Background
To evaluate the association of preoperative clinical and sonographic features with central lymph node metastasis (CLNM) in patients with clinically node‐negative (cN0) papillary thyroid ...carcinoma (PTC) without capsule invasion.
Methods
Clinical and sonographic features of 635 cN0 PTC nodules without capsule invasion were retrospectively reviewed. CLNM was confirmed by pathology. Univariate and multivariate analyses were performed to analyze the predicting factors associated with CLNM in cN0 PTC without capsule invasion.
Results
In the 635 cN0 PTC nodules without capsule invasion, age ≤36 years, male, tumor size >8 mm, the distance between the tumor and the capsule ≤1.1 mm and calcification were independently associated with CLNM (P < .05).
Conclusions
CLNM was associated with age, sex, tumor size, the distance between the tumor and the capsule, and calcification in cN0 PTC without capsule invasion. Preoperative assessment of risk factors could help to select PTC patients who benefit from surgery.
Objectives
The purpose of this study was to assess the differences in sonographic features of papillary thyroid carcinoma between neck lymph node metastatic and non‐metastatic groups.
Methods
A total ...of 155 patients with 155 papillary thyroid carcinoma nodules were included and divided into two groups: with neck lymph node metastases (52 cases) and without neck lymph node metastases (103 cases). The size, shape, border, margin, halo, internal architecture, echogenicity, echo homogeneity, calcifications, and contact extent between the nodule border and thyroid capsule were evaluated by gray scale sonography, and color Doppler sonography was applied to assess the vascularization distribution and vascularization degree in the nodules. The peak systolic velocity, pulsatility index, resistive index, peak systolic velocity difference, pulsatility index difference, and resistive index difference were measured by pulsed Doppler sonography in 80 lesions. The differences in the sonographic features of papillary thyroid carcinoma between the metastatic and nonmetastatic groups were investigated.
Results
The differences in the size, percentage of the nodule border that contacted the thyroid capsule, calcifications, vascularization degree, and resistive index difference of the lesions were statistically significant between the metastatic and nonmetastatic groups (P < .05).
Conclusions
Our findings suggest that a larger size, a greater contact percentage, combined microcalcifications and macrocalcifications, a higher blood supply, and a higher resistive index difference were significantly more common in the metastatic group compared to the nonmetastatic group.
Preoperative prediction of lymph node metastasis is of clinical importance for the surgical treatment of thyroid tumor. The purpose of this study was to evaluate clinicopathologic factors and thyroid ...nodule sonographic features predictive of central lymph node metastasis in papillary thyroid microcarcinoma.
Clinicopathologic factors and thyroid nodule sonographic features of 1204 patients with papillary thyroid microcarcinoma were retrospectively reviewed from January 2014 to June 2015. Central lymph node dissection was performed on each patient. Univariate and multivariate analyses were performed to analyze the clinicopathologic factors and thyroid nodule sonographic features associated with central lymph node metastasis in papillary thyroid microcarcinoma. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the relevance of all potential predictive factors.
Central lymph node metastasis was detected in 395 of the 1204 patients (32.81%). By univariate and multivariate analyses, younger age (≤43 years), male sex, larger tumor size (≥7 mm), multifocal papillary thyroid microcarcinoma and microcalcification were independently associated with central lymph node metastasis in papillary thyroid microcarcinoma (P < .05). The ORs were 1.920 (95% CI, 1.476-2.499), 1.665 (95% CI, 1.234-2.247), 1.534 (95% CI, 1.177-2.000), 2.120 (95% CI, 1.563-2.877), and 4.109 (95% CI, 3.118-5.414), respectively.
Central lymph node metastasis is highly prevalent in papillary thyroid microcarcinoma. Younger age (≤43 years), male sex, larger tumor size (≥7 mm), multifocal papillary thyroid microcarcinoma, and microcalcification were independent predictors of central lymph node metastasis. Surgeons and radiologists need to pay more attention to patients with papillary thyroid microcarcinoma who have these risk predictors.
Objectives
To assess sonographic features of thyroid nodules associated with malignancy and to establish a scoring and categorizing method based on sonographic features.
Methods
A total of 2445 ...patients with 2445 thyroid nodules were included and divided into 2 groups: benign (1493 cases) and malignant (952 cases). First, 10 sonographic features, including shape, border, margin, internal content, echogenicity, microcalcifications, posterior echo, halo, vascularization distribution, and vascularization degree, were defined, and all nodules were retrospectively evaluated. Second, the features associated with malignancy were selected by statistical analysis and were assigned weightings according to their odds ratios. Third, a total score for each nodule was obtained after the assigned weightings of the suspicious features were summed. Fourth, the malignancy rate of each total score was calculated. Then a modified version of the Thyroid Imaging Reporting and Data System (TI‐RADS) was established with reference to the American College of Radiology's Breast Imaging Reporting and Data System.
Results
Seven independent features associated with malignancy were a taller‐than‐wide shape, an obscure border, an irregular margin, solid internal content, marked hypoechogenicity and hypoechogenicity, microcalcifications, and an internal vascularization distribution. The TI‐RADS included 5 categories with different malignancy rates: category 3 (<2%), 4A (2%–5%), 4B (5%–50%), 4C (50%–90%), and 5 (≥90%).
Conclusions
A modified version of TI‐RADS was established on the basis of the sonographic features with different weightings according to the relative risk of malignancy. This system could be of great use in predicting the nature of thyroid nodules in a quantified and standardized way and also helping clinicians decide on the clinical management.
Objectives
Preoperative prediction of lymph node metastasis is of clinical importance for the surgical treatment of thyroid tumor. The purpose of this study was to evaluate clinicopathologic factors ...and thyroid nodule sonographic features predictive of central lymph node metastasis in papillary thyroid microcarcinoma.
Methods
Clinicopathologic factors and thyroid nodule sonographic features of 1204 patients with papillary thyroid microcarcinoma were retrospectively reviewed from January 2014 to June 2015. Central lymph node dissection was performed on each patient. Univariate and multivariate analyses were performed to analyze the clinicopathologic factors and thyroid nodule sonographic features associated with central lymph node metastasis in papillary thyroid microcarcinoma. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the relevance of all potential predictive factors.
Results
Central lymph node metastasis was detected in 395 of the 1204 patients (32.81%). By univariate and multivariate analyses, younger age (≤43 years), male sex, larger tumor size (≥7 mm), multifocal papillary thyroid microcarcinoma and microcalcification were independently associated with central lymph node metastasis in papillary thyroid microcarcinoma (P < .05). The ORs were 1.920 (95% CI, 1.476–2.499), 1.665 (95% CI, 1.234–2.247), 1.534 (95% CI, 1.177–2.000), 2.120 (95% CI, 1.563–2.877), and 4.109 (95% CI, 3.118–5.414), respectively.
Conclusions
Central lymph node metastasis is highly prevalent in papillary thyroid microcarcinoma. Younger age (≤43 years), male sex, larger tumor size (≥7 mm), multifocal papillary thyroid microcarcinoma, and microcalcification were independent predictors of central lymph node metastasis. Surgeons and radiologists need to pay more attention to patients with papillary thyroid microcarcinoma who have these risk predictors.
Purpose
To enhance the diagnostic accuracy of conventional ultrasonography in differentiating papillary thyroid microcarcinomas (PTMCs) from degenerating cystic thyroid nodules mimicking malignancy ...(under 10 mm in diameter).
Methods
A retrospective analysis of hypoechoic thyroid nodules under 10 mm between 162 cases of degenerating cystic thyroid nodules confirmed by ultrasound-guided fine-needle aspiration (US-FNA) and 150 cases of PTMCs confirmed by both US-FNA and postoperative pathology were performed in the aspects of shape, margin, calcification, and vascularity.
Results
Significant differences were observed in the aspects of shape, rim calcification, and vascularity (
P
< 0.05) between two groups in condition of solid hypoechogenicity. An ovoid-to-round regular shape, rim calcification, and no intrinsic blood flow were the statistically significant features for the depiction of a benign degenerating cystic nodule, while a taller-than-wide shape and peripheral or intranodular blood flow were that of a malignancy. Multiple stepwise logistic regression analysis demonstrated each of them as an independent predictor of malignancy (
P
< 0.05).
Conclusions
Shape, rim calcification, and vascularity are efficient criteria to distinguish degenerating cystic thyroid nodules mimicking malignancy from PTMCs in cases of solid hypoechogenic nodules under 10 mm. Such criteria should be acknowledged in cases of solid hypoechogenic thyroid nodules to help guide for the need of US-FNA.
Objective
This prospective observational study aimed to evaluate the efficacy of radiofrequency ablation (RFA) in treating ≤ 2 cm thyroid nodules with Bethesda IV cytology and C-TIRADS 4A ...categorization. Additionally, the factors influencing the completed absorption of ablation (CAA) were examined.
Methods
A total of 62 cases with 62 nodules underwent ultrasound-guided RFA and were included in the study. The volume reduction rate (VRR), CAA, and incomplete absorption of ablation (IAA) were assessed at the 1st, 3rd, 6th, and subsequent 6-month follow-ups. Clinical and ultrasound features were compared between the CAA and IAA groups at the 12th month follow-up.
Results
The average VRR at the 1st, 3rd, 6th, 12th month, and last follow-up were −88.6%, 16.0%, 59.7%, 82.0%, and 98.2%, respectively. More than half of the nodules achieved a 90% VRR after 1 year of RFA, with 88.7% demonstrating CAA at the end of the study (follow-up duration of 14 to 63 months). Nodules with grade 3 vascularity and those associated with chronic thyroiditis showed delayed CAA at the 12th month follow-up (
p
= 0.036 and 0.003, respectively).
Conclusion
RFA is an effective technique for treating ≤ 2 cm thyroid nodules with Bethesda IV cytology and C-TIRADS 4A categorization. Nodules with grade 3 blood supply and patients with chronic thyroiditis exhibited an impact on the completed absorption following RFA.
Clinical relevance statement
Our study has shown that radiofrequency ablation is an effective treatment for ≤ 2 cm thyroid nodules classified as Bethesda IV cytology. However, we identified that high vascularity of the nodule and chronic thyroiditis are adverse factors affecting the completed absorption of the ablation.
Key Points
•
Radiofrequency ablation (RFA) is an effective technique for treatment of ≤ 2 cm Bethesda IV category thyroid nodules
.
•
Higher blood supply and chronic thyroiditis influence the completed absorption after RFA
.
The cystine-cystine （CC） chemokine monocyte chemoattractant protein-1 （MCP-1） has been established playing a pathogenic role in the development of atherosclerosis due to its chemotactic ability of ...leading monocytes to locate to subendothelia. Recent studies have revealed more MCP-1 functions other than chemotaxis. Here we reported that various concentrations （0.1-100 ng/ml） of MCP-1 induced human umbilical vein endothelial cell （HUVEC） strain CRL-1730 apoptosis, caspase-9 activation, and a couple of mitochondrial alterations. Moreover, MCP-1 upregulated p53 expression of HUVECs and the p53- specific inhibitor pifithrin-oL （PFToL） rescued the MCP-1- induced apoptosis of HUVECs. Furthermore, PKC （protein kinase C） activation or inhibition might also affect HUVECs apoptosis induced by MCP-1. These findings together demonstrate that MCP-1 exerts direct proapoptotic effects on HUVECs in vitro via a p53-dependent mitochondrial pathway.
With the help of relative entropy theory, norm theory, and bootstrap methodology, a new hypothesis testing method is proposed to verify reliability with a three-parameter Weibull distribution. Based ...on the relative difference information of the experimental value vector to the theoretical value vector of reliability, six criteria of the minimum weighted relative entropy norm are established to extract the optimal information vector of the Weibull parameters in the reliability experiment of product lifetime. The rejection region used in the hypothesis testing is deduced via the area of intersection set of the estimated truth-value function and its confidence interval function of the three-parameter Weibull distribution. The case studies of simulation lifetime, helicopter component failure, and ceramic material failure indicate that the proposed method is able to reflect the practical situation of the reliability experiment.
A range of Rh(III)-catalyzed ortho-C–H functionalizations have been developed; however, extension of this reactivity to remote C–H functionalizations through large-ring rhodacyclic intermediates has ...yet to be demonstrated. Herein we report the first example of the use of a U-shaped nitrile template to direct Rh(III)-catalyzed remote meta-C–H activation via a postulated 12-membered macrocyclic intermediate. Because the ligands used for Rh(III) catalysts are significantly different from those of Pd(II) catalysts, this offers new opportunities for future development of ligand-promoted meta-C–H activation reactions.
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