Endocrine最新文献

{"title":"Identification of potential biomarkers of papillary thyroid carcinoma.","authors":"Sabire Kilicarslan, Meliha Merve Hiz-Cicekliyurt","doi":"10.1007/s12020-024-04068-9","DOIUrl":"10.1007/s12020-024-04068-9","url":null,"abstract":"<p><p>Papillary thyroid cancer (PTC) is the predominant form of malignant tumor affecting the thyroid gland.</p><p><strong>Aim: </strong>This study aimed to identify candidate biomarkers for papillary thyroid carcinoma using an integrative analysis of bioinformatics and machine learning (ML).</p><p><strong>Material and method: </strong>The PTC datasets GSE6004, GSE3467, and GSE33630 (species: Homo sapiens) were downloaded from NCBI and analyzed using the limma package to obtain DEGs. Once DEGs were identified, GO and KEGG enrichment analyses were performed as the first step in the bioinformatics process. Subsequently, a protein-protein interaction (PPI) network was constructed according to the common genes in bioinformatics and machine learning using STRING to elucidate the important genes involved in PTC pathogenesis. In machine learning, finding genes entails feature selection to identify the key genes that distinguish biological states. Hybrid feature selection will be used for this. In the second step, the original data sets were preprocessed to detect and correct missing and noisy data; after that, all data were merged. Following performing Linear and Discriminative Hybrid Feature Selection (LDHFS) on the processed dataset, machine learning algorithms such as Random Forest (RF), Naive Bayes (NB), and Support Vector Machines (SVM) are utilized.</p><p><strong>Results: </strong>Bioinformatics and machine learning analyses indicate that the genes RXRG, CDH2, ETV5, QPCT, LRP4, FN1, and LPAR5 are integral to the progression of thyroid cancer. This study attained the highest accuracy utilizing the RF algorithm, achieving an accuracy rate of 94.62%, a Kappa value of 91.36%, and an AUC value of 96.13%. These results offer additional evidence and confirmation for the genetic alterations of these genes. These findings may accelerate the development of prospective therapeutic and diagnostic methods in future research.</p><p><strong>Conclusions: </strong>Bioinformatics and machine learning techniques identified the common genes \"RXRG, CDH2, ETV5, QPCT, LRP4, FN1, and LPAR5\" as PTC biomarkers, providing novel reference markers for the diagnosis and treatment of PTC patients. The model is anticipated to possess significant predictive value and assist in the early diagnosis and screening of clinical PTC. These insights enhance the field of PTC management and offer guidance for future research.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"758-771"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoparathyroidism: an update on new therapeutic approaches.","authors":"Marco Pitea, Ruggero Lanzafame, Elisa Sala, Ludovica Crocè, Stefano Mora","doi":"10.1007/s12020-024-04057-y","DOIUrl":"10.1007/s12020-024-04057-y","url":null,"abstract":"<p><strong>Background: </strong>Hypoparathyroidism is a rare endocrine disease characterized by insufficient parathyroid hormone (PTH) secretion by the parathyroid glands, leading to hypocalcemia. In contrast to most hormone deficiencies for which hormone replacement is currently the mainstay of therapy, hypoparathyroidism has conventionally been treated with calcium supplements and active analogs of vitamin D. Although the advent of a replacement therapy with 1-34 and 1-84 PTH represented a major step in the therapeutic history of hypoparathyroidism, several new molecules and different management strategies have recently been developed.</p><p><strong>Purpose: </strong>This review investigates the therapeutic approaches currently under investigation for the treatment of hypoparathyroidism. Clinical trials results have been considered and discussed.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"420-429"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The related factors affecting the relationship between HbA1c and glucose management indicator in adult T2D patients with good glycemic control.","authors":"Zhigu Liu, Beisi Lin, Danrui Chen, Yanling Yang, Wei Jiang, Daizhi Yang, Jinhua Yan, Bin Yao, Xubin Yang, Wen Xu","doi":"10.1007/s12020-024-04083-w","DOIUrl":"10.1007/s12020-024-04083-w","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the relationship between glucose management indicator (GMI) and HbA1c and find the affecting factors in adult T2D patients with good glycemic control.</p><p><strong>Methods: </strong>Adult T2D patients with both HbA1c < 7% and time in range (TIR) > 70% were retrospectively analyzed. A significant difference between GMI and HbA1c was defined as an absolute value of hemoglobin glycation index (|HGI|, HbA1c minus GMI) ≥ 0.5%. Factors associated with high |HGI| were determined by logistic regression analysis. The performance of possible factors in predicting high |HGI| was verified by ROC curve analysis. And the linear relationship between GMI and HbA1c was also investigated.</p><p><strong>Results: </strong>Of all the 94 patients (median HbA1c 6.18%, mean GMI 6.34%) included, 28.72% had an |HGI | ≥ 0.5% and only 15.96% had an |HGI | < 0.1%. Standard deviation of blood glucose (SDBG), a glycemic variability index, affected |HGI| (OR = 3.980, P = 0.001), and showed the best performance in predicting high |HGI| (AUC = 0.712, cutoff value = 1.63 mmol/L, P = 0.001). HbA1c was linearly correlated with GMI (β = 0.295, P = 0.004). Their correlation weakened after further adjusting for SDBG (β = 0.232, P = 0.012). Linear correlation between them was closer in patients with smaller SDBG ( < 1.63 mmol/L) than those with larger SDBG (P = 0.004).</p><p><strong>Conclusions: </strong>Even in adult T2D patients with good glycemic control, the discrepancy between GMI and HbA1c existed. Their relationship was affected by glycemic variability. SDBG mainly accounted for this consequence.</p><p><strong>Trial registration: </strong>Chinese clinical trial registry ( www.chictr.org.cn ), ChiCTR2000034884, 2020-07-23.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"609-618"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative mortality in pituitary adenomas subtypes: a tertiary referral center study.","authors":"Iustin Daniel Toma, Dan Alexandru Niculescu, Simona Andreea Găloiu, Raluca Alexandra Trifănescu, Cătălina Poiană","doi":"10.1007/s12020-024-04073-y","DOIUrl":"10.1007/s12020-024-04073-y","url":null,"abstract":"<p><strong>Purpose: </strong>Mortality in pituitary adenomas (PAs) has been extensively compared to general population. However, direct comparisons between PA subtypes are scarce. We aimed to compare mortality in various subtypes of PA (acromegaly, Cushing's disease (CD), macroprolactinomas and non-functioning pituitary macroadenomas (MacroNFPA)), within a single referral center.</p><p><strong>Methods: </strong>We retrospectively analyzed mortality and survival time in all 962 PAs admitted in our department between 2011 and 2023: acromegaly (n = 306), CD (n = 69), macroprolactinoma (n = 168) and MacroNFPA (n = 419).</p><p><strong>Results: </strong>Median follow-up was 10.2 (5.2, 15.2) years. The overall survival probability was 90.9% and 78.1% after 10 and 20 years respectively with age at diagnosis as the only significant predictor. There were no significant differences in survival probability between various PA subtypes in the whole cohort. In patients over 45 years of age at diagnosis there was a significant difference in survival probability between the four groups (p = 0.01) in the first 15 years of follow-up. In head-to-head comparisons CD had a significantly higher mortality risk than patients with acromegaly (HR 3.38 [CI 95% 1.07 to 10.60]) even after adjusting for age and sex.</p><p><strong>Conclusion: </strong>Patients diagnosed with CD after 45 years of age have a significantly lower survival probability than other PA subtypes in the first 15 years of follow-up. All other PA subtypes had a similar survival probability after adjusting for age and sex. Due to advances in medical treatment of hormone secreting tumors, mortality in patients with PAs might increasingly depend more on tumor mass than on hormonal hypersecretion.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"782-787"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's response regarding timing of genital surgery in congenital adrenal hyperplasia.","authors":"Henrik Falhammar, Gundela Holmdahl, Helena Filipsson Nyström, Anna Nordenström, Kerstin Hagenfeldt, Agneta Nordenskjöld","doi":"10.1007/s12020-024-04080-z","DOIUrl":"10.1007/s12020-024-04080-z","url":null,"abstract":"<p><strong>Purpose: </strong>To study what adult women with congenital adrenal hyperplasia (CAH) thought about the timing of genital surgery.</p><p><strong>Methods: </strong>As part of a larger follow-up study performed between the years 2002-2005 there were questionnaires concerning genital surgery, type of surgery, their thoughts about timing of genital surgery and experience of information about surgery. Early surgery was defined as ≤4 years of age and late ≥10 years. The medical and surgical files were reviewed.</p><p><strong>Results: </strong>62 women with CAH due to 21-hydroxylase deficiency, mean age 28 years (18-63) were included. The age at first genital surgery was 3 years (0-28 years) in the 52 patients (84%) who had had genital surgery, with 60% had early surgery (≤4 years) and 29% late (≥10 years). Almost half of the cohort had a positive experience of the information about surgery, a third had no opinion and a fifth had a negative experience. Of the women 39% thought that early surgery was good, while 19% thought it should be done during or after puberty and 42% had no opinion. Of those preferring early surgery 70% had early surgery themselves. Vaginal surgery was less common among those favoring early surgery. Age, phenotype, genotype, decade of surgery and experience of the information about surgery did not differ significantly between the three groups.</p><p><strong>Conclusion: </strong>Equal numbers of women had no opinion regarding age at surgery or preferred early surgery while 19% thought it would be preferred to have surgery during or after puberty.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"830-835"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tirzepatide administration improves cognitive impairment in HFD mice by regulating the SIRT3-NLRP3 axis.","authors":"Jingjing Ma, Yuanyuan Liu, Junya Hu, Xingjing Liu, Yin Xia, Wenqing Xia, Ziyang Shen, Xiaocen Kong, Xia Wu, Li Mao, Qian Li","doi":"10.1007/s12020-024-04013-w","DOIUrl":"10.1007/s12020-024-04013-w","url":null,"abstract":"<p><strong>Purpose: </strong>High-fat diet (HFD) currently is reported that in connection with cognitive impairment. Tirzepatide is a novel dual receptor agonist for glycemic control. But whether Tirzepatide exerts a protective effect in HFD-related cognitive impairment remains to be explore.</p><p><strong>Methods: </strong>During the study, the cognitive dysfunction mice model induced by HFD were established. The expressions synapse-associated protein and other target proteins were detected. The oxidative stress parameters, levels of inflammatory cytokine were also detected.</p><p><strong>Results: </strong>Our findings proved that Tirzepatide administration attenuates high fat diet-related cognitive impairment. Tirzepatide administration suppresses microglia activation, alleviates oxidative stress as well as suppressed the expression of NLRP3 in HFD mice by up-regulating SIRT3 expression. In conclusion, Tirzepatide attenuates HFD-induced cognitive impairment through reducing oxidative stress and neuroinflammation via SIRT3-NLRP3 signaling.</p><p><strong>Conclusion: </strong>This study suggest that Tirzepatide has neuroprotective effects in HFD-related cognitive dysfunction mice model, which provides a promising treatment of HFD-related cognitive impairment.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"486-497"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The polar vessel sign: insights from CT imaging analysis in Asian Indian primary hyperparathyroidism.","authors":"Anima Sharma, Saba Samad Memon, Manjunath Goroshi, Shetteppa Goroshi, Virendra Patil, Padma Vikram Badhe, Hemangini Thakkar, Vijaya Sarathi, Aditya Phadte, Chethan Yami Channaiah, Manjiri Karlekar, Rohit Barnabas, Anurag Ranjan Lila, Tushar Bandgar","doi":"10.1007/s12020-024-04076-9","DOIUrl":"10.1007/s12020-024-04076-9","url":null,"abstract":"<p><strong>Purpose: </strong>Data on the polar vessel sign (enlarged feeding vessel terminating in parathyroid lesions) on four-dimensional computed tomography (4D-CT) is limited. We performed a retrospective analysis to determine the prevalence, predictors, and adjunctive utility of polar vessel sign in pre-operative 4D-CT of patients with primary hyperparathyroidism (PHPT).</p><p><strong>Methods: </strong>One radiologist blinded to the patients' details reported the 4D-CT of eighty-four operated patients with histopathology-proven single-gland PHPT. Two protocols were used to obtain arterial-phase images: timed via bolus tracking (n = 41) or fixed at 20 s after contrast injection (n = 43).</p><p><strong>Results: </strong>Seventy-one patients were symptomatic for PHPT, with median serum calcium 12.1 mg/dL. On the arterial phase of 4D-CT, 88.1% of lesions had the polar vessel sign, including 7/9 asymptomatic patients, 6/6 parathyroid carcinomas, and 3/4 ectopic(1:mediastinum, 2:thyro-thymic ligament). Predictors of polar vessel sign were maximum lesion dimension (2.2 vs. 1.4 cm; P = 0.03), solid-cystic CT morphology (47.3% vs. none; P = 0.004), and bolus tracking-timed arterial phase (55.4% vs. none; P = 0.001). Of these, bolus tracking improved the polar vessel's visualization (100% vs. 76.7%; P = 0.001) independent of lesion dimension and solid-cystic morphology. The latter two predicted polar vessel sign in images obtained at a fixed interval (20 s). A significantly lower proportion of bolus tracking-timed scans had lesion percentage arterial enhancement (PAE) < 128.9% (2/41 vs. 9/43; P = 0.04). Even with suboptimal PAE, the polar vessel helped identify 9/11 lesions.</p><p><strong>Conclusion: </strong>The polar vessel sign demonstrated an additive role to PAE during CT reporting. Bolus tracking is valuable in optimizing vessel and tumor arterial enhancement and is easily incorporated into parathyroid 4D-CT protocol.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"800-809"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis, treatment, and follow-up of patients with hypophosphatasia.","authors":"Juan Guillermo Cárdenas-Aguilera, Vladimir González-López, Ana María Zarante-Bahamón, Juan Carlos Prieto-Rivera, Richard Baquero-Rodríguez, Kelly Rocío Chacón-Acevedo, Adriana Isabel Meza-Martínez, Ana Katherina Serrano-Gayubo, Adriana Medina-Orjuela, Jimena Adriana Cáceres-Mosquera, Gustavo Adolfo Guerrero-Tinoco, María Fernanda García-Rueda, Pilar Guarnizo-Zuccardi, Gilberto Herrera-Ortiz, Carolina Rojas-Barrera, Martha Isabel Carrascal-Guzmán, María Fernanda Reina-Ávila, Sletza Lissette Arguinzoniz-Valenzuela, Leticia Belmont-Martínez, Mariana Del-Pino, Gisela Lorena Viterbo, Mariana Seijo, Joan Calzada-Hernández, Norma Elizabeth Guerra-Hernández, Oscar Héctor Brunetto","doi":"10.1007/s12020-024-04054-1","DOIUrl":"10.1007/s12020-024-04054-1","url":null,"abstract":"<p><strong>Introduction: </strong>Hypophosphatasia is a rare inherited systemic metabolic disorder, with an estimated prevalence in the severe forms of the disease of 1/100.000-1/300.000, that affects the typical architecture of bone, leading to defective mineralization during growth and remodeling. It is characterized by loss-of-function variants in the ALPL gene, resulting in low activity of tissue-nonspecific alkaline phosphatase. In severe cases, it can be fatal.</p><p><strong>Objective: </strong>To generate recommendations on the diagnosis, treatment, and follow-up of patients with hypophosphatasia based on available evidence.</p><p><strong>Materials and methods: </strong>A search for evidence published between 2012 and 2024 was carried out in Medline and Embase. The search was expanded with information from various sources, including official sites of development groups, consensuses, technology evaluations, Google Scholar, clinical experts, and reference lists. The quality of the evidence was evaluated according to the type of document type. A modified Delphi consensus process was carried out with external experts, apart from the development group, it was established an 80% agreement threshold to define the final recommendations.</p><p><strong>Results: </strong>Sixty-one papers were found in the evidence search. The global quality of the evidence was low. In addition, a consensus was reached on 94 recommendations regarding diagnosis, treatment, and follow-up. Those recommendations were approved by external clinical experts from Colombia, Argentina, Spain, and Mexico.</p><p><strong>Conclusions: </strong>The recommendations proposed in this document are based on the evidence available to the date the search was carried out, and the judgment of clinical experts. The recommendations on diagnosis, treatment, and follow-up are expected to guide the daily clinical practice for patients with HPP.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"400-419"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time course of remnant cholesterol and the risk of heart failure.","authors":"Xiaoxue Liu, Yijun Zhang, Xue Tian, Qin Xu, Xue Xia, Shuohua Chen, Fen Liu, Shouling Wu, Anxin Wang","doi":"10.1007/s12020-024-04028-3","DOIUrl":"10.1007/s12020-024-04028-3","url":null,"abstract":"<p><strong>Background and aim: </strong>Previous studies have shown that remnant cholesterol (RC) was associated with heart failure (HF). However, lack of evidence regarding the long-term trend of RC with HF risk. We aimed to investigate the association between cumulative RC exposure with incident HF and to further explore the modulating effects of the time course of RC accumulation.</p><p><strong>Methods and results: </strong>We enrolled 41,168 participants free of CVD from the Kailuan Study who completed the first three health examinations from 2006 to 2010. Cumulative RC exposure included cumulative RC and time-weighted cumulative RC. The combination of cumulative RC and RC slope over time was characterized as the time course of RC accumulation. Multivariable adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for HF risk. We also considered non-HF-related death as a competing event by performing competing risk models as a sensitivity analysis. During 8.84 years, 839 participants developed HF events. Cumulative RC exposure increased the HF risk, with HRs for cumulative RC of 1.72 (1.41-2.10) and for time-averaged cumulative RC of 1.54 (1.25-1.89). There was a nonlinear relationship between cumulative RC exposure and HF risk. Participants with higher cumulative RC and negative slope had the highest HF risk (HR, 1.46; 95% CI, 1.16-1.83).</p><p><strong>Conclusions: </strong>Both cumulative long-term exposure and the time course of RC accumulation were associated with HF risk. Early RC accumulation resulted in a greater increase in risk compared to later accumulation. This finding suggests that long-term exposure to RC may be useful in identifying individuals at high risk of developing HF and highlights the need for early initiation of appropriate RC control to prevent or reduce incident HF.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"510-521"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pros and cons of surgical versus conservative management for head and neck paraganglioma: a real-world data analysis.","authors":"L Canu, L Zanatta, C Sparano, R Santoro, G Mannelli, S Zamengo, B Jance, F Amore, T Ercolino, M Mannelli, M Maggi, E Rapizzi","doi":"10.1007/s12020-025-04167-1","DOIUrl":"https://doi.org/10.1007/s12020-025-04167-1","url":null,"abstract":"<p><strong>Purpose: </strong>To compare functional deficits associated to surgery with those caused by the growth of the head and neck paragangliomas (HNPGLs).</p><p><strong>Methods: </strong>72 patients with HNPGLs were included. Patients were divided in group A (49 patients undergoing surgery) and group B (23 patients following a wait and see approach). Each patient was subjected to clinical evaluation and genetic testing. The presence of functional neurological deficits in speech or swallowing and quality of life were assessed via a dedicated otolaryngologist visit, three posted questionnaires (VHI, DHI, and MDADI), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35.</p><p><strong>Results: </strong>Thirty-four patients from group A (69.4%) and 18 from group B (78.2%) agreed to fill out the posted questionnaires. Eighteen patients from group A (36.7%) and 10 from group B (43.5%) underwent a dedicated otolaryngologist visit. A significant difference between group A and B was observed in the VHI (p = 0.001) and DHI scoring (p = 0.020), and at the otolaryngologist visit (mild neurological disabilities, p = 0.007). Patients with familial forms presented multiple HNPGLs (p = 0.011), multiple secreting lesions (p = 0.010) and underwent surgery more times for HNPGLs (p = 0.009) and for both HNPGLs and sympathetic PGLs (p = 0.015). ROC curve analysis suggests that surgery in carotid body tumors >34 mm may be more frequently associated with nerve injury.</p><p><strong>Conclusion: </strong>The management of HNPGL patients remains challenging for clinicians. This preliminary study seems to suggest that surgery still represents the first choice for patients with small lesions. An accurate clinical evaluation is mandatory to avoid non-resolving surgery and possible neurovascular long-term complications.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}