Ultrasound features of medullary thyroid cancer as predictors of biological behavior

Background Medullary thyroid cancer (MTC) has more aggressive behavior and poor prognosis. Ultrasound (US) has facilitated the qualitative diagnosis of thyroid nodules, however, some MTC may be diagnosed as a benign nodule on ultrasound because ultrasound features of malignancy are lacking. The aim...

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Veröffentlicht in:Cancer imaging 2021-04, Vol.21 (1), p.33-33, Article 33
Hauptverfasser: Zhao, Jingzhu, Zheng, Xiangqian, Gao, Ming, Zhang, Sheng, Yun, Xinwei, Chi, Jiadong, Xu, Guangwei
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container_issue 1
container_start_page 33
container_title Cancer imaging
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creator Zhao, Jingzhu
Zheng, Xiangqian
Gao, Ming
Zhang, Sheng
Yun, Xinwei
Chi, Jiadong
Xu, Guangwei
description Background Medullary thyroid cancer (MTC) has more aggressive behavior and poor prognosis. Ultrasound (US) has facilitated the qualitative diagnosis of thyroid nodules, however, some MTC may be diagnosed as a benign nodule on ultrasound because ultrasound features of malignancy are lacking. The aim of the study was to investigate the association between ultrasound features and biological behavior of MTC. Methods Ultrasound findings and medical records of patients with MTC between Jan 2015 to Jun 2017 were retrospectively reviewed at Tianjin Medical University Cancer Institute and Hospital. MTC were categorized using modified TI-RADS classification, then were classified as "malignant" (m-MTC) or "US-low-suspicious" (l-MTC). We compared the biological behavior between the two groups, and further analyzed the risk factors for the recurrence. Results A total of 78 patients were enrolled, of which 55 m-MTC (70.5%) and 23 l-MTC (29.5%) were identified. The N staging of the m-MTC was significantly higher than that of l-MTC(P = 0.000). The preoperative serum Ct level in m-MTC were significantly higher than that of l-MTC(P = 0.035). Biochemical cure were more frequent in l-MTC than that of m-MTC (P = 0.002). Disease recurrence rates were 19.7% (14 of 71). Disease recurrence was more frequent in m-MTC than that of l-MTC (P = 0.013). Disease recurrence was positively associated with extrathyroid extension (P = 0.047), N staging (P = 0.003), preoperative serum Ct level (P = 0.009) and negatively associated with biochemical cure(P = 0.000). In multivariable Cox regression analysis, extrathyroid extension and biochemical cure were independent risk factors for recurrence of MTC. Conclusions L-MTC has a more indolent character than m-MTC. The extrathyroid extension and biochemical cure were independent risk factors for recurrence of MTC.
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Ultrasound (US) has facilitated the qualitative diagnosis of thyroid nodules, however, some MTC may be diagnosed as a benign nodule on ultrasound because ultrasound features of malignancy are lacking. The aim of the study was to investigate the association between ultrasound features and biological behavior of MTC. Methods Ultrasound findings and medical records of patients with MTC between Jan 2015 to Jun 2017 were retrospectively reviewed at Tianjin Medical University Cancer Institute and Hospital. MTC were categorized using modified TI-RADS classification, then were classified as "malignant" (m-MTC) or "US-low-suspicious" (l-MTC). We compared the biological behavior between the two groups, and further analyzed the risk factors for the recurrence. Results A total of 78 patients were enrolled, of which 55 m-MTC (70.5%) and 23 l-MTC (29.5%) were identified. The N staging of the m-MTC was significantly higher than that of l-MTC(P = 0.000). The preoperative serum Ct level in m-MTC were significantly higher than that of l-MTC(P = 0.035). Biochemical cure were more frequent in l-MTC than that of m-MTC (P = 0.002). Disease recurrence rates were 19.7% (14 of 71). Disease recurrence was more frequent in m-MTC than that of l-MTC (P = 0.013). Disease recurrence was positively associated with extrathyroid extension (P = 0.047), N staging (P = 0.003), preoperative serum Ct level (P = 0.009) and negatively associated with biochemical cure(P = 0.000). In multivariable Cox regression analysis, extrathyroid extension and biochemical cure were independent risk factors for recurrence of MTC. Conclusions L-MTC has a more indolent character than m-MTC. The extrathyroid extension and biochemical cure were independent risk factors for recurrence of MTC.</description><identifier>ISSN: 1740-5025</identifier><identifier>ISSN: 1470-7330</identifier><identifier>EISSN: 1470-7330</identifier><identifier>DOI: 10.1186/s40644-021-00402-w</identifier><identifier>PMID: 33836831</identifier><language>eng</language><publisher>LONDON: Springer Nature</publisher><subject>Adolescent ; Adult ; Aged ; Analysis ; Biochemistry ; Cancer ; Carcinoma, Neuroendocrine - diagnostic imaging ; Diseases ; Female ; Humans ; Life Sciences &amp; Biomedicine ; Lymphatic system ; Male ; Medical colleges ; Medical records ; Medical research ; Medicine, Experimental ; Medullary thyroid cancer ; Metastasis ; Middle Aged ; Nodules ; Oncology ; Prognosis ; Radiology, Nuclear Medicine &amp; Medical Imaging ; Recurrence ; Regression analysis ; Relapse ; Retrospective Studies ; Risk analysis ; Risk factors ; Science &amp; Technology ; Serum Ct ; Surgery ; Surgical implants ; Thyroid cancer ; Thyroid Neoplasms - diagnostic imaging ; TI-RADS ; Ultrasonic imaging ; Ultrasonic testing ; Ultrasonography - methods ; Ultrasound ; Young Adult</subject><ispartof>Cancer imaging, 2021-04, Vol.21 (1), p.33-33, Article 33</ispartof><rights>COPYRIGHT 2021 BioMed Central Ltd.</rights><rights>2021. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>7</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000638591000001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c594t-d43de009322a4b92d231000cc783f9b90fe878b1818d9aa1660b9cd4a16acd7f3</citedby><cites>FETCH-LOGICAL-c594t-d43de009322a4b92d231000cc783f9b90fe878b1818d9aa1660b9cd4a16acd7f3</cites><orcidid>0000-0003-0034-0235 ; 0000-0003-0304-8635</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033672/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033672/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2115,27929,27930,39263,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33836831$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhao, Jingzhu</creatorcontrib><creatorcontrib>Zheng, Xiangqian</creatorcontrib><creatorcontrib>Gao, Ming</creatorcontrib><creatorcontrib>Zhang, Sheng</creatorcontrib><creatorcontrib>Yun, Xinwei</creatorcontrib><creatorcontrib>Chi, Jiadong</creatorcontrib><creatorcontrib>Xu, Guangwei</creatorcontrib><title>Ultrasound features of medullary thyroid cancer as predictors of biological behavior</title><title>Cancer imaging</title><addtitle>CANCER IMAGING</addtitle><addtitle>Cancer Imaging</addtitle><description>Background Medullary thyroid cancer (MTC) has more aggressive behavior and poor prognosis. Ultrasound (US) has facilitated the qualitative diagnosis of thyroid nodules, however, some MTC may be diagnosed as a benign nodule on ultrasound because ultrasound features of malignancy are lacking. The aim of the study was to investigate the association between ultrasound features and biological behavior of MTC. Methods Ultrasound findings and medical records of patients with MTC between Jan 2015 to Jun 2017 were retrospectively reviewed at Tianjin Medical University Cancer Institute and Hospital. MTC were categorized using modified TI-RADS classification, then were classified as "malignant" (m-MTC) or "US-low-suspicious" (l-MTC). We compared the biological behavior between the two groups, and further analyzed the risk factors for the recurrence. Results A total of 78 patients were enrolled, of which 55 m-MTC (70.5%) and 23 l-MTC (29.5%) were identified. The N staging of the m-MTC was significantly higher than that of l-MTC(P = 0.000). The preoperative serum Ct level in m-MTC were significantly higher than that of l-MTC(P = 0.035). Biochemical cure were more frequent in l-MTC than that of m-MTC (P = 0.002). Disease recurrence rates were 19.7% (14 of 71). Disease recurrence was more frequent in m-MTC than that of l-MTC (P = 0.013). Disease recurrence was positively associated with extrathyroid extension (P = 0.047), N staging (P = 0.003), preoperative serum Ct level (P = 0.009) and negatively associated with biochemical cure(P = 0.000). In multivariable Cox regression analysis, extrathyroid extension and biochemical cure were independent risk factors for recurrence of MTC. Conclusions L-MTC has a more indolent character than m-MTC. The extrathyroid extension and biochemical cure were independent risk factors for recurrence of MTC.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Biochemistry</subject><subject>Cancer</subject><subject>Carcinoma, Neuroendocrine - diagnostic imaging</subject><subject>Diseases</subject><subject>Female</subject><subject>Humans</subject><subject>Life Sciences &amp; Biomedicine</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical colleges</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Medullary thyroid cancer</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Nodules</subject><subject>Oncology</subject><subject>Prognosis</subject><subject>Radiology, Nuclear Medicine &amp; Medical Imaging</subject><subject>Recurrence</subject><subject>Regression analysis</subject><subject>Relapse</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Science &amp; Technology</subject><subject>Serum Ct</subject><subject>Surgery</subject><subject>Surgical implants</subject><subject>Thyroid cancer</subject><subject>Thyroid Neoplasms - diagnostic imaging</subject><subject>TI-RADS</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonic testing</subject><subject>Ultrasonography - methods</subject><subject>Ultrasound</subject><subject>Young Adult</subject><issn>1740-5025</issn><issn>1470-7330</issn><issn>1470-7330</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNqNkktr3DAUhU1padK0f6CLYiiUQnF69bKlTSAMfQQC3SRrIesxo8FjpZKcIf--8kw6zZQuigy6yN898j0-VfUWwTlCvP2cKLSUNoBRA0ABN9tn1SmiHTQdIfC81B2FhgFmJ9WrlNYAWHDRvaxOCOGk5QSdVje3Q44qhWk0tbMqT9GmOrh6Y800DCo-1Hn1EIM3tVajtrFWqb6L1nidQ9yRvQ9DWHqthrq3K3XvQ3xdvXBqSPbN435W3X79crP43lz_-Ha1uLxuNBM0N4YSYwEEwVjRXmCDCQIArTtOnOgFOMs73iOOuBFKobaFXmhDS6W06Rw5q672uiaotbyLflM-WAbl5e4gxKVUMXs9WAlF0DlrHHOC4l5wTLEQtDwt1cKZonWx17qb-jK8tmPxZTgSPX4z-pVchnvJgZC2w0Xg46NADD8nm7Lc-KRtMXG0YUoSM4QwJYhCQd__ha7DFMdi1UxRjhll7A-1VGUAP7pQ7tWzqLxsGWcMOjRfe_4PqixjN16H0Tpfzo8aPjxpWFk15FUKw5R9GNMxiPegjiGlaN3BDARyDqDcB1CWAMpdAOW2NL17auOh5XfiCvBpD2xtH1zS3pZYHbDy-1vCmZhzADDT_P_phc9qnmJR0pzJL7n49bY</recordid><startdate>20210409</startdate><enddate>20210409</enddate><creator>Zhao, Jingzhu</creator><creator>Zheng, Xiangqian</creator><creator>Gao, Ming</creator><creator>Zhang, Sheng</creator><creator>Yun, Xinwei</creator><creator>Chi, Jiadong</creator><creator>Xu, Guangwei</creator><general>Springer Nature</general><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>P5Z</scope><scope>P62</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-0034-0235</orcidid><orcidid>https://orcid.org/0000-0003-0304-8635</orcidid></search><sort><creationdate>20210409</creationdate><title>Ultrasound features of medullary thyroid cancer as predictors of biological behavior</title><author>Zhao, Jingzhu ; Zheng, Xiangqian ; Gao, Ming ; Zhang, Sheng ; Yun, Xinwei ; Chi, Jiadong ; Xu, Guangwei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c594t-d43de009322a4b92d231000cc783f9b90fe878b1818d9aa1660b9cd4a16acd7f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Analysis</topic><topic>Biochemistry</topic><topic>Cancer</topic><topic>Carcinoma, Neuroendocrine - diagnostic imaging</topic><topic>Diseases</topic><topic>Female</topic><topic>Humans</topic><topic>Life Sciences &amp; Biomedicine</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medical colleges</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Medullary thyroid cancer</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Nodules</topic><topic>Oncology</topic><topic>Prognosis</topic><topic>Radiology, Nuclear Medicine &amp; Medical Imaging</topic><topic>Recurrence</topic><topic>Regression analysis</topic><topic>Relapse</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Science &amp; Technology</topic><topic>Serum Ct</topic><topic>Surgery</topic><topic>Surgical implants</topic><topic>Thyroid cancer</topic><topic>Thyroid Neoplasms - diagnostic imaging</topic><topic>TI-RADS</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonic testing</topic><topic>Ultrasonography - methods</topic><topic>Ultrasound</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhao, Jingzhu</creatorcontrib><creatorcontrib>Zheng, Xiangqian</creatorcontrib><creatorcontrib>Gao, Ming</creatorcontrib><creatorcontrib>Zhang, Sheng</creatorcontrib><creatorcontrib>Yun, Xinwei</creatorcontrib><creatorcontrib>Chi, Jiadong</creatorcontrib><creatorcontrib>Xu, Guangwei</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; 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Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Advanced Technologies &amp; Aerospace Database</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Cancer imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhao, Jingzhu</au><au>Zheng, Xiangqian</au><au>Gao, Ming</au><au>Zhang, Sheng</au><au>Yun, Xinwei</au><au>Chi, Jiadong</au><au>Xu, Guangwei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultrasound features of medullary thyroid cancer as predictors of biological behavior</atitle><jtitle>Cancer imaging</jtitle><stitle>CANCER IMAGING</stitle><addtitle>Cancer Imaging</addtitle><date>2021-04-09</date><risdate>2021</risdate><volume>21</volume><issue>1</issue><spage>33</spage><epage>33</epage><pages>33-33</pages><artnum>33</artnum><issn>1740-5025</issn><issn>1470-7330</issn><eissn>1470-7330</eissn><abstract>Background Medullary thyroid cancer (MTC) has more aggressive behavior and poor prognosis. Ultrasound (US) has facilitated the qualitative diagnosis of thyroid nodules, however, some MTC may be diagnosed as a benign nodule on ultrasound because ultrasound features of malignancy are lacking. The aim of the study was to investigate the association between ultrasound features and biological behavior of MTC. Methods Ultrasound findings and medical records of patients with MTC between Jan 2015 to Jun 2017 were retrospectively reviewed at Tianjin Medical University Cancer Institute and Hospital. MTC were categorized using modified TI-RADS classification, then were classified as "malignant" (m-MTC) or "US-low-suspicious" (l-MTC). We compared the biological behavior between the two groups, and further analyzed the risk factors for the recurrence. Results A total of 78 patients were enrolled, of which 55 m-MTC (70.5%) and 23 l-MTC (29.5%) were identified. The N staging of the m-MTC was significantly higher than that of l-MTC(P = 0.000). The preoperative serum Ct level in m-MTC were significantly higher than that of l-MTC(P = 0.035). Biochemical cure were more frequent in l-MTC than that of m-MTC (P = 0.002). Disease recurrence rates were 19.7% (14 of 71). Disease recurrence was more frequent in m-MTC than that of l-MTC (P = 0.013). Disease recurrence was positively associated with extrathyroid extension (P = 0.047), N staging (P = 0.003), preoperative serum Ct level (P = 0.009) and negatively associated with biochemical cure(P = 0.000). In multivariable Cox regression analysis, extrathyroid extension and biochemical cure were independent risk factors for recurrence of MTC. Conclusions L-MTC has a more indolent character than m-MTC. The extrathyroid extension and biochemical cure were independent risk factors for recurrence of MTC.</abstract><cop>LONDON</cop><pub>Springer Nature</pub><pmid>33836831</pmid><doi>10.1186/s40644-021-00402-w</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-0034-0235</orcidid><orcidid>https://orcid.org/0000-0003-0304-8635</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Aged
Analysis
Biochemistry
Cancer
Carcinoma, Neuroendocrine - diagnostic imaging
Diseases
Female
Humans
Life Sciences & Biomedicine
Lymphatic system
Male
Medical colleges
Medical records
Medical research
Medicine, Experimental
Medullary thyroid cancer
Metastasis
Middle Aged
Nodules
Oncology
Prognosis
Radiology, Nuclear Medicine & Medical Imaging
Recurrence
Regression analysis
Relapse
Retrospective Studies
Risk analysis
Risk factors
Science & Technology
Serum Ct
Surgery
Surgical implants
Thyroid cancer
Thyroid Neoplasms - diagnostic imaging
TI-RADS
Ultrasonic imaging
Ultrasonic testing
Ultrasonography - methods
Ultrasound
Young Adult
title Ultrasound features of medullary thyroid cancer as predictors of biological behavior
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