Background: Immune checkpoint inhibitors (ICI) are promising treatment options for various cancer... more Background: Immune checkpoint inhibitors (ICI) are promising treatment options for various cancers. However, their use is associated with immune-related adverse events (irAEs), including ICI-induced diabetes mellitus (ICI-DM). This study aimed to investigate the clinical features of ICI-DM, with a particular focus on alterations to pancreatic volume. Methods: We conducted a retrospective review of 2829 patients who received ICI treatment at the Chang Gung Memorial Hospital, Linkou, between January 2014 and December 2021. New-onset diabetes or diabetic ketoacidosis (DKA) was identified in ten patients receiving ICI therapy. Pancreatic volumes were assessed by manual segmentation of computed tomography (CT) images before and after ICI-DM diagnosis. Results: Among these ten patients, nivolumab was the most commonly used ICI (50.0%), followed by pembrolizumab (30.0%) and atezolizumab (20.0%). One patient received combination therapy with nivolumab and ipilimumab. The median age was 63.0...
Background: this study was designed to compare the long-term survival outcomes of patients prepar... more Background: this study was designed to compare the long-term survival outcomes of patients prepared for radioiodine (RAI) therapy using either thyroid hormone withdrawal (THW) or recombinant human thyrotropin (rhTSH) stimulation, by specifically focusing on cases with distant metastases from papillary thyroid cancer (PTC). Methods: A retrospective analysis was performed on 88 patients with distant metastases from PTC. Fifty-one and thirty-seven patients were prepared for RAI treatment by either THW or rhTSH stimulation, respectively. The primary endpoints were progression-free survival (PFS) and disease-specific survival (DSS). Results: The 10-year DSS rates of patients prepared for RAI therapy using either THW or rhTSH stimulation were 62.2% and 73.3%, respectively. Using multivariate analysis, RAI-avid metastases (p = 0.025) and preparation with rhTSH (p = 0.041) were identified as independent prognostic factors for PFS. Notably, PFS in the group of patients with RAI-avid metastas...
BACKGROUND Many patients with papillary thyroid cancer (PTC) demonstrate satisfactory outcomes. H... more BACKGROUND Many patients with papillary thyroid cancer (PTC) demonstrate satisfactory outcomes. However, 8%-28% of patients with PTC show tumor recurrence, which may affect prognosis. Therefore, identifying factors associated with tumor recurrence in patients with PTC may be helpful to refine therapeutic strategies. PATIENTS AND METHODS To identify factors associated with PTC recurrence, we retrospectively reviewed demographic features (sex and age), operation method, image character, serum thyroglobulin (Tg), accumulated radioactive iodine (I-131) therapeutic dose, I-131 uptake, and metastases at diagnosis in 829 patients with PTC. Patients were grouped into early (stage I and II; n = 698) and advanced (stage III and IV; n = 131) tumor-node-metastasis (TNM) stages. Recurrence rate, mortality rate, risk factors of recurrence, recurrent free survival and overall survival curve were compared between two groups. RESULTS Patients in the early stage demonstrated a lower recurrence rate (7.2%) than did those in the advanced stage (28.2%, p < 0.05). The mortality rate of patients with recurrence in the advanced stage was higher than that of those in the early stage (51.4% vs. 12.0%). The major impact factors on tumor recurrence in early TNM stage were distant metastasis and lymph node metastasis, while in advanced TNM stage were distant metastasis, male gender, total thyroidectomy with limited lymph node dissection, and a high serum Tg level. CONCLUSIONS Strategies to monitor tumor recurrence might be refined according to the TNM stages of PTC patients.
Differentiated thyroid cancer (DTC) from follicular epithelial cells is the most common form of t... more Differentiated thyroid cancer (DTC) from follicular epithelial cells is the most common form of thyroid cancer. Beyond the common papillary thyroid carcinoma (PTC), there are a number of rare but difficult-to-diagnose pathological classifications, such as follicular thyroid carcinoma (FTC). We employed deep convolutional neural networks (CNNs) to facilitate the clinical diagnosis of differentiated thyroid cancers. An image dataset with thyroid ultrasound images of 421 DTCs and 391 benign patients was collected. Three CNNs (InceptionV3, ResNet101, and VGG19) were retrained and tested after undergoing transfer learning to classify malignant and benign thyroid tumors. The enrolled cases were classified as PTC, FTC, follicular variant of PTC (FVPTC), Hürthle cell carcinoma (HCC), or benign. The accuracy of the CNNs was as follows: InceptionV3 (76.5%), ResNet101 (77.6%), and VGG19 (76.1%). The sensitivity was as follows: InceptionV3 (83.7%), ResNet101 (72.5%), and VGG19 (66.2%). The spec...
Additional file 1. The distributions and doses of moderate- to high-intensity statins according t... more Additional file 1. The distributions and doses of moderate- to high-intensity statins according to the 2013 American College of Cardiology/American Heart Association guideline.
Daphne genkwa, a Chinese medicinal herb, is used frequently in Southeast Asian countries to treat... more Daphne genkwa, a Chinese medicinal herb, is used frequently in Southeast Asian countries to treat diseases; the flavonoid hydroxygenkwanin (HGK) is extracted from its flower buds. The bioactivity of HGK, particularly as an anti-liver cancer agent, has not been explored. In this study, human hepatocellular carcinoma (HCC) cell lines and an animal xenograft model were employed to investigate both the activity of HGK against liver cancer and its cellular signaling mechanisms. HCC cells treated with HGK were subjected to cell function assays. Whole transcriptome sequencing was used to identify genes whose expression was influenced by HGK, and the flavonoid’s cancer suppression mechanisms were further investigated through gain- and loss-of-function assays. Finally, in vitro findings were tested in a mouse xenograft model. The data showed that HGK induced the expression of the microRNA miR-320a, which in turn inhibited the expression of the transcription factor ‘forkhead box protein M1’ (...
Patients with thyroid cancer usually have good prognosis. However, 15-20% of patients ultimately ... more Patients with thyroid cancer usually have good prognosis. However, 15-20% of patients ultimately develop recurrence and disease-related death. In this study, we investigate whether the number of circulating tumor cells (CTCs) expressing either epithelial cell adhesion molecule (EpCAM), podoplanin (PDPN, a marker related to poor prognosis in patients with thyroid cancer), or thyroid-stimulating hormone receptor (TSHR, a marker for thyroid cells) is a prognostic marker for non-remission and disease-specific mortality (DSM) of patients with thyroid cancer. Blood samples were collected from patients (n = 128) after thyroidectomy or radioactive iodide therapy. After enrichment of CTCs by a negative selection PowerMag system, enumeration and subtyping of the CD45-depleted cells were performed by immunofluorescence staining using the antibodies aginst EpCAM, TSHR, and PDPN, respectively. Our data revealed that the number of EpCAM+-CTCs (p < 0.001) and PDPN+-CTCs (p < 0.001), and TSHR...
Papillary thyroid carcinoma (PTC) accounts for about 80% of the cases in thyroid cancer. Routine ... more Papillary thyroid carcinoma (PTC) accounts for about 80% of the cases in thyroid cancer. Routine surveillance by serum thyroglobulin (Tg) and medical imaging is the current practice to monitor disease progression of the patients. Whether enumeration of circulating epithelial cells (CECs) helps to define disease status of PTC patients was investigated. CECs were enriched from the peripheral blood of the healthy control subjects (G1, n = 17) and the patients at disease-free status (G2, n = 26) or with distant metastasis (G3, n = 22). The number of CECs expressing epithelial cell adhesion molecule (EpCAM) or thyroid-stimulating hormone receptor (TSHR) was determined by immunofluorescence microscopy analyses. The medium number of EpCAM+-CECs was 6 (intequartile range 1-11), 12 (interquartile range 7-16) and 91 (interquartile range 31-206) cells/ml of blood for G1, G2 and G3, respectively. EpCAM+-CEC counts were significantly higher in G3 than in G1 (p < 0.05) and G2 (p < 0.05). Th...
Changgeng yi xue za zhi / Changgeng ji nian yi yuan = Chang Gung medical journal / Chang Gung Memorial Hospital, 1996
We reviewed 27 patients who received preoperative localization using both parathyroid ultrasonogr... more We reviewed 27 patients who received preoperative localization using both parathyroid ultrasonography and parathyroid 201Tl-99mTc subtraction (TTS) scan from March 1986 to July 1993 in Chang Gung Memorial Hospital, Linkou. These 27 patients were diagnosed hyperparathyroidism by the pathological reports. There were 16 patients with primary hyperparathyroidism [PHPT; 9 males, 7 females; (mean age: 56.3 +/- 4.6 yrs)] and 11 patients with secondary hyperparathyroidism [SHPT; 8 males, 3 females; (mean age: 38.3 +/- 2.5 yrs)] due to end stage renal disease. The diagnostic accuracy was compared, and the results were as follow: (1) in localization of PHPT, the sensitivity and specificity of ultrasonography were 75.0% and 95.8% respectively, whereas the sensitivity and specificity of TTS were 87.5% and 100.0% respectively. The differences were not statistically significant; (2) the sensitivity and specificity of ultrasonography and TTS for patients with SHPT were 32.4% and 85.7% vs. 32.4% an...
ABSTRACT Parathyroid carcinoma is a rare disease that usually presents with severe hypercalcemia ... more ABSTRACT Parathyroid carcinoma is a rare disease that usually presents with severe hypercalcemia and marked elevation of parathyroid hormone level. A 64-year-old male patient with repeated episodes of renal stones sustained chronic renal failure. Subsequently, he developed acute uremic symptoms and underwent a left upper parathyroidectomy. Parathyroid carcinoma was diagnosed after surgery. Asymptomatic hypocalcemia was the initial presentation. Protracted symptomatic hypocalcemia developed 8 months postoperatively, accompanied by an extremely high parathyroid hormone level. Delayed &quot;bone hunger&quot; syndrome concomitant with down-regulation of the parathyroid hormone receptors or production of parathyroid hormone with diminished bioactivity may have been the possible causes.
AimsAngiogenesis from thyroid cancer cell plays the important roles in post‐surgical persistent, ... more AimsAngiogenesis from thyroid cancer cell plays the important roles in post‐surgical persistent, recurrent, and metastatic papillary thyroid cancer (PTC). This study is to investigate the expression of angiopoietin‐1 (Ang‐1), angiopoietin‐2 (Ang‐2), Tek/Tie‐2 receptor, and vascular endothelial growth factors (VEGF) in normal, benign thyroid tissues and different stage of PTC. We expect angiogenetic factors are important in the presentation of local‐regional neck or distant metastases in PTC.Materials and ResultsA total of 101 tissues from the subjects underwent thyroidectomy were enrolled in the study. There were 22 control and 79 thyroid cancer patients in different TNM stagings were collected. Ang‐1 illustrated highest mean immunostaining score in metastatic group. Comparing with normal and benign thyroid tissues, thyroid cancer tissues illustrated significantly high expression of three angiogenetic factors and Tie‐2 receptor. Of the PTC, significantly high expression of three ang...
Background: Immune checkpoint inhibitors (ICI) are promising treatment options for various cancer... more Background: Immune checkpoint inhibitors (ICI) are promising treatment options for various cancers. However, their use is associated with immune-related adverse events (irAEs), including ICI-induced diabetes mellitus (ICI-DM). This study aimed to investigate the clinical features of ICI-DM, with a particular focus on alterations to pancreatic volume. Methods: We conducted a retrospective review of 2829 patients who received ICI treatment at the Chang Gung Memorial Hospital, Linkou, between January 2014 and December 2021. New-onset diabetes or diabetic ketoacidosis (DKA) was identified in ten patients receiving ICI therapy. Pancreatic volumes were assessed by manual segmentation of computed tomography (CT) images before and after ICI-DM diagnosis. Results: Among these ten patients, nivolumab was the most commonly used ICI (50.0%), followed by pembrolizumab (30.0%) and atezolizumab (20.0%). One patient received combination therapy with nivolumab and ipilimumab. The median age was 63.0...
Background: this study was designed to compare the long-term survival outcomes of patients prepar... more Background: this study was designed to compare the long-term survival outcomes of patients prepared for radioiodine (RAI) therapy using either thyroid hormone withdrawal (THW) or recombinant human thyrotropin (rhTSH) stimulation, by specifically focusing on cases with distant metastases from papillary thyroid cancer (PTC). Methods: A retrospective analysis was performed on 88 patients with distant metastases from PTC. Fifty-one and thirty-seven patients were prepared for RAI treatment by either THW or rhTSH stimulation, respectively. The primary endpoints were progression-free survival (PFS) and disease-specific survival (DSS). Results: The 10-year DSS rates of patients prepared for RAI therapy using either THW or rhTSH stimulation were 62.2% and 73.3%, respectively. Using multivariate analysis, RAI-avid metastases (p = 0.025) and preparation with rhTSH (p = 0.041) were identified as independent prognostic factors for PFS. Notably, PFS in the group of patients with RAI-avid metastas...
BACKGROUND Many patients with papillary thyroid cancer (PTC) demonstrate satisfactory outcomes. H... more BACKGROUND Many patients with papillary thyroid cancer (PTC) demonstrate satisfactory outcomes. However, 8%-28% of patients with PTC show tumor recurrence, which may affect prognosis. Therefore, identifying factors associated with tumor recurrence in patients with PTC may be helpful to refine therapeutic strategies. PATIENTS AND METHODS To identify factors associated with PTC recurrence, we retrospectively reviewed demographic features (sex and age), operation method, image character, serum thyroglobulin (Tg), accumulated radioactive iodine (I-131) therapeutic dose, I-131 uptake, and metastases at diagnosis in 829 patients with PTC. Patients were grouped into early (stage I and II; n = 698) and advanced (stage III and IV; n = 131) tumor-node-metastasis (TNM) stages. Recurrence rate, mortality rate, risk factors of recurrence, recurrent free survival and overall survival curve were compared between two groups. RESULTS Patients in the early stage demonstrated a lower recurrence rate (7.2%) than did those in the advanced stage (28.2%, p < 0.05). The mortality rate of patients with recurrence in the advanced stage was higher than that of those in the early stage (51.4% vs. 12.0%). The major impact factors on tumor recurrence in early TNM stage were distant metastasis and lymph node metastasis, while in advanced TNM stage were distant metastasis, male gender, total thyroidectomy with limited lymph node dissection, and a high serum Tg level. CONCLUSIONS Strategies to monitor tumor recurrence might be refined according to the TNM stages of PTC patients.
Differentiated thyroid cancer (DTC) from follicular epithelial cells is the most common form of t... more Differentiated thyroid cancer (DTC) from follicular epithelial cells is the most common form of thyroid cancer. Beyond the common papillary thyroid carcinoma (PTC), there are a number of rare but difficult-to-diagnose pathological classifications, such as follicular thyroid carcinoma (FTC). We employed deep convolutional neural networks (CNNs) to facilitate the clinical diagnosis of differentiated thyroid cancers. An image dataset with thyroid ultrasound images of 421 DTCs and 391 benign patients was collected. Three CNNs (InceptionV3, ResNet101, and VGG19) were retrained and tested after undergoing transfer learning to classify malignant and benign thyroid tumors. The enrolled cases were classified as PTC, FTC, follicular variant of PTC (FVPTC), Hürthle cell carcinoma (HCC), or benign. The accuracy of the CNNs was as follows: InceptionV3 (76.5%), ResNet101 (77.6%), and VGG19 (76.1%). The sensitivity was as follows: InceptionV3 (83.7%), ResNet101 (72.5%), and VGG19 (66.2%). The spec...
Additional file 1. The distributions and doses of moderate- to high-intensity statins according t... more Additional file 1. The distributions and doses of moderate- to high-intensity statins according to the 2013 American College of Cardiology/American Heart Association guideline.
Daphne genkwa, a Chinese medicinal herb, is used frequently in Southeast Asian countries to treat... more Daphne genkwa, a Chinese medicinal herb, is used frequently in Southeast Asian countries to treat diseases; the flavonoid hydroxygenkwanin (HGK) is extracted from its flower buds. The bioactivity of HGK, particularly as an anti-liver cancer agent, has not been explored. In this study, human hepatocellular carcinoma (HCC) cell lines and an animal xenograft model were employed to investigate both the activity of HGK against liver cancer and its cellular signaling mechanisms. HCC cells treated with HGK were subjected to cell function assays. Whole transcriptome sequencing was used to identify genes whose expression was influenced by HGK, and the flavonoid’s cancer suppression mechanisms were further investigated through gain- and loss-of-function assays. Finally, in vitro findings were tested in a mouse xenograft model. The data showed that HGK induced the expression of the microRNA miR-320a, which in turn inhibited the expression of the transcription factor ‘forkhead box protein M1’ (...
Patients with thyroid cancer usually have good prognosis. However, 15-20% of patients ultimately ... more Patients with thyroid cancer usually have good prognosis. However, 15-20% of patients ultimately develop recurrence and disease-related death. In this study, we investigate whether the number of circulating tumor cells (CTCs) expressing either epithelial cell adhesion molecule (EpCAM), podoplanin (PDPN, a marker related to poor prognosis in patients with thyroid cancer), or thyroid-stimulating hormone receptor (TSHR, a marker for thyroid cells) is a prognostic marker for non-remission and disease-specific mortality (DSM) of patients with thyroid cancer. Blood samples were collected from patients (n = 128) after thyroidectomy or radioactive iodide therapy. After enrichment of CTCs by a negative selection PowerMag system, enumeration and subtyping of the CD45-depleted cells were performed by immunofluorescence staining using the antibodies aginst EpCAM, TSHR, and PDPN, respectively. Our data revealed that the number of EpCAM+-CTCs (p < 0.001) and PDPN+-CTCs (p < 0.001), and TSHR...
Papillary thyroid carcinoma (PTC) accounts for about 80% of the cases in thyroid cancer. Routine ... more Papillary thyroid carcinoma (PTC) accounts for about 80% of the cases in thyroid cancer. Routine surveillance by serum thyroglobulin (Tg) and medical imaging is the current practice to monitor disease progression of the patients. Whether enumeration of circulating epithelial cells (CECs) helps to define disease status of PTC patients was investigated. CECs were enriched from the peripheral blood of the healthy control subjects (G1, n = 17) and the patients at disease-free status (G2, n = 26) or with distant metastasis (G3, n = 22). The number of CECs expressing epithelial cell adhesion molecule (EpCAM) or thyroid-stimulating hormone receptor (TSHR) was determined by immunofluorescence microscopy analyses. The medium number of EpCAM+-CECs was 6 (intequartile range 1-11), 12 (interquartile range 7-16) and 91 (interquartile range 31-206) cells/ml of blood for G1, G2 and G3, respectively. EpCAM+-CEC counts were significantly higher in G3 than in G1 (p < 0.05) and G2 (p < 0.05). Th...
Changgeng yi xue za zhi / Changgeng ji nian yi yuan = Chang Gung medical journal / Chang Gung Memorial Hospital, 1996
We reviewed 27 patients who received preoperative localization using both parathyroid ultrasonogr... more We reviewed 27 patients who received preoperative localization using both parathyroid ultrasonography and parathyroid 201Tl-99mTc subtraction (TTS) scan from March 1986 to July 1993 in Chang Gung Memorial Hospital, Linkou. These 27 patients were diagnosed hyperparathyroidism by the pathological reports. There were 16 patients with primary hyperparathyroidism [PHPT; 9 males, 7 females; (mean age: 56.3 +/- 4.6 yrs)] and 11 patients with secondary hyperparathyroidism [SHPT; 8 males, 3 females; (mean age: 38.3 +/- 2.5 yrs)] due to end stage renal disease. The diagnostic accuracy was compared, and the results were as follow: (1) in localization of PHPT, the sensitivity and specificity of ultrasonography were 75.0% and 95.8% respectively, whereas the sensitivity and specificity of TTS were 87.5% and 100.0% respectively. The differences were not statistically significant; (2) the sensitivity and specificity of ultrasonography and TTS for patients with SHPT were 32.4% and 85.7% vs. 32.4% an...
ABSTRACT Parathyroid carcinoma is a rare disease that usually presents with severe hypercalcemia ... more ABSTRACT Parathyroid carcinoma is a rare disease that usually presents with severe hypercalcemia and marked elevation of parathyroid hormone level. A 64-year-old male patient with repeated episodes of renal stones sustained chronic renal failure. Subsequently, he developed acute uremic symptoms and underwent a left upper parathyroidectomy. Parathyroid carcinoma was diagnosed after surgery. Asymptomatic hypocalcemia was the initial presentation. Protracted symptomatic hypocalcemia developed 8 months postoperatively, accompanied by an extremely high parathyroid hormone level. Delayed &quot;bone hunger&quot; syndrome concomitant with down-regulation of the parathyroid hormone receptors or production of parathyroid hormone with diminished bioactivity may have been the possible causes.
AimsAngiogenesis from thyroid cancer cell plays the important roles in post‐surgical persistent, ... more AimsAngiogenesis from thyroid cancer cell plays the important roles in post‐surgical persistent, recurrent, and metastatic papillary thyroid cancer (PTC). This study is to investigate the expression of angiopoietin‐1 (Ang‐1), angiopoietin‐2 (Ang‐2), Tek/Tie‐2 receptor, and vascular endothelial growth factors (VEGF) in normal, benign thyroid tissues and different stage of PTC. We expect angiogenetic factors are important in the presentation of local‐regional neck or distant metastases in PTC.Materials and ResultsA total of 101 tissues from the subjects underwent thyroidectomy were enrolled in the study. There were 22 control and 79 thyroid cancer patients in different TNM stagings were collected. Ang‐1 illustrated highest mean immunostaining score in metastatic group. Comparing with normal and benign thyroid tissues, thyroid cancer tissues illustrated significantly high expression of three angiogenetic factors and Tie‐2 receptor. Of the PTC, significantly high expression of three ang...
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