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Biomedicines
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Recent Advances in Thyroid Cancer: From Diagnosis to Treatment
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Recent Advances in Thyroid Cancer: From Diagnosis to Treatment

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cancer Biology and Oncology".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 24477

Special Issue Editor

Dr. Su Woong Yoo

E-Mail Website
Guest Editor
Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun-gun, Korea
Interests: nuclear medicine; biomedical optics; biomedical engineering

Special Issue Information

Dear Colleague,

Thyroid cancer is the most common endocrine cancer worldwide. Although it is generally known to have a good prognosis, metastatic thyroid cancer or poorly differentiated thyroid cancer have a low survival rate. Therefore, various diagnosis and treatment methods are currently being tested to overcome these limitations, and efforts are being made to improve the patient's prognosis.

This Special Issue will deal with various research articles related to the currently available diagnosis and treatment methods of thyroid cancer. We cordially invite authors and investigators within this field to submit original research or review articles pertaining to this Special Issue. Preclinical and translational research that can suggest new diagnostics and therapeutic strategies is also welcome.

Dr. Su Woong Yoo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • radioiodine refractory thyroid cancer
  • radioiodine therapy
  • molecular imaging
  • target therapy
  • prognostic stratification
  • artificial intelligence
  • theranostics
  • biomarkers
  • molecular genetics

Published Papers (12 papers)

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Research

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12 pages, 2468 KiB  
Article
Ultraviolet Light Exposure Decreases Thyroid Cancer Risk: A National Perspective
by Tessa R. Lavorgna, Mohammad Hussein, Peter P. Issa, Eman Toraih and Emad Kandil
Biomedicines 2022, 10(10), 2452; https://doi.org/10.3390/biomedicines10102452 - 1 Oct 2022
Viewed by 1792
Abstract
Ultraviolet (UV) light has been reported to have both pro-oncogenic and anti-oncogenic effects. Since patient pigmentation can influence the role of UV light exposure, we thought to investigate the recent trends in thyroid cancer incidence and survival with an emphasis on patient race [...] Read more.
Ultraviolet (UV) light has been reported to have both pro-oncogenic and anti-oncogenic effects. Since patient pigmentation can influence the role of UV light exposure, we thought to investigate the recent trends in thyroid cancer incidence and survival with an emphasis on patient race and UV exposure. Patients diagnosed with thyroid cancer from the Surveillance, Epidemiology, and End Results (SEER) database were identified. A total of 284,178 patients were enrolled. Data were stratified according to population sex, race, and state. UV exposure data in Watt-Hours Per Square Meter for the state were obtained from the National Cancer Institute Cancer Atlas. Thyroid cancer incidence rate varied by race, ranging from 14.9 cases per 100,000 in Asian or Pacific Islanders and 14.7 per 100,000 in Caucasians, to 8.7 per 100,000 in African American and 8.0 per 100,000 in Native Americans. UV exposure was negatively correlated with thyroid cancer incidence when analyzed across all populations (r = −0.299, p = 0.035). UV exposure was most steeply negatively correlated with thyroid cancer rates in Black populations (r = −0.56, p < 0.001). Despite this, Black men had the worst 5-year survival rate when compared to other ethnic populations. Overall, UV exposure does not increase the risk of thyroid cancer and may serve as a protective factor in the development of thyroid cancer. Full article
(This article belongs to the Special Issue Recent Advances in Thyroid Cancer: From Diagnosis to Treatment)
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8 pages, 1124 KiB  
Article
Diagnostic Accuracy of Ultrasound in Predicting Extrathyroidal Extension and Its Relation to Body Mass Index in a North American Population
by Mahmoud Omar, Abdallah S. Attia, Peter P. Issa, Bryce R. Christensen, Kavin Sugumar, Ahmed Alnahla, Deena Hadedeya, Hosam Shalaby, Neel Gupta, Mohamed Shama, Eman Toraih and Emad Kandil
Biomedicines 2022, 10(10), 2408; https://doi.org/10.3390/biomedicines10102408 - 26 Sep 2022
Cited by 2 | Viewed by 1179
Abstract
Detection of extrathyroidal extension (ETE) in patients with papillary thyroid carcinoma (PTC) influences treatment plan and surgical aggressiveness. Ultrasound (US) is the long-standing preoperative imaging method of choice. Recent literature from Asia suggests US accuracy to be influenced by patient characteristics, such as [...] Read more.
Detection of extrathyroidal extension (ETE) in patients with papillary thyroid carcinoma (PTC) influences treatment plan and surgical aggressiveness. Ultrasound (US) is the long-standing preoperative imaging method of choice. Recent literature from Asia suggests US accuracy to be influenced by patient characteristics, such as body mass index (BMI). Here, we examine the effect of BMI on the accuracy of US at a North American tertiary referral center. A total of 204 PTC-confirmed patients were retrospectively read by a radiologist blinded to surgical pathology findings. The radiologist recorded multiple sonographic features, including ETE, loss of echogenic capsule, nodule vascularity, capsular abutment, and bulging of contour. When considering all patients, the ultrasonographic feature with the best overall performance was loss of echogenic capsule (diagnostic odds ratio (DOR) = 4.48, 95% confidence interval (CI) = 1.86–10.78). Sub-group analysis by patient BMI found that area under the curve (AUC) for sonographic features was greater in non-obese BMI patients (0.71 ± 0.06) when compared with obese patients (0.43 ± 0.05; p = 0.001). Overall, US diagnostic performance was significantly better in non-obese (DOR = 3.70, 95%CI = 1.53–8.94) patients when compared to those who were obese (DOR = 1.12, 95%CI = 0.62–2.03; p = 0.03). Loss of the echogenic capsule did not differ between the two cohorts with respect to DOR (p = 0.51), specificity (p = 0.52), or sensitivity (p = 0.09). Our work suggests that the diagnostic value of ETE detection by US is impaired in obese patients. Considering that loss of the echogenic capsule did not differ with respect to diagnostic performance, specificity, nor sensitivity between non-obese and obese patients, it could be considered the most important predictor of US-determined ETE. Full article
(This article belongs to the Special Issue Recent Advances in Thyroid Cancer: From Diagnosis to Treatment)
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10 pages, 1345 KiB  
Article
Hashimoto’s Thyroiditis Minimizes Lymph Node Metastasis in BRAF Mutant Papillary Thyroid Carcinomas
by Peter P. Issa, Mahmoud Omar, Yusef Buti, Chad P. Issa, Bert Chabot, Christopher J. Carnabatu, Ruhul Munshi, Mohammad Hussein, Mohamed Aboueisha, Mohamed Shama, Ralph L. Corsetti, Eman Toraih and Emad Kandil
Biomedicines 2022, 10(8), 2051; https://doi.org/10.3390/biomedicines10082051 - 22 Aug 2022
Cited by 11 | Viewed by 2101
Abstract
Hashimoto’s thyroiditis (HT) (autoimmune thyroiditis) is a clinicopathological entity associated with chronic lymphocytic infiltration resulting in hypothyroidism. HT is a double-edged sword that increases the risk of papillary thyroid cancer (PTC), yet it serves as a protective factor for PTC progression. BRAF mutation [...] Read more.
Hashimoto’s thyroiditis (HT) (autoimmune thyroiditis) is a clinicopathological entity associated with chronic lymphocytic infiltration resulting in hypothyroidism. HT is a double-edged sword that increases the risk of papillary thyroid cancer (PTC), yet it serves as a protective factor for PTC progression. BRAF mutation in PTCs is associated with rapid cell growth, aggressive tumor characteristics, and higher mortality rates. Here, we aimed to analyze the influence of HT in patients with PTCs and its effect on lymph node metastasis (LNM) in BRAF mutant tumors. Adults diagnosed with PTC between 2008 and January 2021 were retrospectively included. A total of 427 patients, 128 of whom had underlying HT, were included. The HT group had significantly higher rates of microcarcinoma (49.2% vs. 37.5%, p = 0.025) and less lateral LNM (8.6% vs. 17.1%, p = 0.024). Interestingly, BRAF-mutated PTCs were found to have significantly less overall LNM (20.9% vs. 51%, p = 0.001), central LNM (25.6% vs. 45.1%, p = 0.040) and lateral LNM (9.3% vs. 29.4%, p = 0.010) in patients with HT when compared to those without underlying HT. HT was found to be an independent protective predictor of overall and lateral LNM. Altogether, HT was able to neutralize the effect of BRAF mutation and was determined to be an independent protective factor against LNM. Specifically, our work may influence treatment-aggressiveness decision making for endocrinologists, oncologists and surgeons alike. Full article
(This article belongs to the Special Issue Recent Advances in Thyroid Cancer: From Diagnosis to Treatment)
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17 pages, 2492 KiB  
Article
Latency Trend Analysis as a Guide to Screening Malignancy Survivors for Second Primary Thyroid Cancer
by Mohammad Hussein, Lauren Mueller, Peter P. Issa, Muhib Haidari, Lily Trinh, Eman Toraih and Emad Kandil
Biomedicines 2022, 10(8), 1984; https://doi.org/10.3390/biomedicines10081984 - 16 Aug 2022
Cited by 4 | Viewed by 2057
Abstract
Primary cancer survivors have a higher risk of developing second primary thyroid cancer (SPTC). Patients with SPTC who survived primary malignancies, diagnosed from 1975 to 2016, were identified from the Surveillance, Epidemiology, and End Results (SEER) database (SEER 18 Registry). A total of [...] Read more.
Primary cancer survivors have a higher risk of developing second primary thyroid cancer (SPTC). Patients with SPTC who survived primary malignancies, diagnosed from 1975 to 2016, were identified from the Surveillance, Epidemiology, and End Results (SEER) database (SEER 18 Registry). A total of 33,551 cancer cases were enrolled in the final analysis. Individuals with a primary malignancy were at a significant 90% increased risk of developing SPTC (SIR = 1.90, 95%CI = 1.86–1.93, p < 0.05) compared to the general population. More than half (54.7%) of SPTC diagnoses were made in the first three years after primary cancer diagnosis, and the most aggressive presentations of SPTC occurred within the first year following malignancy. A latency trend analysis identified persistent high risk for development of SPTC after diagnosis of lymphoma, leukemia, soft tissue tumors, kidney, breast, and uterine cancer; elevated 10-year risk for most cancers such as salivary gland, melanoma, stomach, lung, colon, ovarian, pancreas, prostate, and bladder; and high 5-year risk after cancers such as larynx, oral, orbit, bone, small intestine, and liver. Our latency period model identifying risk according to each type of primary cancer may aid clinicians in identifying at-risk patients to be screened for thyroid cancer and guide them in developing a surveillance plan according to the latency period attributed to a patient’s primary cancer. Full article
(This article belongs to the Special Issue Recent Advances in Thyroid Cancer: From Diagnosis to Treatment)
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15 pages, 2583 KiB  
Article
Diagnostic Value of AngioPLUS Microvascular Imaging in Thyroid Nodule Diagnosis Using Quantitative and Qualitative Vascularity Grading
by Nonhlanhla Chambara, Shirley Yuk Wah Liu, Xina Lo and Michael Ying
Biomedicines 2022, 10(7), 1554; https://doi.org/10.3390/biomedicines10071554 - 29 Jun 2022
Cited by 7 | Viewed by 1852
Abstract
This study investigated the diagnostic value of the Angio Planewave Ultrasensitive (AngioPLUS) Doppler ultrasound in improving the efficacy of grey scale ultrasound in thyroid nodule diagnosis. The EU TIRADS was used for the grey scale ultrasound assessment of 94 thyroid nodules. conventional Doppler [...] Read more.
This study investigated the diagnostic value of the Angio Planewave Ultrasensitive (AngioPLUS) Doppler ultrasound in improving the efficacy of grey scale ultrasound in thyroid nodule diagnosis. The EU TIRADS was used for the grey scale ultrasound assessment of 94 thyroid nodules. conventional Doppler and AngioPLUS Doppler ultrasound images were evaluated using qualitative vascularity grading, where predominant central vascularity indicated malignancy-suspicion, and quantitative regional vascularity assessment, where predominant peripheral vascularity using a ratio vascularity index (RVI) of > 1 indicated benign disease. Diagnostic performance outcomes of sole and combination approaches were calculated based on final pathologic results. Using sole EU TIRADS and AngioPLUS + power Doppler imaging (APDI) based on qualitative vascularity and RVI, the results were a sensitivity of 83.3% vs. 83.3 vs. 66.7% and a specificity of 50% vs. 81.3% vs. 73.4, respectively. EU TIRADS combined with APDI significantly improved the specificity using both qualitative vascularity and RVI assessment approaches (84.4% and 81%, respectively, p < 0.05); and slightly reduced the sensitivity (76.7% and 58.1%). For cytologically-equivocal thyroid nodules, the combination approach using qualitative vascularity assessment outperformed the EU TIRADS (sensitivity: both were 88.9%; specificity: 77.4% vs. 38.7%, p < 0.05; and AUROC: 0.83 vs. 0.62, p < 0.05). APDI combined with EU TIRADS is diagnostically efficient in stratifying thyroid nodules, particularly cytologically-equivocal nodules. Full article
(This article belongs to the Special Issue Recent Advances in Thyroid Cancer: From Diagnosis to Treatment)
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13 pages, 2587 KiB  
Article
Assessing Detection Accuracy of Computerized Sonographic Features and Computer-Assisted Reading Performance in Differentiating Thyroid Cancers
by Hao-Chih Tai, Kuen-Yuan Chen, Ming-Hsun Wu, King-Jen Chang, Chiung-Nien Chen and Argon Chen
Biomedicines 2022, 10(7), 1513; https://doi.org/10.3390/biomedicines10071513 - 26 Jun 2022
Cited by 1 | Viewed by 1522
Abstract
For ultrasound imaging of thyroid nodules, medical guidelines are all based on findings of sonographic features to provide clinicians management recommendations. Due to the recent development of artificial intelligence and machine learning (AI/ML) technologies, there have been computer-assisted detection (CAD) software devices available [...] Read more.
For ultrasound imaging of thyroid nodules, medical guidelines are all based on findings of sonographic features to provide clinicians management recommendations. Due to the recent development of artificial intelligence and machine learning (AI/ML) technologies, there have been computer-assisted detection (CAD) software devices available for clinical use to detect and quantify the sonographic features of thyroid nodules. This study is to validate the accuracy of the computerized sonographic features (CSF) by a CAD software device, namely, AmCAD-UT, and then to assess how the reading performance of clinicians (readers) can be improved providing the computerized features. The feature detection accuracy is tested against the ground truth established by a panel of thyroid specialists and a multiple-reader multiple-case (MRMC) study is performed to assess the sequential reading performance with the assistance of the CSF. Five computerized features, including anechoic area, hyperechoic foci, hypoechoic pattern, heterogeneous texture, and indistinct margin, were tested, with AUCs ranging from 0.888~0.946, 0.825~0.913, 0.812~0.847, 0.627~0.77, and 0.676~0.766, respectively. With the five CSFs, the sequential reading performance of 18 clinicians is found significantly improved, with the AUC increasing from 0.720 without CSF to 0.776 with CSF. Our studies show that the computerized features are consistent with the clinicians’ findings and provide additional value in assisting sonographic diagnosis. Full article
(This article belongs to the Special Issue Recent Advances in Thyroid Cancer: From Diagnosis to Treatment)
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14 pages, 4405 KiB  
Article
Thyroid Cancer Detection in a Routine Clinical Setting: Performance of ACR TI-RADS, FNAC, and Molecular Testing in Prospective Cohort Study
by Tereza Grimmichova, Petra Pacesova, Martin Hill, Barbora Pekova, Marketa Vankova, Jitka Moravcova, Jana Vrbikova, Zdenek Novak, Karolina Mastnikova, Eliska Vaclavikova, Josef Vcelak, Bela Bendlova, Jana Drozenova and Vlasta Sykorova
Biomedicines 2022, 10(5), 954; https://doi.org/10.3390/biomedicines10050954 - 20 Apr 2022
Cited by 7 | Viewed by 2289
Abstract
The aim of our study was to address the potential for improvements in thyroid cancer detection in routine clinical settings using a clinical examination, the American College of Radiology Thyroid Imaging Reporting and Database System (ACR TI-RADS), and fine-needle aspiration cytology (FNAC) concurrently [...] Read more.
The aim of our study was to address the potential for improvements in thyroid cancer detection in routine clinical settings using a clinical examination, the American College of Radiology Thyroid Imaging Reporting and Database System (ACR TI-RADS), and fine-needle aspiration cytology (FNAC) concurrently with molecular diagnostics. A prospective cohort study was performed on 178 patients. DNA from FNA samples was used for next-generation sequencing to identify mutations in the genes BRAF, HRAS, KRAS, NRAS, and TERT. RNA was used for real-time PCR to detect fusion genes. The strongest relevant positive predictors for malignancy were the presence of genetic mutations (p < 0.01), followed by FNAC (p < 0.01) and ACR TI-RADS (p < 0.01). Overall, FNAC, ACR TI-RADS, and genetic testing reached a sensitivity of up to 96.1% and a specificity of 88.3%, with a diagnostic odds ratio (DOR) of 183.6. Sensitivity, specificity, and DOR decreased to 75.0%, 88.9%, and 24.0, respectively, for indeterminate (Bethesda III, IV) FNAC results. FNA molecular testing has substantial potential for thyroid malignancy detection and could lead to improvements in our approaches to patients. However, clinical examination, ACR TI-RADS, and FNAC remained relevant factors. Full article
(This article belongs to the Special Issue Recent Advances in Thyroid Cancer: From Diagnosis to Treatment)
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13 pages, 1344 KiB  
Article
A Novel Role of Galectin-3 and Thyroglobulin in Prognosis and Differentiation of Different Stages of Thyroid Cancer and Elucidation of the Potential Contribution of Bcl-2, IL-8 and TNF-α
by Tarek M. Okda, Gamal M. K. Atwa, Ahmed Fathy Eldehn, Naief Dahran, Khalaf F Alsharif and Ehab Kotb Elmahallawy
Biomedicines 2022, 10(2), 352; https://doi.org/10.3390/biomedicines10020352 - 1 Feb 2022
Cited by 7 | Viewed by 2177
Abstract
Thyroid cancer is among the most prevalent cancers with different types and stages. New markers are required for the prognosis and diagnosis of the disease. The present study aimed to detect the role of new markers, including galectin-3 (Gal-3) and thyroglobulin (TG), in [...] Read more.
Thyroid cancer is among the most prevalent cancers with different types and stages. New markers are required for the prognosis and diagnosis of the disease. The present study aimed to detect the role of new markers, including galectin-3 (Gal-3) and thyroglobulin (TG), in the prognosis and staging of thyroid cancer. The study also investigated the potential apoptotic and inflammatory mechanisms involved in thyroid cancer through the determination of B-cell lymphoma 2 (Bcl-2), interleukin-8 (IL-8) and tumor necrosis factor α (TNFα) during the different stages of the cancer using a series of molecular methods. Histopathological and immunohistochemical examinations were also performed. A total of 300 subjects were classified into: 100 normal healthy subjects matched in age and sex, 100 patients with thyroid carcinoma stage I (T1N0M0) and 100 patients with thyroid carcinoma stage 2 (T2N1M1). Interestingly, the present study revealed a significant increase in the levels of TG and Gal-3 in thyroid cancer patients compared to the control group. Furthermore, the levels of Bcl-2, IL-8 and TNF-α significantly increased in the patient serum. The histopathological examination and immunohistochemical observations confirmed the molecular and hematological findings. Collectively, the present study concluded that serum TG and Gal-3 could be useful markers in the prognosis and staging of patients with thyroid cancer. Furthermore, the determination of Bax, Bcl-2, IL-8 and TNF-α levels constitute a major important marker for investigation of the mechanisms of apoptosis and inflammation in thyroid cancer. To our knowledge, this is the first study that used both galectin-3 and TG as tumor markers in the prognosis and differentiation between the different stages of cancer. Full article
(This article belongs to the Special Issue Recent Advances in Thyroid Cancer: From Diagnosis to Treatment)
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11 pages, 1223 KiB  
Article
Predictive Factors for Skip Lymph Node Metastasis and Their Implication on Recurrence in Papillary Thyroid Carcinoma
by Young-Jae Ryu, Seong-Young Kwon, Soo-Young Lim, Yong-Min Na and Min-Ho Park
Biomedicines 2022, 10(1), 179; https://doi.org/10.3390/biomedicines10010179 - 16 Jan 2022
Cited by 7 | Viewed by 1993
Abstract
Skip lymph node (LN) metastases in papillary thyroid carcinoma (PTC) belong to N1b classification in the absence of central neck LN involvement. This study aimed to evaluate the predictive factors of skip metastases and their impact on recurrence in PTC patients with pN1b. [...] Read more.
Skip lymph node (LN) metastases in papillary thyroid carcinoma (PTC) belong to N1b classification in the absence of central neck LN involvement. This study aimed to evaluate the predictive factors of skip metastases and their impact on recurrence in PTC patients with pN1b. A total of 334 PTC patients who underwent total thyroidectomy with LN dissection (central and lateral neck compartment) followed by radioactive iodine ablation were included. Patients with skip metastases tended to have a small primary tumor (≤1 cm) and single lateral neck level involvement. Tumor size ≤ 1 cm was an important predictive factor for skip metastases. Univariate analysis for recurrence showed that patients with a central LN ratio > 0.68, lateral LN ratio > 0.21, and stimulated thyroglobulin (Tg) levels > 7.3 ng/mL had shorter RFS (recurrence-free survival). The stimulated Tg level was associated with shorter RFS on multivariate analysis (>7.3 vs. ≤7.3 ng/mL; hazard ratio, 4.226; 95% confidence interval, 2.226−8.022; p < 0.001). Although patients with skip metastases tended to have a small primary tumor and lower burden of lateral neck LN involvement, there was no association between skip metastases and RFS in PTC with pN1b. Stimulated Tg level was a strong predictor of recurrence. Full article
(This article belongs to the Special Issue Recent Advances in Thyroid Cancer: From Diagnosis to Treatment)
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Review

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11 pages, 519 KiB  
Review
Genetic Changes in Thyroid Cancers and the Importance of Their Preoperative Detection in Relation to the General Treatment and Determination of the Extent of Surgical Intervention—A Review
by Jiri Hlozek, Barbora Pekova, Jan Rotnágl, Richard Holý and Jaromir Astl
Biomedicines 2022, 10(7), 1515; https://doi.org/10.3390/biomedicines10071515 - 27 Jun 2022
Cited by 7 | Viewed by 2413
Abstract
Carcinomas of the thyroid gland are some of the most common malignancies of the endocrine system. The causes of tumor transformation are genetic changes in genes encoding cell signaling pathways that lead to an imbalance between cell proliferation and apoptosis. Some mutations have [...] Read more.
Carcinomas of the thyroid gland are some of the most common malignancies of the endocrine system. The causes of tumor transformation are genetic changes in genes encoding cell signaling pathways that lead to an imbalance between cell proliferation and apoptosis. Some mutations have been associated with increased tumor aggressiveness, metastatic lymph node spread, tendency to dedifferentiate, and/or reduced efficiency of radioiodine therapy. The main known genetic causes of thyroid cancer include point mutations in the BRAF, RAS, TERT, RET, and TP53 genes and the fusion genes RET/PTC, PAX8/PPAR-γ, and NTRK. Molecular genetic testing of the fine needle aspiration cytology of the thyroid tissue in the preoperative period or of the removed thyroid tissue in the postoperative period is becoming more and more common in selected institutions. Positive detection of genetic changes, thus, becomes a diagnostic and prognostic factor and a factor that determines the extent of the surgical and nonsurgical treatment. The findings of genetic research on thyroid cancer are now beginning to be applied to clinical practice. In preoperative molecular diagnostics, the aggressiveness of cancers with the most frequently occurring mutations is correlated with the extent of the planned surgical treatment (radicality of surgery, neck dissection, etc.). However, clear algorithms are not established for the majority of genetic alterations. This review aims to provide a basic overview of the findings of the most commonly occurring gene mutations in thyroid cancer and to discuss the current recommendations on the extent of surgical and biological treatment concerning preoperatively detected genetic changes. Full article
(This article belongs to the Special Issue Recent Advances in Thyroid Cancer: From Diagnosis to Treatment)
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21 pages, 907 KiB  
Review
The Autoantibodies against Tumor-Associated Antigens as Potential Blood-Based Biomarkers in Thyroid Neoplasia: Rationales, Opportunities and Challenges
by Pavel V. Belousov
Biomedicines 2022, 10(2), 468; https://doi.org/10.3390/biomedicines10020468 - 17 Feb 2022
Cited by 2 | Viewed by 2096
Abstract
The Autoantibodies targeting Tumor-Associated Antigens (TAA-AAbs) emerge as a result of a variety of tumor-related immunogenic stimuli and may be regarded as the eyewitnesses to the anti-tumor immune response. TAA-AAbs may be readily detected in peripheral blood to unveil the presence of a [...] Read more.
The Autoantibodies targeting Tumor-Associated Antigens (TAA-AAbs) emerge as a result of a variety of tumor-related immunogenic stimuli and may be regarded as the eyewitnesses to the anti-tumor immune response. TAA-AAbs may be readily detected in peripheral blood to unveil the presence of a particular TAA-expressing tumor, and a fair number of TAAs eliciting the tumor-associated autoantibody response have been identified. The potential of TAA-AAbs as tumor biomarkers has been extensively studied in many human malignancies with a major influence on public health; however, tumors of the endocrine system, and, in particular, the well-differentiated follicular cell-derived thyroid neoplasms, remain understudied in this context. This review provides a detailed perspective on and legitimate rationales for the potential use of TAA-AAbs in thyroid neoplasia, with particular reference to the already established diagnostic implications of the TAA-AAbs in human cancer, to the windows for improvement and diagnostic niches in the current workup strategies in nodular thyroid disease and differentiated thyroid cancer that TAA-AAbs may successfully occupy, as well as to the proof-of-concept studies demonstrating the usefulness of TAA-AAbs in thyroid oncology, particularly for the pre-surgical discrimination between tumors of different malignant potential in the context of the indeterminate results of the fine-needle aspiration cytology. Full article
(This article belongs to the Special Issue Recent Advances in Thyroid Cancer: From Diagnosis to Treatment)
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Other

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11 pages, 2089 KiB  
Systematic Review
Radiologist versus Non-Radiologist Detection of Lymph Node Metastasis in Papillary Thyroid Carcinoma by Ultrasound: A Meta-Analysis
by Peter P. Issa, Lauren Mueller, Mohammad Hussein, Aaron Albuck, Mohamed Shama, Eman Toraih and Emad Kandil
Biomedicines 2022, 10(10), 2575; https://doi.org/10.3390/biomedicines10102575 - 14 Oct 2022
Cited by 4 | Viewed by 1524
Abstract
Papillary thyroid carcinoma (PTC) is the most common thyroid cancer worldwide and is known to spread to adjacent neck lymphatics. Lymph node metastasis (LNM) is a known predictor of disease recurrence and is an indicator for aggressive resection. Our study aims to determine [...] Read more.
Papillary thyroid carcinoma (PTC) is the most common thyroid cancer worldwide and is known to spread to adjacent neck lymphatics. Lymph node metastasis (LNM) is a known predictor of disease recurrence and is an indicator for aggressive resection. Our study aims to determine if ultrasound sonographers’ degree of training influences overall LNM detection. PubMed, Embase, and Scopus articles were searched and screened for relevant articles. Two investigators independently screened and extracted the data. Diagnostic test parameters were determined for all studies, studies reported by radiologists, and studies reported by non-radiologists. The total sample size amounted to 5768 patients and 10,030 lymph nodes. Radiologists performed ultrasounds in 18 studies, while non-radiologists performed ultrasounds in seven studies, corresponding to 4442 and 1326 patients, respectively. The overall sensitivity of LNM detection by US was 59% (95%CI = 58–60%), and the overall specificity was 85% (95%CI = 84–86%). The sensitivity and specificity of US performed by radiologists were 58% and 86%, respectively. The sensitivity and specificity of US performed by non-radiologists were 62% and 78%, respectively. Summary receiver operating curve (sROC) found radiologists and non-radiologists to detect LNM on US with similar accuracy (p = 0.517). Our work suggests that both radiologists and non-radiologists alike detect overall LNM with high accuracy on US. Full article
(This article belongs to the Special Issue Recent Advances in Thyroid Cancer: From Diagnosis to Treatment)
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