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      Analysis of the value and safety of thyroid-stimulating hormone in the clinical efficacy of patients with thyroid cancer

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          Abstract

          BACKGROUND

          Thyroid cancer (TC) is a common malignant tumor in the endocrine system. In recent years, the incidence and recurrence rates of TC have been raising due to increasing work pressure and irregular lifestyles. Thyroid-stimulating hormone (TSH) is a specific parameter for thyroid function screening. This study aims to explore the clinical value of TSH in regulating the progression of TC, so as to find a breakthrough for the early diagnosis and treatment of TC.

          AIM

          To explore the value and safety of TSH in the clinical efficacy of patients with TC.

          METHODS

          75 patients with TC admitted to the Department of Thyroid and Breast Surgery of our hospital from September 2019 to September 2021 were selected as the observation group, and 50 healthy subjects were selected as the control group during the same period. The control group was treated with conventional thyroid replacement therapy, and the observation group was treated with TSH suppression therapy. The soluble interleukin (IL)-2 receptor (sIL-2R), IL-17, IL-35 levels, free triiodothyronine (FT 3), free tetraiodothyronine (FT 4), CD3 +, CD4 +, CD8 +, CD44V6, and tumor supplied group of factor (TSGF) levels were observed in the two groups. The occurrence of adverse reactions was compared between the two groups.

          RESULTS

          After treatment with different therapies, the levels of FT 3, FT 4, CD3 +, and CD4 + in the observation group and the control group were higher than those before treatment, while the levels of CD8 +, CD44V6, and TSGF were lower than those before treatment, and the differences were statistically significant ( P < 0.05). More importantly, the levels of sIL-2R and IL-17 in the observation group were lower than those in the control group after 4 wk of treatment, while the levels of IL-35 were higher than those in the control group, and the differences were statistically significant ( P < 0.05). The levels of FT 3, FT 4, CD3 +, and CD4 + in the observation group were higher than those in the control group, and the levels of CD8 +, CD44V6, and TSGF were lower than those in the control group. There was no significant difference in the overall incidence rate of adverse reactions between the two groups ( P > 0.05).

          CONCLUSION

          TSH suppression therapy can improve the immune function of patients with TC, lower the CD44V6 and TSGF levels, and improve serum FT 3 and FT 4 levels. It demonstrated excellent clinical efficacy and a good safety profile.

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          Most cited references39

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          Cancer statistics, 2019

          Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data, available through 2015, were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data, available through 2016, were collected by the National Center for Health Statistics. In 2019, 1,762,450 new cancer cases and 606,880 cancer deaths are projected to occur in the United States. Over the past decade of data, the cancer incidence rate (2006-2015) was stable in women and declined by approximately 2% per year in men, whereas the cancer death rate (2007-2016) declined annually by 1.4% and 1.8%, respectively. The overall cancer death rate dropped continuously from 1991 to 2016 by a total of 27%, translating into approximately 2,629,200 fewer cancer deaths than would have been expected if death rates had remained at their peak. Although the racial gap in cancer mortality is slowly narrowing, socioeconomic inequalities are widening, with the most notable gaps for the most preventable cancers. For example, compared with the most affluent counties, mortality rates in the poorest counties were 2-fold higher for cervical cancer and 40% higher for male lung and liver cancers during 2012-2016. Some states are home to both the wealthiest and the poorest counties, suggesting the opportunity for more equitable dissemination of effective cancer prevention, early detection, and treatment strategies. A broader application of existing cancer control knowledge with an emphasis on disadvantaged groups would undoubtedly accelerate progress against cancer.
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            2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.

            Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer.
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              2021 American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer: American Thyroid Association Anaplastic Thyroid Cancer Guidelines Task Force

              Background: Anaplastic thyroid cancer (ATC) is a rare but highly lethal form of thyroid cancer. Since the guidelines for the management of ATC by the American Thyroid Association were first published in 2012, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, and researchers on published evidence relating to the diagnosis and management of ATC. Methods: The specific clinical questions and topics addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of the Task Force members (authors of the guideline). Relevant literature was reviewed, including serial PubMed searches supplemented with additional articles. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations. Results: The guidelines include the diagnosis, initial evaluation, establishment of treatment goals, approaches to locoregional disease (surgery, radiotherapy, targeted/systemic therapy, supportive care during active therapy), approaches to advanced/metastatic disease, palliative care options, surveillance and long-term monitoring, and ethical issues, including end of life. The guidelines include 31 recommendations and 16 good practice statements. Conclusions: We have developed evidence-based recommendations to inform clinical decision-making in the management of ATC. While all care must be individualized, such recommendations provide, in our opinion, optimal care paradigms for patients with ATC.
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                Author and article information

                Contributors
                Journal
                World J Clin Cases
                WJCC
                World Journal of Clinical Cases
                Baishideng Publishing Group Inc
                2307-8960
                16 February 2023
                16 February 2023
                : 11
                : 5
                : 1058-1067
                Affiliations
                Department of Medicine, Hebei University, Baoding 071000, Hebei Province, China
                Department of General Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei Province, China
                Department of Cardiology, First Hospital of Xinji City, Xinji 052300, Hebei Province, China
                Department of General Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei Province, China
                Department of General Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei Province, China. yulongliang2020@ 123456163.com
                Author notes

                Author contributions: Liang JJ and Liang YL were responsible for the concept and writing of the manuscript; Liang JJ and Feng WJ analyzed the data; Feng WJ, Li R and Xu RT were responsible for collecting data and revising the paper; all authors have read and agreed to the published version of the manuscript.

                Corresponding author: Yu-Long Liang, MM, Associate Chief Physician, Associate Professor, Department of General Surgery, the Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang 050051, Hebei Province, China. yulongliang2020@ 123456163.com

                Article
                jWJCC.v11.i5.pg1058
                10.12998/wjcc.v11.i5.1058
                9979299
                36874431
                e53fd826-e7aa-415a-81cb-f6e809e08136
                ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.

                This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                : 5 December 2022
                : 4 January 2023
                : 16 January 2023
                Categories
                Observational Study

                thyroid-stimulating hormone,thyroid cancer,clinical efficacy,safety profile

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