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Ultrasound-guided core needle biopsy (US-CNB) of thyroid nodules is a relatively new technique used in surgical workup. However, no systematic review of this method has yet been performed. In the present meta-analysis, literature databases consisting of Cochrane Library, Medline, Embase, Scopus and Google Scholar were searched. Following eligibility assessments of the studies, quality appraisals were performed on the included studies using the Quality Assessment Tool for Diagnostic Accuracy Studies-2 method. The data were systematically analyzed by using Review Manager (version 5.3) and Meta-Disc (version 1.4). Eight investigations were included, and the study qualities were good. There were 1,621 nodules included in the final meta-analysis. The summary estimated that US-CNB had a sensitivity of 0.96 [95% confidence interval (CI)=0.94-0.97] and a specificity of 0.96 (95% CI=0.94-0.97). Positive and negative likelihood ratios, and the diagnostic odds ratio of US-CNB were 18.20 (95% CI=2.21-156.41), 0.08 (95% CI=0.02-0.27) and 250.60 (95% CI=19.11-3286.76), respectively. The area under the summary receiver operating characteristic curve was 0.979. Therefore, US-CNB may be considered as a reliable method in the assessment of thyroid nodules, and has an acceptable risk of complications.

Harmonic scalpel and LigaSure vessel sealing systems have been suggested as options for saving surgical time and reducing postoperative complications. The aim of the present meta-analysis was to compare surgical time, postoperative complications and other parameters between them in for the open thyroidectomy procedure. Studies were retrieved from MEDLINE, Cochrane Library, EMBASE and ISI Web of Science until December 2015. All the randomized controlled trials (RCTs) comparing Harmonic scalpel and LigaSure during open thyroidectomy were selected. Following data extraction, statistical analyses were performed. Among the 24 studies that were evaluated for eligibility, 7 RCTs with 981 patients were included. The Harmonic scalpel significantly reduced surgical time compared with LigaSure techniques (8.79 min; 95% confidence interval, -15.91 to -1.67; P=0.02). However, no significant difference was observed for the intraoperative blood loss, postoperative blood loss, duration of hospital stay, thyroid weight and serum calcium level postoperatively in either group. The present meta-analysis indicated superiority of Harmonic Scalpel only in terms of surgical time compared with LigaSure hemostasis techniques in open thyroid surgery.

The aim of this study was to evaluate the effects of the first radioactive iodine (131I) therapy on functions of salivary glands in patients with differentiated thyroid carcinoma (DTC). There were 36 consented patients with DTC enrolled in this study, who received 3.7 GBq (100mCi) 131I for ablation after total thyroidectomy. Salivary gland function was assessed using salivary gland scintigraphy in two phases, one 4 hours before and the other 6 months after 131I therapy (both under thyrotropin stimulation condition). Quantitative parameters including uptake fraction (UF), uptake index (UI), excretion fraction (EF), and excretion ratio (ER) were measured and compared. Blood parameters were also compared. Associations between sex and outcome of the first 131I therapy as well as individual salivary gland function were measured. Wilcoxon Signed Rank Sum test and χ2 test were used for statistical analysis. When compared between pre-ablation and post-ablation, UF of bilateral parotid and submandibular glands were significantly increased (all P

Serum thyroglobulin (Tg) is the main post-operative tumor biomarker for patients with differentiated thyroid cancer (DTC). However, the presence of thyroglobulin antibodies (TgAb) can interfere with Tg level and invalidate the test. In this study, we aimed to investigate the predicative value of midkine (MK) as a cancer biomarker for DTC patients with positive TgAb before the first 131I therapy. MK levels were measured by enzyme-linked immunosorbent assay in 151 recruited DTC patients after exercising strict inclusion and exclusion criteria. There were 28 TgAb positive DTC patients with metastases and 123 DTC patients without metastases. The value of pre-131I-ablative MK to predict metastasis was assessed by receiver operating characteristic (ROC) curves in these two groups of patients. MK levels in the TgAb positive DTC patients were significantly higher than the DTC patients without metastases. ROC showed good predictability of MK, with an area under the curve of 0.856 (P

131I treatment is an important management method for patients with differentiated thyroid cancer (DTC). Unsuccessful 131I ablation drastically affects the prognosis of the patients. This study aimed to analyze potential predictive factors influencing the achievement of a disease-free status following the first 131I therapy. This retrospective review included 315 DTC patients, and multiple factors were analyzed. Tumor size, pathological tumor stage, lymph node (LN) metastasis, distant metastasis, American Thyroid Association recommended risks, pre-ablation thyroglobulin (Tg), and thyroid stimulating hormone (TSH) displayed significant differences between unsuccessful and successful group. Cutoff values of Tg and TSH to predict a successful outcome were 3.525 ng/mL and 99.700 uIU/ml by receiver operating characteristic curves analysis. Binary logistic regression analysis showed that tumor stage T3 or T4, LN metastasis to N1b station, intermediate and high risks, pre-ablation Tg ≥ 3.525 ng/ml and TSH 1 (LN metastasis) −0.236 X2 (Tg) + 0.015 X3 (TSH). This study demonstrated LN metastasis, pre-ablation Tg and TSH were the most powerful predictors for achieving a disease-free status by the first 131I therapy.

Radioactive iodine (RAI) is considered to be related with hematologic changes. This study aimed to evaluate influence of the first RAI ablation on peripheral complete blood count (CBC) in patients with differentiated thyroid cancer (DTC). Data of CBC at baseline and 6 months after RAI were obtained in 385 patients with DTC with approximately 3700 MBq 131I (ranging 2220–7585 MBq). Further comparison was done in 196 patients with 1-month postablation data available. Routine blood examinations were performed to determine impact of RAI on white blood cell (WBC), red blood cell (RBC), hemoglobin, platelet, neutrophil, lymphocyte, and monocyte in both sexes. Continuous variables were compared by paired t tests and independent samples t test, and categorical variables were compared by chi-square analysis. Data with repeated measurements were analyzed by analysis of variance. The first RAI after thyroidectomy was associated with mild, yet significant declines in WBC, platelet, and lymphocyte, which persisted for 6 months. One month after RAI, significant declines were found in all CBC, including RBC and hemoglobin (all P

The relationship between thyroid-stimulating hormone (TSH) and hyperlipidemia is still a topic of debate. We aimed to explore the impact of gender and age on the association between serum TSH and lipid profile in a large cohort of Chinese. This cross-sectional study enrolled 13,915 participants (8565 male, 5350 female), who self-reported as healthy without any known previous diseases. Clinical data including anthropometric measurements, thyroid function, and other serum parameters were collected. The associations between TSH and hyperlipidemia of males and females were analyzed separately after dividing TSH and age into subgroups. Odds ratio for hyperlipidemia was calculated by binary logistic regression models. Young males had significantly higher prevalence of hypercholesterolemia, hypertriglyceridemia, and high serum low-density lipoprotein-cholesterol than females, yet after menopause, females had higher prevalence than males. TSH was positively associated with hyperlipidemia independent of thyroid hormones. Males showed more reduced risks of hyperlipidemia in low TSH concentrations, while females demonstrated more enhanced risks of hyperlipidemia in high TSH concentrations. For instance, if TSH was lower than 0.3 μIU/mL, the risks of developing hypercholesterolemia and hypertriglyceridemia in males were only 0.198 (P 0.05), respectively. If TSH was higher than 4.0 μIU/mL, women displayed significantly higher risks of developing hypertriglyceridemia than the reference TSH risks (P

The relationship between thyroid dysfunction and metabolic syndrome (MS) is complex. We aimed to explore the impact of gender and age on their association in a large Chinese cohort. This cross-sectional study enrolled 13,855 participants (8532 male, 5323 female), who self-reported as healthy without any known previous diseases. Clinical data including anthropometric measurements, thyroid function, and serum metabolic parameters were collected. The associations between thyroid function and MS of both genders were analyzed separately after dividing thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and age into subgroups. MS risks were calculated by binary logistic regression models. Young males had significantly higher MS prevalence than females, yet after menopause, females had higher prevalence than males. Females had higher incidence of thyroid dysfunction than males. By using TSH quartiles as the categorical variables and the lowest quartile as reference, significantly increased MS risk was demonstrated in quartile 4 for males, yet quartiles 3 and 4 for females. By using FT3 quartiles as the categorical variables, significantly increased MS risk was demonstrated in quartile 2 to 4 for females only. By using age subgroups as the categorical variables, significantly increased MS risk was shown in both genders, with females (4.408–58.455) higher than males (2.588–4.943). Gender and age had substantial influence on thyroid function and MS. Females with high TSH and high FT3 had higher MS risks than males. Aging was a risk for MS, especially for females. Urgent need is necessary to initiate interventional programs.

Leukocyte, erythrocyte or platelet and metabolic syndrome (MS) are closely correlated, and there exist gender differences. We aimed to explore the associations between the hematological parameters and MS in different genders of Chinese. This cross-sectional study included 32,900 participants (20,733 males, 12,167 females) who were enrolled in a health examination. Clinical data including anthropometric measurements and serum parameters were collected. The associations between hematological parameters and MS of both genders were analyzed separately. Odds ratio (OR) of MS was calculated by binary logistic regression models. All hematological parameters were related to MS. With leukocyte and erythrocyte counts rising, the risks of developing MS increased in both genders, which was more obvious in women. For instance, in model 3, the ORs of MS in leukocyte quartiles in females were from 1.333 to 2.045 (P