Endocrine最新文献

{"title":"CXCR4-directed PET with ⁶⁸Ga-pentixafor versus adrenal vein sampling for the diagnosis of unilateral primary aldosteronism.","authors":"Lu Tan, Tao Chen, Wenjie Zhang, Sikui Shen, Haoming Tian, Yuchun Zhu, Rong Tian, Yan Ren","doi":"10.1007/s12020-025-04236-5","DOIUrl":"https://doi.org/10.1007/s12020-025-04236-5","url":null,"abstract":"<p><strong>Objective: </strong>To explore the accuracy of unilateral primary aldosteronism (UPA) classification via adrenal vein sampling (AVS) and C-X-C chemoking receptor 4 (CXCR4)-directed positron emission tomography (PET) with <sup>68</sup>Ga-pentixafor (CXCR4-directed molecular imaging).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted with 89 patients who were diagnosed with UPA and who underwent unilateral adrenalectomy (ADX) at West China Hospital of Sichuan University from January 2021 to June 2023. For these patients, surgical decisions were made on the basis of either AVS (AVS group) or CXCR4-directed molecular imaging (CXCR4 group), and patients were regularly followed up for more than 6 months after surgery. Whether biochemical and clinical success was achieved 6 months after surgery was determined on the basis of the primary aldosteronism surgical outcomes (PASO) criterion. The complete success rates were compared between the AVS group and CXCR4 group. One-way analysis of variance was used to compare preoperative factors, postoperative biochemical success rates and clinical success rates between the two groups. Additionally, the postoperative outcomes of adrenal nodules of different sizes were compared.</p><p><strong>Results: </strong>1. Among the 89 patients with UPA, 66 patients received ADX on the basis of AVS results, and 23 patients on the basis of CXCR4-directed molecular imaging results. The median age of the CXCR4 group [M (P25, P75): 45.00 years (39.00, 51.00)] was significantly lower than that of the AVS group [M (P25, P75): 49.00 years (40.75, 54.00)]. No significant differences in sex, history of hypertension, maximum blood pressure, antihypertensive drug defined daily dose (DDD), plasma aldosterone concentration (PAC), direct renin concentration (DRC), aldosterone-to-renin ratio (ARR), PAC after the captopril challenge test (CCT), PAC after the seated saline infusion test (SSIT), urea nitrogen, estimated glomerular filtration rate (eGFR), serum potassium level, diameter of the adrenal nodules or bilateral adrenal involvement were found. 2. There was no significant difference in the postoperative biochemical complete succcess rate (80.30 vs. 91.30%) or clinical cpmplete success rate (59.05 vs.65.21%) between the AVS group and the CXCR4 group. There were no significant differences in nitrogen, eGFR, serum potassium level, PAC, DRC, ARR, mean postoperative blood pressure or antihypertensive drug DDD after 6 months of follow-up. 3. For the identification of UPA patients with functional adrenal nodules ≥1 cm, CXCR4-directed molecular imaging have comparable diagnostic accuracies. 4. Three patients with adrenal micronodules achieved complete biochemical complete success after successful typing via CXCR4-directed molecular imaging, and unilateral aldosteronogenic micronodules were confirmed by immunohistochemistry (IHC) of CYP11B2 after surgery.</p><p><strong>Conclusion: </strong>CXCR4-directed molec","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional study of two siblings with isolated growth hormone deficiency and pituitary MR imaging abnormalities caused by a novel HESX1 variant.","authors":"NokI Lei, Yun Yang, Yanlin Liu, Ronggui Hu, Chuanyin Li, Wenli Lu","doi":"10.1007/s12020-025-04262-3","DOIUrl":"https://doi.org/10.1007/s12020-025-04262-3","url":null,"abstract":"<p><strong>Purpose: </strong>Our study identifies a novel HESX1 variant in two siblings, resulting in isolated growth hormone deficiency (IGHD) associated with empty sella. To the best of our knowledge, this represents the second recognized mutation within the EH1 repressor domain in HESX1. We explore and interpret the potential mechanism, with the aim of guiding pediatricians comprehend this disorder.</p><p><strong>Methods: </strong>The clinical data for two Chinese siblings was summarized. Furthermore, multiple sequence alignment and pathogenicity prediction of functional effects through five online algorithms were performed. Additionally, AlphaFold 3 was introduced to predict the three-dimensional protein structure of wild-type HESX1 and its variant. Immunoblotting analysis was also employed to examine changes in protein levels, and a luciferase reporter assay was conducted to further investigate the effects of HESX1 and its variant on PROP1 transcriptional activity.</p><p><strong>Results: </strong>This report details two siblings with IGHD and empty sella, caused by a novel Ile23Thr (c.T68C) HESX1 missense mutation in exon 1. This variant was predicted to be disease-causing and to enhance the stability and local contact with E24, as indicated by the 3D prediction model. In the presence of PROP1, the mutant HESX1 exhibited a marked reduction in the suppression of PROP1-mediated activity relative to the wild-type HESX1.</p><p><strong>Conclusions: </strong>The HESX1 (Ile23Thr) mutation is a partial loss-of-function mutation that attenuates the inhibition of PROP1-mediated activation. This suggests that the mutant can lead to GH deficiency and brain malformation.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive clinical and molecular characterization with long-term outcomes in 40 patients with congenital hyperinsulinism.","authors":"Zehra Yavas Abali, Firdevs Bas, Jayne A L Houghton, Saygin Abali, Esin Karakilic Ozturan, Cagrı Gulec, Ayca Dilruba Aslanger, Tugce Kandemir, Durmus Durmaz, Mehmet Akif Yucesoy, Sarah E Flanagan, Sukran Poyrazoglu, Ruveyde Bundak, Feyza Darendeliler","doi":"10.1007/s12020-025-04244-5","DOIUrl":"https://doi.org/10.1007/s12020-025-04244-5","url":null,"abstract":"<p><strong>Purpose: </strong>Congenital hyperinsulinism (CHI) represents the most frequent cause of recurrent hypoglycemia in neonates and infants, stemming from defects in the regulatory pathways of insulin secretion from pancreatic beta cells. This study aims to assess the clinical and genetic characteristics of a CHI cohort and to discuss the complexities involved in managing this heterogeneous disorder.</p><p><strong>Methods: </strong>Forty patients (23 girls) with CHI were included in the study. Data on the diagnosis and treatment of CHI were obtained from the medical records.</p><p><strong>Results: </strong>The median age at diagnosis was 1.4 months (range 0.1-30 months). The mean gestational age was 37.8 ± 2.4 weeks, and the birth weight was 1.1 ± 2.0 SDS. The consanguinity ratio was 35.0%. Median glucose, insulin, and C-peptide concentrations at diagnosis were 34.0 mg/dl (IQR 25.2-41.7), 12.4µU/ml (IQR 4.4-27.1), and 1.5 ng/ml (IQR 0.7-3.8), respectively. Molecular genetic diagnosis could be established in 62.5% (n = 25). Pathogenic variants were predominantly identified in the KATP channel genes (17/25, 68%), with the ABCC8 being the most frequent (n = 15; biallelic: 8, monoallelic: 7). KCNJ11 variants were identified in two (5.0%), GLUD1 variants in three (7.5%), and HADH variants in five patients (12.5%). Pancreatectomy was performed in 10 patients, with a mean age at the time of surgery of 3.9 ± 3.2 months. The genetic etiology was identified in all patients who underwent pancreatectomy, all of whom had defects in the KATP channel. ABCC8 variants were detected in nine (biallelic: 5, monoallelic: 4), while a biallelic variant in the KCNJ11 was identified in one case.</p><p><strong>Conclusion: </strong>A molecular genetic diagnosis was identified in approximately two-thirds of our cohort, underscoring the significance of genetic testing in the management of CHI. Ongoing advances in genetic technologies are anticipated to enhance our understanding of the etiopathogenesis of CHI and support the development of more personalized therapeutic strategies. Although the genotype-phenotype correlation remains only partially elucidated, specific genetic variants may provide predictive insights into treatment resistance, thereby informing more targeted treatment approaches.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phosphate metabolism in primary hyperparathyroidism: a real-life long-term study.","authors":"Carla Columbu, Domenico Rendina, Luigi Gennari, Flavia Pugliese, Vincenzo Carnevale, Antonio Stefano Salcuni, Iacopo Chiodini, Claudia Battista, Patrizia Tabacco, Vito Guarnieri, Giuseppe Guglielmi, Cristina Eller-Vainicher, Cristiana Cipriani, Antonello Cuttitta, Gianpaolo De Filippo, Fernanda Velluzzi, Alberto Falchetti, Salvatore Minisola, Afredo Scillitani, Fabio Vescini","doi":"10.1007/s12020-025-04173-3","DOIUrl":"10.1007/s12020-025-04173-3","url":null,"abstract":"<p><strong>Purpose: </strong>Parathyroid hormone controls calcium and phosphate metabolism. The latter is also regulated by both FGF23 and 1-25(OH)₂VitaminD. The polymorphic variant c.716 C > T of the FGF23 gene was previously found to be associated with renal phosphate leak/nephrolithiasis. The aim of our research is to study the metabolism of phosphate in a cohort of patients with primary hyperparathyroidism (PHPT) and its impact on bone and kidney.</p><p><strong>Methods: </strong>We have retrospectively compared a large sample of sporadic PHPT patients (339) with historical comparison cohort (HCC 503: Olivetti Study Group and Siena Osteoporosis Study). Moreover, in 51 PHPT patients, phosphate metabolism indexes were also revaluated at least 2 years after surgical cure. The variant c.716 C > T of the FGF23 gene was genotyped in patients and in a small sample of the control group.</p><p><strong>Results: </strong>In PHPT patients we found higher levels of serum calcium, PTH, alkaline phosphatase, beta-C-terminal telopeptide (CTx), urinary calcium, while serum phosphate, 25OH-VitaminD, maximal tubular renal phosphate reabsorption adjusted for glomerular filtration rate (TmPO4/GFR) were lower than what was found in HCC. In PHPT patients fibroblast growth factor 23 (FGF23) levels were higher than in controls. Patients with kidney stones carried the 716 T allele more frequently than patients without it (χ² 7.20, p = 0.027). In PHPT patients revaluated at least 2 years after surgery, we observed a significant reduction of 1-25(OH)₂VitaminD and FGF23. According to the median of serum phosphate levels, PHPT patients were subdivided into two subgroups: ≤2.8 mg/dL and > 2.8 mg/dL. The lowest phosphate group had a significantly higher serum calcium, PTH, 1-25(OH)₂VitaminD, urinary calcium and a higher prevalence of kidney stones than in the highest phosphate group. The rate of males in the lowest phosphate group was significantly higher than in the highest phosphate group.</p><p><strong>Conclusion: </strong>Our study shows that the regulators of phosphate metabolism in PHPT patients are higher than controls and they significantly reduce after surgical cure. PHPT patients with low serum phosphate have a worse biochemical and clinical phenotype.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"571-580"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence factors and survival outcomes of different invasion sites in locally advanced thyroid cancer and new site-based risk stratification system.","authors":"Zixia Tao, Zheng Ding, Bomin Guo, Youben Fan, Xianzhao Deng","doi":"10.1007/s12020-025-04165-3","DOIUrl":"10.1007/s12020-025-04165-3","url":null,"abstract":"<p><strong>Purpose: </strong>Locally advanced thyroid cancer (LATC) has gained increased attention, yet factors influencing invasion patterns and their prognostic impact remain poorly understood.</p><p><strong>Methods: </strong>Patients with LATC were identified from the Surveillance, Epidemiology, and End Results (SEER) program. Invasion patterns were visualized using bar graphs. Kaplan-Meier method and log-rank test analyzed outcomes by different invasion sites. Multivariable Cox regression analysis was conducted to adjust confounding factors and establish a new site-based risk stratification.</p><p><strong>Results: </strong>Papillary thyroid carcinoma (PTC) predominantly invaded esophagus or larynx (21.0%) and trachea (26.3%), while follicular thyroid carcinoma/oncocytic thyroid carcinoma (FTC/OTC) mainly invaded blood vessel (31.3%). Anaplastic thyroid carcinoma (ATC) exhibited the highest rate of trachea invasion (33.3%) and multi-invasion (8.1%). Age, tumor size significantly influenced the proportion of trachea invasion (p < 0.001). Locally advanced PTC patients with different invasion sites demonstrated significantly different prognoses: 10-year OS rate of each invasion site was: parathyroid or nerve (82.5%), bone or skeletal muscle (76.6%), esophagus or larynx (68.7%), blood vessel (58.0%), trachea (57.5%), multi-invasion (26.8%). Based on multivariable Cox regression, a novel site-based risk stratification was established for locally advanced PTC patients, with trachea invasion (HR = 1.83, p < 0.001), blood vessel invasion (HR = 2.64, p < 0.001), and multi-invasion (HR = 2.76, p < 0.001) categorized as medium and high risk of mortality, respectively, demonstrating better discrimination than 8th AJCC staging system.</p><p><strong>Conclusion: </strong>This study is the first to utilize population-based cohort to reveal factors influencing invasion sites and their prognostic differences. This study also proposed a new site-based risk stratification that builds upon 8th AJCC T staging for locally advanced PTC patients, which may facilitate more tailored clinical management strategies.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"501-510"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of prognostic factors and establishment of a recurrence risk prediction model for papillary thyroid carcinoma based on BRAF stratification.","authors":"Ang Hu, Yin Li, Zhongyu Wang, Jiahe Tian, Ke Jiang, Jun Chen, Mingjie Jiang, Qiuli Li","doi":"10.1007/s12020-025-04177-z","DOIUrl":"10.1007/s12020-025-04177-z","url":null,"abstract":"<p><strong>Background: </strong>Predicting the likelihood of papillary thyroid carcinoma (PTC) recurrence is crucial for improving patient outcomes. The association between the BRAF V600E (BRAF) mutation and PTC recurrence remains controversial. Our goal was to determine prognostic features of PTC patients and construct models for predicting recurrence risk according to BRAF mutation status.</p><p><strong>Methods: </strong>A total of 811 PTC patients whose clinical information and survival data were available were included in this study. Independent prognostic variables of PTC identified by screening via LASSO-Cox regression analysis were then used to construct nomograms. The performance of the predictive models was assessed according to the C-index, ROC curve, validation curve, and decision curve analyses. Kaplan-Meier curves were used to analyze differences between patients grouped according to prognostic factors and relapse risk.</p><p><strong>Results: </strong>Multivariate Cox regression analysis demonstrated that extrathyroidal extension (ETE), vascular tumor thrombus, and lymph node yield (LNY) were correlated with recurrence-free survival (RFS) in the BRAF mutation-negative group, while extranodal extension (ENE), number of metastatic lymph node (NMLN), pathological stage, and vascular tumor thrombus were correlated with RFS in the BRAF mutation-positive group. The mutation-stratified predictive models demonstrated better performance than the model without stratification, as indicated by the greater C-index values (0.880 vs. 0.859 vs. 0.753), AUC values (1-year AUC: 0.946 vs. 0.947 vs. 0.758; 3-year AUC: 0.889 vs. 0.871 vs. 0.760; 5-year AUC: 0.845 vs. 0.793 vs. 0.758), and net clinical benefit. The calibration curves at 1 year, 3 years, and 5 years showed good consistency. The bootstrap internal validation had good AUC values exceeding 0.8 and showed a well-fitting calibration curve. Significant differences in RFS were observed between the low-risk and high-risk groups (P < 0.001).</p><p><strong>Conclusion: </strong>Stratifying patients based on their BRAF mutation status can facilitate the development of better and more targeted postoperative management strategies. Nomograms for BRAF mutation positive and negative patients were developed to precisely and consistently predict recurrence risk in PTC patients.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"511-522"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Long-term safety and effectiveness of a somatropin biosimilar (Omnitrope®) in children requiring growth hormone therapy: analysis of final data of Italian patients enrolled in the PATRO children study.","authors":"Lorenzo Iughetti, Franco Antoniazzi, Claudia Giavoli, Simonetta Bellone, Tommaso Aversa, Laura Guazzarotti, Maria Elisabeth Street, Emanuele Miraglia Del Giudice, Luca Persani, Gabriella Pozzobon, Letizia Ragusa, Stefano Stagi, Gianluca Tornese, Clara Zecchino, Chiara Mameli, Emiliano Zecchi, Paolo Fedeli, Markus Zabransky, Laura Lucaccioni, Stefano Zucchini","doi":"10.1007/s12020-025-04162-6","DOIUrl":"10.1007/s12020-025-04162-6","url":null,"abstract":"","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"668-669"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of autoimmune thyroiditis is not increased in women with polycystic ovary syndrome after adjustment for family predisposition.","authors":"Andromachi Vryonidou, Maria Mizamtsidi, Eleni Palioura, Nikolaos Kalogeris, Evangeline Vassilatou, Dimitrios Ioannidis, Vicky Loi, Stavroula A Paschou","doi":"10.1007/s12020-025-04181-3","DOIUrl":"10.1007/s12020-025-04181-3","url":null,"abstract":"<p><strong>Purpose: </strong>Several studies suggest a linkage between PCOS and autoimmunity with a high frequency of chronic autoimmune thyroiditis (AIT) reported in PCOS patients, however, this subject remains controversial. The aim of this study was to investigate the prevalence of AIT in PCOS women and identify parameters that would serve as independent predictors of AIT.</p><p><strong>Methods: </strong>Two hundred fifty seven (257) PCOS patients according to the NIH criteria and one hundred forty three (143) controls, women with normal menstrual cycles and without clinical or biochemical hyperandrogenism, were recruited for the study. Anthropometric characteristics and a complete family history for AIT were recorded. Thyroid hormones, antithyroid antibodies, androgen, glucose and insulin levels were measured. Thyroid gland structure was evaluated by ultrasound scan.</p><p><strong>Results: </strong>Patients and controls did not differ in age, BMI as well as genetic predisposition for AIT (p > 0.05). Women with PCOS presented higher levels of androgens and HOMA-IR index, as expected. AIT prevalence did not differ between women with PCOS and controls (4.8 vs 9.3%, p = 0.13). However, the subgroup of PCOS patients with AIT presented a significantly stronger predisposition for AIT (33.3 vs 4.7%, p = 0.004) compared to patients without AIT. In a multivariate regression model, a positive family history of AIT was proved to be the strongest independent predictor of AIT in the PCOS group (OR 7.06, 95% CI 1.04-47.79, R² = 0.39).</p><p><strong>Conclusion: </strong>The prevalence of AIT in the PCOS patients does not differ from the general population when family predisposition to AIT is taken into account.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"529-536"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transoral vestibular robotic thyroidectomy in pediatric thyroid disease: 5 case reports.","authors":"Meng Wang, Yinghao Guo, Gang Wang, Xiaolei Li, Luming Zheng, Qingqing He","doi":"10.1007/s12020-025-04178-y","DOIUrl":"10.1007/s12020-025-04178-y","url":null,"abstract":"<p><strong>Background: </strong>The safety and feasibility of transoral endoscopic thyroidectomy vestibular approach in pediatric patients has been clinically proven, and its cosmetic results have been recognized by children and their families. However, there are no reports on using transoral robotic in pediatric thyroid surgery. In this study, we report the experience of 5 cases of transoral vestibular robotic thyroidectomy in treating of thyroid disease in children.</p><p><strong>Patients and methods: </strong>Retrospective analysis of clinical data of five children who underwent robotic thyroid surgery via the TOVRT in our hospital from February 2021 to April 2023, including operation time, tumor diameter, postoperative hospitalization time, and surgical complications. All five patients were operated on by the same team, and the postoperative pathological results were all follicular adenoma of thyroid. The children had a strong desire for cosmetic surgery, and their families voluntarily chose the robotic surgical system for their surgery.</p><p><strong>Results: </strong>All five patients underwent unilateral thyroid lobectomy without conversion to open surgery. All patients were female, with a mean BMI of (19.63 ± 1.79) kg/m² and the mean age was (14.40 ± 2.33) years. The average operation time was (52.00 ± 5.10) mins, the average tumor diameter was (41.60 ± 8.41) mm, and the average postoperative hospital stay was (3.60 ± 0.49) days. There were no complications such as hypoparathyroidism, recurrent laryngeal nerve injury, genioglossal nerve injury, or skin necrosis.</p><p><strong>Conclusion: </strong>The transoral vestibular robotic thyroidectomy is safe and feasible, providing a new treatment option for pediatric thyroid diseases that require surgical treatment.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"523-528"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of ICG fluorescence in identification and preservation of parathyroid glands in thyroid surgeries and correlation with postoperative parathormone and serum calcium levels.","authors":"Anupam Lahiri, Vishal Yadav, Vikas Arora, Prerit Sharma, A K Dewan","doi":"10.1007/s12020-024-04158-8","DOIUrl":"10.1007/s12020-024-04158-8","url":null,"abstract":"<p><strong>Introduction: </strong>Intraoperative parathyroid gland (PG) localization remains challenging during thyroid surgeries, contributing to postoperative hypocalcemia and hypoparathyroidism. This study assessed the efficacy of indocyanine green (ICG) fluorescence in identifying and preserving PGs during thyroid surgeries and its correlation with postoperative outcomes.</p><p><strong>Materials and methods: </strong>This ambispective observational study included 57 patients undergoing thyroid surgeries using ICG and compared outcomes with 56 historical controls. ICG was administered intravenously in two 5 mg boluses. Parathyroid identification rates, fluorescence intensity, and postoperative calcium and parathormone levels were assessed. Fluorescence intensity was qualitatively scored on a 1-3 scale.</p><p><strong>Results: </strong>ICG significantly improved PG identification (92.5% vs 69.3% with white light alone). Postoperative hypocalcemia occurred in 22.81% of ICG patients compared to 39.29% in controls (p = 0.045). Hypoparathyroidism rates were 10.53% and 32.14% respectively (p = 0.005). Higher fluorescence intensity (FI) correlated with lower risk of postoperative hypocalcemia (p = 0.026) and combined hypocalcemia and hypoparathyroidism (p = 0.046). Considering both FI 2 and 3 as positive yielded 100% sensitivity and 85.7% accuracy. When only FI 3 was considered positive, sensitivity was 78.4%, specificity was 50%, and accuracy was 69.4%.</p><p><strong>Conclusion: </strong>ICG fluorescence is a safe and effective tool for enhancing PG identification and preservation in thyroid surgeries, significantly reducing postoperative hypocalcemia and hypoparathyroidism. It also helps in confirming the vascularity of the PGs post thyroidectomy. Fluorescence intensity of preserved PGs, rather than quantity, better predicts postoperative outcomes. These findings support the integration of ICG fluorescence imaging and the application of our methodology in thyroid surgeries to improve postoperative results.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"564-570"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}