Thyroid最新文献

{"title":"High-Grade Follicular Cell-Derived Non-Anaplastic Thyroid Carcinoma: Correlating Extent of Invasion and Mutation Profile with Oncologic Outcome.","authors":"Daniel W Scholfield, Bin Xu, Helena Levyn, Alana Eagan, Ashok R Shaha, Jatin P Shah, R Michael Tuttle, James A Fagin, Richard J Wong, Snehal G Patel, Ronald Ghossein, Ian Ganly","doi":"10.1089/thy.2024.0499","DOIUrl":"https://doi.org/10.1089/thy.2024.0499","url":null,"abstract":"<p><p><b><i>Background:</i></b> The 2022 World Health Organization classification introduced the term high-grade follicular cell-derived nonanaplastic thyroid carcinoma (HGFCTC) to define invasive/infiltrative nonanaplastic thyroid carcinoma with high-grade features, including poorly differentiated thyroid carcinoma and high-grade differentiated thyroid carcinoma. Our objectives were to compare clinicopathological characteristics, oncologic outcomes, and mutation profiles among HGFCTC subgroups to better inform prognostication and treatment. <b><i>Methods:</i></b> In this single-center, retrospective cohort study of 252 patients who had surgery for HGFCTC from 1986 to 2020, we categorized HGFCTC and its related entity, \"encapsulated noninvasive neoplasms of follicular cells with high-grade features,\" into five subgroups: (A) encapsulated noninvasive, (B) encapsulated with capsular invasion only (minimally invasive), (C) encapsulated angioinvasive with focal vascular invasion (VI), (D) encapsulated angioinvasive with extensive VI, and (E) infiltrative tumors. Next-generation sequencing with Memorial Sloan Kettering Cancer Center-Integrated Mutation Profiling of Actionable Cancer Targets was available for 117/252 patients to investigate differences in mutation profiles. <b><i>Results:</i></b> The cohort comprised 50% infiltrative, 33% encapsulated angioinvasive, and 18% encapsulated noninvasive/minimally invasive tumors. No patients with encapsulated noninvasive or minimally invasive disease had regional or distant metastases at presentation. Patients with infiltrative tumors were significantly more likely to present with T3/T4 disease (71%), regional metastases (55%), and distant metastases (25%) (<i>p</i> ≤ 0.003<i>).</i> Five-year disease-specific survival was poorer in patients with infiltrative disease (67.7%), compared to encapsulated angioinvasive focal VI (90.4%), encapsulated angioinvasive extensive VI (88.1%), and encapsulated noninvasive/minimally invasive (100%) (<i>p =</i> 0.0002) subgroups. Common mutations were <i>TERT</i> (42%), <i>BRAF<sup>V600E</sup></i> (29%), <i>NRAS</i> (27%), <i>EIF1AX</i> (11%), and <i>TP53</i> (9%). Pathways altered included <i>RTK/RAS/RAF/MAPK</i> (69%), <i>PI3K/AKT/MTOR</i> (14%), histone methyltransferases (9%), and SWI/SNF chromatin remodeling complex (8%). Subgroup analysis showed the infiltrative subgroup was mainly <i>BRAF<sup>V600E</sup></i>-driven, and the encapsulated angioinvasive and minimally invasive subgroups were <i>NRAS-</i>driven. Encapsulated noninvasive tumors had a different mutation profile, with <i>DICER1</i> as the main driver mutation. <b><i>Conclusions:</i></b> HGFCTC comprises different subgroups with different clinical behaviors determined by the extent of vascular invasion and degree of infiltration. Excellent recurrence and survival outcomes occur in encapsulated noninvasive and minimally invasive tumors compared to infiltrative tumors. Infiltrative tumors are largely \"<i>BRAF</","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":"35 2","pages":"153-165"},"PeriodicalIF":5.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399959","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":"Linsitinib Decreases Thyrotropin-Induced Thyroid Hormone Synthesis by Inhibiting Crosstalk Between Thyroid-Stimulating Hormone and Insulin-Like Growth Factor 1 Receptors in Human Thyrocytes <i>In Vitro</i> and <i>In Vivo</i> in Mice.","authors":"Alisa Boutin, Elena Eliseeva, Scott Templin, Bernice Marcus-Samuels, D Eric Anderson, Marvin C Gershengorn, Susanne Neumann","doi":"10.1089/thy.2024.0393","DOIUrl":"10.1089/thy.2024.0393","url":null,"abstract":"<p><p><b><i>Background:</i></b> Thyrotropin receptor (TSHR) and insulin-like growth factor 1 receptor (IGF-1R) have been shown to crosstalk in primary cultures of human thyrocytes (hThyros) and Graves' orbital fibroblasts. The phenomenon of TSHR/IGF-1R crosstalk has been largely studied in the pathogenesis of thyroid eye disease (TED) in human orbital fibroblasts. Here, we investigated the effects of inhibiting the IGF-1R-mediated contribution to crosstalk by linsitinib (Lins), a small-molecule IGF-1R kinase inhibitor, on TSH-induced regulation of thyroperoxidase (TPO) and thyroglobulin (TG) mRNAs and proteins in hThyros <i>in vitro,</i> and on TPO and TG mRNAs and free thyroxine (fT4) levels <i>in vivo</i> in mice. <b><i>Methods:</i></b> Steady-state levels of mRNAs of TPO and TG in hThyros <i>in vitro</i> and mouse thyroid glands were measured by RT-qPCR. Human TG (hTG) and human TPO (hTPO) proteins in human thyroid cell cultures were measured by Western blot or ELISA. Translation rates of hTG were quantified by stable isotope labeling by amino acids method (SILAC). Thyroidal mouse <i>Tpo</i> (m<i>Tpo</i>) and <i>Tg</i> (m<i>Tg</i>) mRNAs and fT4 in mice were assessed after Lins administration on 3 consecutive days followed by an intraperitoneal dose of bovine TSH (bTSH) 3 hours prior to drawing blood. <b><i>Results:</i></b> In primary cultures of hThyros, Lins inhibited bTSH-induced upregulation of hTPO mRNA by 61.5%, and hTPO protein was inhibited by 42.4%. There was no effect of Lins on hTG mRNA, but Lins inhibited the upregulation of secreted and cell-associated hTG protein by 50.1% and 42.2%, respectively, by inhibiting hTG mRNA translation. m<i>Tpo</i> mRNA measured in thyroid glands after treatment with Lins was reduced by 31.5%. There was no effect of Lins on m<i>Tg</i> mRNA, however, Lins decreased fT4 levels in mice under basal (endogenous mTSH levels) and bTSH-treated conditions. <b><i>Conclusions:</i></b> The IGF-1R antagonist Lins inhibited bTSH-stimulated hTG and hTPO protein expression in primary cultures of hThyros and fT4 levels in mice. We suggest that thyroid function studies be monitored when Lins is administered to humans, for example, if it is used to treat TED.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"216-224"},"PeriodicalIF":5.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886030","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":"Strength of Genetic Associations with Thyrotropin Values Differs Between Populations with Similarity to African and European Reference Populations.","authors":"Alisha N Wade, Lindsay Guare, Mahtaab Hayat, Peter Straub, Ziyue Gao, Marco Medici, Alexander Teumer, Lea K Davis, Michèle Ramsay, Marylyn D Ritchie, Penn Medicine BioBank, Anne R Cappola","doi":"10.1089/thy.2024.0525","DOIUrl":"10.1089/thy.2024.0525","url":null,"abstract":"<p><p><b><i>Background:</i></b> Epidemiological data suggest the population distribution of thyrotropin (TSH) values is shifted toward lower values in self-identified Black non-Hispanic individuals compared with self-identified White non-Hispanic individuals. It is unknown whether genetic differences between individuals with genetic similarities to African reference populations (GSA) and those with similarities to European reference populations (GSE) contribute to these observed differences. We aimed to compare genome-wide associations with TSH and putative causal TSH-associated variants between GSA and GSE groups. <b><i>Methods:</i></b> We performed genome-wide association studies (GWAS) in 9827 GSA individuals and 9827 GSE individuals with TSH values between 0.45 and 4.5 mU/L. We compared effect sizes and allele frequencies of previously reported putative causal TSH-associated variants and our power to detect associations with these variants between the two groups. We additionally focused on variants in <i>PDE8B</i> and <i>PDE10A</i>, loci that have been most strongly associated with TSH in previous GWAS in GSE populations. <b><i>Results:</i></b> Four loci attained genome-wide significance in the GSA group compared with seven in the GSE group. <i>PDE8B</i> was not significantly associated with TSH in the GSA group, despite its strong association in the GSE group. Eight putative causal variants had significantly different effect sizes between groups. There was ≥80% power in the GSA group to detect significant associations with variants in <i>PDE8B</i>, <i>PDE10A</i>, <i>NFIA</i>, and <i>LOC105377480</i>, with higher expected power than in the GSE group for variants in <i>PDE8B</i>, <i>NFIA</i>, and <i>LOC105377480</i> and similar power for other variants in <i>PDE8B</i> and <i>PDE10A.</i> No additional putative causal variants in <i>PDE8B</i> and <i>PDE10A</i> had effect sizes that differed significantly between the groups; power to identify associations with additional putative causal variants in <i>PDE8B</i> and <i>PDE10A</i> was similar between the groups. <b><i>Conclusions:</i></b> Patterns of genetic associations with TSH differed between identically sized GSA and GSE groups. Failure to replicate the strongest associations previously reported in GSE individuals in our GSA population was not fully explained by differences in allele frequencies or power, assuming similar effect sizes. Larger GSA population GWAS are necessary to confirm our findings and further investigate the contribution of genetic factors to population differences in the distribution of TSH values.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"131-142"},"PeriodicalIF":5.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047885","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":"High Rates of Unnecessary Surgery for Indeterminate Thyroid Nodules in the Absence of Molecular Test and the Cost-Effectiveness of Utilizing Molecular Test in an Asian Population: A Decision Analysis.","authors":"Man Him Matrix Fung, Ching Tang, Gin Wai Kwok, Tin Ho Chan, Yan Luk, David Tak Wai Lui, Carlos King Ho Wong, Brian Hung Hin Lang","doi":"10.1089/thy.2024.0436","DOIUrl":"10.1089/thy.2024.0436","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Cytologically indeterminate thyroid nodules (Bethesda class III or IV) carry a 10-40% risk of malignancy. Diagnostic lobectomies are frequently performed but negative surgeries incur unnecessary costs on the healthcare system, potential complications, and negative impacts on quality of life. Molecular tests (MTs) have been developed to reduce unnecessary surgeries. However, well-validated, high-performance MTs are often expensive, and their cost-effectiveness has not been studied in the Asian population. This study evaluates the rate of unnecessary surgery in the setting without MT (our current practice) and the cost-effectiveness of introducing a commercially available MT for the management of cytologically indeterminate thyroid nodules in a modernized city in Asia. <b><i>Methods:</i></b> Management decisions and outcomes of consecutive Bethesda III or IV thyroid nodules in a tertiary endocrine surgery center in Hong Kong were evaluated. Costs of health service provided by the public health system, which covers >90% of healthcare service in the city, were retrieved. A decision tree model was developed to compare the cost-effectiveness in avoiding unnecessary surgeries of current practice versus routine MT from a public healthcare provider's perspective. In our current practice, MT was not available, and patients with indeterminate nodules received either upfront lobectomy, repeat fine needle aspiration cytology (FNAC), or active surveillance. <b><i>Results:</i></b> Over a 4-year period, 2157 FNACs were performed. After exclusion, 1957 FNACs were analyzed, and 18.6% were Bethesda III or IV. Thirty-six percent of these cytologically indeterminate nodules received upfront surgery, with 28% having malignancy in final pathology, that is, 72% of surgeries were unnecessary. Routine MT could reduce 82 unnecessary surgeries/year, 26% more than current practice. Routine MT resulted in an incremental cost-effectiveness ratio of Hong Kong dollar (HKD) 49,102 (US dollar [USD] 6314) per unnecessary surgery. Sensitivity analysis showed test cost of MT contributed significantly to incremental cost-effectiveness ratio. Lowering the commercial price of MT to below HKD 8044 (USD 1031) would render routine MT cost-saving. <b><i>Conclusion:</i></b> Currently, a high rate of unnecessary surgeries is being performed for cytologically indeterminate thyroid nodules. MT was more effective in reducing unnecessary surgeries than current practice, but at a higher cost. MT will become cost-saving if the test cost could be lowered.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"166-176"},"PeriodicalIF":5.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012006","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>Letter to the Editor:</i> New Current Procedural Terminology Codes for Radiofrequency Ablation of Thyroid Nodules Will Negatively Affect American Patients According to the Executive Council of the North American Society for Interventional Thyroidology.","authors":"Jonathon O Russell, Timothy Huber, Julia Noel, Maria Papaleontiou, Chelsey K Baldwin, Victoria M Banuchi, Vaninder Dhillon, Sophie Dream, Steven P Hodak, Emad Kandil, Jennifer H Kuo, Kepal N Patel, Catherine F Sinclair, Ralph P Tufano","doi":"10.1089/thy.2024.0722","DOIUrl":"10.1089/thy.2024.0722","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"225-226"},"PeriodicalIF":5.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034216","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":"Long-Term Outcomes in Radioiodine-Resistant Follicular Cell-Derived Thyroid Cancers Treated with [¹⁷⁷Lu]Lu-DOTAGA.FAPi Dimer Therapy.","authors":"Sanjana Ballal, Madhav Prasad Yadav, Swayamjeet Satapathy, Frank Roesch, Kunal R Chandekar, Marcel Martin, Mohammad Shakir, Shipra Agarwal, Sameer Rastogi, Euy Sung Moon, Chandrasekhar Bal","doi":"10.1089/thy.2024.0229","DOIUrl":"10.1089/thy.2024.0229","url":null,"abstract":"<p><p><b><i>Aim:</i></b> The study aimed to analyze the long-term outcomes of [¹⁷⁷Lu]Lu-DOTAGA.FAPi dimer therapy in individuals diagnosed with radioiodine-resistant (RAI-R) follicular cell-derived thyroid cancer. <b><i>Materials and Methods:</i></b> In this retrospective study, 73 patients with RAI-R follicular thyroid carcinoma who had undergone multiple lines of previous treatments were included. Following [⁶⁸Ga]Ga-DOTA.SA.FAPi positron emission tomography-computed tomography scan, among the 73 patients, 65 received [¹⁷⁷Lu]Lu-DOTAGA.FAPi dimer monotherapy with a median activity of 5.5 GBq per cycle at 8-week intervals. The remaining eight patients underwent tandem [¹⁷⁷Lu]Lu/[²²⁵Ac]Ac-DOTAGA.FAPi dimer therapy, consisting of a median of two cycles of [¹⁷⁷Lu]Lu-DOTAGA.FAPi dimer followed by one cycle of [²²⁵Ac]Ac-DOTAGA.FAPi dimer, also at 8-week intervals. The primary endpoint included progression-free survival (PFS) and overall survival (OS). Secondary endpoints included PERCIST criteria response assessment and safety assessment according to Common Terminology Criteria for Adverse Events (V5.0). <b><i>Results:</i></b> We enrolled 37 female and 36 male patients, with a mean age of 54.3 years (range: 27 - 80 years). The patients received a median cumulative activity of 22.2 GBq (range, 4 GBq-55.5 GBq) of [¹⁷⁷Lu]Lu-DOTAGA-FAPi dimer over one to nine cycles, with a median of three cycles. Among 73 patients, 20 died and 16 deaths were due to thyroid cancer. Nineteen patients experienced disease progression, with an estimated median PFS of 29 months [CI 14-34 months]. The estimated median OS was 32 months [CI 21-40 months]. Four patients (5.4%) encountered grade III anemia, primarily linked to bone metastasis in three cases and neck tumor mass bleed in one. Grade III thrombocytopenia occurred in three patients (4%). No grade III renal or hepatotoxicity was observed. <b><i>Conclusion:</i></b> In this study, [¹⁷⁷Lu]Lu-DOTAGA.FAPi dimer therapy showed promising safety and efficacy in aggressive, radioiodine-resistant thyroid cancer, achieving a median PFS and OS of 29 and 32 months, respectively, with manageable adverse events. Confirmation of our findings is needed from prospective clinical trials comparing [¹⁷⁷Lu]Lu-DOTAGA.FAPi dimer therapy to other treatments.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"188-198"},"PeriodicalIF":5.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047865","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":"Radiofrequency Ablation of Low-Risk Papillary Thyroid Microcarcinoma: A Retrospective Cohort Study Including Patients with More than 10 Years of Follow-up.","authors":"So Yeong Jeong, Sun Mi Baek, Suyoung Shin, Jung Min Son, Hyunsoo Kim, Jung Hwan Baek","doi":"10.1089/thy.2024.0535","DOIUrl":"10.1089/thy.2024.0535","url":null,"abstract":"<p><p><b><i>Background:</i></b> The longest reported follow-up for thermal ablation of papillary thyroid microcarcinoma (PTMC) is 5 years. We evaluated the long-term efficacy and safety of radiofrequency ablation (RFA) in patients with low-risk PTMC with clinical follow-up of more than 10 years. <b><i>Methods:</i></b> In this retrospective cohort study, we included patients with low-risk PTMC who had more than 10 years of follow-up after ultrasound (US)-guided RFA (performed between May 2008 and December 2013). Sixty-five consecutive patients with 71 low-risk PTMCs who were unsuitable for surgery or declined surgery were included. Before RFA, all patients underwent US and thyroid computerized tomography. Repeat RFA for staged ablation was performed when the first RFA did not secure sufficient safety margins because of the tumor closely abutting the recurrent laryngeal nerve. Follow-up US imaging was performed at 1 week, 3 months, 6 months, every 6 months until 2 years, and then annually afterward. Primary outcomes were the respective cumulative rates of disease progression (defined by local tumor progression, lymph node, or distant metastasis), newly developed thyroid cancer, and conversion surgery. Secondary outcomes were serial volume reduction rate (VRR), complete disappearance rate of ablated PTMC, and adverse events associated with procedures. <b><i>Results:</i></b> Of 65 patients included in the study, 60 had unifocal and 5 had multifocal PTMCs. The mean number of RFA sessions per tumor was 1.2, and the median follow-up duration was 151 months (interquartile ranges, 131-157). Twenty percent (13/65) of patients required repeat RFA. There were no cases of disease progression. Five patients (5/65, 7.7%) developed a new papillary thyroid cancer (four treated with RFA and one with lobectomy). At 24 months, the mean VRR was 100%, and this was maintained throughout the final follow-up. The complete tumor disappearance rates after one or more RFA treatments were 40.8% (29/71), 74.6% (53/71), and 100% (71/71) at 6, 12, and 24 months, respectively. One major (subclinical hypothyroidism) and three minor adverse events occurred. <b><i>Conclusions:</i></b> In our experience, RFA of low-risk PTMC is effective and safe. During more than 10 years of follow-up, we observed no incident local tumor progression nor metastases, but 7.7% of patients developed a new papillary thyroid cancer.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"143-152"},"PeriodicalIF":5.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047870","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":"Association Between Serum Thyrotropin and Cancer Recurrence in Differentiated Thyroid Cancer: A Population-Based Retrospective Cohort Study.","authors":"Judy K Qiang, Rinku Sutradhar, Karl Everett, Antoine Eskander, Iliana C Lega, Afshan Zahedi, Lorraine Lipscombe","doi":"10.1089/thy.2024.0330","DOIUrl":"10.1089/thy.2024.0330","url":null,"abstract":"<p><p><b><i>Background:</i></b> Levothyroxine to suppress thyrotropin (TSH) to <0.5 mIU/L following thyroidectomy in differentiated thyroid cancer (DTC) may reduce recurrence in higher-risk DTC. However, there is limited evidence to support guideline recommendations to maintain TSH in the low-normal range of 0.5-2 mIU/L to reduce recurrence in patients with lower risk DTC. The primary objective was to assess the association between exposure to high normal serum TSH (2-4 mIU/L) as compared with low normal TSH (0.5-2 mIU/L) target ranges and cancer recurrence in patients with DTC after thyroidectomy. <b><i>Methods:</i></b> This population-based retrospective cohort study used linked, administrative health care databases from Ontario, Canada, to follow patients with DTC post-thyroidectomy from 2007 to 2018. The exposure was time updated, serum TSH, treated as a cumulative and instantaneous exposure. Multivariable cause-specific proportional hazard regression analyses were performed to determine time to DTC recurrence from index date, defined as a composite of repeat neck surgery, radioactive iodine (RAI) treatment, and/or DTC-specific death. Results were also stratified by initial treatment as a marker of baseline recurrence risk in a sensitivity analysis. <b><i>Results:</i></b> This cohort of 26,336 individuals (78% female) with DTC and a median age of 50 years were followed for a median of 5.9 (interquartile range 3.6-8.6) years; 40.9% were initially treated with a hemi-thyroidectomy only and 38.2% received a total thyroidectomy and RAI. Compared with exposure to TSH 0.5 to ≤2 mIU/L, DTC recurrence rate was similar for each additional 3 months of exposure to TSH >2 to ≤4 mIU/L (adjusted cause specific [cs] hazard ratio [HR] 0.99 [confidence interval or CI 0.97-1.02]) but was significantly increased with each additional 3 months of exposure to TSH >4 mIU/L (adjusted csHR 1.07 [CI 1.04-1.09]). Results were similar across baseline treatment groups. <b><i>Conclusion:</i></b> There was no difference in clinically significant recurrence in those with low-risk DTC maintained with a TSH of 0.5-2 mIU/L compared with 2-4 mIU/L. Guidelines should consider liberalizing target TSH level post thyroidectomy in low-risk cohorts. These results cannot be applied to patients with high-risk DTC.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"208-215"},"PeriodicalIF":5.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898200","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":"Statin Use and the Risk of Graves' Orbitopathy: A Nationwide Population-Based Cohort Study.","authors":"Yu-Tsung Chou, Chun-Chieh Lai, Chung-Yi Li, Wei-Chen Shen, Yu-Tung Huang, Yi-Lin Wu, Yi-Hsuan Lin, Deng-Chi Yang, Yi-Ching Yang","doi":"10.1089/thy.2024.0536","DOIUrl":"10.1089/thy.2024.0536","url":null,"abstract":"<p><p><b><i>Background:</i></b> Statin use is reported to reduce the risk of Graves' orbitopathy (GO) in Western populations. However, study regarding the protective effect of statins against GO in Asians with Graves' disease (GD) is scarce. This study aims to investigate the efficacy of statins in preventing GO in Asian GD patients. <b><i>Materials and Methods:</i></b> This nationwide, population-based retrospective cohort study used data from beneficiaries aged >40 years diagnosed with GD from the National Health Insurance Research Database (NHIRD) from 2010 to 2020. The International Classification of Diseases codes, Anatomical Therapeutic Chemical codes, and the surgery/procedure codes derived from the NHIRD were used to obtain the information on GD, GO, and statin use. Propensity score (PS) analysis with matching and inverse probability of treatment weighting analysis (IPTW) was conducted to minimize confounding. The Kaplan-Meier survival analysis and multivariable Cox regression analysis were used to compare the risk of GO among statin users and nonusers. <b><i>Results:</i></b> The final analysis included 102,858 patients; 7,073 were statin users (62.9 ± 10.6 years, 29.7% male), and 95,785 were nonusers (53.6 ± 10.4 years, 25.7% male). The crude incidence rate of GO among statin users and nonusers was 5.00‰ versus 6.75‰ and 4.91‰ versus 5.15‰ for the overall population and population after PS matching method, respectively. The Cox regression analysis showed that statin users had a significantly lower risk of GO (adjusted hazard ratio [HR] after PS matching 0.79, 95% confidence interval [CI]: 0.63-0.99, <i>p</i> = 0.037; adjusted HR after IPTW method: 0.64, CI: 0.51-0.79, <i>p</i> < 0.001). The risk of GO was not different among users of different kinds of statins (i.e., atorvastatin, rosuvastatin, pitavastatin, and other statins) or among different intensities of statins (low-to-moderate intensity vs. high intensity). <b><i>Conclusions:</i></b> The use of statins in Asian GD patients was associated with a reduced risk of GO. In addition, the risk of developing GO among users of commonly prescribed statins or users of different intensities of statins was not significantly different.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"199-207"},"PeriodicalIF":5.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971063","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":"Summary of the Year in Review Lectures at the 2024 Annual Meeting of the American Thyroid Association.","authors":"Douglas Forrest, Jennifer A Sipos, Elizabeth G Grubbs","doi":"10.1089/thy.2024.0735","DOIUrl":"10.1089/thy.2024.0735","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"123-130"},"PeriodicalIF":5.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053642","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}