The expression and function of NIS are the prerequisites of radioactive iodine ( RAI ) treatment for DTC, which in turn determine the iodine uptake and outcome in DTC patients. Studies for the factors that might influence the function of NIS for the development of redifferentiation therapy should be conducted in conjunction with the individualized course of treatment in DTC patients having poor iodine up?take in their thyroid tumors. This review summarizes the factors that influence the function and expression of NIS in these patients.

As an important postsurgical adjuvant treatment for DTC, radioactive iodine (RAI) is administered to eliminate residual thyroid tissue as well as the potentially persistent or distant metastatic lesions.It plays a significant role in reducing disease recurrence and tumor-related mortality.The major challenge at present in RAI treatment decision-making is how to achieve optimum clinical outcome with minimal radiation exposure.ATA guidelines recommends a postsurgical recurrence-risk adapted approach to RAI treatment management based on the clinicopathological features.However, RAI therapy is not beneficial to all DTC patients.The potential benefits from RAI therapy in DTC patients with different risk stratification have attracted much attention, and are reviewed in this article in order to provide more evidence-based basis for clinical decision-making.

Recent research has gained much depth and details on the response-to-therapy assessment system (RTAS) of DTC. The concept of RTAS was first proposed in the 2015 ATA guidelines, mainly advocating dynamic and ongoing assessment of a disease process after primary therapy is completed. This recommendation is to compensate for the deficiency of a static, single-parametric evaluation system that is conventionally pathology-dominated. The concept of risk-adaptive management has been adopted in individual decision-making processes, so as to tailor treatment plans accordingly with an understanding that therapies (e.g. surgery, etc.) should also be involved as a continuum of risk assessment. The RTAS according to the new guidelines has been clearly highlighted worldwide. This review aims to outline the progress and latest update of RTAS on DTC.

Recently, the morbidity of differentiated thyroid carcinoma (DTC) has increased annually. American Thyroid Association (ATA) published the management guidelines for patients with thyroid nodules and DTC in 2006 in order to standardize their management. The ATA guidelines was updated for the ifrst time in 2009 and its renewed version was completed in 2015 based on the considerable progress that had been made in the ifelds such as diagnostic assessment and management of thyroid nodules, surgery and radioactive iodine therapy for DTC in recent years. This article tried to interpret the updated contents about radioactive iodine therapy for DTC in 2015 version of the guidelines.

Surgery, selective radioiodine therapy and thyroid stimulating hormone suppressive therapy are the standard treatment modalities for differentiated thyroid cancer (DTC). After therapy, most DTC patients could get good prognosis. However, some patients with distant metastasis lose the ability to concentrate radioiodine at early time or during the treatment, and develop radioiodine-refractory DTC (RAIR-DTC). These patients progress quickly and have high mortality. Looking for effective treatments for these patients has been the hot spot in research of thyroid carcinoma. In this paper, we summarized the recent advances in the diagnosis and treatment of RAIR-DTC, hoping to early identify these patients and buy time for early intervention of other possible beneficial treatments such as targeted therapy and radiotherapy.

During 131Ⅰ therapy or the natural course of DTC,2％ to 5％ of them will gradually no longer be sensitive to 131Ⅰ therapy and lead to radioactive iodine-refractory DTC (RAIR-DTC).Recent studies found that alterations of critical molecular targets in main signal transduction pathways could decrease the iodine-trapping function of thyroid carcinoma,such as BRAFV600E mutation,followed by negative 131 Ⅰ-whole body scan (WBS) and discounted efficacy.This article reviews novel diagnostic and therapeutic modalities for RAIR-DTC.

131 I-metabolizing genes are markers for differentiation of thyroid carcinoma.The loss or down-regulation of these genes represents progression of dedifferentiation,which results in low 131 I uptake and suggests a poor prognosis.The mechanism of dedifferentiation of DTC is important for treatment.This article reviews the mechanism of dedifferentiation from 131I radiation damage,gene mutation,tumor markers and protein.

Background and purpose:Thyroglobulin antibody (TgAb) is often positive in papillary thyroid carcinoma (PTC) patients. This study aimed to investigate the effect of TgAb on radioiodine ablation efficacy in PTC patients.Methods:A total number of 329 PTC patients with no distant metastasis were included and classified into 2 groups[G1 group (>115 U/mL,n=84) and G2 group (<115 U/mL,n=245)], G2 group was further divided into 2 subgroups[S1 (>40 U/mL,n=31) and S2 (<40 U/mL,n=214)], before131I ablation. The median follow-up time was 24 months after a total or subtotal thyroidectomy and subsequent131I ablation. The efficacy in terms of131I ablation success rates (IBR) between two groups were compared and the influencing factors were analyzed according to criteria posed by 2015 American Thyroid Association Guidelines, then the effect of131I dose on IBR was also explored.Results:Female and younger age were more prevalent in patients with high TgAb (P<0.05). The G1 group presented lower IBR over the G2 group (35.7%vs 72.7%,P=0.000). Moreover, S1 group also presented lower IBR over S2 group (54.8%vs 75.2%,P=0.017), indicating the adverse effect from high titer TgAb on IBR. No matter high or low dose, the G1 group presented lower IBR (34.1%vs 71.9%, 37.2%vs 73.2%;P=0.000). However, IBR did not differ in G1 or G2 group either with high or low dose131I (P>0.05). TgAb was the only adverse indicator correlating with IBR in multi-logistic regression analysis (P=0.018).Conclusion:TgAb could negatively affect131I ablation efficacy, while increasing the dose of131I failed to improve the success rate in such cases.

Objective To establish an experimental model for exploring the role of RhoC gene in the invasiveness and metastasis of hepatocellular carcinoma.Method The RhoC gene was digested with restricted enzyme Hind III and XbaI,and direct cloned to pcDNA3.1.The recombinant vector (pcDNA3.1 RhoC) and the vector alone (pcDNA3.1) were transfected into HEPG2 cells with LIPFECTAMINETMReagent.After selected with hygromycin,resistant cloneies was obtained.The transcription and translation of RhoC gene were analysed with the reverse transcription PCR and immunohistochemical stain.Results The recombinant vectort (pc DNA3.1 Rhoc) express steadily in HerpG2 cells.Conclusions The modified tumor cells(HEPG2 RhoC) could be used to study the effect of RhoC protein on the invasiveness and metastasis of hepatocellular carcinoma.

Objective:To evaluate 131I adjuvant therapy in B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutant patients with non-distant metastatic papillary thyroid cancer (PTC). Methods:From January 2008 to January 2019, a total of 181 PTC patients (65 males, 116 females, age: (38.9±11.8) years) with non-distant metastases from Peking Union Medical College Hospital were retrospectively enrolled. All patients received only one time 131I therapy with complete clinicopathological information, data of follow-up (median time: 63 months) and assessment of response to therapy. Patients were divided into mutant and wild type group in terms of BRAF V600E status or ablation group (1.1 GBq) and adjuvant therapy group (3.7-5.5 GBq) in terms of different 131I dosage. Clinicopathological features and the response to therapy were compared between different groups by using independent-sample t test, Mann-Whitney U test and χ2 test. Results:The levels of preablative stimulated thyroglobulin (ps-Tg) in the BRAF V600E mutant type group ( n=150) was significantly higher than that in the wild type group ( n=31; 6.32(0.90, 8.70) vs 3.92(0.40, 4.40) μg/L; z=-2.413, P=0.016), however, there were no significant differences in other clinicopathological characteristics (including age, sex, tumor size, multifocality, capsule invasion and N staging) between the two groups ( t=-0.663, z=-1.151, χ2 values: 0.003-1.491, all P>0.05) and the therapeutic response was also not different between the two groups( χ2=1.094, P=0.778). Of 81 patients who received 131I adjuvant therapy, the ps-Tg level of BRAF V600E mutant type group ( n=69) was higher than that of the wild type group( n=12; 8.70(1.30, 11.80) vs 3.40(0.30, 4.50) μg/L; z=-2.194, P=0.028), while the therapeutic response was not different between the two groups ( χ2=1.792, P=0.617). Compared with BRAF V600E mutant patients received 131I ablation ( n=81), BRAF V600E mutant patients received 131I adjuvant therapy ( n=69) had larger tumors (1.52(0.95, 2.00) vs 1.21(0.60, 1.50) cm; z=-2.728, P=0.006), more advanced N staging ( χ2=11.460, P=0.003) and higher ps-Tg level (8.70(1.30, 11.80) vs 4.34(0.50, 5.30) μg/L; z=-3.314, P=0.001), but the therapeutic response was not different between the two groups ( χ2=6.478, P=0.091). Conclusion:131I adjuvant therapy may improve the longer-term response to therapy in BRAF V600E mutant PTC patients with lager tumors, more advanced N staging and higher ps-Tg level.