Kiyomi HoriuchiDr. Japan

Kiyomi HoriuchiDr.
Dr. Kiyomi Horiuchi graduated from Tokyo Women’s Medical University (TWMU) in 1992 and soon after began her training in general surgery with a focus on endocrine surgery. She completed her general surgery training at Japan Railway Tokyo Hospital and the International Medical Center of Japan. Since then, Dr. Horiuchi has devoted over 20 years to advancing endocrine surgery at TWMU Hospital. Dr. Horiuchi currently serves as Associate Professor and Chief of Endocrine Surgery at TWMU. Her clinical expertise encompasses open surgery of the thyroid and parathyroid, and she has extensive experience in managing patients with Multiple Endocrine Neoplasia (MEN). Dr. Horiuchi’s research focuses on the surgical management of MEN, prognostic factors in thyroid cancer, and patient-reported outcomes in endocrine diseases. Through her work, she strives to improve both the quality of surgical care and the overall patient experience. In addition to her clinical and research activities, Dr. Horiuchi is committed to international volunteer work. Since the Japan Association of Endocrine Surgery (JAES) partnered with Japan Heart two years ago, Dr. Horiuchi has been teaching thyroid surgery techniques to surgeons in Oudomsay, a mountainous region in Laos. She has participated in this hands-on surgical training program annually since its inception and is scheduled to join the third session in January of next year, helping to advance surgical care and education in the region.

20 MARCH

Time Session
10:30
12:00
[Symposium] Thyroid (1)
Preoperative Thyroid Nodule Diagnosis
Chia-Hung LinTaiwan Moderator Novel Biomarkers and Treatment Strategies in Thyroid Eye DiseaseThyroid Eye Disease (TED), also known as Graves' orbitopathy, remains a complex autoimmune condition that significantly impacts patients' vision and quality of life. Traditionally, management has relied mainly on non-specific anti-inflammatory therapies. However, as our understanding of its molecular pathogenesis evolves, there is an increasing clinical demand for more precise diagnostic tools and targeted therapeutic interventions. This presentation provides a comprehensive overview of the current landscape and future directions in the management of TED. We will discuss the emergence of novel serum and molecular biomarkers that offer potential for earlier diagnosis and more accurate prediction of disease progression. These biomarkers may bridge the gap between clinical observation and underlying immunological activity. Furthermore, we will explore the shift in treatment paradigms, moving from conventional systemic corticosteroids toward innovative biological agents. By targeting specific signaling pathways involved in orbital inflammation and remodeling, these new strategies aim to provide more effective and durable clinical outcomes. The integration of novel biomarkers and advanced treatment modalities is reshaping the management of TED. Moving toward a more individualized approach will allow clinicians to optimize therapeutic timing and selection, ultimately improving the long-term prognosis for patients with this challenging condition.
Chin-Sung KuoTaiwan Moderator
  • Preoperative Molecular Testing for Thyroid Nodules
    Guodong FuCanada Speaker Preoperative Molecular Testing for Thyroid NodulesTitle: Preoperative Quantitative Molecular Testing for a Definitive Cancer Diagnosis among Patients with Thyroid Nodules Objective: Molecular testing is increasingly used in the assessment of thyroid nodules. Tumors harboring the same genomic variant may not behave the same because a gene variant is not expressed equally in tumor cells among patients. This study is to delineate interpatient variabilities in genomic variants in thyroid tumors and assess their diagnostic significance in definitive thyroid cancer diagnosis. Methods: Interpatient differences in BRAF V600E, TERT promoter, and RAS variants (ie, NRAS, HRAS, and KRAS) were analyzed in residual thyroid fine-needle aspiration (FNA) biopsies and compared with surgical histopathologic diagnoses. Malignancy rates, sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were calculated. Results: This retrospective study enrolled 620 patients (470 [75.8%] female; mean [SD] age, 50.7 [15.9] years), including 438 surgically resected thyroid tumors and 249 thyroid nodule FNA biopsies. Of 438 tumors, 178 (40.6%) and 58 (13.2%) carcinomas were detected with interpatient variabilities of BRAF V600E and TERT promoter variants (C228T and C250T), with variant allele fraction (VAF) levels ranging from 0.03% to 48.56% and 0.13% to 54.74%, respectively. Furthermore, 89 (20.3%) were identified with the presence of RAS variants, including 51 (11.6%) with NRAS, 29 (6.6%) with HRAS, and 9 (2.1%) with KRAS, with VAF levels ranging from 0.15% to 51.53%. VAF assays of 249 residual FNA specimens identified 50 specimens (20.1%) with BRAF V600E, 25 FNAs (10.0%) with TERT promoter variants, and 36 specimens (14.5%) with RAS variants with interpatient variabilities (including 23 FNAs [9.2%] with NRAS, 10 FNAs [4.0%] with HRAS, and 3 FNAs [1.2%] with KRAS). Interpatient differences in the 5 gene variants (NRAS, HRAS, KRAS, BRAF, and TERT) were detected in 54 of 126 indeterminate FNAs (42.9%) and 18 of 76 ND FNAs (23.7%). Compared with the 5 gene variants detected in the matched surgical specimens, VAF assays on residual FNA biopsies exhibited a high agreement (κ = 0.80; P < .001) and demonstrated a sensitivity of 87.1% (95% CI, 69.2%-95.8%), specificity of 92.5% (95% CI, 78.5%-98.0%), PPV of 90.0% (95% CI, 72.3%-97.4%), and NPV of 90.2% (95% CI, 75.9%-96.8%). Conclusions: This diagnostic study delineated that quantitative discrimination of interpatient variabilities in genomic variants could facilitate cytology examinations in preoperative precision malignancy diagnosis among patients with thyroid nodules.
  • Harnessing Molecular Diagnostics in Cytologically-Indeterminate Thyroid Nodules
    Samantha Peiling YangSingapore Speaker Harnessing Molecular Diagnostics in Cytologically-Indeterminate Thyroid NodulesRe-Differentiation Therapy in RAI-Refractory Thyroid Cancer
  • Preoperative Diagnosis of Thyroid Cancer
    Kiyomi HoriuchiJapan Speaker Preoperative Diagnosis of Thyroid Cancer
102

21 MARCH

Time Session
10:20
11:10
Oral Presentation 3: Thyroid Oncology & Cardiovascular Complications
Kiyomi HoriuchiJapan Moderator Preoperative Diagnosis of Thyroid Cancer
Wei-Yu ChouTaiwan Moderator
103