Gland surgery最新文献

{"title":"Clinical characteristics and outcomes of patients with intrathyroidal thymic carcinoma (ITC): a retrospective cohort study.","authors":"Tingting Zhang, Wangpeng Cui, Xiang Geng, Qinghai Ji, Tuanqi Sun, Junlei Jiang, Yan Zhang, Xiao Shi, Yu Wang","doi":"10.21037/gs-2025-9","DOIUrl":"10.21037/gs-2025-9","url":null,"abstract":"<p><strong>Background: </strong>Intrathyroidal thymic carcinoma (ITC) is an extremely rare type of thyroid cancer with very limited knowledge of its clinical characteristics and optimal treatment modalities. We aimed to assemble the largest ITC cohort to date for a better understanding.</p><p><strong>Methods: </strong>We collected 43 surgically-treated patients with ITC in a single Chinese tertiary center. Kaplan-Meier analysis and multivariate Cox regression analysis is performed to explore prognostic factors. Hazard ratio (HR) and 95% confidence interval (95% CI) were used to indicate the risk associated with the risk factors.</p><p><strong>Results: </strong>A total of 43 cases with ITC were included. Eighteen patients (41.9%) had cervical or mediastinal lymph node metastases, while 16 (37.2%) had distant metastasis at presentation. Ten patients with locally advanced disease received palliative resection and following adjuvant radiotherapy, but none of them showed local progression. After a median follow-up of 69 months, we observed a favorable prognosis with a 3- and 5-year progression-free survival (PFS) of 92.1% and 59.8%, and a 3- and 5-year disease-specific survival (DSS) of 97.0% and 93.1%, respectively. Multivariate analysis showed that palliative resection (HR =5.68, 95% CI: 1.48-21.76, P=0.01) and lateral lymph node metastasis (HR =12.27, 95% CI: 2.40-62.81, P=0.003) were independent risk factors of tumor progression. Partial response was achieved in two patients who received immunotherapy combined with targeted therapy or chemotherapy.</p><p><strong>Conclusions: </strong>Despite with an overall favorable survival, ITC is still prone to lymph node and distant metastasis. Lateral neck metastasis and incomplete tumor resection predicted a poorer outcome. Once achievable, radical surgery combined with radiotherapy should be performed to improve local control, while immunotherapy and targeted therapies are potentially effective in advanced disease.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"866-876"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474988","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":"Intrathyroidal parathyroid carcinoma masquerading as a cystic thyroid nodule: a case report.","authors":"Ko-Ping Tiang, Kah Seng Khoo, Nicholas Ken Yoong Hee, Sharmila Sunita Paramasivam, Khoon-Leong Ng","doi":"10.21037/gs-2025-69","DOIUrl":"10.21037/gs-2025-69","url":null,"abstract":"<p><strong>Background: </strong>Parathyroid carcinomas (PCs) are uncommon malignancies, accounting for an estimated 0.005% of all cancers. Intrathyroidal PCs are exceedingly rare, with fewer than 20 reported cases. Severe hypercalcemia and high parathyroid hormone (PTH) levels at presentation are risk factors for PC. The majority of cases are diagnosed postoperatively. Preoperative localization of PC can be challenging, especially in cystic lesions, where the lack of oxyphil cell predominance may reduce the sensitivity of technetium-99m (^99mTc)-methoxyisobutylisonitrile (MIBI) scans.</p><p><strong>Case description: </strong>We report a female patient diagnosed with primary hyperparathyroidism, presenting with a PTH level of 192 pmol/L (1.8-8 pmol/L) and severe hypercalcemia. Preoperative ^99mTc-MIBI imaging localized a left inferior hyperfunctioning parathyroid gland. Excision of the left parathyroid gland did not yield the expected fall in intraoperative parathyroid hormone (IOPTH) levels. However, an earlier ultrasound scan detected a concomitant right thyroid cyst. The cyst fluid was aspirated and sent for IOPTH assay, which revealed a high PTH level (1,060 pmol/L). The patient subsequently underwent a right hemithyroidectomy. IOPTH levels showed a 78% reduction post-surgery. Histology of the right lobe confirmed an intrathyroidal right PC amid benign thyroid follicles. The serum PTH level normalized to 1.1 pmol/L postoperatively. The patient was discharged in good condition and is undergoing annual ultrasound and PTH level surveillance.</p><p><strong>Conclusions: </strong>This case highlights an unusual presentation of PC masquerading as a cystic thyroid nodule. Clinicians should consider PC in the differential diagnosis of cystic neck lesions. Aspiration of cystic fluid for PTH assay may be a valuable adjunct in diagnosis, though further evidence is needed.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"968-973"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475004","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":"The impact of serum interleukin-17a as a predictive biomarker for neoadjuvant therapy response in breast cancer: a retrospective study.","authors":"Liyan Yu, Zhongzeng Liang, Xiangning Zeng, Guoqing Liu, Jiaxin Xie, Yuanqi Zhang, Huilai Miao","doi":"10.21037/gs-2025-197","DOIUrl":"10.21037/gs-2025-197","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) is a common and highly malignant disease. Recently, interlukin-17a (IL-17a) was found to be associated with several human malignancies. However, the role of IL-17a in predicting treatment response in BC patients undergoing neoadjuvant therapy (NAT) remains unclear, with limited data exploring its potential as a biomarker. There is a significant clinical need for reliable predictive biomarkers to assist in treatment planning and personalized therapy for BC patients. This study aims to investigate plasma IL-17a expression in BC, and explore its role in disease progression and its interaction with the efficacy of neoadjuvant therapy.</p><p><strong>Methods: </strong>This retrospective cohort study included 54 BC patients who underwent NAT. Inclusion criteria were BC patients receiving standard NAT regimens. Plasma IL-17a expression in BC tissue samples was analyzed via immunohistochemistry. Patients were followed up for a predefined period to assess clinical outcomes and treatment response, measured by pathological complete response (pCR) and radiological assessment, per clinical guidelines. Additional covariates, including tumor stage, histological subtype, and demographics, were recorded and analyzed.</p><p><strong>Results: </strong>The statistical analysis showed that a high expression of IL-17a before and after neoadjuvant therapy was positively correlated with poor responses [i.e., stable disease (SD) and progressive disease (PD)] (P=0.04, P=0.0007). Conversely, compared to those with poor responses, IL-17a was significantly decreased in patients with good responses [i.e., a complete response (CR) and partial response] (P<0.0001). Moreover, IL-17a expression was more decreased in patients with early stage disease (P=0.04). Further, plasma IL-17a was positively trended correlated with a poor prognosis [i.e., progression-free survival (PFS)] after treatment (P=0.09).</p><p><strong>Conclusions: </strong>These findings highlight IL-17A as a dynamic biomarker modulated by NAT, with elevated levels indicating aggressive tumor behavior and resistance to therapy. The significant reduction of IL-17A in responsive patients, especially those with early-stage disease, underscores its potential utility in stratifying patients for personalized treatment. Further large-scale studies are warranted to validate its prognostic role and elucidate mechanisms linking IL-17A to chemoresistance and immune evasion in BC.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"929-937"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475009","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":"Which is the best surgical approach for thymectomy: robot-assisted thoracoscopic surgery (RATS), video-assisted thoracoscopic surgery (VATS), thoracotomy (TORA) or subxiphoid video-assisted thoracoscopic surgery (SPT)?-a systematic review and network meta-analysis.","authors":"Qiangqiang Zheng, Yunfeng Zhou, Yang Yuan, Wei Chen, Min Liang, Yusong Lu, Xiong Liu, Yi Shen","doi":"10.21037/gs-24-443","DOIUrl":"10.21037/gs-24-443","url":null,"abstract":"<p><strong>Background: </strong>Thymectomy is indicated in the presence of primary thymic diseases such as thymoma. However, there is no clear conclusion which is the best surgical approach for thymectomy. We performed this network meta-analysis (NMA) to compare the outcomes of different surgical approaches for thymectomy.</p><p><strong>Methods: </strong>An exhaustive search of PubMed, Excerpt Medica Database (EMBASE), Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL) was conducted to identify relevant studies from inception to May 1, 2024. Direct and indirect evidence was combined to calculate the odds ratios (ORs) or standardized mean differences (SMDs), along with their 95% confidence intervals (CIs). Cluster analyses were adopted to compare the outcomes of different surgical approaches according to the similarity of two variables. Publication bias was detected by comparison-adjusted funnel plots.</p><p><strong>Results: </strong>Fifty-eight studies were enrolled in this NMA, involving four surgical approaches: thoracotomy (TORA), robot-assisted thoracoscopic surgery (RATS), video-assisted thoracoscopic surgery (VATS) and subxiphoid video-assisted thoracoscopic surgery (SPT). The results indicated that in terms of blood loss, RATS was the least, and TORA had more blood loss than VATS and SPT. As for pleural drainage volume, TORA had more pleural drainage volume than VATS and SPT. In terms of visual analogue scale (VAS) score, VATS and TORA had higher VAS scores than SPT. The complete stable remission (CSR) of RATS was superior to that of VATS and TORA.</p><p><strong>Conclusions: </strong>SPT has faster postoperative recovery and less postoperative pain, and other perioperative outcomes are not inferior to other surgical approaches. RATS is safer and has certain clinical advantages in CSR. We look forward to more large-sample, high-quality randomized controlled studies published in the future.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"843-865"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475023","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":"Use of choline PET and ultrasound for preoperative localization of hyperfunctioning parathyroid glands: a single-institution retrospective cohort study.","authors":"Vegard Heimly Brun, Olav Inge Håskjold, Trond Velde Bogsrud","doi":"10.21037/gs-2025-12","DOIUrl":"10.21037/gs-2025-12","url":null,"abstract":"<p><strong>Background: </strong>Positron emission tomography (PET) with fluorine-18 or carbon-11 labeled choline (choline PET) has been found to have higher diagnostic accuracy for localizing hyperfunctioning parathyroid glands than other imaging methods. To evaluate if ultrasound (US) still has value in the diagnostic workup, we compared the findings on choline PET with US findings in patients with hyperparathyroidism (HPT).</p><p><strong>Methods: </strong>We retrospectively reviewed all patients with HPT who underwent a choline PET in the University Hospital of North Norway between 2019-2022. The indications for choline PET were negative or inconclusive localization with [^99mTc]Tc-sestamibi scintigraphy and US, previous parathyroid surgery, or suspicion of multiglandular disease. Additionally, a focused parathyroid US was performed either before (67% of patients) or after the choline PET, without any blinding between modalities.</p><p><strong>Results: </strong>Sixty-two patients were included, of which 50 had been operated on at the time of analysis. Parathyroid tissue was removed in all patients, and multiglandular disease was found intraoperatively in 15 patients (30%). 96% of patients became normocalcemic after surgery. Diagnostic accuracy for choline PET and US was 98% and 89%, respectively, and 100% combined. Multiglandular disease was detected in 28% of patients by both modalities. Two patients with negative choline PET had a true positive US finding.</p><p><strong>Conclusions: </strong>Choline PET in combination with US performed by a radiologist specialized in neck US, successfully localized parathyroid disease in all operated patients. Both modalities detected 28% multiglandular disease. Findings on choline PET had better correspondence with intraoperative findings than US.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"834-842"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475021","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":"T-DM1: a promising adjuvant therapy option for stage I HER2-positive breast cancer-interpreting ATEMPT trial results from a clinical perspective.","authors":"Meghana Kesireddy, Jairam Krishnamurthy","doi":"10.21037/gs-2025-23","DOIUrl":"10.21037/gs-2025-23","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 4","pages":"785-790"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127539","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":"Unveiling the enigma: understanding the complex disease course of granulomatous mastitis and seeking ways to shorten it.","authors":"Jia Liu, Wei-Yi Lin, Qiu-Zhou Wang, Xiao-Qin Yang, Qing Lv, Qiu-Wen Tan","doi":"10.21037/gs-2024-557","DOIUrl":"10.21037/gs-2024-557","url":null,"abstract":"<p><strong>Background: </strong>Granulomatous mastitis is an infrequent and intricate ailment. Limited knowledge exists regarding how granulomatous mastitis progresses and its impact on disease management. We aim to prospectively capture symptoms in the general population to accurately ascertain the duration of illness and the prevalence of long-lasting symptoms.</p><p><strong>Methods: </strong>This study reports data from 169 prospectively enrolled real-world patients with pathologically confirmed granulomatous mastitis. Patients were enrolled after screening according to the inclusion and exclusion criteria. Patients were followed-up every 2-4 weeks during treatment, then every 3-6 months (Year 1) and 6-12 months (Year 2). Outcomes included symptom resolution, disease course, and relapse. Associations between clinical variables and outcomes were assessed using appropriate statistical models, with significance defined as P<0.05.</p><p><strong>Results: </strong>The median disease course of granulomatous mastitis was 257 days (range, 55-1,500 days), with the majority of disease regression occurring within a span of 6 months subsequent to diagnosis; 72.78% of patients preferred steroids as the initial treatment. The use of steroids was associated with a shorter disease course after adjusting for age, lump size, abscess, and sinus formation (P=0.02). Abscess formation was observed in 58.57% of patients. Notably, abscess formation during disease progression contributed to a prolonged disease course (358.67 <i>vs.</i> 278.24 days, P=0.03).</p><p><strong>Conclusions: </strong>Our findings highlighted the heterogeneity of granulomatous mastitis disease course and emphasized the importance of steroid usage in shortening disease course. Avoiding abscess and sinus formation, early steroid usage during granulomatous mastitis treatment might be beneficial. These evidences provide novel insights and supports the use of steroids in patients with granulomatous mastitis for modulating their immune response. Studies are urgently needed to further elucidate the role of steroid in granulomatous mastitis management.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 4","pages":"646-657"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127547","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":"Value of dynamic contrast-enhanced ultrasound in predicting cervical lymph node metastasis in papillary thyroid carcinoma patients with Hashimoto's thyroiditis.","authors":"Kairen Zhang, Dan Zhao, Ying Song, Xiaofeng Wu, Chenyang Jin, Fenglin Dong","doi":"10.21037/gs-2024-510","DOIUrl":"10.21037/gs-2024-510","url":null,"abstract":"<p><strong>Background: </strong>Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) commonly coexist. An accurate assessment of cervical lymph node metastasis (CLNM) is crucial for determining treatment options and predicting prognosis. However, traditional examination methods have certain limitations. This study aimed to investigate the potential utility of dynamic contrast-enhanced ultrasound (DCE-US) using VueBox^® software in assessing CLNM in patients with PTC coexisting with HT.</p><p><strong>Methods: </strong>A retrospective analysis was performed on the clinicopathological data and ultrasound characteristics of 180 thyroid cancer patients who underwent either biopsy or surgery from January 2022 to November 2023. The dataset was partitioned into training and validation sets with a 6:4 ratio. Statistical analyses, including <i>t</i>-tests, chi-squared tests, and rank-sum tests, were conducted to evaluate the data. Univariate analysis, least absolute shrinkage and selection operator (LASSO) regression, and multivariate logistic regression were employed to identify the predictive factors for CLNM. Based on these analyses, three predictive models were developed: Model 1, incorporating clinical factors; Model 2, integrating clinical and ultrasound factors; and Model 3, a combined model that included both clinical and ultrasound factors using DCE-US. The diagnostic performance of each model was assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).</p><p><strong>Results: </strong>The Model 3 exhibited superior performance compared to Models 1 and 2. Specifically, in the training set, Model 3 achieved an area under the curve (AUC) value of 0.924 [95% confidence interval (CI): 0.857-0.966], and in the validation set, the AUC value was 0.905 (95% CI: 0.813-0.962). These values were significantly higher (P<0.05) than those of Model 1, which had a training AUC of 0.724 (95% CI: 0.630-0.806) and a validation AUC of 0.677 (95% CI: 0.557-0.783), as well as Model 2, with a training AUC of 0.854 (95% CI: 0.773-0.915) and a validation AUC of 0.797 (95% CI: 0.683-0.883). Moreover, DCA indicated that Model 3 provided a greater net benefit than Models 1 and 2 in both the training and validation cohorts.</p><p><strong>Conclusions: </strong>The use of VueBox^® perfusion analysis in DCE-US provides additional value in predicting CLNM in PTC patients with HT. The integrated model, which combines clinical and ultrasound factors, is a valuable diagnostic tool.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 4","pages":"597-610"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127551","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":"Correlation between ultrasound-based hepatic steatosis grade and thyroid hormone levels.","authors":"Xuanxuan Zhang, Meijuan Jiang, Wei Zhu, Shouxing Xu, Wenqian Wang, Bin Ying, Xiaoting Chen, Shanshan Zhang, Jianlian Pan, Kai Zhang, Frank Tacke, Ju Dong Yang, Jian Chen","doi":"10.21037/gs-2025-62","DOIUrl":"10.21037/gs-2025-62","url":null,"abstract":"<p><strong>Background: </strong>Thyroid hormones impact on metabolic homeostasis, and low thyroid hormone levels, both systemically and hepatically, have been linked to hepatic steatosis. However, prior studies in this area often lacked quantification of steatosis. Ultrasound attenuation analysis (USAT) is a novel imaging technique for hepatic steatosis detection based on the attenuation coefficient. Our objective in this study was to assess the correlation between thyroid hormone levels and hepatic steatosis via the USAT attenuation coefficient in metabolic dysfunction-associated steatotic liver disease (MASLD) and chronic hepatitis B (CHB) groups.</p><p><strong>Methods: </strong>This retrospective study included 86 patients with CHB and 45 patients with suspicious MASLD. Demographic information, biochemical parameters, and thyroid hormone levels were analyzed. The severity of steatosis in MASLD or CHB was assessed by USAT.</p><p><strong>Results: </strong>Patients in the MASLD group were more likely to have type 2 diabetes mellitus (T2DM) and hypertension as compared with those in the CHB group (P<0.05). The levels of triiodothyronine (T3) were significantly lower and the platelet counts higher in the MASLD group than in the CHB group (P<0.05). The body mass index (BMI), distance from skin to capsule, USAT values, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in patients with hepatic steatosis were significantly higher than those in patients without hepatic steatosis (P<0.05). Logistic regression analysis indicated a correlation between free triiodothyronine (FT3) level and hepatic steatosis (P=0.04) as well as between free thyroxine (FT4) level and hepatic steatosis (P=0.045).</p><p><strong>Conclusions: </strong>Quantitative USAT evaluation suggested that hepatic steatosis is strongly correlated with thyroid hormones. These data emphasize the relevance of thyroid hormones for regulating hepatic lipid accumulation and metabolism.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 4","pages":"726-737"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127298","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":"Development and validation of a screening model for benign and malignant breast masses based on S-Detect and microvascular flow imaging.","authors":"Zhongguang Hou, Yunyun Zhan, Jiajia Wang, Mei Peng","doi":"10.21037/gs-2024-488","DOIUrl":"10.21037/gs-2024-488","url":null,"abstract":"<p><strong>Background: </strong>Imaging examination of a breast mass is essential for improving breast cancer detection. Previous screening models of benign and malignant breast masses demonstrated a high level of subjectivity due to the inability to conduct quantitative evaluations. Thus, this study aimed to construct an objective, convenient, and effective nomogram incorporating S-Detect and microvascular flow imaging (MVFI) to predict breast cancer risk.</p><p><strong>Methods: </strong>Female patients with breast masses detected by conventional ultrasound examinations at the Second Affiliated Hospital of Anhui Medical University between January 2021 and October 2024 were retrospectively analyzed. All patients underwent preoperative assessments with both S-Detect and MVFI. The pathological results served as the gold standard for diagnosis. After screening, a total of 724 breast masses from 712 patients were randomized into the training (506 masses) and validation (218 masses) groups. Univariate analysis assessed patient age, as well as the location, size, vascular index (VI), and S-Detect-based diagnosis of the masses. Risk factors for predicting breast cancer were screened using multivariate analysis. A nomogram prediction model was then constructed. Diagnostic performance, clinical utilization value, and calibration were determined using the receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and calibration curve, respectively. Nomogram risk was calculated for each breast mass for risk stratification.</p><p><strong>Results: </strong>The training group included 208 benign and 298 malignant masses, while the validation group comprised 85 benign and 133 malignant masses. Multivariate analysis demonstrated that mass size [odds ratio (OR) =1.08; P<0.001], age (OR =1.09; P<0.001), VI (OR =1.07; P<0.001), and S-Detect-based diagnosis (OR =28.37; P<0.001) were risk factors for predicting breast cancer. The area under the curve (AUC) for the nomogram model was significantly greater than that for S-Detect in both the training (0.93 <i>vs</i>. 0.82, P<0.001) and validation (0.91 <i>vs</i>. 0.82, P<0.001) groups. The diagnostic sensitivity and specificity of the nomogram were 93.3% and 79.8% in the training group, and 98.5% and 72.9% in the validation group, respectively. The optimal cut-off value for nomogram risk differentiation between the high-risk and low-risk sets was 0.495, with a significantly higher proportion of malignant breast masses in the high-risk set compared to that in the low-risk set (P<0.001).</p><p><strong>Conclusions: </strong>This novel nomogram model based on quantitative and objective ultrasound and clinical features can quantify the malignancy risk of breast masses, identify high-risk individuals, and provide a reference for further examinations.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 4","pages":"687-698"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127337","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}