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대한갑상선학회> International Journal of Thyroidology

International Journal of Thyroidology update

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수록정보
수록범위 : 1권1호(2008)~14권2호(2021) |수록논문 수 : 365
International Journal of Thyroidology
14권2호(2021년 11월) 수록논문
최근 권호 논문
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11-4 cm 갑상선 유두상암의 초기 수술로 엽절제술의 적용

저자 : 조진성 ( Jin-seong Cho )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 14권 2호 발행 연도 : 2021 페이지 : pp. 73-80 (8 pages)

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Recently, the early diagnosis and treatment of differentiated thyroid cancer has significantly increased the proportion of thyroid lobectomy rather than total thyroidectomy. Thyroid lobectomy is recommended for less than 1 cm and total thyroidectomy for more than 4 cm except in unusual cases. There are still controversies in papillary cancer, which size from 1 to 4 cm. There are some reports that the indiscriminate expansion of thyroid lobectomy results in inferior results on the recurrence rate and survival rate compared to total thyroidectomy. But several other studies revealed that the recurrence after lobectomy could be diagnosed, it would not increase the rate of locoregional recurrence and mortality. It is necessary to make efforts to completely remove the cancer and lymph node metastasis, even in unilateral multiple papillary cancers, microscopic or gross invasion to the strap muscles (T3b), even in patients with lateral metastasis, or microscopic central lymph node metastasis. Although the proportion of these patients is nearly half of all 1-4 cm patients with papillary cancer, thyroid lobectomy may be considered as an alternative treatment to total thyroidectomy for patients with 1-4 cm papillary cancer.

KCI등재

2분화갑상선암 환자에서 치료적 측경부림프절 절제술의 적절한 범위

저자 : 원호륜 ( Ho-ryun Won ) , 구본석 ( Bon Seok Koo )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 14권 2호 발행 연도 : 2021 페이지 : pp. 81-86 (6 pages)

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Regional neck metastases in well-differentiated thyroid carcinoma (WDTC) are relatively frequent. The prognostic effects of lymph node (LN) metastases remain controversial. However, it is well known that lateral LN metastasis is related to the recurrence of the disease. In general, when lateral neck LN metastasis is confirmed in WDTC patients, therapeutic lateral neck dissection is recommended. However, the optimal surgical extent of therapeutic lateral neck dissection in WDTC patients with clinical lateral LN metastasis is not clearly presented. Traditional comprehensive neck dissection including level II, III, IV and V even in patients with minimal lateral neck metastases may not be reasonable when considering both oncologic safety and functional aspects. There is controversy whether it is always necessary to perform level II and V LN dissection for all WDTC patients with clinical lateral LN metastasis. This is due to the fact that the likelihood of postoperative complications by the damage of the spinal accessory nerve increases with level II and level V dissection. Therefore, many studies have been reported on the possibility of omitting levels II (especially IIb) and V during therapeutic comprehensive lateral neck dissection. However, there have been no definite conclusions about it, and it is still debate. In this article, we reviewed to find out optimal lateral neck dissection range for WDTC patients with clinical lateral neck metastasis.

KCI등재

3잔존 갑상선절제술

저자 : 천용일 ( Yongil Cheon ) , 신성찬 ( Sung-chan Shin ) , 이병주 ( Byung-joo Lee )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 14권 2호 발행 연도 : 2021 페이지 : pp. 87-92 (6 pages)

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Completion thyroidectomy is defined as surgical removal of the remnant thyroid tissue after resection of the thyroid gland. The frequency of completion thyroidectomy varies among researchers, but is estimated to be about 5-45%. Completion thyroidectomy may cause complications due to the presence of inflammation, adhesions, swelling, and scars at the surgical site due to the initial surgery. There is still controversy over the indications and timing of completion thyroidectomy. In this review, we would like to summarize the changes in indications for completion thyroidectomy and review the literature on its necessity.

KCI등재

4갑상선 수술에서 부갑상선을 보존하기 위한 수술 술기

저자 : 김정한 ( Jung-han Kim )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 14권 2호 발행 연도 : 2021 페이지 : pp. 93-97 (5 pages)

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Failure to preserve parathyroid function in patients who have undergone total thyroidectomy is of major concern because hypocalcemia is difficult to prevent and remains a common postoperative complication. It is essential to preserve not only the parathyroid glands themselves but also the vasculature around them to maintain their function after thyroidectomy. In many cases, thyroid and parathyroid glands share the proximal section of the blood vessels supplying them. Therefore, we should try to separate as many vessels as possible from the thyroid capsule and retain their connection to the parathyroid gland for preservation of its proper blood flow and function.

KCI등재

5방사성요오드 불응성 분화갑상선암의 치료, 현재의 상황과 향후 전망

저자 : 송영기 ( Young Kee Shong )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 14권 2호 발행 연도 : 2021 페이지 : pp. 98-111 (14 pages)

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Radioiodine refractory differentiated thyroid cancers are rare but they make a definite problem since they run relentlessly progressive course leading to death in a few years. Recent development of various tyrosine kinase inhibitors significantly prolonged the overall survival of these patients. Currently available agents are mostly directed to VEGFR and are not specific to thyroid cancer and their efficacy is somewhat limited for a certain period of time. Very recently developed specific agents can significantly prolong the overall survival of these patients without serious adverse event and probably this kind of precision medicine shall be available to all the patients in near future but at present successive salvage treatment using different angiogenesis inhibitors may be an alternative option.

KCI등재

6갑상선절제술 후 경부불편감

저자 : 김범수 ( Beomsoo Kim ) , 박재홍 ( Jae Hong Park )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 14권 2호 발행 연도 : 2021 페이지 : pp. 112-116 (5 pages)

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Thyroid and parathyroid surgery is commonly performed for diagnostic or therapeutic purposes for benign tumors as well as malignant tumors. Vocal cord paralysis and hypoparathyroidism are known as major complications. However, majority of patients experience neck pain or discomfort after surgery without any significant cause. Recent studies have reported various and ambiguous symptoms group after thyroidectomy as post-thyroid syndrome. There is still controversy over the etiology of post-thyroidectomy syndrome, however the assumable causes identified so far are damage to the laryngeal mucosa caused by tracheal intubation, disturbances of blood circulation of larynx, synechia of strap muscles, limited vertical motion of laryngeal skeleton, fibrosis during healing process of extrinsic laryngeal muscles. This is the systematic review of the post-thyroidectomy symptoms by cause.

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7갑상선과 장내 마이크로바이옴

저자 : 권슬기 ( Seul Ki Kwon ) , 김남일 ( Namil Kim ) , 박영주 ( Young Joo Park )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 14권 2호 발행 연도 : 2021 페이지 : pp. 117-126 (10 pages)

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The gut microbiome affects the enterohepatic recycling of thyroid hormone and the metabolism and absorption of micronutrients including iodine and selenium. Changes in thyroid function trigger changes in the neuro-muscular function of the gut, resulting in a two-way interaction that affects the composition of gut microbiome. In recent years, based on animal experiments and prospective clinical studies, many possibilities have been suggested that the influences in naïve immune cells differentiation or increasing permeability of proinflammatory cytokines and endotoxins to blood due to intestinal integrity disruption may affect the progression of autoimmune thyroid disease or thyroid cancers. In this review, we focused on refining the progression on the hypothesis that there is a link between the gut microbiome and the thyroid gland.

KCI등재

8Treatment Effect of Combining Lenvatinib and Vemurafenib for BRAF Mutated Anaplastic Thyroid Cancer

저자 : Chae Moon Hong , Ji Min Oh , Prakash Gangadaran , Ramya Lakshmi Rajendran , Byeong-cheol Ahn

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 14권 2호 발행 연도 : 2021 페이지 : pp. 127-134 (8 pages)

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Background and Objectives: Even though most of the thyroid cancer shows good prognosis, de-differentiated thyroid cancer is still refractory to conventional treatments. Recently, kinase inhibitors including multi-kinase and BRAF inhibitors are widely used for treatment of de-differentiated thyroid cancers, but resistant to single kinase inhibitor treatment eventually encountered. Therefore, combination therapy may have better therapeutic effect than single therapy for thyroid cancer. In this study, we evaluated therapeutic effect of multi-kinase and BRAF inhibitor combination to anaplastic thyroid cancer cell lines with and without BRAF mutation. Materials and Methods: We used anaplastic thyroid cancer cell lines with BRAFV600E mutation (8505C) and with NRAS mutation (HTh7). Both cell lines were treated with various concentration of multi-kinase inhibitor (lenvatinib) and BRAF inhibitor (vemurafenib). And combination of various concentration of both kinase inhibitors were used to treat both cell lines. Cytotoxic effect was assessed with cell counting kit-8 and therapeutic effect of single kinase inhibitor therapy and the combination therapy was compared. Results: Anti-proliferative effect of vemurafenib on 8505C BRAFV600E-mutated cells was demonstrated from 0.25 μM concentration. However, HTh7 cells with NRAS mutation represented drug resistance up to 4 μM of vemurafenib. In case of lenvatinib treatment as a multi-kinase inhibitor, 8505C and HTh7 cells showed decreased cell viability dose-dependent manner. Combination treatment with vemurafenib and lenvatinib showed synergistic cytotoxic effect in BRAF mutated 8505C cell line, even at lower concentrations. Conclusion: Combination treatment with multi-kinase inhibitor and BRAF inhibitor showed promising therapeutic results in BRAF mutated anaplastic thyroid cancer cell line.

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9Null Association between BRAF V600E Mutation and Tumor Recurrence in Patients with Papillary Thyroid Microcarcinoma in South Korea

저자 : Ji Yoon Kim , Kyoung Jin Kim , Jae Hyun Bae , Joo Hyung Kim , Nam Hoon Kim , Hee Young Kim , Hoon Yub Kim , Seung-kuk Baek , Sin Gon Kim , Kwang Yoon Jung , Kyeong Jin Kim

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 14권 2호 발행 연도 : 2021 페이지 : pp. 135-142 (8 pages)

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Background and Objectives: The clinical implications of the BRAF V600E mutation in papillary thyroid microcarcinoma (PTMC), defined as ≤1.0 cm of tumor size, remain controversial. We investigated the association between the BRAF V600E mutation and PTMC recurrence in a retrospective cohort of patients with thyroid cancer. Materials and Methods: This study included 2319 patients with PTMC (median age, 50 years [interquartile range (IQR), 41-57 years]) who underwent thyroid surgery from 2010 to 2019 at a single tertiary medical center. The median follow-up time was 75 months (IQR, 30-98 months). Tumor recurrence was confirmed by histological, cytological, radiographic, and biochemical criteria, combined with persistent and recurrent disease. Results: A total of 60.2% (1395/2319) patients with PTMC had the BRAF V600E mutation. The tumor recurrence rate was 2.1% (19/924) in BRAF mutation-negative patients and 2.9% (41/1395) in BRAF mutation-positive patients, with a hazard ratio (HR) of 1.05 (95% confidence interval [CI], 0.61-1.84) after adjusting for clinicopathological risk factors. Similar results were found in patients with high-risk PTMC (adjusted HR, 1.09; 95% CI, 0.56-2.11) who had lymph node metastasis (LNM), extrathyroidal extension (ETE), or distant metastasis (DM) at diagnosis and in patients with low-risk PTMC (adjusted HR, 1.00; 95% CI, 0.35-2.83) who had no LNM, ETE, or DM. Conclusion: The finding that the BRAF V600E mutation was not associated with tumor recurrence in our cohort of Korean patients with PTMC, especially in patients with low-risk PTMC, suggests that its value in the prediction of disease progression is limited.

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10Serum Carcinoembryonic Antigen as a Biomarker for Medullary Thyroid Cancer

저자 : Jinyoung Kim , Hyunju Park , Min Sun Choi , Jun Park , Hye Won Jang , Tae Hyuk Kim , Sun Wook Kim , Jae Hoon Chung

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 14권 2호 발행 연도 : 2021 페이지 : pp. 143-151 (9 pages)

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Background and Objectives: The lack of known elevated biomarkers in cancer surveillance is a challenge for diagnostics. However, few studies have assessed the proportion of patients with medullary thyroid cancer (MTC) that presented with elevated serum carcinoembryonic antigen (CEA) level. Materials and Methods: This was a retrospective study of 115 patients treated for MTC at Samsung Medical Center between 1995 and 2017. Serum calcitonin and CEA levels that were available at one of the following time points were included: (a) within 3 months before the initial surgery, (b) when a structural recurrence was confined to the neck, or (c) when a distant metastasis was identified during follow-up. Considering the high false-positive rate of serum CEA testing, 5 ng/mL was selected as the cut-off threshold. Results: The sensitivity of CEA at the time of diagnosis was 54%, but it significantly increased with anatomical stage, from 20% in stage I to 88% in stage IV (p for trend <0.001). At the time of diagnosis, larger tumor size, more frequent gross extra-thyroidal extension, more frequent N1b, and a higher number of metastatic lymph nodes were significantly observed in CEA-positive patients compared with CEA-negative patients (p<0.05). The sensitivity of CEA at the time of recurrence was 56% for local recurrence and 80% for distant recurrence. Conclusion: The CEA value was associated with anatomical stage as a biomarker for MTC and could be used to predict poor prognosis. However, serum CEA testing plays a limited role in diagnosis and follow-up of MTC because it can show normal values even in advanced disease.

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