Gland surgery最新文献

{"title":"Diagnostic accuracy of automated breast volume scanning, hand-held ultrasound and molybdenum-target mammography for breast lesions: a systematic review and meta-analysis.","authors":"Xiaozhen Liu, Yujuan Dai, Yanming Wu, Fang Li, Meijuan Liang, Qiuling Wu","doi":"10.21037/gs-24-135","DOIUrl":"https://doi.org/10.21037/gs-24-135","url":null,"abstract":"<p><strong>Background: </strong>Given the high incidence and increasing burden of breast cancer, more approaches are needed to improve the early diagnosis of breast cancer. The three mainstream diagnostic methods, automated breast volume scanning (ABVS), hand-held ultrasound (HHUS) and mammography, are still controversial in their diagnostic accuracy. The aim of this study is to systematically evaluate the accuracy of three diagnostic methods.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, The Cochrane Library, Wanfang Data, China National Knowledge Infrastructure (CNKI), VIP and SinoMed databases were searched by computer. Studies on the accuracy of ABVS, HHUS and mammography in the diagnosis of benign and malignant breast lesions were collected, and the search time limit was from the establishment of the database to August 2022. The Chi-square test was then performed using Meta-Disc software, and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used for bias and quality assessment.</p><p><strong>Results: </strong>A total of 31 studies involving 8,107 benign or malignant lesion were included in the meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under curve for HHUS were 0.86 (0.84, 0.87), 0.80 (0.78, 0.81), 4.20 (3.53, 4.99), 0.20 (0.16, 0.24), 22.88 (16.84, 31.08) and 0.898, respectively. And those for ABVS were 0.90 (0.89, 0.91), 0.87 (0.86, 0.88), 7.93 (5.05, 12.45), 0.11 (0.09, 0.15), 74.63 (45.37, 122.76) and 0.956, respectively. And those for molybdenum-target mammography were 0.81 (0.78, 0.84), 0.90 (0.88, 0.91), 6.94 (4.32, 11.17), 0.23 (0.18, 0.29), 31.41 (17.01, 57.98) and 0.887, respectively. Indicators related to patient selection and reference standards suggested a high risk of bias in several included studies.</p><p><strong>Conclusions: </strong>Meta-analysis found a higher diagnostic accuracy of ABVS in benign and malignant breast lesions. These results provide a reference for clinical practitioners in the selection of diagnostic methods, but considering the possible bias of the included studies, the results need to be treated with caution and further verified.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 3","pages":"294-304"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004080","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":"Application of pectoralis major fascia in retropectoral breast reconstruction: the five-step method.","authors":"Chang-Sheng Yu, Jun Ma, Liang-Geng Yang, Bin Chen, Fang Fang, Ya-Bing Wang, Zheng Wang","doi":"10.21037/gs-24-463","DOIUrl":"https://doi.org/10.21037/gs-24-463","url":null,"abstract":"<p><p>The demand for breast reconstruction following early-stage breast cancer diagnosis has been steadily increasing. While prepectoral prosthetic reconstruction offers several advantages, its application is often limited by the necessity of acellular dermal matrix (ADM), which significantly increases costs and restricts widespread adoption. Conversely, traditional retropectoral implant reconstruction presents challenges, particularly in achieving optimal breast softness and mobility. This article aims to provide a comprehensive review of the indications and contraindications for modified retropectoralis major prosthetic breast reconstruction, based on a synthesis of literature and clinical experience. We detail the surgical technique and post-operative care involved in utilizing the pectoralis major fascia as an autologous alternative to ADM. The procedure is summarized into five key steps: (I) surgical positioning and incision design; (II) preservation of the pectoralis major fascia during mastectomy; (III) dissection of the pectoralis major fascia; (IV) creation of the implant pocket; and (V) prosthesis placement and final wound closure. We propose that this five-step approach not only offers a novel and cost-effective solution for prosthetic reconstruction in early-stage breast cancer patients but also demonstrates high feasibility and safety. By eliminating the need for ADM, this technique has the potential to enhance accessibility and promote broader clinical adoption.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 3","pages":"520-528"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962066","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":"Hot topics in breast reconstruction world wide.","authors":"Tine Engberg Damsgaard, C Andrew Salzberg, Jørn Bo Thomsen","doi":"10.21037/gs-2024b-4","DOIUrl":"https://doi.org/10.21037/gs-2024b-4","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 3","pages":"577-578"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019323","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":"Study on the relationship between lymphedema stage and related symptoms in patients with breast cancer after surgery.","authors":"Yun Li, Yan Ma, Shengqun Hou, Xia Zhang, Yaqiong Chen, Youman Ma, Lichen Tang, Xiaoju Zhang, Zhenqi Lu, Jiajia Qiu","doi":"10.21037/gs-2024-536","DOIUrl":"https://doi.org/10.21037/gs-2024-536","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer-related lymphedema (BCRL) seriously affects patients' quality of life. We aimed to understand the stage of postoperative lymphedema and the occurrence of related symptoms in breast cancer patients, and to analyze the relationship between the two, so as to provide reference for the implementation of targeted clinical interventions.</p><p><strong>Methods: </strong>Convenience sampling method was used to select postoperative breast cancer patients attending the lymphedema evaluation clinic of a tertiary hospital in Shanghai for questionnaire survey. A professional lymphedema therapist assessed the severity of the patients' lymphedema according to the International Society of Lymphology (ISL) lymphedema grading criteria, and the Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI) was used to assess the severity of the patients' lymphedema and patients' experience of lymphedema-related symptoms. This study aimed to understand the occurrence of lymphedema in breast cancer patients after surgery, and to explore the characteristics of related symptoms in patients with different stages of lymphedema.</p><p><strong>Results: </strong>Of the 1,021 patients, 744 (72.86%) were in stage 0, 161 (11.36%) in stage 1, 98 (9.5%) in stage 2, and 18 (1.7%) in stage 3. The higher the lymphedema stage, the number and severity of symptoms significantly increased (P<0.001), with stage 2 and 3 patients reporting more symptoms and greater severity compared to stage 0 and 1 patients. In terms of symptom distress, the higher lymphedema stage was associated with a significant increase in the total symptom distress score as well as in the functional and emotional dimensions of distress (P<0.001).</p><p><strong>Conclusions: </strong>The number of symptom presentations, symptom severity and their degree of distress increased with higher lymphedema stage. Attention should be paid to patients' symptom complaints, and early identification and timely intervention should be made in patients with stage 0 and 1 lymphedema to alleviate their symptoms and slow down the progression of edema.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 3","pages":"358-367"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016880","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":"Feasibility and outcomes of remote-access endoscopic and robotic lateral neck dissection for thyroid cancer: a scoping review.","authors":"Junyi Wang, Yan Zhang, Xiangqian Zheng, Kyung Tae","doi":"10.21037/gs-2024-535","DOIUrl":"https://doi.org/10.21037/gs-2024-535","url":null,"abstract":"<p><strong>Background: </strong>Remote-access endoscopic and robotic thyroid surgery has progressively evolved over the decades to minimize visible neck scarring. Various approaches, including axillary, anterior chest, breast, postauricular, and transoral routes, have been developed, extending their application to lateral neck dissection (LND) in thyroid cancer. This study aims to comprehensively review and synthesize recent literature on remote-access endoscopic and robotic techniques for LND, with a focus on outcomes, advantages, and limitations.</p><p><strong>Methods: </strong>A systematic literature review was conducted using PubMed and Cochrane Library databases. Search terms included \"lateral neck dissection\", \"thyroid cancer\", \"remote-access\", \"robotic\", \"endoscopic\", and \"video-assisted\". Eligible studies were analyzed to provide an in-depth overview of current techniques, addressing the following aspects: (I) incision location; (II) surgical procedures; (III) complications and surgical outcomes; and (IV) advantages and limitations of each approach.</p><p><strong>Results: </strong>Various remote-access techniques for LND were identified, including gasless infraclavicular, breast-chest, gasless transaxillary, bilateral axillo-breast, gasless retroauricular, transoral, and combined approaches. Outcomes, including the number of removed lateral lymph nodes, complication rates, and recurrence rates, were comparable across remote-access approaches. The extent of dissection achieved with these techniques was equivalent to conventional approaches for levels IIa, III, IV, and V, except for the transoral approach, which was generally limited to levels III and IV. Postoperative cosmetic outcomes were significantly superior with remote-access techniques.</p><p><strong>Conclusions: </strong>Remote-access approaches for thyroidectomy combined with LND are both feasible and safe, achieving complete resection of targeted neck levels with excellent surgical and cosmetic outcomes. The unique advantages and limitations of each method underscore the importance of careful patient selection to optimize clinical benefits.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 3","pages":"543-562"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013720","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":"Preoperative localization of single gland disease in primary hyperparathyroidism: a comparative study for preoperative localization with four-dimensional computed tomography, ultrasonography, and technetium-99m-sestamibi single-photon emission computed tomography.","authors":"Ha-Nee Kwon, Hyeon-Su Kim, Sung-Chan Shin, Yong-Il Cheon, Bo Hyun Kim, Yun Kyung Jeon, Mijin Kim, Keunyoung Kim, Lee Hwangbo, Byung-Joo Lee","doi":"10.21037/gs-2024-482","DOIUrl":"https://doi.org/10.21037/gs-2024-482","url":null,"abstract":"<p><strong>Background: </strong>Treatment guidelines for primary hyperparathyroidism (PHPT) recommend high-resolution neck ultrasonography (US), technetium-99m-sestamibi single-photon emission computed tomography (^99mTc-sestamibi SPECT), and contrast-enhanced four-dimensional computed tomography (4D CT) as image evaluation methods. This study aimed to compare the sensitivity and accuracy of the three image evaluation methods recommended in the guidelines for patients with PHPT and evaluate the utility of 4D CT for preoperative localization in single gland disease.</p><p><strong>Methods: </strong>A retrospective medical chart review was performed on 41 patients who underwent surgery for single gland disease at the Department of Otorhinolaryngology, Pusan National University Hospital, between January 2021 and March 2023. All the patients underwent preoperative US, ^99mTc-sestamibi SPECT, and 4D CT. The location of the abnormal parathyroid lesion, removed during surgery and confirmed by postoperative pathological examination, was used as the reference standard. The sensitivity, specificity, and accuracy of the three imaging evaluations were assessed and compared to the reference standard location.</p><p><strong>Results: </strong>The sensitivity, specificity, and accuracy of the imaging modalities were as follows: 4D CT, 95.1%, 98.4%, and 97.6%; US, 82.9%, 95.1%, and 92.1%; and ^99mTc-sestamibi SPECT, 78.0%, 97.6%, and 92.7%, respectively. Furthermore, a total of nine cases were identified where accurate localization could not be achieved through US and ^99mTc-sestamibi SPECT. The presence of coexisting thyroid lesions was significantly correlated with incorrect localization in preoperative US (P<0.05). The small volume of the parathyroid tumor was significantly associated with an increased rate of false-negatives using ^99mTc-sestamibi SPECT (P<0.05).</p><p><strong>Conclusions: </strong>In the preoperative localization of abnormal parathyroid lesions, 4D CT demonstrated higher sensitivity and specificity than US and ^99mTc-sestamibi SPECT. 4D CT can accurately localize abnormal parathyroid lesions, even in cases in which both US and ^99mTc-sestamibi SPECT yielded incorrect localizations.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 3","pages":"305-316"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993246","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":"Nomogram to predict late extraluminal postpancreatectomy hemorrhage in patients with postoperative pancreatic fistula after pancreaticoduodenectomy.","authors":"Yichen Li, Haoqi Zhang, Jun Gong, Yue Jian, Siyu Li, Yuxin Yang, Zhenjiang Zheng, Yonghua Chen, Xing Wang, Xubao Liu, Shanmiao Gou, Chunlu Tan","doi":"10.21037/gs-24-412","DOIUrl":"https://doi.org/10.21037/gs-24-412","url":null,"abstract":"<p><strong>Background: </strong>Late extraluminal postpancreatectomy hemorrhage (LEPPH) is a rare but severe complication of pancreaticoduodenectomy (PD). Current predictors of LEPPH are limited and cannot quantify bleeding risk. As a consequence, establishment of a prediction model of LEPPH is important. This study aims to construct a nomogram combining perioperative factors to predict LEPPH.</p><p><strong>Methods: </strong>A total of 2,924 retrospective and 467 prospective cases undergoing PD, 420 retrospective cases and 131 prospective cases with postoperative pancreatic fistula (POPF) after PD from three centers were included. Three hundred and seventy-one retrospective cases from West China Hospital were divided randomly into the development cohort (n=259) and the internal validation cohort (n=112). Another 180 patients consisting of 49 retrospective and 131 prospective cases from three pancreatic centers were enrolled as the external validation set. A nomogram was established based on the independent risk factors.</p><p><strong>Results: </strong>Multivariable analysis identified pancreaticoenteric anastomotic dorsal fluid accumulation, bubble sign, pancreaticoenteric anastomotic cracking (PEAC), surgery-related acute pancreatitis (AP), and positive culture in intra-abdominal drainage fluid as independent risk factors of LEPPH. Combined with those variables, the nomogram showed reliable C-index of 0.932, 0.924 and 0.954 in predicting LEPPH in the three cohorts respectively.</p><p><strong>Conclusions: </strong>The nomogram exhibited excellent predictive capabilities for LEPPH after PD. It could aid surgeons in early identification of patients prone to LEPPH following PD, enabling timely interventions and improving patient survival.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 3","pages":"281-293"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008366","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":"Navigating the rare: a case report of intrathyroidal thymic carcinoma.","authors":"Xiuming Wang, Huabin Zhang, Bojuan Wang, Lei Zhang","doi":"10.21037/gs-2024-540","DOIUrl":"https://doi.org/10.21037/gs-2024-540","url":null,"abstract":"<p><strong>Background: </strong>Intrathyroidal thymic carcinoma (ITTC) is an exceedingly rare malignancy of the thyroid, which presents significant diagnostic challenges. ITTC often has nonspecific clinical manifestations and histological features similar to other thyroid neoplasms, making its diagnosis difficult. This rarity and complexity result in a lack of consensus on its diagnostic criteria and management strategies. ITTC typically arises from ectopic thymic tissue, and despite its malignancy, it generally has a relatively favorable prognosis when accurately diagnosed and treated in a timely manner.</p><p><strong>Case description: </strong>This case report discusses a rare instance of ITTC in a 38-year-old male patient who presented with a 2-month history of neck lumps, accompanied by symptoms of neck compression and hoarseness. Clinical imaging, including ultrasound, suggested the possibility of lymphoma due to the appearance of a hypoechoic lesion encasing the carotid artery. However, after conducting immunohistochemical analysis, including markers such as CD5 and CD117, a definitive diagnosis of ITTC was made. The case highlights the diagnostic challenges posed by this rare malignancy and the critical role of histopathology in its identification.</p><p><strong>Conclusions: </strong>ITTC is a rare, low-grade malignant tumor that can often be mistaken for other types of thyroid cancers. Multidisciplinary collaboration is essential for accurate diagnosis and optimal treatment planning. While the diagnosis of ITTC can be complex, immunohistochemical markers are instrumental in confirming the presence of this tumor. Despite its rarity, ITTC generally carries a favorable prognosis, with a 5-year survival rate of approximately 90%. This case report contributes to the limited body of literature on ITTC and underscores the importance of recognizing its unique immunophenotype in achieving an accurate diagnosis.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 3","pages":"570-576"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984525","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 multidimensional machine learning-based nomogram for predicting central lymph node metastasis in papillary thyroid microcarcinoma.","authors":"Xingqi Liu, Haoyang Li, Lixin Zhang, Qing Gao, Yingfei Wang","doi":"10.21037/gs-2024-508","DOIUrl":"https://doi.org/10.21037/gs-2024-508","url":null,"abstract":"<p><strong>Background: </strong>Papillary thyroid microcarcinoma (PTMC), a subset of papillary thyroid carcinoma (PTC), is characterized by tumors ≤10 mm in size. While generally indolent, central lymph node metastasis (CLNM) is associated with higher risks of recurrence and distant metastasis. Existing prediction models for CLNM predominantly depend on isolated clinical or imaging parameters, failing to integrate multidimensional predictors such as clinicopathological, ultrasonographic, and serological features. This limitation significantly undermines their clinical applicability. Therefore, we developed a machine learning-based nomogram that integrates comprehensive predictors to enhance preoperative risk stratification and facilitate personalized surgical decision-making.</p><p><strong>Methods: </strong>A retrospective study was conducted on 503 PTMC patients who underwent thyroidectomy in Liaoyang Central Hospital between 2020 and 2023. Patients were randomly divided into training (n=352) and validation (n=151) cohorts. Inclusion criteria required preoperative imaging to confirm no cervical lymph node metastasis (LNM), complete clinicopathologic data, and initial surgery with central lymph node dissection, as well as postoperative pathology confirming PTC. Multidimensional predictors (clinical demographics, ultrasonographic features, serological markers, and histopathological characteristics) were analyzed. CLNM was definitively diagnosed via postoperative histopathology. Least absolute shrinkage and selection operator (LASSO) regression was used to identify key predictors, which were incorporated into a logistic regression model. The model's performance was evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Among 503 enrolled patients (mean age: 48.5 years; male: 24%, female: 76%), CLNM was pathology confirmed in 28.8% (145/503). Age, gender, tumor size, tumor location, and extrathyroidal extension (ETE) were identified as independent predictors of CLNM. The nomogram achieved an area under the curve (AUC) of 0.88 (sensitivity 0.84, specificity 0.76) in the training cohort and 0.78 (sensitivity 0.80, specificity 0.70) in the validation cohort. Calibration plots indicated excellent agreement between predicted and observed probabilities, with mean absolute errors below 0.05. DCA demonstrated clinical utility for threshold probabilities ranging from 15% to 88%. These results suggest that the nomogram has good predictive performance and clinical applicability in assessing the risk of CLNM in PTMC patients.</p><p><strong>Conclusions: </strong>This Machine learning-based predictive nomogram provides a reliable tool for assessing CLNM risk in PTMC patients, supporting personalized surgical strategies. Further validation in external cohorts is required to confirm its generalizability.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 3","pages":"344-357"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963147","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":"Sleep factors and risk of thyroid cancer, nodules and dysfunction: Mendelian randomization study.","authors":"Yuanyuan Fan, Xun Zheng, Tianfeng Xu, Pengyu Li, Yujie Zhang, Yanhao Ran, Tao Wei","doi":"10.21037/gs-24-435","DOIUrl":"https://doi.org/10.21037/gs-24-435","url":null,"abstract":"<p><strong>Background: </strong>The interplay between sleep physiology and endocrine regulation has been well-established, with the thyroid gland, as a key endocrine organ, demonstrating a physiologically plausible. Previous studies have indicated a potential correlation between sleep factors and thyroid diseases, yet causality remains uncertain. Given the complex interplay of confounders associated with sleep disorders and lifestyle factors, we employed a two-sample Mendelian randomization (MR) approach to minimize confounding bias and rigorously investigate the causal relationship.</p><p><strong>Methods: </strong>The specific information on thyroid diseases-including thyroid cancer, thyroid nodules (TNs), and thyroid dysfunction-was obtained from the FinnGen Biobank using the International Classification of Diseases, 10th Revision (ICD-10). Information on sleep factors such as insomnia symptoms, chronotype, and sleep duration were sourced from genome-wide association studies (GWAS) conducted within the UK Biobank, which provides validated GWAS data through self-report assessment. We employed stringent single nucleotide polymorphisms (SNPs) selection criteria as instrumental variables (IVs) for analyzing sleep factors' causal impact on thyroid diseases. Statistical methods including inverse variance weighted (IVW), weighted median (WM), MR-Egger, and MR-PRESSO were utilized to determine causality, supplemented by F-statistics and sensitivity analyses to ensure robustness and detect biases.</p><p><strong>Results: </strong>The analysis supported that a morning chronotype is protective against thyroid cancer, with results showing a significantly reduced risk [IVW: odds ratio (OR) =0.632, 95% confidence interval (CI): 0.426-0.937, P=0.02]. Conversely, insomnia symptoms were identified as a potential risk factor for developing TNs (IVW: OR =1.973, 95% CI: 1.152-3.377, P=0.01). Sensitivity analyses, including Cochran's <i>Q</i> test, MR-Egger intercept, and MR-PRESSO, showed no significant heterogeneity, horizontal pleiotropy, or outliers (all P values >0.05). However, no significant causal links were found between genetic predispositions to sleep factors and thyroid dysfunction.</p><p><strong>Conclusions: </strong>These findings suggest that therapeutic management of sleep disorders could potentially reduce the risk of developing thyroid diseases, underscoring the importance of routine thyroid monitoring in individuals experiencing sleep disturbances.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 3","pages":"368-379"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011072","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}