Quality Improvement in Thyroid Fine-Needle Aspiration Biopsy accuracy at San Juan City Hospital Endocrinology Clinics.

OBJECTIVE: This study aimed to determine if there was a reduction in the amount of non-diagnostic cytopathology results of thyroid fine-needle aspiration (FNA) biopsies performed at San Juan City Hospital (SJCH) endocrinology clinics since the inclusion of a cytopathologist at the clinics. METHODS: This research consisted of a retrospective analysis of thyroid nodule FNA biopsy results performed at SJCH endocrinology clinics. The biopsies analyzed were performed during academic years from July 2017-June 2018 and July 2018-June 2019, a period that reflects one academic year prior and a year after the inclusion of a cytopathologist to the clinics. The patients were classified into "pre group" and "post -group." Descriptive analysis was conducted, taking into consideration variables including sex, age, period, location, size of the nodule, and cytology results. A Chi-square test and Confidence Interval were used to assess the association and estimates between predictors and outcomes. RESULTS: From the 145 thyroid nodules biopsied, a total of 121 nodules (83.4%) resulted in diagnostic cytologic results, while 24 nodules (16.6%) were non-diagnostic. From the "pre group," 57 nodules (78.1%) had a diagnosis, while the other 16 (21.9%) were reported as non-diagnostic. From the "post group", 64 nodules (88.9%) had a diagnosis, while the other 8 (11.1%) resulted in non-diagnostic findings (p-value: = 0.08). Even though results were statistically non-significant, a clear trend towards a decrease in non-diagnostic samples was evident. CONCLUSION: In our study, there was a decrease in the number of non-diagnostic thyroid nodule FNA results after on-site adequacy determination guided by a cytopathologist.

HLA-BAT1 alters migration, invasion and pro-inflammatory cytokines in prostate cancer.

Prostate cancer (PCa) accounts for more than 1 in 5 diagnoses and is the second cause of cancer-related deaths in men. Although PCa may be successfully treated, patients may undergo cancer recurrence and there is a need for new biomarkers to improve the prediction of prostate cancer recurrence and improve treatment. Our laboratory demonstrated that HLA-B-associated transcript 1 (BAT1) was differentially expressed in patients with high Gleason scores when compared to low Gleason scores. BAT1 is an anti-inflammatory gene but its role in PCa has not been identified. The objective of this study is to understand the role of BAT1 in prostate cancer. In vitro studies showed that BAT1 down-regulation increased cell migration and invasion. In contrast, BAT1 overexpression decreased cell migration and invasion. RT-PCR analysis showed differential expression of pro-inflammatory cytokines (TNF-α and IL-6) and cell adhesion and migration genes (MMP10, MMP13, and TIMPs) in BAT1 overexpressed cells when compared to BAT1 siRNA cells. Our in vivo studies demonstrated up-regulation of TNF-α, IL-6, and MMP10 in tumors developed from transfected BAT1 shRNA cells when compared to tumors developed from BAT1 cDNA cells. These findings indicate that BAT1 down-regulation modulates TNF-α and IL-6 expression which may lead to the secretion of MMP-10 and inhibition of TIMP2.

A Rare Case of Uterine Leiomyosarcoma with Metastasis to the Thyroid Gland.

Uterine leiomyosarcomas are aggressive tumors associated with a poor prognosis. These neoplasms have high metastatic potential, more frequently affecting the lungs, liver, and peritoneum. There are very few cases of metastasis to the thyroid described in the literature. We present the case of a 47-year-old female diagnosed with uterine leiomyosarcoma metastatic to the thyroid gland. In this case report, we want to emphasize the utility of ancillary studies to help differentiate a leiomyosarcoma from anaplastic thyroid carcinoma since cytologic evaluation alone can be challenging.