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From articles published since 2021.

Original article
Antinociceptive Effect of BPC-157 in the Formalin-induced Pain Model
Sang Yoong Park, So Ron Choi, Jeong Ho Kim, Seung Cheol Lee, Seong Yeop Jeong, Joon Ho Jeong, Tae Young Lee
Kosin Med J. 2021;36(1):1-13.   Published online June 30, 2021
DOI: https://doi.org/10.7180/kmj.2021.36.1.1
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  • 3 Citations
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

Body protective compound-157 (BPC-157) is a stable gastric pentadecapeptide that has been effective in trials aiming to increase wound healing capabilities and decrease inflammatory cell influx, including studies on the healing of muscles and tendons. There are no studies about the effect of BPC-157 on pain transmission via nociception. This study examined the antinociceptive effects of BPC-157 using formalin tests and immunohistochemistry.

Methods

Rats were randomly divided into the control, morphine and BPC-157 groups. Pain behavior was quantified periodically at 5- and 35- min intervals (representative values of phases 1 and 2) by counting the number of flinches exhibited by the injected paw after injection. The dorsal root ganglia (DRG) and spinal cords (SC) were collected, and then, the number of cytokine-positive cells was determined via immunostaining.

Results

BPC-157 dose-dependently decreased the number of flinches during phase 1 but did not decrease the number of flinches during phase 2. During phase 1, interleukin-1β (IL-1β) in the DRG tissue was significantly different in the morphine, 10 μg/kg BPC-157, and 20 μg/kg BPC-157 groups. During phase 2, statistical significance was achieved in the DRG tissue in the morphine, 20 μg/kg BPC-157, and 40 μg/kg BPC-157 groups. During phase 1, interleukin-6 was significantly different in the DRG tissue in the morphine group and the SC tissue in the 10 μg/kg BPC-157 group. During phase 2, statistical significance was achieved in the morphine group and the BPC-157 20 μg/kg group in both the DRG and SC tissues. There were no significant differences in tumor necrosis factor-α between the DRG and SC tissues.

Conclusions

BPC-157 was effective during phase 1 but not during phase 2, as determined by the formalin test. BPC-157 decreased the expression of IL-1β in the DRG tissue in phases 1 and 2.

Citations

Citations to this article as recorded by  
  • The anti-nociceptive effect of BPC-157 on the incisional pain model in rats
    Young-Hoon Jung, Haekyu Kim, Hyaejin Kim, Eunsoo Kim, Jiseok Baik, Hyunjong Kang
    Journal of Dental Anesthesia and Pain Medicine.2022; 22(2): 97.     CrossRef
  • Stable Gastric Pentadecapeptide BPC 157 as Useful Cytoprotective Peptide Therapy in the Heart Disturbances, Myocardial Infarction, Heart Failure, Pulmonary Hypertension, Arrhythmias, and Thrombosis Presentation
    Predrag Sikiric, Mario Udovicic, Ivan Barisic, Diana Balenovic, Gordana Zivanovic Posilovic, Dean Strinic, Sandra Uzun, Suncana Sikiric, Ivan Krezic, Helena Zizek, Haidi Yago, Slaven Gojkovic, Ivan Maria Smoday, Luka Kalogjera, Hrvoje Vranes, Marija Sola,
    Biomedicines.2022; 10(11): 2696.     CrossRef
  • Stable Gastric Pentadecapeptide BPC 157 and Striated, Smooth, and Heart Muscle
    Mario Staresinic, Mladen Japjec, Hrvoje Vranes, Andreja Prtoric, Helena Zizek, Ivan Krezic, Slaven Gojkovic, Ivan Maria Smoday, Katarina Oroz, Eva Staresinic, Vilim Dretar, Haidi Yago, Marija Milavic, Suncana Sikiric, Eva Lovric, Lovorka Batelja Vuletic,
    Biomedicines.2022; 10(12): 3221.     CrossRef
Review articles
Role of biomarkers in the heart failure clinic
Bong-Joon Kim, Jae-Hyeong Park
Kosin Med J. 2022;37(1):4-17.   Published online March 29, 2022
DOI: https://doi.org/10.7180/kmj.22.019
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Heart failure (HF) is a common cardiovascular disease that has a complex pathophysiology. Because it is the final stage of many cardiovascular diseases, proper diagnosis and treatment are crucial for prolonging patients’ survival and improving their well-being. Several biomarkers have been identified in HF, and their roles in diagnosis and prognostication have been widely investigated. Among them, natriuretic peptides are key for diagnosing HF, predicting its prognosis, and monitoring the effectiveness of HF treatment. Moreover, natriuretic peptides can also be used to treat HF. In addition to natriuretic peptides, several other biomarkers were included in the most recent HF management guidelines. Thus, we reviewed the role of the biomarkers included in these guidelines and discussed future perspectives.
How to conduct well-designed clinical research
Da Jung Kim, Song Yi Kil, Jongwon Son, Ho Sup Lee
Kosin Med J. 2022;37(3):187-191.   Published online September 27, 2022
DOI: https://doi.org/10.7180/kmj.22.122
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  • 2 Citations
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Clinicians and healthcare decision-makers conduct their clinical practice based on the results of clinical trials. However, some health problems remain unresolved; in such cases, further research is required. To ensure reliable research results, it is important to understand the study design and conduct well-designed clinical trials. Many study designs can be chosen within the two broad categories of observational and interventional. Clinical studies have a variety of designs, including case series, case-control, cross-sectional, and prospective and retrospective cohort studies. Well-designed clinical studies can clarify important differences between treatment options and provide data on long-term drug efficacy and safety. Interpreting the results of clinical trials can be difficult because weaknesses in research design, data collection methods, analytic methods, and reporting can compromise their value and usefulness. However, although randomized controlled trials are limited owing to ethical and practical issues, they are optimal for investigating the effects of therapy and establishing causality. Here we present an overview of different clinical research designs and review their advantages and limitations.

Citations

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  • Evaluation of automated calibration and quality control processes using the Aptio total laboratory automation system
    Namhee Kim, Yein Kim, Jeongeun Park, Jungsoo Choi, Hyunyong Hwang
    Kosin Medical Journal.2022; 37(4): 342.     CrossRef
  • The effects of rebamipide, sucralfate, and rifaximin against inflammation and apoptosis in radiation-induced murine intestinal injury
    Won Moon, Sangwook Lim, Yeonsoon Jung, Yuk Moon Heo, Seun Ja Park, Moo In Park, Sung Eun Kim, Jae Hyun Kim, Kyoungwon Jung
    Kosin Medical Journal.2022; 37(4): 320.     CrossRef
Original article
Incidence of arterial steno-occlusive disease and related factors in patients undergoing coronary artery bypass graft surgery
Seong Gyu Kim, Geun Woo Lee, Chul Ho Lee
Kosin Med J. 2022;37(2):140-145.   Published online June 24, 2022
DOI: https://doi.org/10.7180/kmj.22.104
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  • 1 Citations
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Background
Patients who undergo coronary artery bypass graft (CABG) surgery receive regular physical examinations and medications on an outpatient basis. However, these patients are at risk of developing other vascular diseases, such as postoperative arterial steno-occlusive disease (SOD). This study investigated the incidence of SOD and related factors.
Methods
In total, 246 patients who underwent CABG surgery from January 1, 2017 to December 31, 2021 were investigated. The incidence and risk factors of vascular disease were analyzed by dividing the included patients into SOD and non-SOD groups. Laboratory tests, medical history, surgical information, and family history were investigated through an electronic chart review.
Results
Data from 193 patients who met the criteria were analyzed. SOD occurred in 19.1% of patients, and the cerebral artery (38%) was the most common artery involved, followed by the peripheral artery (32%), the coronary artery (22%), and the retinal artery (8%). Risk factors for the development of SOD included estimated glomerular filtration rate (eGFR; odds ratio [OR]=0.977, p=0.008), cholesterol (OR=1.020, p=0.001), and patients with diabetes complications (OR=5.077, p=0.010). The 3-year cumulative incidence rate was 21.6%, and the risk factors for cumulative occurrence were a low eGFR, elevated cholesterol, and complications of diabetes.
Conclusions
Low eGFR, high cholesterol, and the presence of diabetic complications before CABG surgery may be associated with postoperative vascular disease. In these cases, close monitoring, proper drug administration, and patient warnings may be required.

Citations

Citations to this article as recorded by  
  • Why should you not overlook the postoperative evaluation of steno-occlusive arterial disease for coronary artery bypass graft patients?
    Jong Hyun Baek, Haeyoung Lee
    Kosin Medical Journal.2022; 37(2): 93.     CrossRef
Review article
Safety issues regarding melatonin use in child and adolescent patients with sleep problems
Eunsoo Moon, Jung Hyun Lee
Kosin Med J. 2022;37(4):264-270.   Published online December 23, 2022
DOI: https://doi.org/10.7180/kmj.22.142
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Several studies have reported that melatonin may be effective in treating sleep problems in children and adolescents. However, evidence regarding the safety of melatonin use in children and adolescents in their growth and developmental stages is warranted. Therefore, we aimed to summarize the literature on the safety of melatonin use in children and adolescents with insomnia and sleep disturbances. According to existing evidence, there are no serious adverse effects of long-term melatonin use in children and adolescents. The common adverse effects reported in long-term studies are fatigue, somnolence, and mood swings. In addition, there is no evidence that long-term use of melatonin inhibits the natural secretion of melatonin. It is necessary to monitor potential drug interactions with medications such as inhibitors and enhancers of cytochrome P450 1A2 (CYP1A2). Furthermore, low CYP1A2 expression in young children requires proper dose adjustment. Although sufficient experience of melatonin use in children and adolescents has yet to be attained, accumulating evidence suggests that the use of melatonin in children and adolescents with sleep problems might be effective and tolerable. Considering the abuse or overdose risk of hypnotics or benzodiazepines, melatonin supplements may be a good therapeutic alternative. Future studies on the long-term safety of melatonin for physiological and mental function in children and adolescents are required to establish certainty about melatonin use in children and adolescents.
Original articles
New approach to learning medical procedures using a smartphone and the Moodle platform to facilitate assessments and written feedback
Sang-Shin Lee, Haeyoung Lee, Hyunyong Hwang
Kosin Med J. 2022;37(1):75-82.   Published online March 25, 2022
DOI: https://doi.org/10.7180/kmj.22.010
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Background
To overcome communication obstacles between medical students and trainers, we designed serial learning activities utilizing a smartphone and web-based instruction (WBI) on the Moodle platform to provide clear and retrievable trainer feedback to students on an objective structured clinical examination (OSCE) item.
Methods
We evaluated students’ learning achievement and satisfaction with the new learning tool. A total of 80 fourth-year medical students participated. They installed the Moodle app (the WBI platform) on their smartphones and practiced an endotracheal suction procedure on a medical simulation mannequin while being evaluated by a trainer regarding competence in clinical skills on the smartphone app. Students’ competency was evaluated by comparing the scores between the formative assessment and the summative assessment. The degree of satisfaction and usefulness for the smartphone and WBI system were analyzed.
Results
The means (standard deviations, SDs) of the formative and summative assessments were 8.80 (2.53) and 14.24 (1.97) out of a total of 17 points, respectively, reflecting a statistically significant difference (P<0.05). The degree of satisfaction and perceived usefulness of the smartphone app and WBI system were excellent, with means (SDs) of 4.60 (0.58), and 4.60 (0.65), respectively.
Conclusion
We believe that the learning process using a smartphone and the Moodle platform offers good guidance for OSCE skill development because trainers’ written feedback is recorded online and is retrievable at all times, enabling students to build and maintain competency through frequent feedback review.

Citations

Citations to this article as recorded by  
  • How does quiz activity affect summative assessment outcomes? An analysis of three consecutive years’ data on self-directed learning
    Chi Eun Oh, Hyunyong Hwang
    Kosin Medical Journal.2022; 37(3): 228.     CrossRef
Evaluation of automated calibration and quality control processes using the Aptio total laboratory automation system
Namhee Kim, Yein Kim, Jeongeun Park, Jungsoo Choi, Hyunyong Hwang
Kosin Med J. 2022;37(4):342-353.   Published online December 22, 2022
DOI: https://doi.org/10.7180/kmj.22.144
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Background
The objective of this study was to determine whether manually performed calibration and quality control (QC) processes could be replaced with an automated laboratory system when installed analyzers fail to provide automated calibration and QC functions.
Methods
Alanine aminotransferase (ALT), total cholesterol (TC), creatinine (Cr), direct bilirubin (DB), and lipase (Lip) items were used as analytes. We prepared pooled serum samples at 10 levels for each test item and divided them into two groups; five for the analytical measurement range (AMR) group and five for the medical decision point (MDP) group. Calibration and QC processes were performed for five consecutive days, and ALT, TC, Cr, DB, and Lip levels were measured in the two groups using automated and manual methods. Precision and the mean difference between the calibration and QC methods were evaluated using the reported values of the test items in each group.
Results
Repeatability and within-laboratory coefficients of variation (CVs) between the automated system and the conventional manual system in the AMR group were similar. However, the mean reported values for test items were significantly different between the two systems. In the MDP group, repeatability and within-laboratory CVs were better with the automation system. All calibration and QC processes were successfully implemented with the Aptio total laboratory automation system.
Conclusion
The Aptio total laboratory automation system could be applied to routine practice to improve precision and efficiency.
Correlation of long interspersed element-1 open reading frame 1 and c-Met proto-oncogene protein expression in primary and recurrent colorectal cancers
Kyung-Yoon Jeon, Eun-Ji Ko, Hee-Kyung Chang, Seung-Hyun Lee, Byung-Kwon Ahn, Mee Sun Ock, Hee-Jae Cha
Kosin Med J. 2022;37(4):283-290.   Published online December 22, 2022
DOI: https://doi.org/10.7180/kmj.22.106
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Background
Colorectal cancer is one of the most common cancers worldwide. Colorectal cancer that has recurred and metastasized to other organs also has a very poor prognosis. According to recent studies, the long interspersed element-1 (LINE-1) retrotransposon open reading frame (ORF) is located in the intron of the c-Met proto-oncogene, which is involved in cancer progression and metastasis, and regulates its expression. However, no study has compared the expression patterns of LINE-1 ORF1 and c-Met, which are closely related to cancer progression and metastasis, and their correlation in primary and recurrent cancers.
Methods
In the present study, we compared the expression patterns of LINE-1 ORF1 and c-Met in both primary and recurrent colorectal cancer tissues from 10 patients. Expression patterns and correlations between LINE-1 ORF1 and c-Met proto-oncogene proteins were analyzed by immunofluorescence staining using both LINE-1 ORF1 and c-Met antibodies.
Results
The expression patterns of LINE-1 ORF1 and c-Met showed significant individual differences, and the expression of both proteins was correlated in all colorectal cancer patients. However, the expression levels of LINE-1 ORF1 and c-Met were not significantly different between primary and recurrent colorectal cancers.
Conclusions
The protein expression levels of LINE-1 ORF1 and c-Met were correlated, but did not change significantly in cases of recurrent colorectal cancer in the same patient.
Review article
Psychosomatic Approach to Fibromyalgia Syndrome: Concept, Diagnosis and Treatment
Sang-Shin Lee
Kosin Med J. 2021;36(2):79-99.   Published online December 31, 2021
DOI: https://doi.org/10.7180/kmj.2021.36.2.79
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  • 1 Citations
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Fibromyalgia syndrome (FMS) has chronic widespread pain (CWP) as a core symptom and a variety of associated somatic and psychological symptoms such as fatigue, sleep problems, cognitive disturbances, multiple somatic pain, and depression. FMS is the subject of considerable controversy in the realm of nosology, diagnosis, pathophysiology, and treatment. Moreover, the fact that FMS and mental illness are closely associated with each other might intensify the confusion for the distinction between FMS and mental disorders. This narrative literature review aims to provide the concept, diagnosis, and treatment of FMS from the integrative biopsychosocial and psychosomatic perspective. This article first explains the concepts of FMS as a disease entity of biopsychosocial model, and then summarizes the changes of diagnostic criteria over past three decades, differential diagnosis and comorbidity issue focused on mental illnesses. In addition, an overview of treatment of FMS is presented mainly by arranging the recommendations from the international guidelines which have been developed by four official academic associations.

Citations

Citations to this article as recorded by  
  • The prevalence and correlates of depression in Korean adults with rheumatoid arthritis: Results from the Korea National Health and Nutrition Examination Surveys
    Hyunseuk Kim, Haeyoung Lee, Sang‐Shin Lee
    International Journal of Rheumatic Diseases.2022; 25(4): 454.     CrossRef
Original articles
Performance comparison between Elecsys Anti-SARS-CoV-2 and Anti-SARS-CoV-2 S and Atellica IM SARS-CoV-2 Total and SARS-CoV-2 IgG assays
Seri Jeong, Yoo Rha Hong, Hyunyong Hwang
Kosin Med J. 2022;37(2):154-162.   Published online June 27, 2022
DOI: https://doi.org/10.7180/kmj.22.114
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  • 1 Citations
Abstract PDFPubReader   CrossRef-TDMCrossref - TDM
Background
Although serological severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests from several manufacturers have been introduced in South Korea and some are commercially available, the performance of these test kits has not yet been sufficiently validated. Therefore, we compared the performance of Elecsys Anti-SARS-CoV-2 (ACOV2) and Anti-SARS-CoV-2 S (ACOV2S) and Atellica IM SARS-CoV-2 Total (COV2T) and SARS-CoV-2 IgG (sCOVG) serological tests in this study.
Methods
A total of 186 patient samples were used. For each test, we analyzed the positive rate of serological antibody tests, precision, linearity, and agreement among the four assays.
Results
The positive rates of COV2T, sCOVG, and ACOV2S were high (81.7%–89.2%) in total, with those for ACOV2S being the highest, while those of ACOV2 were as low as 44.6%. This may be related to the high completion rate of vaccination in Korea. The repeatability and within-laboratory coefficients of variation were within the claimed allowable imprecision; however, further research is needed to establish an allowable imprecision at low concentrations. COV2T showed a linear fit, whereas sCOVG and ACOV2S were appropriately modeled with a nonlinear fit. Good agreement was found among COV2T, sCOVG, and ACOV2S; however, the agreement between ACOV2 and any one of the other methods was poor.
Conclusions
Considering the different antigens used in serological SARS-CoV-2 antibody assays, the performance of the tested assays is thought to show no significant difference for the qualitative detection of antibodies to SARS-CoV-2.

Citations

Citations to this article as recorded by  
  • Evaluation of automated calibration and quality control processes using the Aptio total laboratory automation system
    Namhee Kim, Yein Kim, Jeongeun Park, Jungsoo Choi, Hyunyong Hwang
    Kosin Medical Journal.2022; 37(4): 342.     CrossRef
Students’ perceptions of the learning environment at a medical school in Korea: comparisons of the most recent 4 years’ results using the Dundee Ready Education Environment Measure (DREEM)
Sejin Kim
Kosin Med J. 2022;37(4):299-310.   Published online December 7, 2022
DOI: https://doi.org/10.7180/kmj.22.129
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Background
The learning environment is an essential factor influencing students’ educational processes and personal quality of life. The purpose of this study was to examine medical students’ perceptions of the learning environment at a medical school over the most recent 4 years and explore possibilities for learning environment reform and revision based on the results.
Methods
Participating students were asked about their perceptions of the learning environment using the Dundee Ready Education Environment Measure (DREEM) questionnaire, which was distributed to first-year, third-year, and fourth-year students, representing each learning period. In total, 349 students participated in this study. Analysis of variance was conducted to determine differences in DREEM scores among years and learning periods.
Results
There were no statistically significant differences in DREEM scores by year and learning period, except for students’ perceptions of teachers and students’ perceptions of atmosphere. However, in an analysis of differences in DREEM scores in the class of 2018 cohort by learning period, four domains of the DREEM (except for students’ academic self-perceptions) and the total DREEM score were found to be significantly different.
Conclusions
Students’ perceptions of the learning environment at Kosin University College of Medicine were relatively high. The total score increased from 2019 to 2022, except for 2021. Another significant result was that basic science students had the highest perceptions, whereas students in basic clinical science had the lowest perceptions. To improve the learning environment for medical students, continuing support for students’ emotional stability, learning motivation, physical environment, social relationships, and counseling is essential.
Review articles
Ethical issues in clinical research and publication
Hyoung Shin Lee
Kosin Med J. 2022;37(4):278-282.   Published online December 15, 2022
DOI: https://doi.org/10.7180/kmj.22.132
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Clinical research including human participants should be based on truth, demonstrate scientific integrity, and follow ethical standards and guidelines to protect study participants. The publication of clinical research should be transparent and adhere to strict criteria for authorship. A thorough understanding and knowledge of ethical issues will limit investigator misconduct in clinical research and publication. In this article, basic ethical issues in clinical research and publication are reviewed and summarized based on recent guidelines.
How to write an original article in medicine and medical science
Gwansuk Kang, Sung Eun Kim
Kosin Med J. 2022;37(2):96-101.   Published online June 24, 2022
DOI: https://doi.org/10.7180/kmj.22.105
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  • 2 Citations
Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Excellent research in the fields of medicine and medical science can advance the field and contribute to human health improvement. In this aspect, research is important. However, if researchers do not publish their research, their efforts cannot benefit anyone. To make a difference, researchers must disseminate their results and communicate their opinions. One way to do this is by publishing their research. Therefore, academic writing is an essential skill for researchers. However, preparing a manuscript is not an easy task, and it is difficult to write well. Following a structure may be helpful for researchers. For example, the standard structure of medical and medical science articles includes the following sections: introduction, methods, results, and discussion (IMRAD). The purpose of this review is to present an introduction for researchers, especially novices, on how to write an original article in the field of medicine and medical science. Therefore, we discuss how to prepare and write a research manuscript for publication, using the IMRAD structure. We also included specific tips for writing manuscripts in medicine and medical science.

Citations

Citations to this article as recorded by  
  • How does quiz activity affect summative assessment outcomes? An analysis of three consecutive years’ data on self-directed learning
    Chi Eun Oh, Hyunyong Hwang
    Kosin Medical Journal.2022; 37(3): 228.     CrossRef
  • The effects of rebamipide, sucralfate, and rifaximin against inflammation and apoptosis in radiation-induced murine intestinal injury
    Won Moon, Sangwook Lim, Yeonsoon Jung, Yuk Moon Heo, Seun Ja Park, Moo In Park, Sung Eun Kim, Jae Hyun Kim, Kyoungwon Jung
    Kosin Medical Journal.2022; 37(4): 320.     CrossRef
Considerations for experimental animal ethics in the research planning and evaluation process
Jaewon Shim, Jeongtae Kim
Kosin Med J. 2022;37(4):271-277.   Published online December 22, 2022
DOI: https://doi.org/10.7180/kmj.22.139
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Research using experimental animals has substantially contributed to advances in science and medicine. Animal experiments are nearly essential for biomedical research and development efforts. Because many animals are sacrificed, researchers should consider the welfare of experimental animals and related ethical issues, along with the successful results of their experiments. This review introduces the criteria that should be considered in terms of experimental animal ethics, based on the principles of the 3 R’s: replacement, representing careful consideration of the need for animal experiments; reduction, representing the use of the minimal number of animals to obtain meaningful experimental results; and refinement, representing continuous effects to find alternative methods to reduce pain and distress in experimental animals. Based on these principles, the following points should be considered when planning experiments: the necessity of animal experiments; alternatives to animal experiments; the relevance of the species and numbers of experimental animals; appropriate assessment and management of pain; the proper usage of sedatives, painkillers, and anesthesia; and valid timing for humane endpoints and euthanasia. These criteria are beneficial for both experimental animals and researchers because careful handling to ensure experimental animal welfare guarantees that scientific research will yield convincing, repeatable, and accurate results.
Original article
Risk factors for central and lateral lymph node metastasis in papillary thyroid carcinoma
Ji Hyun Ahn, Hee Kyung Chang
Kosin Med J. 2022;37(4):311-319.   Published online December 19, 2022
DOI: https://doi.org/10.7180/kmj.22.136
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Background
Lymph node metastasis (LNM) is commonly observed in papillary thyroid carcinoma. This study aimed to investigate the risk factors for LNM in patients with papillary thyroid carcinoma.
Methods
The clinicopathological factors of 417 patients were investigated, and differences according to the presence or absence of LNM were evaluated.
Results
LNM was associated with age <55 years, male sex, tumor size >10 mm, multiple and bilateral tumors, tumor involving the lower pole or entire lobe, lymphovascular invasion (LVI), perineural invasion (PNI), and extrathyroidal extension (ETE). Univariable and multivariable analyses showed that age <55 years, male sex, tumor size >10 mm, LVI, and ETE were related to central LNM. Male sex, tumor size >10 mm, and LVI were correlated with lateral LNM (p<0.05). Compared to central LNM, more lymph nodes were involved in metastases and the metastatic tumors were larger in lateral LNM. Extranodal extension (ENE) was more commonly observed in lateral LNM (p<0.001) and was associated with tumor size >10 mm, multifocality, PNI, ETE, and the absence of lymphocytic thyroiditis (p<0.05).
Conclusions
Younger age, male sex, tumor size >10 mm, LVI, and ETE were risk factors for central LNM, while male sex, tumor size >10 mm, and LVI were risk factors for lateral LNM. ENE was more commonly observed in lateral LNM, and tumor size >10 mm, multifocal tumors, PNI, ETE, and tumors unrelated to lymphocytic thyroiditis were risk factors for ENE.

KMJ : Kosin Medical Journal