最新刊期
卷 26 ， 期 1 ， 2016
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- 摘要：Recently, the morbidity of differentiated thyroid carcinoma (DTC) has increased annually. American Thyroid Association (ATA) published the management guidelines for patients with thyroid nodules and DTC in 2006 in order to standardize their management. The ATA guidelines was updated for the first time in 2009 and its renewed version was completed in 2015 based on the considerable progress that had been made in the fields such as diagnostic assessment and management of thyroid nodules, surgery and radioactive iodine therapy for DTC in recent years. This article tried to interpret the updated contents about radioactive iodine therapy for DTC in 2015 version of the guidelines.关键词：2015 version of American Thyroid Association Guidelines;Differentiated thyroid carcinoma;Radioactive iodine therapy;Research progress2|6176|0更新时间：2025-12-31
- 摘要：The prevalence of thyroid nodules, especially differentiated thyroid cancer, has increased during the past decades. With the consideration of increasing prevalence of the disease, American Thyroid Association (ATA) updated the guidelines for adult patients with thyroid nodules and differentiated thyroid cancer in 2015. The aim of the new guidelines was to minimize potential harm from overtreatment in majority of patients at low risk for diseasespecific mortality and morbidity while appropriately treat and monitor those patients at higher risk. The updates of surgery-related contents in new ATA guidelines are interpreted in this article.关键词：Thyroid nodules;Differentiated thyroid cancer;American Thyroid Association Guidelines2|4371|0更新时间：2025-12-31
- 摘要：The ultrasound part of “2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer” is comprehensive and informative. The content includes the indications for thyroid ultrasound and aspects needed to be evaluated, malignancy risk prediction based on sonographic pattern, decision-making based on ultrasound appearances, follow-up of benign thyroid nodules and surveillance of persistent and recurrent thyroid cancer with ultrasound. Compared with 2009 version of American Thyroid Association (ATA) guidelines, there is a great deal of development. The most important revision was that it analyzed ultrasound pattern of risk stratification of malignancy in thyroid nodules and gave a detailed description of relevant concepts and definitions. Altogether, the new guidelines provided an algorithm for evaluation and management of patients with thyroid nodules based on sonographic pattern and fine needle aspiration (FNA) cytology. Comprehensive review of the guidelines and appropriate adjustment in practices will make ultrasound examination more reasonable and may enhance the level of medical practices basically.关键词：Differentiated thyroid carcinoma;American Thyroid Association;Guidelines;Ultrasound2|9014|0更新时间：2025-12-31
- 摘要：Thyroid cancer is the most common endocrine gland malignanct tumor. Numerous studies have found that the content of peripheral blood circulating RNA in various cancer types is aberrantly expressed, which could be a potential biological diagnostic marker and therapeutic target. Tissue-specific messenger RNA has a dysregulated expression and may be used for the diagnosis and residual/metastatic detection of thyroid cancer. Recent studies have showed that non-coding RNA (ncRNA) could act as oncogene or tumor suppressor gene in bacteria, fungi and mammals. It plays a regulatory role in occurrence and development of tumors and stably exists in peripheral blood. It is hopeful that it will become a new marker for diagnosis of tumors. This review introduces some latest research progress on circulating RNA associated with thyroid cancer; and emphatically discuss the role of mRNA, microRNA (miRNA), long non-coding RNA (lncRNA) and circular RNA (circRNA) in thyroid tumorigenesis and metastasis.关键词：Thyroid tumor;Circulating RNA;mRNA;Non-coding RNA4|2299|0更新时间：2025-12-31
- 摘要：Along with the extensive understanding of differentiated thyroid cancer (DTC), its distinct molecular genotype and signaling pathway was revealed, which improved the development of molecular-targeted therapy. Regarding radioactive iodine-refractory DTC, multiple multikinase inhibitors including sorafenib and lenvatinib, which target vascular endothelial growth factor (VEGF) pathway, were proved to be effective. Moreover, selective inhibitors and redifferentiation agents were shown to be promising. In the future, individual genetic testing would provide more specific information in directing individualized molecular-targeted therapy.关键词：Differentiated thyroid cancer;Molecular genotype;Sorafenib;Lenvatinib2|1865|0更新时间：2025-12-31
- 摘要：Clinical management of radioiodine-refractory differentiated thyroid cancer (RR-DTC) is extremely difficult. Re-differentiation compounds, such as retinoids, peroxisome proliferator-activated receptor (PPAR) agonists, DNA methyltransferase inhibitors and histone deacetylase inhibitors, have been used in trials to increase iodine uptake in RR-DTC. However, data on these drugs failed to meet the initial high expectations. In recent years, targeted agents have been increasingly used in pre-clinical and clinical studies to induce re-differentiation and mediate 131I therapy, and the outcomes are encouraging.关键词：Thyroid cancer;Re-differentiating therapy;Targeted agents;131I2|2998|0更新时间：2025-12-31
- 摘要：Thyroid nodules are common lesions which are over-treated in Mainland China. This article encourages using standard diagnostic procedures to differentiate malignant nodules from benign nodules especially by fine needle aspiration (FNA) cytology. The proper treatment should be applied according to different FNA results to avoid overtreatment.关键词：Thyroid nodule;Surgery;Diagnosis2|3782|0更新时间：2025-12-31
- 摘要：Incidence of thyroid cancer has continuously increased in the last three decades globally. A similar trend of thyroid cancer incidence appeared in China. New cases and deaths of thyroid cancer in China accounted for 15.6% and 13.8% of the global new cases and deaths in 2012. The incidence in East China was the highest while that in Middle China was the lowest. Thyroid cancer was more common in urban areas than in rural counterparts. The incidence was substantially higher in female patients than male. Thyroid cancer occurred most commonly in middle age. Radiation exposure, iodine sufficiency or deficiency, sex hormone and genetic mutations were risk factors for thyroid cancer. To prevent it, potassium iodide should be taken to prevent radiation fallout in nuclear accidents, unnecessary exposure to radiation from medical imaging is reduced, iodine surveillance system is improved and appropriate standards for iodized salt are established.关键词：Thyroid cancer;Distribution;Risk factors;Prevention4|8349|0更新时间：2025-12-31
- 摘要：Background and purpose: The incidence of thyroid cancer (TC) is increasing worldwide. However, there were some differences among different regions. The purpose of this study was to investigate the incidence trends and clinicopathological characteristics of TC in Qingdao, a typical eastern coastal city, and to analyze the change in etiological spectrum of surgical thyroid diseases in recent years. Methods: A total of 2 251 patients who underwent thyroidectomy in 2014 due to thyroid nodules at the Affiliated Hospital of Qingdao University were retrospectively reviewed. The clinicopathological characteristics were further analyzed among 1 306 patients with TC and compared with the corresponding data from the Surveillance Epidemiology and End Results (SEER) database as well as previous data from this hospital. Results: With the increasing number of thyroidectomy in Qingdao, there was also an increase in the proportion of TC in patients after thyroidectomy, from 34.8% in 2010 to 59.0% in 2014. Among those with TC, the male-to-female ratio was 1∶2.80, with a relatively high incidence among 20-54 year-old adults, who were younger than those reported in terms of distribution of age in SEER database (U=2 289, P=0.000). About 50.2% of the TC patients were overweight or obese, 78.2% TC patients had only asymptomatic nodules detected by ultrasound at initial diagnosis, while 16.6% had visible or palpable thyroid nodules. Only 5.2% presented hoarseness or other repression symptoms. Micro-carcinoma accounted for 61.7% of TC in 2014 at this hospital, which was significantly higher than the proportion in 2010 (37.7%). Lymph node involvement was significantly more frequent at this hospital than in SEER database (49.5% vs 26.0%, χ2=11.806, P=0.001). Even among patients with micro-carcinoma, 31.3% already presented lymph node metastases. The proportions of papillary, follicular, medullary and anaplastic carcinoma were 97.5%, 1.1%, 1.0% and 0.5%, respectively, among which the percentage of papillary carcinoma was higher than that in SEER database (U=4 654.5, P=0.055). Conclusion: There was an increase in the number of thyroidectomy in Qingdao, and the preoperative diagnostic accuracy of TC in this area kept rising. The incidence of TC was relatively high in a younger population, with more common lymph node involvements and an overweight trend. The increasing proportion of micro-carcinoma might be related to the popularization of health examination. However, the frequent lymph node metastasis in patients with micro-carcinoma is an important indicator of the invasive behavior of micro-carcinoma, which should not be overlooked.关键词：Thyroid cancer;Surgical therapy;Thyroid nodule;Clinicopathological characteristics2|2119|0更新时间：2025-12-31
- 摘要：Background and purpose: Three-dimensional power Doppler angiography (3D-PDA) is a new technique to investigate the vessels in the organs, but the research in thyroid is limited. The purpose of this research was to investigate three-dimensional power Doppler angiography (3D-PDA) in differentiating malignant from benign thyroid nodules. Methods: This study prospectively evaluated 103 lesions in 94 patients who were scheduled for surgery. The patients underwent preoperative 3D-PDA scanning. Analysis of the 3D-PDA characteristics includes blood flow pattern, the number of blood vessels, the shape of vessels, the spatial distribution of the vessels, the existence of rich local blood flow within nodules or in the parenchyma surrounding the nodules. This study also analyzed the difference between the benign lesions and the malignant lesions. Results: There were 50 benign lesions and 53 malignant lesions. The sensitivity and specificity of irregular vessels, the asymmetry spatial distribution, rich local blood flow within nodules or in the parenchyma surrounding the nodules were 64.2%, 96.0%; 56.0%, 88.0%; 54.7%, 96.0%; 60.4% and 94.0%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 3D-PDA were 83.0%, 94.0%, 93.6%, 83.9% and 90.3%, respectively. Conclusion: 3D-PDA provides a useful tool to investigate vascularization of thyroid leisions．This technique is feasible for clinical application and plays an important role in diagnosis of thyroid nodules.关键词：Thyroid nodule;Three-dimensional power Doppler angiography;Diagnosis2|2525|0更新时间：2025-12-31
- 摘要：Background and purpose: This study aimed to investigate the relationship between lymph node metastatic rate (LR) and response to radioiodine therapy in patients with papillary thyroid carcinoma (PTC). Methods: A total number of 143 PTC patients after radioiodine therapy were included and classified into 4 groups [Ⅰ(0%-10%),Ⅱ(＞10%-25%), Ⅲ(＞25%-50%), Ⅳ(＞50%)] according to the lymph node metastatic rate, and the responses to initial radioiodine therapy after a median follow-up period of 20.7 months were evaluated. They were classified into 4 groups [excellent response (ER), indeterminate response (IDR), biochemical incomplete response (BIR), and structural incomplete response (SIR)] according to the guideline proposed by 2015 American Thyroid Association. One-Way analysis of variance, χ2 test and Kruskal-Wallis test were used to evaluate the differences in basic clinicopathological features and clinical responses among the 4 groups. The ROC curve was analyzed to evaluate the clinical value of lymph node metastatic rate for predicting ER and optimal cut-off point. Results: There were no significant differences in gender and T-stage among 4 groups (P>0.05). However,Ⅰ group was significantly older than the other 3 groups (P=0.001). With the increase of lymph node metastatic rate, the number of ER cases decreased, while cases of BIR and SIR generally increased. Compared with the other 3 groups, less cases of ER (27.8%), while more BIR (27.8%) or SIR (11.1%) were observed in group Ⅳ (H=18.816, P=0.000). Cut-off value of lymph node involved rate was 52.27%, with a better specificity of predicting ER. Area under the ROC curve was 0.668. Conclusion: The higher lymph node metastatic rate in patients with PTC, the worse clinical outcome it could be. A cut-off value of lymph node metastatic rate 52.27% is a specific independent predictor for the clinical outcome in PTC patients treated with radioiodine therapy.关键词：Papillary thyroid carcinoma;Lymph node metastatic rate;Radioiodine remnant ablation;Clinical outcome2|3305|0更新时间：2025-12-31
- 摘要：Background and purpose: Pathological lymph node metastasis (LNM) is not rare in clinical lymph node negative (cN0) papillary thyroid carcinoma (PTC). The aim of this study was to investigate the risk factors of LNM, especially of high volume LNM (more than 5 metastatic lymph nodes) and contralateral central compartment LNM, in cN0 PTC. Methods: Medical records of 350 PTC patients (265 female, 85 male, 212 patients with solitary lesion in unilateral lobe) were reviewed. All operations of these patients were performed by one surgical team. The clinical pathological data were collected, and univariate and multivariate analysis was performed. Results: LNM was confirmed in 138 patients (39.4%) and 20 patients had high volume LNM. In 169 patients with solitary lesion in unilateral lobe with total thyroidectomy and bilateral central neck dissection, 24 patients had contralateral metastasis (14.2%). In univariate analysis, tumor size (58.5% in >1 cm vs 33.6% in ≤1 cm) and tumor with calcification in preoperational ultrasonography (43.7% with vs 31.7% without) showed significant difference in prevelance of LNM. In multivariate analysis, tumor size >1 cm (OR=2.792) was the independent risk factor of LNM. Gender (3.8% in male vs 11.8% in female), age (10.7% <40 years vs 3.4% ≥40 years ), tumor size(13.4% in >1 cm vs 3.4% in ≤1 cm) and tumor with low echo in preoperational ultrasonography (13.9% with vs 4.8% without) showed significant difference in univariate analysis of high volume LNM. Male (OR=5.152), tumor size >1 cm (OR=5.712) and age <40 years (OR=3.959) were confirmed as independent risk factors of high volume LNM. Male (OR=3.105) and tumor size >1 cm (OR=3.863) were also demonstrated as independent risk factors of contralateral LNM in patients with solitary lesion in unilateral lobe, the prevalence of LNM were 26.5% in male and 26.1% in tumor size >1 cm, respectively. Conclusion: LNM was not “rare” in cN0 PTC patients. Prophylactic central neck dissection should be performed in cN0 patients with tumor size >1 cm. For cN0 microcarcinoma, more active surgical treatment may be considered in male and young patients.关键词：Papillary thyroid carcinoma;Clinical lymph node negative;Lymph node metastasis;Risk factor2|2107|0更新时间：2025-12-31
- 摘要：Background and purpose: For treatment of papillary thyroid carcinoma (PTC), there is substantial divergence of opinion in neck dissection currently. In this study, we aimed to provide theoretical basis for selective neck dissection through summarizing the characteristics of cervical lymph node metastasis (LNM) in PTC. Methods: From Jul. 2006 to Aug. 2014, 462 patients with PTC at our hospital were retrospectively analyzed. We analyzed the characteristics and predictive factors of cervical LNM and evaluated the accuracy of cN0 standard. Results: All patients received ipsilateral central cervical lymph node dissection (Level Ⅵ). 320 patients underwent lateral cervical lymph node dissection (Level Ⅱ-Ⅴ) or elective lymph node dissection (some or all of Level Ⅱ-Ⅳ). 90 patients received contralateral central cervical lymph node biopsy. 73.2% (338/462) were cN0 patients, but among those 184 patients were pathologically confirmed with LNM. The misdiagnosis rate of cN0 standards was 60.9%. The cervical LNM rate was 65.4% (302/462) in total. The lateral compartment LNM rate was 42.6% (197/462). 13.1% (42/320) patients had skip lateral cervical LNM leaping central compartment, whereas 50% (45/90) with contralateral level Ⅵ metastasis. Male, tumor involving upper 1/3 gland, tumors T3 or T4, and multicentricity were all predictive factors of LNM. Patients with tumor involving upper 1/3 gland prone to prelaryngeal lymph node (PLN) metastasis and “skip metastasis”. Lateral compartment LNM increased significantly when PLN(+) and ≥2 central lymph nodes metastasis (85.7% and 83.3%, respectively, P<0.05). Conclusion: Existing cN0 standard is not a suitable criteria for determining the margin of lymph node dissection. PTC is prone to lymph node metastasis, and level Ⅵ is most likely to be involved, then Ⅲ, Ⅱ, Ⅳ, Ⅴ. Ipsilateral central lymph nodes should be routinely dissected and intraoperative frozen examination is suggested in initial surgery. If patients had PLN metastasis, or ≥2 central lymph nodes metastasis, or tumor involving upper 1/3 gland, lateral cervical lymph node dissection (or elective lymph node dissection) is necessary. Attention should be paid to contralateral level Ⅵ for it has high metastasis rate. Subdivision of central compartment is of great significance and needs thorough research.关键词：PTC;Lymph node metastases;cN0;Intraoperative frozen;Prelaryngeal lymph node2|5703|0更新时间：2025-12-31
- 摘要：Background and purpose: The evaluation of treatment response is one of the most important building blocks in determining the best strategy for the management of malignant tumors. In lymphoma and several solid cancer types, PET/CT-based response evaluation has been shown to be valuable, especially in visualizing the effect of the targeted treatment, which induces tumor activity changes not necessarily followed by tumor shrinkage. This study aimed to evaluate the role of 18F-FDG PET/CT in the monitoring of response to sorafenib treatment in radioiodine-refractory differentiated thyroid cancer (RR-DTC) patients; and to compare the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) with the European Organization for Research and Treatment of Cancer (EORTC) criteria. Methods: This was a single-center retrospective analysis of 14 patients with RR-DTC treated with sorafenib in the period from Dec. 2011 to Dec. 2014. A Wilcoxon signed-rank sum test was used to assess the differences in percentage changes between the sum of diameter and ΣSUVmax. These values of responses were statistically compared using the chi-square test (Fisher’s exact test). The differences in PFS between response categories according to either RECIST 1.1 or the EORTC criteria were evaluated using the Wilcoxon signed-rank sum test. The Spearman rank correlation coefficient was estimated between PFS and either morphologic (RECIST 1.1) or metabolic response (EORTC criteria) categories. Results: There was an agreement between the RECIST 1.1 and EORTC criteria in 10 of the 14 patients (χ2=2.345, P=0.424). The remaining 4 patients with SD included 2 patients with PMR and 2 patients with PMD. Differences in PFS among different response categories according to either RECIST 1.1 (χ2=8.571, P=0.003) or EORTC criteria (χ2=8.781, P=0.003) were statistically significant. Correlations were found between PFS and either morphologic (r=0.741, P=0.002) or metabolic (r=0.816, P=0.0004) response criteria. Conclusion: 18F-FDG PET/CT imaging is of value in the monitoring of response to sorafenib in patients with RR-DTC. Although RECIST 1.1 and EORTC criteria agree in 71.4% patients, PET-based metabolic response criteria seems to be more accurate in predicting therapeutic outcome and may be more suitable than morphologic response criteria for the evaluation of response to targeted therapy.关键词：18F-FDG PET/CT;RECIST 1.1;EORTC;Radioiodine refractory differentiated thyroid cancer;Sorafenib2|2344|0更新时间：2025-12-31
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Cervical ultrasound and thyroglobulin in diagnosis of recurrence of differentiated thyroid carcinoma
摘要：Background and purpose: This study investigated the value of cervical ultrasound and TSH-suppressed thyroglobulin in the diagnosis of recurrence or metastasis of differentiated thyroid carcinoma (DTC). Methods: This study analyzed the data on 196 thyroid carcinoma patients who underwent neck dissection after clinically suspecious recurrence of DTC in Peking Union Medical College Hospital from Aug. 2010 to Dec. 2014. Among the 196 patients, 62 patients sonographically suspecious recurrence after total thyroidectomy and/or radioactive iodine ablation therapy were enrolled in this study. The ultrasonic features of lymph node involvement were retrospectively analyzed. The value of the ultrasonic features in the diagnosis of lymph node involvement and a TSH-suppressed serum Tg level in the diagnosis of recurrence or metastasis of DTC was also evaluated. Results: Of the 62 patients, 59 were pathologically confirmed with lymph node involvement, 1 case with local recurrence and 2 cases without recurrence or metasta-thyroidsis. There were 121 ultrasonographically suspected lymph nodes, confirmed by pathology, 92 were metastatic ltsions, 25 were non-metastatic, 3 were fibrous tissue and 1 was striated muscle. The positive predictive rate of cyst, calcification or hyper-echogenicity in cortex was 100% in the diagnosis of lymph node involvement. There was a significant difference in disordered vascularity and cyst in cortex between metastatic and non-metastatic lymph nodes. Forty-nine patients were positive for Tg, whereas 13 were negative. The accuracy, sensitivity and specificity of TSH-suppressed serum Tg in the diagnosis of recurrence or metastasis of DTC were 82.3%, 81.7% and 100%. Conclusion: The disordered vascularity and cyst in cortex of the lymph node are highly specific indexes in diagnosing lymph node involvement. TSH-suppressed serum Tg level has high diagnostic value for detection of recurrence or metastasis of DTC. Cervical ultrasound can identify recurrent or metastatic lesions in both Tg-positive and Tg-negative patients.关键词：Differentiated thyroid carcinoma;Recurrence;Cervical ultrasound;Thyroglobulin2|2291|0更新时间：2025-12-31 - 摘要：Background and purpose: During recent years, the incidence of papillary thyroid microcarcinoma (PTMC) has increased year by year. There are many differences in its diagnosis and treatment. This research investigated and summarized the clinical diagnosis and treatment of thyroid papillary carcinoma by means of analyzing the patients’ data. Methods: Clinical data of 61 pathology-confirmed PTMC patients admitted to the Department of Head and Neck Surgery, Shanxi Dayi Hospital from Feb. 2012 to Jan. 2015 were retrospectively analyzed. Result: Sixty-one cases underwent high resolution ultrasound examination before operation, and the accuracy rate was 86.9%. All patients underwent surgical treatment. Thirty-nine patients had thyroid lobectomy and ipsilateral central lymph node dissection (CLND), 11 underwent concurrent partial thyroidectomy, 22 had total thyroidectomy and bilateral central lymph node dissection and 5 underwent concurrent cervical lymph node dissection. The incidences of central and cervical lymph node metastasis were 44.3% and 8.2%, respectively. Univariate analysis showed that the risk factors for central lymph node metastasis were age <45 years, multifocality, tumor location near or across the midline, tumor diameter ≥5 mm, but not gender. The rates of central lymph node metastasis were 66.7%, 60.7%, 66.7% and 53.8, respectively.. Conclusion: High resolution ultrasound examination has a high sensitivity for the detection of PTMC. It is important to implement standardized and individualized treatment plan to the patients with PTMC.关键词：Papillary thyroid micro-carcinoma;High resolution ultrasound;Surgical treatment;Central lymphnode metastasis2|4021|0更新时间：2025-12-31
- 摘要：Background and purpose: A non-recurrent course is a rare anatomic variation of the recurrent laryngeal nerve, which is highly predisposed to injury in thyroidectomy. The study was to summarize preoperative judgment and injury prevention of non-recurrent laryngeal nerve (NRLN) during thyroidectomy. Methods: Preoperative diagnosis and precautions during thyroidectomy were investigated, clinical data from eleven cases of NRLN were analyzed and related literature was reviewed as well. Results: All eleven cases were NRLN of type 1. Among those, the right subclavian artery was found posteriorly to the trachea and esophagus shown by preoperative CT in seven cases. One case who had NRLN injury underwent nerve anastomosis. Conclusion: NRLN is a rare anatomical variation. Preoperative neck CT scan identifies presence of a NRLN, which may reduce the incidence of nerve injures by using intraoperative capsular dissection.关键词：Thyroidectomy;Recurrent laryngeal nerve;Non-recurrent laryngeal nerve2|2719|0更新时间：2025-12-31
- 摘要：Because of development and popularization of the ultrasound techniques, the detection rate of nodal thyroid has increased. Surgery is the long-established therapeutic option. However, due to the surgical trauma, complications and the effect on quality of life, various minimally invasive treatments have been proposed and widely used. A large number of foreign studies have shown that ultrasound-guided percutaneous ethanol injection is a more commonly used minimally invasive way to treat benign pure cystic and predominantly cystic thyroid nodules. This article provides an up-to-date review of the overseas studies and summarized on percutaneous ethanol injection for the treatment of benign cystic thyroid nodules.关键词：Percutaneous ethanol ablation;Cystic thyroid nodule;Ultrasound;Treatment2|3446|0更新时间：2025-12-31
- 摘要：Long non-coding RNAs (lncRNAs) are defined as transcripts longer than 200 nt without coding capacities. Although they were initially argued to be transcriptional by-products of RNA polymerase Ⅱ, recent evidence suggests that lncRNAs have been associated with a spectrum of biological processes, and aberrant lncRNA expression may be a major contributor to tumorigenesis, progression and prognosis. This study summarizes the up-to-date studies on lncRNAs in urological neoplasms.关键词：Long non-coding RNAs;Urological neoplasms;Gene expression2|1603|0更新时间：2025-12-31
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