Background: Involvement of the recurrent laryngeal nerve (RLN) in papillary thyroid carcinoma (PTC) is an important prognostic factor and is associated with a higher risk of recurrence. This study ...aimed to retrospectively analyze the outcomes of patients treated with hemithyroidectomy (HT) in PTC patients with an exclusive RLN invasion who could not tolerate staged surgery, did not wish to undergo another operation, or had other reasons. Methods: A retrospective review was conducted on 163 patients with PTC and exclusive RLN involvement at our institution between 2013 and 2019. Patients were divided into a total thyroidectomy (TT) group and HT group. The clinicopathologic factors and prognostic outcomes were compared between the two groups. A propensity score-matched analysis was carried out to reduce selection bias, with the following covariates: gender, age, tumor size, multifocality, central lymph node metastasis (CLNM), and RLN resection. The Kaplan–Meier method was used for a comparison of recurrence outcomes. Results: In the baseline data of the 163 PTC patients, tumor size (p < 0.001), multifocality (p = 0.011), CLNM (p < 0.001), and RLN resection (p < 0.008) in the TT and HT groups differed significantly, whereas age and gender did not differ between the two groups. The TT group reported significantly higher temporary and permanent hypoparathyroidism than the HT group (p < 0.001 and p = 0.042, respectively). With 72-month median follow-up, 11 (6.7%) patients developed recurrence. After propensity score matching, 24 patients with HT and 43 patients with TT were included. Recurrence-free survival (RFS) in the matched samples showed no difference between the TT and HT groups (p = 0.092). Conclusion: Our results indicate that HT may be a feasible treatment for PTC patients with exclusive RLN involvement in specific circumstances without significantly increasing the risk of recurrence. Performing a thorough preoperative examination is crucial to exclude multifocal tumors and lymph node metastasis before undergoing HT.
Background
The optimal treatment of papillary thyroid microcarcinomas (PTMCs) located in the isthmus (iPTMCs) is still controversial. The purpose of this study was to compare the clinicopathologic ...features of patients with iPTMCs ≤5 mm and >5 mm in diameter after total thyroidectomy, and to identify the risk factors for recurrence in patients with iPTMCs.
Methods
A total of 102 iPTMC patients who underwent total thyroidectomy were reviewed retrospectively. The clinicopathologic characteristics of iPTMCs ≤5 mm group (
n
= 29) have been compared with a group >5 mm (
n
= 73). Univariate and multivariate Cox proportional hazard models served to identify risk factors associated with recurrence-free survival (RFS).
Results
Gender (
p
= 0.033), multifocality (
p
= 0.041), and central lymph node metastasis (CLNM) (
p
= 0.009) of patients in the ≤5 mm and >5 mm groups differed significantly. iPTMC patients with age <55 years, male, multiple tumor, and extrathyroidal extension showed comparatively more frequent of CLNM in >5 mm groups. Of the 102 patients, nine (8.8%) developed recurrence during follow-up (median: 49.5 months). The patients with recurrences had comparatively high rates of CLNM (
p
= 0.038), extranodal invasion (
p
= 0.018), and more MNCND (Metastasis Nodes for Central Neck dissection) (
p
= 0.020). A cutoff of MNCND >2.46 was established as the most sensitive and specific level for the prediction of recurrence based on receiver operating characteristic (ROC) curve analyses. Multivariate analysis showed that the number of MNCND ≥3 was an independent predictor of poor RFS (
p
= 0.028).
Conclusion
We have found that the recurrence rates are similar in patients with iPTMCs ≤5 mm and >5 mm. The iPTMCs >5 mm were more likely to be associated with pathological features such as multifocality and CLNM. The male gender, extrathyroidal extension, and CLNM were associated with recurrence of iPTMCs except for tumor size and multifocality. Higher risk of CLNM should be considered in iPTMC >5 mm when it reaches some risk factors. The numbers of MNCND ≥3 may be an independent predictor for recurrence, which could help clinicians for the decision of radioiodine administration and the modulation of follow-up modalities.
The tumor microenvironment heterogeneity of papillary thyroid cancer (PTC) is poorly characterized. The relationship between PTC and Hashimoto thyroiditis (HT) is also in doubt. Here, we used ...single-cell RNA sequencing to map the transcriptome landscape of PTC from eight PTC patients, of which three were concurrent with HT. Predicted copy number variation in epithelial cells and mesenchymal cells revealed the distinct molecular signatures of carcinoma cells. Carcinoma cells demonstrated intertumoral heterogeneity based on
BRAF
V600E mutation or lymph node metastasis, and some altered genes were identified to be correlated with disease-free survival in The Cancer Genome Atlas datasets. In addition, transcription factor regulons of follicular epithelial cells unveil the different transcription activation state in PTC patients with or without concurrent HT. The immune cells in tumors exhibited distinct transcriptional states, and the presence of tumor-infiltrating B lymphocytes was predominantly linked to concurrent HT origin. Trajectory analysis of B cells and plasma cells suggested their migration potential from HT adjacent tissues to tumor tissues. Furthermore, we revealed diverse ligand–receptor pairs between non-immune cells, infiltrating myeloid cells, and lymphocytes. Our results provided a single-cell landscape of human PTC. These data would deepen the understanding of PTC, as well as the immunological link between PTC and HT.
Travel time prediction of a given trajectory plays an indispensable role in intelligent transportation systems. Although many prior researches have struggled for accurate prediction results, most of ...them achieve inferior performance due to insufficient feature extraction of travel speed and road network structure from the trajectory data, which confirms the challenges involved in this topic. To overcome those issues, we propose a novel neural Net work for T ravel T ime P rediction based on tensor decomposition and graph embedding, named TTPNet , which can extract travel speed and representation of road network structure effectively from historical trajectories, as well as predict the travel time with better accuracy. Specifically, TTPNet consists of three components: the first module (Travel Speed Features Layer) leverages non-negative tensor decomposition to restore travel speed distributions on different roads in the previous hour, and integrates a CNN-RNN model to extract both long-term and short-term travel speed features of the query trajectory; the second module (Road Network Structure Features Layer) utilizes graph embedding to generate the representation of local and global road network structure; the last module (Deep LSTM Prediction Layer) completes the final predicting task. Empirical results over two real-world large-scale datasets show that our proposed TTPNet model can achieve significantly better performance and remarkable robustness.
•High quality CdZnTe (CZT) films are prepared by close-spaced sublimation method.•CZT detectors are fabricated using BGZO transparent conductive contacts.•Ohmic contacts are formed between BGZO and ...CZT with low contact resistivity.•CZT UV detectors with BGZO contacts exhibit high UV photo response.
High quality Cd1-xZnxTe (CZT) films were prepared using the close-spaced sublimation (CSS) technique. CZT film UV (ultraviolet) photodetectors were fabricated with B and Ga co-doped ZnO (BGZO) transparent conductive interdigitated contacts. The contact properties of BGZO/CZT were investigated by the transmission line model (TLM). The results indicate that a good ohmic contact is formed between BGZO and CZT with a very low contact resistivity of about 0.26Ω·cm2. Compared with CZT photodetectors with Au contacts, the detectors with BGZO contacts show a higher value of UV photo response.
Papillary thyroid carcinoma (PTC) has a favorable prognosis. However, involvement of the recurrent laryngeal nerve (RLN) significantly increases the risk of recurrence. RLN invasion was an important ...factor in determining the extent of thyroid surgery. The purpose of this study was to compare clinicopathologic features and characterize risk factors of central and lateral lymph node metastasis (LLNM) of RLN invasion in patients with PTC.
A retrospective review was conducted of 130 patients with PTCs who had exclusive tumor involvement of the RLN at our institution between January 2014 and February 2019. All patients underwent total thyroidectomy and high-dose radioactive iodine (RAI) therapy. The clinicopathologic factors and prognostic outcomes of the patients with solitary and multiple RLN involvements were compared. Kaplan-Meier method was performed to compare the outcomes of tumor recurrence. Univariate and multivariate logistic regression analyses were used to identify risk factors associated with LLNM.
The invasion of the RLN was similar on both sides, with 58.5% on the right, 40.0% on the left, and 1.5% on both sides. Significant differences were observed in tumor size (p < 0.001), lymph node metastasis classification (p = 0.002), RLN resection (p < 0.001), and thyroglobulin (p = 0.010) in the solitary and multiple groups. During the median follow-up of 67 months, 9 (6.9%) patients developed recurrence. There were no statistical differences in recurrence for age, tumor size, gender, multifocality, lymph node metastasis (LNM), and RLN resection. According to receiver operating characteristic (ROC) curve analyses, a cut-off of tumor size > 1.7 cm was identified as the most sensitive and specific predictor of RLN with multiple involvements or LNM invasion. Univariate and multivariate analyses revealed that central lymph node metastasis (CLNM) and RLN invasion by LNM can serve as independent risk factors for LLNM (p = 0.006 and p < 0.001, respectively).
Our results indicate that recurrence was comparable in patients with solitary and multiple RLN involvements. Multiple RLN involvement was associated with pathological features such as larger tumors, RLN resection, and LLNM. The presence of LNM invading RLN and multiple nerve involvement increases the risk of intraoperative RLN resection. A higher risk of multiple invasion or LNM invasion should be considered when tumor size > 1.7 cm. The presence of CLNM and RLN invaded by LNM were independent predictors for LLNM, which could aid surgeons in deciding on lateral lymph node dissection.
•High quality CdZnTe thick films were prepared by close-spaced sublimation method.•A well ohmic contact was formed between the Au/GZO electrodes and CdZnTe films.•The specific contact resistivity ...(ρc) was studied by CTLM method.•A CdZnTe film γ-ray detector with Au/GZO contacts was reported for the first time.
In this work, high quality Cd1−xZnxTe films were prepared on fluorine doped tin oxide (FTO) glass substrates by close-spaced sublimation (CSS) method. A low resistivity sputtered Ga-doped ZnO (GZO) film was used as an interlayer between Au electrodes and Cd1−xZnxTe films try to reduce the contact resistance and contribute to bring about a better Ohmic contact. Circular transmission line model (CTLM) was adopted to investigate the effects of GZO intermediate layer on the contact properties of Au/GZO/Cd1−xZnxTe structure. The results show a low contact resistivity of 0.37Ωcm2 for Au/GZO contacts on Cd1−xZnxTe films. Cd1−xZnxTe film radiation detectors were also fabricated using Au/GZO contacts and an energy resolution of about 28% was obtained from a 60KeV 241Am γ-ray source for the first time.
Polycrystalline CdZnTe films with thickness about 300μm were deposited by close spaced-sublimation (CSS) method. The as-deposited CdZnTe samples were polished by mechanical polishing (MP) process. ...Cu-doped ZnTe films were sputtered by RF magnetron sputtering as an intermediate layer to improve the performance of Ohmic contact of Au electrodes to CdZnTe films. The effect of Cu-doped ZnTe intermediate layers on the electrical characteristics of Au/CdZnTe and Au/ZnTe:Cu/CdZnTe was investigated by the circular transmission line model (CTLM). The results indicate a good Ohmic contact of Au/ZnTe:Cu/CdZnTe with low contact resistivity of about 0.79Ω·cm2.
•High quality CdZnTe films are deposited by close spaced-sublimation method.•Ohmic contacts are formed on polished CdZnTe films by inserting ZnTe:Cu interlayer.•The CTLM is used to reveal the contact performance of contacts on CdZnTe films.•Low contact resistivity of ~0.79Ω·cm2 is obtained for Au/ZnTe:Cu/CdZnTe contacts.
PDF
