BACKGROUND Hydrodissection is a widely used technique during radiofrequency ablation(RFA)for benign thyroid nodules.Although it could effectively avoid thermal injury to the surrounding critical structures and achieve...BACKGROUND Hydrodissection is a widely used technique during radiofrequency ablation(RFA)for benign thyroid nodules.Although it could effectively avoid thermal injury to the surrounding critical structures and achieve complete treatment,routine operation of the remaining needle could cause perithyroidal hemorrhage.In this report,we present 2 cases of perithyroidal hemorrhage during RFA caused by a hydrodissection needle,which have not been reported before.CASE SUMMARY A 21-year-old female and a 45-year-old male were admitted for RFA for benign thyroid nodules.Considering that their nodules were adjacent to the recurrent laryngeal nerve,the needle used for hydrodissection was placed and remained between the dorsal capsule of the lateral lobe and the recurrent laryngeal nerve.During the procedure,active bleeding near the needle appeared on ultrasonography(US).Although moderate pressure was quickly applied to the neck for several minutes,contrast-enhanced US(CEUS)still showed an active hemorrhage.A radiofrequency electrode was placed at the bleeding point under the guidance of CEUS to stop the bleeding,and the procedure was finally confirmed to be successful by CEUS,without other complications.CONCLUSION Hydrodissection during RFA of benign thyroid nodules was associated with a risk of perithyroidal hemorrhage.The timely recognition of this acute hemorrhage could help in the timely control of the bleeding,and CEUS-guided ablation of the bleeding point could be useful.展开更多
Objective:To analyze the clinical and pathological characteristics of thyroid nodules and to explore the related risk factors of malignant thyroid nodules.Methods: According to the criteria of inclusion and exclusion,...Objective:To analyze the clinical and pathological characteristics of thyroid nodules and to explore the related risk factors of malignant thyroid nodules.Methods: According to the criteria of inclusion and exclusion, a total of 283 patients with thyroid nodules during January 2015 and December 2017 were divided into benign group (benign nodule,n =172) and malignant group (malignant nodule,n = 111) based on postoperative histopathological results. The age, sex, serum thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), thyroid stimulating hormone (TSH), free thyroxine (fT4), free three iodine thyroxine (fT3) and fT4/ fT3 ratio were subjected to univariate analysis, and the risk factors of malignant thyroid nodule were screened by multivariate logistic regression analysis.Results:Univariate analysis showed that age, TgAb, fT4 (P < 0.05) and fT4/ fT3 quotient (P < 0.01) were significantly different between the two groups. The fT4/fT3 quotient is a risk factor of malignant nodules. Multivariate logistic regression analysis indicated that the risk factors of malignant thyroid nodule were age (0R: 0.934,95% CI:0.911-0.957), TgAb(0R: 2.069,95% CI: 1.008-4.247) and fT4 (0R: 1.206,95% CI: 1.038-1.401).Conclusion: The fT4/fT3 quotient has important diagnostic value in differentiating benign and malignant thyroid nodules. When fT4 / fT3 > 3, it increases the risk of malignancy. The age, TgAb and fT4 are independent risk factors for malignant thyroid nodule, which is of great value in distinguishing benign from malignant thyroid nodules.展开更多
Objective： This systematic review examined whether radiofrequency ablation （RFA） is a sate treatment modality for benign thyroid nodules （BTNs）. Data Sources： PubMed, Embase, and the Cochrane Library database we...Objective： This systematic review examined whether radiofrequency ablation （RFA） is a sate treatment modality for benign thyroid nodules （BTNs）. Data Sources： PubMed, Embase, and the Cochrane Library database were searched for articles that （a） targeted human beings and （b） had a study population with BTNs that were confirmed by fine-needle aspiration cytology and/or core needle biopsy. Study Selection： Thirty-two studies relating to 3409 patients were included in this systematic review. Results： Based on literatures, no deaths were associated with the procedure, serious complications were rare, and RFA appears to be a sale and well-tolerated treatment modality. However, a broad spectrum of complications offers insights into some undesirable complications, such as track needle seeding and Hornet syndrome. Conclusions： RFA appears to be a safe and well-tolerated treatment modality for BTNs. More research is needed to characterize the complications of RFA for thyroid nodules.展开更多
Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this stu...Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this study,we aimed to explore the microbial community in thyroid tissues and its contribution to papillary thyroid cancer(PTC).In parallel,we performed microbial profiling and transcriptome sequencing in the tumor and adjacent normal tissues of a large cohort of 340 PTC and benign thyroid nodule(BTN)patients.Distinct microbial signatures were identified in PTC,BTN,and their adjacent nontumor tissues.Intra-thyroid tissue bacteria were verified by means of bacteria staining,fluorescence in situ hybridization,and immunoelectron microscopy.We found that 17 bacterial taxa were differentially abundant in PTC compared with BTN,which included enrichment in PTC of the pathobionts Rhodococcus,Neisseria,Streptococcus,Halomonas,and Devosia,and depletion of the beneficial bacteria Amycolatopsis.These differentially abundant bacteria could differentiate PTC tumor tissues(PTC-T)from BTN tissues(BTN-T)with an area under the curve(AUC)of 81.66%.Microbial network analysis showed increased correlation strengths among the bacterial taxa in PTC-T in comparison with BTN-T.Immunefunction-corresponding bacteria(i.e.,Erwinia,Bacillus,and Acinetobacter)were found to be enriched in PTC with Hashimoto’s thyroiditis.Moreover,our integrative analysis revealed that the PTC-enriched bacteria had a positive association with key PTC-oncogenic pathway-related genes,including BRAF,KRAS,IRAK4,CTNNB1,PIK3CA,MAP3K7,and EGFR.In conclusion,our results suggest that intratumor bacteria dysbiosis is associated with the thyroid tumorigenesis and oncogenic signaling pathways of PTC.展开更多
目的探讨动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)定量参数联合小视野弥散加权成像在甲状腺良恶性结节鉴别中的应用价值。材料与方法收集2022年1月至2023年10月于滨州医学院附属医院诊...目的探讨动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)定量参数联合小视野弥散加权成像在甲状腺良恶性结节鉴别中的应用价值。材料与方法收集2022年1月至2023年10月于滨州医学院附属医院诊治并经手术病理证实为甲状腺结节的患者38例(52个结节),将其分为良性结节组和恶性结节组。术前患者均行3.0 T MRI扫描,包括常规MRI、小视野弥散加权成像(b值取0、800 s/mm^(2))和DCE-MRI检查,并测量其表观弥散系数(apparent diffusion coefficient,ADC)值和DCE-MRI定量参数,包括对比剂容积转运常数(volume transport constant,K^(trans))、速率常数(rate constant,K_(ep))、血管外细胞外间隙容积分数(extravascular extracellular volume fraction,V_(e))。对甲状腺良恶性结节组的ADC、K_(ep)、V_(e)、K^(trans)采用独立样本t检验分析,以P<0.05为差异有统计学意义,后将差异有统计学意义的变量进行逐步logistic回归模型分析,得到甲状腺良恶性结节的独立预测因素,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析ADC、K^(trans)独立诊断模型及ADC与K^(trans)联合诊断模型的诊断效能。结果良性结节组平均ADC值、K^(trans)值、K_(ep)值分别为(1.659±0.370)×10^(-3)mm^(2)/s、(0.427±0.214)min^(-1)、(0.966±0.225)min^(-1),恶性结节组平均ADC值、K^(trans)值、K_(ep)值分别为(1.182±0.195)×10^(-3)mm^(2)/s、(0.178±0.073)min^(-1)、(0.600±0.248)min^(-1)。良性结节组的ADC、K^(trans)、K_(ep)值均高于恶性结节组,差异均有统计学意义(P<0.001)。经过独立样本t检验及逐步logistic回归分析显示,ADC值和K^(trans)差异具有统计学意义(P<0.05),是鉴别甲状腺结节良恶性的独立预测因子。单独ADC值曲线下面积(area under the curve,AUC)为0.915、单独K^(trans)值AUC为0.827。ADC值与K^(trans)联合诊断模型AUC为0.973,较二者单独应用明显增高,联合诊断模型诊断效能最高。经DeLong检验,联合诊断模型与单独K^(trans)诊断差异存在统计学意义(P<0.05)。ADC值与K^(trans)联合诊断模型在鉴别甲状腺良恶性结节中敏感度为97.3%,较ADC、K^(trans)更高,特异度为84.6%,较ADC值更高。结论ADC值和K^(trans)是鉴别甲状腺良恶性结节的重要参数,两者联合诊断可提高临床诊断准确性,为术前诊断提供重要依据。展开更多
文摘BACKGROUND Hydrodissection is a widely used technique during radiofrequency ablation(RFA)for benign thyroid nodules.Although it could effectively avoid thermal injury to the surrounding critical structures and achieve complete treatment,routine operation of the remaining needle could cause perithyroidal hemorrhage.In this report,we present 2 cases of perithyroidal hemorrhage during RFA caused by a hydrodissection needle,which have not been reported before.CASE SUMMARY A 21-year-old female and a 45-year-old male were admitted for RFA for benign thyroid nodules.Considering that their nodules were adjacent to the recurrent laryngeal nerve,the needle used for hydrodissection was placed and remained between the dorsal capsule of the lateral lobe and the recurrent laryngeal nerve.During the procedure,active bleeding near the needle appeared on ultrasonography(US).Although moderate pressure was quickly applied to the neck for several minutes,contrast-enhanced US(CEUS)still showed an active hemorrhage.A radiofrequency electrode was placed at the bleeding point under the guidance of CEUS to stop the bleeding,and the procedure was finally confirmed to be successful by CEUS,without other complications.CONCLUSION Hydrodissection during RFA of benign thyroid nodules was associated with a risk of perithyroidal hemorrhage.The timely recognition of this acute hemorrhage could help in the timely control of the bleeding,and CEUS-guided ablation of the bleeding point could be useful.
基金National Natural Science Foundation of China.Projects No:81302577.
文摘Objective:To analyze the clinical and pathological characteristics of thyroid nodules and to explore the related risk factors of malignant thyroid nodules.Methods: According to the criteria of inclusion and exclusion, a total of 283 patients with thyroid nodules during January 2015 and December 2017 were divided into benign group (benign nodule,n =172) and malignant group (malignant nodule,n = 111) based on postoperative histopathological results. The age, sex, serum thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), thyroid stimulating hormone (TSH), free thyroxine (fT4), free three iodine thyroxine (fT3) and fT4/ fT3 ratio were subjected to univariate analysis, and the risk factors of malignant thyroid nodule were screened by multivariate logistic regression analysis.Results:Univariate analysis showed that age, TgAb, fT4 (P < 0.05) and fT4/ fT3 quotient (P < 0.01) were significantly different between the two groups. The fT4/fT3 quotient is a risk factor of malignant nodules. Multivariate logistic regression analysis indicated that the risk factors of malignant thyroid nodule were age (0R: 0.934,95% CI:0.911-0.957), TgAb(0R: 2.069,95% CI: 1.008-4.247) and fT4 (0R: 1.206,95% CI: 1.038-1.401).Conclusion: The fT4/fT3 quotient has important diagnostic value in differentiating benign and malignant thyroid nodules. When fT4 / fT3 > 3, it increases the risk of malignancy. The age, TgAb and fT4 are independent risk factors for malignant thyroid nodule, which is of great value in distinguishing benign from malignant thyroid nodules.
文摘Objective： This systematic review examined whether radiofrequency ablation （RFA） is a sate treatment modality for benign thyroid nodules （BTNs）. Data Sources： PubMed, Embase, and the Cochrane Library database were searched for articles that （a） targeted human beings and （b） had a study population with BTNs that were confirmed by fine-needle aspiration cytology and/or core needle biopsy. Study Selection： Thirty-two studies relating to 3409 patients were included in this systematic review. Results： Based on literatures, no deaths were associated with the procedure, serious complications were rare, and RFA appears to be a sale and well-tolerated treatment modality. However, a broad spectrum of complications offers insights into some undesirable complications, such as track needle seeding and Hornet syndrome. Conclusions： RFA appears to be a safe and well-tolerated treatment modality for BTNs. More research is needed to characterize the complications of RFA for thyroid nodules.
基金supported by the National Natural Science Foundation of China(81772850 and 82273300)。
文摘Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this study,we aimed to explore the microbial community in thyroid tissues and its contribution to papillary thyroid cancer(PTC).In parallel,we performed microbial profiling and transcriptome sequencing in the tumor and adjacent normal tissues of a large cohort of 340 PTC and benign thyroid nodule(BTN)patients.Distinct microbial signatures were identified in PTC,BTN,and their adjacent nontumor tissues.Intra-thyroid tissue bacteria were verified by means of bacteria staining,fluorescence in situ hybridization,and immunoelectron microscopy.We found that 17 bacterial taxa were differentially abundant in PTC compared with BTN,which included enrichment in PTC of the pathobionts Rhodococcus,Neisseria,Streptococcus,Halomonas,and Devosia,and depletion of the beneficial bacteria Amycolatopsis.These differentially abundant bacteria could differentiate PTC tumor tissues(PTC-T)from BTN tissues(BTN-T)with an area under the curve(AUC)of 81.66%.Microbial network analysis showed increased correlation strengths among the bacterial taxa in PTC-T in comparison with BTN-T.Immunefunction-corresponding bacteria(i.e.,Erwinia,Bacillus,and Acinetobacter)were found to be enriched in PTC with Hashimoto’s thyroiditis.Moreover,our integrative analysis revealed that the PTC-enriched bacteria had a positive association with key PTC-oncogenic pathway-related genes,including BRAF,KRAS,IRAK4,CTNNB1,PIK3CA,MAP3K7,and EGFR.In conclusion,our results suggest that intratumor bacteria dysbiosis is associated with the thyroid tumorigenesis and oncogenic signaling pathways of PTC.
文摘目的探讨动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)定量参数联合小视野弥散加权成像在甲状腺良恶性结节鉴别中的应用价值。材料与方法收集2022年1月至2023年10月于滨州医学院附属医院诊治并经手术病理证实为甲状腺结节的患者38例(52个结节),将其分为良性结节组和恶性结节组。术前患者均行3.0 T MRI扫描,包括常规MRI、小视野弥散加权成像(b值取0、800 s/mm^(2))和DCE-MRI检查,并测量其表观弥散系数(apparent diffusion coefficient,ADC)值和DCE-MRI定量参数,包括对比剂容积转运常数(volume transport constant,K^(trans))、速率常数(rate constant,K_(ep))、血管外细胞外间隙容积分数(extravascular extracellular volume fraction,V_(e))。对甲状腺良恶性结节组的ADC、K_(ep)、V_(e)、K^(trans)采用独立样本t检验分析,以P<0.05为差异有统计学意义,后将差异有统计学意义的变量进行逐步logistic回归模型分析,得到甲状腺良恶性结节的独立预测因素,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析ADC、K^(trans)独立诊断模型及ADC与K^(trans)联合诊断模型的诊断效能。结果良性结节组平均ADC值、K^(trans)值、K_(ep)值分别为(1.659±0.370)×10^(-3)mm^(2)/s、(0.427±0.214)min^(-1)、(0.966±0.225)min^(-1),恶性结节组平均ADC值、K^(trans)值、K_(ep)值分别为(1.182±0.195)×10^(-3)mm^(2)/s、(0.178±0.073)min^(-1)、(0.600±0.248)min^(-1)。良性结节组的ADC、K^(trans)、K_(ep)值均高于恶性结节组,差异均有统计学意义(P<0.001)。经过独立样本t检验及逐步logistic回归分析显示,ADC值和K^(trans)差异具有统计学意义(P<0.05),是鉴别甲状腺结节良恶性的独立预测因子。单独ADC值曲线下面积(area under the curve,AUC)为0.915、单独K^(trans)值AUC为0.827。ADC值与K^(trans)联合诊断模型AUC为0.973,较二者单独应用明显增高,联合诊断模型诊断效能最高。经DeLong检验,联合诊断模型与单独K^(trans)诊断差异存在统计学意义(P<0.05)。ADC值与K^(trans)联合诊断模型在鉴别甲状腺良恶性结节中敏感度为97.3%,较ADC、K^(trans)更高,特异度为84.6%,较ADC值更高。结论ADC值和K^(trans)是鉴别甲状腺良恶性结节的重要参数,两者联合诊断可提高临床诊断准确性,为术前诊断提供重要依据。
