Endocrinology and Metabolism

Original Articles

Thyroid
Diagnostic Performance of Thyroid Core Needle Biopsy Using the Revised Reporting System: Comparison with Fine Needle Aspiration Cytology: Kwangsoon Kim, Ja Seong Bae, Jeong Soo Kim, So Lyung Jung, Chan Kwon Jung; Endocrinol Metab. 2022;37(1):159-169. Published online February 28, 2022; DOI: https://doi.org/10.3803/EnM.2021.1299

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Background
We aim to validate the diagnostic performance of thyroid core needle biopsy (CNB) for diagnosing malignancy in clinical settings to align with the changes made in recently updated thyroid CNB guidelines.
Methods
We retrospectively analyzed 1,381 thyroid CNB and 2,223 fine needle aspiration (FNA) samples. The FNA and CNB slides were interpreted according to the Bethesda System for Reporting Thyroid Cytopathology and updated practice guidelines for thyroid CNB, respectively.
Results
Compared to FNA, CNB showed lower rates of inconclusive results: categories I (2.8% vs. 11.2%) and III (1.2% vs. 6.2%), and higher rates of categories II (60.9% vs. 50.4%) and IV (17.5% vs. 2.0%). The upper and lower bounds of the risk of malignancy (ROM) for category IV of CNB were 43.2% and 26.6%, respectively. The CNB subcategory IVb with nuclear atypia had a higher ROM than the subcategory without nuclear atypia (40%–62% vs. 23%–36%). In histologically confirmed cases, there was no significant difference in the diagnostic performance between CNB and FNA for malignancy. However, neoplastic diseases were more frequently detected by CNB than by FNA (88.8% vs. 77.6%, P=0.046). In category IV, there was no difference in unnecessary surgery rate between CNB and FNA (4.7% vs. 6.9%, P=0.6361).
Conclusion
Thyroid CNB decreased the rate of inconclusive results and showed a higher category IV diagnostic rate than FNA. The revised guidelines for thyroid CNB proved to be an excellent reporting system for assessing thyroid nodules.

Citations

Citations to this article as recorded by

Examining the impact of several factors including COVID‐19 on thyroid fine‐needle aspiration biopsy
Muzaffer Serdar Deniz, Merve Dindar
Diagnostic Cytopathology.2024; 52(1): 42. CrossRef
Consensus SFE-AFCE-SFMN 2022 sur la prise en charge des nodules thyroïdiens : intérêt et place de la cytologie thyroïdienne
Myriam Decaussin-Petrucci, Beatrix Cochand Priollet, Emannuelle Leteurtre, Frédérique Albarel, Françoise Borson-Chazot
Annales de Pathologie.2024; 44(1): 20. CrossRef
A comparative analysis of core needle biopsy and repeat fine needle aspiration in patients with inconclusive initial cytology of thyroid nodules
Xuejiao Su, Can Yue, Wanting Yang, Buyun Ma
Frontiers in Endocrinology.2024;[Epub] CrossRef
Preoperative Risk Stratification of Follicular-patterned Thyroid Lesions on Core Needle Biopsy by Histologic Subtyping and RAS Variant-specific Immunohistochemistry
Meejeong Kim, Sora Jeon, Chan Kwon Jung
Endocrine Pathology.2023; 34(2): 247. CrossRef
2023 Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules
Young Joo Park, Eun Kyung Lee, Young Shin Song, Soo Hwan Kang, Bon Seok Koo, Sun Wook Kim, Dong Gyu Na, Seung-Kuk Baek, So Won Oh, Min Kyoung Lee, Sang-Woo Lee, Young Ah Lee, Yong Sang Lee, Ji Ye Lee, Dong-Jun Lim, Leehi Joo, Yuh-Seog Jung, Chan Kwon Jung
International Journal of Thyroidology.2023; 16(1): 1. CrossRef
Reevaluating diagnostic categories and associated malignancy risks in thyroid core needle biopsy
Chan Kwon Jung
Journal of Pathology and Translational Medicine.2023; 57(4): 208. CrossRef
A Matched-Pair Analysis of Nuclear Morphologic Features Between Core Needle Biopsy and Surgical Specimen in Thyroid Tumors Using a Deep Learning Model
Faridul Haq, Andrey Bychkov, Chan Kwon Jung
Endocrine Pathology.2022; 33(4): 472. CrossRef

Diabetes, Obesity and Metabolism Big Data Articles (National Health Insurance Service Database)
Drug Repositioning Using Temporal Trajectories of Accompanying Comorbidities in Diabetes Mellitus: Namgi Park, Ja Young Jeon, Eugene Jeong, Soyeon Kim, Dukyong Yoon; Endocrinol Metab. 2022;37(1):65-73. Published online February 8, 2022; DOI: https://doi.org/10.3803/EnM.2021.1275

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Background
Most studies of systematic drug repositioning have used drug-oriented data such as chemical structures, gene expression patterns, and adverse effect profiles. As it is often difficult to prove repositioning candidates’ effectiveness in real-world clinical settings, we used patient-centered real-world data for screening repositioning candidate drugs for multiple diseases simultaneously, especially for diabetic complications.
Methods
Using the National Health Insurance Service-National Sample Cohort (2002 to 2013), we analyzed claims data of 43,048 patients with type 2 diabetes mellitus (age ≥40 years). To find repositioning candidate disease-drug pairs, a nested case-control study was used for 29 pairs of diabetic complications and the drugs that met our criteria. To validate this study design, we conducted an external validation for a selected candidate pair using electronic health records.
Results
We found 24 repositioning candidate disease-drug pairs. In the external validation study for the candidate pair cerebral infarction and glycopyrrolate, we found that glycopyrrolate was associated with decreased risk of cerebral infarction (hazard ratio, 0.10; 95% confidence interval, 0.02 to 0.44).
Conclusion
To reduce risks of diabetic complications, it would be possible to consider these candidate drugs instead of other drugs, given the same indications. Moreover, this methodology could be applied to diseases other than diabetes to discover their repositioning candidates, thereby offering a new approach to drug repositioning.

Citations

Citations to this article as recorded by

Drug Repositioning: Exploring New Indications for Existing Drug-Disease Relationships
Hun-Sung Kim
Endocrinology and Metabolism.2022; 37(1): 62. CrossRef

Diabetes
Retrospective Analysis of the Efficacy of Dapagliflozin in Patients with Type 2 Diabetes in a Primary Clinic in Korea: Sang Hyun Park, Young Ju Choi, Eun-Jung Rhee, Kab Bum Huh; Endocrinol Metab. 2019;34(1):70-79. Published online March 21, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.1.70

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Background

We aimed to retrospectively analyze the efficacy of 10 mg dapagliflozin (DAPA), which is a sodium-glucose cotransporter-2 inhibitor, in Korean patients with type 2 diabetes who visited a primary diabetes clinic.

Methods

In total, 83 patients with type 2 diabetes, who received treatment with DAPA for the first time in a primary diabetes clinic between January 2015 and October 2015, were included in the study. The effect of DAPA in lowering glycosylated hemoglobin (HbA1c) levels was evaluated via chart review at 6 months follow-up. The patients were categorized into five groups according to add-on to or switched from other glucose-lowering agents: add-on to metformin (MET, n=10), add-on to MET+dipeptidyl peptidase 4 inhibitor (DPP4i, n=12), switched from sulfonylurea (SU, n=13), switched from DPP4i (n=11), and switched from thiazolidinedione (TZD, n=37). All the participants had already used MET for their regimen.

Results

Treatment with DAPA reduced HbA1c level by 1.2%±0.8%. Moreover, a significant decrease was observed in all subgroups: add-on to MET, −1.2%±0.7%; add-on to MET+DPP4i, −1.4%±0.8%; switched from SU, −1.4%±0.7%; switched from DPP4i, −0.5%±0.7%; and switched from TZD, −1.2%±0.9% (P<0.01). A significant decrease in body weight (−3.1±2.6 kg, P<0.001) was observed after DAPA administration. Estimated glomerular filtration rate and urine microalbumin were significantly decreased after 6 months of treatment with DAPA (−4.0±13.5 mL/min/1.73 m², P=0.03; −23.6±45.9 mg/L, P<0.001).

Conclusion

Treatment with DAPA, whether added to or switched from other glucose-lowering agents, significantly decreased HbA1c levels in Korean patients with type 2 diabetes who visited a single primary diabetes clinic. DAPA can be considered as an optimal second-line treatment for patients with type 2 diabetes, as supported by real-world evidence studies.

Citations

Citations to this article as recorded by

The sodium glucose co-transporter 2 inhibitor dapagliflozin ameliorates the fluid-retaining effect of the endothelin A receptor antagonist zibotentan
Vandana Veenit, Hiddo J L Heerspink, Christine Ahlström, Peter J Greasley, Stanko Skritic, Natalie van Zuydam, Donald E Kohan, Pernille B L Hansen, Robert I Menzies
Nephrology Dialysis Transplantation.2023; 38(10): 2289. CrossRef

Poorly Differentiated Thyroid Carcinoma: 10-Year Experience in a Southeast Asian Population: Marc Gregory Yu, Jonathan Rivera, Cecilia Jimeno; Endocrinol Metab. 2017;32(2):288-295. Published online June 23, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.2.288

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Background

No previous studies have been published on poorly differentiated thyroid carcinoma (PDTC) in Southeast Asia.

Methods

We included all adult PDTC patients diagnosed using the Turin criteria at the Philippine General Hospital from 2006 to 2015. The data collected included demographics, clinical presentation, histopathology, treatment, and outcomes. Tests of association were employed to compare these data with foreign studies on PDTC, as well as with local studies on well differentiated thyroid carcinoma (WDTC) and anaplastic thyroid carcinoma (ATC).

Results

Eighteen PDTC cases were identified. The median age was 62 years old, with the majority being females. All patients had goiter on presentation, and most were stage IV at the time of diagnosis. In terms of PDTC subtype, insular and trabecular patterns were equally common. Extrathyroidal extension was documented in eight patients, while five patients each had nodal and distant metastasis. All but one patient underwent surgery; however, less than half received adjuvant radioiodine therapy. The 5-year survival rate was 83%. Three patients (16.7%) died at a median of 12 months after diagnosis. Nine (50%) are still alive with persistent and/or recurrent disease at a median of 39 months after diagnosis.

Conclusion

The behavior of PDTC in this Southeast Asian population was found to be similar to patterns observed in other regions, and exhibited intermediate features between WDTC and ATC. Appropriate surgery provided excellent 5-year survival rates, but the role of adjuvant therapy remains unclear. Larger studies are needed to identify prognostic factors in this population.

Citations

Citations to this article as recorded by

Poorly differentiated thyroid carcinomas: conceptual controversy and clinical impact
Andrés Coca-Pelaz, Juan P. Rodrigo, Abbas Agaimy, Michelle D. Williams, Nabil F. Saba, Sandra Nuyts, Gregory W. Randolph, Fernando López, Vincent Vander Poorten, Luiz P. Kowalski, Francisco J. Civantos, Mark E. Zafereo, Antti A. Mäkitie, Oded Cohen, Iain
Virchows Archiv.2024;[Epub] CrossRef
Management of Poorly Differentiated Thyroid Cancer and Differentiated High-Grade Thyroid Carcinoma
Iram S. Alam, Kepal N. Patel
Surgical Clinics of North America.2024;[Epub] CrossRef
I-131 Avid Tumor Thrombus in a Case of Poorly Differentiated Thyroid Cancer
Sana Munir Gill, Aamna Hassan, Humayun Bashir, Waqas Shafiq
Molecular Imaging and Radionuclide Therapy.2023; 32(2): 178. CrossRef
Prognostic Impact of Focal Poorly Differentiated Areas in Follicular Differentiated Thyroid Cancer: Is It a Distinct Entity from Poorly Differentiated Thyroid Cancer?
Ramakanth Bhargav Panchangam, Pradeep Puthenveetil, Sabaretnam Mayilvaganan
Indian Journal of Surgical Oncology.2022; 13(1): 157. CrossRef
Newly proposed survival staging system for poorly differentiated thyroid cancer: a SEER-based study
W. Sun, Z. Wang, J. Xiang, Y. Qin, F. Zhang, H. Zhang
Journal of Endocrinological Investigation.2022; 46(5): 947. CrossRef
Clinicopathological Characteristics and Prognosis of Poorly Differentiated Thyroid Carcinoma Diagnosed According to the Turin Criteria
Jiapeng Huang, Wei Sun, Qingfu Zhang, Zhihong Wang, Wenwu Dong, Dalin Zhang, Chengzhou Lv, Liang Shao, Ping Zhang, Hao Zhang
Endocrine Practice.2021; 27(5): 401. CrossRef
Osteopontin Expression in Thyroid Cancer: Deciphering EMT-Related Molecular Mechanisms
Bruna Prunes Pena Baroni Viana, Amanda Vitória Pampolha Gomes, Etel Rodrigues Pereira Gimba, Luciana Bueno Ferreira
Biomedicines.2021; 9(10): 1372. CrossRef
Poorly differentiated thyroid carcinoma (PDTC) characteristics and the efficacy of radioactive iodine (RAI) therapy as an adjuvant treatment in a tertiary cancer care center
Shivakumar Thiagarajan, Aamir Yousuf, Ratan Shetty, Harsh Dhar, Yash Mathur, Deepa Nair, Sandeep Basu, Asawari Patil, Shubadha Kane, Sarbani Ghosh-Laskar, Devendra Chaukar
European Archives of Oto-Rhino-Laryngology.2020; 277(6): 1807. CrossRef
Major vessel invasion by thyroid cancer: a comprehensive review
Michael S. Xu, Jennifer Li, Sam M. Wiseman
Expert Review of Anticancer Therapy.2019; 19(2): 191. CrossRef
Poorly differentiated thyroid carcinoma and poorly differentiated area in differentiated thyroid carcinoma: is there any difference?
Raouef Ahmed Bichoo, Anjali Mishra, Niraj Kumari, Narendra Krishnani, Gyan Chand, Gaurav Agarwal, Amit Agarwal, Saroj Kanta Mishra
Langenbeck's Archives of Surgery.2019; 404(1): 45. CrossRef

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