Papillary thyroid cancer with biochemical incomplete response: Clinico-pathological characteristics and disease outcome

Contrast-enhanced ultrasound (CEUS) can be used to evaluate microcirculation in cancers, which in turn is associated with the biologic features and ultimately patient prognosis. We conducted a retrospective analysis to examine potential association between CEUS parameters and prognosis in patients with papillary thyroid cancer (PTC). The analysis included 306 patients who underwent CEUS prior to thyroidectomy at our center during a period from 2012 to 2019. Subjects with excellent response (ER) were compared to the non-ER group (including indeterminate response, biochemical incomplete response and structural incomplete response). During the median follow-up of 34 months, ER was observed in 195 (63.7%) subjects. The remaining 111 (36.3%) patients developed non-ER events, with distant metastasis in five (1.6%) cases. In a multivariate COX regression, non-ER event was associated with the male sex (OR = 1.83, 95%CI: 1.21–2.76) and blood-rich enhancement in CEUS (OR = 1.69, 95%CI: 1.04–2.75). Based on this finding, we developed a predictive model: high risk for developing non-ER events was defined as having both risk factors; low risk was defined as having none or only one risk. In receiver operating characteristic (ROC) analysis, the area under the curve was 0.59 (95%CI: 0.52–0.66). The sensitivity and specificity were 17.1 and 95.4%, respectively. The positive and negative predictive values were 67.9 and 66.9%, respectively. In conclusion, blood-rich enhancement in CEUS is associated with non-ER events after thyroidectomy in patients with PTC.

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Associations between body mass index and clinico-pathological characteristics of papillary thyroid cancer

Clinical Endocrinology ◽

10.1111/j.1365-2265.2012.04506.x ◽

2012 ◽

Vol 78 (1) ◽

pp. 134-140 ◽

Cited By ~ 63

Author(s):

Hye Jeong Kim ◽

Na Kyung Kim ◽

Ji Hun Choi ◽

Seo Young Sohn ◽

Se Won Kim ◽

...

Keyword(s):

Body Mass Index ◽

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Body Mass ◽

Papillary Thyroid ◽

Pathological Characteristics

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Nomogram for the Prediction of Biochemical Incomplete Response in Papillary Thyroid Cancer Patients

Cancer Management and Research ◽

10.2147/cmar.s320993 ◽

2021 ◽

Vol Volume 13 ◽

pp. 5641-5650

Author(s):

Seung Taek Lim ◽

Ye Won Jeon ◽

Hongki Gwak ◽

Ja Seong Bae ◽

Young Jin Suh

Keyword(s):

Thyroid Cancer ◽

Cancer Patients ◽

Papillary Thyroid Cancer ◽

Papillary Thyroid ◽

Incomplete Response

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Analysis of the association of BRAFV600E mutation and Ki-67 overexpression with clinical and pathological characteristics in papillary thyroid cancer

Radiation and Environmental Biophysics ◽

10.1007/s00411-021-00904-y ◽

2021 ◽

Author(s):

Maira Espenbetova ◽

Aynur Krykpayeva ◽

Zhanar Zamanbekova ◽

Zhanar Zhumanbaeva ◽

Baurzhan Azizov ◽

...

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Papillary Thyroid ◽

Brafv600e Mutation ◽

Ki 67 ◽

Pathological Characteristics

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UNFAVORABLE RESPONSES TO RADIOIODINE THERAPY IN N1B PAPILLARY THYROID CANCER: A PROPENSITY SCORE MATCHING STUDY

Endocrine Practice ◽

10.4158/ep-2019-0155 ◽

2019 ◽

Vol 25 (12) ◽

pp. 1286-1294 ◽

Cited By ~ 1

Author(s):

Yan-Qing Liu ◽

Hui Li ◽

Jie-Rui Liu ◽

Yan-Song Lin

Keyword(s):

Thyroid Cancer ◽

Propensity Score ◽

Propensity Score Matching ◽

Papillary Thyroid Cancer ◽

Odds Ratio ◽

Radioactive Iodine ◽

Nodal Metastases ◽

Papillary Thyroid ◽

Incomplete Response ◽

Therapeutic Responses

Objective: Regional nodal metastases carry prognostic significance in papillary thyroid cancer (PTC). However, whether different locational nodal metastases correlate with different therapeutic responses remains controversial. We innovatively applied the response to therapy restratification system to evaluate the dynamic disease status after surgery and radioactive iodine (RAI) therapy in PTC patients with different locational nodal metastases. Methods: A total of 585 nondistant-metastatic PTC patients who underwent total thyroidectomy and RAI therapy were retrospectively enrolled. Patients with nodal metastases were categorized into N1a and N1b groups. Propensity score matching was used to balance the bias between the 2 groups. Therapeutic responses were dynamically evaluated, and responses to RAI therapy were classified into excellent (ER), indeterminate (IDR), biochemical incomplete (BIR) and structural incomplete response (SIR). Results: N1b group patients showed a significantly higher pre-ablation stimulated thyroglobulin (Ps-Tg) level than N1a group patients (7.4 ng/mL versus 3.2ng/mL, P<.001). After RAI therapy, N1b group patients took a longer time to achieve ER (9.86 months versus 3.29 months, P<.001) and exhibited a higher proportion of non-ER (IDR, BIR, and SIR) (39.15% versus 17.46%, P<.001) compared to N1a group patients. In logistic regression, N1b and Ps-Tg ≥10 ng/mL were confirmed to be independent factors predicting non-ER (odds ratio: 2.591, and 9.196, respectively). In Cox regression, patients with N1b disease and Ps-Tg ≥10 ng/mL showed significantly lower hazards for achieving ER (hazard ratio: 0.564, and 0.223, respectively). Conclusion: N1b PTC patients showed inferior responses to surgery and RAI therapy compared to N1a patients. N1b was confirmed to be an independent factor predicting unfavorable responses to RAI therapy. Abbreviations: AJCC = American Joint Committee on Cancer; ATA = American Thyroid Association; BIR = biochemical incomplete response; BRAFV600E = proto-oncogene B-Raf V600E mutation; CI = confidence interval; CT = computed tomography; DNA = deoxyribonucleic acid; DTC = differentiated thyroid cancer; ER = excellent response; ETE = extrathyroidal extension; HR = hazard ratio; IDR = indeterminate response; LNM = lymph node metastasis; N1a = central cervical LNM; N1b = lateral cervical LNM; OR = odds ratio; PSM = propensity score matching; Ps-Tg = pre-ablation stimulated thyroglobulin; PTC = papillary thyroid cancer; RAI = radioactive iodine; SIR = structural incomplete response; Tg = thyroglobulin; TgAb = thyroglobulin antibody; TSH = thyroid-stimulating hormone

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Combined Mutational and Clonality Analyses Support the Existence of Intra-Tumor Heterogeneity in Papillary Thyroid Cancer

Journal of Clinical Medicine ◽

10.3390/jcm10122645 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2645

Author(s):

Marina Muzza ◽

Gabriele Pogliaghi ◽

Luca Persani ◽

Laura Fugazzola ◽

Carla Colombo

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Single Mutation ◽

Papillary Thyroid ◽

Time Data ◽

Double Mutation ◽

Pathological Characteristics ◽

Single Clone ◽

Potential Clinical Impact ◽

First Time

Despite its potential clinical impact, intra-tumor genetic heterogeneity (ITH) has been scantly investigated in papillary thyroid cancer (PTC). We studied ITH in PTC by combining, for the first time, data derived from the evaluation of the normalized allelic frequencies (NAF) of the mutation/s, using a customized MassARRAY panel, and those obtained by the HUMARA clonality assay. Among tumors with a single mutation, 80% of cases with NAF 50 ± 5% were clonal, consistent with the presence of a single mutated clone, while 20% of cases showed a polyclonal pattern, suggesting the presence of the same mutation in two or more clones. Differently, all cases with NAF < 45% were polyclonal. Among tumors with double mutation, cases with both mutations showing NAF 50 ± 5% were monoclonal, consistent with the presence of a single clone harboring both mutations. On the other hand, all cases with double mutation at NAF < 45% were polyclonal, indicating the presence of two clones with different mutations. Finally, no significant differences in the clinico-pathological characteristics were found between monoclonal and polyclonal tumors. In conclusion, the present study adds insights into the concept of ITH in PTC, which warrants attention because the occurrence of this phenomenon is likely to affect the response to targeted drugs.

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