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A qualitative study published in the journal Thyroid examined the barriers and facilitators to selecting active surveillance (AS) as a treatment strategy for low-risk papillary thyroid microcarcinoma (PTMC) in China. The study found that some patients lacked a definitive pathological diagnosis, which may influence their decision to choose AS. Additionally, not all PTMCs are suitable for AS, and patients with aggressive clinical characteristics or high risk of invasion are recommended immediate surgery. The perception of PTMC as a "good carcinoma" and the ability of clinicians to reduce patients' fear and provide detailed follow-up protocols also affect patients' choices. The authors suggest that a multidisciplinary team and good quality control are necessary for accurate diagnosis and evaluation of primary tumors considered for AS. [Extracted from the article]

BACKGROUND Radiofrequency ablation (RFA) is used to treat various cancers, but its use in thyroid cancer remains controversial. The aim of this study was to investigate surgical findings after RFA for papillary thyroid cancer (PTC). MATERIAL AND METHODS The study included 21 patients (average age 44.9±13.3 years) who had biopsy-confirmed thyroid cancer treated with RFA in multiple hospitals. Surgery was done in the First Hospital of China Medical University. RESULTS The 21 patients had a total of 32 thyroid nodules that were treated with RFA. Twenty-eight nodules were malignant, and 4 nodules were benign. Before RFA, 17 of the malignant nodules were >1 cm and 11 were ≤1 cm. Among the 28 malignant nodules, post-ablation lesions adhered to or invaded the structures surrounding the thyroid in 17 (60.7%), 19 (67.9%), and 22 (78.6%) nodules evaluated with ultrasound, contrast-enhanced computed tomography, and intraoperatively, respectively. Based on pathology results, 7 (33.3%) of the 21 patients had bilateral cancer. Ten (47.6%) of the 21 patients had central lymph node metastasis and 2 (9.5%) had lateral lymph node metastasis. For 5 (15.6%) of the 32 nodules, the fine-needle aspiration results were not consistent with the postoperative pathological results. Five (23.8%) of the 21 patients with lymph node metastasis had clinically negative (CN0) lesions. CONCLUSIONS RFA for PTC primary lesions may be incomplete and leave residual lymph node metastasis, even in lesions ≤1 cm. RFA should be recommended with caution in the treatment of operable patients with primary PTC.

Background: An increase in the prevalence of thyroid disease has been found with increasing iodine intake, since universal salt iodization (USI) was instituted throughout China in 1996. The aim of this study was to analyze the incidence of thyroid carcinoma (TC) before and after USI in Shenyang, a city of northeastern China., Material/methods: The pathology reports were collected from patients with thyroid diseases who underwent surgery in the First Hospital of China Medical University from January 1, 1992 to December 31, 2009. The detection rate, the constituent ratio, the changes of sex, age, and concomitant thyroid diseases of each histological type of TC were analyzed., Results: The detection rate of TC, papillary thyroid carcinoma (PTC), and medullary thyroid carcinoma (MTC) increased; that of follicular thyroid carcinoma (FTC) decreased; and that of undifferentiated thyroid carcinoma (UTC) showed no change after USI. The constituent ratio of PTC increased, that of FTC and UTC decreased, and that of MTC showed no change after USI. The mean age of female patients with TC decreased after USI. The incidences of PTC complicated with either nodular goiter or chronic lymphocytic thyroiditis increased after USI., Conclusions: The detection rate of TC increased significantly, PTC predominated in the histological types of TC, and the mean age of female patients with TC decreased after USI. The patients with either nodular goiter or chronic lymphocytic thyroiditis under high iodine intake should be followed up.

Background: The aim of this study was to investigate the expression patterns of estrogen receptor (ER) β1 (wild-type ERβ) and ERβ2 (ERβcx) in papillary thyroid cancer (PTC) and nodular thyroid goiter (NTG), and to explore the reasons for the higher incidence of PTC in women of reproductive age., Material/methods: ERβ1 and ERβ2 expression was examined immunohistochemically on paraffin-embedded thyroid tissues from 106 patients with PTC and 30 patients with NTG., Results: There was significant difference in the subcellular localization of ERβ1 (P<0.001), but not in the positive percentage, between PTC and NTG specimens. No significant difference was found in the positive percentage or the subcellular distribution of ERβ2 expression between PTC and NTG specimens. Both nuclear and nucleocytoplasmic ERβ1 expressions were significantly lower in PTC lesions than in NTG tissue (P<0.001 and P<0.05, respectively), while ERβ2 expression was significantly higher in the former than the latter (P<0.05). ERβ1 expression in reproductive-aged (18~45 years) female patients with PTC was lower than that in age-matched male patients (P<0.05), while ERβ2 expression had the opposite expression profile (P<0.05). There was no significant difference in ERβ1 and ERβ2 expression between reproductive-aged and advanced reproductive-aged (>45 years) female patients with PTC., Conclusions: This preliminary study indicates that the expression patterns of ERβ1 and ERβ2 differ between malignant PTC lesions and benign NTG tissue, and their expression might be involved in the female predominance of PTC during the reproductive years. The clinical and biological significance of these results await further investigation.