Gland surgery最新文献

{"title":"Artificial intelligence-assisted HER2 interpretation for breast cancers in a multi-laboratory study.","authors":"Libo Yang, Jie Chen, Leyi Gao, Fengling Li, Xudan Yang, Juan Ji, Pei Zhang, Ping Hua, Xiulan Liu, Rong Wang, Zhenru Wu, Fei Chen, Bing Wei, Zhang Zhang","doi":"10.21037/gs-2024-560","DOIUrl":"10.21037/gs-2024-560","url":null,"abstract":"<p><strong>Background: </strong>Improving the concordance of human epidermal growth factor receptor 2 (HER2) examinations among laboratories remains a challenge. In this multi-laboratory study, we investigated the concordance of HER2 immunohistochemistry (IHC) examination through manual and artificial intelligence (AI)-assisted interpretation.</p><p><strong>Methods: </strong>A tissue microarray (TMA) comprising 53 breast cancer samples was constructed and distributed to 35 participating laboratories. For each sample on every slide, IHC scores of 0, 1+, 2+, and 3+ were recorded. Subsequently, cases that failed to achieve complete agreement during manual interpretation were re-evaluated using an AI-assisted microscope.</p><p><strong>Results: </strong>During manual interpretation, 14 out of 53 cases (14/53, 26.4%) demonstrated concordant results across all laboratories, including 13 IHC-0 cases and 1 IHC-3+ case. Notably, cases scored as 1+ in at least one laboratory exhibited a low overall percentage agreement (OPA) and Fleiss Kappa value. Among the 39 cases with non-concordant manual interpretation, 14 cases (14/39, 35.9%) achieved complete agreement through AI-assisted HER2 interpretation. In cases where manual interpretation discrepancies were restricted to scores of 0 and 1+, 69.6% (16/23) of the cases still showed differences between 0 and 1+ in AI-assisted HER2 interpretation. Disagreements between manual and AI-assisted interpretation occurred significantly more frequently in sections manually scored as 1+ compared to those scored as 0 (58.6% <i>vs</i>. 2.1%, P<0.001).</p><p><strong>Conclusions: </strong>The weakly staining phenotype leads to poor agreement in the manual interpretation of HER2 IHC-1+ breast cancers. AI-assisted HER2 interpretation offers a viable approach for multi-laboratory studies, effectively avoiding the subjective errors inherent in manual interpretation.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 6","pages":"1042-1051"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649306","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":"Comparison of pathological complete response (pCR) between short-term (<6 cycles) and long-term (≥6 cycles) neoadjuvant trastuzumab therapy for HER2-positive breast cancer: a systematic review and meta-analysis of randomized controlled trials.","authors":"Siyi Chen, Zitong Yang, Jiahong Sun, Huiyan Si, Hu Xu, Qingyang Li, Shiqi Guo, Yuanbo Xue, Li Zhu, Jiandong Wang","doi":"10.21037/gs-2025-25","DOIUrl":"10.21037/gs-2025-25","url":null,"abstract":"<p><strong>Background: </strong>Human epidermal growth factor receptor 2 (HER2) positive breast cancer is a distinct molecular subtype. Trastuzumab-based neoadjuvant therapy (NAT) (combined with chemotherapy and/or additional anti-HER2 agents) is the standard of care, but the optimal duration of trastuzumab cycles (short-term: <6 <i>vs.</i> long-term: ≥6) remains controversial. This meta-analysis aims to comprehensively evaluate the efficacy and safety of long-term (≥6 cycles) and short-term (<6 cycles) neoadjuvant trastuzumab treatment for HER2-positive breast cancer.</p><p><strong>Methods: </strong>The PubMed, EMBASE, and Web of Science databases were systematically searched to include randomized controlled trials (RCTs) comparing long-term and short-term neoadjuvant trastuzumab treatment for HER2 positive breast cancer. The primary outcome measurement was the pathological complete response (pCR) rate, and the secondary outcome measurement was the incidence of adverse events. RevMan and STATA software were used for meta-analysis.</p><p><strong>Results: </strong>A total of five RCTs involving 799 patients were included. The meta-analysis showed that there was no significant difference in pCR between long-term and short-term treatment [risk ratio (RR) =0.78, 95% confidence interval (CI): 0.60-1.02; P=0.07; I²=62%], but long-term treatment had a higher trend in pCR. After excluding the Z1041 trial with high heterogeneity, the pCR of long-term treatment was significantly better than that of short-term treatment (RR =0.69, 95% CI: 0.50-0.95; P=0.02; I²=50%). The incidence of grade 3 and above adverse events in short-term treatment was significantly lower than that in long-term treatment (RR =0.75, 95% CI: 0.59-0.96; P=0.02; I²=0%). Subgroup analysis showed that in single anti-HER2 therapy, after excluding Z1041, the pCR of long-term treatment was better than that of short-term treatment (RR =0.61, 95% CI: 0.45-0.84; P=0.002; I²=0%); in the hormone receptor positive (HR+) group, after excluding Z1041, the pCR of long-term treatment was significantly better than that of shor-term treatment (RR =0.45, 95% CI: 0.24-0.83; P=0.01; I²=2%).</p><p><strong>Conclusions: </strong>This meta-analysis indicates that when using single anti-HER2 therapy (trastuzumab + chemotherapy without additional anti-HER2 agents) for neoadjuvant treatment, a long-term treatment may bring better efficacy. In dual anti-HER2 therapy, the efficacy of long- and short-term treatments is similar, and a shorter treatment cycle can be considered to reduce adverse events.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 6","pages":"1079-1090"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649308","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":"Predictive value of the pretreatment serum sialic acid/total protein ratio for bone metastases in newly diagnosed prostate cancer patients: development of a nomogram model.","authors":"Laiyuan Qiu, Tian Tian, Zhipeng Ma, Jingtao Sun, Yuxuan Zhao, Lin Yang, Yu Ji, Li Yi, Lei Yan, Chuanbing Xu, Dawei Li","doi":"10.21037/gs-2025-39","DOIUrl":"10.21037/gs-2025-39","url":null,"abstract":"<p><strong>Background: </strong>Bone is a common site of distant metastasis, and its metastasis is one of the major causes of death in prostate cancer (PCa) patients. Currently, there is a lack of effective predictive methods. This study aimed to evaluate the potential of pretreatment serum sialic acid/total protein (SA/TP) ratio as a biomarker for predicting PCa and its associated bone metastases.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 641 patients diagnosed with benign prostatic hyperplasia (BPH) or PCa between November 2014 and July 2021. We conducted a comparative analysis of SA/TP levels across various subgroups and investigated the correlation between SA/TP levels and multiple clinical parameters. Independent risk factors were identified through both univariate and multivariate logistic regression analyses, and a predictive model for assessing the risk of bone metastases was developed.</p><p><strong>Results: </strong>PCa patients presented significantly higher median pretreatment SA/TP levels than BPH patients (P<0.001). Furthermore, within the cohort of PCa patients, individuals with bone metastases demonstrated markedly elevated pretreatment SA/TP levels in contrast to their counterparts without bone metastases (P<0.001). Additionally, receiver operating characteristic (ROC) curve analysis identified an optimal cut-off value of 0.7973 for distinguishing BPH from PCa, accompanied by an area under the curve (AUC) of 0.606 [95% confidence interval (CI): 0.559-0.653, P<0.001]. In parallel, the optimal cut-off value for differentiating between bone metastases and without bone metastases in PCa patients was identified as 0.8560 with an AUC of 0.770 (95% CI: 0.707-0.833, P<0.001). Multivariate logistic regression analysis revealed that a pretreatment SA/TP ≥0.7973 was independently correlated with PCa [hazard ratio (HR) =1.704, 95% CI: 1.016-2.806, P=0.04], whereas a pretreatment SA/TP ≥0.8560 served as an independent risk factor for PCa with bone metastases (HR =2.567, 95% CI: 1.051-6.271, P=0.04).</p><p><strong>Conclusions: </strong>The elevated pretreatment SA/TP level is closely associated with the risk of PCa and its subsequent bone metastases.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 6","pages":"1066-1078"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649243","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 nomogram based on clinicopathological characteristics and multimodal ultrasound parameters for predicting lateral lymph node metastasis in papillary thyroid carcinoma.","authors":"Pan Guan, Weiwei Li, Lingling Tao, Yingyan Zhao, Weiwei Zhan, Hui Chen, Wenjun Huang, Wei Zhou","doi":"10.21037/gs-2024-525","DOIUrl":"10.21037/gs-2024-525","url":null,"abstract":"<p><strong>Background: </strong>Tumor neovascularization and increased extracellular matrix stiffness have been confirmed to be crucial for oncology research, however, they are rarely integrated into diagnostic prediction models for predicting lateral cervical lymph node metastasis (LLNM). This study aimed to explore the correlation between these ultrasound parameters, clinicopathological characteristics and LLNM in papillary thyroid carcinoma (PTC), and construct a nomogram prediction model, as well as estimate its preoperative diagnosis values for LLNM.</p><p><strong>Methods: </strong>The clinical and ultrasound imaging data of 703 patients with postoperative histopathologically confirmed PTC were retrospectively analyzed. Conventional ultrasound, superb micro-vascular imaging (SMI) and strain ultrasound elastography (SUE) were performed for all patients, and they were stratified into training and validation cohorts based on the chronological sequence of surgery with a ratio of 7:3. Comprehensive evaluations of clinicopathological and ultrasonic features were conducted using least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression, with the aim of identifying independent predictors of LLNM, and a nomogram prediction model was constructed. All LLNM patients were confirmed by postoperative pathology. Receiver operating characteristic curves (ROC) and calibration curves were drawn. Decision curve analysis (DCA) was performed to calculate the predictive efficiency, consistency, and clinical practicality of the model.</p><p><strong>Results: </strong>Among the 703 patients, 98 patients were diagnosed with LLNM (13.9%). According to the results of LASSO regression and multivariable logistic regression model, eight independent risk variables were screened to construct a prediction model, including sex, tumor size, multifocality, capsular invasion, microcalcification, perforator vessel, strain rate ratio (SRR) and ratio of metastatic central lymph nodes (LNR). The consistency index of the prediction model in the training cohort was 0.895, and it was 0.866 in the validation cohort. The optimal cutoff value (0.149) showed the balance between the sensitivity (80.6%) and specificity (84.5%). In both the training cohort and the validation cohort, the calibration curves were close to the standard curve, and the DCA curves showed that more than 90% of PTC patients could benefit from the prediction model.</p><p><strong>Conclusions: </strong>Compared with conventional imaging modalities used alone, the integrated application of novel ultrasonographic technologies, including SMI and SUE, demonstrates superior diagnostic performance in predicting LLNM in PTC patients. This nomogram incorporating the aforementioned ultrasound parameters might be helpful for accurate preoperative risk stratification of LLNM, thereby assisting surgeons in formulating individualized surgical strategies prior to intervention.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 6","pages":"998-1011"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649238","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 diagnosis and treatment of hyperthyroidism: a bibliometric analysis from 2004 to 2024.","authors":"Xuejiao Yu, Jiajia Tang, Liangkai Wang, Zhe Sun, Jiaojiao Ma, Tongtong Zhou, Xinyi Liu, Yang Li, Bo Zhang","doi":"10.21037/gs-2025-228","DOIUrl":"10.21037/gs-2025-228","url":null,"abstract":"<p><strong>Background: </strong>Hyperthyroidism is a common condition associated with osteoporosis, heart disease, and increased mortality. However, bibliometric analyses on hyperthyroidism are scarce. This study aimed to characterize the literature on the diagnosis and treatment of hyperthyroidism through bibliometric analysis.</p><p><strong>Methods: </strong>We retrieved the relevant literature on the diagnosis and management of hyperthyroidism published from 2004 to 2024 from the Web of Science Core Collection (WOSCC) database. Bibliometric analysis was performed via CiteSpace and VOSviewer.</p><p><strong>Results: </strong>We identified 6,041 publications from 629 countries/regions. The annual number of related publications showed a steady increase over time. Among countries/regions, the United States led in publication volume, while the University of Pisa led among the contributing institutions. <i>The Journal of Clinical Endocrinology and Metabolism</i> had the highest publication output, while <i>Thyroid</i> was the most frequently cited journal. This identified publications involving 28,157 authors, with Lazlo Hegedüs being the most prolific author. The most frequently cited articles were the \"2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis\" and the \"2018 European Thyroid Association Guideline for the Management of Graves' Hyperthyroidism\". In terms of keywords, \"Graves' disease\" and \"guidelines\" were the most frequently used terms in the field of hyperthyroidism diagnosis and treatment.</p><p><strong>Conclusions: </strong>This bibliometric study provides a comprehensive analysis of publications on the diagnosis and management of hyperthyroidism. Key research hotspots include management strategies for Graves' disease, international treatment guidelines and emerging areas such as immunotherapy for hyperthyroidism, which suggests the future directions, potential opportunities, and challenges in the field.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 6","pages":"1140-1153"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649324","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":"Comparison of targeted axillary dissection with sentinel node biopsy alone on nodal recurrence for patients who have node-positive breast cancer treated with neoadjuvant chemotherapy: a critical appraisal.","authors":"Janhavi Venkataraman, Artefaa Al-Shamari, Kefah Mokbel","doi":"10.21037/gs-2025-152","DOIUrl":"10.21037/gs-2025-152","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 6","pages":"1171-1173"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649309","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":"Survival benefit of surgery for inflammatory breast cancer patients.","authors":"Yilong Lin, Songsong Wang, Qingfeng Liu, Yun Zhang, Shengjie Lin, Jing She, Ruidan Zhao, Qiaolu Yang, Liyi Zhang, Qingmo Yang","doi":"10.21037/gs-2024-561","DOIUrl":"10.21037/gs-2024-561","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory breast cancer (IBC) is considered as the most aggressive subtype of breast cancer. The purpose of this study is to evaluate the effect of surgical treatments on IBC patients.</p><p><strong>Methods: </strong>Based on propensity score matching (PSM) analysis, we evaluated the prognostic significance of surgical intervention in patients with IBC by Cox proportional hazard models. A subgroup analysis was conducted to evaluate the impact of surgical treatment on patients of various groups. Kaplan-Meier (KM) analysis and log-rank tests were used to compare survival in the matched population.</p><p><strong>Results: </strong>A total of 2,473 patients with IBC diagnosed between 2000 and 2020 were assessed from the Surveillance, Epidemiology, and End Results (SEER) database. There were 298 patients in the non-surgery group and 2,175 patients in the surgery group. In the multivariable Cox analysis, IBC patients treated by surgery showed higher overall survival (OS) rates [hazard ratio (HR) =0.50, 95% confidence interval (CI): 0.43-0.57, P<0.001]. After PSM, the multivariable Cox analysis revealed significant associations between age, race, node (N) status, estrogen receptor (ER) status, human epithelial growth factor receptor-2 (HER2) status, surgery, chemotherapy, and OS. Within the matched population analysis, patients derived significant benefits from surgery (HR =0.51, 95% CI: 0.42-0.62, P<0.001). Moreover, the OS outcomes of patients who received radiation therapy or chemotherapy in addition to surgical treatment were superior to those without surgery (chemotherapy, P<0.001; radiation therapy, P<0.001).</p><p><strong>Conclusions: </strong>IBC patients who were treated with surgery had better OS outcomes. Therefore, a multimodality approach is recommended for the management of IBC, which involves the use of surgical intervention as the main treatment modality.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 6","pages":"983-997"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649322","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 preoperative HELPP score can be used as a prognostic assessment tool for resectable pancreatic cancer patients, and may be applicable to patients in China as well.","authors":"Jin Li, Qizhu Lin, Huangpeng Lin, Zexian Ma, Xuefeng Huang, Huimin Chen, Katsunori Sakamoto, Yongjie Su","doi":"10.21037/gs-2025-132","DOIUrl":"10.21037/gs-2025-132","url":null,"abstract":"<p><strong>Background: </strong>The incidence of pancreatic ductal adenocarcinoma (PDAC) is increasing annually, and the prognosis remains poor. There is currently no consensus on using neoadjuvant therapy for resectable pancreatic cancer. Further, existing preoperative prognostic scoring tools have notable limitations, making it challenging to identify patients who may benefit from neoadjuvant therapy. There is an urgent need for a widely recognized and effective tool to assess postoperative prognosis and guide treatment decisions. This study assessed and compared several widely used indicators, including the Heidelberg prognostic pancreatic cancer (HELPP) score, the Glasgow prognostic score (GPS), the systemic immune-inflammation index (SII), and the neutrophil-lymphocyte ratio (NLR).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 61 pancreatic cancer patients who underwent radical resection at Zhongshan Hospital of Xiamen University from February 2015 to February 2022. The SII was calculated as (platelets × neutrophils/lymphocytes), and the NLR as (neutrophils/lymphocytes). The preoperative HELPP score was derived from American Society of Anesthesiologists (ASA) classification, carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), C-reactive protein (CRP), albumin, and platelets. The GPS was based on albumin and CRP levels. Optimal cut-off values for the quantitative data were established using Youden's index. Kaplan-Meier method and log-rank tests were used to categorize and group the HELPP scores. Univariate and multivariate survival analyses were conducted to explore the relationship between the HELPP score, GPS, SII, NLR, and postoperative survival of the pancreatic cancer patients. Chi-squared tests were used to compare the clinicopathological data across the prognostic score subgroups. The area under the receiver operating characteristic (ROC) curve (AUC) for each score was evaluated to assess predictive accuracy of 1- and 2-year survival.</p><p><strong>Results: </strong>The optimal cut-off values for the SII and NLR were 675.51 and 2.53, respectively. There were no significant differences in the survival times of the patients with HELPP scores of 1, 2, or 3 points (P>0.05); nor between those with scores of 4 and 5 points (P=0.058). The patients with preoperative HELPP scores of ≤3 points were allocated to the low HELPP score group, while those with scores >3 points were allocated to the high HELPP score group. A HELPP score >3 points, CEA ≥1.48 µg/L, and a tumor diameter >4 cm were found to be independent risk factors affecting postoperative prognosis (P<0.05). The SII, GPS, and NLR were not found to be significantly associated with prognosis. There were no statistically significant differences in the clinicopathological characteristics between the two HELPP score groups (P>0.05). The AUCs for overall survival (OS) for the HELPP score were 0.874 at 1 year and 0.696 at 2 years.</p><p><strong>Concl","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 6","pages":"1112-1127"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649325","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":"Postmastectomy radiotherapy indications using pathological prognostic staging in node-positive breast cancer.","authors":"Juan Zhou, Lin-Feng Guo, San-Gang Wu, Zhen-Yu He","doi":"10.21037/gs-2025-84","DOIUrl":"10.21037/gs-2025-84","url":null,"abstract":"<p><strong>Background: </strong>The role of pathological prognostic staging (PPS) on postmastectomy radiotherapy (PMRT) selection remains unclear. This study aimed to investigate the impact of PPS on PMRT selection in patients with node-positive breast cancer (BC).</p><p><strong>Methods: </strong>We included women diagnosed with BC between 2010 and 2015 from the Surveillance, Epidemiology, and End Results database. Chi-square test, operating characteristic curve, and competing-risks analyses with the Fine and Gray model were used for statistical analyses.</p><p><strong>Results: </strong>A total of 14,830 patients were included. Overall, 8,807 (59.4%) patients received PMRT while 6,023 (40.6%) did not. Among them, 11,767 patients (79.3%) had their stage changed, with 1,086 (7.3%) upstaged and 10,681 (72.0%) downstaged. PPS had better prognostic accuracy compared with anatomical staging (AS) (P<0.001). Regarding PPS, PMRT significantly decreased 5-year breast cancer-specific mortality in patients with stage IIIA (14.4% <i>vs</i>. 19.7%, P<0.001), IIIB (19.8% <i>vs</i>. 27.2%, P=0.003), and IIIC (38.5% <i>vs</i>. 45.7%, P=0.049) diseases compared with those of other stages. However, no significant effects were observed in stage IA, IB, IIA, and IIB diseases.</p><p><strong>Conclusions: </strong>Our study highlights significant staging differences between AS and PPS in patients with node-positive BC. The high rate of downstaging observed with PPS suggests its potential to enhance risk stratification and optimize treatment strategies, especially in guiding the appropriate use of PMRT.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 6","pages":"1101-1111"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649242","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":"Association of thyroglobulin antibody and thyroid peroxidase antibody status with aggressive features in papillary thyroid carcinoma with Hashimoto's thyroiditis.","authors":"Qianqian Lu, Yunzhe Dou, Tian Yu, Xing Ren, Yao Li, Xiaoquan Zhu, Yanyang Zhao, Gang Miao","doi":"10.21037/gs-2025-47","DOIUrl":"10.21037/gs-2025-47","url":null,"abstract":"<p><strong>Background: </strong>Thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) are thought to be linked to the development and prognosis of papillary thyroid carcinoma (PTC) combined with Hashimoto's thyroiditis (HT). However, the association between TgAb and TPOAb statuses and aggressive features in PTC with HT remains unclear. This study aims to elucidate the invasive or protective effects of different TgAb and TPOAb statuses in PTC patients with HT.</p><p><strong>Methods: </strong>A total of 317 patients who were pathologically diagnosed with PTC and HT were enrolled in this retrospective study. Data on preoperative serum TgAb, TPOAb, and thyroid hormone levels, as well as histopathological and ultrasound characteristics, were collected and analyzed. Based on TgAb and TPOAb status, patients were divided into four groups. The Kruskal-Wallis H test and Pearson chi-squared test were applied to compare aggressive features between the groups.</p><p><strong>Results: </strong>In our study, we enrolled 317 patients, who were divided into four groups based on TgAb and TPOAb status. Significant differences were found between groups in tumor size >4 cm (P=0.004), the number of central lymph node metastases (NCLNM, P=0.01), the central lymph node metastasis ratio (CLNMR, P=0.03), and the lateral lymph node metastasis ratio (LLNMR, P=0.01). Then we conducted pairwise comparisons between groups, which showed that the TgAb and TPOAb double-negative (TAb^-) group had a higher proportion of tumors >4 cm compared to the TgAb and TPOAb double-positive (TAb⁺) group (P=0.008) and the TPOAb-positive (TPOAb⁺) group (P=0.03). More importantly, the TAb^- group also exhibited significantly higher NCLNM than the TAb⁺ group (P=0.02) and TPOAb⁺ group (P=0.03), as well as higher CLNMR compared to the TPOAb⁺ group (P=0.02) and higher LLNMR compared to the TAb⁺ group (P=0.02).</p><p><strong>Conclusions: </strong>The TAb^- group showed an increased risk of aggressive features, whereas the TAb⁺ and TPOAb⁺ groups indicated a reduced risk. These findings suggest that TgAb and TPOAb statuses may help predict tumor aggressiveness preoperatively.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 6","pages":"1091-1100"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649307","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}