In order to clarify the molecular mechanism involved in thyroid carcinogenesis and to identify candidate molecular targets for diagnosis and treatment, we analyzed genome-wide gene expression profiles of 18 papillary thyroid carcinomas with a microarray representing 38,500 genes in combination with laser microbeam microdissection. We identified 243 transcripts that were commonly up-regulated and 138 transcripts that were down-regulated in thyroid carcinoma. Among these 243 transcripts identified, only 71 transcripts were reported as up-regulated genes in previous microarray studies, in which bulk cancer tissues and normal thyroid tissues were used for the analysis. We further selected genes that were overexpressed very commonly in thyroid carcinoma, though were not expressed in the normal human tissues examined. Among them, we focused on the regulator of G-protein signaling 4 (RGS4) and knocked-down its expression in thyroid cancer cells by small-interfering RNA. The effective down-regulation of its expression levels in thyroid cancer cells significantly attenuated viability of thyroid cancer cells, indicating the significant role of RGS4 in thyroid carcinogenesis. Our data should be helpful for a better understanding of the tumorigenesis of thyroid cancer and could contribute to the development of diagnostic tumor markers and molecular-targeting therapy for patients with thyroid cancer.

In recent years, there are numerous reports indicating the presence of familial papillary carcinoma. Unfortunately, no genetic defect can be linked directly to the disease. In this study, we set the goal to make a retrospective analysis of the cases with papillary carcinoma in the Department of Endocrine Surgery for the past 10 years, to compare the characteristics of sporadic and familial forms of the disease and to find families with hereditary papillary carcinoma. The study included 810 patients treated for thyroid cancer in the Department of Endocrine Surgery, USBALE "Acad. Iv. Penchev" Hospital, between January 1, 2006 and December 31, 2015. We used chi square test to determine statistical significant difference. The data analysis and interpretation was performed on SPSS 20.0. Both groups had similar demographic distribution. We found that 587 patients have sporadic papillary carcinoma, while 147 have a relative with thyroid pathology in the first degree of kinship. In 8 patients, there was a blood relative with thyroid cancer. When we compared the two groups, we found statistically significant difference only in tumor size. There was no significant difference in aggressiveness of the thyroid cancer (multifocality and lymph node metastasis). When analyzing the results, we identified 147 patients with a family history of thyroid disease (20%). In 8 patients (5.44%), we found at least one relative with papillary thyroid carcinoma. However, our study does not demonstrate any difference in the aggressiveness of familial and sporadic papillary thyroid carcinoma.

<b><i>Background:</i></b> Several thyroid societies have endorsed ultrasound (US) malignancy risk stratification systems for thyroid nodules and the recently released European Thyroid Imaging Reporting and Data System (EU-TIRADS) needs large prospective studies for validation. <b><i>Objective:</i></b> The purpose of our study was to evaluate the performance of EU-TIRADS in identifying thyroid nodules for fine-needle aspiration biopsy (FNAB) and its ability to reduce the number of unnecessary biopsies. <b><i>Methods:</i></b> This was a single-center prospective study. From August 2017 to September 2018, 783 consecutive patients with 1,000 thyroid nodules underwent US examination and US-guided FNAB. A total of 741 patients (median age 50 years; range, 15–87 years; 649 females, 92 males) with 942 nodules (median largest diameter 14 mm; range, 4–96 mm) met the following inclusion criteria: (1) nodules with benign or malignant cytology – categories II and VI of the Bethesda System for Reporting Thyroid Cytopathology (BSRTC); (2) nodules with non-diagnostic and indeterminate cytology (BSRTC I, BSRTC III, and BSRTC IV), or suspicious for malignancy (BSRTC V), if postoperative histology was present; (3) nodules classified as BSRTC I and BSRTC III with a repeat FNAB and conclusive cytology. <b><i>Results:</i></b> Of 942 nodules, 839 (89.1%) were benign and 103 (10.9%) were malignant. Nodules were classified as follows: EU-TIRADS 2 – 4.8%, EU-TIRADS 3 – 37.4%, EU-TIRADS 4 – 25.2%, and EU-TIRADS 5 – 32.6%. The malignancy rate in categories 2 to 5 was 0, 0, 3.8, and 30.6%, respectively. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of EU-TIRADS with a cut-off set at category 5 were 91.3, 74.6, 30.6, 98.6, and 76.4%, respectively. Diagnostic performance other than sensitivity and NPV was superior in nodules ≥10 mm. FNAB number would be reduced by 53.4% if FNAB criteria were strictly applied. When the indication for FNAB was applied as test positivity, the estimated sensitivity, specificity, PPV, and NPV of EU-TIRADS were 69.9, 56.3, 16.4, and 93.8%, respectively. <b><i>Conclusion:</i></b> EU-TIRADS provides effective malignancy risk stratification that can guide the selection of thyroid nodules for biopsy. The application of the guidelines criteria for FNAB in the clinical practice might reduce significantly the number of unnecessary FNAB.

No abstract

Objective:The purpose of this prospective study was to evaluate the efficacy and safety in the application of ultrasonic scalpel compared to conventional operative technique in open surgery of the thyroid gland. Methods:The study included 100 patients operated between May 2013 and August 2013. Patients were divided into two groups -50 patients were operated using So-noSurg® and 50 patients were operated using classic "clamp and Tie" technique. We evaluated and compared the outcome between the two groups.Results: Both groups had a similar distribution in the demographic features such as gender, age, functional activity and malignant diseases of the thyroid gland. When comparing the results, we found a significant reduction in the duration of surgery in patients operated with So-noSurg® (SST group) (72 ± 20 min vs 100 ± 32 min, p = 0.01). There was no difference for fluid in the vacuum drainage during the first 24 hrs. Hospital stay of patients in both groups was similar -an average of 3 days stay into the clinic. Conclusion:Our results showed that "ultrasonic scalpel" is an effective, easy to use and completely reliable method for achieving hemostasis with visible advantages over classical operational technique. J Clin Exp Invest 2015; 6 (3): [209][210][211][212][213]