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Skeletal health in patients with differentiated thyroid carcinoma.
Cellini, M, Rotondi, M, Tanda, ML, Piantanida, E, Chiovato, L, Beck-Peccoz, P, Lania, A, Mazziotti, G
Journal of endocrinological investigation. 2021;(3):431-442
Abstract
Osteoporosis and fractures are important comorbidities in patients with differentiated thyroid cancer (DTC), with potential negative impact on quality of life and survival. The main determinant of skeletal fragility in DTC is the thyrotropin (TSH)-suppressive therapy, which is commonly recommended to prevent disease's recurrence, especially in patients with structural incomplete response after thyroid surgery and radio-iodine therapy. TSH-suppressive therapy can stimulate bone resorption with consequent bone loss, deterioration of bone microstructure and high risk of fragility fractures. The skeletal effects of TSH-suppressive therapy may be amplified when thyroid cancer cells localize to the skeleton inducing alterations in bone remodelling, impairment of bone structure and further increase in risk of fractures. The management of skeletal fragility in DTC may be challenging, since prediction of fractures is a matter of uncertainty and data on effectiveness and safety of bone-active agents in this clinical setting are still scanty. This review deals with pathophysiological, clinical and therapeutic aspects of skeletal fragility of patients with DTC.
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A Review of the Role of the S-Detect Computer-Aided Diagnostic Ultrasound System in the Evaluation of Benign and Malignant Breast and Thyroid Masses.
Zhang, D, Jiang, F, Yin, R, Wu, GG, Wei, Q, Cui, XW, Zeng, SE, Ni, XJ, Dietrich, CF
Medical science monitor : international medical journal of experimental and clinical research. 2021;:e931957
Abstract
Computer-aided diagnosis (CAD) systems have attracted extensive attention owing to their performance in the field of image diagnosis and are rapidly becoming a promising auxiliary tool in medical imaging tasks. These systems can quantitatively evaluate complex medical imaging features and achieve efficient and high-diagnostic accuracy. Deep learning is a representation learning method. As a major branch of artificial intelligence technology, it can directly process original image data by simulating the structure of the human brain neural network, thus independently completing the task of image recognition. S-Detect is a novel and interactive CAD system based on a deep learning algorithm, which has been integrated into ultrasound equipment and can help radiologists identify benign and malignant nodules, reduce physician workload, and optimize the ultrasound clinical workflow. S-Detect is becoming one of the most commonly used CAD systems for ultrasound evaluation of breast and thyroid nodules. In this review, we describe the S-Detect workflow and outline its application in breast and thyroid nodule detection. Finally, we discuss the difficulties and challenges faced by S-Detect as a precision medical tool in clinical practice and its prospects.
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Osteonecrosis of the jaw: a rare but possible side effect in thyroid cancer patients treated with tyrosine-kinase inhibitors and bisphosphonates.
Lorusso, L, Pieruzzi, L, Gabriele, M, Nisi, M, Viola, D, Molinaro, E, Bottici, V, Elisei, R, Agate, L
Journal of endocrinological investigation. 2021;(12):2557-2566
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Abstract
Osteonecrosis of the jaw (ONJ) is a rare but very serious disease that can affect both jaws. It is defined as exposed bone in the maxillofacial region that does not heal within 8 weeks after a health care provider identification. ONJ can occur spontaneously or can be due to drugs like bisphosphonates (BPS) and anti-RANK agents, in patients with no history of external radiation therapy in the craniofacial region. Although in phase 3 trials of tyrosine kinase inhibitors (TKIs) used in thyroid cancer (TC) the ONJ was not reported among the most common side effects, several papers reported the association between ONJ and TKIs, both when they are used alone and in combination with a bisphosphonate. The appearance of an ONJ in a patient with metastatic radio-iodine refractory differentiated TC, treated with zoledronic acid and sorafenib, has put us in front of an important clinical challenge: when a ONJ occurred during TKIs treatment, it really worsens the patients' quality of life. We should consider that in the case of ONJ a TKI discontinuation becomes necessary, and this could lead to a progression of neoplastic disease. The most important aim of this review is to aware the endocrinologists/oncologists dealing with TC to pay attention to this possible side effect of BPS and TKIs, especially when they are used in association. To significantly reduced the risk of ONJ, both preventive measures before initiating not only antiresorptive therapy but also antiangiogenic agents, and regular dental examinations during the treatment should always be proposed.
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Assessment and Care of Oral Lesions for Patients Who Undergo Radioiodine Treatment for Thyroid Cancer.
Mester, A, Piciu, A, Lucaciu, O, Apostu, D, Piciu, D, Voina-Tonea, A
The American journal of the medical sciences. 2021;(1):8-13
Abstract
Patients with differentiated thyroid cancer who undergo radioiodine treatment often present oral complications with a significant impact on their oral cavity function. Any potential sources of systemic infections like periodontal disease, unfitted dentures, orthodontic appliances, deficient/rough fillings, or traumatic dentition must be treated by the dental practitioner, because they represent the main source of spread and dissemination. Any systemic complication of a dental foci may result from improper dental preparation of the patient before radioiodine therapy and inadequate post-radioiodine therapy oral care. Therefore, all patients proceeding into radioiodine treatment should be addressed by the oncological team to undergo thorough dental check-up and receive appropriate treatment in due time.
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Plant natural products with anti-thyroid cancer activity.
Sharifi-Rad, J, Rajabi, S, Martorell, M, López, MD, Toro, MT, Barollo, S, Armanini, D, Fokou, PVT, Zagotto, G, Ribaudo, G, et al
Fitoterapia. 2020;:104640
Abstract
Thyroid cancer is the most frequent endocrine malignancy, with more than 500,000 cases per year worldwide. Differentiated thyroid cancers are the most common forms with best prognosis, while poorly/undifferentiated ones are rare (2% of all thyroid cancer), aggressive, frequently metastasize and have a worse prognosis. For aggressive, metastatic and advanced thyroid cancer novel antitumor molecules are urgently needed and phytochemical products can be a rational and extensive source, since secondary plant metabolites can guarantee the necessary biochemical variability for therapeutic purpose. Among bioactive molecules that present biological activity on thyroid cancer, resveratrol, curcumin, isoflavones, glucosinolates are the most common and used in experimental model. Most of them have been studied both in vitro and in vivo on this cancer, but rarely in clinical trial. This review summarizes phytochemicals, phytotherapeutics and plant derived compounds used in thyroid cancer.
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ENDOCRINE TUMOURS: Calcitonin in thyroid and extra-thyroid neuroendocrine neoplasms: the two-faced Janus.
Giannetta, E, Guarnotta, V, Altieri, B, Sciammarella, C, Guadagno, E, Malandrino, P, Puliani, G, Feola, T, Isidori, AM, Colao, AAL, et al
European journal of endocrinology. 2020;(6):R197-R215
Abstract
An increased calcitonin serum level is suggestive of a medullary thyroid cancer (MTC), but is not pathognomonic. The possibility of false positives or other calcitonin-secreting neuroendocrine neoplasms (NENs) should be considered. Serum calcitonin levels are generally assessed by immunoradiometric and chemiluminescent assays with high sensitivity and specificity; however, slightly moderately elevated levels could be attributable to various confounding factors. Calcitonin values >100 pg/mL are strongly suspicious of malignancy, whereas in patients with moderately elevated values (10-100 pg/mL) a stimulation test may be applied to improve diagnostic accuracy. Although the standard protocol and the best gender-specific cut-offs for calcium-stimulated calcitonin are still controversial, the fold of the calcitonin increase after stimulation seems to be more reliable. Patients with MTC show stimulated calcitonin values at least three to four times higher than the basal values, whereas calcitonin-secreting NENs can be distinguished from a C-cell disease by the absence of or
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Thyroid nodules: diagnostic evaluation based on thyroid cancer risk assessment.
Singh Ospina, N, Iñiguez-Ariza, NM, Castro, MR
BMJ (Clinical research ed.). 2020;:l6670
Abstract
Thyroid nodules are extremely common and can be detected by sensitive imaging in more than 60% of the general population. They are often identified in patients without symptoms who are undergoing evaluation for other medical complaints. Indiscriminate evaluation of thyroid nodules with thyroid biopsy could cause a harmful epidemic of diagnoses of thyroid cancer, but inadequate selection of thyroid nodules for biopsy can lead to missed diagnoses of clinically relevant thyroid cancer. Recent clinical guidelines advocate a more conservative approach in the evaluation of thyroid nodules based on risk assessment for thyroid cancer, as determined by clinical and ultrasound features to guide the need for biopsy. Moreover, newer evidence suggests that for patients with indeterminate thyroid biopsy results, a combined assessment including the initial ultrasound risk stratification or other ancillary testing (molecular markers, second opinion on thyroid cytology) can further clarify the risk of thyroid cancer and the management strategies. This review summarizes the clinical importance of adequate evaluation of thyroid nodules, focuses on the clinical evidence for diagnostic tests that can clarify the risk of thyroid cancer, and highlights the importance of considering the patient's values and preferences when deciding on management strategies in the setting of uncertainty about the risk of thyroid cancer.
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[Progress of risk factors for thyroid tumors].
Liu, S, Song, JY, Zhang, JQ
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine]. 2020;(8):897-901
Abstract
In recent years, both benign and malignant thyroid tumors have grown rapidly in the world, and have become one of the most common tumors in the endocrine system. At present, the pathogenesis of thyroid tumor is still unclear, but more and more studies have found that certain factors are related to the occurrence and development of thyroid tumors. It is of great significance to summarize and analyze these risk factors. This article reviews the research progress of its risk factors reported in recent years, so as to provide a basis for the accuracy and scientific prevention and control of thyroid tumors.
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Review of Factors Contributing to Nodular Goiter and Thyroid Carcinoma.
Yildirim Simsir, I, Cetinkalp, S, Kabalak, T
Medical principles and practice : international journal of the Kuwait University, Health Science Centre. 2020;(1):1-5
Abstract
There is an increased incidence of thyroid nodules and cancer. In this article, the reasons for this increase are evaluated and discussed. The factors causing increases in the incidence of nodules are the same as those causing increases in thyroid cancer. There are publications from all over the world regarding the rising incidence of thyroid cancer; it is especially associated with papillary cancer. The literature was reviewed and evaluated with regard to this significant phenomenon. Thyroid-stimulating hormone (TSH) is the main mitotic factor. Any agent that elevates TSH will stimulate nodule formation. Therefore, the incidence of thyroid nodules is high in endemic goiter regions due to iodine deficiency. This paper has described many of the factors causing this higher incidence. Of note, metabolic syndrome and insulin resistance are important factors associated with the increased incidence of nodular goiter and papillary thyroid cancer today. However, these data must be confirmed by other studies in the future.
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10.
Circular RNAs: New players in thyroid cancer.
Borran, S, Ahmadi, G, Rezaei, S, Anari, MM, Modabberi, M, Azarash, Z, Razaviyan, J, Derakhshan, M, Akhbari, M, Mirzaei, H
Pathology, research and practice. 2020;(10):153217
Abstract
The prevalence of thyroid cancer the most frequent endocrine malignancy, is rapidly increasing. Most of thyroid cancers are relatively indolent, however, some cases still possess a risk of developing into lethal types of thyroid cancer. Regarding its multistep tumorigenesis, the determination of the underlying mechanisms is a vital issue for thyroid cancer therapy. Circular RNAs (circRNAs) are a type of non-coding RNAs with a closed loop structure. Numerous circRNAs have been identified in cancerous tissues. Mounting data recommends that the biological activities of circRNAs, such as serving as microRNA or ceRNAs sponges, interacting with proteins, modulating gene translation and transcription, suggesting that circRNAs will be potential targets as well as agents for the prognosis and diagnosis of diseases, including cancer. Given that circular RNAs acts as oncogenes or tumor suppressors in the thyroid cancer. Several studies documented that circular RNAs via microRNA and protein sponges could regulate a sequences of cellular and molecular mechanisms e.g., apoptosis, angiogenesis, tumor growth, and invasion that are involved in thyroid cancer pathogenesis. Herein, we summarized the role of circular RNAs as therapeutic and diagnostic biomarkers in the thyroid cancer. Moreover, we highlighted the role of these molecules in the pathogenesis of various cancers.