Roxana Grigorovici

Dr. Roxana Grigorovici


Research Focus & Metrics

Academic Career Length

2Years (2025-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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Verified
Journal Article
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MCMaria-Paula Comanescu
Maria-Paula Comanescu
OBOtilia Boisteanu
Otilia Boisteanu
DHDelia Hinganu
Delia Hinganu
Marius Valeriu Valeriu HinganuMarius Valeriu Valeriu Hinganu
Marius Valeriu Valeriu Hinganu
RGRoxana Grigorovici
Roxana Grigorovici
AGAlexandru Grigorovici
Alexandru Grigorovici
The parathyroid and thymus glands are key components of the endocrine and immune systems, respectively, with intriguing developmental, anatomical, and functional interrelationships. This study starts from the hypothesis that, given their shared embryological origin, it is plausible that the thymus and parathyroid glands interact functionally and may share pathological pathways. The present study explores the developmental pathways, spatial proximity, and potential cross-talk between these glands. Recent studies suggest that parathyroid hormone (PTH) may influence thymic function, including T-cell maturation and immune regulation, while thymic signaling molecules could impact calcium homeostasis and parathyroid activity. Understanding the functional and etiopathogenical relations between these endocrine glands offers new insights into endocrine–immunological crosstalk, and therapeutic approaches targeting disorders such as hypoparathyroidism, thymomas, myasthenia gravis and thymic hypoplasia. Perspectives and conclusion: Future research is essential to discover the molecular mechanisms underpinning this dynamic interrelation and its broader implications for health and disease. Because there is still very little data on this interaction, in-depth studies are necessary on large groups of patients. This research proposes a cross-study of the receptors for the main substances secreted by the two categories of endocrine glands. At the same time, it is essential to carry out an in-depth study on the cervico-pericardial ligaments through the lens of this glandular interaction. These ligaments could contain the main blood and nerve communication pathway between the parathyroids and the glands.

2 January 2026 in Medicina
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Journal Article
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AAAndrei Alexandru Andoni
Andrei Alexandru Andoni
FSFlorentina Severin
Florentina Severin
ACAlina Calin Frij Calin
Alina Calin Frij Calin
FMFlorin Mocanu
Florin Mocanu
IRIonut Andrei Roman
Ionut Andrei Roman
AGAlexandru Grigorovici
Alexandru Grigorovici
Background and Objectives: Mean platelet volume (MPV) is a routinely available blood marker that measures platelet size and activation, and it has been evaluated as a potential marker for thyroid malignancies. Platelets participate in tumor genesis through angiogenesis, immune evasion, and metastasis, making them plausible adjuncts for cancer risk evaluation. The objective is to systematically evaluate the role of MPV in thyroid cancers, with the main focus on diagnostic accuracy, prognostic value, and limitations, focusing on papillary thyroid carcinoma (PTC). Materials and Methods: A systematic search of PubMed was conducted from January 2015 to September 2025. Only free full-text studies on human subjects were included. Eligible studies included case–control, cohort, or observational designs reporting MPV or platelet indices in thyroid cancer compared with benign nodules or healthy controls. Data on diagnostic performance, associations with tumor stage, lymph node involvement, and recurrence were extracted and synthesized narratively. No formal risk-of-bias or study quality assessment tool was applied. The literature search was restricted to studies with freely available full-text articles, which may have introduced access-based selection bias. Results: Eleven studies met the inclusion criteria. Most of them reported high MPV values in papillary thyroid carcinoma (PTC), with limited evidence regarding other thyroid cancer subtypes. High values of MPC were reported in the majority of studies in PTC compared to benign nodules or healthy controls. The diagnostic performance of MPV alone was poor, but integration with inflammatory ratios such as the neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte ratio (PLR), and with ultrasound systems (TI-RADS), improved accuracy. Regarding prognostic utility, some studies linked higher MPV with lymph node involvement or recurrence risk, while others did not find significant data. Thyroid function, autoimmune thyroid disease, and methodological variability in MPV measurement limited comparability across studies. Conclusions: MPV is a low-cost adjunct biomarker, especially when combined with other hematologic and imaging markers. However, MPV should not be used as a stand-alone diagnostic or prognostic tool. Larger, prospective studies are mandatory to clarify its clinical role.

Verified
Journal Article
Open access
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MCMaria-Paula Comanescu
Maria-Paula Comanescu
OBOtilia Boisteanu
Otilia Boisteanu
DHDelia Hinganu
Delia Hinganu
LLLudmila Lozneanu
Ludmila Lozneanu
FLFabian C Lupu
Fabian C Lupu
Marius Valeriu Valeriu HinganuMarius Valeriu Valeriu Hinganu
Marius Valeriu Valeriu Hinganu
The thymus and parathyroid glands share a common embryological origin from the third pharyngeal pouch, yet their potential morphological and functional interconnections remain insufficiently explored. We conducted a comparative study integrating immunohistochemistry (IHC) and SEM on human thymic tissue, parathyroid adenomas, and parathyroid tissue excised during thyroidectomy. IHC staining targeted Thymosin-α1, CaSR, and PTH1R, with semi-quantitative evaluation of staining intensity and distribution. SEM analysis was performed at multiple magnifications to assess stromal organization and microvascular relief. Non-parametric statistical tests (Kruskal–Wallis with Mann–Whitney post hoc comparisons) were applied to clinical and laboratory data across the three cohorts. Scanning electron microscopy (SEM) revealed convergent ultrastructural features between thymus and parathyroid, including reticular stromal meshes and vascular grooves suggestive of comparable microcirculatory organization. IHC demonstrated robust Thymosin expression in thymus, with heterogeneous/apical distribution in parathyroid tissue; CaSR showed strong membranous and cytoplasmic expression in parathyroid, but weak diffuse signal in thymus; PTH1R exhibited low-to-moderate expression in thymus and moderate heterogeneous expression in parathyroid, with apical accentuation in adenomas. Statistical analysis confirmed significant differences in ionized calcium, PTH, and anti-AChR titers among the three cohorts (all p < 0.001), while TSH and calcitonin did not differ significantly. Our findings strengthen the hypothesis of a morpho-functional parathyroid–thymus axis. The robust parathyroid expression of CaSR and PTH1R aligns with established roles in calcium–PTH homeostasis, while the novel detection of Thymosin in parathyroid tissue suggests an expanded functional repertoire. These results highlight a continuum between embryological proximity and adult tissue cross-talk, with potential clinical implications for parathyroid pathology and immune regulation.

29 December 2025 in Journal of Clinical Medicine
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Journal Article
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ACAlina Calin Frij Calin
Alina Calin Frij Calin
CVCristian Velicescu
Cristian Velicescu
AAAndrei Alexandru Andoni
Andrei Alexandru Andoni
RCRoxana Covali
Roxana Covali
ACAlin Ciubotaru
Alin Ciubotaru
AGAlexandru Grigorovici
Alexandru Grigorovici
Introduction: Severe acute pancreatitis (SAP) is a critical condition that affects 20–30% of people with acute pancreatitis (AP). Prompt detection and accurate classification are crucial to direct prompt interventions, increase resource allocation, and improve patient outcomes. Current scoring systems, while beneficial, frequently face challenges related to speed, complexity, and early predictive accuracy. Method: We developed and validated an effective six-parameter risk assessment scale for AP, incorporating pancreatic-specific biomarkers (trypsinogen-activating peptide [TAP], trypsin-2), systemic inflammation markers (C-reactive protein), pancreatic enzyme concentrations, blood glucose, and patient age. The study cohort included 104 patient samples. Reliability was assessed using Cronbach’s alpha and Spearman–Brown coefficients, factorial validity was determined by principal component analysis, and predictive validity was analyzed using logistic regression and receiver operating characteristic (ROC) analysis. Biotemporal changes at 24 and 48 h were assessed to classify risk scoring. Results: The scale demonstrated satisfactory internal consistency (Cronbach’s alpha = 0.72) and a distinct structure with two factors representing local pancreatic damage and systemic inflammation, explaining 65% of the variability. Logistic regression established predictive validity for serious outcomes, with TAP and trypsin-2 showing significant correlations. ROC analysis demonstrated remarkable discriminative capacity (AUC = 0.85), showing a sensitivity of 82.4% and a specificity of 76.8%. Assessment of temporal biomarkers showed a reduction in TAP, signifying resolution of the initial enzymatic activation, while trypsin-2 levels continued to increase, indicating persistent damage to the pancreatic tissue. Patients were classified into low-, moderate- and high-risk groups, facilitating practical clinical decision-making. Discussion and Conclusions: This six-parameter risk score provides a rapid, biologically based, and clinically useful method for early detection of patients at risk for SAP. Combining indicators of local pancreatic involvement with systemic inflammation allows for prompt triage, improves the allocation of intensive therapy, and supports informed prognostic conversations.

5 January 2026 in Medicina
Verified
Journal Article
Open access
PDF file
ACAlina Calin Frij Calin
Alina Calin Frij Calin
CVCristian Velicescu
Cristian Velicescu
AAAndrei Alexandru Andoni
Andrei Alexandru Andoni
RCRoxana Covali
Roxana Covali
Ciubotaru Alin FlorentinCiubotaru Alin Florentin
Ciubotaru Alin Florentin
AGAlexandru Grigorovici
Alexandru Grigorovici
Background and Objectives: Acute pancreatitis (AP) has a wide range of clinical severity, and early prediction of disease progression is still challenging. Trypsinogen-activating peptide (TAP) and trypsin-2 serve as direct biomarkers for intrapancreatic proteolytic activation and may provide earlier pathophysiological information compared with traditional markers. Materials and Methods: In this retrospective cohort analysis involving 54 AP patients, we evaluated 24 h serum and urinary TAP and trypsin-2 concentrations by Bayesian correlation, mediation analysis, unsupervised K-means clustering, and supervised machine learning (Elastic Net and Random Forest). The analyses investigated the relationships of biomarkers with inflammation (CRP), enzymatic activities (amylase, lipase), and clinical factors, as well as inflammation severity (CRP levels). Results: Bayesian correlations indicated moderate evidence for a relationship between serum TAP and CRP (BF10 = 8.42), as well as strong evidence linking age to serum TAP (BF10 = 12.75). Serum trypsin-2 showed no correlation with CRP, while urinary trypsin-2 had a correlation with amylase (BF10 = 6.89). Mediation analysis indicated that TAP and trypsin-2 accounted for 42–44% of the impact of CRP on pancreatic enzyme elevation. Clustering revealed three phenotypic subgroups (“Mild Activation”, “Moderate System”, and “Severe Pancreatic-Renal”), the latter showing the highest levels of CRP and biomarkers. Machine learning models highlighted urinary trypsin-2 and age as the most significant predictors of inflammation, with Random Forest achieving the highest performance (R2 = 0.53). Conclusions: Early urinary trypsin-2 outperforms serum markers as a predictor of systemic inflammatory intensity, indicating total proteolytic impairment and renal clearance. This integrative analysis reveals unique biological phenotypes and highlights the potential of these biomarkers for early assessment of the inflammatory burden. Their role in predicting clinical disease progression requires prospective validation. Integrative biomarker analysis reveals unique biological phenotypes and improves assessment of inflammatory burden in PA. Larger cohorts are required for prospective validation to incorporate these biomarkers into precision-based diagnostic frameworks.

Verified
Journal Article
Open access
PDF file
MCMaria-Paula Comanescu
Maria-Paula Comanescu
DHDelia Hînganu
Delia Hînganu
Marius Valeriu Valeriu HinganuMarius Valeriu Valeriu Hinganu
Marius Valeriu Valeriu Hinganu
OBOtilia Boisteanu
Otilia Boisteanu
LLLudmila Lozneanu
Ludmila Lozneanu
AGAlexandru Grigorovici
Alexandru Grigorovici
Although the thymus and parathyroid glands originate from the third pharyngeal pouch, their postnatal relationship has been predominantly interpreted in embryological terms, with limited structural evidence supporting a functional interaction. The aim of this study was to explore whether multimodal observations support a previously underrecognized structural relationship between the thymus and parathyroid glands. For this purpose, microCT-based three-dimensional reconstruction was used to assess their spatial and branching high-attenuation structures, and the findings were correlated with histomorphometric analysis, immunohistochemical evaluation of vascular and extracellular matrix markers, scanning electron microscopy (SEM), and available clinical data. MicroCT analysis revealed distinct three-dimensional architectural patterns in thymic and parathyroid tissues. Histomorphometric and immunohistochemical findings revealed stromal organization and molecular expression patterns compatible with tissue remodeling. SEM provided additional microarchitectural detail, supporting the presence of structural continuity. Notably, the integration of three-dimensional imaging with histological and ultrastructural data revealed a previously underrecognized level of organization at the parathyroid–thymus interface. The overall findings indicate a more complex organized anatomical and microvascular relationship rather than a simple juxtaposition of two distinct structures. Taken together, these multimodal findings support the hypothesis of a previously underexplored structural relationship between the thymus and parathyroid glands. However, the proposed microarchitectural framework should be considered exploratory and requires validation using dedicated vascular imaging and morphometric techniques. The observed micro-tissue-specific architecture suggests that an organized structure may facilitate inter-structural communication, potentially resembling a port system-like arrangement. Further studies are required to clarify its physiological relevance.