Restratification of survival prognosis of N1b papillary thyroid cancer by lateral lymph node ratio and largest lymph node size

Kim, Hye In; Kim, Tae Hyuk; Choe, Jun-Ho; Kim, Jung-Han; Kim, Jee Soo; Oh, Young Lyun; Hahn, Soo Yeon; Shin, Jung Hee; Jang, Hye Won; Kim, Young Nam; Kim, Hosu; Ahn, Hyeon Seon; Kim, Kyunga; Kim, Sun Wook

doi:10.1002/cam4.1160

Cited by 15 publications

(9 citation statements)

References 32 publications

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“…In the 8th AJCC staging system, any lymph node involvement in either the central or lateral neck defines a patient as stage group II (in the absence of gross extrathyroidal extension or distant metastases) in patients aged 55 years or older. While in a number of studies, the presence of lymph node metastasis was associated with a statistically significant decrease in survival rate (46,47). Furthermore, lateral lymph node metastasis is considered to be an independent prognostic risk factor in patients with thyroid carcinoma (48,49).…”

Section: Discussionmentioning

confidence: 99%

Low expression of ryanodine receptor 2 is associated with poor prognosis in thyroid carcinoma

Zhang

Chen

et al. 2019

Oncol Lett

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Genetic alterations are vital in the progression of thyroid carcinoma. Ryanodine receptor 2 (RyR2) is reported to serve an important role in several types of human carcinoma. However, the expression and effect of RyR2 in thyroid carcinoma remain unknown. Therefore, the present study analyzed the status of RyR2 in thyroid carcinoma using bioinformatics tools. The mRNA profiles of thyroid carcinoma were downloaded from The Cancer Genome Atlas. RyR2 was distinguished as a differentially expressed gene that has not been reported in thyroid carcinoma. Further analysis indicated that there was selective downregulation of RyR2 expression in thyroid carcinoma tissues compared with that in normal thyroid tissues. Survival analysis showed that RyR2 expression was associated with poorer disease-free survival (DFS) for all patients with thyroid carcinoma. Univariate analysis revealed that a low expression of RyR2 was significantly associated with lymphatic metastasis, extracapsular extension, and the Tumor-Node-Metastasis stage. Cox analysis demonstrated that RyR2 was an independent prognostic factor in thyroid carcinoma for DFS. The biological processes and signaling pathways of RyR2 were reviewed with Gene Set Enrichment Analysis. In conclusion, the present study has revealed that RyR2 is downregulated in thyroid carcinoma, and that low expression of RyR2 is associated with poor prognosis in patients with thyroid carcinoma. RyR2 may therefore serve as a promising tumor suppressor gene in thyroid carcinoma.

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Section: Discussionmentioning

confidence: 99%

Low expression of ryanodine receptor 2 is associated with poor prognosis in thyroid carcinoma

Zhang

Chen

et al. 2019

Oncol Lett

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“…DEG, differentially expressed gene. patients have a good prognosis (24,25). Many studies have examined the prognosis of the thyroid gland; for example, studies have been conducted on the BRAF gene mutation, RAS gene mutation, rearranged during transfection gene rearrangement, telomerase reverse transcriptase promoter mutation, and phosphatase and TENsin gene mutation.…”

Section: Discussionmentioning

confidence: 99%

The relationship between autophagy-related genes and the staging and prognosis of thyroid cancer: a bioinformatics analysis

Gao

Miao

2021

Gland Surg

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Background: The number of patients with thyroid cancer is increasing. Autophagy is closely related to thyroid cancer. This study conducted a bioinformatics analysis to examine the relationship between autophagy-related genes and the prognosis of thyroid cancer. Methods: Based on The Cancer Genome Atlas (TCGA) database, the standardized ribonucleic acid (RNA) sequencing data and corresponding clinical records of 497 patients were obtained. The gene set of autophagy-related genes was obtained from reactom [https://reactome.org/; gene set identification: (R-HSA-1632852)]. Based on the completeness of the sequencing and prognostic data, 135 effective genes were screened to form a gene set. A cluster analysis of the genetic expression of the whole genome was conducted. Different groups and subgroups were defined according to the clustering situation. The relationship between the expression levels of different autophagy-related genes and the clinical characteristics of thyroid cancer were analyzed. Results: Patients were divided into 2 clusters and 4 subclusters. A comparison of the clinical parameters of the 2 clusters showed that there were differences in node (N)-stage, and a comparison of the 4 subclusters showed that there were differences in age and 4 other characteristics. In relation to the survival comparison, there was a difference in the disease-free survival (DFS) between the 2 clusters, and there was a difference in overall survival (OS) and DFS between subclusters. The 2 clusters had 114 differentially expressed genes (DEGs), and the 4 subclusters had 131 DEGs. In relation to the 5 different factors in each group, there were differences in the distribution of N0N1NX in clusters and subclusters, there were differences in the distribution of M0M1MX in subclusters, and there were differences in the distribution of age and the American Joint Committee on Cancer stage in subclusters. In relation to the stage/N stage/Metastasis (M) stage-related DEGs, 5 common genes were identified: EPAS1, ATG4A, BECN1, ATG4C, and PLIN3. In relation to the stage/N stage/M stage-related DEGs and age-related DEGs 1 common gene was identified: EPAS1. Conclusions: Autophagy-related genes are related to the staging of thyroid cancer, but have no clear relationship with long-term prognosis.

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“…This definition thus referred to both recurrent and biochemically persistent disease that was newly identified in imaging studies. Recurrence-free survival was defined as the time interval (in months) between the initial surgery date and the most recent follow-up date for patients without structural persistent/recurrent disease (13)(14)(15)(16)(17).…”

Section: Study Design and Statistical Analysismentioning

confidence: 99%

Impact of Extranodal Extension on Risk Stratification in Papillary Thyroid Carcinoma

Kim

Hyeon

Park

et al. 2019

Thyroid

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Background: The current American Thyroid Association risk-stratification system for papillary thyroid carcinoma (PTC) incorporates the number and size of positive lymph nodes (LNs) but places less weight on extranodal extension (ENE). This study investigated how to incorporate ENE into the current system to predict recurrence better in PTC N1 patients. Methods: A total of 369 N1 PTC patients without distant metastasis were enrolled. The combination of number of positive LNs and LNs with ENE that had the highest C-index were identified with multivariable Cox proportional hazards models. ENE number was incorporated into the current system considering the recurrence rate and unadjusted and adjusted hazard ratios (HRs) of the subgroups. Kaplan-Meier curves for recurrence based on current and alternative systems were compared by log-rank test. Results: The recurrence rate for the subgroup with five or fewer positive LNs and one to three ENEs (7/61; 11.5%) was higher than that of the subgroup with five or fewer positive LNs without ENE (5/129; 3.9%; adjusted HR = 3.42 [confidence interval (CI) 0.99-11.75]; p = 0.050). In contrast, adjusted HRs of the subgroup with more than five positive LNs and one to three ENEs (2.33 [CI 0.52-10.35]) or with four or more ENEs (3.86 [CI 1.05-14.17]) were not higher than those of the subgroup with more than five LNs without ). Incorporating ENE into the current system as an intermediate-risk group yielded a lower log-rank p-value (0.05 vs. 0.01) than the current system. Conclusions: The presence of ENE in low volume LN metastasis confers an intermediate risk of recurrence.Incorporating ENE into the current system allows more accurate decisions regarding further management of PTC N1 patients.

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Restratification of survival prognosis of N1b papillary thyroid cancer by lateral lymph node ratio and largest lymph node size

Cited by 15 publications

References 32 publications

Low expression of ryanodine receptor 2 is associated with poor prognosis in thyroid carcinoma

Low expression of ryanodine receptor 2 is associated with poor prognosis in thyroid carcinoma

The relationship between autophagy-related genes and the staging and prognosis of thyroid cancer: a bioinformatics analysis

Impact of Extranodal Extension on Risk Stratification in Papillary Thyroid Carcinoma

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