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Expanding the phenotype of multiple endocrine neoplasia type 5 (MEN5): Pituitary gigantism, myelolipoma and familial pheochromocytoma due to a germline pathogenic MAX variant. 扩展多发性内分泌肿瘤 5 型(MEN5)的表型:由种系致病性 MAX 变体引起的垂体巨大症、骨髓脂肪瘤和家族性嗜铬细胞瘤。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-02-11 DOI: 10.1007/s12020-025-04186-y
Adnan Haider, Jesse Sundar, Albert Beckers, Hermine Mohr, Atsuko Kasajima, Natalia S Pellegata, Patrick Pétrossians, Adrian F Daly
{"title":"Expanding the phenotype of multiple endocrine neoplasia type 5 (MEN5): Pituitary gigantism, myelolipoma and familial pheochromocytoma due to a germline pathogenic MAX variant.","authors":"Adnan Haider, Jesse Sundar, Albert Beckers, Hermine Mohr, Atsuko Kasajima, Natalia S Pellegata, Patrick Pétrossians, Adrian F Daly","doi":"10.1007/s12020-025-04186-y","DOIUrl":"https://doi.org/10.1007/s12020-025-04186-y","url":null,"abstract":"<p><strong>Purpose: </strong>Multiple endocrine neoplasia type 5 (MEN5) is an emerging syndrome of endocrine and non-endocrine tumors caused by germline pathogenic variants or genomic rearrangements of the MAX gene. Although MAX variants are predominantly associated with pheochromocytoma-paraganglioma (PPGL) risk, there are a growing number of associated tumors in other organs, including pituitary adenomas. We characterized the clinical presentation of various tumors in an extensive new kindred with a novel germline pathogenic variant of MAX.</p><p><strong>Methods: </strong>Clinical, genetic, pathological, radiological and hormonal investigations to identify and characterize disease status related to germline MAX gene sequence status.</p><p><strong>Results: </strong>We identified a novel germline pathological variant in exon 4 of the MAX gene, c.228delG, which was predicted to lead to a truncated protein (p.Asn78Thrfs*92). The propositus had developed pituitary gigantism due to a mixed growth hormone-prolactin secreting pituitary macroadenoma, which was controlled after two surgeries, medical therapy and radiotherapy. He subsequently developed bilateral and recurrent pheochromocytomas and following his death, an extra-adrenal myelolipoma was identified that was negative on MAX immunohistochemistry. An extensive history of pheochromocytomas or uncontrolled hypertension was present in the kindred and multiple affected and unaffected carriers of the c.228delG MAX pathogenic variant were characterized.</p><p><strong>Conclusion: </strong>We report the first case of pituitary gigantism in association with a pathogenic variant in the MAX gene, and characterize myeloplipoma as a new disease-association in MEN5. Increased awareness of MEN5 as a clinical entity and comprehensive screening of MAX pathogenic variant carriers can help to identify rare disease associations beyond PPGL.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398616","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}
引用次数: 0
Transoral vestibular robotic thyroidectomy in pediatric thyroid disease: 5 case reports. 经口前庭机器人甲状腺切除术治疗小儿甲状腺疾病5例报告。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-02-10 DOI: 10.1007/s12020-025-04178-y
Meng Wang, Yinghao Guo, Gang Wang, Xiaolei Li, Luming Zheng, Qingqing He
{"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":"https://doi.org/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/m<sup>2</sup> 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":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prediction model for lymph node metastasis in the right lateral region of papillary thyroid carcinoma. 甲状腺乳头状癌右外侧淋巴结转移的预测模型。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-02-10 DOI: 10.1007/s12020-025-04188-w
Jiabo Qin, Haoran Ding, Weijun Jing, Yudong Qiu, Jianfeng Sang
{"title":"Prediction model for lymph node metastasis in the right lateral region of papillary thyroid carcinoma.","authors":"Jiabo Qin, Haoran Ding, Weijun Jing, Yudong Qiu, Jianfeng Sang","doi":"10.1007/s12020-025-04188-w","DOIUrl":"https://doi.org/10.1007/s12020-025-04188-w","url":null,"abstract":"<p><strong>Objective: </strong>To compare the differences among patients with papillary thyroid carcinoma (PTC) whose right lateral lymph node biopsy results indicating positive (pN1b) or negative lymph node metastasis (pN0 or pN1a) so as to explore whether there is a high risk of long-term metastasis in right lateral lymph node among patients who are classified as pN0 or pN1a at present. Only those whose preoperative ultrasound result indicating lymph node metastasis in the right lateral region (cN1b) are included. Meanwhile, to establish predictive models to help clinicians distinguish high-risk and low-risk populations and adopt different follow-up strategies.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on clinical data of patients who underwent right neck side area biopsy or dissection (cN1b) at the Affiliated Drum Tower Hospital, Medical School of Nanjing University from January 2017 to August 2022 to establish a predictive model. The model will then be validated on patients who undergo right neck lateral area biopsy or clearance from September 2022 to August 2023. Data including demographic characteristics, pathological results, and laboratory examinations were collected. The predictive model was established and evaluated by SPSS 26.0 and R 4.3.1.</p><p><strong>Result: </strong>This study includes a total of 316 patients diagnosed with papillary thyroid carcinoma and with preoperative ultrasound indicating lymph node metastasis in the neck lateral compartment (cN1b), who were treated at the Affiliated Drum Tower Hospital, Medical School of Nanjing University from January 2017 to August 2023. The training set included 264 patients, and the validation set included 52 patients.The area under the ROC curve for the prediction model is 0.83, with a diagnostic optimal threshold of 0.595. At this threshold, the model achieves a sensitivity of 81.6% and a specificity of 75.2%. Similar results were obtained when utilizing the model on the validation set.</p><p><strong>Conclusion: </strong>There are distinct disparities in demographics, pathological result, and laboratory examinations that can differentiate between high-risk and low-risk populations for lymph node metastasis in the right lateral region. These differences can be effectively identified by developing predictive models.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390485","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}
引用次数: 0
Association of metabolic phenotypes with cardiovascular events in patients aged 18-45 with acute coronary syndrome. 18-45岁急性冠脉综合征患者代谢表型与心血管事件的关系
IF 3.7 3区 医学
Endocrine Pub Date : 2025-02-10 DOI: 10.1007/s12020-025-04169-z
Rongdi Xu, Chen Wang, Hongliang Cong, Le Wang
{"title":"Association of metabolic phenotypes with cardiovascular events in patients aged 18-45 with acute coronary syndrome.","authors":"Rongdi Xu, Chen Wang, Hongliang Cong, Le Wang","doi":"10.1007/s12020-025-04169-z","DOIUrl":"https://doi.org/10.1007/s12020-025-04169-z","url":null,"abstract":"<p><strong>Background: </strong>Obesity and metabolic syndrome are related to cardiovascular events. However, the association different metabolic phenotypes and obesity with cardiovascular events among young adults aged 18-45 with acute coronary syndrome (ACS) remains unclear. The study aimed to investigate the prognosis of patients aged 18-45 years with ACS based on their metabolic phenotype.</p><p><strong>Methods: </strong>This study included 1787 patients with ACS ≤ 45 years of age who underwent coronary angiography. Patients were divided into four groups according to metabolic phenotype: metabolically healthy non-obesity (MHN); MHO; metabolically unhealthy non-obesity (MUN); and metabolically unhealthy obesity (MUO). The primary outcome was major adverse cardiovascular events (MACE), including all-cause death, myocardial infarction, stroke, or unplanned revascularization.</p><p><strong>Results: </strong>Among 1787 patients with ACS, the median age was 41.6 years, 1675 (93.7%) were men, 1111 (62.2%) had obesity, and 659 (36.9%) were classified as MHO. During a median 65 months follow-up, 404 MACE occurred. Multivariate analysis showed that MHO was correlated with a decreased risk of MACE, while MUN significantly increased the risk compared to MHN (MHO: HR 0.69, 95%CI 0.52-0.92, P = 0.011; MUN: HR 1.47, 95%CI 1.07-2.02 P = 0.018). Moreover, restricted cubic spline analysis revealed a linear relationship between body mass index (BMI) and the incidence of MACE (P<sub>nonlinear </sub>= 0.304, P<sub>overall</sub> < 0.001).</p><p><strong>Conclusions: </strong>MHO was correlated with a decreased risk of MACE, while MUN significantly increased the risk compared to MHN. Moreover, there was a linear relationship between BMI and the incidence of MACE.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390484","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}
引用次数: 0
Calcimimetics or parathyroidectomy for kidney transplant recipients: is there still a question? a systematic review, meta-analysis and trial sequential analysis. 肾移植受者用钙化剂或甲状旁腺切除术:还有问题吗?系统回顾、荟萃分析和试验序贯分析。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-02-08 DOI: 10.1007/s12020-025-04189-9
Georgios Koimtzis, Leandros Stefanopoulos, Georgios Geropoulos, Nikos Tteralli, Kyriakos Psarras
{"title":"Calcimimetics or parathyroidectomy for kidney transplant recipients: is there still a question? a systematic review, meta-analysis and trial sequential analysis.","authors":"Georgios Koimtzis, Leandros Stefanopoulos, Georgios Geropoulos, Nikos Tteralli, Kyriakos Psarras","doi":"10.1007/s12020-025-04189-9","DOIUrl":"https://doi.org/10.1007/s12020-025-04189-9","url":null,"abstract":"<p><strong>Purpose: </strong>Secondary hyperparathyroidism is one of the most common complications of chronic kidney disease. The optimal treatment for chronic kidney disease nowadays is kidney transplant. Nonetheless, hyperparathyroidism does not always resolve after transplantation leading to tertiary hyperparathyroidism. The management of tertiary hyperparathyroidism can be either medical (calcimimetics) or surgical (parathyroidectomy). The aim of this study is to compare the medical and surgical treatment in terms of control of hyperparathyroidism and long-term implications on kidney graft function.</p><p><strong>Methods: </strong>We carried out a systematic review and meta-analysis of relevant studies up to March 2024 on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Scopus databases. We compared the parathyroid hormone, calcium, creatinine and estimated glomerular filtration rate between the groups of patients that were treated with parathyroidectomy and those that were treated with calcimimetcs. Subsequently, we performed a trial sequential analysis to corroborate our findings.</p><p><strong>Results: </strong>Four studies were included in the final analysis with a total number of 247 patients. Parathyroidectomy resulted in a greater decrease in parathyroid hormone and calcium levels (WMD 149.37, CI 95% 126.81-171.93, p < 0.0001 and WMD 0.7, CI 95% 0.45-0.96, p < 0.0001 respectively) but there was no difference between the surgical and medical management groups in the creatinine and eGFR levels (CI 95%, -0.62-0.17, p = 0.27 and CI 95%, -8.06 - 20.54 p = 0.39). The trial sequential analysis corroborated these findings.</p><p><strong>Conclusion: </strong>Parathyroidectomy is more effective in controlling hyperparathyroidism in kidney transplant recipients, as it leads to a greater decrease in parathyroid hormone and calcium levels. However, there is no difference in the long-term function of the kidney graft, as the creatinine and estimated glomerular filtration values were similar in the surgical and medical management groups.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373921","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}
引用次数: 0
Patterns of olfactory perception, eating behavior and body composition in adolescents with different body weights. 不同体重青少年嗅觉知觉、饮食行为和身体组成的模式。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-02-08 DOI: 10.1007/s12020-025-04190-2
Daria V Podchinenova, Iuliia G Samoilova, Mariia V Matveeva, Oxana A Oleynik, Tamara D Vachadze, Aleksandr Kanev
{"title":"Patterns of olfactory perception, eating behavior and body composition in adolescents with different body weights.","authors":"Daria V Podchinenova, Iuliia G Samoilova, Mariia V Matveeva, Oxana A Oleynik, Tamara D Vachadze, Aleksandr Kanev","doi":"10.1007/s12020-025-04190-2","DOIUrl":"https://doi.org/10.1007/s12020-025-04190-2","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate associations between olfactory function, eating behavior, and characteristics of body composition in adolescents with different body weights.</p><p><strong>Methods: </strong>The study included 87 children aged 10-17 years with normal and excess body weight. The study group consisted of overweight and obese adolescents. All children underwent anthropometry with calculation of SDS body mass index (WHO Anthro Plus), body composition was assessed using Inbody 770, diagnosis of olfactory dysfunction was performed using a set of Sniffin Sticks (Odofin, Germany). The Dutch Eating Behavior Questionnaire was used for assessment of eating disorders. IBM SPSS. Statistics v.20 program was used for statistical analysis.</p><p><strong>Results: </strong>In adolescents with decreased sense of smell, regardless of SDS BMI, restrictive type of eating behavior was more common (p = 0.04). Among girls, hypoosmia was diagnosed in 21.7% (n = 10) of cases, being accompanied by a higher proportion of body fat, higher prevalence of emotionogenic type of eating behavior compared to girls without olfactory impairment, who, on the contrary, more frequently exhibited the restrictive type of eating disorder. Among boys, hypoosmia was found in 39% (n = 16) of cases. There were no statistically significant differences with the normoosmia subgroup in terms of eating behavior type and body composition parameters. Girls with hypoosmia showed positive associations between body fat percentage and discriminatory olfactory test results (r = 0.805; p = 0.020), externalizing type of eating behavior and BMI-FOR-AGE (r = 0.873; p = 0.005), body fat mass (r = 0.764; p = 0.027) and body fat percentage (r = 0.805; p = 0.016). The emotiogenic type of eating behavior showed significant correlations with total body phase angle (r = 0.805; p = 0.029), skeletal muscle mass (r = 0.791; p = 0.034). In boys with hypoosmia, positive associations were found between restrictive type of eating behavior and BMI-FOR-AGE (r = 0.784; p = 0.002), visceral fat area (r = 0.701; p = 0.008), body fat mass (r = 0.660; p = 0.014) and body fat percentage (r = 0.742; p = 0.004).</p><p><strong>Conclusion: </strong>The results of this study suggest that hypoosmia is associated with changes in eating behavior and body composition in adolescents with different body weight, yet the direction of such casual relationship remains unclear.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373922","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}
引用次数: 0
The potential role of neoadjuvant treatment in thyroid cancers in the era of kinase inhibitors: a narrative review. 激酶抑制剂时代甲状腺癌新辅助治疗的潜在作用:叙述性回顾。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-02-04 DOI: 10.1007/s12020-025-04182-2
D Barbaro, C Giani, P Lapi, M Profilo, R Forleo, J Rosada, G Basili, G Materazzi
{"title":"The potential role of neoadjuvant treatment in thyroid cancers in the era of kinase inhibitors: a narrative review.","authors":"D Barbaro, C Giani, P Lapi, M Profilo, R Forleo, J Rosada, G Basili, G Materazzi","doi":"10.1007/s12020-025-04182-2","DOIUrl":"https://doi.org/10.1007/s12020-025-04182-2","url":null,"abstract":"<p><strong>Aim: </strong>To analyse the literature on the potential role of kinase inhibitors (KI) as neoadjuvant treatment (NAT) in all thyroid cancers (TC).</p><p><strong>Materials and methods: </strong>Online databases were systematically examined, including MEDLINE (via PubMed) Embase, ISI Web of Science, Google Scholar, and Scopus. As many papers were published before the classification of TC was revised, our search was conducted as follows: NAT in TC, NAT in papillary thyroid cancer (PTC), NAT in follicular thyroid cancer (FTC), NAT in anaplastic thyroid cancer (ATC), and NAT in medullary thyroid cancer (MTC).</p><p><strong>Results: </strong>The search revealed 21 single case reports and three small series on NAT in TC. Overall, 32 cases were found: 24 follicular cell derived cancers (FCDC) of which nine were ATC, eight were MTC. We also found four major retrospective series, in two of which the cohort was divided and analysed into different groups according to the kind of treatment. In these four series, NAT was performed in in a total of 99 patients (32 FCDC, 60 ATC, and 7 MTC).</p><p><strong>Conclusions: </strong>While awaiting large-scale clinical trials, the literature highlights that NAT may be an option for locally advanced TC (and above all ATC) when surgery may be too destructive or when the tumour is inoperable. The use of NAT should be discussed with the patient. An R0 or at least an R1 should be the goal of NAT, and the molecular profile should be performed as rapidly as possible.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122535","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}
引用次数: 0
Analysis of prognostic factors and establishment of a recurrence risk prediction model for papillary thyroid carcinoma based on BRAF stratification. 基于BRAF分层的甲状腺乳头状癌预后因素分析及复发风险预测模型的建立。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-02-03 DOI: 10.1007/s12020-025-04177-z
Ang Hu, Yin Li, Zhongyu Wang, Jiahe Tian, Ke Jiang, Jun Chen, Mingjie Jiang, Qiuli Li
{"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":"https://doi.org/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":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-03","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}
引用次数: 0
Comparison of metformin with inositol versus metformin alone in women with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. 多囊卵巢综合征妇女服用二甲双胍加肌醇与单用二甲双胍的比较:随机对照试验的系统综述和荟萃分析。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-02-01 Epub Date: 2024-09-27 DOI: 10.1007/s12020-024-04052-3
Francinny Alves Kelly, Artur de Oliveira Macena Lôbo, Jorge Henrique Cavalcanti Orestes Cardoso, Francisco Cezar Aquino de Moraes
{"title":"Comparison of metformin with inositol versus metformin alone in women with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials.","authors":"Francinny Alves Kelly, Artur de Oliveira Macena Lôbo, Jorge Henrique Cavalcanti Orestes Cardoso, Francisco Cezar Aquino de Moraes","doi":"10.1007/s12020-024-04052-3","DOIUrl":"10.1007/s12020-024-04052-3","url":null,"abstract":"<p><strong>Purpose: </strong>Metformin was the first medication targeting insulin resistance in PCOS, and it has been extensively studied as a metabolic treatment option. In recent years, inositols have emerged as potential treatment options for PCOS, but confidence in the available evidence supporting their use is limited.</p><p><strong>Methods: </strong>We comprehensively searched PubMed, Embase, and Cochrane databases for RCTs comparing the use of combined metformin and inositol versus metformin alone in women with PCOS. A random-effects model was used to calculate the risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). A p-value of <0.05 was deemed as statistically significant.</p><p><strong>Results: </strong>Six RCTs and 388 patients were included in the analysis, with follow-up ranging from 3 to 6 months. Combination therapy was significantly associated with improved menstrual cycle regularity (RR 1.56; 95% CI 1.01 to 2.41; p = 0.04), and lower values of modified Ferriman-Gallwey score (MD -0.97; 95% CI -1.53 to -0.40; p < 0.01) and LH/FSH ratios (MD -0.13; 95% CI -0.24 to -0.03; p = 0.01). Differences in acne (p = 0.58), body mass index (p = 0.13), fasting blood glucose (p = 0.07) and HOMA-IR (p = 0.25) were not statistically significant.</p><p><strong>Conclusion: </strong>In this meta-analysis of RCTs, combination therapy was associated with cycle regularization and reduction in hirsutism and LH/FSH ratio compared to metformin monotherapy. Further studies are needed to clarify the true benefits of the use of inositol in PCOS treatment.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"389-399"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343809","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}
引用次数: 0
Effects of endoscopic lobectomy and conventional lobectomy on psychological and sleep quality in patients with papillary thyroid microcarcinoma-a prospective observational study. 内窥镜甲状腺叶切除术和传统甲状腺叶切除术对甲状腺乳头状微癌患者心理和睡眠质量的影响--一项前瞻性观察研究。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-02-01 Epub Date: 2024-10-09 DOI: 10.1007/s12020-024-04034-5
Yixue Jiang, Pan Zhang, Genpeng Li, Tao Wei, Jianyong Lei, Zhihui Li, Juxiang Gou
{"title":"Effects of endoscopic lobectomy and conventional lobectomy on psychological and sleep quality in patients with papillary thyroid microcarcinoma-a prospective observational study.","authors":"Yixue Jiang, Pan Zhang, Genpeng Li, Tao Wei, Jianyong Lei, Zhihui Li, Juxiang Gou","doi":"10.1007/s12020-024-04034-5","DOIUrl":"10.1007/s12020-024-04034-5","url":null,"abstract":"<p><strong>Background: </strong>Both endoscopic thyroid lobectomy and conventional thyroid lobectomy are effective modalities for treating papillary thyroid microcarcinoma (PTMC). However, their respective psychological and sleep quality ramifications in patients remain largely unexplored.</p><p><strong>Materials and methods: </strong>Patients diagnosed with PTMC who underwent thyroid lobectomy at our institution between July 15, 2021, and July 15, 2022, were prospectively recruited. Psychological distress and sleep quality were assessed at five intervals (hospital admission, hospital discharge, and 1, 3, and 6 months posttreatment) utilizing four validated scales. The PTMC patients who completed the questionnaires diligently were subsequently categorized into either the endoscopic thyroid lobectomy group (trial group) or the conventional thyroid lobectomy group (control group). A propensity score matching (PSM) cohort was then established to examine longitudinal and cross-sectional alterations in psychological parameters.</p><p><strong>Results: </strong>Out of 602 eligible PTMC patients, 560 individuals completed all the questionnaires diligently during the follow-up period (response rate: 93.02%). This cohort comprised 176 patients (31.43%) who underwent endoscopic thyroid lobectomy and 384 patients (68.57%) who underwent conventional thyroid lobectomy. Following PSM, a comprehensive set of 176 matched patient pairs was successfully established. Both groups of patients exhibited a decline in sleep quality throughout the 6-month postoperative follow-up period; however, patients in the control group experienced concomitant elevation in anxiety levels. The PSQI scores of patients in the control group were markedly higher than those in the trial group across all follow-up time points, whereas the HAMA, HADS, and HEI scale scores did not significantly differ between the two groups.</p><p><strong>Conclusions: </strong>In terms of sleep quality and psychological well-being, endoscopic thyroid lobectomy is superior to conventional thyroid lobectomy for PTMC patients.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"667-674"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388949","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}
引用次数: 0
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