Thyroid最新文献

{"title":"Comparison of Patient Reported Outcomes between Active surveillance and Immediate Lobectomy in Patients with Low-risk Papillary Thyroid Microcarcinoma: Initial Findings from the KoMPASS cohort.","authors":"Min Joo Kim,Hojeong Won,Won Bae Kim,Eun Kyung Lee,Chang Yoon Lee,Sun Wook Cho,Han-Sang Baek,Yong Sang Lee,Yae Eun Kang,Sun Wook Kim,Ho Cheol Kang,Jeongmin Lee,Mijin Kim,Min Ji Jeon,Jae Hoon Moon","doi":"10.1089/thy.2024.0264","DOIUrl":"https://doi.org/10.1089/thy.2024.0264","url":null,"abstract":"BACKGROUNDPatients diagnosed with low-risk papillary thyroid microcarcinoma (PTMC) face the decision between thyroid lobectomy and active surveillance (AS). This study aimed to investigate the factors influencing treatment decisions in low-risk PTMC and to compare the quality of life (QoL) according to the treatment plan.METHODSThe multicenter prospective cohort study comparing AS and thyroid lobectomy was conducted. Clinical characteristics were compared between the AS and Lobectomy groups. QoL questionnaires were administered every 6 months in the initial year and annually thereafter.RESULTSA total of 927 patients (453 in the AS group and 474 in the Lobectomy group) with low-risk PTMC were included in this study. The mean age was 47.4 ± 12.2 years, and 72.2% of the patients were women. Older age (odd ratio [OR] 1.04, 95% confidence interval [CI] 1.02 - 1.05, p <0.001), smaller tumor size (OR 0.78, 95% CI 0.69 - 0.87, p <0.001), family history of thyroid cancer (OR 1.48, 95% CI 1.03 - 2.12, p = 0.035), prior awareness of AS (OR 1.53, 95% CI 1.16 - 2.02, p = 0.003), and higher income (OR 1.79, 95% CI 1.13 - 2.83, p = 0.013) were significantly associated with a higher likelihood of choosing AS. The median follow-up was 27.3 months (23.9 - 43.9) in the AS group and 28.7 months (20.4 - 44.5) in the Lobectomy group. During the follow-up period, the AS group showed significantly better QoL scores compared to the Lobectomy group (β 0.17, 95% CI 0.02 - 0.33, p = 0.029). Although baseline QoL scores favored the AS group significantly (7.1 ± 1.2 vs. 6.7 ± 1.2, p < 0.001), no significant difference was observed after 12 months (7.2 ± 1.2 vs. 7.1 ± 1.2, p =0.592).CONCLUSIONSThis study demonstrated that age, tumor size, family history of thyroid cancer, awareness of AS, and income were associated with patients' treatment choices. Although the overall QoL scores were significantly higher in the AS group, the QoL became similar between the two groups after 12 months.","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":"16 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249483","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":"Consideration of Early Dynamic Risk Stratification to Guide Discharge from Oncologic Follow-up in Patients with Differentiated Thyroid Cancer.","authors":"Amina Attia,Eliane Touma,Charlotte Lussey-Lepoutre,Cécile Ghander,Anne Jouinot,Malanie Roy,Selma Housni,Nathalie Chereau,Fabrice Menegaux,Laurence Leenhardt,Camille Buffet","doi":"10.1089/thy.2024.0119","DOIUrl":"https://doi.org/10.1089/thy.2024.0119","url":null,"abstract":"BACKGROUNDThe current dogma is a life-long follow-up for patients treated for follicular-derived differentiated thyroid cancers (DTC). Our primary objective was to determine the time to recurrence in a series of DTC patients with an excellent response to therapy 6 months after total thyroidectomy and radioiodine therapy. The secondary objectives were to determine the time to suspicion of recurrence and to identify factors associated with recurrence.METHODSThis retrospective cohort study included patients treated for DTC between 2008 and 2012 and in remission 6 months after total thyroidectomy and radioiodine treatment. The criteria for remission were negative imaging and suppressed thyroglobulin (Tg) < 0.2 ng/mL or rh-TSH-(recombinant human TSH) stimulated Tg < 1 ng/mL according to the 2015 ATA (American Thyroid Association) guidelines. Recurrence was defined by cytologically and/or histologically proven cervical lymph node metastasis or the administration of a second radioiodine treatment.RESULTSAmong 721 patients treated for DTC, 158 were excluded because of persistent disease at 6 months and 71 because of missing follow-up data and 492 were included. The mean and median follow-up time were 7.0 and 7.9 years [IQR 2.1-11.3]. Recurrence occurred for 7 patients (1.4%), 1 initially classified as high recurrence risk, 3 as intermediate and 3 as low risk according to the 2015 ATA guidelines. All relapses occurred within 10 years after initial management (4 within the first 5 years). For patients with recurrence, rise in Tg and/or suspicious lymph node were detected in 6 out of 7 cases in the first 8 years, and for the last case 10 years after initial surgery.CONCLUSIONLow and intermediate recurrence risk DTC patients with excellent response 6 months after total thyroidectomy and radioiodine and in remission 10 years later have an extremely low recurrence risk. Follow-up might be undertaken by primary care providers from this time point. These discharge recommendations should be confirmed by further prospective studies.","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":"195 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249482","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":"Risk of Progression of Gestational Subclinical Hypothyroidism and Hypothyroxinemia to Overt Hypothyroidism After Pregnancy is Associated with Underlying Thyroid Autoimmunity.","authors":"Stacy Hander, Sun Y Lee","doi":"10.1089/thy.2024.0435","DOIUrl":"10.1089/thy.2024.0435","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1066-1067"},"PeriodicalIF":5.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894370","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":"Cardiac Electrical and Structural Changes after Iodinated Contrast Media Administration: A Longitudinal Cohort Analysis.","authors":"Kosuke Inoue, Muhammad T Bashir, Alberta L Warner, Ramin Ebrahimi, Natalia V Neverova, Jesse W Currier, Seo Young Sohn, Connie M Rhee, Martin L Lee, Angela M Leung","doi":"10.1089/thy.2024.0131","DOIUrl":"10.1089/thy.2024.0131","url":null,"abstract":"<p><p><b><i>Background:</i></b> Iodinated contrast is commonly used for radiological procedures, with one dose delivering several hundred-fold the daily requirements needed for normal thyroid hormone production. Risks of excess iodine include incident thyroid dysfunction, which is associated with adverse cardiac outcomes, yet there are no prospective studies investigating the changes in cardiac physiology following iodine contrast administration. This study was conducted to investigate the longitudinal relationships between the amount of iodinated contrast administration and changes in cardiac electrophysiology and structure. <b><i>Methods:</i></b> A longitudinal cohort study was conducted with prospectively enrolled participants who received iodine contrast for elective computed tomography or coronary angiography. Serum thyroid function tests, electrocardiograms (EKG), and transthoracic echocardiograms were obtained serially until 36 months. Trends of electrical and structural cardiac changes following iodine contrast administration were assessed using mixed effect models. <b><i>Results:</i></b> The cohort was composed of 129 patients (median age, 70 [interquartile range: 63, 75] years; 98% male). Larger amounts of iodine exposure were associated with increases in QRS and QTc durations and decreased ejection fraction (EF), and these associations were still observed for follow-up EF after additionally adjusting for baseline values (the high-iodine contrast group vs. the low-iodine contrast group, -4.23% [confidence interval, -7.66% to -0.79%]). Dose-response analyses also showed lower EF with larger amounts of iodine received; these trends were not significant for the EKG parameters studied. <b><i>Conclusions:</i></b> Over a period of up to 36 months, a larger amount of administered iodine contrast was associated with lower EF among participants. Further investigation is needed to elucidate the long-term trends of electrical and structural cardiac function after iodine contrast administration.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1163-1170"},"PeriodicalIF":5.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005339","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":"Thyroid Hormone Replacement Dosing after Bariatric Surgery in Patients with Primary Hypothyroidism And Severe Obesity: Tehran Obesity Treatment Study.","authors":"Maryam Barzin, Danial Molavizadeh, Maryam Mahdavi, Alireza Khalaj, Sara Sadeghi, Majid Valizadeh, Fereidoun Azizi, Farhad Hosseinpanah","doi":"10.1089/thy.2024.0073","DOIUrl":"10.1089/thy.2024.0073","url":null,"abstract":"<p><p><b><i>Background:</i></b> Obesity and hypothyroidism are common medical conditions that are associated with each other. Bariatric surgery (BS) is a common approach used to achieve substantial weight loss in obese patients. However, there is limited evidence regarding the need for postsurgery levothyroxine (LT4) dose adjustment in patients with hypothyroidism undergoing BS. <b><i>Methods:</i></b> This was a three-year prospective cohort study assessing postsurgery LT4 requirements with attention to body composition changes. The current study included 1030 patients with hypothyroidism, who underwent sleeve gastrectomy (SG) (<i>n</i> = 707, 88.3% women) or one anastomosis gastric bypass (OAGB) (<i>n</i> = 323, 92% women). Patients were followed for 36 months after surgery. A bioelectrical impedance analyzer was used for body composition assessment. LT4 requirements were assessed by generalized estimating equation (GEE) methods adjusted for weight as a time-varying covariate. <b><i>Results:</i></b> During the follow-up, TSH (mIU/L) and T4 (ng/dL) measurements did not significantly change in the OAGB group over time. However, in the SG group, TSH measurement decreased over time (<i>p_trend</i> = <0.001). In the third year of the follow-up, 56.1% and 33.3% of patients in the SG and OAGB groups experienced LT4 (μg/day) dose reduction, while 24.4% and 9.1% of the participants experienced LT4 dose increments, respectively. GEE analysis showed a significant increase in the LT4/fat mass (FM) (μg/kg) ratio after 36 months of follow-up compared with the baseline in both the SG [1.8 (1.5-2.2) to 2.7 (2.0-3.5), <i>p_trend</i> = 0.039)] and OAGB [1.7 (1.4-2.2) to 3.2 (2.7-4.8), <i>p_trend</i> = <0.001)] groups. Moreover, patients who underwent OAGB experienced greater LT4/FM (μg/kg) dose adjustments compared to those undergoing SG (<i>p_between</i> = 0.060). In both groups, after the first year, the increase in LT4/FM (μg/kg) plateaued (<i>p_interaction</i> = 0.009). <b><i>Conclusion:</i></b> Most hypothyroid patients experienced either a reduction or no change in LT4 (μg/day) dosage after 36 months in both surgical groups. The LT4/FM (μg/kg) was significantly increased in patients undergoing either SG or OAGB with greater alterations in the latter. Further studies on larger populations and with longer duration of follow-up are needed to confirm our results.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1105-1116"},"PeriodicalIF":5.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000719","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 Prospective Clinical Trial of Radiofrequency Ablation in Patients with Low-Risk Unifocal Papillary Thyroid Microcarcinoma Favoring Active Surveillance Over Surgery.","authors":"Ji Ye Lee, Dong Gyu Na, Jung Suk Sim, Jin Yong Sung, Sun Wook Cho, Do Joon Park, Young Joo Park, Ji-Hoon Kim","doi":"10.1089/thy.2024.0098","DOIUrl":"10.1089/thy.2024.0098","url":null,"abstract":"<p><p><b><i>Background:</i></b> Active surveillance (AS) of papillary thyroid microcarcinomas (PTMC) is emerging as an alternative to immediate surgery. While thermal ablation has also shown promise for low-risk PTMC, it has not been prospectively studied in patients appropriate for AS. This study aimed to evaluate the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) for tumor control and quality of life (QoL) management in patients with PTMC who favored AS over immediate surgery. <b><i>Methods:</i></b> This prospective clinical trial was conducted at a single tertiary referral hospital from 2018 to 2021. Of 227 adult patients aged ≤60 years with low-risk unifocal PTMC favoring AS over immediate surgery, 100 patients underwent RFA for their management. The primary endpoint was the disease progression rate, and secondary endpoints were technical success, volume reduction rate (VRR), complication rates, and QoL. <b><i>Results:</i></b> The median age of the study population was 42 years (range, 27-59 years), and 83% (83/100, [CI: 66.1-100]) were female. The median follow-up was 30 months (range, 12-56 months). All 100 patients underwent RFA with technical success. Most of the ablation zones showed continuous volume reduction, and 95.9% (94/98, [CI: 77.5-100.0]) showed complete disappearance at the last follow-up. The median VRR was 100.0% at 1-year follow-up and persisted throughout the last follow-up. The cumulative disease progression rate among 98 patients who underwent at least 1-year follow-up was 3.1% (3/98, [CI: 0.6-9.0]); one patient had lymph node metastasis (treated with surgery), and two patients had new PTMC (1 treated with RFA, 1 ongoing AS). Major complications were not observed. Psychological (baseline vs. last follow-up, 7.3 vs. 8.0, <i>p</i> = 0.002) and social (8.0 vs. 8.7, <i>p</i> = 0.005) QoL scores significantly improved during follow-up without compromising physical QoL (8.6 vs. 8.5, <i>p</i> = 0.99). <b><i>Conclusions:</i></b> RFA can be a reasonable strategy for effectively and safely controlling tumors and improving QoL in non-elderly patients with low-risk PTMC appropriate for AS. Clinical Trial registration: This trial is registered with ClinicalTrials.gov: NCT03432299.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1126-1136"},"PeriodicalIF":5.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112229","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>FGFR</i> Alterations in Thyroid Carcinoma: A Novel Class of Primary Drivers with Significant Therapeutic Implications and Secondary Molecular Events Potentially Mediating Resistance in Thyroid Malignancy.","authors":"Mark F Sabbagh, Tyler Janovitz, Dora Dias-Santagata, Stephanie Siegmund, Valentina Nardi, Lori J Wirth, Gregory W Randolph, Jochen K Lennerz, Brennan Decker, Vania Nose, Bayan A Alzumaili, William C Faquin, Justine A Barletta, Long P Le, A John Iafrate, Peter M Sadow, Adam S Fisch","doi":"10.1089/thy.2024.0216","DOIUrl":"10.1089/thy.2024.0216","url":null,"abstract":"<p><p><b><i>Background:</i></b> Diagnostic classification of thyroid malignancy is primarily accomplished through examination of histomorphological features and may be substantiated and clarified by molecular data. Individual molecular drivers show relatively robust and specific associations with histological subtypes of thyroid malignancy, including <i>BRAF</i> sequence variants and kinase gene fusions in papillary thyroid carcinoma, predominantly <i>RAS</i> variants in follicular-patterned neoplasia, and additional \"late\" mutations affecting <i>TERT</i> promoter, <i>TP53</i>, and the PI3K/AKT/PTEN pathway in high-grade malignancies. Given the oncogenic role of <i>FGFR</i>, particularly <i>FGFR1-3</i>, the goal of this study was to explore the role of <i>FGFR</i> in thyroid carcinoma biology. <b><i>Methods:</i></b> We completed a multicenter retrospective observational study for thyroid carcinomas with pathogenic alterations in the <i>FGFR</i> gene family. We performed this study by querying the molecular data accumulated for thyroid carcinomas from each center. <b><i>Results:</i></b> Overall, 5030 sequenced thyroid malignancies were reviewed, yielding 17 tumors with <i>FGFR</i> alterations, including 11 where <i>FGFR</i> was the primary molecular driver and 6 where <i>FGFR</i> was a secondary pathogenic alteration, with a subset for which there was available clinical follow-up data. Of the 11 carcinomas with an <i>FGFR</i> driver, 9 were gene fusions involving <i>FGFR2:VCL</i> (4 tumors), <i>TG::FGFR1</i> (3 tumors), <i>FGFR2::CIT</i>, and <i>FGFR2::SHTN1</i>, and the remaining 2 were driven by <i>FGFR1</i> amplification. In the 6 tumors where a canonical driver of thyroid neoplasia was present (5 cases) or no clear primary driver was detected (1 case), sequencing detected secondary <i>FGFR2</i> p.W290C, p.Y375C, and p.N549K, as well as <i>FGFR1</i> p.N546K in the respective tyrosine kinase domains, some at subclonal variant allele frequencies. <b><i>Conclusions:</i></b> This study presents the first description of a collection of thyroid carcinomas grouped by primary driver alterations in <i>FGFR</i>, as well as a cohort of thyroid tumors with secondary alterations that potentially lead to tumor progression or resistance to targeted therapy. Given the availability of small molecular inhibitors targeting oncogenic <i>FGFR</i>, this study emphasizes the significant implications for patients from identification of <i>FGFR</i> alterations as they are currently under-recognized in the literature and, most importantly, have potential novel treatment options.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1137-1149"},"PeriodicalIF":5.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604140","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":"Prevalence and Management of Complications of Percutaneous Ethanol Injection for Cystic Thyroid Nodules: A Systematic Review of Literature and Meta-analysis.","authors":"Lorenzo Scappaticcio, Pamela Ferrazzano, Nicole Di Martino, Roberto Negro, Maurilio Deandrea, Maria Ida Maiorino, Paola Caruso, Michela Di Nuzzo, Miriam Longo, Giovanni Docimo, Giampaolo Papi, Pierpaolo Trimboli, Katherine Esposito, Giuseppe Bellastella","doi":"10.1089/thy.2024.0241","DOIUrl":"10.1089/thy.2024.0241","url":null,"abstract":"<p><p><b><i>Background:</i></b> We assessed the prevalence of complications from percutaneous ethanol injection (PEI) for benign and cystic thyroid nodules (CTNs) and their management. <b><i>Methods:</i></b> We conducted a systematic review with meta-analysis of data from published observational studies on PEI of CTNs. We also included unpublished retrospectively collected data on complications after PEI from all consecutive patients with cytologically benign CTNs who underwent PEI at the Unit of Endocrinology and Metabolic Diseases, AOU University of Campania Luigi Vanvitelli (Naples, Italy) between June 1, 2021, and March 31, 2024. A random effects meta-analysis was performed on the prevalence rate data. Pooled prevalence data were presented with confidence intervals (CIs). The <i>I</i>² statistic index was used to quantify the heterogeneity. The details of the complications and the management were qualitatively described. <b><i>Results:</i></b> The literature search yielded 1189 studies, of which 48 studies were included in the systematic review and meta-analysis, in addition to our institutional experience (3670 CTNs in total). The overall quality of each included study was judged as fair. The prevalence of \"Overall\" complications of PEI was 32% ([CI 25-40%], <i>I</i>² 92.7%, 967 of 3195 thyroid nodules [TNs]). The prevalence of \"Minor\" complications of PEI was 32% ([CI 25-40%], <i>I</i>² 92.7%, 952 of 3195 TNs). The prevalence of \"Major\" complications of PEI was 2% ([CI 1-2%], <i>I</i>² 0%, 22 of 3670 TNs). Sensitivity analyses did not modify the results. The pooled prevalence rate of local pain was 21% (CI [16-27] <i>I</i>² 90.3). Local pain was typically transient and mild, sometimes moderate, and requiring analgesics for few days. The pooled prevalence rate of dysphonia was 1% (CI [1-2], <i>I</i>² 0). Dysphonia was transient and could last from several hours to 12 months after PEI. <b><i>Conclusions:</i></b> Complications of PEI for benign and CTNs are relatively common, but most are minor and usually transient, not requiring treatment. Dysphonia was a major complication, but it was uncommon and transient. PEI for CTNs could be considered a generally safe technique.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1068-1081"},"PeriodicalIF":5.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731422","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 Long-Term Exposure to Environmental Fine Particulate Matter and the Prevalence of Thyroid Disorders: A National Cross-Sectional Study in China.","authors":"Kaijie Yang, Cihang Lu, Kang Chen, Zhongyan Shan, Weiping Teng, Yongze Li","doi":"10.1089/thy.2024.0286","DOIUrl":"10.1089/thy.2024.0286","url":null,"abstract":"<p><p><b><i>Background:</i></b> Exposure to particles with an aerodynamic diameter of ≤2.5 μm (PM_2.5) is associated with the occurrence of thyroid dysfunction among pregnant women and neonates, but it is not known if this association occurs in the general population. We aimed to determine the association of prolonged exposure to PM_2.5 with the prevalence of thyroid disorders among adults in China. <b><i>Methods:</i></b> A nationally representative cross-sectional study of thyroid disorders, iodine status, and diabetes status was carried out in all 31 provinces across China from 2015 to 2017. In total, 73,900 adults aged 18 years and older were included. Serum concentrations of thyroid hormones, thyrotropin, and thyroid antibodies and the urine iodine concentration were measured. The environmental concentration of PM_2.5 for each participant's residential address at a spatial resolution of 1 × 1 km was estimated. <b><i>Results:</i></b> The average long-term exposure to PM_2.5 at residential addresses was 66.41 μg/m³, ranging from 17.58 μg/m³ to 120.40 μg/m³. Compared with that of individuals with lower exposure levels, the prevalence of thyroid diseases such as autoimmune thyroiditis and subclinical hypothyroidism was greater in those with PM_2.5 concentrations within the third quartile range (60.18 to 73.78 μg/m³). Compared with those in the first quartile (17.58 to 46.38 μg/m³), participants in the highest PM_2.5 quartile (73.78 to 120.40 μg/m³) presented an increased risk of overt hypothyroidism (OR 1.23 [CI 0.94-1.61]), subclinical hypothyroidism (1.10 [1.01-1.21]), autoimmune thyroiditis (1.09 [1.00-1.18]), and thyroglobulin antibody positivity (1.17 [1.07-1.29]). However, there was no association between PM_2.5 exposure and overt hyperthyroidism, subclinical hyperthyroidism, Graves' disease, or thyroid peroxidase antibody positivity (<i>p</i> > 0.05). Each 10 μg/m³ increase in the PM_2.5 concentration was associated with an increased risk of overt hypothyroidism (OR 1.05 [1.00-1.11]), subclinical hypothyroidism (1.02 [1.00-1.03]), and thyroglobulin antibody positivity (1.02 [1.00-1.04]). Furthermore, a nearly linear exposure-response relationship was observed between long-term PM_2.5 exposure and thyroglobulin antibody positivity. <b><i>Conclusions:</i></b> PM_2.5 exposure was associated with thyroid disorders among Chinese adults. A dose-response relationship between PM_2.5 exposure and autoimmune thyroiditis, as well as thyroglobulin antibody positivity, was also observed.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1094-1104"},"PeriodicalIF":5.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005336","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":"Macrophage-Induced Carboxypeptidase A4 Promotes the Progression of Anaplastic Thyroid Cancer.","authors":"Yeon-Sook Choi, Min Ji Jeon, Woo Kyung Lee Doolittle, Dong Eun Song, Kyunggon Kim, Won Bae Kim, Won Gu Kim","doi":"10.1089/thy.2023.0427","DOIUrl":"10.1089/thy.2023.0427","url":null,"abstract":"<p><p><b><i>Background:</i></b> The density of tumor-associated macrophages in the tumor microenvironment of anaplastic thyroid cancer (ATC) is associated with poor prognosis. However, the crosstalk between macrophages and ATC cells is poorly understood. This study aimed to examine the impact of macrophages on cancer cell phenotypes. We found a new mediator between M2 macrophages and ATC cells through proteomics analysis. <b><i>Methods:</i></b> The role of macrophages in proliferation, migration, and invasion of ATC cells was evaluated using coculture assay and conditioned medium (CM). Secretory factors in the CM from single or coculture were identified using liquid chromatography-tandem mass spectrometry proteomics analysis. We evaluated the role of the secretory factor in proliferation, migration, and invasion of cancer cells. In vivo xenograft model was used to evaluate the effect of the factor. <b><i>Results:</i></b> M2 macrophages significantly increased the proliferation, migration, and invasion of ATC cells, whereas M1 macrophages decreased the proliferation, migration, and invasion of ATC cells. Based on proteomic analysis of CM, we identify carboxypeptidase A4 (CPA4) as a mediator of the crosstalk between macrophages and ATC cells. CPA4 was only detected in the coculture media of M2 macrophage/8505C, and its expression in cancer cells increased by M2 macrophage. The expression of CPA4 protein was significantly higher in human thyroid cancers, particularly in ATCs, than normal and benign tissues. A bioinformatics analysis of public data revealed that CPA4 expression was associated with poor prognosis and dedifferentiation of thyroid cancer. Knockdown of CPA4 suppressed proliferation, colony formation, migration, and invasion of ATC cells, consistent with the decrease of STAT3, ERK, and AKT/mTOR phosphorylation and epithelial-mesenchymal transition (EMT) marker expression. In addition, the increased expression of CPA4 in cancer cells by M2 macrophage stimulation induced the polarization of macrophages to the M2 phenotype, which formed a positive feedback loop. Xenograft tumors did not develop after CPA4 knockdown. <b><i>Conclusions:</i></b> Our data suggest that CPA4 stimulates the progression of thyroid cancer by mediating between M2 macrophages and ATC cells. CPA4 can be a new therapeutic target for the treatment of patients with ATC.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1150-1162"},"PeriodicalIF":5.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866603","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}