Thyroid最新文献

{"title":"Suppressed cGAS-STING DNA Sensing Drives Immune Evasion in Anaplastic Thyroid Cancer.","authors":"Xu-Guang Zhu, Manju Acharya, Eunmi Hwang, Nathan Wong, Naris Nilubol, Sheue-Yann Cheng","doi":"10.1177/10507256261481666","DOIUrl":"10.1177/10507256261481666","url":null,"abstract":"<p><strong>Background: </strong>Anaplastic thyroid cancer (ATC) is a highly lethal malignancy with poor survival and limited therapeutic options. The mechanisms driving immune evasion in ATC remain poorly understood. The cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway is a key mediator of innate immune sensing and antitumor immunity.</p><p><strong>Methods: </strong>We investigated the role of cGAS-STING signaling in ATC using three complementary models (i) a genetically engineered mouse model harboring triple mutations in <i>Thrb1</i>, <i>Trp53</i>, and <i>Pten</i> (RU3 model); (ii) an orthotopic tumor model derived from <i>Trp53</i>- and <i>Braf</i>-mutant ATC cells; and (iii) subcutaneous tumor models of <i>Ifnb1</i>- or <i>Trp53</i>-expressing ATC cells. Tumor immune microenvironment alterations were assessed using comprehensive molecular approaches, including single-cell RNA sequencing.</p><p><strong>Results: </strong>The models demonstrated marked suppression of cGAS-STING signaling during ATC progression. This suppression was associated with impaired antitumor immunity, characterized by reduced CD8⁺ T cell infiltration and diminished type I interferon (IFN-I) responses. Restoration of IFNβ1 signaling in ATC cells significantly enhanced CD8⁺ T cell recruitment and inhibited tumor growth <i>in vivo</i>. These findings indicate that immune evasion in ATC is driven by decreased IFNβ1 production rather than resistance to its downstream effects. Mechanistically, p53 was found to sustain cGAS-STING-IFNβ1-mediated antitumor immunity, and its loss contributed to reduced IFNβ1 expression and immune escape.</p><p><strong>Conclusions: </strong>Impaired DNA sensing via suppression of the cGAS-STING-IFNβ1 axis promotes immune evasion in ATC. Therapeutic strategies aimed at restoring this pathway may enhance antitumor immunity and represent a promising approach for treating this aggressive disease.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1074-1084"},"PeriodicalIF":6.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819520","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":"Pregnancy after Hemithyroidectomy: Increased Risk of Gestational Overt Hypothyroidism Despite Favorable Obstetric Outcomes: A Nationwide Study.","authors":"Tzahi Yamin, Auriane Asias, Yonathan Osovizky, Oren Ziv, Keren Bartal, Lior Tolkin, Gregory W Randolph, Marika Russell, Elizabeth N Pearce, Jeremy Freeman, Neil Tolley, Roy Kessous, Uri Yoel, Oded Cohen","doi":"10.1177/10507256261483410","DOIUrl":"10.1177/10507256261483410","url":null,"abstract":"<p><strong>Background: </strong>To assess the association between preconception hemithyroidectomy and the risk of gestational hypothyroidism and obstetric outcomes.</p><p><strong>Methods: </strong>This nationwide population-based retrospective cohort study compared euthyroid pregnant women with a history of hemithyroidectomy prior to conception with age- and body mass index-matched (81 ratio) pregnant women with intact thyroid glands. Data were retrieved from a comprehensive integrated healthcare database. The primary outcome was overt gestational hypothyroidism (elevated thyrotropin [TSH] with low free T4). Secondary outcomes included thyroid hormone replacement therapy, obstetric complications, and the interval from surgery to the onset of overt hypothyroidism during pregnancy.</p><p><strong>Results: </strong>A total of 521 pregnancies following hemithyroidectomy were compared with 4168 matched control pregnancies. Overt gestational hypothyroidism was significantly more frequent among women with prior hemithyroidectomy than among controls (22.5% vs. 1.9%, <i>p</i> < 0.001), and the risk was highest among those operated for thyroid cancer. Thyroid hormone replacement therapy during pregnancy was markedly higher in the hemithyroidectomy cohort (19% vs. 2.7%, <i>p</i> < 0.001). TSH levels exceeding 10 mIU/L occurred in 4.7% of exposed pregnancies compared with less than 0.1% of controls (<i>p</i> < 0.001). The median interval from surgery to gestational diagnosis was 2.5 years (interquartile range, 1.0-5.4 years), with nearly two-thirds of affected women already meeting biochemical criteria at their first prenatal assessment. Notably, a profound surveillance gap was uncovered 29.5% of post-hemithyroidectomy women completely missed first-trimester TSH screening. Despite the higher burden of biochemical thyroid dysfunction, absolute rates of adverse obstetric outcomes did not differ significantly between cohorts.</p><p><strong>Conclusions: </strong>Preconception hemithyroidectomy is associated with a markedly increased risk of gestational hypothyroidism and a higher need for thyroid hormone replacement, particularly in women treated for thyroid cancer. These findings support closer biochemical monitoring during pregnancy, in line with current guidelines. Despite this increased risk, obstetric outcomes were similar to those of women with intact thyroid glands.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1106-1115"},"PeriodicalIF":6.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808921","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":"A Novel Protocol for Pre-Treatment Diagnostic ¹³¹I Scan Within 24 Hours Post-Second rhTSH Administration to Guide Radioiodine Therapy in Differentiated Thyroid Cancer.","authors":"Rongfang Shen, Huiting Yang, Xiaoting Ye, Ziqing Li, Xuequn Zhu, Rongqin Zhang, Zhanwen Zhang","doi":"10.1177/10507256261483389","DOIUrl":"10.1177/10507256261483389","url":null,"abstract":"<p><strong>Background: </strong>In the current conventional recombinant human thyrotropin (rhTSH) protocol, radioiodine therapy (RAIT) is given at 24 h post-second injection and diagnostic ¹³¹I whole-body scan (Dx-WBS) at 72 h; hence, Dx-WBS cannot precede RAIT within the same two-injection cycle. This study aimed to evaluate whether Dx-WBS could be performed within 24 hours after the second injection of a novel rhTSH, thereby enabling timely pre-RAIT evaluation without altering the established rhTSH-based RAIT schedule.</p><p><strong>Methods: </strong>This single-center, prospective trial enrolled patients with differentiated thyroid carcinoma (DTC) who had undergone total thyroidectomy. All patients received rhTSH (0.9 mg daily) on 2 consecutive days. On the same day, about 6 hours after the second rhTSH injection, a low-dose diagnostic activity of ¹³¹I was given, followed by Dx-WBS at approximately 12, 18, and 24 hours post-administration. RAIT was administered on the same day following the 24-hour Dx-WBS, and post-treatment whole-body scan (Rx-WBS) served as the reference standard for assessing concordance with Dx-WBS. Thyroglobulin (Tg) and anti-thyroglobulin antibody (TgAb) levels were measured at baseline and at 6, 24, and 72 hours following the second rhTSH injection. In TgAb-negative patients, sTg values were stratified into three categories (<1, 1-10, and ≥10 ng/mL), and concordance of 6h- and 24h-sTg with 72h-sTg was assessed based on identical categorization.</p><p><strong>Results: </strong>A total of 110 patients were eventually enrolled, concordance rates of 12h-, 18h-, and 24h-Dx-WBS with Rx-WBS were 82.7% [CI: 74.3-89.3%], 91.8% [CI: 85.0-96.2%], and 92.7% [CI: 86.2-96.8%], respectively. Concordance at both 18 and 24 hours was significantly higher than that at 12 hours (<i>p</i> < 0.05). The concordance rate of 24-hour sTg with 72-hour sTg was significantly higher than that of 6-hour sTg (89.3%, [CI: 80.1-95.3%] vs. 72.0%, [CI: 60.4-81.8%], <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>The rhTSH-aided Dx-WBS and sTg, performed within 24 hours post-second rhTSH injection, are reliable and efficient in enabling pre-RAIT disease evaluation and subsequent RAIT within the same two-injection cycle, providing a cost-effective strategy.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1085-1093"},"PeriodicalIF":6.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814194","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":"Predictors of Long-Term Fatigue in Patients with Differentiated Thyroid Cancer: A Nationwide Prospective Study.","authors":"Julia Winter, Erland Axelsson, Stephanie Bonn, Catharina Ihre Lundgren, Linda Björkhem-Bergman, Christel Hedman","doi":"10.1177/10507256261479260","DOIUrl":"10.1177/10507256261479260","url":null,"abstract":"<p><strong>Background: </strong>Fatigue is a frequent and distressing symptom in patients with differentiated thyroid cancer (DTC) and may persist for years posttreatment, negatively impacting the quality of life. This study aimed to investigate predictors of long-term fatigue in DTC patients to identify patients who may benefit from early intervention to prevent fatigue and to examine whether thyrotropin (TSH) suppression is associated with fatigue.</p><p><strong>Methods: </strong>This nationwide prospective study included 351 DTC patients treated with thyroidectomy and planned for radioiodine treatment during 2012-2017 in Sweden. Patients completed the Short Form-36 Health Survey (SF-36) and a study-specific questionnaire at inclusion and after 1, 3, and 5 years. Fatigue was assessed using the SF-36 vitality subscale. TSH values were retrieved from medical records. Fatigue 5 years after DTC treatment was predicted using linear regression with the following variables measured at 1 year: age, sex, education, number of comorbidities, body mass index (BMI), smoking, DTC risk, bodily pain, mental health, fatigue, sleep disturbance, change in view of life after diagnosis, and fear of cancer recurrence. The association between TSH and fatigue was studied using linear mixed models.</p><p><strong>Results: </strong>In univariable linear regression analyses, significant early predictors of 5-year fatigue were a higher number of comorbidities, higher BMI, more bodily pain, worse mental health, more early fatigue, more sleep disturbance, a negative view of life following DTC diagnosis, and greater fear of cancer recurrence. Fatigue and poor mental health 1 year after DTC treatment were highly correlated (<i>r</i> = 0.79) and therefore analyzed in separate multivariable models. In multivariable regression analyses, fatigue at year one remained a significant predictor of fatigue at year five (<i>β</i> = 0.66, <i>p</i> < 0.001). Worse mental health also remained a significant predictor of fatigue at year five (<i>β</i> = -0.41, <i>p</i> < 0.001). TSH was not a significant predictor of fatigue ( <i>p</i> = 0.161).</p><p><strong>Conclusions: </strong>This study found several predictors of long-term fatigue in DTC patients. One year after treatment, fatigue and poor mental health are particularly important predictors of long-term fatigue. TSH suppression does not explain fatigue in DTC patients. Identifying early fatigue and mental health issues in the clinic posttreatment is important, as patients may benefit from intervention to prevent long-term fatigue.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1063-1073"},"PeriodicalIF":6.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798128","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":"Liver, Portal, and Systemic Thyroid Hormone Concentrations in End-Stage MASH Reveal Distinct Roles for T3/rT3 Ratio and T4.","authors":"Xinru Zhang, Zhixiong Ying, Tonguç Utku Yilmaz, Piter Bosma, Maarten Tushuizen, Anita Boelen, Eveline Bruinstroop","doi":"10.1177/10507256261476458","DOIUrl":"10.1177/10507256261476458","url":null,"abstract":"<p><strong>Background: </strong>The liver is a central organ in thyroid hormone (TH) metabolism, mediating the conversion of thyroxine (T4) to bioactive triiodothyronine (T3) via type 1 deiodinase and the clearance of reverse T3 (rT3). Selective thyromimetics targeting the TH receptor β in the liver are in development and, recently, are FDA-approved for the treatment of metabolic dysfunction-associated steatohepatitis (MASH). To unravel TH metabolism during MASH in patients, we aim to determine specific alterations in TH concentrations in both the liver and circulation in patients with end-stage MASH.</p><p><strong>Methods: </strong>In this cross-sectional study, liver tissue, portal plasma, and systemic plasma were collected intraoperatively from 12 patients with MASH cirrhosis undergoing liver transplantation and 12 living liver donors serving as healthy controls (fibrosis stage F0-F1). Total T4, T3, and rT3 were quantified by liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>Patients with MASH cirrhosis exhibited substantially lower total T3 and T4 across all three compartments, with elevated rT3 in portal and systemic plasma. The T3/rT3 ratio, a functional index of deiodinase-mediated TH metabolism, was markedly suppressed (-65% to -83%). For disease discrimination, hepatic T3 demonstrated the strongest capacity (body mass index [BMI]-adjusted odds ratios [OR] = 0.009, 95% confidence intervals [CI]: 0.001-0.190; <i>p</i> < 0.001), followed by the systemic T3/rT3 ratio (BMI-adjusted OR = 0.045, 95% CI: 0.001-0.328; <i>p</i> < 0.001). Within the MASH cohort, systemic T4 correlated inversely with model for end-stage liver disease score (<i>r</i> = -0.867, adjusted <i>p</i> = 0.005) and Child-Pugh score (r = -0.760, adjusted <i>p</i> = 0.033), confirmed as the predominant severity correlate by multivariable regression independent of BMI (standardized <i>β</i> = -0.744, adjusted <i>p</i> = 0.004).</p><p><strong>Conclusions: </strong>This study characterized TH metabolism in human end-stage MASH, which provides direct tissue-level evidence supporting intrahepatic hypothyroidism. The systemic T3/rT3 ratio and hepatic T3 potently discriminate MASH from healthy liver, while total systemic T4 tracks disease severity within established cirrhosis. Our findings suggest that distinct TH parameters serve complementary roles as biomarkers in diagnosis and prognosis.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1116-1125"},"PeriodicalIF":6.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680071","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>Reply to:</i> When Guidelines Meet Reality: Implementing the 2025 ATA Recommendations for Differentiated Thyroid Cancer in Limited-Resource Settings.","authors":"Allen S Ho, Matthew D Ringel, Julie Ann Sosa, Julie H Johnson, Ellen Marqusee","doi":"10.1177/10507256261478396","DOIUrl":"10.1177/10507256261478396","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1151-1152"},"PeriodicalIF":6.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713644","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":"Second Primary Malignancies Among Pediatric and Young Adult Survivors of Differentiated Thyroid Cancer: Real-World Evidence.","authors":"Rachel Bello, Michal Yackobovitch-Gavan, Liora Lazar, Samah Hayek","doi":"10.1177/10507256261475827","DOIUrl":"10.1177/10507256261475827","url":null,"abstract":"<p><strong>Background: </strong>Differentiated thyroid cancer (DTC) is the most common endocrine malignancy among children, adolescents, and young adults (CAYA). While prognosis is generally favorable, rising incidence, longer survivorship, and radioactive iodine (RAI) treatment raise concern for late effects, particularly second primary malignancies (SPMs) and late mortality.</p><p><strong>Objective: </strong>To evaluate SPM risk, all-cause mortality, and the impact of RAI in CAYA DTC survivors.</p><p><strong>Methods: </strong>Retrospective cohort study (1982-2022) using Clalit Health Services records, including DTC patients diagnosed <40 years, who survived ≥2 years. Participants were matched to cancer-free controls (1:4) by birth year, sex, ethnicity, and socioeconomic status. Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among 5267 DTC survivors (<i>n</i> = 497 [∼9.5%] diagnosed before age 20 years) and 21,062 matched controls, SPM incidence was higher in survivors with 50% increased risk (500 vs. 360 per 100,000 person-years; HR 1.50, CI 1.34-1.67) and occurred after a shorter latency (13.8 vs. 15.1 years; <i>p</i> = 0.042). Survivors diagnosed before age 20 were significantly younger at data retrieval than those diagnosed at 20-40 years (median 33 vs. 47 years; <i>p</i> < 0.001) and had significantly lower SPM rates (<i>n</i> = 28 [5.6%] vs. <i>n</i> = 398 [9.0%]; <i>p</i> = 0.012). Compared with RAI-untreated survivors, SPM risk increased after one RAI treatment (HR 1.91, CI 1.52-2.40) and further after ≥2 RAI treatments (HR 2.73, CI 2.13-3.50). Overall mortality rate was low (<i>n</i> = 148, 2.8%) and similar to that of matched controls (<i>n</i> = 517, 2.5%) but was significantly higher among survivors who developed SPMs and/or received RAI treatment (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Over four decades of follow-up, SPMs were identified as a significant long-term risk among CAYA DTC survivors, frequently manifesting many years after the initial diagnosis. Both SPM occurrence and higher cumulative RAI doses were associated with increased mortality. These findings support careful risk-adapted use of RAI and underscore the need for extended surveillance, particularly for those diagnosed in childhood or adolescence, as malignancies may arise many years after diagnosis.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1094-1105"},"PeriodicalIF":6.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766131","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 Thyroid Cancer Modified Anxiety Scale (TC-MAX): Development and External Validation of a Thyroid Cancer Distress Instrument.","authors":"Amanda J Bastien, Sungjin Kim, Cynthia Zalt, Iris Cong, Jewel Ng, Caroline Marshall, Christopher V Almario, Omer Liran, Brennan M R Spiegel, Jon Mallen-St Clair, Evan S Walgama, Kevin S Scher, Julie K Jang, Yufei Chen, Samuel Zhang, Gary Bloom, Michelle M Chen, K Linnea Peterson, Wendy L Sacks, Zachary S Zumsteg, Allen S Ho","doi":"10.1177/10507256261475819","DOIUrl":"10.1177/10507256261475819","url":null,"abstract":"<p><strong>Background: </strong>Patient distress associated with thyroid cancer greatly influences treatment choice, yet is underestimated by clinicians. We developed and validated the Thyroid Cancer Modified Anxiety Scale (TC-MAX) to measure patient-reported thyroid cancer-related worry.</p><p><strong>Methods: </strong>Development entailed (1) conceptualization (systematic literature review, expert panel [<i>n</i> = 4], patient focus groups [<i>n</i> = 10]); (2) qualitative revision (pilot testing [<i>n</i> = 59], expert panel [<i>n</i> = 4], patient feedback [<i>n</i> = 4]); (3) internal validation (<i>n</i> = 148); and (4) external validation (<i>n</i> = 1002), with papillary thyroid cancer patients. Internal consistency, test-retest reliability, exploratory/confirmatory factor analysis, and construct validity were evaluated. Severity categories and minimal clinically important differences (MCIDs) were determined.</p><p><strong>Results: </strong>An 18-question scale was constructed, encompassing three subscales (Collective Anxiety, Ultrasound Anxiety, and Fear of Recurrence/Progression). Internal validation revealed high internal consistency (Cronbach's <i>α</i> = 0.93), excellent test-retest reliability (intraclass correlation coefficient [ICC] 0.86), and significant construct validity (Distress Thermometer [Spearman's <math><mi>ρ</mi></math> = 0.56, <i>p</i> < 0.001], Hospital Anxiety Depression Scale [HADS] [Spearman's ρ = 0.52, <i>p</i> < 0.001], and Functional Assessment of Cancer Therapy-General [FACT-G] [Spearman's <math><mi>ρ</mi></math> = -0.50, <i>p</i> < 0.001]). Exploratory factor analysis showed expected loadings for respective subscales, and confirmatory factor analysis confirmed that the structure was parsimonious. External validation exhibited similar psychometrics, including internal consistency (Cronbach's <i>α</i> = 0.94), test-retest reliability (ICC 0.87), and construct validity (Distress Thermometer [Spearman's <math><mi>ρ</mi></math> = 0.54, <i>p</i> < 0.001], HADS [Spearman's <math><mi>ρ</mi></math> = 0.67, <i>p</i> < 0.001], and FACT-G [Spearman's <math><mi>ρ</mi></math> = -0.62, <i>p</i> < 0.001]). Proposed ranges (low = 0-26, moderate = 26-43, and severe = 43-100) were in excellent agreement between internal and external validation cohorts (weighted <i>κ</i> = 0.84, <i>p</i> < 0.001). Anchor-based MCID was found to be 16.7 (active surveillance vs. surgery) (25.9 [standard deviation (SD) ± 16.4] vs. 42.6 [SD ± 23.3], <i>p</i> < 0.001) or 16.9 (hemithyroidectomy vs. thyroidectomy) (33.6 [SD ± 17.4] vs. 50.5 [SD ± 24.1], <i>p</i> = 0.005).</p><p><strong>Conclusions: </strong>TC-MAX represents the first dedicated measure of anxiety in thyroid cancer. It exhibits robust psychometric properties in a vulnerable population, accounting for complex viewpoints. The scale effectively assesses preference and informs patients, including determining fit for active surveillance or extent of surgery.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1043-1052"},"PeriodicalIF":6.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707648","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> When Guidelines Meet Reality: Implementing the 2025 ATA Recommendations for Differentiated Thyroid Cancer in Limited-Resource Settings.","authors":"Fabián Pitoia, Erika Abelleira, Anabella Smulever, Luis Agustín Ramírez Stieben, Inés Califano","doi":"10.1177/10507256261470298","DOIUrl":"10.1177/10507256261470298","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1148-1150"},"PeriodicalIF":6.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449681","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":"Diminished Pro-Inflammatory Characteristics in Murine Bone Marrow Derived Macrophages with Impaired Thyroid Hormone Receptor Alpha 1 Signaling.","authors":"Esmée Hoen, Kim Falize, Aldo Jongejan, Sheue-Yann Cheng, Xu-Guang Zhu, Eveline Bruinstroop, Anne H van der Spek, Anita Boelen","doi":"10.1177/10507256261479514","DOIUrl":"10.1177/10507256261479514","url":null,"abstract":"<p><strong>Background: </strong>Macrophages are versatile phagocytes of the innate immune system with functions ranging from pro-inflammatory to immunomodulatory. Macrophages are receptive to signals from thyroid hormones (THs). Here, we studied the role of the TH receptor (TR)α1 in macrophage function.</p><p><strong>Methods: </strong>Using wild type (WT) and transgenic mice with a mutation in the T3 binding domain of the TRα1 (TRα1PV), we generated bone marrow derived macrophages (BMDMs) and subsequently polarized them into pro-inflammatory or immunomodulatory phenotypes. The phenotype and function of the unpolarized, pro-inflammatory and immunomodulatory TRα1PV BMDMs was compared with the respective WT BMDMs.</p><p><strong>Results: </strong>RNA sequencing revealed different expression profiles and alterations of biological pathways, including immune functions in all TRα1PV BMDM phenotypes. The pro-inflammatory TRα1PV BMDMs exhibited decreased marker expression associated with this phenotype, while marker expression of unpolarized and immunomodulatory TRα1PV BMDMs was unaltered. Glycolysis, a characteristic of pro-inflammatory macrophages, was reduced in all three TRα1PV macrophage phenotypes.</p><p><strong>Conclusions: </strong>Altogether, we observed that the TRα1PV mutation results in phenotypical and functional different BMDMs, with most striking changes in the pro-inflammatory phenotype, underlining the significance of adequate T3-TRα1 signaling in pro-inflammatory macrophage responses.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1126-1136"},"PeriodicalIF":6.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798103","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}