Objective To investigate the role of preoperative serum thyroid stimulating hormone (TSH) in evaluating differentiated thyroid cancer (DTC). Methods A total of 551 patients with thyroid nodules met the study criteria, who got treatment in the First Affiliated Hospital of Jiamusi University between Aug. 2017 and Dec. 2017. And the patients were divided into DTC group (n=110) and benign group (n=441) according to the postoperative pathological results. The difference of serum TSH level between the 2 groups was compared and then explored the diagnostic significance of serum TSH level, thyroid imaging report and data system (TI-RADS), and serum TSH combined withTI-RADS. Results The serum TSH level was higher in the DTC group than that of the benign group (Z=5.198, P<0.05). The sensitivity of preoperative serum TSH level in the diagnosis of DTC was 80.9% (89/110), the specificity was 74.4% (328/441), and the area under receiver operating characteristic (ROC) curve was 0.660 ［95%CI was (0.602, 0.719), P<0.05］. The sensitivity of TI-RADS in the diagnosis of DTC was 82.7% (91/110), the specificity was 73.5% (324/441), and the area under the ROC curve was 0.772 ［95%CI was (0.711, 0.823), P<0.05］. The sensitivity of preoperative serum TSH combined with TI-RADS in the diagnosis of DTC was 91.8% (101/110), the specificity was 87.5% (386/441), and the area under the ROC curve was 0.831 ［95%CI was (0.786, 0.876), P<0.05］. Conclusions Preoperative serum TSH level may be a potential risk factor for the occurrence of DTC. Preoperative serum TSH level combined with TI-RADS classification can improve the accuracy of preoperative diagnosis of DTC, not only to reduce the misdiagnosis of thyroid cancer, but also can avoid excessive treatment.
Positron emission tomography (PET) is a highly sensitive and low invasive technology for cancer biological imaging. Integrated PET/computed tomography (PET/CT) cameras combine functional and anatomical information in a synergistic manner that improves diagnostic interpretation. The role of 18F FDG PET/CT in differentiated thyroid cancer (DTC) is well established, particularly in patients presenting with elevated thyroglobulin (Tg) levels and negative radioactive iodine scan. This review presents the evidence supporting the use of 18F FDG PET/CT throughout the diagnosis and management of thyroid cancer, and provides suggestions for its clinical uses.
Objective To summarize the advanced researchs of autoimmune thyroid disease(ATD) complicated with differentiated thyroid cancer (DTC). Methods The related literatures about concurrent ATD and DTC were consulted and reviewed. Results Hashimoto diseas (HD) complicated with DTC at home and abroad were reported more and more, whether merging with HD or other ATD disease could affect the prognosis of papillary thyroid cancer (PTC) was a controversial topic. HD and DTC (mainly PTC) had some same epidemiological and molecular features. Conclusion Better understanding of clinical pathology and characteristic of DTC concurrent with ATD can provide some new insights to immunotherapy for DTC.
ObjectiveTo explore the application value of carbon nanoparticles during radical operation of differentiated thyroid cancer (DTC).MethodsThe DTC patients underwent total thyroidectomy plus neck lymph node (area Ⅳ) dissection from September 2017 to September 2019 in this hospital were retrospectively collected, who were divided into observation group and control group according to using carbon nanoparticles or not during the operation. The operation related informations [operation time, intraoperative blood loss, total drainage volume on day 3 after operation, postoperative hospitalization time, number of lymph nodes dissection (area Ⅳ), lymph node metastasis rate, and rate of parathyroid glands resected by mistake during operation] and blood calcium (Ca2+) level and parathyroid hormone (PTH) level before and after (24 h and 1 month) operation were compared between the two groups.ResultsA total of 134 patients with DTC were collected, including 76 patients in the observation group and 58 patients in the control group. There were no significant differences in baseline data such as gender, age, etc. between the two groups (P>0.05). Although there were no significant differences in terms of operation time, intraoperative blood loss, total drainage volume on day 3 after operation, postoperative hospitalization time, lymph node metastasis rate between the two groups (P>0.05), the numbers of lymph node dissection and metastasis (area Ⅳ) were more and rate of parathyroid glands resected by mistake during operation was lower in the observation group as compared with the control group (P<0.05). On hour 24 after operation, the levels of Ca2+ and PTH in the observation group were higher than those in the control group (P<0.05). On month 1 after operation, the PTH level in the observation group was still higher than that in the control group (P<0.05), but there was no significant difference in Ca2+ level between the two groups (P>0.05). ConclusionCarbon nanoparticles can better protect the function of parathyroid gland during radical operation of DTC and clean neck lymph nodes more thoroughly.
【Abstract】ObjectiveTo discuss the value of thyroglobulin (TG) in diagnosis and treatment of differentiated thyroid cancer (DTC) patients. MethodsLiteratures on measurement and clinical application of serum TG were reviewed. ResultsImmunometric assay (IMA) was adopted by most clinical lab.TG antibody （TGAb） should be measured in the same sample of DTC patient.TG detection before operation is of less value in confirming diagnosis of DTC, but is helpful in differential diagnosis of histopathological type of DTC.TG detection after operation is very important in patients who had undergone total thyroidectomy.Monitoring TG after thyroid hormone withdrawal or recombinant human TSH stimulation is more sensitive to identify tumor recurrence. ConclusionMonitoring TG after total thyroidectomy has great value in followup of DTC patients.
Initial surgical treatment plays an important role in the treatment of differentiated thyroid cancer, and standardized surgical treatment can help to reduce underdiagnosis and overtreatment. Accurate preoperative diagnosis is the premise of standardized surgical treatment, which helps to reduce the overtreatment of thyroid nodules. Preoperative clinical TN staging assessment for differentiated thyroid cancer should be highly valued, the extent of thyroidectomy should be individualized, and the cervical lymph nodes should be performed in a standardized manner. In addition, the indications for endoscopic thyroid surgery should be strictly selected to maximize the benefit of the patient.
ObjectiveTo explore the safety-related factors for total thyroidectomy in differentiated thyroid carcinoma. MethodsThe clinical data of 72 patients with differentiated thyroid carcinoma treated by total thyroidectomy from January 2002 to January 2010 were retrospectively analyzed, the laryngeal recurrent nerve injury and hypoparathyroidism were observed. ResultsThe incidences of hypoparathyroidism and laryngeal recurrent nerve injury were 15.28% （11/72) and 4.17%（3/72）, respectively. The hypoparathyroidism was significantly related to the thyroid reoperation, the lymph nodes metastases of central compartment, or the extraglandular invasion of the primary tumor (Plt;0.05), but not to the dissection of neck lymph nodes (Pgt;0.05). The laryngeal recurrent nerve injury was not relative to those factors (Pgt;0.05). ConclusionThe safetyrelated factors of total thyroidectomy in differentiated thyroid carcinoma include thyroid reoperation, the lymph node metastasis of central compartment, and the extraglandular invasion of the primary tumor.
ObjectiveIn order to improve the levels of clinical diagnosis and treatment of differentiated thyroid cancer, the research status and progress of blood markers of differentiated thyroid cancer in recent years were reviewed.MethodThe literatures about blood markers and liquid biopsy of differentiated thyroid cancer at home and abroad in recent years were searched and summarized.ResultsThyroglobulin and thyroglobulin antibody were the most commonly used for markers of differentiated thyroid cancer. The application value of blood markers such as microRNA and long non-coding RNA in the diagnosis, treatment and follow-up of differentiated thyroid cancer had also been found.ConclusionBecause of the advantages of high specificity, high sensitivity, and no-invasion, blood markers are useful indicators to help improve the diagnosis of thyroid cancer patients and monitor the disease progression and recurrence in the future.