Thyroid cancer is a common malignancy of endocrine system, and has now become the fastest increasing cancer among all the malignancies. The development, progression, invasion, and metastasis are closely associated with multiple signaling pathways and the functions of related molecules, such as Src, Janus kinase (JAK)-signal transducers and activators of transcription (STAT), mitogen-activated protein kinase (MAPK), phosphoinositide 3-kinase (PI3K)/Akt, NF-κB, thyroid stimulating hormone receptor (TSHR), Wnt-β-catenin and Notch signaling pathways. Each of the signaling pathways could exert its function singly or through network with other pathways. These pathways could cooperate, promote, antagonize, or interact with each other to form a complex network for the regulation. Dysfunction of this network could increase the development, progression, invasion, and metastasis of thyroid cancer. Inoperable thyroid cancer still has a poor prognosis. However, signaling pathway-related targeted therapies offer the hope of longer quality of meaningful life for this small group of patients. Signaling pathway-related targets provide unprecedented opportunities for further research and clinical development of novel treatment strategies for this cancer. In the present work, the advances in these signaling pathways and targeted treatments of thyroid cancer were reviewed.
This study aimed to establish a model for predicting lateral neck lymph node metastasis in patients with papillary thyroid carcinoma. A total of 106 patients with papillary thyroid carcinoma undergoing initial treatment of neck lymph node dissection (including central and lateral neck lymph nodes) at the thyroid surgery department were enrolled from January 2009 to April 2017. Logistic regression analysis was used to screen the factors influencing lateral neck lymph node metastasis and develop a prediction model. The receiver operating characteristic curve was used to evaluate the predictive power and boundary value of the model for lateral neck lymph node metastasis. Prediction model: Logistic(P) = −5.699 + 0.681 × (TSH) + 0.342 × (Metastatic rate of central lymph nodes) + 1.463 × (Combined with Hashimoto’s disease) + 1.525 × (Number of tumors). When logistic (P) was ≥ 0.821, it was predicted that lateral neck lymph node metastasis occurred in patients with papillary thyroid carcinoma. When logistic (P) was <0.821, it was predicted that no metastasis was found in the lateral neck lymph node. The prediction accuracy was 78.3%. The model helped in evaluating lateral neck lymph node metastasis in patients with papillary thyroid carcinoma. Also, it had significance in determining reasonable surgical range, reducing unnecessary lateral neck lymph node dissection, and further improving the quality of life of patients.
Background. Thyroidectomy is one of the most frequently performed surgical procedures worldwide. Despite technical advances and high experience of thyroidectomy of specialized centers, it is still burdened by a significant rate of postoperative complications. Among them, the skin sinus formation is an extremely rare postthyroidectomy complication. Here, we first report the incidence of the skin sinus formation after thyroidectomy to identify the causes for skin sinus formation after thyroidectomy and to discuss its prevention and treatment options. Methods. A retrospective analysis was carried out of patients who underwent excision operation of fistula for postthyroidectomy skin sinus formation. Data were retrieved from medical records department of the Affiliated Hospital of Inner Mongolia Medical University. Results. Of the 5,686 patients who underwent thyroid surgery, only 5 patients (0.088%) had developed skin sinus formation. All 5 patients successfully underwent complete excision of fistula. Conclusion. Infection, foreign body, thyroid surgery procedure, combined disease, and iatrogenic factors may be related with skin sinus formation after thyroidectomy. To reduce the recurrence of postoperative infections and sinus formation, intra- and postoperative compliance with aseptic processing, intraoperative use absorbable surgical suture/ligature, repeated irrigation and drainage, and postoperative administration of anti-inflammatory treatment are to be followed.
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