Incidence Of Nodules Research Articles

Lung Nodule Evaluation Using Robotic-Assisted Bronchoscopy at a Veteran's Affairs Hospital.

The incidence of lung nodules has increased with improved diagnostic imaging and screening protocols. Despite improvements for diagnosing pulmonary nodules with technologies such as electromagnetic navigational bronchoscopy (ENB), several limitations still exist including adequate visualization, localization, and diagnostic yield. Robotic-assisted bronchoscopy with ENB has been introduced as a method to overcome these shortcomings. We describe our initial experience in evaluating lung nodules with robotic assisted bronchoscopy. We retrospectively reviewed data on the first 25 patients that underwent robotic-assisted bronchoscopy and biopsy. We analyzed success with localization, diagnostic yield, and post procedural morbidity. Diagnostic yield was 96% (24/25) with no periprocedural morbidity. The majority of nodules were malignant or atypical (76%) and were located in the right upper lobe. Diameter ranged between 0.8–6.9 cm (median size 1–2 cm). Seventy-five percent of patients underwent subsequent treatment for cancer based on these results, with 25% having continued surveillance. Robotic assisted bronchoscopy is safe and accurate. Studies with larger numbers will allow better understanding of the diagnostic yield and clinical utility of this approach in comparison to other diagnostic tools for lung nodules.

Goitre and thyroid lumps

Thyroid swellings are relatively common; they are three times more common in females than males. The incidence of palpable nodules is approximately 5% in women and 1% in men. Thyroid cancer constitutes less than 1% of all malignancies registered in the UK, with an incidence of approximately 5 per 100 000 women and 2 per 100 000 men. However, thyroid cancer is the most common endocrine malignancy and accounts for more than 90% of cancers of the endocrine glands. Over the last decade the incidence of thyroid cancer in the UK has increased by more than two-thirds (68%).

Morphological Plaque Characteristics and Clinical Outcomes in Patients With Acute Coronary Syndrome and a Cancer History

BackgroundAlthough patients with a cancer history have a 2 to 3 times higher risk for acute coronary syndrome (ACS), the morphological characteristics of ACS culprit plaque in those patients and their relations with clinical outcomes remain unknown.Methods and ResultsThis retrospective, multicenter, observational cohort study included consecutive patients with ACS who underwent optical coherence tomography‐guided emergent percutaneous coronary intervention. Patients were categorized into those without a cancer history, those with a cancer history, and those currently receiving cancer treatment. ACS culprit lesions were classified as plaque rupture, plaque erosion, or calcified nodule using optical coherence tomography. Plaque erosion frequency was significantly higher in culprit lesions of patients with current cancer and patients with cancer history than in those of patients without cancer history (56.3% versus 61.7% versus 36.5%). Calcified nodule incidence was significantly higher in patients without cancer history than in patients with current cancer and patients without cancer history (patients with current cancer: 12.4% versus patients without cancer history: 25.5% versus patients without cancer history: 12.6%, P<0.001). Cancer history was independently associated with nonplaque rupture (plaque erosion or calcified nodule) in ACS culprit lesions (odds ratio, 4.00; P<0.001). Cancer history was independently associated with major adverse cardiovascular events (hazard ratio [HR], 1.98; P=0.002). Nonplaque rupture in ACS culprit lesions was independently associated with major adverse cardiovascular events (HR, 1.60; P=0.011).ConclusionsPatients with a cancer history had significantly worse clinical outcomes after ACS than those without a cancer history. Those with a cancer history had significantly higher plaque erosion and calcified nodule incidences in the ACS culprit lesions, which might partly explain their worse clinical outcomes.RegistrationURL: www.umin.ac.jp/ctr/index.htm. Unique Identifier: UMIN000038442.

Are Incidental Minute Pulmonary Nodules Ultimately Determined to Be Metastatic Nodules in Esophageal Cancer Patients?

Purpose: Esophageal cancer patients may simultaneously have resectable esophageal cancer and undiagnosable incidental minute solid pulmonary nodules. While the latter is rarely metastatic, only a few studies have reported on the outcomes of such nodules after surgery. In this retrospective study, we assessed the incidence of such nodules, the probability that they are ultimately metastatic nodules, and the prognosis of patients after esophagectomy according to the metastatic status of the nodules. Methods: Data of 398 patients who underwent esophagectomy for resectable esophageal cancer between January 2012 and December 2016 were collected. We reviewed computed tomography (CT) images from the first visit and searched for incidental minute pulmonary nodules <10 mm in size. We followed the outcomes of these nodules and compared the characteristics of metastatic and nonmetastatic nodules. We also assessed the prognosis of patients whose minute pulmonary nodules were metastatic. Results: Among the patients who underwent esophagectomy, 149 (37.4%) had one or more minute pulmonary nodules, with a total of 285 nodules. Thirteen (4.6%) of these nodules in 12 (8.1%) patients were ultimately diagnosed as being metastatic. Thirteen (8.7%) patients experienced recurrence at a different location from where the nodules were originally identified. Characteristics of the metastatic nodules were not unique in terms of size, SUVmax, or location in the lungs. Two-year and 5-year overall survival rates of patients whose nodules were metastatic were 64.2 and 32.1%, respectively. Conclusion: The rate of minute pulmonary nodules which were ultimately metastatic was 4.6%. Our findings suggest that esophagectomy followed by the identification of minute pulmonary nodules is an acceptable strategy even if the nodules cannot be diagnosed as being metastatic on the first visit CT due to their small size.

Joint Detection of Tap and CEA Based on Deep Learning Medical Image Segmentation: Risk Prediction of Thyroid Cancer.

In recent years, the incidence of thyroid nodules has shown an increasing trend year by year and has become one of the important diseases that endanger human health. Ultrasound medical images based on deep learning are widely used in clinical diagnosis due to their cheapness, no radiation, and low cost. The use of image processing technology to accurately segment the nodule area provides important auxiliary information for the doctor's diagnosis, which is of great value for guiding clinical treatment. The purpose of this article is to explore the application value of combined detection of abnormal sugar-chain glycoprotein (TAP) and carcinoembryonic antigen (CEA) in the risk estimation of thyroid cancer in patients with thyroid nodules of type IV and above based on deep learning medical images. In this paper, ultrasound thyroid images are used as the research content, and the active contour level set method is used as the segmentation basis, and a segmentation algorithm for thyroid nodules is proposed. This paper takes ultrasound thyroid images as the research content, uses the active contour level set method as the basis of segmentation, and proposes an image segmentation algorithm Fast-SegNet based on deep learning, which extends the network model that was mainly used for thyroid medical image segmentation to more scenarios of the segmentation task. From January 2019 to October 2020, 400 patients with thyroid nodules of type IV and above were selected for physical examination and screening at the Health Management Center of our hospital, and they were diagnosed as thyroid cancer by pathological examination of thyroid nodules under B-ultrasound positioning. The detection rates of thyroid cancer in patients with thyroid nodules of type IV and above are compared; serum TAP and CEA levels are detected; PT-PCR is used to detect TTF-1, PTEN, and NIS expression; the detection, missed diagnosis, misdiagnosis rate, and diagnostic efficiency of the three detection methods are compared. This article uses the thyroid nodule region segmented based on deep learning medical images and compares experiments with CV model, LBF model, and DRLSE model. The experimental results show that the segmentation overlap rate of this method is as high as 98.4%, indicating that the algorithm proposed in this paper can more accurately extract the thyroid nodule area.

Using a risk model for probability of cancer in pulmonary nodules

BackgroundConsidering the high morbidity and mortality of lung cancer and the high incidence of pulmonary nodules, clearly distinguishing benign from malignant lung nodules at an early stage is of great significance. However, determining the kind of lung nodule which is more prone to lung cancer remains a problem worldwide.MethodsA total of 480 patients with pulmonary nodule data were collected from Shandong, China. We assessed the clinical characteristics and computed tomography (CT) imaging features among pulmonary nodules in patients who had undergone video‐assisted thoracoscopic surgery (VATS) lobectomy from 2013 to 2018. Preliminary selection of features was based on a statistical analysis using SPSS. We used WEKA to assess the machine learning models using its multiple algorithms and selected the best decision tree model using its optimization algorithm.ResultsThe combination of decision tree and logistics regression optimized the decision tree without affecting its AUC. The decision tree structure showed that lobulation was the most important feature, followed by spiculation, vessel convergence sign, nodule type, satellite nodule, nodule size and age of patient.ConclusionsOur study shows that decision tree analyses can be applied to screen individuals for early lung cancer with CT. Our decision tree provides a new way to help clinicians establish a logical diagnosis by a stepwise progression method, but still needs to be validated for prospective trials in a larger patient population.

Clinical study of solitary nodule of thyroid and role of FNAC in the management of solitary nodule of thyroid

Background: Solitary nodule of thyroid has increased in incidence in the present day as compared to two decades before. Because of possibility of malignancy, some clinicians especially those in surgical subspecialties recommended that all nodules have to be removed. Objectives: Clinical study of solitary nodule of thyroid and role of FNAC in the management of solitary nodule of thyroid. Method: This prospective study includes 70 patients, presenting in KIMS, Koppal who were clinically diagnosed as solitary nodule of thyroid. All patients were admitted and were subjected to thyroid profile, USG and FNAC. All patients were operated appropriately depending on the FNAC report. Histopathological examination of the operated specimen was done for all the patients. Depending on the histo-pathological report appropriate postoperative therapies were administered to all the patients and all the patients were followed up appropriately. Result: The peak incidence of solitary nodule was observed in 3rd to 5th decade, constituting 60% of the cases studied. Females predominated in number over males in occurrence of solitary nodule in ratio of 1:8.16. 33% of all clinically solitary nodule turned out to be multi-nodular goiter. Incidence of malignancy in solitary thyroid nodule was 10.9%. Male to female ratio in case of malignant nodule was1:5. Incidence of carcinoma in males presenting as solitary nodule was higher (16.67%) compared to that of females (10.20%). The most common cause of malignancy was papillary carcinoma (67%) followed by follicular carcinoma (33%). Conclusion: USG can be accurately used to detect patients with multinodulary goiter who clinically present as solitary nodule of thyroid. Common causes of solitary nodule of thyroid are MNG, follicular adenoma and adenomatous goiter.

Radiofrequency ablation for management of thyroid nodules: a case report

Background: Thyroid nodules constitute a frequently seen clinical problem and the incidence of thyroid nodules has increased with the recently increased use of thyroid ultrasonography. Radiofrequency ablation (RFA) is an effective and safe method for treating benign thyroid nodules and recurrent thyroid cancers.Case Presentation: A 48 years old woman came to the surgical oncology clinic with the presence of a getting bigger, moves when the patient swallows, and painless mass on her neck since 20 years ago. The physical examination measured 5x5 cm mass, mobile on swallowing, no pain on palpation, and the laboratory examination shows a euthyroid state.  The ultrasound result has revealed an enlargement of the right and left thyroid with increased echo intensity of parenchyma and increased vascularisation. This mass was concluded as struma nodus bilateral. The FNAB was follicular neoplasm, Bethesda system class 4. The patient underwent a single session RFA. RFA was performed employing transisthmic access using a 7 cm 18 gauge electrode-needle with a 1 cm active needle tip. The patient well tolerated the procedure and no adverse events were noted. Conclusion: Radiofrequency ablation for thyroid lesions is a safe and effective method for treating benign thyroid nodules and even recurrent thyroid cancers. Therefore, various factors, including serum TSH, clinical risk factor assessment, size of the nodule, ultrasound characteristics, patient preferences, and results of the FNA biopsy, should be considered to manage thyroid nodule.

LDCT Screening in Smokers in India-A Pilot, Proof-of-Concept Study.

Aim The aim of the study is to assess the effectiveness of low dose CT scan (LDCT) to pick up nodules and carcinomas in smokers in India. Methods A retrospective study of 350 smokers scanned with LDCT was performed in a private practice center in Mumbai, India. Their demographic profile, smoking history in pack-years, lung nodules, and associated findings/superimposed complications were recorded and analyzed. The nodules were assigned the appropriate Lung-RADS category and results of the patients undergoing biopsy were recorded. Results Of the 350 smokers, 15 (4%) were women . The mean age was 61 years (32–90 years) with a mean smoking history of 22 pack-years (1–160 pack-years). Lung nodules were found in 335 (93%) smokers, with Lung-RADS category 1 nodules seen in 117 (36%), category 2 in 133 (41%), category 3 in 29 (9%), and category 4 in 46 (14%) of positive scans. Seven of the category 4 patients who underwent biopsy showed carcinoma, with a mean smoking history of 30 pack years. Superimposed interstitial lung disease, airways diseases, and infections were also seen in the scans and recorded. Discussion It has been proven in the Western world that screening for lung cancer with LDCT saves lives with early pick-up of malignant nodules. This pilot study from India, shows that even in a tuberculosis endemic country, LDCT picks up malignant lung nodules early and saves lives. Conclusion Smokers with a more than 20 pack years history have a higher incidence of lung nodules, which may represent carcinoma, in a tuberculosis endemic country like India, as has been proven in other countries in the Western world. Larger studies and trials may be performed to elaborate further on this proof-of-concept study.

Clinicopathological study of thyroid swellings and it’s correlation with ultrasonography

Background: Thyroid diseases are common and comprise a spectrum of entities. After diabetes mellitus, the thyroid gland is the most common gland to cause endocrine disorder. Lesions of thyroid are predominantly confined to female in the ratio 5:1 to male. Thyroid enlargement is the most common sign, it may be diffuse or generalized or localized. Both benign and malignant lesions of thyroid commonly present with a nodule. Prevalence of thyroid nodule ranges from 0.2% to 1.2% in children and from 4-10% in general adult population. Presently due to common use of ultra-sonography in the clinical practice the incidence of thyroid nodule has risen to 14-50%.Methods: A prospective, observational, single hospital base study done during the period from 2018 to 2020 in the Department of Surgery, Gandhi medical college Bhopal. Sample size was taken 60 patients.Results: In this study as patients present with thyroid enlargement and ulrasonography scoring according to TIRAD score, as TIRAD score is increased possibility of malignancy increased. On the basis of ultrasonography of thyroid to detect the malignancy sensitivity is 88.9% and specificity is 98%.Conclusions: Commonest clinical presentation is multinodular goitre is about 53% and ultrasonography scoring is TIRAD-2 and TIRAD-3 which was consistent with nodular hyperplasia. Second commonest clinical presentation is colloid goitre (31%) and ultrasonography score is TIRAD-2 and TIRAD-3. On the basis of ultrasonography TIRAD-4 and TIRAD-5 are about 13.4% and these findings consistent with Neoplastic thyroid swelling in histopathology.

Incidence of microcarcinoma and non\u2010microcarcinoma in ultrasound\u2010found thyroid nodules

BackgroundsThe incidence of thyroid nodules is increasing year by year around the world. However, ultrasound is not recommended as a screening test for the general population or patients with a normal thyroid on palpation by the American Association of Clinical Endocrinologists (AACE). In practice, some individuals with normal thyroid palpation have nodules that can just be found out by ultrasound. No studies have directly described the risk of nodules found by ultrasound or by palpation up to now. More evidence is needed to carry out for helping us balance the over diagnosis and missed diagnosis of malignant lesions. Therefore, we carried out a retrospective study to investigate the incidence of malignant lesions in ultrasound-found nodules in a large cohort.MethodsWe conducted a retrospective analysis involving 2957 patients who underwent thyroid ultrasound evaluation and fine-needle aspiration (FNA) between Jan 2013 and Dec 2019. The cytologic examinations were analyzed based on the Bethesda system. For nodules suspected to be follicular neoplasm or other malignant tumors by cytological tests, patients were recommended for surgery and histopathology examinations.ResultsCompared with palpation-found nodules, ultrasound-found nodules were presenting less as purely cystic nodules (10.1 % vs. 39.9 %, x2 = 355.69, p = 0.000), smaller size (17.5 ± 9.9 mm vs. 28.0 ± 12.5 mm, t = 23.876 p = 0.000), and higher TI-RADS score (5.5 ± 2.9 vs. 3.4 ± 3.3, t = 18.084, p = 0.000), respectively. More ultrasound-found nodules were diagnosed as carcinoma by histology examinations [136 (11.2 %) nodules found by ultrasound vs. 68 (3.9 %) by palpation, x2 = 59.737, p = 0.000], and 88 (64.7 %) nodules found by ultrasound were non-microcarcinoma. Among the malignant nodules confirmed by histopathology, a higher proportion of microcarcinoma was detected in ultrasound-found nodules [35.3 % (48/136) vs. 16.2 % (11/68), x2 = 8.183, p = 0.004].ConclusionsIn view of the results observed in our research, malignant nodules were more common in nodules screened out by ultrasound, and nearly two thirds of them were non-microcarcinoma. We suggest the recommendation against screening thyroid nodules by ultrasound needs to be re-evaluated.

Satellite nodules in pleomorphic adenomas of the parotid gland: A nightmare for less invasive parotid surgery?

ObjectivesThe aim of this study was to thoroughly investigate the incidence of satellite nodules (SN) and some of their characteristics (number, distance to main lesion) in a large series of pleomorphic adenomas (PA) and to compare several surgical modalities regarding their efficacy in addressing this critical morphological feature. Materials and methodsThe records of all patients treated for primary PA of the parotid gland between 2006 and 2020 were studied retrospectively. All the histological slides of all tumours were critically re-evaluated for this study by an experienced head and neck pathologist. Results845 cases made up our initial study sample. SNs were detected in 68/845 cases (8%). No statistically significant difference could be detected in the incidence of SNs in the surgical specimens between the patient groups managed by extracapsular dissection (46/577, 7.9%) and facial nerve dissecting surgery (22/268, 8.2%, p = 0.502). In the group of cases with SNs, no recurrences were detected (mean follow-up time: 71.4 months). The mean distance from the main lesion to the most distant SN was 1.1 mm (0.08–6.3 mm). The mean size of the SN was 1.9 mm (0.1–9.7 mm). Altogether, the mean distance from the main lesion to the outer periphery of the most distant SN was 3.1 mm (0.4–10.5 mm). ConclusionOur analysis could not award SNs the title of an “extracapsular dissection’s nightmare”. In the majority of cases, their favourable histological patterns offer the ideal circumstances for their surgical inclusion in a tumour specimen.

A novel technique for preoperative localization of pulmonary nodules using a mixture of tissue adhesive and iohexol under computed tomography guidance: A 140 patient single-center study.

BackgroundThe increase in the incidence of pulmonary nodules has made computed tomography (CT) screening a requirement for diagnosis and treatment. Small pulmonary nodule detection during video‐assisted thoracoscopic surgery (VATS) or thoracotomy is frequently challenging; however, accurate and efficient localization of nodules is critical for precise resection. Herein, we introduce and evaluate the feasibility and safety of a novel technique for preoperative pulmonary nodule localization.MethodsFrom March 2018 to December 2019, 140 patients with 153 pulmonary nodules measuring <2 cm in diameter were enrolled in this study. Preoperative, CT‐guided localization was performed on each nodule with an injected mixture of tissue adhesive and iohexol. Patient and nodule characteristics, localization data, complications, surgical data, and pathological results were analyzed.ResultsAll 153 nodules in 140 patients were successfully marked preoperatively and detected during surgery (n = 153/153). Mean nodule size was 8.7 ± 2.6 mm, and mean distance from nodule to pleura was 7.9 ± 8.2 mm. The mean procedural time was 8.7 ± 1.0 min. Nine patients (6.4%) underwent two simultaneous nodule localizations and two patients (1.4%) underwent three simultaneous nodule localizations. Pneumothorax (17/140, 12.1%), pain (6/140, 4.3%), and pungent odor (5/140, 3.6%) were the major complications. No patient required further treatment, and no allergic reactions or embolisms were observed.ConclusionsPreoperative CT‐guided nodule localization using a mixture of tissue adhesive and iohexol is an efficient technique for localizing small and impalpable pulmonary lesions, including multiple pulmonary nodules. Our study demonstrates that this novel method is safe and straightforward to implement.

Indeterminate pulmonary nodules are not associated with worse overall survival in Ewing Sarcoma

AimLung metastases are a negative prognostic factor in Ewing sarcoma, however, the incidence and significance of sub-centimetre pulmonary nodules at diagnosis is unclear. The aims of this study were to (1): determine the incidence of indeterminate pulmonary nodules (IPNs) in patients diagnosed with Ewing sarcoma (2); establish the impact of IPNs on overall and metastasis-free survival and (3) identify patient, oncological and radiological factors that correlate with poorer prognosis in patients that present with IPNs on their staging chest CT. Materials & methodsBetween 2008 and 2016, 173 patients with a first presentation of Ewing sarcoma of bone were retrospectively identified from an institutional database. Staging and follow-up chest CTs for all patients with IPN were reviewed by a senior radiologist. Clinical and radiologic course were examined to determine overall- and metastasis-free survival for IPN patients and to identify demographic, oncological or nodule-specific features that predict which IPN represent true lung metastases. ResultsFollowing radiologic re-review, IPN were found in 8.7% of patients. Overall survival for IPN patients was comparable to those with a normal staging chest CT (2-year overall survival of 73.3% [95% CI 43.6–89] and 89.4% [95% CI 81.6–94], respectively; p = 0.34) and was significantly better than for patients with clear metastases (46.0% [95% CI 31.9–59]; p < 0.0001). Similarly, there was no difference in metastasis-free survival between ‘No Metastases’ and ‘IPN’ patients (p = 0.16). Lung metastases developed in 40% of IPN patients at a median 9.6 months. Reduction of nodule size on neoadjuvant chemotherapy was associated with worse overall survival in IPN patients (p = 0.0084). ConclusionIPN are not uncommon in patients diagnosed with Ewing sarcoma. In this study, we were unable to detect a difference in overall- or metastasis-free survival between patients with IPN at diagnosis and patients with normal staging chest CTs.

Impact of Insulin Treatment on Prognosis of non-B non-C Hepatocellular Carcinoma After Hepatectomy.

Several studies have reported that DM is closely associated with an increased incidence of hepatocellular carcinoma (HCC). To clarify the effects of diabetes mellitus (DM) and antidiabetic medications on the prognosis of patients with non-B non-C (NBNC) HCC following curative initial hepatectomy. HCC patients (n=156) were divided into three groups according to the presence or absence of chronic viral hepatitis: hepatitis B virus (HBV) group, hepatitis C virus (HCV) group, and NBNC group. The clinical characteristics and survival outcomes were compared. In the NBNC group, univariate and multivariate analyses were conducted to determine prognostic factors. The NBNC group had a higher incidence of DM, ethanol intake, and large nodules than the other groups. Disease-free survival (DFS) was significantly worse in the NBNC group than in the HBV group. In the NBNC group, insulin treatment was an independent prognostic factor for DFS and overall survival (OS). Medications for DM that affect insulin resistance might be appropriate prognostic factors for NBNC-HCC.

Evaluation of thyroid nodules on radiation-exposed workers

Background. Ionizing radiation could cause negative effects on DNA molecules, which leads mutation and tumorigenesis. Thyroid gland is one of the most radiosensitive organ due to the great oxidative process on their physiological condition. Medical workers have been exposed to radiation during medical image acquisition. The relation between radiation and the increase of thyroid cancer incidence have been studied before, the discussion mostly explain the acute effect of radiation. The aim of this study is to describe the incidence of thyroid nodule on radiation-exposed worker. Methods. The study was performed in 40 radiation-exposed workers with at least has 5 years working period. We examined using thyroid ultrasonography and blood level of T3, fT4 and TSH. Result. The incidence of thyroid nodule in radiation-exposed worker is 37.5%, which is higher among female (66%) than in male (29%). Based on the age distribution, most of the nodules were find in workers with age more than 35 years old. According to ultrasonography result and TIRADS scoring, 66.7% of the nodules were benign which categorize as TIRADS 1 and only 33% of the nodules were categorize as moderately suspicious or TIRADS 4. Conclusion. Radiation-exposed workers have high risk to develop thyroid nodules. This study could be used as basic data to do further evaluation. It is important to perform thyroid screening periodically among them.

Autoimmune Thyroid Disease, Thyroid Functions, and Thyroid Ultrasonography in Pediatric Celiac Disease

Objective: To compare thyroid function tests, autoantibodies and ultrasound findings in pediatric celiac patients following a gluten-free diet with the non-celiac control group.&#x0D; Material and Methods: The data of 64 celiac patients (median age 11 years) followed up with a gluten-free diet in the pediatric outpatient clinic and 143 control patients were retrospectively reviewed. The patient group consisted of 18 men, 46 women, and the control group 39 men and 103 women. The age range of the cases was 6-17 years. The duration of gluten-free diet was between three months and 15 years (median four years). The diagnosis of celiac disease was made according to the criteria of the European Society for Paediatric Gastroenterology, Association of Hepatology, and Nutrition. Free thyroxin, thyroid stimulating hormone (TSH), anti-thyroid peroxidase (anti-TPO), and antithyroglobulin (anti-Tg) levels were measured. In the thyroid ultrasound, gland volume, parenchymal structure, and thyroid nodules were evaluated. The positivity of thyroid autoantibodies and a heterogeneous appearance on ultrasound were assessed in favor of thyroiditis. The findings were compared between the celiac and control groups.&#x0D; Results: Autoimmune thyroid disease was seen in 12.5% of celiac patients and 4.2% of the controls (p&lt;0.05). The rate of abnormalities in thyroid function tests was 9.3% in the celiac group and 2.8% in the control group (p=0.05). The mean thyroid volume was 3.58 ml in celiac patients and 3.95 ml in controls (p&gt;0.05). The parenchymal heterogeneity was 12.5% in the celiac group and 2.1% in the control group (p&lt;0.05), and the incidence of thyroid nodules was 25% and 4.2%, respectively (p&lt;0.05).&#x0D; Conclusion: The autoimmune thyroiditis and thyroid dysfunction is more frequent in children with celiac disease. In addition, heterogeneous parenchyma and thyroid nodules are more common than the normal population on ultrasound. Celiac patients should be carefully evaluated for possible thyroid disease.

The mevalonate pathway promotes the metastasis of osteosarcoma by regulating YAP1 activity via RhoA

Osteosarcoma is the most common malignant bone tumour, and the metastasis of osteosarcoma is an important cause of death. Evidence has shown that the mevalonate pathway is highly activated and is expected to be a new target for tumour therapy. In this study, we investigated the effect of mevalonate signalling on osteosarcoma metastasis and its molecular mechanism. First, we found that the key rate-limiting enzyme of mevalonate signalling, 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), was highly expressed in osteosarcoma cells, and inhibition of HMGCR with simvastatin significantly inhibited the motility of 143B cells. Next, we found that YAP1 activity was significantly upregulated in osteosarcoma cells and that YAP1 knockdown inhibited the motility of 143B cells. We also found that the mevalonate pathway regulated the motility of 143B cells by modulating YAP1 phosphorylation and cellular localization. Moreover, we found that the activity of YAP1 was regulated by the mevalonate pathway by modulating the cell membrane localization of RhoA. Finally, we demonstrated that inhibition of the mevalonate pathway notably reduced the lung metastasis of 143B cells, as reflected by the decreased incidence and number of metastatic nodules and the increased survival time of the nude mice. Taken together, our findings suggest that the mevalonate pathway can promote the metastasis of osteosarcoma by activating YAP1 via RhoA. Inhibition of the mevalonate pathway may be a promising therapeutic strategy for osteosarcoma metastasis.

Thyroid nodules in xeroderma pigmentosum patients: a feature of premature aging.

Xeroderma pigmentosum (XP) is an autosomal recessive disease with defective DNA repair, a markedly increased risk of skin cancer, and premature aging. Reports from North Africa have described thyroid nodules in XP patients, but thyroid nodule prevalence has never been determined in XP patients enrolled in our natural history study at the National Institutes of Health (NIH). We performed thyroid ultrasound examinations on all 29 XP patients examined from 2011 to 2019 and assessed nodule malignancy using the Thyroid Imaging Reporting and Data System. Thyroid nodule prevalence was also obtained from comparison cohorts. DNA sequencing was performed on thyroid tissue from XP patients who had surgery for thyroid cancer. Thyroid nodules were identified in 18/29 XP patients (62%). The median age of patients with thyroid nodules in our XP cohort (20years) was younger than that of three comparison groups: 36years (California study-208 subjects), 48years (Korean study-24,757 subjects), and 52years (NIH-682 research subjects). Multiple (2-4) thyroid nodules were found in 12/18 (67%) of the patients with nodules. Autopsy examination revealed follicular adenomas in 4/8 (50%) additional XP patients. DNA sequencing revealed rare mutations in two other XP patients with papillary thyroid cancer. XP patients have an increased incidence of thyroid nodules at an early age in comparison to the general population. These finding confirm another premature aging feature of XP.

Expression level of NEAT1 differentiates benign and malignant thyroid nodules by regulating NEAT1/miR‑9/PTEN and NEAT1/miR‑124/PDCD6 signalling.

The incidence of thyroid nodules has been increasing worldwide; however, there are currently no feasible and robust methods to differentiate malignant thyroid nodules from benign thyroid nodules. The present study aimed to establish a practical method to determine the malignancy of thyroid nodules. Reverse transcription-quantitative PCR and western blot analyses were performed to compare the levels of long non-coding RNA nuclear enriched abundant transcript 1 (NEAT1), microRNA (miR)-9, miR-124, PTEN and programmed cell death protein 6 (PDCD6) in the peripheral blood and thyroid tissue samples between patients with malignant and benign thyroid nodules. Additionally, a regulatory relationship between NEAT1, miR-124, miR-9, PTEN and PDCD6 was established in the present study. The diagnostic value of NEAT1, miR-124 and miR-9 was determined using a ROC analysis. The expression levels of NEAT1, PTEN and PDCD6 in peripheral blood and thyroid tissue samples collected from the benign group were higher compared with those in the malignant group, whereas the expression levels of miR-124 and miR-9 were lower in the benign group. In the peripheral blood, NEAT1 expression exhibited an area under the curve (AUC) value of 0.8546, whereas miR-124 and miR-9 expression had AUC values of 0.7657 and 0.7019, respectively. In the thyroid tissue, NEAT1, miR-124, and miR-9 had AUC values of 0.9304, 0.8221 and 0.7757, respectively. Additionally, miR-9 and miR-124 expression levels in BCPaP and SW579 cells was decreased after transfection with a NEAT1 expression vector compared with those in cells transfected with the control vector, whereas the expression of PTEN and PDCD6 was upregulated. By contrast, transfection with short hairpin RNA targeting NEAT1 notably increased the expression of miR-9 and miR-124 while downregulating the expression of PTEN and PDCD6 compared with that in the control cells. In conclusion, the results of the present study demonstrated that the dysregulation of NEAT1 expression may be used to differentiate benign and malignant thyroid nodules.