node metastasis in papillary thyroid carcinoma
Ya Sun, Jian Jiang, Pengfei Zhang, Zhiyong Lv, Jiajun Wang, Nan Zhou, Lei Liang
Current Radiopharmaceuticals.2026; 19(2): 100016. CrossRef
The molecular mechanisms and potential therapeutic implications of the crosstalk between DNA methylation and metabolic reprogramming in thyroid cancer
Tianying Zhang, Hengtong Han, Yating Zhang, Tingting Zhang, Libin Ma, Ze Yang, Yong-xun Zhao
Cell Death Discovery.2026;[Epub] CrossRef
The critical role of ferroptosis in thyroid cancer development and potential therapeutic implications
Yinghao Li, Tao Qian, Zhongyu Han, Chuchu Wang, Meiqi Zhang, Chi Huang, Qingqing Gu, Shuangyan Zhang, Yumeng Lin, Jianhua Wang, Shouqiang Chen
Frontiers in Oncology.2026;[Epub] CrossRef
Acetate Metabolism in Thyroid Cancer Progression
Enke Baldini, Silvia Cardarelli, Eleonora Lori, Poupak Fallahi, Camilla Virili, Marco Centanni, Vito D’Andrea, Alessandro Antonelli, Salvatore Sorrenti, Salvatore Ulisse
International Journal of Molecular Sciences.2026; 27(4): 2013. CrossRef
Ferroptosis in Differentiated Thyroid Cancer: Redox–Iodine Metabolism, Dedifferentiation, and Therapeutic Sensitization Beyond Anaplastic Disease
Jaewang Lee, Jong-Lyel Roh
Cells.2026; 15(7): 630. CrossRef
Advances in plasma metabolomics detection technology and its clinical applications in lung cancer and other malignancies
Yue He, Juntong Guo, Pufan Gao, Zifan Li, Wenxiang Wang, Kezhong Chen
Holistic Integrative Oncology.2026;[Epub] CrossRef
Metabolic crosstalk between differentiated thyroid cancer and cardiovascular disease: insulin resistance as a molecular bridge—a proposed mechanism
Guizhang Hou, Tianshu Gao
Frontiers in Endocrinology.2026;[Epub] CrossRef
Bilateral chylothorax following total thyroidectomy with neck lymph node dissection for thyroid cancer: a case report and literature review
Yunsheng Wang, Xudong Liu, Xingyue Wang, Youxin Tian, Qinjiang Liu, Jun Wang, Jincai Xue
Frontiers in Oncology.2025;[Epub] CrossRef
The emerging landscape of small nucleolar RNA host gene 10 in cancer mechanistic insights and clinical relevance
Jingyu Zhu, Zihao Jian, Fangteng Liu, Lulu Le
Cellular Signalling.2025; 127: 111590. CrossRef
The Role of WDR77 in Cancer: More than a PRMT5 Interactor
Isaac Silverman, Aaron Shaykevich, Radhashree Maitra
Molecular Cancer Research.2025; 23(4): 269. CrossRef
Systems biology approach delineates critical pathways associated with papillary thyroid cancer: a multi-omics data analysis
Febby Payva, Santhy K. S., Remya James, Amrisa Pavithra E, Venketesh Sivaramakrishnan
Thyroid Research.2025;[Epub] CrossRef
Identification of oxidative stress-related subgroups and signature genes for the prediction of prognosis and immune microenvironment in thyroid cancer
Zhenwei Qiu, Jing Li, Mei Tian
Molecular Genetics and Genomics.2025;[Epub] CrossRef
The current state and influencing factors of negative social expectations among thyroid cancer patients: a single-center cross-sectional analysis
Zhitong Wang, Cui Chen, Jing Lu, Zhenfan Liu
Frontiers in Psychology.2025;[Epub] CrossRef
Turning tumor microenvironmental foes to friends: A new opportunity for thyroid cancer therapy and redifferentiation
Liya Zhu, Xiuli Jing, Byeong-Cheol Ahn
Oral Oncology.2025; 168: 107513. CrossRef
Targeting the ATG12–ATG3 protein-protein interaction: From structural insights to therapeutic opportunities in autophagy modulation
Emadeldin M. Kamel, Sally Mostafa Khadrawy, Ahmed A. Allam, Noha A. Ahmed, Faris F. Aba Alkhayl, Al Mokhtar Lamsabhi
Pathology - Research and Practice.2025; 273: 156156. CrossRef
Association between metabolic dysfunction-associated steatotic liver disease and the risk of thyroid cancer: a nationwide cohort study
Jeongmin Lee, Jeongeun Kwak, Min-Hee Kim, Seung-Hwan Lee, Jae-Hyoung Cho, Dong-Jun Lim, Jung Min Lee, Sang-Ah Chang, Hun-Sung Kim
The Korean Journal of Internal Medicine.2025; 40(5): 813. CrossRef
Thyroid cancer: From molecular insights to therapy (Review)
Zhuozheng Li, Nuofan Wang, Xiao Li, Yongfang Xie, Zemin Dou, Hongbing Xin, Yuzhuo Lin, Yan Si, Tingting Feng, Guohui Wang
Oncology Letters.2025; 30(5): 1. CrossRef
The role of WNT signaling in papillary thyroid cancer: Mechanisms, epigenetic regulation, therapeutic resistance, and emerging clinical strategies
Zhongqiang Li, Dongxia Lv, Lingjuan Niu, Yacun Wan, Junli Li
Pathology - Research and Practice.2025; 275: 156231. CrossRef
Exosome-mediated metabolic reprogramming: effects on thyroid cancer progression and tumor microenvironment remodeling
Shouhua Li, Hengtong Han, Kaili Yang, Xiaoxiao Li, Libin Ma, Ze Yang, Yong-xun Zhao
Molecular Cancer.2025;[Epub] CrossRef
Oncogenic mutation-driven metabolism-immunity regulatory axis: Potential prospects for thyroid cancer precision therapy
Tingting Zhang, Hengtong Han, Tianying Zhang, Yating Zhang, Libin Ma, Ze Yang, Yong-xun Zhao
Biochimica et Biophysica Acta (BBA) - Reviews on Cancer.2025; 1880(6): 189459. CrossRef

Original Articles

Thyroid
Diagnostic Accuracy of Preoperative Radiologic Findings in Papillary Thyroid Microcarcinoma: Discrepancies with the Postoperative Pathologic Diagnosis and Implications for Clinical Outcomes: Ying Li, Seul Ki Kwon, Hoonsung Choi, Yoo Hyung Kim, Sunyoung Kang, Kyeong Cheon Jung, Jae-Kyung Won, Do Joon Park, Young Joo Park, Sun Wook Cho; Endocrinol Metab. 2024;39(3):450-460. Published online May 27, 2024; DOI: https://doi.org/10.3803/EnM.2023.1872

6,065 View
101 Download
1 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
The diagnostic accuracy of preoperative radiologic findings in predicting the tumor characteristics and clinical outcomes of papillary thyroid microcarcinoma (PTMC) was evaluated across all risk groups.
Methods
In total, 939 PTMC patients, comprising both low-risk and non-low-risk groups, who underwent surgery were enrolled. The preoperative tumor size and lymph node metastasis (LNM) were evaluated by ultrasonography within 6 months before surgery and compared with the postoperative pathologic findings. Discrepancies between the preoperative and postoperative tumor sizes were analyzed, and clinical outcomes were assessed.
Results
The agreement rate between radiological and pathological tumor size was approximately 60%. Significant discrepancies were noted, including an increase in tumor size in 24.3% of cases. Notably, in 10.8% of patients, the postoperative tumor size exceeded 1 cm, despite being initially classified as 0.5 to 1.0 cm based on preoperative imaging. A postoperative tumor size >1 cm was associated with aggressive pathologic factors such as multiplicity, microscopic extrathyroidal extension, and LNM, as well as a higher risk of distant metastasis. In 30.1% of patients, LNM was diagnosed after surgery despite not being suspected before the procedure. This group was characterized by smaller metastatic foci and lower risks of distant metastasis or recurrence than patients with LNM detected both before and after surgery.
Conclusion
Among all risk groups of PTMCs, a subset showed an increase in tumor size, reaching 1 cm after surgery. These cases require special consideration due to their association with adverse clinical outcomes, including an elevated risk of distant metastasis.

Citations

Citations to this article as recorded by

Preoperative hydrodissection for predicting extrathyroidal extension in thyroid tumors
Yeseul Kim, Jae Ho Shin, Sung-Hye You, Bo Kyu Kim, Byungjun Kim, Kyeong Jin Kim
Minimally Invasive Therapy & Allied Technologies.2026; : 1. CrossRef

Thyroid
Dynamic Risk Model for the Medical Treatment of Graves’ Hyperthyroidism according to Treatment Duration: Meihua Jin, Chae A Kim, Min Ji Jeon, Won Bae Kim, Tae Yong Kim, Won Gu Kim; Endocrinol Metab. 2024;39(4):579-589. Published online May 23, 2024; DOI: https://doi.org/10.3803/EnM.2024.1918

6,908 View
194 Download
3 Web of Science
3 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Changes in thyrotropin receptor antibody (TRAb) levels are associated with the clinical outcomes of Graves’ hyperthyroidism. However, the effects of the patterns of TRAb changes on patient prognosis according to the treatment duration of antithyroid drugs (ATDs) are not well established.
Methods
In this retrospective cohort study, 1,235 patients with Graves’ hyperthyroidism who were treated with ATDs for more than 12 months were included. Patients were divided into two groups according to treatment duration: group 1 (12–24 months) and group 2 (>24 months). Risk prediction models comprising age, sex, and either TRAb levels at ATD withdrawal (model A) or patterns of TRAb changes (model B) were compared.
Results
The median treatment duration in groups 1 (n=667, 54%) and 2 (n=568, 46%) was 17.3 and 37.1 months, respectively. The recurrence rate was significantly higher in group 2 (47.9%) than in group 1 (41.4%, P=0.025). Group 2 had significantly more goiter, thyroid eye disease, and fluctuating and smoldering type of TRAb pattern compared with group 1 (all P<0.001). The patterns of TRAb changes were an independent risk factor for recurrence after adjusting for other confounding factors in all patients, except in group 1. Integrated discrimination improvement and net reclassification improvement analyses showed that model B performed better than model A in all patients, except in group 1.
Conclusion
The dynamic risk model, including the patterns of TRAb changes, was more suitable for predicting prognosis in patients with Graves’ hyperthyroidism who underwent longer ATD treatment duration.

Citations

Citations to this article as recorded by

Integrating shear wave elastography into clinical prediction of Graves’ disease recurrence: a novel risk scoring system
Xiao-Yun Zha, Ze-Hong Xu, Jia-Jia Dong, Liang-Xiao Xie, Peng-Bin Lai, Chang-Shun Wei, Hua-Qiang Zheng, Duo-Bin Huang, Jin-Zhi Wu
Frontiers in Endocrinology.2025;[Epub] CrossRef
Risk factors and outcomes of Graves’ orbitopathy after radioactive iodine therapy
Hwa Young Ahn, Jooyoung Lee, Mina Kim, Jeong Kyu Lee
Endocrine.2025; 90(1): 248. CrossRef
High TRAb Titer at Diagnosis Predicts Persistent Positivity and Relapse in Graves’ Disease after Prolonged Antithyroid Therapy
Zimiao Chen, Jinglu Xu, Wenrui Kang, Yang Zhang, Rujun Chen, Xiaohua Gong
Endocrinology and Metabolism.2025; 40(6): 950. CrossRef

Thyroid
Utilizing Immunoglobulin G4 Immunohistochemistry for Risk Stratification in Patients with Papillary Thyroid Carcinoma Associated with Hashimoto Thyroiditis: Faridul Haq, Gyeongsin Park, Sora Jeon, Mitsuyoshi Hirokawa, Chan Kwon Jung; Endocrinol Metab. 2024;39(3):468-478. Published online May 20, 2024; DOI: https://doi.org/10.3803/EnM.2024.1923

6,063 View
98 Download
3 Web of Science
3 Crossref

Abstract PDF PubReader ePub

Background
Hashimoto thyroiditis (HT) is suspected to correlate with papillary thyroid carcinoma (PTC) development. While some HT cases exhibit histologic features of immunoglobulin G4 (IgG4)-related disease, the relationship of HT with PTC progression remains unestablished.
Methods
This cross-sectional study included 426 adult patients with PTC (≥1 cm) undergoing thyroidectomy at an academic thyroid center. HT was identified based on its typical histologic features. IgG4 and IgG immunohistochemistry were performed. Wholeslide images of immunostained slides were digitalized. Positive plasma cells per 2 mm² were counted using QuPath and a pre-trained deep learning model. The primary outcome was tumor structural recurrence post-surgery.
Results
Among the 426 PTC patients, 79 were diagnosed with HT. With a 40% IgG4 positive/IgG plasma cell ratio as the threshold for diagnosing IgG4-related disease, a cutoff value of >150 IgG4 positive plasma cells per 2 mm² was established. According to this criterion, 53% (43/79) of HT patients were classified as IgG4-related. The IgG4-related HT subgroup presented a more advanced cancer stage than the IgG4-non-related HT group (P=0.038). The median observation period was 109 months (range, 6 to 142). Initial assessment revealed 43 recurrence cases. Recurrence-free survival periods showed significant (P=0.023) differences, with patients with IgG4 non-related HT showing the longest period, followed by patients without HT and those with IgG4-related HT.
Conclusion
This study effectively stratified recurrence risk in PTC patients based on HT status and IgG4-related subtypes. These findings may contribute to better-informed treatment decisions and patient care strategies.

Citations

Citations to this article as recorded by

Usefulness of core needle biopsy of thyroid for the diagnosis of IgG4 Hashimoto's thyroiditis
Chenxu Zhao, Yang Yu, Jumei Liu, Yang Zhang, Lei Chen, Guizhi Lu, Ying Gao
Journal of Translational Internal Medicine.2026; 14(2): 306. CrossRef
Proteomic analysis of papillary thyroid carcinoma in the context of Hashimoto’s thyroiditis
Hui Zhou, Gongxun Tan, Hui Sun, Muhammad Asad Iqbal, Ziou Zhao, Jie Hou, Nida Fatima Moazzam, Xian Wang, Donggang Pan
Scientific Reports.2026;[Epub] CrossRef
Advanced pathological subtype classification of thyroid cancer using efficientNetB0
Hongpeng Guo, Junjie Zhang, You Li, Xinghe Pan, Chenglin Sun
Diagnostic Pathology.2025;[Epub] CrossRef

Review Article

Mineral, Bone & Muscle
Roles of Parathyroid Hormone and Fibroblast Growth Factor 23 in Advanced Chronic Kidney Disease: Yosuke Nakagawa, Hirotaka Komaba; Endocrinol Metab. 2024;39(3):407-415. Published online May 16, 2024; DOI: https://doi.org/10.3803/EnM.2024.1978

17,352 View
415 Download
9 Web of Science
13 Crossref

Abstract PDF PubReader ePub

Parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) each play a central role in the pathogenesis of chronic kidney disease (CKD)-mineral and bone disorder. Levels of both hormones increase progressively in advanced CKD and can lead to damage in multiple organs. Secondary hyperparathyroidism (SHPT), characterized by parathyroid hyperplasia with increased PTH secretion, is associated with fractures and mortality. Emerging evidence suggests that these associations may be partially explained by PTH-induced browning of adipose tissue and increased energy expenditure. Observational studies suggest a survival benefit of PTHlowering therapy, and a recent study comparing parathyroidectomy and calcimimetics further suggests the importance of intensive PTH control. The mechanisms underlying the regulation of FGF23 secretion by osteocytes in response to phosphate load have been unclear, but recent experimental studies have identified glycerol-3-phosphate, a byproduct of glycolysis released by the kidney, as a key regulator of FGF23 production. Elevated FGF23 levels have been shown to be associated with mortality, and experimental data suggest off-target adverse effects of FGF23. However, the causal role of FGF23 in adverse outcomes in CKD patients remains to be established. Further studies are needed to determine whether intensive SHPT control improves clinical outcomes and whether treatment targeting FGF23 can improve patient outcomes.

Citations

Citations to this article as recorded by

Heterogeneous regulation of fibroblast growth factor 23 in acute kidney injury, chronic kidney disease, and polycystic kidney disease: mechanisms, diagnostic utility, and clinical implications
Xiaohua Hu, Bo Yang, Haimin Chen, Min Min, Nanmei Liu, Cheng Xue
Frontiers in Molecular Biosciences.2026;[Epub] CrossRef
Endocrine disorders linked to chronic kidney disease: Mechanisms and clinical implications
Marcio J Concepción-Zavaleta, Jenyfer M Fuentes-Mendoza, Elida P López-Ramírez, Jesús A Martínez-García, Luis A Concepción-Urteaga, José Paz-Ibarra
World Journal of Nephrology.2026;[Epub] CrossRef
Gene expression and hormonal signaling in osteoporosis: from molecular mechanisms to clinical breakthroughs
Gurinderdeep Singh, Ronald Darwin, Krishna Chandra Panda, Shaikh Amir Afzal, Shashwat Katiyar, Ram C. Dhakar, Sangeetha Mani
Journal of Biomaterials Science, Polymer Edition.2025; 36(10): 1466. CrossRef
Correlation linking fibroblast growth factor 23 in circulation (FGF-23) and serum aldosterone levels in different stages of chronic kidney disease
Amira Hassan Elsaid Dohuim, Medhat Abd El Megeid Ghazy, Nahla Abdel Aziz Nosair, Amr Khalifa Hussien
The Egyptian Journal of Internal Medicine.2025;[Epub] CrossRef
Effects of Blood Flow Restriction Training and Possible Applications in Chronic Kidney Disease: A Narrative Review
Shen Liu, Zhuo Wang, Jia-fu Tang, Yong-long Yang, Wei-xiu Ji, Da-qi Xu
Current Physical Medicine and Rehabilitation Reports.2025;[Epub] CrossRef
Correlation Between Fibroblast Growth Factor 23 and Biochemical Parameters in Hemodialysis Patients With End-Stage Renal Disease
Barat Yusubov, Mirkhalig Javadov, Khanbaba Huseynov, Muradali Bakhshiyev
Cureus.2025;[Epub] CrossRef
Serum FGF-23 and Vitamin D Deficiency as Predictors of Metabolic Syndrome in Chronic Kidney Disease

Pakistan Journal of Medicine and Dentistry.2025; : 334. CrossRef
Efficacy of Different Doses of Sodium in the Dialysis Fluid on the Levels of Calcium, Phosphorus and Parathyroid Hormone in Patients Undergoing Chronic Hemodialysis
Asieh Aref, Ladan Mirzaei, Ali Ghorbani, Samaneh Tirom, Elham Farhadi
Nephro-Urology Monthly.2025;[Epub] CrossRef
Skeletal Health in Youth with Type 2 Diabetes
Hanine AlArab, Anna Zenno, Melinda Pierce
Current Osteoporosis Reports.2025;[Epub] CrossRef
Capture the superior anti-osteoporotic innovative multi-component complex from Ligustri Lucidi Fructus based on Component Recombination strategy
Jun Jiang, Baixiu Zhao, Yuwen Ma, Yichen Zeng, Yusong Zeng, Jin Fang, Wenjiao Kang, Tong Chen
Phytomedicine.2025; 146: 157116. CrossRef
Serum Calcium as a Determinant of Fibroblast Growth Factor 23 Levels in Patients With Primary Hyperparathyroidism and Graves’ Disease
Hiroyuki Yamashita, Yusuke Mori, Yasuo Imanishi, Hisakazu Shindo, Daisuke Tatsushima, Seigo Tachibana, Takashi Fukuda, Hiroshi Takahashi, Yuji Nagayama, Shinya Satoh
Cureus.2025;[Epub] CrossRef
Immune mechanisms in chronic kidney disease-mineral and bone disorder: current insights and therapeutic implications
Bin Xu, Rui Ma, Yuqiang Wu, Chi Liu, Xiangrong Song
Frontiers in Medicine.2025;[Epub] CrossRef
Treatment outcomes and determinants of combined hemodialysis-hemoperfusion therapy in chronic glomerulonephritis
Xiaotong Yuan
American Journal of Translational Research.2025; 17(11): 8612. CrossRef

Original Articles

Thyroid
Clinical Manifestations of Malignant Struma Ovarii: A Retrospective Case Series in a Tertiary Hospital in Korea: Hyun Jin Ryu, Da Eun Leem, Ji Hyun Yoo, Tae Hyuk Kim, Sun Wook Kim, Jae Hoon Chung; Endocrinol Metab. 2024;39(3):461-467. Published online May 9, 2024; DOI: https://doi.org/10.3803/EnM.2023.1863

7,361 View
164 Download
10 Web of Science
10 Crossref

Abstract PDF PubReader ePub

Background
Malignant struma ovarii (MSO) is a very rare disease in which thyroid cancer originates from the ovary. Because it is rare for endocrinologists to encounter patients with MSO, endocrinologists may have a limited understanding of the disease. Therefore, we analyzed and introduced its incidence and clinical course in a tertiary hospital in Korea.
Methods
We retrospectively investigated the clinical data of 170 patients who underwent surgery for struma ovarii at the Department of Obstetrics and Gynecology of Samsung Medical Center from 1994 to May 2023.
Results
Among 170 patients with struma ovarii, 15 (8.8%) were diagnosed with MSO. The median age of patients with MSO was 48 years (range, 30 to 74), and the median tumor size was 3.3 cm (range, 0.5 to 11.0). Papillary thyroid carcinoma (46.7%) was the most common subtypes followed by follicular thyroid carcinoma (26.7%). All patients were diagnosed after surgery, with no predictions from preoperative imaging. The surgical extent of gynecological surgery was variable. Four patients (26.7%) underwent thyroidectomy for thyroid cancer, while one underwent total thyroidectomy and radioactive iodine therapy for MSO with peritoneal metastasis. Except for one patient who underwent hemithyroidectomy, thyroid stimulating hormone suppression therapy was performed in four patients. Only 53% of MSO patients were consulted by an endocrinologist. With a median follow-up period of 33 months (range, 4 to 156), 11 patients remained disease-free, one experienced progression with peritoneal seeding, and the remaining one was in treatment. There have been no recurrences or deaths due to MSO.
Conclusion
An endocrinologist should be involved in establishing a therapeutic plan for MSO, for which the overall prognosis is generally favorable.

Citations

Citations to this article as recorded by

Malignant struma ovarii: Advances in molecular pathogenesis, classification, diagnosis and treatment
Wanrun Lin, Xin Zhou, Yudong Wang, Feng Zhou
Histopathology.2026;[Epub] CrossRef
The 12 cm Masquerader: Struma Ovarii Disguised as a Benign Mucinous Cystadenoma (Ovarian-Adnexal Reporting and Data System 3) in a Young Woman
Rizwana Anjum, Mohammad Tariq Mahmood, Alaa Elghobashy
Cureus.2026;[Epub] CrossRef
Struma ovarii—diagnostic and treatment strategy: a case report
Mohammed Alnaggar, Mueataz A. Mahyoub, Nabil Alshargabi, Li Gong
Journal of Medical Case Reports.2025;[Epub] CrossRef
Successful Management and Long-term Survival of Malignant Struma Ovarii with Radioactive Iodine Therapy
Nimmagadda Ajit, Zakir Ali Abubacker, Prathyusha Bikkina, CB Virupakshappa
Indian Journal of Nuclear Medicine.2025; 40(2): 109. CrossRef
A retrospective case series at a tertiary hospital in china: ultrasonographic features of Struma ovarii
Yanan Feng, Yanjie Chen, Qiong Wu, Zhenghao Bao, Chunping Ning, Cheng Zhao
BMC Cancer.2025;[Epub] CrossRef
Non-invasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features (NIFTP) Arising in Struma Ovarii: A Pathologist’s Perspective
Hasnae Ismaili, Sanae El Bardai, Majda Bendahhou Idrissi, Chahrazed Bouchikhi, Nadia Alaoui Ismaili, Nawal Hammas, Laila Chbani, Layla Tahiri Elousrouti
Cureus.2025;[Epub] CrossRef
Malignant struma ovarii: clinicopathological and molecular features in a series of nine cases
Xuxi Yang, Wanrun Lin, Lei Qin, Xin Zhou, Zhiyan Liu, Yudong Wang, Feng Zhou
Virchows Archiv.2025;[Epub] CrossRef
Retrospective Multicenter Analysis of Malignant Struma Ovarii: Clinical Characteristics, Management, and Outcomes
Atacem Mert Aytekin, Yagmur Arslan, Utku Akgor, Murat Cengiz, Banu Boso Aslantas, Huseyin Akilli, Cansu Turker Saricoban, Ibrahim Yalcin, Mehmet Kefeli, Onur Karaaslan, Dogan Vatansever, Ipek Betul Ozcivit Erkan, Abdullah Serdar Acikgoz, Tugan Bese, Oguzh
Journal of Clinical Medicine.2025; 14(24): 8807. CrossRef
Diagnostic Value of Nuclear Hybrid Imaging in Malignant Struma Ovarii: A Systematic Review of Case Reports
Claudiu Peștean, Doina Piciu
Diagnostics.2024; 14(23): 2630. CrossRef
The Role of Radioiodine Therapy in Differentiated Thyroid Cancer Arising from Struma Ovarii: A Systematic Review
Pietro Bellini, Francesco Dondi, Valentina Zilioli, Elisa Gatta, Maria Cavadini, Carlo Cappelli, Gian Luca Viganò, Francesco Bertagna
Journal of Clinical Medicine.2024; 13(24): 7729. CrossRef

Thyroid Thyroid Cancer Screening
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; Endocrinol Metab. 2024;39(2):310-323. Published online April 9, 2024; DOI: https://doi.org/10.3803/EnM.2023.1870

7,203 View
132 Download
1 Web of Science
1 Crossref

Abstract PDF Supplementary Material PubReader 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.

Citations

Citations to this article as recorded by

Conventional and Emerging Diagnostic Approaches for Differentiated Thyroid Carcinoma
Kathelina Kristollari, Abraham Abbey Paul, Sagi Angel, Robert S. Marks
Chemosensors.2024; 12(11): 229. CrossRef

Review Article

Mineral, Bone & Muscle
Treatment of Hypoparathyroidism by Re-Establishing the Effects of Parathyroid Hormone: Lars Rejnmark; Endocrinol Metab. 2024;39(2):262-266. Published online April 4, 2024; DOI: https://doi.org/10.3803/EnM.2024.1916

29,814 View
916 Download
16 Web of Science
15 Crossref

Abstract PDF PubReader ePub

The conventional treatment of hypoparathyroidism (HypoPT) includes active vitamin D and calcium. Despite normalization of calcium levels, the conventional treatment is associated with fluctuations in calcium levels, hypercalciuria, renal impairment, and decreased quality of life (QoL). Replacement therapy with parathyroid hormone (PTH)(1-84) is an option in some countries. However, convincing beneficial effects have not been demonstrated, which may be due to the short duration of action of this treatment. Recently, palopegteriparatide (also known as TransCon PTH) has been marketed in Europe and is expected also to be approved in other countries. Palopegteriparatide is a prodrug with sustained release of PTH(1-34) designed to provide stable physiological PTH levels for 24 hours/day. A phase 3 study demonstrated maintenance of normocalcemia in patients with chronic HypoPT, with no need for conventional therapy. Furthermore, this treatment lowers urinary calcium and improves QoL. Another long-acting PTH analog with effects on the parathyroid hormone receptor (eneboparatide) is currently being tested in a phase 3 trial. Furthermore, the treatment of autosomal dominant hypocalcemia type 1 with a calcilytic (encaleret) is also being tested. All in all, improved treatment options are on the way that will likely take the treatment of HypoPT to the next level.

Citations

Citations to this article as recorded by

Construction of a predictive model for postoperative hypoparathyroidism in papillary thyroid cancer based on the Inflammatory Load Index
Xiangdong ZHAO, Yakun ZHANG, Yang PEI, Kewen LU, Shuaichong JI, Yuexin WANG
Chirurgia.2026;[Epub] CrossRef
Long-Term Morbidity after Postoperative Hypoparathyroidism in Thyroid Cancer Patients: A Nationwide Population-Based Cohort Study
Seong Hee Ahn, Sung-Hyo Seo, Chai Young Jung, Dong Han Yu, Ki-Pyo Kim, Youngjoon Kim, Yongin Cho, Da Hea Seo, So Hun Kim, Jun-Il Yoo, Seongbin Hong
Thyroid®.2026; 36(3): 320. CrossRef
First Reported Use of Recombinant Parathyroid Hormone in Kenny–Caffey Syndrome Type 2: A Case Report and Literature Review
Maja Djordjevic Milosevic, Anita Skakic, Marina Andjelkovic, Angelica Maria Delgado-Vega, Håkan Thonberg, Kristel Klaassen, Jovana Komazec, Bozica Kecman, Nikola Jocic, Erik Björck, Anna Lindstrand, Maja Stojiljkovic
Diseases.2026; 14(3): 91. CrossRef
Clinical characteristics of chinese patients with autosomal dominant hypocalcemia type 1: a single-center study
Yiyang Gao, Yue Jiang, Yabing Wang, Jing Yang, Jiajia Wang, An Song, Yan Jiang, Mei Li, Weibo Xia, Xiaoping Xing, Min Nie, Ou Wang
Journal of Endocrinological Investigation.2026;[Epub] CrossRef
Gender differences in long-term complications of chronic hypoparathyroidism: a systematic review
Filomena Cetani, Laura Pierotti, Ilaria Bodini, Claudia Bongermino, Serena Cagnina, Silvia Carrara, Veronica De Michelis, Laura Gianotti, Alessia Pusterla, Sabrina Corbetta
Journal of Endocrinological Investigation.2026;[Epub] CrossRef
Gene expression and hormonal signaling in osteoporosis: from molecular mechanisms to clinical breakthroughs
Gurinderdeep Singh, Ronald Darwin, Krishna Chandra Panda, Shaikh Amir Afzal, Shashwat Katiyar, Ram C. Dhakar, Sangeetha Mani
Journal of Biomaterials Science, Polymer Edition.2025; 36(10): 1466. CrossRef
Hypoparathyroidism: diagnosis, management and emerging therapies
Sarah Khan, Aliya A. Khan
Nature Reviews Endocrinology.2025; 21(6): 360. CrossRef
2024 FDA TIDES (Peptides and Oligonucleotides) Harvest
Othman Al Musaimi, Danah AlShaer, Beatriz G. de la Torre, Fernando Albericio
Pharmaceuticals.2025; 18(3): 291. CrossRef
PTH Substitution Therapy for Chronic Hypoparathyroidism: PTH 1–84 and Palopegteriparatide
Andrea Palermo, Anda Mihaela Naciu, Yu Kwang Tay Donovan, Gaia Tabacco, Guido Zavatta
Current Osteoporosis Reports.2025;[Epub] CrossRef
La gestione terapeutica dell’ipoparatiroidismo: tra terapia convenzionale e nuove prospettive
Giulia Del Sindaco, Giovanna Mantovani
L'Endocrinologo.2025; 26(2): 189. CrossRef
Advancements and Clinical Strategies in Parathyroid Transplantation: A Comprehensive Review
Sun Ae Hwang, Ik Jin Yun, Kyoung Sik Park
Journal of Endocrine Surgery.2025; 25(1): 1. CrossRef
Chronic Hypoparathyroidism—Current and Emerging Therapies
Sarah Khan, Aliya A. Khan
Endocrine Practice.2025; 31(11): 1478. CrossRef
HIPOPARATIREOIDISMO SECUNDÁRIO À HIPOMAGNESEMIA EM UM PACIENTE EM USO DE POLIMIXINA B: UM RELATO DE CASO
Victor Soriano Duarte Prado Tenório, Caio Raphael Coura De Alencar, Laura Quintella Souto Méro, Gabriela Rocha Nascimento, Jhony Wilams Gusmão Do Nascimento
LUMEN ET VIRTUS.2025; 16(51): e7483. CrossRef
Hypoparathyroidism update
Cherie Chiang
Current Opinion in Endocrinology, Diabetes & Obesity.2024; 31(4): 164. CrossRef
Potential of Calcilytics as a Novel Treatment for Post-Surgical Hypoparathyroidism
Han Seok Choi
Endocrinology and Metabolism.2024; 39(3): 534. CrossRef

Original Articles

Thyroid
Clinicopathological Features and Molecular Signatures of Lateral Neck Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: Jinsun Lim, Han Sai Lee, Jin-Hyung Heo, Young Shin Song; Endocrinol Metab. 2024;39(2):324-333. Published online April 4, 2024; DOI: https://doi.org/10.3803/EnM.2023.1885

5,549 View
96 Download
5 Web of Science
4 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
The predictive factors for lateral neck lymph node metastasis (LLNM) in papillary thyroid microcarcinoma (PTMC) remain undetermined. This study investigated the clinicopathological characteristics, transcriptomes, and tumor microenvironment in PTMC according to the LLNM status. We aimed to identify the biomarkers associated with LLNM development.
Methods
We retrospectively reviewed the medical records of patients with PTMC from two independent institutions between 2018 and 2022 (n=597 and n=467). We compared clinicopathological features between patients without lymph node metastasis (N0) and those with LLNM (N1b). Additionally, laser capture microdissection and RNA sequencing were performed on primary tumors from both groups, including metastatic lymph nodes from the N1b group (n=30; 20 primary tumors and 10 paired LLNMs). We corroborated the findings using RNA sequencing data from 16 BRAF-like PTMCs from The Cancer Genome Atlas. Transcriptomic analyses were validated by immunohistochemical staining.
Results
Clinicopathological characteristics, such as male sex, multifocality, extrathyroidal extension, lymphatic invasion, and central node metastasis showed associations with LLNM in PTMCs. Transcriptomic profiles between the N0 and N1b PTMC groups were similar. However, tumor microenvironment deconvolution from RNA sequencing and immunohistochemistry revealed an increased abundance of tumor-associated macrophages, particularly M2 macrophages, in the N1b group.
Conclusion
Patients with PTMC who have a male sex, multifocality, extrathyroidal extension, lymphatic invasion, and central node metastasis exhibited an elevated risk for LLNM. Furthermore, infiltration of M2 macrophages in the tumor microenvironment potentially supports tumor progression and LLNM in PTMCs.

Citations

Citations to this article as recorded by

Prediction of lymph node metastasis in papillary thyroid carcinoma using non-contrast CT-based radiomics and deep learning with thyroid lobe segmentation: A dual-center study
Hao Wang, Xuan Wang, Yusheng Du, You Wang, Zhuojie Bai, Di Wu, Wuliang Tang, Hanling Zeng, Jing Tao, Jian He
European Journal of Radiology Open.2025; 14: 100639. CrossRef
Risk factors for lateral neck lymph node metastasis in papillary thyroid ultra micro carcinoma with implications for active surveillance
Hyeung Kyoo Kim, Ho Jung Jeong, Jin Seok Lee, Soo Young Kim, Yong Sang Lee, Hang-Seok Chang
Scientific Reports.2025;[Epub] CrossRef
Risk factors for predicting lateral lymph node metastasis of papillary thyroid carcinoma based on LASSO-logistic regression
Han Han, Lei Yang, WenJun Jia, Xiao Chen
Frontiers in Endocrinology.2025;[Epub] CrossRef
Predictive Factors of Lymph Node Metastasis in Papillary Thyroid Microcarcinoma (PTMC)
Odysseas Violetis, Maria Sfakiotaki, Ariadni Spyroglou, Evangelia Pissadaki, Konstantinos Iliakopoulos, Eleni-Konstantina Syntzanaki, Panagiota Konstantakou, Eleni Chouliara, Constantinos Nastos, Nikolaos Dafnios, George Simeakis, Konstantinos Bramis, Des
Medicina.2025; 61(10): 1800. CrossRef

Thyroid
Prognostic Roles of Inflammatory Biomarkers in Radioiodine-Refractory Thyroid Cancer Treated with Lenvatinib: Chae A Kim, Mijin Kim, Meihua Jin, Hee Kyung Kim, Min Ji Jeon, Dong Jun Lim, Bo Hyun Kim, Ho-Cheol Kang, Won Bae Kim, Dong Yeob Shin, Won Gu Kim; Endocrinol Metab. 2024;39(2):334-343. Published online April 4, 2024; DOI: https://doi.org/10.3803/EnM.2023.1854

5,686 View
108 Download
5 Web of Science
4 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR), serve as valuable prognostic indicators in various cancers. This multicenter, retrospective cohort study assessed the treatment outcomes of lenvatinib in 71 patients with radioactive iodine (RAI)-refractory thyroid cancer, considering the baseline inflammatory biomarkers.
Methods
This study retrospectively included patients from five tertiary hospitals in Korea whose complete blood counts were available before lenvatinib treatment. Progression-free survival (PFS) and overall survival (OS) were evaluated based on the median value of inflammatory biomarkers.
Results
No significant differences in baseline characteristics were observed among patients grouped according to the inflammatory biomarkers, except for older patients with a higher-than-median NLR (≥2) compared to their counterparts with a lower NLR (P= 0.01). Patients with a higher-than-median NLR had significantly shorter PFS (P=0.02) and OS (P=0.017) than those with a lower NLR. In multivariate analysis, a higher-than-median NLR was significantly associated with poor OS (hazard ratio, 3.0; 95% confidence interval, 1.24 to 7.29; P=0.015). However, neither the LMR nor the PLR was associated with PFS. A higher-than-median LMR (≥3.9) was significantly associated with prolonged OS compared to a lower LMR (P=0.036). In contrast, a higher-than-median PLR (≥142.1) was associated with shorter OS compared to a lower PLR (P=0.039).
Conclusion
Baseline inflammatory biomarkers can serve as predictive indicators of PFS and OS in patients with RAI-refractory thyroid cancer treated with lenvatinib.

Citations

Citations to this article as recorded by

Development and validation of a prognostic model for first-line immunotherapy for metastatic esophageal squamous cell carcinoma
Loulu Gao, Jieqiong Peng, Zixuan Hu, Xiangxue Li, Siyi Zhang, Xiaoxuan Li, Ziheng Zhang, Jing Lv, Jialin Song, Wensheng Qiu
International Immunopharmacology.2026; 168: 115813. CrossRef
Nomogram Model for Prognosis of Distant Metastatic DTC Based on Inflammatory and Clinicopathological Factors
Chenghui Lu, Guoqiang Wang, Zengmei Si, Fengqi Li, Xinfeng Liu, Na Han, Congcong Wang, Jiao Li, Xufu Wang
Journal of the Endocrine Society.2025;[Epub] CrossRef
Turning tumor microenvironmental foes to friends: A new opportunity for thyroid cancer therapy and redifferentiation
Liya Zhu, Xiuli Jing, Byeong-Cheol Ahn
Oral Oncology.2025; 168: 107513. CrossRef
Predictive and prognostic role of Neutrophil-to-Lymphocyte ratio in patients with advanced thyroid cancer treated with targeted therapy
Tuerhong Diliyaer, Yueyan Ren, Xuejiao Chen, Xixi Zhu, Tuerxun Yilidana, Jiaye Liu, Gang Chen, Zhihui Li
Endocrine.2025; 90(3): 1380. CrossRef

Mineral, Bone & Muscle
Protein Signatures of Parathyroid Adenoma according to Tumor Volume and Functionality: Sung Hye Kong, Jeong Mo Bae, Jung Hee Kim, Sang Wan Kim, Dohyun Han, Chan Soo Shin; Endocrinol Metab. 2024;39(2):375-386. Published online March 21, 2024; DOI: https://doi.org/10.3803/EnM.2023.1827

5,770 View
85 Download
1 Web of Science
1 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Parathyroid adenoma (PA) is a common endocrine disease linked to multiple complications, but the pathophysiology of the disease remains incompletely understood. The study aimed to identify the key regulator proteins and pathways of PA according to functionality and volume through quantitative proteomic analyses.
Methods
We conducted a retrospective study of 15 formalin-fixed, paraffin-embedded PA samples from tertiary hospitals in South Korea. Proteins were extracted, digested, and the resulting peptides were analyzed using liquid chromatography-tandem mass spectrometry. Pearson correlation analysis was employed to identify proteins significantly correlated with clinical variables. Canonical pathways and transcription factors were analyzed using Ingenuity Pathway Analysis.
Results
The median age of the participants was 52 years, and 60.0% were female. Among the 8,153 protein groups analyzed, 496 showed significant positive correlations with adenoma volume, while 431 proteins were significantly correlated with parathyroid hormone (PTH) levels. The proteins SLC12A9, LGALS3, and CARM1 were positively correlated with adenoma volume, while HSP90AB2P, HLA-DRA, and SCD5 showed negative correlations. DCPS, IRF2BPL, and FAM98A were the main proteins that exhibited positive correlations with PTH levels, and SLITRK4, LAP3, and AP4E1 had negative correlations. Canonical pathway analysis demonstrated that the RAN and sirtuin signaling pathways were positively correlated with both PTH levels and adenoma volume, while epithelial adherence junction pathways had negative correlations.
Conclusion
Our study identified pivotal proteins and pathways associated with PA, offering potential therapeutic targets. These findings accentuate the importance of proteomics in understanding disease pathophysiology and the need for further research.

Citations

Citations to this article as recorded by

Aberrant Histone Methylation Profile in Patients with Sporadic Primary Hyperparathyroidism
Poonam Kumari, Sanjay Kumar Bhadada, Ashutosh Kumar Arya, Jyotdeep Kaur, Naresh Sachdeva, Uma Nahar Saikia, Divya Dahiya, Anoop Kumar, Chirag Kharbanda, Sudhaker D Rao
The Journal of Clinical Endocrinology & Metabolism.2025;[Epub] CrossRef

Thyroid Big Data Articles (National Health Insurance Service Database)
Risk of Subsequent Primary Cancers in Thyroid Cancer Survivors according to the Dose of Levothyroxine: A Nationwide Cohort Study: Min-Su Kim, Jang Won Lee, Min Kyung Hyun, Young Shin Song; Endocrinol Metab. 2024;39(2):288-299. Published online March 4, 2024; DOI: https://doi.org/10.3803/EnM.2023.1815

13,962 View
236 Download
3 Web of Science
4 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Current research has not investigated the effect of thyroid-stimulating hormone suppression therapy with levothyroxine on the risk for developing subsequent primary cancers (SPCs). This study aimed to investigate the association between levothyroxine dosage and the risk for SPCs in thyroid cancer patients.
Methods
We conducted a nationwide population-based retrospective cohort study form Korean National Health Insurance database. This cohort included 342,920 thyroid cancer patients between 2004 and 2018. Patients were divided into the non-levothyroxine and the levothyroxine groups, the latter consisting of four dosage subgroups according to quartiles. Cox proportional hazard models were performed to evaluate the risk for SPCs by adjusting for variables including cumulative doses of radioactive iodine (RAI) therapy.
Results
A total of 17,410 SPC cases were observed over a median 7.3 years of follow-up. The high-dose levothyroxine subgroups (Q3 and Q4) had a higher risk for SPC (adjusted hazard ratio [HR], 1.14 and 1.27; 95% confidence interval [CI], 1.05–1.24 and 1.17– 1.37; respectively) compared to the non-levothyroxine group. In particular, the adjusted HR of stomach (1.31), colorectal (1.60), liver and biliary tract (1.95), and pancreatic (2.48) cancers were increased in the Q4 subgroup. We consistently observed a positive association between high levothyroxine dosage per body weight and risk of SPCs, even after adjusting for various confounding variables. Moreover, similar results were identified in the stratified analyses according to thyroidectomy type and RAI therapy, as well as in a subgroup analysis of patients with good adherence.
Conclusion
High-dose levothyroxine use was associated with increased risk of SPCs among thyroid cancer patients regardless of RAI therapy.

Citations

Citations to this article as recorded by

Risk of atrial fibrillation in patients with differentiated thyroid cancer: a nationwide population-based analysis
Jung Heo, Seo Young Sohn, Yun Jin Kim, Sung Woo Cho
The Korean Journal of Internal Medicine.2026; 41(2): 286. CrossRef
Tailoring TSH suppression in differentiated thyroid carcinoma: evidence, controversies, and future directions
Xinxin Song, Xin Zhi, Linxue Qian
Endocrine.2025; 89(1): 1. CrossRef
The Levothyroxine Odyssey: Navigating the Path of Survivorship in Thyroid Cancer
Jin Hwa Kim
Endocrinology and Metabolism.2024; 39(2): 283. CrossRef
Levothyroxine Dosage and the Increased Risk of Second Primary Malignancy in Thyroid Cancer Survivors
Young Joo Park
Clinical Thyroidology®.2024; 36(7): 258. CrossRef

Review Article

Thyroid
Active Surveillance for Low-Risk Thyroid Cancers: A Review of Current Practice Guidelines: Min Joo Kim, Jae Hoon Moon, Eun Kyung Lee, Young Shin Song, Kyong Yeun Jung, Ji Ye Lee, Ji-hoon Kim, Kyungsik Kim, Sue K. Park, Young Joo Park; Endocrinol Metab. 2024;39(1):47-60. Published online February 15, 2024; DOI: https://doi.org/10.3803/EnM.2024.1937

24,082 View
939 Download
28 Web of Science
34 Crossref

Abstract PDF PubReader ePub

The indolent nature and favorable outcomes associated with papillary thyroid microcarcinoma have prompted numerous prospective studies on active surveillance (AS) and its adoption as an alternative to immediate surgery in managing low-risk thyroid cancer. This article reviews the current status of AS, as outlined in various international practice guidelines. AS is typically recommended for tumors that measure 1 cm or less in diameter and do not exhibit aggressive subtypes on cytology, extrathyroidal extension, lymph node metastasis, or distant metastasis. To determine the most appropriate candidates for AS, factors such as tumor size, location, multiplicity, and ultrasound findings are considered, along with patient characteristics like medical condition, age, and family history. Moreover, shared decision-making, which includes patient-reported outcomes such as quality of life and cost-effectiveness, is essential. During AS, patients undergo regular ultrasound examinations to monitor for signs of disease progression, including tumor growth, extrathyroidal extension, or lymph node metastasis. In conclusion, while AS is a feasible and reliable approach for managing lowrisk thyroid cancer, it requires careful patient selection, effective communication for shared decision-making, standardized follow-up protocols, and a clear definition of disease progression.

Citations

Citations to this article as recorded by

Active Surveillance for Locoregional Recurrent Differentiated Thyroid Cancer: A Systematic Review and Meta-Analysis
Hunjong Lim, Se Jin Cho, Jung Hwan Baek
Thyroid®.2026; 36(2): 121. CrossRef
Shared Decision-Making for Determining Treatment Strategies in Low-Risk Thyroid Cancer: Protocol of a Multicenter Cluster-Randomized Trial (MAeSTro-SDM)
Eun Kyung Lee, Min Joo Kim, Yul Hwangbo, Jae Hoon Moon, Sun Wook Cho, Young Jun Chai, June Young Choi, Yuh-Seog Jung, Kyu Eun Lee, Eun-Jae Chung, Kyungsik Kim, Su-jin Kim, Woochul Kim, Yoo Hyung Kim, Young Ki Lee, Jinsun Jang, Young Shin Song, Ka Hee Yi,
Journal of Korean Medical Science.2026;[Epub] CrossRef
Feasibility and Safety of Active Surveillance in Subcapsular Thyroid Nodules with High Suspicion for Malignancy
Yan Hu, Wei Zhou, Lu Zhang, Weiwei Zhan
Ultrasound in Medicine & Biology.2026; 52(4): 816. CrossRef
Radiofrequency Ablation for Primary Thyroid Cancer
Iram Hussain
Endocrine Practice.2026;[Epub] CrossRef
De-escalation strategies in the management of differentiated thyroid cancer
Mubeen Hussein Arawker, Fitrat Habibullah, Shantanu Baral, Lijun Fu, Ning Sun, Hongting Li, Xinguang Qiu
Endocrine.2026;[Epub] CrossRef
Current Challenges in Imaging-Based Cancer Screening, From the AJR Special Series on Screening
Lars J. Grimm, Danielle E. Kruse, Tina D. Tailor, Karen S. Johnson, Brian C. Allen, Marc D. Ryser
American Journal of Roentgenology.2026;[Epub] CrossRef
Controlled minimally invasive surgical interventions for the treatment of patients with thyroid carcinoma
David D. Dolidze, Zurab A. Bagatelia, Suren G. Laboyan, Arshak V. Vardanyan, Konstantin S. Titov, Ivan N. Lebedinsky, Georgi Genadi Melkonyan, Dmitriy V. Matveev, Nodar N. Gogitidze, Andrei Y. Lukin, Armen R. Oganyan, David G. Gogolashvili, Anastasia V. B
Journal of Experimental and Clinical Surgery.2026; 19(1): 45. CrossRef
Radiofrequency Ablation in the Management of Papillary Thyroid Carcinoma: Literature Review
V. A. Solovov, A. A. Fedulov
Creative surgery and oncology.2026; 16(1): 62. CrossRef
Proteomic Analysis of Tissue Proteins Related to Lateral Lymph Node Metastasis in Papillary Thyroid Microcarcinoma
Qiyao Zhang, Zhen Cao, Yuanyang Wang, Hao Wu, Zejian Zhang, Ziwen Liu
Journal of Proteome Research.2025; 24(1): 256. CrossRef
Active Surveillance of Papillary Thyroid Cancer—A Feasibility Experience from a Tertiary Care Centre
Narmada Nangadda, Hetashvi Gondaliya, Deepali Bhat, Anirudh J. Shetty, Kranti S. Khadilkar, Shivaprasad Kumbenahalli Siddegowda, Basavaraj G. Sooragonda, Vijay Pillai, Vidhya Bhushan Rangappa, Vivek Shetty, Yogesh Madhav Dokhe, Trupti C. Kolur, Naveen Ban
Indian Journal of Surgical Oncology.2025; 16(3): 743. CrossRef
Association Between Metabolic Dysfunction-Associated Steatotic Liver Disease and Thyroid Cancer
Sang Yi Moon, Minkook Son, Jung-Hwan Cho, Hye In Kim, Ji Min Han, Ji Cheol Bae, Sunghwan Suh
Thyroid®.2025; 35(1): 79. CrossRef
Navigating Active Surveillance for Low-Risk PTMC by Standardizing Ultrasound Evaluation: Key Takeaways from the Latest Korean Society of Thyroid Radiology Consensus Statements
Young Joo Park
Clinical Thyroidology®.2025; 37(1): 27. CrossRef
Assessing the Rise in Papillary Thyroid Cancer Incidence: A 38-Year Australian Study Investigating WHO Classification Influence
Steven Weller, Cordia Chu, Alfred King-yin Lam
Journal of Epidemiology and Global Health.2025;[Epub] CrossRef
A Personalized, Risk-Based Approach to Active Surveillance for Prostate Cancer with Takeaways from Broader Oncology Practices: A Mixed Methods Review
Jeroen J. Lodder, Sebastiaan Remmers, Roderick C. N. van den Bergh, Arnoud W. Postema, Pim J. van Leeuwen, Monique J. Roobol
Journal of Personalized Medicine.2025; 15(3): 84. CrossRef
Exploration of immunocytochemical biomarkers related to central lymph node metastasis in papillary thyroid microcarcinoma
Lulu Rong, Jie Wang, Qian Wang, Yanli Zhu, Wenhao Ren
Cytojournal.2025; 22: 18. CrossRef
Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP)
Jae Hoon Moon, Eun Kyung Lee, Wonjae Cha, Young Jun Chai, Sun Wook Cho, June Young Choi, Sung Yong Choi, A Jung Chu, Eun-Jae Chung, Yul Hwangbo, Woo-Jin Jeong, Yuh-Seog Jung, Kyungsik Kim, Min Joo Kim, Su-jin Kim, Woochul Kim, Yoo Hyung Kim, Chang Yoon Le
Endocrinology and Metabolism.2025; 40(2): 236. CrossRef
2024 International Expert Consensus on US-guided Thermal Ablation for T1N0M0 Papillary Thyroid Cancer
Zhen-long Zhao, Shu-rong Wang, Jennifer Kuo, Bülent Çekiç, Lei Liang, Hossam Arafa Ghazi, Shu-hang Xu, Gerardo Amabile, Song-song Wu, Ajit Yadav, Gang Dong, Ingo Janssen, Bo-qiang Fan, Nobuhiro Fukunari, Jun-feng He, Le Thanh Dung, Song-yuan Yu, Sum Leong
Radiology.2025;[Epub] CrossRef
Ultrasound and gene-guided microwave ablation vs. surgery for low-risk papillary thyroid carcinoma: a prospective observational cohort study
Yunfang Yu, Yuxin Shen, Yujie Tan, Yisikandaer Yalikun, Tian Tian, Qingqing Tang, Qiyun Ou, Yue Zhu, Miaoyun Long
Precision Clinical Medicine.2025;[Epub] CrossRef
Global research landscape on active surveillance for papillary thyroid microcarcinoma: a bibliometric analysis
Dong-Shu Kang, Yu-Hao Lin, Jian-Qing Tian
Discover Oncology.2025;[Epub] CrossRef
2025 Korean Thyroid Association Clinical Management Guideline on Active Surveillance for Low-Risk Papillary Thyroid Carcinoma
Eun Kyung Lee, Min Joo Kim, Seung Heon Kang, Bon Seok Koo, Kyungsik Kim, Mijin Kim, Bo Hyun Kim, Ji-hoon Kim, Shin Je Moon, Kyorim Back, Young Shin Song, Jong-hyuk Ahn, Hwa Young Ahn, Ho-Ryun Won, Won Sang Yoo, Min Kyoung Lee, Jeongmin Lee, Ji Ye Lee, Kyo
International Journal of Thyroidology.2025; 18(1): 30. CrossRef
2025 Korean Thyroid Association Clinical Management Guideline on Active Surveillance for Low-Risk Papillary Thyroid Carcinoma
Eun Kyung Lee, Min Joo Kim, Seung Heon Kang, Bon Seok Koo, Kyungsik Kim, Mijin Kim, Bo Hyun Kim, Ji-hoon Kim, Shinje Moon, Kyorim Back, Young Shin Song, Jong-hyuk Ahn, Hwa Young Ahn, Ho-Ryun Won, Won Sang Yoo, Min Kyoung Lee, Jeongmin Lee, Ji Ye Lee, Kyon
Endocrinology and Metabolism.2025; 40(3): 307. CrossRef
Current evidence and strategies for preventing tumor recurrence following thermal ablation of papillary thyroid carcinoma
Ru Li, Luyang Yang, Ming Xu, Baofeng Wu, Qinhao Liu, Qin An, Yuchen Sun, Yi Zhang, Yunfeng Liu
Cancer Imaging.2025;[Epub] CrossRef
Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP) (Endocrinol Metab 2025;40:236-46, Jae Hoon Moon et al.)
Eun Kyung Lee, Jae Hoon Moon, Young Joo Park
Endocrinology and Metabolism.2025; 40(4): 655. CrossRef
The association between composite inflammatory indicators and the clinicopathological characteristics of differentiated thyroid carcinoma
Li-Yuan Yang, Li-Peng Yang
Frontiers in Molecular Biosciences.2025;[Epub] CrossRef
Sorveglianza attiva nei noduli tiroidei: pro e contro
Giulia Brigante, Gloria Agrimonti, Nicolò Bacchi, Francesco Costantino, Roberta Sueri, Vincenzo Rochira, Manuela Simoni
L'Endocrinologo.2025; 26(5): 623. CrossRef
Microwave Ablation versus Surgery for Low-Risk Papillary Thyroid Cancer: Comparable Long-Term Oncologic Outcomes
Iram Hussain
Clinical Thyroidology®.2025; 37(9): 328. CrossRef
The effect of thyroid nodule location in ultrasound on the diagnosis of papillary thyroid carcinoma
Jia-fei Hu, Jun Xu, Li-ping Gao, Xiao-lin Shen, Yan-li Wang, Min-juan Wu, Ling Zhang
Discover Oncology.2025;[Epub] CrossRef
Low-risk thyroid cancer: surgery or active surveillance—an application of shared decision-making: a narrative review
Min Joo Kim, Eun Kyung Lee, Sun Wook Cho, Yoo Hyung Kim, Kyu Eun Lee, Su-jin Kim, Woochul Kim, Eun-Jae Chung, Jungirl Seok, Yul Hwangbo, Young Ki Lee, Jinsun Jang, Junsun Ryu, Yuh-Seog Jung, Chang Hwan Ryu, Jae Hoon Moon, June Young Choi, Hyeong Won Yu, K
Journal of the Korean Medical Association.2025; 68(9): 573. CrossRef
Thyroid Cancer: Pathogenesis, Clinicopathology, Diagnosis, and Management
Yu‐Dong Li, Qing‐Yao Ye, Yan‐Xing Chen, Xia‐Rong Hu
MedComm.2025;[Epub] CrossRef
2023 Update of the Korean Thyroid Association Guidelines for the Management of Thyroid Nodules
Eun Kyung Lee, Young Joo Park
Clinical Thyroidology®.2024; 36(4): 153. CrossRef
Association between exercise habits and incident type 2 diabetes mellitus in patients with thyroid cancer: nationwide population-based study
Jiyun Park, Jin-Hyung Jung, Hyunju Park, Young Shin Song, Soo-Kyung Kim, Yong-Wook Cho, Kyungdo Han, Kyung-Soo Kim
BMC Medicine.2024;[Epub] CrossRef
Prediction of Recurrent Laryngeal Nerve Invasion in Thyroid Cancer by Ultrasound
Jin Hyang Jung, Eunji Kim, Byung Ju Kang
Journal of Surgical Ultrasound.2024; 11(1): 18. CrossRef
Advances in clinical research on ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma
Hua Xu, Jin-yan Yang, Xing Zhao, Zhe Ma
Frontiers in Oncology.2024;[Epub] CrossRef
Systemic therapy for differentiated thyroid cancer with distant metastasis
Eun Kyung Lee
Journal of the Korean Medical Association.2024; 67(7): 484. CrossRef

First
Prev
Page of 12
Next
Last

Search