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Context Obesity is a risk factor for the development of papillary thyroid cancer (PTC). However, the molecular mechanisms by which obesity promotes PTC are unclear. Objective This study aims to identify adipokines that are linked to PTC progression. Methods An adipokine antibody array was used to determine the serum levels of 40 adipokines in normal-weight and obese PTC patients. Enzyme-linked immunosorbent assay was used to determine the serum levels of adiponectin. Recombinant human adiponectin was produced by human adipose-derived stem cells and used to treat PTC cells. Cell proliferation and migration were evaluated using the CCK8 and Transwell assays. Bioinformatics analysis was used to predict mechanisms by which adiponectin affects PTC. Results Adipokines differentially expressed between normal-weight and obese patients showed a gender-dependent pattern. Obese PTC patients had a significantly lower serum adiponectin level than normal-weight patients, especially in female individuals. Adiponectin levels were negatively correlated with aggressive features of PTC, including tumor diameter > 1 cm, extrathyroidal extension, and lymph node metastasis. Recombinant human adiponectin inhibited the proliferation and migration of human PTC cells in vitro. Bioinformatics analysis identified adiponectin receptor 2 (ADIPOR2) and the autophagy pathway as possible mediators of adiponectin function in TC. In vitro experiments confirmed that adiponectin activated autophagy in PTC cells. These findings shed new lights into the role and mechanisms of adiponectin in TC pathogenesis. Conclusion Adiponectin is involved in development of obesity-related PTC. Adiponectin can directly inhibit thyroid cancer growth and metastasis through the autophagy pathway. [ABSTRACT FROM AUTHOR]

To compare the prevalence of single and multiple thyroid nodules and associate them with the presence of thyroid cancers. This was an observational, retrospective study carried out in a reference center for pathology and a private hospital in Joinville, state of Santa Catarina, Brazil. Data were collected from January 2011 to December 2021. Patients were divided into two groups: those with single and multiple thyroid nodules. The variables were age, sex, size, location, number of nodules, ultrasound findings, cytology based on needle aspiration biopsy (FNA), and histology of lesions. Multiple thyroid nodules presented higher irregularity and affected older individuals. In the adjusted odds ratio, single and multiple nodules were compared, demonstrating a higher number of cases of single nodules with BETHESDA classification 4. There were no significant differences in the association between single and multiple thyroid nodules and a higher incidence of malignant neoplasms. [ABSTRACT FROM AUTHOR]

Drawing upon the theory of reasoned action, the protection motivation theory, and theories of regret, this study proposes and examines three communication strategies to curb the overuse of low-value cancer screening: (a) highlighting negative affective consequences of screening; (b) providing information about diagnostic uncertainty, and (c) using a noncancer disease label. An online survey-based experiment using a 2 (affective message: absent vs. present) × 2 (diagnostic uncertainty information: absent vs. present) × 2 (disease label: thyroid cancer vs. a borderline thyroid neoplasm) full-factorial between-subject design with a control condition was conducted. A total of 612 South Korean women participated. As predicted, the affective message and diagnostic uncertainty information significantly reduced positive attitudes toward screening uptake and anticipated regret regarding screening nonuptake, respectively, thereby reducing screening intention. The noncancer label also reduced screening intention by lowering perceived severity and positive attitude in sequence. [ABSTRACT FROM AUTHOR]

Background: Differentiated thyroid cancer is the commonest endocrine malignancy. Mortality in the presence of distant metastasis can increase dramatically. Bony metastasis often leads to increased morbidity and mortality. We report a case of a 60-year-old male who had metastatic spread of follicular cancer of the thyroid, without any identifiable primary. Case Presentation: A 60-year-old male presented with backache and weakness of lower limbs due to the collapse of the 11th thoracic vertebra. He underwent laminectomy and internal fixation. The histopathology revealed that it was the metastatic spread of follicular cancer of the thyroid. The histopathology revealed no malignancy in the thyroidectomy specimen. Subsequent administration of radioactive iodine showed a fall in thyroglobulin from 6,000 to 203 ng/ml. Conclusion: In cases of metastasis from an unknown primary, follicular thyroid cancer should be included in the differential diagnosis. Treatment after thyroidectomy can lead to good results. [ABSTRACT FROM AUTHOR]

Aging modifies risk in all cancers, but age is used as a clinical staging criterion uniquely in thyroid cancer (TC). The molecular drivers of age-dependent TC onset and aggressiveness remain poorly understood. We applied an integrative, multi-omics data analysis approach to characterize these signatures. Our analysis reveals that aging, independent of BRAFV600E mutational status, drives a significant accumulation of aggressiveness-related markers and poorer survival outcomes, most noticeably at age 55 and over. We identified that chromosomal alterations in loci 1p/1q as aging-associated drivers of aggressiveness, and that depleted infiltration with tumor surveillant CD8+T and follicular helper T cells, dysregulation of proteostasis- and senescence-related processes, and ERK1/2 signaling cascade are key features of the aging thyroid and TC onset/progression and aggressiveness in aging patients but not in young individuals. A panel of 23 genes, including those related to cell division such as CENPF, ERCC6L, and the kinases MELK and NEK2, were identified and rigorously characterized as aging-dependent and aggressiveness-specific markers. These genes effectively stratified patients into aggressive clusters with distinct phenotypic enrichment and genomic/transcriptomic profiles. This panel also showed excellent performance in predicting metastasis stage, BRAFV600E, TERT promoter mutation, and survival outcomes and was superior to the American Thyroid Association (ATA) methodology in predicting aggressiveness risk. Our analysis established clinically relevant biomarkers for TC aggressiveness factoring in aging as an important component. [ABSTRACT FROM AUTHOR]

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Although thyroid-stimulating hormone (TSH) is known to induce thyroid malignancies, the relationship between pre-operative TSH and pathological findings has not been thoroughly evaluated. This study aimed to assess the relationship between pre-operative TSH levels and pathological findings. Materials and Methods: The records of 156 patients (135 women and 21 men) operated for papillary thyroid cancer (PTC) between January 2017 and June 2020 were retrospectively reviewed and divided according to TSH level 2.5 mIU/L above (50 patients) and below (106 patients). The relationship between pre-operative fine-needle aspiration biopsy (FNAB) result, pathological findings, tumor diameter, multicentricity, lymphovascular invasion, extrathyroidal extension, capsule invasion, and neck (central, lateral) metastasis were compared for pre-operative TSH levels. Results: There was no significant difference between pre-operative TSH level and lymphovascular invasion, extrathyroidal extension, central and lateral lymph node metastasis, primary tumor size, and multifocality. However, TSH levels were found to be significant above 2.5 mIU/L in patients with capsule invasion positivity (p=0.007). TSH levels were significantly lower in our patients with malignant or suspected FNAB (p=0.015). Conclusion: Although pre-operative high TSH levels tend to be more common malignant in the literature, malignancy and suspected FNAB results are obtained in low TSH levels. TSH level should be considered as an independent factor in preoperative diagnosis, and thyroid malignancies should be suspected in cases with a TSH level below 2.5 mIU/L. [ABSTRACT FROM AUTHOR]

Thyroid cancer (TC) is the fastest growing cancer in China and has lots of influencing factors which can be intervened to reduce its incidence. In this article, we aimed to identify the risk factors of TC. The regional TC data in 2016 were obtained from the China Cancer Registry Annual Report published by the National Cancer Center (NCC). Univariate correlation analysis and generalized linear Poisson regression analysis were used to determine risk factors for morbidity of TC from the provincial and prefecture levels. High urbanization rate (UR) (RR = 1.109, 95%CI: 1.084, 1.135), high GDP per capita (PGDP) (RR = 1.013, 95%CI: 1.007, 1.018), high aquatic products (RR = 1.047, 95%CI: 1.020, 1.075) and dry and fresh fruit consumption (RR = 1.024, 95%CI: 1.007, 1.040) can increase TC incidence. Therefore, high PGDP, high UR, high aquatic products and dry and fresh fruit consumption were all risk factors for TC incidence. Our results may be helpful for providing analytical ideas and methodological references for the regionalized prevention and control of TC in a targeted manner. [ABSTRACT FROM AUTHOR]

[Display omitted] • Eu: Cs dots were used as ECL tags with ideal luminescence properties and ECL performance. • Dendritic Ag nanostructure/conductive gel as sensing interface to enhance the ECL signal. • BRAF in thyroid cancer exosome was detected for the diagnosis of lymphatic metastasis. In this work, a novel electrochemiluminescence (ECL) biosensor has been constructed with Eu-doped chitosan carbon dot (Eu: Cs dot) and dendritic silver nanostructure. Firstly, Eu: Cs dots were synthesized as ECL tags, which not only possessed exceptional electrochemical characters and intense luminescence, but also can reacted with H 2 O 2 as co-reactant to generate ECL signal. Furthermore, dendritic silver nanostructure with conductive gel was successfully prepared as sensing interface. The dendritic silver nanostructure with conductive gel displayed the ideal conductivity, good electrochemical stability, which can enhance the ECL intensity of Eu: CS dots. Finally, BRAF V600E from thyroid cancer exosome in the clinic eluate can be captured and detected. The results indicated the relative association between BRAF V600E mutation and lymphatic metastasis, which can be used in assessing thyroid cancer progression for advancing clinical diagnosis applications. [ABSTRACT FROM AUTHOR]

Thyroid cancer is the most prevalent endocrine malignancy. The development of sensitive and reliable methods to detect the thyroid cancer is the currently urgent requirement. Herein, we developed an electrochemiluminescence (ECL) biosensor based on MBene derivative quantum dots (MoB QDs) and Ag NP-on-mirror (NPoM) nanocavity structure. On the one hand, MBene QDs as a novel luminescent material in the ECL process was reported for the first time, which can react with H 2 O 2 as co-reactant. On the other hand, the NPoM nanostructure was successfully constructed with the Ag mirror and Ag NPs to provide highly localized hot spots. The NPoM structure had high degree of light field confinement and electromagnetic field enhancement, which can amplify the ECL signal as the signal modulator. Therefore, the synergistic effect of the nanocavity and localized surface plasmon resonance (LSPR) mode in the NPoM facilitated the enhancement of the ECL signal of MoB QDs over 21.7 times. Subsequently, the proposed ECL biosensing system was employed to analyze the expression level of miRNA-222-3p in the thyroid cancer exosome. The results indicated the relative association between miRNA-222-3p and BRAFV600E mutation. The MoB QDs/NPoM biosensor displayed the ideal potential in assessing thyroid cancer progression for advancing clinical diagnosis applications. [Display omitted] • The ECL signal of MBene-derivative QDs was generated with low background co-reactant. • The NPoM structure enhanced the electrochemiluminescence of MoB QDs. • The nanocavity-modulated ECL biosensor achieved the detection of exosomal miRNA. [ABSTRACT FROM AUTHOR]

Context: Thyroid nodules’ size should not be the sole criterion for thyroidectomy; however, many patients undergo surgery for large or slowly growing nodules. Objective: We evaluated risk for clinically significant thyroid cancer in patients with large or slowly growing nodules. Methods: We reviewed data from 2 prospectively collected databases of patients undergoing thyroidectomies in tertiary referral centers in the USA and Greece over 14 consecutive years. We collected data on the preoperative surgical indication, FNA cytology, and surgical pathology. We included subjects operated solely for large or growing thyroid nodules, without any known or presumed thyroid cancer or high risk for malignancy, family history of thyroid cancer, or prior radiation exposure. Results: We reviewed 5523 consecutive cases (USA: 2711; Greece: 2812). After excluding 3059 subjects, we included 2464 subjects in the present analysis. Overall, 533 thyroid cancers were identified (21.3%): 372 (69.8%) microcarcinomas (<1 cm) and 161 (30.2%) macrocarcinomas (≥1 cm). The histology was consistent with papillary cancer (n = 503), follicular cancer (n = 12), Hürthle cell cancer (n = 9), medullary cancer (n = 5), and mixed histology cancers n = 4. Only 47 (1.9%) of our subjects had any form of thyroid cancer in the nodule that originally led to surgery. The cancers were multifocal in 165 subjects; had extrathyroidal extension in 61, capsular invasion in 80, lymph node involvement in 35, and bone metastasis in 2 subjects. Conclusion: The risk of synchronous, clinically important thyroid cancers is small, but not null in patients with large or slow growing thyroid nodules. Therefore, more precise preoperative evaluation is needed to separate the patients who would clearly benefit from thyroid surgery from the vast majority of those who do not need to be operated. [ABSTRACT FROM AUTHOR]

Context: Measurement of driver mutations in circulating tumoral DNA (ctDNA) obtained by liquid biopsy has been shown to be a sensitive biomarker in several human tumors. Objective: The aim of this study was to evaluate the clinical relevance of pre- and post-operative ctDNA in sporadic medullary thyroid cancer (sMTC). Methods: We studied pre- and post-operative ctDNA in 26 and 23 sMTC patients, respectively. ctDNA results were correlated to serum calcitonin (Ct), carcinoembryonic antigen (CEA), and other clinical/pathological features. Results: Twenty-six of 29 (89.7%) sMTCs were mutated either for RET or RAS and 3/29 (10.3%) were negative. Four of 26 (15.4%) cases showed positive pre-operative ctDNA with a significantly higher presence of RET M918T mutation (P = 0.0468). Patients with positive preoperative ctDNA showed a higher variation allele frequency value of the somatic driver mutation (P = 0.0434) and a higher frequency of persistent disease (P = 0.0221). Post-operative ctDNA was positive only in 3/23 (13%) sMTCs and no one was positive for pre-operative ctDNA. Higher values of both Ct (P = 0.0307) and CEA (P = 0.0013) were found in positive ctDNA cases. Finally, the 7 cases harboring either pre- or post-operative positive ctDNA had a persistent disease (P = 0.0005) showing a higher post-operative serum Ct when compared with cases with negative ctDNA (P = 0.0092). Conclusions: Pre-operative ctDNA in medullary thyroid cancer is not useful for diagnostic purposes, but it can be useful for predicting the outcome of the disease. In our series, post-operative ctDNA showed a potential for monitoring the response to therapies, but further studies are required to confirm our results. [ABSTRACT FROM AUTHOR]

Background and Objective: Studies show that single nucleotide polymorphisms of the HOTAIR gene are associated with a variety of cancers, including colorectal, breast, and thyroid cancers. The product of the HOTAIR gene is a long non-coding RNA that is involved in regulating gene expression, cell cycle and apoptosis and is considered an oncogene. The present study was conducted to investigate the association between HOTAIR rs1899663 G>T gene polymorphism and thyroid cancer susceptibility in northwestern Iran. Methods: In this case-control study, peripheral blood was obtained from 90 patients with thyroid cancer referred to Tabriz hospitals as well as 198 healthy individuals. After DNA extraction by saturated salt and proteinase K method, single nucleotide polymorphism of HOTAIR rs1899663 gene was examined by tetra-primers ARMS PCR. Then, allelic and genotypic frequencies of control and case groups were calculated and compared. Findings: In this study, the genotypic frequencies of GG, GT and TT in the case group were 23.3%, 49% and 27.7%, and in the control group were 20.2%, 41% and 38.8%, respectively. Allele frequencies of G and T were 48% and 52.2% in the case group and 41% and 59% in the control group, respectively. Allelic and genotypic comparisons between case and control groups showed no significant relationship. Conclusion: The results of the study showed that HOTAIR rs1899663 gene polymorphism is not associated with any of the clinicopathological features of thyroid cancer. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to identify the characteristic features of patients with distant metastasis as the only manifestation of well-differentiated thyroid cancers and to analyze the treatment outcomes. Methods: A retrospective review of all patients with well-differentiated thyroid cancers and distant metastasis as the sole initial presentation was carried out. Data regarding age, gender, tumor histology, site, symptoms, and treatment outcomes were collected. Results: There were 10 patients who presented with distant metastasis as the only presentation. The mean age was 56.1 years. Eight (80%) patients had osseous metastasis, one (10%) had pulmonary and one (10%) had both. Follicular thyroid carcinoma was more common and seen in six (60%) patients. Seven (77.8%) out of nine patients had demised within five years of initial presentation. Conclusion: Distant metastases without a neck lump as the initial presentation of welldifferentiated thyroid cancers are extremely rare. No specific guidelines are available to manage such patients due to lack of relevant data in the literature. [ABSTRACT FROM AUTHOR]

AHNAK nucleoprotein 2 (AHNAK2) has been proposed to have an oncogenic role in various human cancers. However, the functional role of AHNAK2 in thyroid carcinoma (TC) progression has never been explored. In this study, quantitative real-time polymerase chain reaction and western blot were conducted to evaluate the expression of genes. The functional role of AHNAK2 was elucidated by cell count kit-8, colony-forming assay, wound-healing assay, and Transwell invasion assay. We found that AHNAK2 was highly expressed in thyroid carcinoma, and it was tightly correlated with the pathological stage in TC. The mRNA and protein levels of AHNAK2 were increased in TC cells. Silencing of AHNAK2 restricted the proliferation, metastasis, and epithelial-mesenchymal transition (EMT) of TC cells. AHNAK2 silencing inhibited the protein expression of β-catenin and cyclin D1, and AHNAK2 overexpression had the opposite effects. Moreover, LiCl or ICG-001 exposure counteracted the effects of AHNAK2 silencing or upregulation on malignant phenotypes of TC cells. In conclusion, the knockdown of AHNAK2 restrained the proliferation, metastasis, and EMT of TC cells by inhibiting the Wnt/β-catenin pathway, providing a new potential mechanism of AHNAK2 in understanding the oncogenesis and progression of TC. [ABSTRACT FROM AUTHOR]

Thyroid Carcinoma (THCA) is the most common endocrine tumor that is mainly treated using surgery and radiotherapy. In addition, immunotherapy is a recently developed treatment option that has played an essential role in the management of several types of tumors. However, few reports exist on the use of immunotherapy to treat THCA. The study downloaded the miRNA, mRNA and lncRNA data for THCA patients from the TCGA database (https://portal.gdc.cancer.gov/). Thereafter, the tumor samples were divided into cold and hot tumors, based on the immune score of the tumor microenvironment. Moreover, the differentially expressed lncRNAs and miRNAs were obtained. Finally, the study jointly constructed a ceRNA network through differential analysis of the mRNA data for cold and hot tumors. The study first assessed the level of immune infiltration in the THCA tumor microenvironment then divided the samples into cold and hot tumors, based on the immune score. Additionally, a total of 568 up-regulated and 412 down-regulated DEGs were screened by analyzing the differences between hot and cold tumors. Thereafter, the study examined the differentially expressed genes for lncRNA and miRNA. The results revealed 629 differentially expressed genes related to lncRNA and 114 associated with miRNA. Finally, a ceRNA network of the differentially expressed genes was constructed. The results showed a five-miRNA hubnet, i.e., hsa-mir-204, hsa-mir-128, hsa-mir-214, hsa-mir-150 and hsa-mir-338. The present study identified the immune-related mRNA, lncRNA and miRNA in THCA then constructed a ceRNA network. These results are therefore important as they provide more insights on the immune mechanisms in THCA. The findings also provides additional information for possible THCA immunotherapy. [ABSTRACT FROM AUTHOR]

This study tests the hypothesis that evaluation of thyroid nodule (TN) margin irregularities by three-dimensional ultrasound (3-D-US) distinguishes benign from malignant TNs with greater sensitivity and specificity than two-dimensional ultrasound (2-D-US). We prospectively evaluated 344 TNs using both 2-D-US and 3-D-US followed by fine needle aspiration biopsy. TNs were divided into four groups based on the 3-D-US appearance of the margins. Bi-variate and multi-variate analyses were used. Surgical pathology confirmed 44 thyroid cancers in 40 patients. For 2-D-US, irregular margins and micro-calcifications (p < 0.001) were found more frequently in malignant TNs. Irregular margins on 2-D-US had a sensitivity and specificity of 61.4% and 79.3%, respectively. Irregular margins on 3-D-US had a sensitivity and specificity of 86.4% and 83.3%, respectively. Sensitivity, specificity, positive and negative predictive values were higher for irregular margins on 3-D-US than micro-calcifications and irregular margins on 2-D-US. Evaluation of TN margins by 3-D-US distinguished benign from malignant TNs with greater sensitivity and specificity than 2-D-US. [ABSTRACT FROM AUTHOR]

Background/Aim: Core needle biopsy (CNB) has been widely used as an alternative method to ultrasound-guided fine-needle aspiration cytology for histological diagnosis of thyroid specimens. However, nuclear artifactual vacuoles (NuVas) produced during tissue processing can be very difficult and sometimes impossible to distinguish from intranuclear inclusions (NuIns). P62 is an autophagy receptor that recognizes, targets, and eliminates toxic cellular materials during autophagy. Herein, we examined the utility of p62 immunohistochemical staining to detect NuIns in thyroid core needle biopsy specimens. Patients and Methods:Thirty-five thyroid CNB slides from 32 patients and corresponding resection specimens stained with hematoxylin and eosin were reviewed by two pathologists. The immunohistochemical staining pattern of p62 was used to differentiate NuIns from NuVas. The diameter of each nucleus (A) and NuIn (B) was measured, and the number of p62-expressing NuIn-positive (p62In) cells was counted using 1/2 (B/A) and 1/3 (B/A) criteria. The criterion of 1/3 includes NuIns larger than 1/3 and smaller than 1/2 of the nuclear diameter. The criteria of 1/2 includes NuIns larger than 1/2 of the nuclear diameter. Results: By applying the 1/2 criterion, there were no p62In cells in follicular adenoma (FA) samples. However, in papillary thyroid carcinoma (PTC) samples, 22 of 25 specimens exhibited p62In cells. The sensitivity and specificity to distinguish FA from PTC using the 1/2 criterion were 0.88 and 1.00, respectively. By applying the 1/3 criterion, there was one p62In cell hit in FA samples. However, 23 of 25 PTC specimens showed p62In cells. The sensitivity and specificity to distinguish FA from PTC using the 1/3 criterion were 1.00 and 0.90, respectively. Conclusion: P62 is a useful marker for distinguishing FA and PTC based on CNB specimens. We suggest the 1/2 criteria for identifying p62In cells. [ABSTRACT FROM AUTHOR]

In recent decades, the incidence and diagnosis of thyroid cancer have risen dramatically, and thyroid cancer has now become the most common endocrine cancer in the world. The onset of thyroid cancer is insidious, and its progression is slow and difficult to detect. Therefore, early prevention and treatment have important strategic significance. Moreover, an in-depth exploration of the pathogenesis of thyroid cancer is key to early prevention and treatment. Substantial evidence supports obesity as an independent risk factor for thyroid cancer. Adipose tissue dysfunction in the obese state is accompanied by dysregulation of a variety of adipocytokines. Adiponectin (APN) is one of the most pivotal adipocytokines, and its connection with obesity and obesity-related disease has gradually become a hot topic in research. Recently, the association between APN and thyroid cancer has received increasing attention. The purpose of this review is to systematically review previous studies, give prominence to APN, focus on the relationship between APN, obesity and thyroid cancer, and uncover the underlying pathogenic mechanisms. [ABSTRACT FROM AUTHOR]

Background: Some evidence supports that the significance of inflammation is linked to a variety of tumors, including thyroid carcinoma. This work measured the preoperative serum inflammatory factors in thyroid tumors to explore their diagnostic values. Material and Methods: Altogether 487 thyroid tumor patients were recruited, their neutrophil (NE), white blood cell (WBC), monocyte (MO), lymphocyte (LY), platelet (PLT) counts, together with monocyte/lymphocyte ratio (MLR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), C-reactive protein (CRP), interleukin (IL)-1β, IL-2, IL-27, and tumor necrosis factor-α (TNF-α) levels were compared with controls. Afterward, the receiver operating characteristics (ROC) curve was plotted to further evaluate the values of these inflammatory markers in diagnosis. In addition, multivariable regression analysis was conducted to analyze all these inflammatory factors. Results: Serum PLR, NLR, CRP, and IL-27 levels in thyroid adenoma (TA) and differentiated thyroid carcinoma (DTC) patients were higher than those in controls. Only the areas under the curve (AUC) for CRP and IL-27 were significant in the context of DTC. Besides, the AUC for IL-27 was significant between papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) groups, while that for NLR+PLR was also significant between PTC and healthy control groups. According to multivariable logistic regression analysis, IL-27 and CRP were associated with DTC. Conclusions: Inflammation plays an important role in TA and DTC progression. Preoperative IL-27 and CRP levels help to differentially diagnose DTC. Moreover, IL-27 assists in distinguishing FTC from PTC, and NLR+PLR is important for the differential diagnosis of PTC. [ABSTRACT FROM AUTHOR]

Background Thyroid nodules are very common and may be observed at ultrasound (US) in 50% of adult population. US elastography is a noninvasive technique for evaluating thyroid nodules to decrease the number of tissue biopsies. Thyroid imagingreportingand data system(TIRADS) is theassessment of risk stratification of thyroid nodules using a score. Patients and methods This cross-sectional study was carried out on 100 patients with 146 thyroid nodules. The study was conducted in the period from October 2018 to October 2020 at the Radiology Department and approved by the Ethics Committee, and all patients gave their informed consent before inclusion in the study. Results were collected and then analyzed using a specialized computer statistical program. Results We found 124 (84.9%) benign nodules and 22 (15.1%) malignant nodules. The accuracy of elastography color score in detection of malignancy was found to be 95.1%, 89.7% for strain ratio, and 88.4% for TIRADS. Conclusion Adding elastography examination and TIRADS score to the routine thyroid US will be of high diagnostic value in detection of malignancy. [ABSTRACT FROM AUTHOR]

Columnar cell variant of papillary carcinoma of the thyroid gland is a rare and aggressive thyroid malignancy with the clinical course predicated on the clinical stage, with the presence or absence of extrathyroid invasion. The tumors tend to occur in the elderly. We herein report a case of columnar cell variant of papillary carcinoma of the thyroid gland with lymph node metastasis in a 22-year-old African female who presented with 2 years' history of anterior neck swelling. The clinical examination, imaging, and cytological examination were suggestive of a benign neoplasm. An initial subtotal thyroidectomy was histologically diagnosed to be a columnar variant of papillary carcinoma. She subsequently had a completion thyroidectomy with resection of residual malignant thyroid tissue and lymph node, which showed metastasis. The patient is on follow-up. [ABSTRACT FROM AUTHOR]

There are still many questions remaining about the etiopathogenesis of thyroid cancer, the most common type of endocrine neoplasia. Numerous occupational and environmental exposures have been shown to represent important risk factors that increase its incidence. Updated information about thyroid cancer diagnostics related to occupational and environmental risk factors is reviewed here, considering an integrated risk assessment approach; new data concerning thyroid cancer etiology and pathogenesis mechanisms, diagnostic biomarkers and methodologies, and risk factors involved in its pathogenesis are presented. A special emphasis is dedicated to specific occupational risk factors and to the association between environmental risk agents and thyroid cancer development. The occupational environment is taken into consideration, i.e., the current workplace and previous jobs, as well as data regarding risk factors, e.g., age, gender, family history, lifestyle, use of chemicals, or radiation exposure outside the workplace. Finally, an integrative approach is presented, underlying the need for an accurate Risk Assessment Matrix based on a systematic questionnaire. We propose a complex experimental design that contains different inclusion and exclusion criteria for patient groups, detailed working protocols for achieving coherent and sustainable, well-defined research stages from sample collection to the identification of biomarkers, with correlations between specific oncometabolites integrated into the Risk Assessment Matrix.

The coexistence of primary hyperparathyroidism (PHPT) and non-medullary differentiated thyroid carcinoma (NMTC) is rare but it does happen. The possibility of thyroid cancer should be considered in cases of primary hyperparathyroidism with coexistent thyroid nodules. The clinical diagnosis and treatment is quite challenging when sestamibi scan is negative that will lead to second surgery and exposing the patients to morbidity. There are multiple opinions regarding the role of investigating thyroid lesions in primary hyperparathyroidism patients. Multiple imaging modalities are used for preoperative localization of parathyroid lesion, including ultrasonography (USG), sestamibi scintigraphy SPECT/CT, and four-dimensional computed tomography (4D-CT) with different sensitivity and specificity. These various imaging techniques are meant for localization of nodular parathyroid lesions to reduce the need for unnecessary exploration by targeting the focal lesion approach. Sestamibi scintigraphy SPECT/CT is usually recommended as an investigation of choice. However, ultrasound acts as the perfect diagnostic tool to detect concomitant thyroid and parathyroid nodules because it is an inexpensive and non-invasive technique. [ABSTRACT FROM AUTHOR]

A 14 year-old girl with a previous medical history of cholecystic polyps was referred to our department with throat discomfort during swallowing. The cervical ultrasound and magnetic resonance imaging revealed a massive polycystic formation with a diameter of 45 x 24 x 31 mm consistent with a right lobe goiter. However, there were no findings for suspected malignancy. Hemithyroidectomy was performed and the specimen was sent for histopathological assessment. Hematoxylin-eosin staining of the right lower nodule showed variably-sized follicles consistent with adenomatous goiter. The right upper nodule showed a growth of relatively compact sized follicles with a thick fibrous capsule. A satellite nodule lying outside of the tumor capsule was consistent with minimally invasive follicular thyroid microcarcinoma. We observed her without any additional treatment and no recurrence is seen at present. [ABSTRACT FROM AUTHOR]

The diffuse sclerosing variant of papillary thyroid carcinoma (DSPTC) is uncommon. Herein, we report a rare case of DSPTC in a 9-year-old girl who initially presented with a painless diffuse goiter. Thyroid peroxidase antibody testing yielded positive results, and the initial clinical diagnosis was Hashimoto’s thyroiditis. However, thyroid ultrasonography revealed characteristic findings of DSPTC, which was confirmed through the postoperative histopathological diagnosis. Although thyroid cancers are rare in the pediatric population, DSPTC should be included in the differential diagnosis of goiter in these patients. Moreover, ultrasonography may prevent a diagnostic delay and facilitate the detection of a concomitant malignancy. [ABSTRACT FROM AUTHOR]

Purpose To evaluate a deep learning model to predict recurrence of thyroid tumor using preoperative ultrasonography (US). Materials and Methods We included representative images from 229 US-based patients (male:female = 42:187; mean age, 49.6 years) who had been diagnosed with thyroid cancer on preoperative US and subsequently underwent thyroid surgery. After selecting each representative transverse or longitudinal US image, we created a data set from the resulting database of 898 images after augmentation. The Python 2.7.6 and Keras 2.1.5 framework for neural networks were used for deep learning with a convolutional neural network. We compared the clinical and histological features between patients with and without recurrence. The predictive performance of the deep learning model between groups was evaluated using receiver operating characteristic (ROC) analysis, and the area under the ROC curve served as a summary of the prognostic performance of the deep learning model to predict recurrent thyroid cancer. Results Tumor recurrence was noted in 49 (21.4%) among the 229 patients. Tumor size and multifocality varied significantly between the groups with and without recurrence (p < 0.05). The overall mean area under the curve (AUC) value of the deep learning model for prediction of recurrent thyroid cancer was 0.9 ± 0.06. The mean AUC value was 0.87 ± 0.03 in macrocarcinoma and 0.79 ± 0.16 in microcarcinoma. Conclusion A deep learning model for analysis of US images of thyroid cancer showed the possibility of predicting recurrence of thyroid cancer. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Tepecik Education & Research Hospital / İzmir Tepecik Eğitim ve Araştırma Hastanesi Dergisi is the property of Logos Medical Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Utilizing historical clinical datasets to guide future treatment choices is beneficial for patients and physicians. Machine learning and feature selection algorithms (namely, Fisher's discriminant ratio, Kruskal-Wallis' analysis, and Relief-F) have been combined in this research to analyse a SEER database containing clinical features from de-identified thyroid cancer patients. The data covered 34 unique clinical variables such as patients' age at diagnosis or information regarding lymph nodes, which were employed to build various novel classifiers to distinguish patients that lived for over 10 years since diagnosis, from those who did not survive at least five years. By properly optimizing supervised neural networks, specifically multilayer perceptrons, using data from large groups of thyroid cancer patients (between 6,756 and 20,344 for different models), we demonstrate that unspecialized and existing medical recording can be reliably turned into power of prediction to help doctors make informed and optimized treatment decisions, as distinguishing patients in terms of prognosis has been achieved with 94.5% accuracy. We also envisage the potential of applying our machine learning strategy to other diseases and purposes such as in designing clinical trials for unmasking the maximum benefits and minimizing risks associated with new drug candidates on given populations. [ABSTRACT FROM AUTHOR]

A direct association has been shown between Cyclin D1 and C-myc gene expressions and the proliferation of human thyroid tumor cells. Our previous study showed that increased β catenin led to a reduction in disease-free probability in patients with papillary thyroid cancer. This study was designed to investigate Cyclin D1 and C-myc genes as targets for β catenin function in PTC and to determine the association between genes expression and staging, recurrence, metastasis, and disease-free survival of PTC. This study was conducted via a thorough investigation of available data from medical records as well as paraffin blocks of 77 out of 400 patients over a 10-year period. Cyclin D1 and C-myc gene expression levels were measured using real-time polymerase chain reaction (RT-PCR) and the Kaplan-Meier method was used to evaluate disease-free survival. Higher levels of Cyclin D1 and C-myc gene expressions were observed in patients with recurrence by 8.5 (P = 0.004) and 19.5 (p = 0.0001) folds, respectively. A significant positive correlation was found between Cyclin D1 expression and the cumulative dose of radioactive iodine received by patients (r = −0.2, p value = 0.03). The ten-year survival rate in the patients included in this study was 98.25% while disease-free survival was 48.1%. Higher Cyclin D1 and C-myc gene expression levels were observed in patients with recurrence/distant metastasis. Inversely, lower expression of Cyclin D1 and C-myc genes were associated with better survival of patients (SD, 0.142-0.052) (Mantel-Cox test, P = 0.002). The enhancement of Cyclin D1 and C-myc gene expression may be a potential mechanism for recurrence and aggressiveness of PTC. [ABSTRACT FROM AUTHOR]

Angiotensin-converting enzymes, ACE and ACE2, play not only a pivotal role in the regulation of blood pressure, but are involved in the processes of pathophysiology, including thyroid dysfunction or progression of several neoplasia such as cancers of skin, lungs, pancreas and leukemia. However, their role in the thyroid carcinogenesis remains unknown. We examined in this study the expression of ACE and ACE2 in thyroid tissues and their possible employment as biomarkers for thyroid cancer progression. Thyroid tissues, including 14 goiters (G), 12 follicular adenomas (FA), 10 follicular thyroid carcinomas (FTC), 14 papillary thyroid carcinomas (PTC) and 11 undifferentiated thyroid carcinomas (UTC), were subjected to RT-PCR and protein analyses with primers or antibodies specific for ACE and ACE2, respectively. FA revealed significantly increased ACE compared to other groups and FTC was significantly higher than UTC. ACE2 was significantly increased in PTC in comparison to G, FA and UTC, and in FTC as compared to G. The ratio ACE/ACE2 decreased, while ACE2/ACE increased with the differentiation grade of thyroid carcinoma. ACE was significantly diminished in individuals older than 50. Both ACEs were significantly diminished in M1 patients, ACE2 additionally in higher tumor masses. ACE and ACE2 are regulated within thyroid benign and malignant tissues. As the transcript ratio between both enzymes correlate proportional with the differentiation status of thyroid cancer, ACE and ACE2 may serve as new markers for thyroid carcinoma. [ABSTRACT FROM AUTHOR]

Several patients with thyroid cancer experience symptom distress after diagnosis and surgery. Data on the association between symptomatology and disease recurrence are limited. A retrospective review of a prospectively maintained database was performed, and 57 patients who had recurrence after operation of differentiated thyroid cancer were identified. Controlling for age, sex, surgery, and tumour stage, 114 patients without recurrent disease were selected by case-control matching. Subjective symptoms at follow-up visits were extracted from medical records and classified into three symptom clusters: pharyngolaryngeal, psychoneurological, and gastrointestinal. Compared to the control group, patients with recurrence had higher symptom totals in the pharyngolaryngeal (P < 0.001) and psychoneurological clusters (P = 0.005). Symptom score >3 yielded a sensitivity of 61.4% and a specificity of 80.7% to predict recurrence. Multivariate Cox regression analysis revealed that high symptom score (hazard ratio [HR] = 4.184), family history of thyroid cancer (HR = 2.463), and obesity (HR = 1.981) were independently associated with disease recurrence. Taken together, the likelihood of postoperative recurrence seemed to increase with high self-perceived symptom burden, family history, and obesity in patients with thyroid cancer. The results could be applied to the recurrence surveillance and symptomatic management of thyroid cancer post-operation. [ABSTRACT FROM AUTHOR]

S100A12 belongs to the S100 family and acts as a vital regulator in different types of tumors. However, the function of S100A12 in thyroid carcinoma has not yet been investigated. In this study, we analyzed the expression of S100A12 in human papillary thyroid cancer (PTC) samples and two PTC cell lines. In addition, we explored the effects of S100A12 on PTC cell progression in vitro and in vivo. Our results showed that S100A12 was significantly upregulated in PTC specimens. Moreover, silencing S100A12 markedly inhibited PTC cell proliferation, migration, invasion and cell cycle progression. In addition, knockdown of S100A12 significantly reduced the expression of CyclinD1, CDK4 and p-ERK in PTC cells. An in vivo study also showed that silencing S100A12 dramatically suppressed tumor cell growth and decreased Ki67 expression in a xenograft mouse model. This study provides novel evidence that S100A12 serves as an oncogene in PTC. Knockdown of S100A12 suppressed PTC cell proliferation, migration, and invasion and induced G0/G1 phase arrest via the inhibition of the ERK signaling pathway. Therefore, S100A12 may be a potent therapeutic target for PTC. [ABSTRACT FROM AUTHOR]

Thyroid cancer is one common endocrine malignancy with various pathological types. MicroRNAs (miRNAs) play essential roles in development, prognosis and treatment of thyroid cancer. However, the roles of miR-17-5p in thyroid cancer progression and its mechanism remain poorly understood. The expressions of miR-17-5p and phosphatase and tensin homolog (PTEN) were measured in thyroid cancer tissues and cells by quantitative real-time polymerase chain reaction or western blot. Cell proliferation and apoptosis were detected by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide assay and flow cytometry, respectively. The protein levels of biomarkers in autophagy or protein kinase B (AKT)/mechanistic target of rapamycin (mTOR) pathway were analyzed by western blot. The interaction between miR-17-5p and PTEN was probed by luciferase activity assay. We found that miR-17-5p expression was elevated and PTEN level was reduced in thyroid cancer tissues and cells compared with their corresponding controls. Knockdown of miR-17-5p or overexpression of PTEN suppressed cell proliferation and autophagy but promoted apoptosis in thyroid cancer cells. PTEN was indicated as a target of miR-17-5p and its interference reversed abrogation of miR-17-5p-mediated inhibition of proliferation and autophagy and increase of apoptosis. Moreover, downregulation of miR-17-5p impeded the activation of AKT/mTOR pathway in thyroid cancer cells, which was attenuated by silencing PTEN. Our data supported that knockdown of miR-17-5p upregulated PTEN expression, therefore leading to suppression of the malignancy of thyroid cancer and inactivation of AKT/mTOR pathway, providing a novel avenue for treatment of thyroid cancer. [ABSTRACT FROM AUTHOR]

Thyroid nodules are a common clinical problem. Ultrasonography (US) is the main tool used to sensitively diagnose thyroid cancer. Although US is non-invasive and can accurately differentiate benign and malignant thyroid nodules, it is subjective and its results inevitably lack reproducibility. Therefore, to provide objective and reliable information for US assessment, we developed a CADx system that utilizes convolutional neural networks and the machine learning technique. The diagnostic performances of 6 radiologists and 3 representative results obtained from the proposed CADx system were compared and analyzed. [ABSTRACT FROM AUTHOR]

The combination of highly sensitive electrochemiluminescence (ECL) techniques with localized surface plasmon resonance (LSPR) effect can achieve the highly sensitive and specific detection in the analytical and biosensing applications. However, how to effectively improve the electromagnetic field intensity is an unresolved issue. Herein, we have developed an ECL biosensor based on sulfur dots and Au@Ag nanorod array architecture. Firstly, the high luminescent sulfur dots with ionic liquid capping (S dots (IL) have been prepared as the new ECL emitter. The ionic liquid greatly improved the conductivity of sulfur dots in the sensing process. Furthermore, Au@Ag nanorods array structure was constructed on the electrode surface by the evaporation induced self-assembly. On the one hand, the LSPR of Au@Ag nanorods was more significant than that of good nanomaterial due to the plasma hybridization and the competition between free electrons and oscillating electrons. On the other hand, nanorods array structure had strong electromagnetic field intensity as hot spots due to the surface plasmon coupling ECL effect (SPC-ECL) effect. Therefore, the Au @Ag nanorods array architecture not only greatly enhanced the ECL intensity of sulfur dots, but also changed the ECL signals into polarized emission. Finally, the constructed polarized ECL sensing system was used to detect the mutated BRAF DNA in the eluent of thyroid tumor tissue. The biosensor showed the linear range from 100 fM to 10 nM with a detection limit of 20 fM. The satisfactory results demonstrated that the developed sensing strategy had great potential in the clinical diagnosis of BRAF DNA mutation in thyroid cancer. [Display omitted] • The polarized SPC-ECL sensor based on Au@Ag nanorods array was developed. • Nanorods array had strong electromagnetic field intensity as hot spots due to the SPC-ECL effect. • The sensor was used to detect BRAF gene in the eluent of thyroid tumor tissue. [ABSTRACT FROM AUTHOR]

Thyroid cancer is the most common cancer in the endocrine system, and papillary thyroid carcinoma (PTC) is the most prevalent type of thyroid cancer, accounting for 70 to 80% of all thyroid cancer cases. In clinical practice, visual inspection of cytopathological slides is an essential initial method used by the pathologist to diagnose PTC. Manual visual assessment of the whole slide images is difficult, time consuming, and subjective, with a high inter-observer variability, which can sometimes lead to suboptimal patient management due to false-positive and false-negative. In this study, we present a fully automatic, efficient, and fast deep learning framework for fast screening of papanicolaou-stained thyroid fine needle aspiration (FNA) and ThinPrep (TP) cytological slides. To the authors’ best of knowledge, this work is the first study to build an automated deep learning framework for identification of PTC from both FNA and TP slides. The proposed deep learning framework is evaluated on a dataset of 131 WSIs, and the results show that the proposed method achieves an accuracy of 99%, precision of 85%, recall of 94% and F1-score of 87% in segmentation of PTC in FNA slides and an accuracy of 99%, precision of 97%, recall of 98%, F1-score of 98%, and Jaccard-Index of 96% in TP slides. In addition, the proposed method significantly outperforms the two state-of-the-art deep learning methods, i.e., U-Net and SegNet, in terms of accuracy, recall, F1-score, and Jaccard-Index (p<0.001). Furthermore, for run-time analysis, the proposed fast screening method takes 0.4 min to process a WSI and is 7.8 times faster than U-Net and 9.1 times faster than SegNet, respectively.

Background: Follicular thyroid carcinoma (FTC) is a type of thyroid cancer that arises from the follicular cells of the thyroid gland. It accounts for about 10%-15% of all thyroid cancers. CA 125 is a protein that is often used as a tumor marker for ovarian cancer, but it can also be elevated in other types of cancers, including thyroid cancer. The significance of raised CA 125 levels in FTC is not clear, but it indicates a more advanced or aggressive form of the disease [1,2]. Case Presentation: A 62-year-old male presented with a painless neck mass (Figure 1) for 8 years. Ultrasonography revealed a solid nodule in the left lobe of the thyroid gland. Fine-needle aspiration cytology of the nodule showed features of follicular neoplasm. Contrast-enhanced computed tomography (CECT) abdomen and blood routine ruled out other causes of raised CA 125. Chest X ray and CECT neck (Figure 2) and thorax showed lung (Figure 3) and thoracic vertebra metastasis (Figure 5). Total thyroidectomy with bilateral central compartment lymph node dissection was performed. Histopathology confirmed FTC (Figure 4) with capsular invasion, and lymphovascular and perineural invasion and lymph node-positive. The tumor was classified as T3bN1a according to the tumor, nodes, and metastasis staging system. I131 scan post-surgery showed uptake in lung metastasis sites which confirmed the diagnosis. Conclusion: The role of serum tumor markers, such as CA 125, in predicting the prognosis of FTC is not well established. However, elevated CA 125 levels have been reported in some cases of thyroid carcinoma with metastasis, and may reflect the presence of peritoneal or pleural involvement [3,4]. This case highlights the aggressive nature of FTC with metastasis and the limited treatment options available for patients with advanced disease. CA 125 as a prognostic marker in FTC warrants further investigation [5]. [ABSTRACT FROM AUTHOR]

In recent decades, there has been a marked increase in the prevalence of thyroid cancer. This phenomenon has paralleled the increase in the prevalence of obesity worldwide, which is associated with insulin resistance. Associations between these entities have been hypothesized, mainly for older and female populations, but they remain unclear. The aim of this article is to systematically review the literature in an attempt to determine whether the increase in the prevalence of thyroid cancer is due to obesity or due only to improved detection with the better imaging techniques available. A thorough literature search on PubMed and application of selection criteria identified 15 appropriate studies. The detailed analysis of the data from these studies indicated that there is a suggestive association between thyroid cancer, obesity, insulin resistance and hyperinsulinemia for both genders. Therefore, the increased prevalence of thyroid cancer is not dependent on improved detection only. Further research should be performed for complete understanding of the pathophysiological associations, especially regarding adipose tissue and genetics, but also for the improvement of preventive public health policies. [ABSTRACT FROM AUTHOR]

Thyroid cancers (TCs) are the most frequent endocrine malignancy with an unpredictable fast-growing incidence, especially in females all over the world. Fine-needle aspiration biopsy (FNAB) analysis is an accurate diagnostic method for detecting thyroid nodules and classification of TC. Though simplicity, safety, and accuracy of FNAB, 15–30% of cases are indeterminate, and it is not possible to determine the exact cytology of the specimen. This demands the need for innovative methods capable to find crucial biomarkers with adequate sensitivity for diagnosis and prediction in TC researches. Cancer-based metabolomics is a vast emerging field focused on the detection of a large set of metabolites extracted from biofluids or tissues. Using analytical chemistry procedures allows for the potential recognition of cancer-based metabolites for the purposes of advancing the era of personalized medicine. Nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS) coupled with separation techniques e.g., gas chromatography (GC) and liquid chromatography (LC) are the main approaches for metabolic studies in cancers. The immense metabolite profiling has provided a chance to discover novel biomarkers for early detection of thyroid cancer and reduce unnecessary aggressive surgery. In this review, we recapitulate the recent advances and developed methods of diverse metabolomics tools and metabolic phenotypes of thyroid cancer, following a brief discussion of recent challenges in the thyroid cancer diagnosis. [ABSTRACT FROM AUTHOR]

BACKGROUND: : Thyroid carcinoma is the most common endocrine malignancy worldwide. Changes in DNA methylation can cause silencing of normally active genes, especially tumour suppressor genes (TSG) or activation of normally silent genes. OBJECTIVE: : The aim of this study is to evaluate the degree of promoter methylation for a panel of markers for thyroid neoplasms and to establish their relationship with thyroid oncogenesis. METHODS: : To generate a comprehensive DNA methylation signature of TSGs involved in thyroid neoplasia, we use Human TSG EpiTect Methyl II Signature PCR Array-Qiagen for 24 samples (follicular adenomas and papillary thyroid carcinomas) compared with normal thyroid tissue. We extended the evaluation for three TSGs (TP73, WIF1, PDLIM4) using qMS-PCR. Statistical analysis was performed with GraphPad Prism. RESULTS: : We noted four important genes NEUROG1, ESR1, RUNX3, MLH1, which presented methylated promoter in tumour samples compared to normal. We found new characteristic of thyroid tumours: methylation of TP73, WIF1 and PDLIM4 TSGs, which can contribute to thyroid neoplasia. A significant correlation between BRAF V600E mutation and RET/PTC rearrangements with TIMP3 and CDH13, RARB methylation, respectively was observed. CONCLUSIONS: : TSGs promoter hypermethylation is a hallmark of cancer and a test that uses methylation quantification method is suitable for diagnosis and prognosis of thyroid cancer. [ABSTRACT FROM AUTHOR]

Cribriform-morular variant of papillary thyroid carcinoma (CMVPTC) is usually an inherited malignancy and may be a presenting indicator of familial adenomatous polyposis syndrome although it may occasionally be sporadic. Known CMVPTC mutations include adenomatous polyposis coli (APC) and β-catenin (CTNNB1) genes. Despite its malignant classification, CMVPTC is considered to be a well-differentiated thyroid tumor with a generally good behavior. In contrast, poorly differentiated thyroid carcinoma is an aggressive tumor. We report a case of CMVPTC with poorly differentiated features in a young female without phenotypic features of familial adenomatous polyposis but with known germline alterations of the APC gene. High throughput sequencing showed germline chromosome 5q deletion encompassing the APC gene in all components with additional unique genetic alterations in the somatic components. A single nucleotide substitution (c.1548+1G>A, NM_000038.5) located one base pair downstream of exon 12 of the APC gene was identified in the CMVPTC component, and a pathogenic frameshift deletion in exon 14 of APC (c.3642del, p.Ser1214Argfs*51, NM_000038.5) was identified in the poorly differentiated thyroid carcinoma component. No other cancer-associated genes were identified by our techniques. Our case represents a rare phenomenon of poorly differentiated features in association with CMVPTC. To our knowledge, ours is the only such report of poorly differentiated features arising in association with an inherited CMVPTC. [ABSTRACT FROM AUTHOR]

Objectives: To assess the impact of the eighth edition AJCC/TMN staging system on patients with new diagnoses of differentiated thyroid cancers presenting to our regional multidisciplinary team meetings. Design: We analysed Endocrine Cancer MDT meeting records from 2009 to 2015 to identify all patients in the region presenting with a new diagnosis of differentiated thyroid cancer. We re‐staged patients according to the eighth edition AJCC/TNM staging classification and analysed the survival outcomes of patients in each stage under the seventh and eighth systems. Setting: Tertiary referral centre in South East Scotland (NHS Lothian). Participants: Three hundred and sixty‐one patients were newly diagnosed with DTC within South East Scotland during the study period and met our inclusion criteria. Main outcome measures: Disease‐specific mortality at any time during follow‐up. Results: In total, 119 of 361 (33%) patients were re‐staged when the eighth edition AJCC/TMN system was applied. The number of patients classified as having advanced stage (III/IV) disease fell from 76 (21%) to 8 (2%). The most common reason for down‐staging was re‐classification of tumour size, a factor in 96 (80.7%) down‐staged patients. The five‐year disease‐specific survival of the cohort overall was 98%. Overall, 7 (1.9%) thyroid cancer–related deaths occurred during follow‐up, three of whom were down‐staged. Conclusions: On implementation of the eighth edition of the AJCC/TMN staging system, we expect many patients who would previously have been considered to have advanced thyroid cancer will now be classified as early stage. This will accurately reflect their excellent survival outcomes. [ABSTRACT FROM AUTHOR]

Poorly differentiated thyroid carcinoma (PDTC) are unusual tumours which are rarely diagnosed with accuracy in cytology. Plasmacytoid morphology of the tumour cells can cause diagnostic difficulty as it mimics many other primary thyroid tumours: however it can be accurately diagnosed if certain fine morphological clues are identified while reporting. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica de Rosario is the property of Circulo Medico de Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Whether plasma miRNAs could be used as novel non-invasive biomarkers in diagnosing papillary thyroid carcinoma (PTC) remains unknown. In this study, we designed a four-phase study to identify differentially expressed plasma miRNAs in Chinese PTC patients. Exiqon panel was initially utilized to conduct plasma miRNA profile (3 PTC pools VS. 1 healthy control (HC) pool; each 10 samples were pooled as 1 sample). The dysregulated miRNAs were then analyzed in the training (30 PTC VS. 30 HCs), testing (57 PTC VS. 54 HCs) and external validation phases (33 PTC VS. 30HCs). The identified miRNAs were further affirmed in benign nodules (2 nodular goiter (NG) pool VS. 1 HC pool). We also verified the expression of identified miRNAs in 17 matched malignant and normal tissue samples, NG plasma samples (29 PTC VS. 29 NG) and plasma exosomes (25 PTC VS. 25 HCs). Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic value of the identified miRNAs. As a result, the screening phase demonstrated 30 dysregulated plasma miRNAs in PTC patients compared with HCs. After multiphase experiment processes, miR-346, miR-10a-5p and miR-34a-5p were found significantly elevated in PTC plasma samples relative to HCs. The areas under the ROC curve (AUC) of the three-miRNA panel for the training, testing and validation phases were 0.926, 0.811 and 0.816, separately. The panel could also differentiate PTC from NG with the AUC of 0.877. MiR-346 and miR-34a-5p but not miR-10a-5p were up-regulated in PTC tissues. And the three miRNAs showed consistently up-regulation in PTC plasma exosomes. In conclusion, our study established a three-miRNA panel in plasma with considerable clinical value in discriminating PTC from HC or NG. Highlights • Plasma miR-346, miR-10a-5p and miR-34a-5p were elevated in PTC patients relative to HCs. • The three-miRNA panel could differentiate PTC patients from NG patients or HCs. • MiR-346 and miR-34a-5p but not miR-10a-5p were elevated in tumor tissues to normal tissues. • All the three miRNAs were up-regulated in exosomes from PTC plasma samples compared to HCs. [ABSTRACT FROM AUTHOR]

Long non-coding RNA FOXD2 Adjacent Opposite Strand RNA 1 (FOXD2-AS1) has been widely reported to be implicated in the progression and recurrence of several cancers. The clinical significance and functional role of FOXD2-AS1 in thyroid carcinoma remain unknown. FOXD2-AS1 expression was evaluated by analyzing thyroid cancer RNA sequencing dataset from The Cancer Genome Atlas (TCGA). In vitro and in vivo assays were performed to assess the biological roles of FOXD2-AS1 in thyroid cancer cells. Western blot, luciferase, immunoprecipitation (IP), and RNA immunoprecipitation (RIP) assays were used to identify the underlying miRNA and mRNA target mediating the biological roles of FOXD2-AS1 in thyroid cancer cells. FOXD2-AS1 was upregulated in thyroid carcinoma tissues and cells. High expression of FOXD2-AS1 significantly correlated with clinical stage, recurrence of thyroid carcinoma. Silencing FOXD2-AS1 inhibited cancer stem cell-like phenotypes and attenuates the anoikis resistance in vitro. Downregulating FOXD2-AS1 represses the tumorigenesis of thyroid carcinoma cells in vivo. FOXD2-AS1 acts as a competitive endogenous RNA (ceRNA) for miR-7-5p, up-regulating the expression of telomerase reverse transcriptase (TERT), which further promotes the cancer stem cells features and anoikis resistance in thyroid cancer cells. Our findings indicate that FOXD2-AS1 functions as an oncogenic regulator in the development of thyroid cancer, contributing to early recurrence of thyroid cancer. [ABSTRACT FROM AUTHOR]