Thyroid最新文献

{"title":"<i>Corrigendum to:</i> Clinical and Surgical Year in Review.","authors":"","doi":"10.1177/10507256251388007","DOIUrl":"10.1177/10507256251388007","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1351"},"PeriodicalIF":6.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Clinical Outcomes for Total Thyroidectomy/Lobectomy and Isthmusectomy in Patients with Isthmic Papillary Thyroid Carcinoma.","authors":"Seungho Lee, Su-Jin Kim, June Young Choi, Nanhee Park, Jayoun Kim, Yoon Kong, Hye Lim Bae, Ja Kyung Lee, Woochul Kim, Hyeong Won Yu, Young Jun Chai, Kyu Eun Lee","doi":"10.1177/10507256251382600","DOIUrl":"10.1177/10507256251382600","url":null,"abstract":"<p><p><b><i>Background:</i></b> The optimal surgical extent for isthmus-confined papillary thyroid carcinoma (PTC) remains unclear. We aimed to evaluate the clinicopathological characteristics, surgical complications, and recurrence rates based on the extent of resection. <b><i>Methods:</i></b> This retrospective cohort study included 345 patients who underwent thyroidectomy for solitary isthmus-confined PTC at two affiliated tertiary centers from 2013 to 2022. Patients were excluded if they had multifocal PTC with lobar involvement, large tumors (>4 cm), suspected extrathyroidal extension (ETE), clinically positive lymph nodes (LNs), or aggressive histological subtypes. Clinicopathological features, surgical complication rates, and recurrence rates were compared among the total thyroidectomy (TT), lobectomy (L), and isthmusectomy (I) groups. This retrospective cohort study used propensity score matching (PSM), resulting in two groups of 85 patients: TT/L and I. <b><i>Results:</i></b> Among the 345 included patients, 89 underwent TT, 30 underwent L, and 226 underwent I. After PSM, 170 patients were analyzed. The mean age was 48.2 years, and the mean tumor size was 0.8 cm. Microcarcinoma accounted for 71.8% of cases. The rates of ETE (65.3%), multifocality (9.4%), <i>BRAF</i> mutation (75.3%), and Hashimoto's thyroiditis (19.4%) were observed without significant differences between the TT/L and I groups. Risk stratification for central LN metastasis showed no significant difference (high-risk: 21.2% vs. 27.1%, <i>p</i> = 0.353). No recurrence or distant metastasis was observed in either group during a median follow-up of 4.3 years. Median follow-up was longer in the TT/L group (6.1 years [interquartile range (IQR): 4.0-8.5] vs. 3.6 years [IQR: 2.1-4.9], <i>p</i> < 0.001). Major complications were more frequent in TT/L group: transient/permanent hypocalcemia (14.1%/1.2% vs. 0%/0%) and transient vocal cord palsy (3.5% vs. 0%). Levothyroxine dependency was significantly higher in the TT/L group in terms of usage (90.6% vs. 34.1%, <i>p</i> < 0.001), average administered dose (85.5 ± 45.1 µg vs. 21.9 ± 33.2 µg, <i>p</i> < 0.001), and duration (5.2 ± 3.1 years vs. 0.9 ± 1.3 years, <i>p</i> < 0.001). Newly noted thyroid lesions occurred more frequently in the I group (1.3% vs. 10.6%, <i>p</i> = 0.039). <b><i>Conclusions:</i></b> Isthmusectomy may be considered for carefully selected patients with isthmus-confined PTC. Validation in long-term prospective studies is warranted.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1322-1330"},"PeriodicalIF":6.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Corrigendum to:</i> 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer.","authors":"","doi":"10.1177/10507256251387671","DOIUrl":"10.1177/10507256251387671","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1350"},"PeriodicalIF":6.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Germline Telomere-Regulating Gene Variants Are Not Associated with Thyroid Cancer in a Saudi Arabian Population.","authors":"Ali S Alzahrani, Burair Alsaihati, Allianah Benito, Balgees Alghamdi, Kheloud M Alhamoudi, Arwa Alsaud, Norah Altuwaijri, Midrar Alhossiny, Ahmed Alfares, Avaniyapuram Kannan Murugan","doi":"10.1177/10507256251388092","DOIUrl":"10.1177/10507256251388092","url":null,"abstract":"<p><p><b><i>Background:</i></b> Germline variants in the telomere-regulating genes (TRG) of the shelterin complex have recently been associated with long telomere length and increased risk of several tumors, including thyroid cancer (TC). We aimed to validate these findings in a different ancestral population. <b><i>Patients and Methods:</i></b> We conducted a cross-sectional study in a tertiary care hospital in Saudi Arabia. We included 189 patients with sporadic TC and 63 members of 26 families with at least two members with TC. Whole exome sequencing was performed on genomic DNA isolated from peripheral blood, and bioinformatics analysis focused on TRG variants. <b><i>Results:</i></b> In the 189 sporadic TC patients, 8 TRG variants were found in 39 patients (20.6%). These included 3 <i>ACD</i> variants in 30 patients (NM_001082486.2: c.22G>A, c.617A>C and c.824C>T), 2 variants in <i>TERF1</i> in 4 patients (NM_003218.4: c.162_163insGAG and c.1126C>G) and 3 variants in <i>TERT</i> in 5 patients (NM_198253: c.769G>T, c.76A>G and c.1323_1325del). In 63 patients with a family history of TC (26 families), only two variants were found: a <i>TERF1</i> variant in one patient (NM_017489.3: c.347C>T), and an <i>ACD</i> variant (NM_001082486.2: c.22G>A) in 2 affected members of a 4-member family with papillary TC and in another patient from an unrelated family. All the TRG variants found in this study were either variants of unknown significance or likely benign. The TRG variants described in the recent studies from the United States were absent in the current study and our local database of >18,000 exomes. <b><i>Conclusions:</i></b> Unlike the recently reported results from the United States, TRG variants do not seem to play a role in sporadic or familial TC samples from the Saudi Arabian population. These results suggest that the role of TRG variants may vary among different ethnic populations and call for validation of these findings in diverse populations.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1277-1284"},"PeriodicalIF":6.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2025 American Thyroid Association Thyroid Cancer Guidelines-Praise and Pleas.","authors":"Peter A Kopp","doi":"10.1177/10507256251393510","DOIUrl":"10.1177/10507256251393510","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1211-1213"},"PeriodicalIF":6.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Rescue of a Subset of Thyroid Follicular Cells Restores Thyroid Function in Dyshormonogenic <i>Duoxa^-/-</i> Mice.","authors":"Sami Djerbib, Helmut Grasberger, Steven Goossens, Jody Haigh, Lieven Haenebalcke, Tim Pieters, Jukka Kero, Françoise Miot, Xavier De Deken","doi":"10.1177/10507256251388325","DOIUrl":"10.1177/10507256251388325","url":null,"abstract":"<p><p><b><i>Background:</i></b> Under sufficient iodine supply, dual oxidase (DUOX)-dependent H₂O₂ production constitutes the limiting factor for thyroid hormone (TH) synthesis. Inherited loss-of-function mutations in related genes can trigger congenital hypothyroidism (CH). TH supplementation is not always well-tolerated and requires dose adjustments throughout life. Regenerative medicine directed at thyroid follicular cells (TFCs) could offer an alternative therapy; however, the minimal number of TFCs to be corrected remains unknown. <b><i>Methods:</i></b> Thyroid dyshormonogenesis in <i>Duoxa^-/-</i> deficient mice was rescued by conditional thyroid-specific expression of DUOXA2/DUOX2 subunits. In order to restrict reactivation in a subset of TFCs, low doses of tamoxifen (0.1-2 mg) were injected. Thyroid function was assessed by immunostaining of iodinated-thyroglobulin (iTG). Circulating serum thyrotropin (TSH) and total thyroxin (T4) were quantified, and thyroidal expression of TSH-responsive genes (<i>Nis</i>, <i>Tpo</i>, <i>Tshr</i>) and hepatic deiodinase type-1 (<i>Dio1</i>) was measured. Last, combining iTG immunostaining with Duox2 <i>in situ</i> hybridization, we estimated the fraction of rescued TFCs required to restore follicular TG iodination. <b><i>Results:</i></b> Colloidal iTG⁺ staining in more than 90% of follicles demonstrated the successful rescue of TH biogenesis in doxycycline-induced Tet:<i>Da2D2^+/-</i>;<i>mTg</i>:CreER^T2+/<i>^-</i>;<i>Duoxa^-/-</i> animals (3TA). In contrast, reducing tamoxifen doses to 0.1 mg resulted in unresolved primary CH with thyroid enlargement, induction of <i>Nis</i>, <i>Tpo</i>, and <i>Tshr</i>, decrease of <i>Dio1</i>, and growth delay. Corresponding thyroid sections revealed scattered iTG⁺ colloidal lumens dispersed in histologically altered parenchyma. Nevertheless, we determined that only 11-15% of TFCs need to be reactivated within the follicle to functionally restore iodide organification. Goiter involution was also studied in 3TA following functional oxidase recovery or levothyroxine supplementation. Although thyroid enlargement was similarly reduced in both groups, expression of <i>Nis</i>, <i>Tpo</i>, <i>Tshr</i>, and <i>Dio1</i> more rapidly normalized in genetically rescued 3TA. In these pathological conditions, around 50-70% of iTG⁺ follicles would seem sufficient to recover a healthy thyroid function until two weeks. <b><i>Conclusions:</i></b> Our data in <i>Duoxa^-/-</i> mice suggest that the percentage of TFCs to be corrected is limited to 10-15% per follicle, which could be compatible with future somatic gene therapies. Furthermore, the reconstitution of hormonogenic-competent TFCs successfully results in goiter resolution, to an extent comparable to that of gold-standard TH replacement therapy.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1230-1244"},"PeriodicalIF":6.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Tolerability of Selpercatinib Compared to Cabozantinib/Vandetanib: A Secondary Analysis of the LIBRETTO-531 Randomized-Controlled Trial in <i>RET</i>-Mutant Medullary Thyroid Cancer.","authors":"Rossella Elisei, Lori J Wirth, Jaume Capdevila, Ana Oliveira Hoff, Makoto Tahara, Eric J Sherman, Mimi I Hu, Ming-Hua Ge, Jonathan Wadsley, Fernanda Vaisman, Katerina Kopeckova, Jolanta Krajewska, Dinorath Olvera, Collin Churchill, Patricia Maeda, Adrienne M Gilligan, Yan Lin, Nalin Payakachat, Bruce Robinson, Julien Hadoux, Marcia S Brose","doi":"10.1177/10507256251367352","DOIUrl":"10.1177/10507256251367352","url":null,"abstract":"<p><p><b><i>Background:</i></b> Progression-free survival (PFS) may not fully capture the impact of treatment on patients, especially in cancers with longer natural histories and thus, could be complemented by robust measures of patient-reported tolerability (PRT). We report the use of a novel, quantifiable PRT metric as a multiplicity-controlled endpoint to support regulatory and clinical decision-making for selpercatinib use. Comparative PRT was assessed in LIBRETTO-531 (NCT04211337), a randomized phase 3 trial of selpercatinib versus vandetanib/cabozantinib (control) in advanced <i>RET</i>-mutant medullary thyroid cancer (MTC). <b><i>Patients and Methods:</i></b> Patients were self-administered the single Functional Assessment of Cancer Therapy item GP5: \"I am bothered by side effects\" weekly, and scores were dichotomized into \"low\" (0-2) and \"high\" (3-4) side-effect burden. PRT measured the proportion of time on treatment (PTT) with \"high\" side-effect burden for each patient. Comparative PRT was tested at a two-sided significance level of 0.05, conditional on achieving significance for efficacy endpoints. Complementary patient-reported outcomes included health-related quality of life (HRQoL) and symptomatic adverse events self-administered at baseline and at different intervals post-baseline during treatment period. <b><i>Results:</i></b> In the tolerability evaluable population (N = 242; selpercatinib n = 161 and control n = 81 [56 received cabozantinib, 25 received vandetanib]), patients on selpercatinib had significantly better PRT with lower PTT with \"high side-effect burden\" than control (8% vs. 24%, <i>p</i> < 0.0001). Post-baseline compliance rates for PRO questionnaires were generally greater than 80% in both treatment groups. Patients on selpercatinib reported significantly less PTT with HRQoL impairment across physical (36% vs. 52%), role (2% vs. 11%), cognitive (4% vs. 8%), emotional (6% vs. 11%), and social (2% vs. 8%) function (all <i>p</i> < 0.01); and significantly less PTT with severe diarrhea (5% vs. 38%), fatigue (6% vs. 21%), taste change (3% vs. 15%), decreased appetite (2% vs. 15%), and hand-foot syndrome (2% vs. 9%) (all <i>p</i> < 0.001). <b><i>Conclusion:</i></b> This study demonstrated superior PRT for selpercatinib compared with control in patients with <i>RET</i>-mutant MTC, further supporting selpercatinib use as the first-line treatment for patients with advanced <i>RET</i>-mutant MTC. Comparative PRT deserves further adoption as a complement to traditional endpoints in future randomized-controlled trials.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1162-1172"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Corrigendum to:</i> Clinical Outcomes of Congenital Hypothyroidism Due to <i>DUOX2</i> Biallelic Mutations after Levothyroxine Withdrawal.","authors":"","doi":"10.1177/10507256251384934","DOIUrl":"10.1177/10507256251384934","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1208"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Corrigendum to:</i> A Phase 2 Study of Encorafenib in Combination with Binimetinib in Patients with Metastatic <i>BRAF</i>-Mutated Thyroid Cancer in Japan.","authors":"","doi":"10.1177/10507256251384793","DOIUrl":"10.1177/10507256251384793","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1209"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Features of Chinese Patients with Thyroid Eye Disease: A Multicenter Retrospective Study.","authors":"Chaoyu Lei, Xukun Lyu, Yujie Ren, Dingwei Wei, Siyuan Zhang, Yuwei Zhang, Liu Wang, Libin Liu, Junping Wen, Xiaowei Liu, Chaobin Lin, Wei Lu, Jian Liu, Runchuan Li, Shuo Zhang, Xuefei Song, Zhangsheng Yu, Rebecca S Bahn, Huifang Zhou","doi":"10.1177/10507256251359559","DOIUrl":"10.1177/10507256251359559","url":null,"abstract":"<p><p><b><i>Background:</i></b> Thyroid eye disease (TED) is a debilitating autoimmune disorder linked to thyroid dysfunction. There is limited knowledge of TED in Asian populations. This multicenter study characterizes the clinical features and treatment response of TED in a large Chinese cohort. <b><i>Methods:</i></b> A retrospective multicenter study included 4157 patients with TED from nine Chinese hospitals from February 2016 to July 2023. Disease severity and activity were evaluated according to the European Group on Graves' Orbitopathy standards. We examined associations of variables including sex, age, smoking status, I¹³¹ treatment, consultation department, and geographical region with clinical outcomes. Logistic regression and nomogram models were developed to examine associations with sight-threatening TED and, in a subgroup analysis (<i>n</i> = 126), patients' responsiveness to intravenous glucocorticoid (IVGC) therapy. <b><i>Results:</i></b> We included 4157 patients with mean age and standard deviation (SD) 45.96 ± 16.44 years. Of these, 63.6% (<i>n</i> = 2644) were females. Over half (55.6%, <i>n</i> = 2310) of participants were in the inactive phase, with a mean clinical activity score of 2.19 ± 1.61 (SD) for all patients. TED severity was categorized as mild (9.3%, <i>n</i> = 385), moderate-to-severe (82.5%, <i>n</i> = 3428), and sight-threatening (8.2%, <i>n</i> = 344). The average degree of exophthalmos was 20.04 ± 5.27 mm, and 48.8% (<i>n</i> = 2029) of patients had diplopia. Patients treated with I¹³¹ had higher disease activity (47.5%, <i>n</i> = 468, vs. 43.5%, <i>n</i> = 1379, <i>p</i> < 0.05). Coastal region patients exhibited more severe TED (sight-threatening cases: 10.1%, <i>n</i> = 195, vs. 7.2%, <i>n</i> = 147) and higher diplopia scores (1.00 ± 1.10 vs. 0.86 ± 1.09, <i>p</i> < 0.001) than inland counterparts. TED severity was also greater in patients treated in Ophthalmology departments (mild cases: 6.0%, <i>n</i> = 213; moderate-to-severe cases: 85.6%, <i>n</i> = 3055) compared with Endocrinology departments (mild cases: 29.3%, <i>n</i> = 172; moderate-to-severe cases: 63.5%, <i>n</i> = 373). Nomograms had an area under the receiver operating curve of 0.742 (confidence interval [CI] 0.716-0.768) for sight-threatening TED and 0.759 (CI 0.674-0.843) for IVGC therapy responsiveness. <b><i>Conclusions:</i></b> We characterized the clinical features and treatment response of TED in a large Chinese cohort. These findings offer valuable insights informing TED risk stratification in Asian patients and forming a foundation for future prospective studies.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1187-1197"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}