Malignant Thyroid Tumors Research Articles

Surgical treatment of papillary thyroid carcinoma involving larynx and trachea

Objective: To evaluate the efficacy of surgical treatment of papillary thyroid carcinoma (PTC) involving larynx and trachea. Methods: A total of 1 436 cases of thyroid malignant tumors were admitted to the Department of Otolaryngology, Qilu Hospital of Shandong University from 2004 to 2019, including 110 cases of PTC involving larynx and trachea, and of which 105 cases with complete follow-up data were retrospectively analyzed. There were 42 males and 63 females, with a male/female ratio of 1∶1.5, aged from 28 to 81 years. All lesions involved trachea, including 11 cases involving both trachea and larynx. Of those 83 cases underwent laryngeal and airway wall tumor excision, and 22 cases underwent radical tumor excision plus laryngeal and trachea repair. Extubation rate was analyzed and the postoperative survival curve of patients was analyzed by Kaplan-Meier method. Results: Among 105 cases, 16 cases underwent tracheotomy and 12 cases were successfully extubated. The overall 3- 5- and 10-year survival rates were 100.0%, 86.4% and 72.5%, and the disease-free survival rates were 93.1%, 81.6% and 57.7%, respectively. There was significant difference in survival curve between the two groups (χ2=4.21, P=0.040). The 5-year and 10-year survival rates were 94.6% and 77.3% in laryngeal and tracheal tumor exclusion group, and 85.7% and 51.4% in the radical tumor resection group. There was no significant difference in the survival curves between the two groups (χ2=3.50, P=0.061). Conclusion: PTC patients with laryngeal and tracheal involvement can achieve long survival and good quality of life through reasonable surgical treatment.

Clinical analysis of 13 cases of primary squamous-cell thyroid carcinoma.

ObjectiveTo analyze the clinical features, ultrasonographic manifestations, pathological features, treatment and prognosis of primary thyroid squamous cell carcinoma (PSCTC) and summarize the experience in diagnosis and treatment of this condition.MethodsA retrospective analysis was conducted on patients who were admitted to Zhejiang Cancer Hospital from 2007 to 2021 due to thyroid nodules or thyroid malignant tumors that were ultimately confirmed by postoperative pathology as primary thyroid squamous cell carcinoma. We summarize the general situation, clinical information, laboratory examination, ultrasonic image characteristics, pathological examination, clinical treatment and prognosis of the patients.ResultsPSCTC is most often seen in older men and progresses rapidly. In laboratory tests, some patients had elevated levels of tumor markers (CA199, squamous cell carcinoma antigen level), thyroglobulin levels and tumor-related substances, but all these indicators lacked specificity. The ultrasound features of PSCTC are mainly hypoechoic, hard, substantial nodules with gross borders and a grade 1-2 blood flow signal, sometimes with signs of necrosis and calcification. In terms of treatment, PSCTC is mainly surgically resected, though some patients in this study underwent iodine-131 radiation therapy, local radiotherapy, and chemotherapy with unclear results. None of the patients survived for very long after treatment, but the prognosis of patients with highly differentiated squamous carcinoma was significantly better than that of patients with poorly differentiated squamous carcinoma. Papillary thyroid carcinoma may be one of the causes of PSCTC.ConclusionPSCTC is a malignant tumor with high malignancy and rapid clinical progression. Treatment options are mainly based on surgical resection and can be supplemented with radiotherapy and chemotherapy, but there is still a lack of a standardized treatment management system, and more cases and reports are needed to accumulate data.

Actual prevalence of hypoparathyroidism after total thyroidectomy: a health insurance claims-database study.

Persistent hypoparathyroidism (hypoPT) is a major complication of total thyroidectomy. Nonetheless, previous reports may have underestimated the prevalence of hypoPT due to patient selection bias. We aimed to estimate the actual prevalence of persistent hypoPT after total thyroidectomy and to find predictive factors for postoperative hypoPT. This study retrospectively reviewed data from a health insurance claims-based database provided by the Japan Medical Data Center Co., Ltd. From 2009 to 2019, 2388 patients who underwent total thyroidectomy were identified using the medical procedure codes. Persistent hypoPT was defined as the prescription of active vitamin D supplements for >1 year postoperatively and the assignment of hypoPT codes. The prevalence of persistent hypoPT was estimated at two different levels: minimum and maximum estimations with or without postoperative osteoporosis and/or renal failure codes. Correlates for persistent hypoPT were investigated among several demographic and clinical variables. Of the 2388 patients, 1752 (73.4%) were women with a mean age of 45 years. The types of diseases were: benign thyroid disease (n = 235), malignant thyroid tumors (n = 1570), Graves ' disease (n = 558), and malignancy combined with Graves' disease (n = 25). The minimum and the maximum estimation of the prevalence of persistent hypoPT were 15.0 and 20.3%, respectively. Multivariate logistic regression analysis showed that the malignant tumor (odds ratio, 1.8) independently correlated with persistent hypoPT. The prevalence of persistent hypoPT after total thyroidectomy estimated by the claims-based database was higher than previously recognized. Comprehensive attempts to preserve parathyroid function, especially in malignant diseases, are essential.

Clinicopathological features and outcomes of thyroid nodules with EIF1AX mutations.

EIF1AX gene mutations are reported in both benign and malignant thyroid tumors, with unclear outcomes when detected preoperatively. The aim of this study was to determine the features and outcomes of thyroid nodules with various types of mutation identified in cytologic (fine-needle aspiration) samples on preoperative ThyroSeq testing and with surgical outcomes. In this single-institution retrospective study of 31 consecutive patients, 77% were female and nodule size ranged from 1.5 to 9.4 cm with widely varying cytologic and TI-RADS ultrasound categorizations. Among two main mutational hotspots, 55% were located in exon 2 and 45% at the intron 5/exon 6 splice site. On histology, 45% of -positive nodules were cancer/noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) including 19% encapsulated follicular variant papillary thyroid carcinoma, 10% follicular carcinoma, 10% anaplastic carcinoma (ATC), and 7% NIFTP. Almost half (48%) of patients had one or more coexisting mutations, most frequently RAS. The prevalence of cancer/NIFTP was 80% for mutation with coexisting molecular alteration vs 13% with an isolated mutation (P = 0.0002). Cancer probability was associated with mutation type and was 64% for splice-site mutation and 29% for non-splice mutation (P = 0.075). All 3 nodules with EIF1AX+RAS+TERT+TP53 mutations were ATC. In summary, in this study, all nodules with an isolated non-splice mutation were benign, one-third of those with an isolated splice mutation were cancer, and most nodules with coexisting with RAS or other alterations were malignant. These findings suggest that clinical management decisions for patients with EIF1AX-mutant nodules should consider both the type of mutation and its co-occurrence with other genetic alterations.

Metastatic lung carcinoma in thyroid aspirates: A case series and literature review illustrating diagnostic challenges

Papillary thyroid carcinoma (PTC) is the most common primary malignant thyroid neoplasm and malignant diagnosis in thyroid aspirates. Metastatic adenocarcinoma of the lung is an under-recognised mimicker which overlaps cytomorphologically and immunocytochemically with PTC. This case series reviews thyroid aspirates of metastatic lung carcinomas, aiming to address the similarities and methods of differentiating this entity from PTC. Thyroid aspirates of metastatic lung carcinomas were obtained by a computerised search. Clinico-cytological features and ancillary test results were reviewed. A literature review was performed for published cases of metastatic lung carcinomas in thyroid aspirates. A total of 14 cases were found, including nine adenocarcinomas, three TTF1-positive non-small cell lung carcinomas (NSCLCs), one small cell carcinoma and one squamous cell carcinoma. The adenocarcinomas and TTF1-positive NSCLCs displayed PTC-like features including papillae/papillary-like fronds (n=6/12, 50%), nuclear grooves (n=5/12, 41.7%) and inclusions (n=1/12, 8.3%), chromatin clearing (n=3/12, 25%), calcifications (n=3/12, 25%) and multinucleated giant cells (n=2/12, 16.7%). Useful distinguishing features observed were prominent nucleoli, coarse chromatin, mitosis, and necrosis. TTF-1 immunocytochemistry was positive in most cases (n=5/6, 83.3%), while PAX8 and thyroglobulin were consistently negative. EGFR exon 19 deletion was detected on cell block preparation in a single case, corresponding to its lung primary. The literature search yielded 84 cases of metastatic malignancies, with lung carcinomas comprising of 3.6%-33.3% in case series of metastatic malignancies. Metastatic adenocarcinoma of lung and PTC share significant cytomorphological and immunocytochemical similarities. A high degree of caution, meticulous clinico-cytological assessment and prudent use of ancillary techniques is necessary to avoid potential misdiagnosis.

IMP3 Expression in Thyroid Cancers and its Relationship with Prognostic Parameters

To determine the expression of IMP3 (Insulin-like growth factor-II mRNA binding protein 3), which has been reported to be associated with poor prognosis in many organ malignancies, in thyroid malignant tumors and to determine its relationship with prognostic factors such as age, gender, tumor size, and histological type of tumor.

Concomitant Bilateral Papillary Thyroid Carcinoma and Parathyroid Adenoma

Thyroid malignant neoplasms are the most prevalent cancer of the endocrine system, and their concurrence with parathyroid neoplasms is extremely rare. We report a 69-year-old woman presenting with hypercalcemia and thyroid nodule, which histologic examination revealed bilateral papillary thyroid carcinoma with different variants coincident with parathyroid adenoma. Awareness of concomitant parathyroid and thyroid diseases may help manage patients with hypercalcemia history. So, we recommended a preoperative calcium check in a patient with a thyroid nodule.

INFORMATION OF BLOOD REDOX STATUS IN THE DIAGNOSIS OF VARIOUS TUMORS OF THE THYROID GLAND

Identification of markers of cancer is an urgent problem in modern oncology. The aim of our study was to determine the redox balance in the blood of patients with thyroid tumors, which, together with cytological and ultrasound examination, will confirm the diagnosis of cancer.The activity of the non-enzymatic antioxidant system in the blood serum of healthy individuals and patients (with a nonmalignant tumor of the thyroid gland and thyroid cancer) was studied. The study found that in patients with nonmalignant tumor pathology, the level of activity of the non-enzymatic antioxidant system of blood serum was lower than in healthy individuals. In patients with thyroid cancer, the activity of the non-enzymatic antioxidant system of blood serum increased sharply.Oxidative stress is an important participant in the process of carcinogenesis. Therefore, the detected difference in the activity of the nonenzymatic antioxidant system in the blood serum of patients with nonmalignant and malignant thyroid tumors can be used as a marker to confirm the diagnosis of cancer. To increase the diagnostic value of the activity of the non-enzymatic antioxidant system of blood serum in patients with various thyroid tumors, additional studies are needed.

Expression of β-Catenin in Thyroid Neoplasms (Histopathological and Immunohistochemical Study)

Background: Thyroid cancer is the most common malignant tumor of the endocrine system accounting for more than 90% of all endocrine cancer and 63% of all endocrine cancer deaths. β-catenin is a multifunctional protein that plays a key role in Wnt (wingless type) pathway and influences the expression of different genes and their proliferation, thus making it a potential therapeutic target.
 Aim of Work: This work aimed to examine immunohistochemical expression of β-catenin in different cases of thyroid neoplasms and to correlate between β-catenin expression and clinicopathological features of these thyroid neoplasms.
 Methods: This retrospective study was conducted on sixty cases of archived, formalin fixed, paraffin embedded tissue blocks that included different histologic types of thyroid neoplasms. Immunohistochemistry using β-catenin monoclonal antibody was performed using a standard avidin-biotin-peroxidase system. β-catenin expression was quantified both at membranous and cytoplasmic level. Immunostaining scores were based on the staining intensity (I) and the percentage of positive cells (P). β-catenin final score (H score) resulted by summation of I and P (ranging from 0 to 7). Cases with H score between 1–3 were considered with low score and cases with H score between 4–7 were considered with high score.
 Results: Of the malignant thyroid neoplasms in the studied cases, 81% showed positive β-catenin expression with the majority (86%) of the benign thyroid cases showing positive expression. Both membranous and cytoplasmic staining were both assessed in which the majority of the negative and high positive membranous cases also showed the same interpretation for cytoplasmic β-catenin expression. Positive correlations were proved between β-catenin expression of diagnosed malignant cases, (pvalue =0.042) where all hurthle cell, follicular and medullary carcinoma cases, 87.5% of studied papillary carcinoma cases and 50% of poorly differentiated carcinoma cases showed β-catenin positivity while all anaplastic carcinoma cases were negative. Furthermore, statistically significant findings were seen in cases with absence of extrathyroid extension (P value= 0.045) especially those displaying β-Catenin cytoplasmic expression with extrathyroid extension of studied malignant cases showing a P value= (0.011) . No significant correlation was found between β-catenin expression and patients' pathological diagnosis, gender, extent of primary tumor (pT), lymph node metastasis, multifocality and co-existing pathology among studied malignant cases.
 Conclusion: The present study suggests the prognostic role of β-catenin and its possible usage to identify patients who may benefit from adjuvant β-catenin targeted mono- or combined therapy for tumors expressing this protein, especially for thyroid cases that cannot be removed surgically or that do not respond to traditional treatment options.
 
 Key Words: β-catenin, immunohistochemistry, malignant thyroid neoplasms, benign thyroid neoplasms.

Genomic variation associated with carcinoma showing thymus-like elements (CASTLE) in thyroid gland.

BackgroundCarcinoma showing thymus‐like elements (CASTLE) is a rare kind of malignant tumor of thyroid gland. The genetic mutation characteristics of CASTLE are not clear.MethodsWe retrospectively analyzed seven patients diagnosed as CASTLE tumor in our hospital, and performed whole exome sequencing (WES) in five cases to analyze the genomic variation of CASTLE in thyroid gland.ResultsThe diagnosis of CASTLE was confirmed by histopathological and immunohistochemical results. Immunohistochemical staining showed that cell membranes of tumor samples in all cases were moderately to strongly positive for CD5 and CD117. WES presented a large number of single nucleotide variants (SNVs), insertions and deletions (InDel), and copy number variations (CNVs). By comparing with the TCGA database, we found novel mutations in significantly mutated genes such as FBXL16, PAQR7, LEFTY1, UBA52, and FLNA, as well as in potential disease‐related driver genes such as MLLT10, FLNA, CYLD, HLA‐B, KMT2D, SFPQ, MUC16, EEF2, and KMT2C. ConclusionsCASTLE tumors contain unique tumor driver gene mutations. The information about mutations in several novel genes obtained in this study may contribute to unraveling the molecular mechanisms responsible for the emergence of thyroid CASTLE tumors and help formulating possible in‐roads for treatment.

Multi-omics analysis revealed TEK and AXIN2 are potential biomarkers in multifocal papillary thyroid cancer

BackgroundPapillary thyroid carcinoma (PTC), the most common endocrine cancer, accounts for 80–85% of all malignant thyroid tumors. This study focused on identifying targets that affect the multifocality of PTC. In a previous study, we determined 158 mRNAs related to multifocality in BRAF-mutated PTC using The Cancer Genome Atlas.MethodsWe used multi-omics data (miRNAs and mRNAs) to identify the regulatory mechanisms of the investigated mRNAs. miRNA inhibitors were used to determine the relationship between mRNAs and miRNAs. We analyzed the target protein levels in patient sera using ELISA and immunohistochemical staining of patients’ tissues.ResultsWe identified 44 miRNAs that showed a negative correlation with mRNA expression. Using in vitro experiments, we identified four miRNAs that inhibit TEK and/or AXIN2 among the target mRNAs. We also showed that the downregulation of TEK and AXIN2 decreased the proliferation and migration of BRAF ( +) PTC cells. To evaluate the diagnostic ability of multifocal PTC, we examined serum TEK or AXIN2 in unifocal and multifocal PTC patients using ELISA, and showed that the serum TEK in multifocal PTC patients was higher than that in the unifocal PTC patients. The immunohistochemical study showed higher TEK and AXIN2 expression in multifocal PTC than unifocal PTC.ConclusionsBoth TEK and AXIN2 play a potential role in the multifocality of PTC, and serum TEK may be a diagnostic marker for multifocal PTC.

Thyroid nodules: diagnostic performance of ATA and ACR tirads on risk for malignancy

Aim: we aimed to compare the American Thyroid Association (ATA) and The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TIRADS) guidelines that stratify the risk of nodule malignancy and compare with cytological classification. Then, the diagnostic performance of the ATA and ACR TIRADS categories for predicting malignancy were performed. Methods: a total of 190 thyroid nodules image obtained from 120 individuals were classified in accordance with ACR TIRADS and ATA guidelines. After classified, all nodules were categorized by using cytological classification (2017 Bethesda System). Results: comparing diagnostic accuracy of each ultrasound classification, both of them revealed the same sensitivity and negative predictive value but ACR TIRADS reached higher positive predictive value. A high positive correlation between the two methods were found (r=0.860, p <0.0001). The ATA and ACR TIRADS classifications were correlated with the cytological analysis, but the correlation was weak. Conclusions: Both guidelines have similar accuracy in the ultrasound evaluation of thyroid nodules but have shown an overestimation of the presence of malignant thyroid neoplasms.

Metformin in Differentiated Thyroid Cancer: Molecular Pathways and Its Clinical Implications

Metformin is a synthetic biguanide that improves insulin sensitivity and reduces hepatic gluconeogenesis. Aside being the first-line therapy for Type 2 Diabetes (T2D), many pleiotropic effects have been discovered in recent years, such as its capacity to reduce cancer risk and tumorigenesis. Although widely studied, the effect of metformin on thyroid cancer remains controversial. Potential mechanisms for its growth inhibitory effects have been elucidated in various preclinical studies that involved pathways related to adenosine mono-phosphate-activated protein kinase (AMPK), mammalian target of rapamycin (mTOR), mitochondrial glycerophosphate dehydrogenase (mGPDH), and the nuclear factor κB (NF-κB). Hyperinsulinemia increases cell glucose uptake and oxidative stress, and promotes thyroid cell growth, leading to hyperproliferation, carcinogenesis, and the development of malignant tumors. Furthermore, it has also been related to thyroid nodules size in nodular disease, as well as tumoral size in patients with thyroid cancer. Several clinical studies concluded that metformin might have an important role as an adjuvant therapy to reduce the growth of benign and malignant thyroid neoplasms. This suggests that metformin might be useful for patients with differentiated or poorly differentiated thyroid cancer and metabolic diseases such as insulin resistance or diabetes.

Extracellular Vesicles as Signal Carriers in Malignant Thyroid Tumors?

Extracellular vesicles (EVs) are small, membranous structures involved in intercellular communication. Here, we analyzed the effects of thyroid cancer-derived EVs on the properties of normal thyroid cells and cells contributing to the tumor microenvironment. EVs isolated from thyroid cancer cell lines (CGTH, FTC-133, 8505c, TPC-1 and BcPAP) were used for treatment of normal thyroid cells (NTHY), as well as monocytes and endothelial cells (HUVEC). EVs’ size/number were analyzed by flow cytometry and confocal microscopy. Gene expression, protein level and localization were investigated by qRT-PCR, WB and ICC/IF, respectively. Proliferation, migration and tube formation were analyzed. When compared with NTHY, CGTH and BcPAP secreted significantly more EVs. Treatment of NTHY with cancer-derived EVs changed the expression of tetraspanin genes, but did not affect proliferation and migration. Cancer-derived EVs suppressed tube formation by endothelial cells and did not affect the phagocytic index of monocytes. The number of 6 μm size fraction of cancer-derived EVs correlated negatively with the CD63 and CD81 expression in NTHY cells, as well as positively with angiogenesis in vitro. Thyroid cancer-derived EVs can affect the expression of tetraspanins in normal thyroid cells. It is possible that 6 μm EVs contribute to the regulation of NTHY gene expression and angiogenesis.

Review of the Korean Society of Interventional Radiology and European Thyroid Association Guidelines Regarding the Role of Radiofrequency Ablation for Benign and Malignant Thyroid Tumors

While radiofrequency ablation (RFA) for the treatment of symptomatic thyroid nodules has been gaining more widespread adoption in the United States, there is limited societal guidance for its role, and safe adoption. As many of the first adopters of thyroid nodule RFA developed their practices, they looked to the Korean Society of Interventional Radiology (KSIR), and European Thyroid Association (ETA) guidelines as a framework. Currently, efforts are underway from the American Thyroid Association to create updated guidelines for US providers. International consensus guidelines are also underway. Until these guidelines are available, a thorough understanding of the current available guidelines is key for interventionalists building a thyroid nodule RFA program.

Molecular Pathological Diagnosis of Thyroid Tumors Using Spatially Resolved Metabolomics.

The pathological diagnosis of benign and malignant follicular thyroid tumors remains a major challenge using the current histopathological technique. To improve diagnosis accuracy, spatially resolved metabolomics analysis based on air flow-assisted desorption electrospray ionization mass spectrometry imaging (AFADESI-MSI) technique was used to establish a molecular diagnostic strategy for discriminating four pathological types of thyroid tumor. Without any specific labels, numerous metabolite features with their spatial distribution information can be acquired by AFADESI-MSI. The underlying metabolic heterogeneity can be visualized in line with the cellular heterogeneity in native tumor tissue. Through micro-regional feature extraction and in situ metabolomics analysis, three sets of metabolic biomarkers for the visual discrimination of benign follicular adenoma and differentiated thyroid carcinomas were discovered. Additionally, the automated prediction of tumor foci was supported by a diagnostic model based on the metabolic profile of 65 thyroid nodules. The model prediction accuracy was 83.3% when a test set of 12 independent samples was used. This diagnostic strategy presents a new way of performing in situ pathological examinations using small molecular biomarkers and provides a model diagnosis for clinically indeterminate thyroid tumor cases.

Detection of DNA methylation of HYAL2 gene for differentiating malignant from benign thyroid tumors

To assess the value of DNA methylation level of HYAL2 gene as a molecular marker for differential diagnosis of malignant and benign thyroid tumors. DNA methylation of HYAL2 gene in tissue specimens of 190 patients with papillary thyroid cancer (PTC) and 190 age- and gender-matched patients with benign thyroid tumors was examined by mass spectrometry, and the protein expression of HYAL2 was detected immunohistochemically for another 55 pairs of patients. Logistic regression analysis was performed to calculate the odds ratio (OR) and evaluate the correlation of per 10% reduction in DNA methylation with PTC. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) was calculated to assess the predictive value of alterations in HYAL2 methylation. Hypomethylation of HYAL2_CpG_3 was significantly correlated with early-stage PTC (OR=1.51, P=0.001), even in stage I cancer (OR=1.42, P=0.007). Age-stratified analysis revealed a significantly stronger correlation between increased HYAL2_CpG_ 3 methylation and early-stage PTC in patients below 50 years than in those older than 50 years (OR: 1.89 vs 1.37, P < 0.05); ROC analysis also showed a larger AUC of 0.787 in younger patients. The results of immunohistochemistry showed that patients with PTC had significantly higher protein expressions of HYAL2 than patients with benign tumors. The alterations of DNA methylation level of HYAL2 gene is significantly correlated with early-stage PTC, suggesting the value of DNA methylation level as a potential biomarker for differentiation of malignant from benign thyroid tumors.

Diagnostic Utility of Immunohistochemistry Markers Galectin-3, CK19 and CD56 in Thyroid Neoplasms: A Descriptive Study

Introduction: The spectrum of follicular patterned thyroid lesions vary from benign to malignant, their categorisation based solely on morphology can often be equivocal. Diagnostic value of immunohistochemistry as a useful ancillary technique is researched in detail, but there is no consensus for use of a marker of diagnostic utility in differentiated thyroid carcinoma. Aim: To evaluate the differential immunohistochemical expression of galectin-3, CK19 and CD56 in benign and malignant thyroid neoplasms. Materials and Methods: The present descriptive cross-sectional study was carried out in the Department of Pathology of a tertiary care centre, Government Medical College, Ernakulam, Kerala, India, from January 2018 to January 2019. Immunohistochemistry staining of galectin-3, Cytokeratin 19 (CK19) and Cluster Differentiation 56 (CD56) was done in 47 thyroid neoplasms. Cytoplasmic and nuclear staining of galectin-3, cytoplasmic or membranous staining of CK19 and loss of membranous expression of CD56 in more than 10% neoplastic cells were taken as positive expression. The data was analysed using IBM Statistical Package for the Social Sciences (SPSS) software version 22.0. Diagnostic test evaluation for markers done by calculating sensitivity and specificity. Results: Out of total 47 neoplasms, 26 were malignant and 21 were benign neoplasms. Of these, galectin-3 positivity was seen in 22 (84.61%) malignant neoplasms and in 2 (9.52%) benign neoplasms. Cytokeratin 19 positivity was seen in 26 (100%) malignant neoplasms and in 7 (33.33%) benign neoplasms. Loss of CD56 expression was observed in 24 (92.3%) malignant neoplasms and in 4 (19.04%) benign neoplasms. Considering histopathology as the gold standard, the sensitivity for detecting malignancy for the 3 markers, galectin-3, CK19 and CD56 was 84.62%, 100%, 92.3% and specificity was 90.48%, 66.67%, 80.95%, respectively. The diagnostic accuracy of galectin-3, CK19 and CD56 was 92.3%, 80.95%, 87.23%, respectively. Diagnostic Odd’s ratio for Galectin-3 was 2.3% in the present study. Conclusion: Galectin-3 was found to be a reliable marker for thyroid papillary carcinoma and for differentiating malignancy. The panel consisting of galectin-3 and CD56, is valuable and complementary when used in two marker combination. CK19 was found to be the least specific diagnostic marker of thyroid malignancy.

Evaluation the serum levels of T3, T4, TSH, Thyroglobulin and Galactin-3 in patients with benign and malignant thyroid tumors

Evaluation the serum levels of T3, T4, TSH, Thyroglobulin and Galactin-3 in patients with benign and malignant thyroid tumors

VsN, a Reliability-index of Shear-wave Measurement in Sonoelastography, Is Useful for the Diagnosis of Thyroid Tumor Malignancy.

Shear wave measurement (SWM) is a new elastography modality that quantifies the shear wave velocity (Vs) and the percentage of the net effective shear wave velocity (VsN). This study examined whether these parameters could be used to differentiate between malignant and benign thyroid tumors. The study of SWM enrolled 111 patients (133 nodules) who underwent thyroid surgery. Overall, 61 nodules were diagnosed as benign and 72 as malignant, of which 68 nodules were diagnosed as papillary thyroid carcinoma (PTC) and 4 as follicular thyroid carcinoma (FTC). A preoperative SWM revealed that Vs was significantly higher and VsN significantly lower in the PTC compared to the benign nodules. The VsN of FTC was significantly lower than that of follicular adenoma. Multivariate analysis revealed that VsN significantly correlated with nodule malignancy. SWM parameters, especially VsN, can potentially differentiate between benign and malignant thyroid nodules non-invasively.