European Thyroid Journal最新文献

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Insight into the metabolic shifts in Graves' hyperthyroidism: a study of acylcarnitine and lipid profiles. 深入了解格雷夫斯甲亢的代谢变化:酰基肉碱和脂质谱的研究。
IF 3.5 2区 医学
European Thyroid Journal Pub Date : 2025-06-11 Print Date: 2025-06-01 DOI: 10.1530/ETJ-25-0004
Mikael Thomassen Neset, Arve Ulvik, Kristian Løvås, Johnny Laupsa-Borge, Lars Ertesvåg Breivik, Ann-Elin Meling Stokland, Bjørn Gunnar Nedrebø, Eyvind Rødahl, Eystein Husebye, Grethe Åstrøm Ueland, Hans Olav Ueland
{"title":"Insight into the metabolic shifts in Graves' hyperthyroidism: a study of acylcarnitine and lipid profiles.","authors":"Mikael Thomassen Neset, Arve Ulvik, Kristian Løvås, Johnny Laupsa-Borge, Lars Ertesvåg Breivik, Ann-Elin Meling Stokland, Bjørn Gunnar Nedrebø, Eyvind Rødahl, Eystein Husebye, Grethe Åstrøm Ueland, Hans Olav Ueland","doi":"10.1530/ETJ-25-0004","DOIUrl":"10.1530/ETJ-25-0004","url":null,"abstract":"<p><strong>Objective: </strong>Graves' disease increases metabolism and leads to net lipid degradation. Circulating acylcarnitines reflect lipid metabolism and the state of fatty acid oxidation in individuals. The aim of this study was to explore the lipid and acylcarnitine profiles in patients with Graves' disease.</p><p><strong>Methods: </strong>Seven lipids/apolipoproteins and 23 acylcarnitines were analysed in 100 newly diagnosed Graves' disease patients and validated in another 51 patients. Both groups were age- and sex-matched with healthy subjects.</p><p><strong>Results: </strong>The hyperthyroid Graves' disease patients (n = 88) from the main cohort (78 females, median age 42 (17-67) years) had significantly (P < 0.05) higher levels of medium- and long-chain acylcarnitines, and lower levels of short-chain acylcarnitines, compared with healthy subjects. Factor analysis showed that medium- and long-chain acylcarnitines explained most of the differences between the two groups. Serum levels of the five lipids/apolipoproteins were significantly lower in the hyperthyroid Graves' disease patients compared with healthy subjects. Patients (n = 21) treated with antithyroid drugs for 6 weeks had acylcarnitine levels closer to healthy subjects, compared with 79 treatment-naïve hyperthyroid patients. The main findings were confirmed in the validation group.</p><p><strong>Conclusion: </strong>Increased levels of medium- and long-chain acylcarnitines in patients with newly diagnosed Graves' disease may reflect accelerated catabolism. Lower levels of short-chain acylcarnitines point to Graves' disease being a catabolic condition, with a shift in energy source from carbohydrates to fat.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Usefulness of local therapy for distant metastases of differentiated thyroid cancer. 分化性甲状腺癌远处转移局部治疗的有效性。
IF 3.5 2区 医学
European Thyroid Journal Pub Date : 2025-06-11 Print Date: 2025-06-01 DOI: 10.1530/ETJ-24-0237
Sueyoshi Moritani, Masao Takenobu, Masakazu Yasunaga, Taihei Fujii, Hiroya Kitano
{"title":"Usefulness of local therapy for distant metastases of differentiated thyroid cancer.","authors":"Sueyoshi Moritani, Masao Takenobu, Masakazu Yasunaga, Taihei Fujii, Hiroya Kitano","doi":"10.1530/ETJ-24-0237","DOIUrl":"10.1530/ETJ-24-0237","url":null,"abstract":"<p><strong>Objective: </strong>Treatment for distant metastases (DM) of differentiated thyroid cancer (DTC) aims to improve the prognosis and quality of life (QOL). Radioactive iodine and molecular targeted therapies are the primary systemic treatments for DM. Combining these with local treatments, such as surgery and radiotherapy targeting metastatic sites, may provide additional benefits to systemic therapy.</p><p><strong>Methods: </strong>This study reviewed the additional effects of local therapies on common metastatic sites of DTC, such as pulmonary or bone metastases (BM), the efficacy of bone-modifying agents (BMAs) for BM, and the therapeutic effects of local treatments for less common brain metastases.</p><p><strong>Results: </strong>Although based on retrospective studies with no definitive conclusions on the effectiveness of each treatment, local therapy for DM in DTC patients has been shown to enhance prognosis and QOL in several studies. Considering the results of clinical trials for metastatic tumors, local therapy for one or a few pulmonary or BM in DTC should be considered, if expected to improve prognosis and QOL. Surgical intervention is recommended for spinal metastases presenting with spinal compression symptoms or for long BM in extremities at risk of pathological or impending fractures. BMAs are also recommended to reduce the risk of skeletal-related events. Surgery, stereotactic radiotherapy, and whole-brain radiotherapy are suggested for brain metastases to improve the prognosis and QOL.</p><p><strong>Conclusion: </strong>Incorporating local therapy alongside systemic treatment can enhance the prognosis and QOL and should be considered a viable treatment option.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical management of alemtuzumab-induced autoimmune thyroid diseases: a narrative review. 阿仑单抗诱导的自身免疫性甲状腺疾病的临床管理:叙述性回顾
IF 3.5 2区 医学
European Thyroid Journal Pub Date : 2025-06-10 Print Date: 2025-06-01 DOI: 10.1530/ETJ-25-0007
Jacopo Manso, Ilaria Muller, Caterina Mian
{"title":"Clinical management of alemtuzumab-induced autoimmune thyroid diseases: a narrative review.","authors":"Jacopo Manso, Ilaria Muller, Caterina Mian","doi":"10.1530/ETJ-25-0007","DOIUrl":"10.1530/ETJ-25-0007","url":null,"abstract":"<p><p>Alemtuzumab is a powerful anti-CD52 drug that is an established treatment option in patients with multiple sclerosis due to its proven efficacy. However, in about 50% of patients, the use of alemtuzumab is burdened by the development of secondary autoimmune thyroid diseases, constituting a range of alemtuzumab-induced autoimmune thyroid diseases (AIATDs). Graves' disease (GD) is the most common AIATD, with an incidence of approximately 60%, and presents different characteristics from the conventional form. Indeed, GD with a fluctuating course is significantly more prevalent (15-50%), which poses a major challenge for physicians in its management. Other AIATDs also exhibit distinct features compared to their conventional counterparts; notably, hypothyroidism is frequently associated with TSH-receptor blocking antibodies, and alemtuzumab-induced GD demonstrates a higher rate of fluctuating course and potential for spontaneous remission. Alemtuzumab-induced thyroid eye disease (TED) is less common than conventional TED, with similar clinical and management characteristics. In this review, we summarize the latest evidence, also from real-world studies, with a focus on clinical management and possible predictors of AIATDs.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Alterations in gene expression associated with invasion of RAS-mutant thyroid tumors and their potential diagnostic and therapeutic utility. 与ras突变甲状腺肿瘤侵袭相关的基因表达改变及其潜在的诊断和治疗价值。
IF 3.5 2区 医学
European Thyroid Journal Pub Date : 2025-06-10 Print Date: 2025-06-01 DOI: 10.1530/ETJ-25-0022
Vincenzo Condello, William R Doerfler, Alyaksandr V Nikitski, Daniel M Spagnolo, Ian J Fornal, Gavin M Schmidt, Abigail I Wald, Marina N Nikiforova, Yuri E Nikiforov
{"title":"Alterations in gene expression associated with invasion of RAS-mutant thyroid tumors and their potential diagnostic and therapeutic utility.","authors":"Vincenzo Condello, William R Doerfler, Alyaksandr V Nikitski, Daniel M Spagnolo, Ian J Fornal, Gavin M Schmidt, Abigail I Wald, Marina N Nikiforova, Yuri E Nikiforov","doi":"10.1530/ETJ-25-0022","DOIUrl":"10.1530/ETJ-25-0022","url":null,"abstract":"<p><strong>Introduction: </strong>Mutations of RAS genes are detected in a spectrum of follicular-patterned thyroid tumors. Preoperative prediction of invasive cancers based on the presence of RAS mutation alone is challenging because non-invasive and invasive tumors tend to have similar sonographic and cytologic features. The aim of this study was to perform clinicopathologic and molecular analyses of RAS-mutant tumors, identify molecular and clinical markers associated with invasiveness, and determine their diagnostic and therapeutic potentials.</p><p><strong>Methods: </strong>We collected clinicopathologic characteristics and performed RNA-seq on 48 surgically resected RAS-mutant thyroid tumors (23 non-invasive and 25 invasive). A classifier using expression data of selected invasiveness markers and clinical parameters was applied to an independent set of 54 RAS-mutant fine-needle aspiration (FNA) samples to predict invasion. Selected markers were investigated in vitro and in vivo.</p><p><strong>Results: </strong>On RNA-seq analysis, invasive RAS-mutant tumors showed different gene expression profiles compared to non-invasive tumors. Expression levels of six selected genes (CA12, CD44, LRP4, ECM1, FN1, and CRABP1) were associated with invasiveness on qRT-PCR. Expression levels of these genes plus nodule size predicted invasion in RAS-mutant FNA samples with 95% sensitivity and 89% specificity. siRNA silencing and chemical inhibition of CA12 reduced invasion of RAS-mutant human thyroid cells. Treatment of RAS-mutant xenografts with CA12 inhibitors arrested tumor growth.</p><p><strong>Conclusions: </strong>Development of invasion in RAS-mutant tumors is associated with significant alteration in gene expression. Expression levels of six genes and nodule size may predict invasion in RAS-mutant thyroid nodules, whereas chemical inhibition of CA12 may have a potential therapeutic effect in RAS-mutant tumors.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Why so many doses, and why now? 为什么这么多剂量,为什么是现在?
IF 3.5 2区 医学
European Thyroid Journal Pub Date : 2025-06-09 Print Date: 2025-06-01 DOI: 10.1530/ETJ-25-0115
S Bilgic, B Akovalı
{"title":"Why so many doses, and why now?","authors":"S Bilgic, B Akovalı","doi":"10.1530/ETJ-25-0115","DOIUrl":"10.1530/ETJ-25-0115","url":null,"abstract":"","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Follow-up and transition of care for low recurrence risk thyroid cancer patients in Canada. 加拿大低复发风险甲状腺癌患者的随访和护理转移。
IF 3.5 2区 医学
European Thyroid Journal Pub Date : 2025-06-05 Print Date: 2025-06-01 DOI: 10.1530/ETJ-25-0072
Ralf Paschke, Sana Ghaznavi, Syed Ali Imran, Jennifer Jacquier, Heather Lochnan, Marie-Hélène Massicotte, Elliot Mitmaker, Deric Morrison, Vicki Munro, Michelle Sveistrup, Sam M Wiseman, Afshan Zahedi
{"title":"Follow-up and transition of care for low recurrence risk thyroid cancer patients in Canada.","authors":"Ralf Paschke, Sana Ghaznavi, Syed Ali Imran, Jennifer Jacquier, Heather Lochnan, Marie-Hélène Massicotte, Elliot Mitmaker, Deric Morrison, Vicki Munro, Michelle Sveistrup, Sam M Wiseman, Afshan Zahedi","doi":"10.1530/ETJ-25-0072","DOIUrl":"10.1530/ETJ-25-0072","url":null,"abstract":"<p><p>The incidence of differentiated thyroid cancer (DTC) has increased significantly in recent decades. Following initial diagnosis, DTC patients are classified according to the American Thyroid Association (ATA) as low, intermediate, and high risk for recurrence. Patients in the ATA low recurrence-risk category have a recurrence risk of ≤5%, with 20-year disease-specific mortality of <1%. Accordingly, there has been a shift to de-escalating initial treatment, including the relaxation of thyroid-stimulating hormone suppression. In addition, fewer low-risk patients undergo total thyroidectomy or radioactive iodine therapy. However, the optimal long-term surveillance strategy remains unclear, with many patients continuing follow-up in speciality clinics for many years. In addition, emerging evidence suggests that long-term surveillance can be effectively managed in primary care settings. To enhance understanding among Canadian thyroid practitioners and to improve care for Canadian patients diagnosed with low-risk DTC, we developed this consensus statement by collecting feedback from a multidisciplinary team led by one chairperson (endocrinologist), an additional eight endocrinologists, two surgeons, and one patient partner. This consensus statement reflects current evidence and expert opinion regarding initial management and long-term surveillance of low-risk DTC patients. This work is valuable to Canadian thyroid practitioners as it provides standardized guidelines to ensure optimal care and improved outcomes for low-risk DTC patients.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pathogenic MCT8V235L creates a steric clash that is alleviated by a compensating mutation of MCT8F285A. 致病性MCT8V235L产生空间冲突,MCT8F285A的补偿性突变减轻了这种冲突。
IF 3.5 2区 医学
European Thyroid Journal Pub Date : 2025-06-02 Print Date: 2025-06-01 DOI: 10.1530/ETJ-25-0009
Niklas Sonntag, Felix Schreiner, Ulrich Schweizer, Doreen Braun
{"title":"Pathogenic MCT8V235L creates a steric clash that is alleviated by a compensating mutation of MCT8F285A.","authors":"Niklas Sonntag, Felix Schreiner, Ulrich Schweizer, Doreen Braun","doi":"10.1530/ETJ-25-0009","DOIUrl":"10.1530/ETJ-25-0009","url":null,"abstract":"<p><strong>Objective: </strong>The monocarboxylate transporter (MCT) 8 is a specific transporter for thyroid hormones. Pathogenic variants in MCT8 lead to a severe psychomotor disorder called MCT8 deficiency. A recently published patient carries a MCT8V235 to leucine substitution that was incapable of T3 transport. Analyses of our MCT8 homology model predicted steric clashes between Leu235 and Phe285 as well as Gln288, possibly affecting another transport-sensitive phenylalanine at position 287.</p><p><strong>Methods: </strong>We analyzed the occurrence of potential van der Waals (VDW) interactions between Leu235 and Phe285 as well as Gln288 in the homology model. We overexpressed MCT8V235 and MCT8F287 mutants with altered side-chain properties in cells to assess their role in T3 transport function. In addition, we created an MCT8V235L,F285A double mutant.</p><p><strong>Results: </strong>Mutations of MCT8V235 to alanine, threonine or isoleucine, as well as the analysis of potential VDW interactions, helped us to identify Phe285, but not Gln288, as the amino acid responsible for the inactivity of MCT8V235L. The hypothesis was supported by activity measurements of an MCT8V235L,F285A double mutant that showed rescued T3 transport with KM values similar to wild-type MCT8. The analyses of MCT8F287 mutated to tyrosine, tryptophan and valine revealed that the size and/or the aromatic properties of the amino acid side chain are crucial for proper membrane expression and T3 transport.</p><p><strong>Conclusion: </strong>We were able to restore transport activity of MCT8V235L by introducing a second mutation (MCT8V235L,F285A). We speculate that the additional mutation prevents a shift of Phe287 into the potential transport cavity, eventually restoring T3 transport.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
NOVEL INSIGHTS IN ADVANCED THYROID CARCINOMA: FROM MECHANISMS TO TREATMENTS: Molecular insights into the origin, biology, and treatment of anaplastic thyroid carcinoma. 甲状腺间变性癌的分子起源、生物学和治疗。
IF 3.5 2区 医学
European Thyroid Journal Pub Date : 2025-06-02 Print Date: 2025-06-01 DOI: 10.1530/ETJ-25-0057
Amir Hossein Karimi, Peter Yf Zeng, Matthew Cecchini, John W Barrett, Harrison Pan, Shengjie Ying, Nhi Le, Joe S Mymryk, Laurie E Ailles, Anthony C Nichols
{"title":"NOVEL INSIGHTS IN ADVANCED THYROID CARCINOMA: FROM MECHANISMS TO TREATMENTS: Molecular insights into the origin, biology, and treatment of anaplastic thyroid carcinoma.","authors":"Amir Hossein Karimi, Peter Yf Zeng, Matthew Cecchini, John W Barrett, Harrison Pan, Shengjie Ying, Nhi Le, Joe S Mymryk, Laurie E Ailles, Anthony C Nichols","doi":"10.1530/ETJ-25-0057","DOIUrl":"10.1530/ETJ-25-0057","url":null,"abstract":"<p><p>Anaplastic thyroid carcinoma (ATC) is among the most daunting entities in clinical oncology. Large-scale genomic studies of thyroid cancer within the last decade have uncovered a distinct set of recurrent somatic alterations implicated in the development, aggressiveness, and treatment resistance of ATC. The sequence of events leading to the development of ATC commonly begins with a tumorigenic mutation that constitutively activates the mitogen-activated protein kinase (MAPK) pathway, giving rise to indolent entities such as well-differentiated papillary or follicular thyroid carcinomas. This is followed by recurring alterations that drive oncogenic properties such as enhanced proliferation, genomic instability, replicative immortality, and dedifferentiation, culminating in the emergence of highly aggressive ATC tumors. The truncal MAPK-activating events present therapeutic opportunities, as small molecule inhibitors against key components of this pathway are available. Indeed, genotype-guided targeting of the MAPK pathway is now the standard of care for subgroups of ATC patients, and further efforts exploring additional MAPK inhibitors and the combination of immune checkpoint blockade with MAPK inhibition are overcoming resistance to the current targeted therapies in the clinic and expanding our arsenal against this disease. In this review, we summarize the current understanding of the genomic landscape of ATC, discuss the biological and clinical ramifications of recurring aberrations, and provide an overview of the opportunities and challenges in the clinical management of this lethal malignancy.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Role of the calcium stimulation test in diagnosing medullary thyroid cancer: is it adequate to achieve a diagnosis in both sexes? An individual patient data meta-analysis. 钙刺激试验在诊断甲状腺髓样癌中的作用:是否足以在两性中获得诊断?个体患者数据荟萃分析。
IF 3.5 2区 医学
European Thyroid Journal Pub Date : 2025-05-29 Print Date: 2025-06-01 DOI: 10.1530/ETJ-24-0347
Franz Sesti, Tiziana Feola, Pasquale Dolce, Valentina Guarnotta, Alessandro Veresani, Elia Guadagno, Filomena Bottiglieri, Maria Grazia Tarsitano, Andrea M Isidori, Annamaria Colao, Antongiulio Faggiano, Elisa Giannetta
{"title":"Role of the calcium stimulation test in diagnosing medullary thyroid cancer: is it adequate to achieve a diagnosis in both sexes? An individual patient data meta-analysis.","authors":"Franz Sesti, Tiziana Feola, Pasquale Dolce, Valentina Guarnotta, Alessandro Veresani, Elia Guadagno, Filomena Bottiglieri, Maria Grazia Tarsitano, Andrea M Isidori, Annamaria Colao, Antongiulio Faggiano, Elisa Giannetta","doi":"10.1530/ETJ-24-0347","DOIUrl":"10.1530/ETJ-24-0347","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of medullary thyroid cancer (MTC) when basal calcitonin (CT) levels are <100 pg/mL remains a clinical challenge. The calcium stimulation test is a unique tool for stimulating CT. However, standardized and sex-specific cutoff values are lacking. Therefore, this study aimed to investigate whether the calcium stimulation test for CT is adequate for diagnosing MTC in both sexes and to identify sex-specific cutoff values.</p><p><strong>Methods: </strong>This was an individual patient data (IPD) meta-analysis. A literature search was performed using Scopus, PubMed, and Web of Science until September, 2024, to identify articles on the calcium stimulation test for diagnosing MTC.</p><p><strong>Results: </strong>A total of five studies involving 243 patients (148 females and 95 males) who underwent total thyroidectomy were included in this study. Before surgery, all patients underwent the calcium stimulation test with calcium gluconate (25 mg/kg) for CT assessed by chemiluminescence assay. In females, a global threshold of 162 pg/mL was identified, with a pooled sensitivity of 0.90 (95% confidence interval (95% CI): 0.79-0.97) and specificity of 0.66 (95% CI: 0.56-0.75). The pooled area under the curve (AUC) was 0.87 (95% CI: 0.76-0.97). In males, a global threshold of 562 pg/mL was identified, with a pooled sensitivity of 0.79 (95% CI: 0.60-0.92) and specificity of 0.89 (95% CI: 0.79-0.96). The pooled AUC was 0.94 (95% CI: 0.90-0.99).</p><p><strong>Conclusions: </strong>The calcium stimulation test for CT for the diagnosis of MTC showed better performance in males than in females, with a suggested cutoff value of 562 pg/mL in males.</p><p><strong>Significance statement: </strong>The management of indeterminate calcitonin (CT) values is still challenging in the early diagnosis of MTC, lacking general recommendations, which can help clinicians in these cases. This is the first IPD meta-analysis that underscores the sex-based disparity in the diagnostic accuracy of the calcium stimulation test for CT in suspected MTC cases, showing better performance in diagnosing MTC in male versus female patients, with a cutoff value of 562 pg/mL in male subjects. In the context of the limited literature, this paper provides added value for the clinical endocrine practitioner, suggesting the use of the calcium stimulation test in highly selected cases with indeterminate CT values (10-100 pg/mL) with a sex-oriented and personalized approach.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impaired thyroid hormone receptor signaling in anterior hypothalamic parvalbumin neurons causes bradycardia in male mice. 下丘脑前小白蛋白神经元中甲状腺激素受体信号的受损导致雄性小鼠心动过缓。
IF 3.5 2区 医学
European Thyroid Journal Pub Date : 2025-05-15 Print Date: 2025-06-01 DOI: 10.1530/ETJ-25-0055
Beke Kolms, Riccardo Dore, Sarah C Sentis, Leonardo Vinicius Monteiro de Assis, Henrik Oster, Jens Mittag
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