Thyroid Cancer Group Research Articles

Assessment of anxiety levels of patients awaiting surgery for suspected thyroid cancer: A case-control study in a Chinese-Han population.

The objective of this study was to evaluate levels and prevalence of anxiety in thyroid tumor patients awaiting surgery and diagnosis and to investigate whether significant differences existed in preoperative anxiety levels between patients with postoperative pathological diagnosis of benign thyroid tumors (BTT) or thyroid cancer (TC) in a Chinese-Han population. Five hundred and twenty-nine patients awaiting surgery and diagnosis were chosen as the patient group, and 419 healthy Chinese were chosen as the control group. Anxiety levels were assessed by the State-Trait Anxiety Inventory. The cytological and histopathologic examinations showed BTT in 390 patients and TC in 139 patients. Moderate and high state-anxiety prevalence were 63.3%, 66.9%, and 38.9%, and moderate and high trait-anxiety prevalence were 53.6%, 56.1%, and 20.5% for BTT, TC, and healthy groups, respectively. There were significant differences in sample distributions between low and moderate/high anxiety levels among the three groups (state-anxiety, χ2 = 60.95, P < 0.001; trait-anxiety, χ2 = 111.73, P < 0.001). The mean state-anxiety scores were 41.02 ± 8.82, 42.71 ± 8.74, and 37.18 ± 7.46, and the mean trait-anxiety scores were 41.91 ± 8.40, 42.69 ± 9.40, and 38.28 ± 6.30 for BTT, TC, and healthy groups, respectively. There were significant differences in the state-anxiety (χ2 = 73.43, P < 0.001) and trait-anxiety levels (χ2 = 72.21, P < 0.001) among these three groups. This study has demonstrated that patients with BTT or TC have a high level of anxiety. The anxiety level of patients with TC is significantly higher than those with BTT. Our results indicate that anxiety may be a relative risk of thyroid tumor in Han-Chinese. © 2016 John Wiley & Sons Australia, Ltd.

Spanish consensus for the management of patients with anaplastic cell thyroid carcinoma.

Anaplastic thyroid cancer (ATC) is the most aggressive solid tumor and almost uniformly lethal in humans. The Boards of the Thyroid Cancer Group of the Spanish Society of Endocrinology and Nutrition and the Grupo Español de Enfermedades Huérfanas e Infrecuentes of the Spanish Society of Oncology requested that an independent task force draft a more comprehensive consensus statement regarding ATC. All relevant literature was reviewed, including serial PubMed searches together with additional articles. This is the first, comprehensive Spanish consensus statement for ATC and includes the characteristics, diagnosis, initial evaluation, treatment goals, recommendations and modalities for locoregional and advanced disease, palliative care options, surveillance, and long-term monitoring. Newer systemic therapies are being investigated, but more effective combinations are needed to improve patient outcomes. Though more aggressive radiotherapy has reduced locoregional recurrences, median overall survival has not improved in more than 50years.

초음파검사로 진단된 갑상선결절의 융복합 위험요인

최근 초음파검사의 접근이 일반화되면서 한국에서는 갑상선암발생율의 연간변화율이 24.5%로 상승하였다. 이에 고식적 갑상선암의 위험요인인 전리방사선과 요오드식이 이외의 갑상선암의 위험요인을 파악하고자 하였다. 2011년 1월부터 2013년 3월까지 종합검진센타에서 초음파검사 후 미세침흡인검사로 진단된 양성결절 260명과 악성 결절 151명의 여자를 대상으로 나이, 혈액학적 수치, 비만지수, 허리둘레, 폐경여부, 유방결절 유무, 자근근종 유무, 지방간 유무를 비교하였다. 연구 결과 갑상선암 그룹에서 비만인 경우, 유방의 결절과 자궁근종이 있는 경우가 많았으며 갑상선자극호르몬 수치가 양성결절그룹보다 높게 나타났다. 향후 갑상선 및 갑상선암에 영향을 끼치는 요인들을 정립시키기 위한 연구가 지속적으로 필요할 것이다. Recently as the ultrasonography became generalized, the annual change rate of the incidence of thyroid cancer extraordinarily grew to 24.5% in Korea. Therefore, the aim of this study was performed to identify the risk factors of thyroid cancer apart from conventional risk factors of dietary iodine and ionizing radiation. In this retrospective study, 411 patients underwent fine-needle aspiration biopsy were examined from January 2011 to March 2013. The subjects are divided into two groups which are 260 patients with benign nodule and 151 patients with malignancy nodule. We compared age, hematologic values, body mass index, waist circumference, menopausal status, breast nodules status, uterine myoma status, fatty liver status of targeted group of patients. According to the result, in thyroid cancer group with obesity, the number of case of breast nodules and myoma was higher, and their thyroid stimulating hormone values was higher than the benign nodule group. In order to establish factors influencing thyroid and thyroid cancer, there is a definite need for continuous study.

Evaluation of Serum Vascular Adhesion Protein-1 as a Potential Biomarker in Thyroid Cancer.

Vascular adhesion protein-1 (VAP-1) is a glycoprotein that mediates tissue-selective lymphocyte adhesion. The prognostic value of VAP-1 has been determined in gastric cancer. The aim of this study was to evaluate the changes and the predictive value of serum VAP-1 in patients with thyroid cancer. A total of 126 patients with thyroid nodules and 53 healthy controls participated in this study. The patients were further divided into subgroup 1 (69 cases with benign thyroid nodules) and subgroup 2 (57 cases with thyroid cancer). Serum VAP-1 was measured by time-resolved immunofluorometric assay. Diagnostic value of presurgical VAP-1 for thyroid cancer was conducted by receiver operating characteristic (ROC) curves. Serum levels of VAP-1 were significantly lower in thyroid cancer group than in healthy control and benign thyroid nodule groups. VAP-1 concentrations negatively correlated with serum thyroglobulin (Tg) levels in thyroid cancer patients (r = −0.81; p < 0.001). The optimum cut-off value of VAP-1 was 456.6 ng/mL with a 77.4% specificity and 66.7% sensitivity for thyroid cancer diagnosis. Serum VAP-1 decreased in thyroid cancer patients and VAP-1 could be a potential useful adjunct biomarker in the diagnosis of thyroid cancer.

Changes of Clinicopathologic Characteristics and Survival Outcomes of Anaplastic and Poorly Differentiated Thyroid Carcinoma

This study aimed to analyze the temporal changes of the clinicopathologic characteristics, and the long-term outcomes, of various types of anaplastic thyroid cancer (ATC) and poorly differentiated thyroid cancer (PDTC). A retrospective analysis was conducted on patients with ATC and PDTC who were treated from 1985 to 2013. The outcome measures included the clinical response to treatment and the survival rates of three separate thyroid cancer groups: ATC, PDTC, and differentiated thyroid cancer (DTC) with anaplastic foci. The five-year disease-specific survival rate was significantly higher, both in DTC with anaplastic foci and in PTDC (81.3% and 65.8%, respectively), than it was in ATC (14.3%; p < 0.001). The proportion of cases of DTC with anaplastic foci has been increasing over time, while that of ATC has decreased. The survival rate was found to be significantly higher in resectable tumors (71.4% and 26.5%, respectively; p < 0 .001). In ATC, external beam radiation therapy showed longer survival rates than did surgery-based treatment in unresectable tumors (19.2 vs. 7.7 months, p = 0.006). Adjuvant treatment with external beam radiation or radioactive iodine increased survival duration in PDTC and in DTC with anaplastic foci. Lymphatic invasion was the most significant postoperative prognosticator in ATC (p = 0.013). The choice of treatment of ATC and PDTC could be modified according to resectability and lymphatic invasion of the cancer.

15. Histopathological features and outcomes of poorly differentiated thyroid carcinoma

Introduction: Poorly differentiated thyroid carcinomas (PDTC) represent a rare group of thyroid cancers, often regarded as anaplastic carcinomas and therefore not treated with curative intent. Current literature is limited when reporting, histopathological features, treatment options and outcomes. The aim of this paper is to describe our experience of managing this group of patients and to provide evidence for an optimal treatment algorithm.

13. Neck hematoma after thyroidectomy. Do antiplatelet/anticoagulant drugs use or coagulopathies affect it? A case control study from a single center on 3150 patients

13. Neck hematoma after thyroidectomy. Do antiplatelet/anticoagulant drugs use or coagulopathies affect it? A case control study from a single center on 3150 patients

12. Forgotten goiter (FG). Lession learned from a multicentric experience

12. Forgotten goiter (FG). Lession learned from a multicentric experience

Modifiable risk factors and thyroid cancer.

To evaluate the association between modifiable patient risk factors including tobacco use, alcohol consumption, body mass index (BMI), and thyroid cancer. Retrospective study with chart review. Midwest university hospital. Retrospective study comparing Midwest patients with thyroid cancer from our Thyroid Tumor and Cancer Registry with Midwest controls without a personal history of cancer. Descriptive statistics were created from patient questionnaires and chart reviews. Odds ratios (ORs) were reported for significant associations. There were 467 patients with cancer and 255 controls. The thyroid cancer group included 404 papillary, 47 follicular, 13 medullary, and 3 anaplastic cancers. When comparing all patients with cancer with controls, smoking more than 100 lifetime cigarettes was associated with a reduced cancer risk (OR, 0.68; 95% confidence interval [CI], 0.50-0.94). Secondhand smoke exposure did not show a statistically significant relationship to thyroid cancer. Compared with never drinking, current drinking was associated with a reduced cancer risk (OR, 0.46; 95% CI, 0.29-0.73) as was consuming 1 to 2 drinks daily compared to drinking <1 drink daily (OR, 0.58; 95% CI, 0.34-0.89). There was no difference between median BMI at age 20 years, lifetime maximum BMI, or current BMI between patients with cancer and controls. Our data showed no positive correlation between tobacco use, alcohol consumption, or obesity and thyroid cancer risk. Our data suggest that tobacco use and mild alcohol consumption may be associated with a slightly reduced risk of thyroid cancer. There was no association between BMI and thyroid cancer in our study population.

The Role of Modifiable Risk Factors in the Development of Thyroid Cancer

Objectives: Evaluate the role of modifiable patient risk factors including tobacco use, secondhand smoke exposure, alcohol consumption, and body mass index (BMI) in the development of thyroid cancer. Methods: Retrospective study comparing Midwest thyroid cancer patients from our multicenter Thyroid Tumor and Cancer Registry and Midwest controls without personal history of cancer. Descriptive statistics were created from detailed questionnaires, thyroid cancer type, and odds ratios were reported for significant associations. Results: There were 469 cancer patients and 425 controls. The thyroid cancer group included 406 papillary, 47 follicular, 13 medullary, and 3 anaplastic cancers. Comparing all cancer patients with controls, there was no association between smoking and thyroid cancer ( P = .18). Living or working with smokers was associated with increased cancer risk (odds ratio [OR] = 1.36, 95% confidence interval [CI] 1.04-1.77). Compared with never drinking, current drinking was associated with reduced cancer risk (OR = 0.48, 95% CI 0.31-0.75) as was consuming 1 to 2 drinks daily compared with drinking &lt;1 drink daily (OR = 0.55, 95% CI 0.36-0.85). Consuming &gt;2 drinks daily was not associated with cancer risk ( P = 0.26, 95% CI 0.47-1.22). There was no association between BMI and papillary cancer, except in patients older than 45 years with a BMI &gt;30 (OR = 1.87, 95% 1.20-2.92). Conclusions: Our data suggest that secondhand smoke exposure is a risk factor for developing thyroid cancer and mild alcohol consumption is associated with reduced risk of developing thyroid cancer. BMI over 30 may be associated with thyroid cancer development for individuals over 45 years old.

The age factor in survival of a population cohort of well-differentiated thyroid cancer.

Well-differentiated thyroid carcinoma (WDTC) represents a group of thyroid cancers with excellent prognosis. Age, a well-recognized risk factor for WDTC, has been consistently included in various prognostic scoring systems. An age threshold of 45 years is currently used by the American Joint Cancer Committee-TNM staging system for the risk stratification of patients. This study analyzes the relationship between the patients' age at diagnosis and thyroid cancer-specific survival in a population-based thyroid cancer cohort of 2115 consecutive patients with WDTC, diagnosed during 1970–2010, and evaluates the appropriateness of the currently used age threshold. Oncological outcomes of patients in terms of disease-specific survival (DSS) and disease-free survival (DFS) were calculated by the Kaplan–Meier method, while multivariable analysis was done by the Cox proportional hazard model and proportional hazards regression for sub-distribution of competing risks to assess the independent influence of various prognostic factors. The mean age of the patients was 47.3 years, 76.6% were female and 83.3% had papillary carcinoma. The median follow-up of the cohort was 122.4 months. The DSS and DFS were 95.4 and 92.8% at 10 years and 90.1 and 87.6% at 20 years, respectively. Multivariable analyses confirmed patient's age to be an independent risk factor adversely affecting the DSS but not the DFS. Distant metastasis, incomplete surgical resection, T3/T4 stages, Hürthle cell histology, and male gender were other independent prognostic determinants. The DSS was not independently influenced by age until the age of 55 years. An age threshold of 55 years is better than that of 45 years for risk stratification.

Clinicopathologic Characteristics of Synchronous Primary Thyroid Cancer Detected by Initial Staging 18F-FDG PET-CT Examination in Patients with Underlying Malignancy

The objective of this study was to define clinicopathologic characteristics in concurrent primary thyroid cancer detected by initial (18)fluorine-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) scanning in patients with underlying malignancy. Among 155 patients with known underlying malignancy and with focal FDG uptake in the thyroid, 25 patients (22 females; mean age ± SD 54.4 ± 11.2 years; age range 27-70 years) who were confirmed as having papillary thyroid cancer (PTC; synchronous thyroid cancer) by cytological examination were included. Another 25 patients (24 females; mean age ± SD, 48.8 ± 12.7 years) with focal uptake in preoperative (18)F-FDG PET-CT due to PTC and no history of other malignancy (primary thyroid cancer) were also included. Immunohistochemical studies were performed for glucose transporter-1 (GLUT-1) and vascular endothelial growth factor (VEGF). GLUT-1 expression was significantly lower in synchronous thyroid cancer (7 of 25 patients, 28%) compared with primary thyroid carcinoma (15 of 25 patients, 60%; p = 0.045). However, age and tumor size of synchronous thyroid cancer were not significantly different from the patients with primary thyroid carcinomas. There was no significant difference in VEGF expression, maximal standardized uptake values, extrathyroidal extension, lymph node metastasis, advanced stage, and multifocality between both thyroid cancer groups. Clinicopathologic characteristics of synchronous thyroid cancer in patients with underlying malignancy were not different from those of patients with primary thyroid cancers except for GLUT-1 expression.

Correlations between papillary thyroid cancer and peripheral blood levels of matrix metalloproteinase-2, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, and tissue inhibitor of metalloproteinase-2

Background The relationship between the presence of metalloproteinases and thyroid cancer remains unknown, and many controversies still exist in this field. The objective of this study was to investigate the correlations between papillary thyroid cancer and peripheral blood levels of matrix metalloproteinase-2, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, and tissue inhibitor of metalloproteinase-2. Methods The correlations were studied by detecting the levels of matrix metalloproteinase-2, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, and tissue inhibitor of metalloproteinase-2 by enzyme-linked immunosorbant assay and reverse-transcription polymerase chain reaction in the peripheral blood of 30 patients with papillary thyroid carcinoma, 27 patients with benign thyroid disease, and 25 healthy volunteers. Results The levels of matrix metalloproteinase-2, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, and tissue inhibitor of metalloproteinase-2 in the peripheral blood of patients with papillary thyroid carcinoma were significantly higher than those in the peripheral blood of patients with benign thyroid disease and healthy volunteers (P &lt;0.05). However, there were no significant differences between patients with benign thyroid disease and healthy volunteers (P &gt;0.05). The accuracy of detection by both enzyme-linked immunosorbant assay and reverse-transcription polymerase chain reaction in the papillary thyroid cancer group was 83.33%. Conclusions The levels of matrix metalloproteinase-2, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, and tissue inhibitor of metalloproteinase-2 in the peripheral blood are helpful in identifying thyroid carcinoma and aid in preoperative assessment.

“Is there any association between insulin resistance and thyroid cancer? : a case control study”

Insulin stimulates proliferation of thyroid cells in culture. The presence of insulin resistance (IR) is associated with larger thyroid gland volume and an increased prevalence of thyroid nodules. The aim of this study was to investigate the presence of any possible association between IR and thyroid cancer. Forty-one patients with diffuse thyroid cancer (Group 1) were matched for age and gender with 41 patients with nodular goiter (Group 2). Both groups were compared in terms of frequency of IR, as estimated by the homeostasis model assessment, as well as other parameters of the metabolic syndrome (MetS). Fourteen patients (34.1 %) in each group had MetS. Twelve patients (29.3 %) in group 1 had IR compared to 10 (24.4 %) in group 2. Mean HOMA-IR scores in group 1 and 2 were 2.5 ± 2.2 and 1.8 ± 1.1, respectively. Thirty-two patients (78 %) in group 1 had a body mass index (BMI) of more than 25 compared to 33 patients (80.5 %) in group 2. The difference between groups with regard to HOMA-IR, the frequency of IR, BMI, and any of the parameters of MetS was statistically insignificant (p > 0.05). A subgroup analysis based on tumor size did not reveal a significant difference between patients with microcarcinoma (≤10 mm) and macrocarcinoma (>10 mm) in terms of any of the study parameters (p > 0.05). Neither MetS nor IR was a significant risk factor for thyroid cancer following logistic regression analysis (p > 0.05). IR is not more prevalent in patients with thyroid cancer. Some other pathologic mechanisms may be more prominent during thyroid carcinogenesis.

Micronucleus frequency among Iraqi thyroid disorder patients.

Micronucleus (MN) assay has been extensively used in detection of DNA damage, instability in cancer, and genetic disorders. In the current study, MN, binucleated cells, and nuclear division index (NDI) were investigated in Iraqi patients with thyroid disorders. The results indicated significantly (p < 0.05) increased binucleated cells with micronucleus (BNMN) frequencies in thyroid cancer group (37.58 ± 3.07) versus other thyroid disorder groups (6.60 ± 1.29, 14.90 ± 1.69, 15.56 ± 1.76). On the other hand, the frequency of micronucleus per 1,000 and the NDI were significantly (p < 0.05) decreased in hypothyroidism (MN 1.55 ± 0.36) (NDI 0.009 ± 0.001) versus other thyroid disorder groups (MN: 6.05 ± 0.97, 6.09 ± 0.53, 5.34 ± 0.56) (NDI: 0.049 ± 0.003, 0.032 ± 0.002, 0.025 ± 0.002), with no difference versus healthy group (0.0 ± 0.0). The number of BNMN and MN are parallel to the severity of thyroid disorders which were 6.60 ± 1.29, 14.90 ± 1.69, 15.56 ± 1.76, and 37.58 ± 3.07 for hypothyroidism, thyroid toxic goiter, thyroid nontoxic goiter, and thyroid cancer, respectively. The number of BNMN and MN are parallel to the severity of thyroid disorders which were 6.60 ± 1.29, 14.90 ± 1.69, 15.56 ± 1.76, and 37.58 ± 3.07 for hypothyroidism, thyroid toxic goiter, thyroid nontoxic goiter, and thyroid cancer, respectively. The results also indicate that there were no significant differences among age and sex groups as related with BNMN formation within each thyroid disorder groups and healthy control group.

Complications of Completion Versus Total Thyroidectomy

The objective of this study was to analyze the complication rates after completion thyroidectomy and compare them with primary total benign and malign thyroidectomy causes in total of 647 patients. Among 647 patients, there were 159 receiving completion thyroidectomy for differentiated thyroid cancer (DTC) (Group 1); 217 patients receiving total thyroidectomy for DTC (Group 2) and 271 given total thyroidectomy for benign diseases (Group 3). When groups were compared for complications, there were no significant difference except temporary hypocalcemia between completion thyroidectomy and total thyroidectomy for DTC. When the total thyroidectomies were compared (Group 2 and 3), there were no significant difference observed except unilateral temporary RLN palsy. With improvements in surgical technique and experience, complication rates of thyroidectomy performed for benign or malign diseases are reduced. In spite of the improvement in surgical experience, temporary RLN palsy and hypoparathyroidism are the main complications in completion thyroidectomies which need special attention. To evaluate the patients more carefully in preoperative period and performing adequate thyroidectomy appears more logical.

IL-1β a potential factor for discriminating between thyroid carcinoma and atrophic thyroiditis

Interactions between cytokines and others soluble factors (hormones, antibodies...) can play an important role in the development of thyroid pathogenesis. The purpose of the present study was to examine the possible correlation between serum cytokine concentrations, thyroid hormones (FT4 and TSH) and auto-antibodies (Tg and TPO), and their usefulness in discriminating between different thyroid conditions. In this study, we investigated serum from 115 patients affected with a variety of thyroid conditions (44 Graves' disease, 17 Hashimoto's thyroiditis, 11 atrophic thyroiditis, 28 thyroid nodular goitre and 15 papillary thyroid cancer), and 30 controls. Levels of 17 cytokines in serum samples were measured simultaneously using a multiplexed human cytokine assay. Thyroid hormones and auto-antibodies were measured using ELISA. Our study showed that IL-1β serum concentrations allow the discrimination between atrophic thyroiditis and papillary thyroid cancer groups (p = 0.027).

Serum copper levels in benign and malignant thyroid diseases

To examine the changes in serum copper (Cu) levels in benign and malignant thyroid disease in humans. Thyroid hormones influence the metabolism of trace elements including copper. 47 papillary thyroid cancer and 43 benign multinodular goitre patients who underwent total thyroidectomy and 37 healthy control subjects were included into this study. All of the patients and controls were females. Serum Cu levels were detected with atomic absorption spectrophotometer. In the papillary thyroid cancer group serum level of Cu was 131.61 ± 33.9 μg/dL before surgery and 120.81 ± 30.4 μg/dL after 20 days from surgery. In the benign group serum Cu level was 84.75 ± 12.1 μg/dL and 68.01 ± 9.4 μg/dL postoperatively.These results were compared to healthy control's value of 105.87 ± 10.68 μg/dL. In the papillary thyroid cancer group pre- and postoperative serum Cu level was significantly higher when compared to control group (p<0.05). Postoperative serum Cu level significantly decreased when compared to pre-operative level(p<0.05), in which, it was still higher than the control(p<0.05). In the benign group pre- and postoperative serum Cu level was significantly lower than in the control group (p<0.05).Postoperative serum Cu level significantly decreased when compared to pre-operative level in the benign group (p<0.05). This is a pioneer study to examine serum Cu level in benign and malignant thyroid patients compared to controls. In our small groups serum Cu levels increased in malignant thyroid patients and decreased in the benign group (Tab. 1, Ref. 18).

Leptin: A Correlated Peptide to Papillary Thyroid Carcinoma?

Introduction. Leptin as an adipose-tissue-related peptide hormone contributes to the control of food intake, energy expenditure, and other activities such as cell proliferation. Therefore, association of leptin level with thyroid cancer has been suggested recently. Considering that thyroid cancer is the most common endocrine cancer, the aim of this study was evaluation of leptin levels in thyroid cancer. Materials and Methods. 83 patients with papillary thyroid cancer (35 males and 48 females) with 90 healthy persons as control group (40 male and 50 females) were selected. serum thyroxine, thyrotropin, and leptin levels were determined in both groups. As a body fat tissue affects leptin level, so height and weight were measured and body mass index was calculated too. Results. There was no statistically significant difference in age, serum Thyroxine, and Thyrotropin levels. BMI in women was more than in men in both groups. Serum leptin levels in thyroid cancer group were significantly higher than control group (P < 0.05). Conclusion. The results of this study showed an acceptable association between the hormone Leptin levels with papillary thyroid cancer, so it may be considerad as a correlated peptide which may help in the diagnosis or confirmation of thyroid cancer beside in other specific tumor markers.

Detection and its clinical significance of CD+4 CDHi25 CDLo127 regulatory T cells in peripheral blood of patients with thyroid neoplasm

：Objective To analyzeCD+4 CDHi25 CDLo127 regulatory T cells (Treg) in peripheral blood of patients with thyroidnodules and differentiated thyroid cancer and their change regularity, and to investigatethe immunosuppression mechanism. Methods The peripheral blood was collected from 175patients with thyroid nodules, including 43 patients with differentiated thyroid cancerand 132 patients with nodular goiter.By using monoclonal antibodies, the blood sampleswere evaluated with the flow cytomertry for lymphocyte subsets and Treg cells. Results Theresults showed the prevalence of the CD+4 CDHi25 CDLo127 Treg in differentiated thyroidcancer group [(6.48±1.49) %] and nodular goiter group [(6.23+1.67) %] was higher thanthose in the healthy group [(5.62±1.48) %], and the difference was significant(P 0.005).Conclusion It is concluded that therelative increase of CD+4 CDHi25 CDLo127 Treg in peripheral blood of patients with nodulargoiter and differentiated thyroid cancer may be related to immunosuppression and tumorprogression.