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Journal of Gastric Cancer Jan 2024This review comprehensively examines the diverse spectrum of gastric cancers, focusing on unusual or uncommon histology that presents significant diagnostic and... (Review)
Review
This review comprehensively examines the diverse spectrum of gastric cancers, focusing on unusual or uncommon histology that presents significant diagnostic and therapeutic challenges. While the predominant form, tubular adenocarcinoma, is well-characterized, this review focuses on lesser-known variants, including papillary adenocarcinoma, micropapillary carcinoma, adenosquamous carcinoma, squamous cell carcinoma (SCC), hepatoid adenocarcinoma, gastric choriocarcinoma, gastric carcinoma with lymphoid stroma, carcinosarcoma, gastroblastoma, parietal cell carcinoma, oncocytic adenocarcinoma, Paneth cell carcinoma, gastric adenocarcinoma of the fundic gland type, undifferentiated carcinoma, and extremely well-differentiated adenocarcinoma. Although these diseases have different nomenclatures characterized by distinct histopathological features, these phenotypes often overlap, making it difficult to draw clear boundaries. Furthermore, the number of cases was limited, and the unique histopathological nature and potential pathogenic mechanisms were not well defined. This review highlights the importance of understanding these rare variants for accurate diagnosis, effective treatment planning, and improving patient outcomes. This review emphasizes the need for ongoing research and case studies to enhance our knowledge of these uncommon forms of gastric cancer, which will ultimately contribute to more effective treatments and better prognostic assessments. This review aimed to broaden the pathological narrative by acknowledging and addressing the intricacies of all cancer types, regardless of their rarity, to advance patient care and improve prognosis.
PubMed: 38225767
DOI: 10.5230/jgc.2024.24.e7 -
Frontiers in Endocrinology 2023Differentiated thyroid cancer (DTC) is rare in childhood and adolescence although it represents the most frequent endocrine malignancy in this population. DTC includes... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Differentiated thyroid cancer (DTC) is rare in childhood and adolescence although it represents the most frequent endocrine malignancy in this population. DTC includes both papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC). Most pediatric DTCs are PTCs, while FTCs are rare. To date, no systematic reviews on the global epidemiology of pediatric and adolescent DTC have been published. This systematic review and meta-analysis aims to estimate the overall incidence and prevalence of DTCs in patients aged 0-19 years.
METHODS
The systematic research was conducted from January 2000 to December 2021 through MEDLINE via PubMed, Cochrane Library, and Embase databases. Two separate meta-analyses were performed for PTC and FTC.
RESULTS
After the selection phase, a total of 15 studies (3,332 screened) met the inclusion criteria and are reported in the present systematic review. Five studies were conducted in Europe, five in North America, two in South America, one in Asia, one reported data for 49 countries and territories across the five continents, and one from both the USA and Africa. Most of the studies ( = 14) reported data obtained from national registries, and only one provided information collected from hospital medical records. Beyond the actual trend over time, our study reported a pooled global incidence rate (IR) of PTC and FTC in the pediatric age of 0.46 (95% CI: 0.33-0.59) and 0.07 (95% CI: 0.02-0.12) per 100,000 person-years, respectively. The highest IRs were recorded among Caucasian girls, and the lowest in black or other races/ethnicities.
CONCLUSION
Our data confirm that DTC in the pediatric population is a rare condition. The pooled IRs of the studies included in this meta-analysis are ~0.5 for PTC, which is the most common histological type when both genders and all age groups are considered. The implementation of a prospective international registry on pediatric DTC, as part of the wider European Registries for Rare Endocrine Conditions, has been recently proposed. In addition to providing relevant information on the clinical behavior of this rare disease, standardization of data collection will be pivotal to fill current gaps and allow an accurate estimation of the real incidence and risk factors of DTC.
Topics: Adolescent; Humans; Child; Male; Female; Incidence; Prevalence; Prospective Studies; Carcinoma, Papillary; Thyroid Neoplasms; Adenocarcinoma, Follicular; Thyroid Cancer, Papillary
PubMed: 37795368
DOI: 10.3389/fendo.2023.1270518 -
Frontiers in Endocrinology 2023Papillary thyroid cancer (PTC) is the most common endocrine malignancy worldwide. The treatment of PTC has attracted extensive attention and discussion from the public...
BACKGROUND
Papillary thyroid cancer (PTC) is the most common endocrine malignancy worldwide. The treatment of PTC has attracted extensive attention and discussion from the public and scholars. However, no article has systematically assessed the related literature. Therefore, we conducted a bibliometric and knowledge map analysis to reveal the dynamic scientific developments in the PTC therapy field.
METHODS
We retrieved publications related to PTC therapy from the Web of Scientific Core Collection (WoSCC) on May 1, 2023. The bibliometric package in R software, VOSviewer and CiteSpace software were used to analyze countries/regions, institutions, journals, authors, references, and keywords. Then, we systematized and summarized the research landscape, global trends and hot topics of research.
RESULTS
This bibliometric analysis spanned from 2012 to 2022 and involved 18,501 authors affiliated with 3,426 institutions across 87 countries/regions, resulting in the publication of 3,954 papers in 860 academic journals. Notably, the number of publications and citations related to PTC therapy research has exhibited a steady increase over the past decade. China and the United States have emerged as leading contributors in terms of publication count, with the United States also being the most cited country. Furthermore, among the top 10 institutions with the highest number of published papers, half were located in China. Among the journals, Thyroid is ranked first in terms of total publications and citations. The most productive individual author was Miyauchi Akira. While previous research primarily focused on surgery and radioactive iodine therapy, the increasing emphasis on health awareness and advancements in medical technology have led to the emergence of active surveillance, thermal ablation, and genomic analysis as prominent areas of research.
CONCLUSION
In conclusion, this comprehensive and quantitative bibliometric analysis elucidates the research trends and hotspots within PTC therapy, drawing from a substantial body of publications. This study provides valuable insights into the historical and current landscape of PTC therapy research while also offering guidance for future research directions. This study serves as a valuable resource for researchers and practitioners seeking new avenues of exploration in the field.
Topics: Humans; Thyroid Cancer, Papillary; Iodine Radioisotopes; Thyroid Neoplasms; Hyperthermia, Induced; Bibliometrics
PubMed: 37795362
DOI: 10.3389/fendo.2023.1252389 -
Annales de Pathologie Mar 2024
Topics: Humans; Thyroid Neoplasms; Carcinoma, Papillary, Follicular; Neoplasms, Glandular and Epithelial; Adenocarcinoma, Follicular
PubMed: 38388329
DOI: 10.1016/j.annpat.2024.01.016 -
Thyroid : Official Journal of the... Sep 2023Alterations in DNA methylation are stable epigenetic events that can serve as clinical biomarkers. The aim of this study was to analyze methylation patterns among...
Alterations in DNA methylation are stable epigenetic events that can serve as clinical biomarkers. The aim of this study was to analyze methylation patterns among various follicular cell-derived thyroid neoplasms to identify disease subtypes and help understand and classify thyroid tumors. We employed an unsupervised machine learning method for class discovery to search for distinct methylation patterns among various thyroid neoplasms. Our algorithm was not provided with any clinical or pathological information, relying exclusively on DNA methylation data to classify samples. We analyzed 810 thyroid samples ( = 256 for discovery and = 554 for validation), including benign and malignant tumors, as well as normal thyroid tissue. Our unsupervised algorithm identified that samples could be classified into three subtypes based solely on their methylation profile. These methylation subtypes were strongly associated with histological diagnosis ( < 0.001) and were therefore named normal-like, follicular-like, and papillary thyroid carcinoma (PTC)-like. Follicular adenomas, follicular carcinomas, oncocytic adenomas, and oncocytic carcinomas clustered together forming the follicular-like methylation subtype. Conversely, classic papillary thyroid carcinomas (cPTC) and tall cell PTC clustered together forming the PTC-like subtype. These methylation subtypes were also strongly associated with genomic drivers: 98.7% -driven cancers were PTC like, whereas 96.0% -driven cancers had a follicular-like methylation pattern. Interestingly, unlike other diagnoses, follicular variant PTC (FVPTC) samples were split into two methylation clusters (follicular like and PTC like), indicating a heterogeneous group likely to be formed by two distinct diseases. FVPTC samples with a follicular-like methylation pattern were enriched for mutations (36.4% vs. 8.0%; < 0.001), whereas FVPTC- with PTC-like methylation patterns were enriched for mutations (52.0% vs. 0%, Fisher exact = 0.004) and fusions (16.0% vs. 0%, Fisher exact = 0.003). Our data provide novel insights into the epigenetic alterations of thyroid tumors. Since our classification method relies on a fully unsupervised machine learning approach for subtype discovery, our results offer a robust background to support the classification of thyroid neoplasms based on methylation patterns.
Topics: Humans; DNA Methylation; Proto-Oncogene Proteins B-raf; Thyroid Neoplasms; Thyroid Cancer, Papillary; Adenocarcinoma, Follicular; Mutation
PubMed: 37392021
DOI: 10.1089/thy.2023.0074 -
International Journal of Hyperthermia :... Dec 2023To analyze the efficacy and safety of radiofrequency ablation (RFA), microwave ablation (MWA) and laser ablation (LA) in T1N0M0 papillary thyroid carcinoma (PTC)... (Meta-Analysis)
Meta-Analysis Review
Efficacy and safety of ultrasound-guided radiofrequency, microwave and laser ablation for the treatment of T1N0M0 papillary thyroid carcinoma on a large scale: a systematic review and meta-analysis.
BACKGROUND
To analyze the efficacy and safety of radiofrequency ablation (RFA), microwave ablation (MWA) and laser ablation (LA) in T1N0M0 papillary thyroid carcinoma (PTC) patients by evaluating data on several outcomes on a large scale.
MATERIALS AND METHODS
Literature searches were conducted in PUBMED, EMBASE and the Cochrane Library for studies of thermal ablation (TA) for treating T1N0M0 PTC. Data on the volume reduction rate (VRR) at the 12-month follow-up and final follow-up, complete disappearance rate, local recurrence rate, lymph node metastasis rate, and complication rate of RFA, MWA and LA were evaluated separately. RFA effects were compared between T1aN0M0 and T1bN0M0 patients.
RESULTS
A total of 36 eligible studies were included. RFA presented superior efficacy than MWA in 12-month VRR. At the final follow-up, the difference was slight in subgroups, showing a significant reduction. The complete disappearance rate of LA (93.00%) was higher than that of RFA (81.00%) and MWA (71.00%). Additionally, the local recurrence rate pooled proportions of MWA and RFA were both 2.00%, lower than that of the LA group (3.00%). There was no event of distant metastasis. The lymph node metastasis rates were similar, as RFA (1.00%) had the lowest. For minor complication rates, the pooled proportions of RFA (3.00%) were smaller than those of LA (6.00%) and MWA (13.00%). T1aN0M0 lesions presented with better outcomes than T1bN0M0 lesions.
CONCLUSION
RFA, MWA and LA were reliable in curing PTC, and RFA presented advantages in most outcomes. T1aN0M0 patients may experience fewer side effects than T1bN0M0 patients.
Topics: Humans; Microwaves; Lymphatic Metastasis; Thyroid Cancer, Papillary; Laser Therapy; Thyroid Neoplasms; Ultrasonography, Interventional
PubMed: 37604507
DOI: 10.1080/02656736.2023.2244713 -
Indian Journal of Cancer Oct 2023Concurrence of medullary and papillary thyroid carcinoma (MTC and PTC) represents less than 1% of all thyroid malignancies. We aimed to reveal the demographic and...
PURPOSE
Concurrence of medullary and papillary thyroid carcinoma (MTC and PTC) represents less than 1% of all thyroid malignancies. We aimed to reveal the demographic and clinical characteristics of this rare pathology and to evaluate the effect of the same or contralateral lobular localization of these two malignancies in clinical and laboratory features. Evaluation of progression-free survival (PFS) in current pathology is one of the important features of our study.
METHODS
All patients diagnosed with simultaneous MTC and PTC after thyroidectomy were evaluated retrospectively. Data on the following variables were recorded: age, gender, tumor localization (ipsilateral lobe located MTC and PTC-Group I, contralateral lobe located MTC and PTC-Group II), tumor size, cervical lymph node metastasis, distant metastasis, tumor stage, postoperative basal calcitonin, carcinoembryonic antigen, thyroglobulin (Tg), and anti-Tg values. In all our cases, since MTC progressed before PTC, progression was accepted as serum calcitonin values exceeded 150 pg/mL.
RESULTS
Groups were formed as follows: Group I, four cases where MTC and PTC were localized in different foci in the same lobe; Group II, nine cases where they were localized in different lobes. There was only one case in which two tumors were located in the same focus. The case with dual differentiation was included in Group I (35. 7%). When the PFS of the two groups were compared, no statistically significant difference was found ( P = 0.87).
CONCLUSIONS
As a result of this analysis, the location of the simultaneously detected PTC in the same or different lobes with the MTC does not make a significant difference in clinical and laboratory features.
Topics: Humans; Thyroid Cancer, Papillary; Calcitonin; Survival Rate; Retrospective Studies; Carcinoma, Papillary; Thyroid Neoplasms; Carcinoma, Neuroendocrine
PubMed: 38090963
DOI: 10.4103/ijc.IJC_9_21 -
Clinical and Translational Medicine Mar 2024Papillary thyroid carcinoma (PTC) is the most common malignant endocrine tumour, and its incidence and prevalence are increasing considerably. Cellular heterogeneity in...
BACKGROUND
Papillary thyroid carcinoma (PTC) is the most common malignant endocrine tumour, and its incidence and prevalence are increasing considerably. Cellular heterogeneity in the tumour microenvironment is important for PTC prognosis. Spatial transcriptomics is a powerful technique for cellular heterogeneity study.
METHODS
In conjunction with a clinical pathologist identification method, spatial transcriptomics was employed to characterise the spatial location and RNA profiles of PTC-associated cells within the tissue sections. The spatial RNA-clinical signature genes for each cell type were extracted and applied to outlining the distribution regions of specific cells on the entire section. The cellular heterogeneity of each cell type was further revealed by ContourPlot analysis, monocle analysis, trajectory analysis, ligand-receptor analysis and Gene Ontology enrichment analysis.
RESULTS
The spatial distribution region of tumour cells, typical and atypical follicular cells (FCs and AFCs) and immune cells were accurately and comprehensively identified in all five PTC tissue sections. AFCs were identified as a transitional state between FCs and tumour cells, exhibiting a higher resemblance to the latter. Three tumour foci were shared among all patients out of the 13 observed. Notably, tumour foci No. 2 displayed elevated expression levels of genes associated with lower relapse-free survival in PTC patients. We discovered key ligand-receptor interactions, including LAMB3-ITGA2, FN1-ITGA3 and FN1-SDC4, involved in the transition of PTC cells from FCs to AFCs and eventually to tumour cells. High expression of these patterns correlated with reduced relapse-free survival. In the tumour immune microenvironment, reduced interaction between myeloid-derived TGFB1 and TGFBR1 in tumour focus No. 2 contributed to tumourigenesis and increased heterogeneity. The spatial RNA-clinical analysis method developed here revealed prognosis-associated cellular heterogeneity in the PTC microenvironment.
CONCLUSIONS
The occurrence of tumour foci No. 2 and three enhanced ligand-receptor interactions in the AFC area/tumour foci reduced the relapse-free survival of PTC patients, potentially leading to improved prognostic strategies and targeted therapies for PTC patients.
Topics: Humans; Thyroid Cancer, Papillary; Thyroid Neoplasms; Ligands; Tumor Microenvironment; Neoplasm Recurrence, Local; Gene Expression Profiling; Prognosis; RNA
PubMed: 38426403
DOI: 10.1002/ctm2.1594 -
Frontiers in Endocrinology 2023The 2015 American Thyroid Association guidelines proposed recurrence risk stratification of differentiated thyroid carcinoma, including papillary thyroid carcinoma... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The 2015 American Thyroid Association guidelines proposed recurrence risk stratification of differentiated thyroid carcinoma, including papillary thyroid carcinoma (PTC), but this stratification excluded non-initial treatment patients with worse outcomes. This study aimed to explore the potential risk factors for recurrence in PTC and develop a predictive model for both initial and non-initial treatment of patients with PTC.
METHODS
A total of 955 patients were included in this study. Differences between the recurrence (-) and recurrence (+) groups were compared. The 955 patients were randomized into two groups: the training group (671 cases) and the validation group (284 cases). All variables were selected using the LASSO regression analysis. A nomogram was developed based on the results of the univariate and multivariate logistic regression analyses. The nomogram performance was evaluated using discrimination and calibration.
RESULTS
Patients aged ≥55 years, extranodal extension (ENE), metastatic LN ratio (LNR) >0.5, and non-initial treatment were identified as potential risk factors for recurrence through LASSO regression and univariate and multivariate analyses. The receiver operating characteristic curve (ROC curve) showed high efficiency, with an area under the ROC curve (AUC) of 0.819 (95% confidence interval [CI], 0.729-0.909) and 0.818 (95% CI, 0.670-0.909) in the training and validation groups, respectively. The calibration curve indicated that the nomogram had a good consistency.
CONCLUSION
In patients with PTC, age ≥55 years, ENE, LNR >0.5, and non-initial treatment are potential risk factors for recurrence. The predictive model of recurrence was confirmed to be a practical and convenient tool for clinicians to accurately predict PTC recurrence.
Topics: Humans; Thyroid Cancer, Papillary; Retrospective Studies; Lymph Nodes; Thyroid Neoplasms; Risk Factors
PubMed: 37810888
DOI: 10.3389/fendo.2023.1268282