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Thyroid Cancer: Diagnosis, Prognosis, Treatment, and Management
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Thyroid Cancer: Diagnosis, Prognosis, Treatment, and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 36121

Special Issue Editor

Dr. Maria Trovato

E-Mail Website
Guest Editor
Department of Clinical and Experimental Medicine, University Hospital, 98125 Messina, Italy
Interests: thyroid cancer; cytokines; molecular biology; autoimmunity; nanoparticles
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Thyroid cancers (TC) are malignancies occurring at any geographical latitude and involving any age and sex group. However, highest diffusion of TC appears dependent on man-made nuclear accidents and natural disasters caused by volcanic eruptions. Further, TC emerge more frequently in woman after age 30.

Clinically, TC appear quite as nodular lesions. Early diagnosis is assisted by conventional ultrasound (US) and US elastography information. Cytological examinations combined with authentication of molecular biomarkers are essential for precise diagnosis. Precocious diagnosis of thyroid nodules has increased the percentage of TC incidence. However, the mortality rate has not decreased.

Histological identification of TC variants is the best know prognostic factor. Mainly, both follicular and parafollicular cells develop TC. Follicular TC include well differenced thyroid carcinomas (WDTC) and anaplastic carcinomas (ATC). Parafollicular TC make up medullary thyroid carcinomas (MTC). Overall, WDTC display good prognosis, ATC poor prognosis and MTC relatively poor prognosis.

Total or near total thyroidectomy is still the most common therapeutic treatment.

Aim of this special issue is to provide an overview of diagnostic and prognostic factors for TC. In order to find adequate diagnostic and prognostic protocols, we are focusing on geographical diffusion, molecular biomarkers and therapeutic approaches of TC.

Dr. Maria Trovato
Guest Editor

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Keywords

  • thyroid carcinomas
  • well-differentiated thyroid carcinomas
  • diagnostic biomarkers
  • prognostic biomarkers
  • therapeutic approaches
  • volcanic eruption
  • nuclear accidents

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Published Papers (6 papers)

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Research

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11 pages, 1581 KiB  
Article
Serum Anti-Thyroglobulin Autoantibodies Are Specific in Predicting the Presence of Papillary-like Nuclear Features and Lymphocytic Infiltrate in the Thyroid Gland
by Daniela Cabibi, Antonino Giulio Giannone, Sandro Bellavia, Roberta Lo Coco, Anna Lo Bianco, Eleonora Formisano, Gregorio Scerrino and Giuseppa Graceffa
Diagnostics 2023, 13(12), 2042; https://doi.org/10.3390/diagnostics13122042 - 13 Jun 2023
Cited by 2 | Viewed by 2313
Abstract
(1) Background: Previous studies have reported a correlation between serum anti-Thyroglobulin-antibodies (TgAb) and papillary thyroid carcinoma. The aim of our study was to evaluate whether serum TgAb and anti-thyroid-peroxidase antibody (TPO) positivity was also related to pre-neoplastic histological changes such as papillary-like nuclear [...] Read more.
(1) Background: Previous studies have reported a correlation between serum anti-Thyroglobulin-antibodies (TgAb) and papillary thyroid carcinoma. The aim of our study was to evaluate whether serum TgAb and anti-thyroid-peroxidase antibody (TPO) positivity was also related to pre-neoplastic histological changes such as papillary-like nuclear features (PLNF) and with the presence of lymphocytic infiltrate (LI) in thyroid surgical specimens. (2) Methods: The study was retrospectively carried out on 70 consecutively recruited patients who underwent thyroidectomy for benign process and whose TgAb and TPOAb values were retrieved from clinical records. Histological sections of thyroid surgical samples were revised, looking for PLNF and lymphocytic infiltrate. HBME1 expression was assessed by immunohistochemistry. (3) Results: Our results showed a significant association between TgAb, PLNF, and lymphocytic infiltrate. The presence of TgAb was highly specific, but less sensitive, in predicting the presence of PLNF (sensitivity = 0.6, specificity = 0.9; positive predictive value (PPV) = 0.88; negative predictive value (NPV) = 0.63). TgAb positivity showed a good association with the presence of lymphocytic infiltrate (sensitivity = 0.62, specificity = 0.9; PPV = 0.88 and NPV = 0.68). HBME1 immunoreactivity was observed in the colloid of follicles showing PLNF and/or closely associated with LI. (4) Conclusions: The presence of PLNF and LI is associated with serum TgAb positivity. The presence of TgAb and of LI could be triggered by an altered thyroglobulin contained in the HBME1-positive colloid, and could be a first defense mechanism against PLNF that probably represent early dysplastic changes in thyrocytes. Full article
(This article belongs to the Special Issue Thyroid Cancer: Diagnosis, Prognosis, Treatment, and Management)
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13 pages, 4951 KiB  
Article
Prognostic Value of Serum Thyroglobulin and Anti-Thyroglobulin Antibody in Thyroid Carcinoma Patients following Thyroidectomy
by Hashem O. Zahra, Gamal A. Omran, Ahmed G. Gewely, Ahmed Fathy Eldehn, Walied Abdo, Ehab Kotb Elmahallawy and Tarek M. Okda
Diagnostics 2021, 11(11), 2080; https://doi.org/10.3390/diagnostics11112080 - 10 Nov 2021
Cited by 9 | Viewed by 7532
Abstract
Well-differentiated thyroid cancer (WDTC) is a malignant head and neck tumor with a very high incidence. Thyroidectomized WDTC patients have been referred to nuclear medicine for radioactive iodine (RAI) ablation therapy and/or annual follow-up with diagnostic whole-body imaging. Serum thyroglobulin (TG) and thyroglobulin [...] Read more.
Well-differentiated thyroid cancer (WDTC) is a malignant head and neck tumor with a very high incidence. Thyroidectomized WDTC patients have been referred to nuclear medicine for radioactive iodine (RAI) ablation therapy and/or annual follow-up with diagnostic whole-body imaging. Serum thyroglobulin (TG) and thyroglobulin antibodies (TGAb) are biochemical tumor markers used to monitor WDTC. A global rise in the prevalence of WDTC is increasing the number of thyroidectomized patients requiring lifelong monitoring for persistent or recurrent diseases. The present study aimed to identify the most successful prognostic factors in well-defined thyroid carcinoma patients following total thyroidectomy and RAI therapy, followed by an estimation of the cutoff value of TG and TGAb. In this context, a total of 100 subjects were recruited and classified as follows: 60 thyroid carcinoma patients underwent total thyroidectomy and successful RAI therapy, while 40 normal healthy individuals matched for age, sex, and socioeconomic status constituted the control group. Interestingly, the levels of TG did not differ significantly between the relapsed and non-relapsed cases, but the levels of TGAb differed significantly between the relapsed and non-relapsed cases. Collectively, TG and TGAb are considered the most successful prognostic factors in well-defined thyroid carcinoma patients after total thyroidectomy and RAI therapy. The present study also concluded that the TGAb determination was better than that of the TG level, with a cutoff value of 10 ng/mL. These findings provide baseline information for follow-up and lifelong monitoring of thyroidectomized WDTC patients. Further research is warranted to explore more about serum TG and TGAb in thyroid carcinoma patients on a larger scale. Full article
(This article belongs to the Special Issue Thyroid Cancer: Diagnosis, Prognosis, Treatment, and Management)
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12 pages, 15075 KiB  
Article
Updated Incidence of Thyroid Cancer in the North East Region of Romania after 35 Years of Chernobyl Fallout. Is There a Link between?
by Laura Teodoriu, Maria Christina Ungureanu, Letitia Leustean, Cristina Preda, Delia Ciobanu, Irena Grierosu, Mioara Matei, Roxana Iacob and Cipriana Stefanescu
Diagnostics 2021, 11(5), 907; https://doi.org/10.3390/diagnostics11050907 - 19 May 2021
Cited by 5 | Viewed by 16113
Abstract
Thyroid cancer (TC) represents a worldwide problem, the consistent growth of the incidence increment issues about management of risk factors and curative treatment. Updated statistical data are not complete in the North East region of Romania and need to be improved. Therefore, through [...] Read more.
Thyroid cancer (TC) represents a worldwide problem, the consistent growth of the incidence increment issues about management of risk factors and curative treatment. Updated statistical data are not complete in the North East region of Romania and need to be improved. Therefore, through this study, we aim to renew the existing data on thyroid cancer. We conducted a retrospective study covering a period of 10 years. Data were collected from a hospital information system (InfoWorld) between 2009 and 2019. Patients’ age groups were stratified in relation with the age at the moment of the Chernobyl event. A database was obtained (Microsoft Excel) and statistical correlations were applied. In the studied period, 1159 patients were diagnosed: 968 females and 191 males, distributed by region, with the highest addressability in Iasi (529), followed by neighboring counties. Age distribution displayed that most of the thyroid cancers were in the range 4060 years old (50.94%), followed by 60–80 years old (32.41%). Most patients were diagnosed with papillary carcinoma 63.10%, then follicular 14.7%, medullary 6.74% and undifferentiated 1.02%. Romania was in the vicinity of the radioactive cloud at Chernobyl fallout, so we must deliberate whether the increased incidence of thyroid cancer in the age group 40–60 years is associated with radiogenicity (iodine 131) given the fact that over has 35 years and the half-life of other radioisotopes like Caesium-137 and Strontium -90 is completed. Full article
(This article belongs to the Special Issue Thyroid Cancer: Diagnosis, Prognosis, Treatment, and Management)
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11 pages, 1713 KiB  
Article
Raman Spectroscopy Discloses Altered Molecular Profile in Thyroid Adenomas
by Armida Sodo, Martina Verri, Andrea Palermo, Anda Mihaela Naciu, Marialuisa Sponziello, Cosimo Durante, Michael Di Gioacchino, Alessio Paolucci, Alessandra di Masi, Filippo Longo, Pierfilippo Crucitti, Chiara Taffon, Maria Antonietta Ricci and Anna Crescenzi
Diagnostics 2021, 11(1), 43; https://doi.org/10.3390/diagnostics11010043 - 29 Dec 2020
Cited by 12 | Viewed by 2879
Abstract
Follicular patterned nodules are sometimes complex to be classified due to ambiguous nuclear features and/or questionable capsular or vascular invasion. In this setting, there is a poor inter-observer concordance even among expert pathologists. Raman spectroscopy was recently used to separate benign and malignant [...] Read more.
Follicular patterned nodules are sometimes complex to be classified due to ambiguous nuclear features and/or questionable capsular or vascular invasion. In this setting, there is a poor inter-observer concordance even among expert pathologists. Raman spectroscopy was recently used to separate benign and malignant thyroid nodules based on their molecular fingerprint; anyway, some histologically proved follicular adenomas were clustered as having a characteristic profile of malignant lesions. In this study, we analyzed five follicular thyroid adenomas with a malignant spectroscopic profile compared to five follicular adenomas with a benign Raman spectrum in order to assess possible molecular differences between the two groups. Morphological, immunohistochemical, and molecular analyses evidenced expression of malignancy-associated proteins in four out of five malignant clustered adenomas. The remaining malignant clustered adenoma showed a TSHR mutation previously associated with autonomously functioning follicular carcinomas. In conclusion, thyroid follicular adenomas are a group of morphologically benign neoplasms that may have altered the mutational or expression profile; cases of adenomas with altered immunophenotype are recognized as showing a profile associated with malignancy by Raman spectroscopy. This correlation warrants a more extensive evaluation and suggests a potential predictive value of spectroscopic assessment in recognizing characteristics associated with tumor progression in follicular thyroid neoplasms. Full article
(This article belongs to the Special Issue Thyroid Cancer: Diagnosis, Prognosis, Treatment, and Management)
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Review

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8 pages, 239 KiB  
Review
Update on International Medical Taxonomies of Biomarkers and Their Applications in Management of Thyroid Cancers
by Maria Trovato
Diagnostics 2022, 12(3), 662; https://doi.org/10.3390/diagnostics12030662 - 9 Mar 2022
Cited by 2 | Viewed by 2601
Abstract
Biomarkers (BMs) are medical signs which can be precisely measured and reproduced. Mainly, BMs provide information on the likely disease which can occur in an individual. On the other hand, BMs also signal disease recurrence in patients receiving therapy. The U.S. Food and [...] Read more.
Biomarkers (BMs) are medical signs which can be precisely measured and reproduced. Mainly, BMs provide information on the likely disease which can occur in an individual. On the other hand, BMs also signal disease recurrence in patients receiving therapy. The U.S. Food and Drug Administration coupled with the National Institutes of Health and the European Medicines Agency have proposed two distinct procedures to validate BMs. These agencies have elaborated two glossaries to describe the role of BMs. The aim of this study was to investigate medical taxonomies adopted by different governmental agencies for BM validation. Additional goals were to analyze efficiencies of the validated and candidate BMs for thyroid cancers (TCs). Currently, thyroglobulin is validated for monitoring TCs. Sorafenib-tosylate, Doxorubicin-hydrochloride, Vandetanib, Cabozantinib-s-malate, Dabrafenib-mesylate, Trametinib-dimethyl-sulfoxide, Lenvatinib-mesylate, Pralsetinib and Selpercatinib are validated for TC treatment. Among candidate BMs for TC diagnosis, there are molecular combinations including BRAF, RAS, RET/PTC and PAX8-PPARγ mutations. Noteworthy are BRAF and RET/PTC alterations already validated as targets of Dabrafenib-mesylate, Pralsetinib and Selpercatinib. Finally, cellular expressions of c-met in nodal TC metastases have diagnostic imaging applications. On the basis of this analysis, BM taxonomies should have common standards internationally recognized. BMs show different efficiencies depending on their diagnostic or therapeutic use. Full article
(This article belongs to the Special Issue Thyroid Cancer: Diagnosis, Prognosis, Treatment, and Management)

Other

Jump to: Research, Review

11 pages, 1959 KiB  
Viewpoint
Practical Guidelines for Diagnosing and Treating Thyroid Disease Based on the WOMED Metabolic Model of Disease Focusing on Glycolysis and Coenzyme Q10 Deficiency—A Clinical Alternative to the 2021 Retired Clinical Practice Guidelines of the Endocrine Society
by Roy Moncayo and Helga Moncayo
Diagnostics 2022, 12(1), 107; https://doi.org/10.3390/diagnostics12010107 - 4 Jan 2022
Cited by 5 | Viewed by 3200
Abstract
This review aims to provide a functional, metabolic view of the pathogenesis of benign thyroid disease. Here, we summarize the features of our previous publications on the “WOMED model of benign thyroid disease”. As of 2021, the current state of art indicates that [...] Read more.
This review aims to provide a functional, metabolic view of the pathogenesis of benign thyroid disease. Here, we summarize the features of our previous publications on the “WOMED model of benign thyroid disease”. As of 2021, the current state of art indicates that the basic alteration in benign thyroid disease is a metabolic switch to glycolysis, which can be recognized using 3D-power Doppler ultrasound. A specific perfusion pattern showing enlarged vessels can be found using this technology. This switch originates from an altered function of Complex I due to acquired coenzyme Q10 deficiency, which leads to a glycolytic state of metabolism together with increased angiogenesis. Implementing a combined supplementation strategy that includes magnesium, selenium, and CoQ10, the morphological and perfusion changes of the thyroid can be reverted, i.e., the metabolic state returns to oxidative phosphorylation. Normalization of iron levels when ferritin is lower than 50 ng/mL is also imperative. We propose that a modern investigation of probable thyroid disease requires the use of 3D-power Doppler sonography to recognize the true metabolic situation of the gland. Blood levels of magnesium, selenium, CoQ10, and ferritin should be monitored. Thyroid function tests are complementary so that hypo- or hyperthyroidism can be recognized. Single TSH determinations do not reflect the glycolytic state. Full article
(This article belongs to the Special Issue Thyroid Cancer: Diagnosis, Prognosis, Treatment, and Management)
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