Thyroid Research最新文献

{"title":"Molecular alteration patterns predict tumor behavior in papillary thyroid carcinoma independent of tumor size: insights from an international multicenter retrospective study.","authors":"Grégoire B Morand, Idit Tessler, Simon E Thurnheer, Kayla E Payne, Maxine Noik, Josh Krasner, Tzahi Yamin, Marc P Pusztaszeri, Richard J Payne, Galit Avior","doi":"10.1186/s13044-025-00231-0","DOIUrl":"10.1186/s13044-025-00231-0","url":null,"abstract":"<p><strong>Background: </strong>Molecular testing is a well-established tool that assists in the management of thyroid nodules and allows classification in distinct molecular alteration patterns: BRAF-like, RAS-like and non-BRAF-non-RAS (NBNR). Yet classical TNM classification and ATA guidelines currently rely on tumor size for risk stratification. In this study, we compared tumor behavior according to molecular alteration patterns versus tumor size.</p><p><strong>Methods: </strong>Retrospective multicenter multinational study of thyroid nodules that underwent preoperative molecular profiling with ThyGenX/ThyGeNEXT or ThyroSeq V3 between 2015 and 2022. Clinical characteristics, including demographics, cytology results, tumor size, surgical pathology, and molecular alterations, were analyzed.</p><p><strong>Results: </strong>The study included 718 patients who underwent surgery for papillary thyroid cancer, with a majority of 556 (77.4%) being female. The distribution of molecular alteration patterns was as follows: BRAF-like in 227 (31.6%), RAS-like in 171 (23.8%), NBNR in 59 (8.2%), BRAF/RAS overlap 8 (1.1%) and no detectable mutation in 224 (31.2%) cases. The median tumor size was 15 mm (IQR 10-24). Extrathyroidal extension (ETE) was observed in 6.2% of cases with gross ETE and 5.6% with minimal ETE. Notably, nodules with BRAF-like molecular alterations were more likely to exhibit ETE compared to those with RAS-like or NBNR alterations (P < 0.001). There was no significant correlation between ETE and median tumor size (P > 0.05).</p><p><strong>Conclusion: </strong>Molecular testing of thyroid nodules provides a more accurate prediction of tumor behavior compared to tumor size alone. These findings suggest that future staging systems could benefit from incorporating molecular alteration patterns into their algorithms.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"14"},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of thyroid hormone levels and incidence of chronic kidney disease: the Tehran thyroid study (TTS).","authors":"Atoosa Motaghedi Larijani, Safdar Masoumi, Hengameh Abdi, Atieh Amouzegar, Fereidoun Azizi","doi":"10.1186/s13044-025-00228-9","DOIUrl":"10.1186/s13044-025-00228-9","url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding the relationship between thyroid hormone levels within the normal range and the incidence of chronic kidney disease (CKD) in adults is scarce. This study aimed to identify the association between thyrotropin (TSH) and free thyroxine (FT4) levels with the incidence of CKD in a large cohort study over long-term follow-up.</p><p><strong>Methods: </strong>This prospective cohort study, with an 18-year follow-up, included 4118 adults without CKD from the Tehran thyroid Study (TTS). Participants were categorized by tertiles of normal TSH levels (low-normal, middle-normal, and high-normal) and abnormal TSH. The study outcome was incident CKD, defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) for CKD incidence based on thyroid hormone levels.</p><p><strong>Results: </strong>The HR for CKD development was 1.08 (95%CI: 1.01-1.15) per 1 SD increase in the TSH levels. Compared with participants with low-normal TSH levels, those with high-normal (HR:1.37; 95%CI: 1.03-1.84) and abnormal TSH (HR:1.24; 95%CI: 1.05-1.46) had a significantly higher risk of developing CKD. In subgroup analyses, the association between TSH level and CKD was significant in participants younger than 60 years, females, non-obese, non-smokers, and those without diabetes and hypertension. No association was observed between FT4 levels and incident CKD (HR: 0.92; 95%CI: 0.79-1.09). However, a significant association was observed between FT4 levels within the normal range and CKD development in those younger than 60 years old (HR: 0.77; 95% CI: 0.61-0.98).</p><p><strong>Conclusion: </strong>Increased TSH levels, even within the normal range, linearly increased the risk of CKD even after adjustment for important risk factors. As a result, TSH may potentially be an independent risk factor for incident CKD.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"13"},"PeriodicalIF":1.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid hormone use in clinical practice by Israeli endocrinologists: a THESIS* questionnaire survey : *Treatment of hypothyroidism in Europe by specialists: an international survey.","authors":"Liat Sasson, Keren Kaminer, Chagit Adler Cohen, Laszlo Hegedüs, Roberto Negro, Endre V Nagy, Enrico Papini, Petros Perros, Roberto Attanasio, Eyal Robenshtok","doi":"10.1186/s13044-024-00219-2","DOIUrl":"10.1186/s13044-024-00219-2","url":null,"abstract":"<p><strong>Objective: </strong>Several thyroid hormone formulations are available for treatment of hypothyroidism. This study aimed at evaluating the use of these treatment options by Israeli endocrinologists in various clinical scenarios.</p><p><strong>Methods: </strong>Israeli Endocrine Society members were invited to participate in a web-based questionnaire, Treatment of Hypothyroidism in Europe by Specialists: An International Survey.</p><p><strong>Results: </strong>99.2% of respondents used LT4 tablets as first line therapy for hypothyroidism. Thyroid hormone replacement options considered by respondents included LT4 tablets (100%), soft-gel capsules (4.0%), liquid solution (15.4%), combined LT4 + LT3 (2.4%) and LT3 tablets (17.8%). In cases of impaired absorption or persistent symptoms, most would continue LT4 tablets (86.1% and 95.1%, respectively), of whom 39.0% noted that only tablets are available in Israel. In patients with normal serum TSH and persistent symptoms, 95.1% would continue LT4 tablets, 57.5% would consider the addition of LT3 whereas 24.4% stated that LT4/LT3 combination should never be used. In euthyroid patients, LT4 therapy was considered in infertile women with high levels of thyroid antibodies (33.6%) and for simple goiter growing over time (11.4%).</p><p><strong>Conclusions: </strong>In Israel, LT4 tablets are the treatment of choice for hypothyroidism in most clinical scenarios, including in patients with impaired absorption or with persistent symptoms, for whom a combination therapy with LT4 + LT3 is considered by half of respondents. Other LT4 formulations are not widely available in Israel, thus are infrequently considered compared to other European countries. These data suggest that international guidelines regarding the use of various thyroid hormone formulations in specific clinical scenarios are warranted.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"12"},"PeriodicalIF":1.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of hemorheology in patients with hyperthyroidism via blood viscosity, erythrocyte deformability and aggregation.","authors":"Sena Ebru Caglar, Yunus Karakoc, Alpaslan Tanoglu, Refik Demirtunc, Seher Tanrikulu, Hande Kilickaya, Muhterem Ercan","doi":"10.1186/s13044-025-00227-w","DOIUrl":"10.1186/s13044-025-00227-w","url":null,"abstract":"<p><strong>Objective: </strong>Hyperthyroidism's impact on cardiovascular, hematopoietic systems and metabolism might lead to hemorheological changes. This study aimed to investigate the changes in hemorheological properties via erythrocyte deformability and aggregation, whole blood viscosity (WBV) and plasma viscosity (PV) in hyperthyroid patients. The effect of anti-thyroid treatment on hemorheology was also studied. MATERIAL METHODS: Thirty-six patients with overt hyperthyroidism, 19 patients with subclinical hyperthyroidism and 66 controls were included in the study. Hematocrit, erythrocyte deformability and aggregation, plasma and whole blood viscosity values were measured before treatment. Hemorheological parameters of the patients were compared with the control. Before and after treatment results of overt hyperthyroidism were analyzed. Methimazole was given as anti-thyroid treatment. Deformability and aggregation measurements were conducted using a laser ektacytometer (LORRCA) while viscosity measurements were performed with a cone-plate viscometer (Brookfield DV-III).</p><p><strong>Results: </strong>The maximum elongation index (EImax) decreased significantly from 0.664 (0.01) pre-treatment to 0.657 (0.01) post-treatment (p = 0.04). The aggregation index was significantly higher in both the subclinical hyperthyroidism group [68.05 (7.66), p = 0.001] and the overt hyperthyroidism group [66.78 (8.815), p = 0.001] compared to the control group. Additionally, the aggregation half-time was significantly shorter in the subclinical hyperthyroidism group [1.9 (1.21-2.27), p = 0.001] and the overt hyperthyroidism group [1.91 (1.43-2.46), p = 0.001] relative to the control group.</p><p><strong>Conclusion: </strong>The hemorheological status of patients was influenced by excessive thyroid hormones in both subclinical and overt hyperthyroidism groups. Additionally, anti-thyroid therapy with methimazole may play a role in the observed decrease in the maximum elongation index following treatment.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"11"},"PeriodicalIF":1.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of thyroid autoimmunity is potentially associated with the deficiency of vitamin D3 rather than vitamin D2 in euthyroid men.","authors":"Dongdong Luo, Chenxi Zhang, Bingrui Gao, Deping Wang, Zhaoying Chen, Kan Chen, Bojuan Li, Song Leng, Jing Li","doi":"10.1186/s13044-025-00226-x","DOIUrl":"10.1186/s13044-025-00226-x","url":null,"abstract":"<p><strong>Objective: </strong>Vitamin D(VitD) deficiency has been found prevalent among patients with thyroid autoimmunity (TAI). This study aimed to investigate whether low VitD2 or VitD3 potentially contributed to the development of TAI in euthyroid male patients, which had not been reported before.</p><p><strong>Methods: </strong>A total of 2882 euthyroid male petroleum workers were recruited from those participants in the healthcare program at the second affiliated hospital of Dalian Medical University in 2021, whose serum VitD levels, thyroid functions, and autoantibody titers were all examined at the same time. Among them, 2587 (89.8%) individuals received the second health follow-up in 2022. Serum VitD including 25(OH)D2 (VitD2) and 25(OH)D3 (VitD3) levels were detected by liquid chromatography-tandem mass spectrometry. Thyroid functions and autoantibody titers were quantified using chemiluminescent immunoassays.</p><p><strong>Results: </strong>The serum levels of VitD and VitD3 were pronouncedly lower in the male euthyroid subjects with TAI (n = 195) than those non-TAI men (n = 2687, P < 0.05), whereas serum VitD2 was not significantly different based on the data from the initial investigation in 2021. The prevalence of subjects with TAI among the total male euthyroid subjects with TAI population was markedly increased with the decreasing levels of serum VitD and VitD3, respectively (P for trend < 0.05), but not significantly changed with that of serum VitD2. The binary logistic regression analysis revealed that either the deficiency of VitD (serum VitD < 20 ng/mL, VDD) or low VitD3 level was an independent risk factor for the development of TAI, which had been further demonstrated by the follow-up observation in 2022. Among the non-TAI men in 2021, 6.52% (n = 157) individuals became TAI patients after a one-year follow-up, and their serum VitD and VitD3 levels both exhibited significantly more reduction as compared with those of the remained non-TAI ones in 2022. More of those with VDD developed TAI than the non-VDD ones did in 2022 (8.5% vs. 5.6%, P<0.05). Additionally, the change in serum VitD over the two years was more strongly correlated with serum VitD3 (rs = 0.971, P < 0.001) when compared with that of VitD2 (rs = 0.085, P < 0.001) in the whole euthyroid male population.</p><p><strong>Conclusion: </strong>Based on the cross-sectional and prospective investigations, our findings further indicate that VDD may be an independent risk factor for TAI development. Moreover, the latter is potentially associated with the deficiency of VitD3 rather than VitD2 in the euthyroid male population although the related mechanisms await in-depth exploration. Our findings also suggest that VitD3 supplementation might provide more potential benefits than VitD2 among VDD men in terms of preventing TAI development.</p><p><strong>Study registration: </strong>the Dalian Health Management Cohort (DHMC) ChiCTR2300073363.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"10"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women-specific reference ranges for serum TSH in Liguria: the impact of age and year of collection in a single-center cross-sectional study.","authors":"Massimo Giusti, Marilena Sidoti","doi":"10.1186/s13044-025-00225-y","DOIUrl":"10.1186/s13044-025-00225-y","url":null,"abstract":"<p><strong>Background: </strong>TSH is the first-line test of thyroid function, and the normal TSH references provided by manufacturers are generally used in diagnoses. In the age of gender medicine, however, there is a need to refine normal TSH ranges.</p><p><strong>Aim: </strong>The aim of this study was to construct a normal TSH range in women living in our district. The data were collected in a secondary-level centre located in Savona (Liguria, Italy).</p><p><strong>Methods: </strong>From 2003 to 2022, 6227 medical records from women undergoing their first endocrinological examination were anonymously evaluated. After the application of exclusion criteria, statistical analysis was anonymously performed on a sample of 2597 medical records.</p><p><strong>Results: </strong>The pooled median 2.5th and 97.5th percentiles of TSH provided by manufacturers were 0.20 mIU/l and 5.64 mIU/l, respectively. In the study population, median (2.5th - 97.5th percentiles) TSH was 1.70 mIU/l (0.37-6.95 mIU/l). TSH and patient age did not vary significantly over the years (2003-2022). A slight negative correlation was found between TSH and age (P = 0.05). On stratifying the sample into three age-groups (18-44 years, N = 1200; 45-64 years N = 934; ≥65 years, N = 463), TSH was 1.75 mIU/l (0.49-5.94 mIU/l), 1.70 mIU/l (0.30-6.89 mIU/l) and 1.64 mIU/l (0.30-7.69 mIU/l), respectively. When TSH was evaluated according to the age-related range instead of the pooled range reported by manufacturers, the number of women aged 18-44 years considered to have sub-clinical hyperthyroidism increased slightly (P = 0.02) and the number of women in the 45-64-year and ≥ 65-year age-groups considered to have sub-clinical hypothyroidism decreased significantly (P = 0.05 and P < 0.001).</p><p><strong>Conclusions: </strong>This is the first study in Liguria aimed at establishing new age-specific reference values for TSH in women. Based on a large number of data, this new age-related range could be more extensively employed in order to improve diagnosis. The main result of implementing age-related normal TSH levels between the 2.5th and 97.5th percentiles seems to be both a slight increase in 18-44-year-old women and a significant reduction in > 45-year-old women in whom sub-clinical hyperthyroidism or hypothyroidism, respectively, should be promptly treated.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"8"},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of age at diagnosis on central lymph node metastasis in clinically low-risk papillary thyroid microcarcinoma patients.","authors":"Yunhe Liu, Lida Liao, Dangui Yan, Jie Liu, Wensheng Liu, Shaoyan Liu, Hui Huang","doi":"10.1186/s13044-025-00224-z","DOIUrl":"10.1186/s13044-025-00224-z","url":null,"abstract":"<p><strong>Background: </strong>Age is an independent risk factor for central lymph node metastasis (CLNM) in clinically negative lymph node (cN0) papillary thyroid microcarcinoma (PTMC) patients. The objective of this study was to investigate the impact of age on CLNM in clinically low-risk PTMC patients.</p><p><strong>Methods: </strong>A retrospective analysis was performed on patients with clinically low-risk PTMC who underwent surgery between January 2016 and December 2018. Logistic regression analysis was used to examine the impact of age on the risk of CLNM. The associations between age and pN1a and the lymph node ratio (LNR) were examined by a restricted cubic spline (RCS) curve with logistic regression models.</p><p><strong>Results: </strong>A total of 1352 patients (mean [range] age, 43[18-76] years; 325 males [24.0%]) were enrolled in this study. Logistic regression analysis revealed that age was a significant factor influencing the risk of CLNM (OR 0.95, 95% CI 0.94-0.96; p < 0.001). The RCS curve revealed a significant nonlinear association between age and pN1a status and the LNR. For patients under the age of 55, the risk of CLNM (OR 0.59, 95% CI 0.55-0.65, p < 0.001) and the LNR (beta - 0.23, 95% CI -0.27, -0.19, p < 0.001) significantly decreased as age increased. For patients aged ≥ 55 years, the risk of LNM (OR 1.03, 95% CI 0.81-1.32; p = 0.79) and the LNR (Beta - 0.03, 95% CI -0.07,0.13, p = 0.54) did not change with age.</p><p><strong>Conclusions: </strong>This study confirmed that age was a significant factor influencing the risk and severity of CLNM in patients with low-risk PTMC. The risk and severity of LNM were lowest in patients aged ≥ 55 years.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"6"},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Celastrol promotes apoptotic cell death in thyroid cancer cells through a caspases-dependent pathway.","authors":"Ruoyi Yang, Jie Yao, Hong Ma, Chunyan Shui, Teng Li, Sicheng Zhang, Chao Li","doi":"10.1186/s13044-024-00222-7","DOIUrl":"10.1186/s13044-024-00222-7","url":null,"abstract":"<p><strong>Background: </strong>Celastrol, a naturally occurring bioactive compound, has demonstrated potential in treating inflammation, obesity, and tumors, particularly in colorectal, gastric, and breast cancers. However, its therapeutic effects on thyroid cancer (TC), which have poor clinical outcomes, remain unclear. This study aimed to investigate Celastrol's potential in treating thyroid cancer using cell lines.</p><p><strong>Methods: </strong>The viability and proliferation of thyroid cancer cells treated with or without Celastrol were analyzed by CCK-8 and colony formation assay. The state of thyroid cancer cells treated with or without Celastrol were observed by microscopy. Further evidence from flow cytometry and TUNEL staining demonstrated the induction of apoptotic processes in thyroid cancer cells. The expression of PARP1, Caspase-3, Bax, BCL2 in thyroid cancer cells after indicated treatment was analyzed by Western blot and Caspase-3 expression in thyroid cancer cells after 12 and 24 h of Celastrol treatment was detected by immunofuorescence assay. Anaplastic thyroid cancer growth-limiting of Celastrol was evaluated in nude mice.</p><p><strong>Results: </strong>Celastrol induction promoted apoptotic in TC cells, increased the expression of PARP1, Bax and Caspase-3 and reduces expression of BCL2 by Western Blot. The expression of Caspase-3 was increased by immunofluorescence, which indicating that Celastrol may serve as an adjuvant therapeutic agent for thyroid cancer treatment by inducing apoptosis through the caspase-3 pathway. Celastrol treatment of mice implanted with anaplastic thyroid cancer cells also inhibited tumor growth, associated with reduced Ki-67 and increased Caspase-3.</p><p><strong>Conclusions: </strong>Celastrol promotes apoptotic cell death in thyroid carcinoma cells by the Caspase-3 pathway.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"9"},"PeriodicalIF":1.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subacute thyroiditis in pregnancy: a narrative review.","authors":"Mahmoud Ali Kaykhaei, Zahra Heidari","doi":"10.1186/s13044-024-00221-8","DOIUrl":"10.1186/s13044-024-00221-8","url":null,"abstract":"<p><p>Thyroid dysfunction can adversely affect pregnancy outcomes. Apart from gestational thyrotoxicosis, thyroid dysfunction during pregnancy shares similar etiologies with the non-gravid state. Graves' disease is the most common cause of spontaneous hyperthyroidism in pregnancy, followed by thyroid autonomy. Although subacute thyroiditis is a less common cause of thyrotoxicosis in pregnancy, its associated pain, systemic symptoms, and thyroid dysfunction can present diagnostic and therapeutic challenges. In its painful form, subacute thyroiditis may lead to severe disability, with systemic glucocorticoids being the best effective treatment option. When painless, the condition often comes to medical attention due to thyroid dysfunction. During the thyrotoxic phase, subacute thyroiditis should be differentiated from gestational thyrotoxicosis, Graves' disease, and thyroid autonomy. Additionally, the transient hypothyroid phase may be misdiagnosed as permanent hypothyroidism, such as in Hashimoto's thyroiditis. Once properly diagnosed, management is symptomatic and focused on correcting the predominant abnormality. In this review, we summarize the current reported cases of subacute thyroiditis in pregnancy and discuss the challenges in diagnosis and management. Clinical trial number Not applicable.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"4"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BRAF^V600E mutation is associated with better prognoses in radioactive iodine refractory thyroid cancer patients treated with multi-kinase inhibitors: a retrospective analysis of registered clinical trials.","authors":"Di Sun, Xin Zhang, Xiaona Jin, Cong Shi, Yuqing Sun, Yingqiang Zhang, Jun Liang, Yansong Lin","doi":"10.1186/s13044-025-00223-0","DOIUrl":"10.1186/s13044-025-00223-0","url":null,"abstract":"<p><strong>Background: </strong>The antiangiogenic multi-kinase inhibitors (MKIs) apatinib, donafenib, and anlotinib have demonstrated satisfactory efficacy in radioactive iodine refractory differentiated thyroid cancer (RAIR-DTC) in their phase II/III trials. However, the potential impact factors on the efficacy of these MKIs remain unclear.</p><p><strong>Methods: </strong>RAIR-DTC patients enrolled in clinical trials of apatinib, donafenib, and anlotinib in our center were retrospectively reviewed. The Kaplan-Meier method was used to examine the relationship between clinicopathological variables and progression-free survival (PFS) and overall survival (OS), followed by a multivariate Cox analysis on PFS.</p><p><strong>Results: </strong>A total of 71 progressive RAIR-DTC patients were reviewed, of which 26.7% were treated by anlotinib, 45.1% by apatinib, and 28.2% by donafenib. The median follow-up time was 44.1 months, the median PFS was 21.1 months, and the estimated median OS was 47.7 months. PFS and OS showed no significant differences in patients treated with apatinib, donafenib, or anlotinib. In the univariate analyses, patients with BRAF^V600E mutation showed longer PFS (HR 0.345, 95% CI 0.187-0.636, p < 0.001) and OS (HR 0.382, 95% CI 0.166-0.878, p = 0.019) compared with patients with wild-type BRAF. Patients with follicular thyroid cancer and bone metastases had shorter PFS, and patients with worse Eastern Cooperative Oncology Group performance status, bone metastases, and a larger tumor burden had shorter OS. In the multivariate Cox analysis, BRAF^V600E mutation was the only independent predictor of longer PFS (HR 0.296, 95% CI 0.138-0.638, p = 0.002). The overall response rate and disease control rate didn't differ between BRAF^V600E mutation status. Subgroup analysis of PFS in papillary thyroid cancer patients stratified by BRAF^V600E mutation status showed that BRAF^V600E mutation was associated with longer PFS in all clinicopathological subgroups (hazard ratio < 1).</p><p><strong>Conclusion: </strong>RAIR-DTC patients with BRAF^V600E mutation treated with apatinib, donafenib, or anlotinib achieved better prognoses compared with patients with wild-type BRAF, indicating that the genetic background may play a role in predicting the efficacy of MKIs therapies.</p><p><strong>Trial registration: </strong>This retrospective cohort included patients in our center from clinical trials of apatinib (NCT02731352, NCT03048877), donafenib (NCT02870569, NCT03602495), and anlotinib (NCT05007093).</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"5"},"PeriodicalIF":1.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}