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1.
Medicine (Baltimore) ; 98(50): e18213, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31852078

RESUMEN

We aimed to investigate the association between excess body mass index (BMI) and papillary thyroid cancer (PTC) in an operative population, and the impact of higher BMI on clinicopathological aggressiveness of PTC.Charts of 10,844 consecutive patients with thyroid nodules undergoing partial or total thyroidectomy between 1993 and 2015 were reviewed. Patients diagnosed with PTC were stratified in 4 groups: BMI < 18.5 (underweight), 18.5 ≤ BMI < 24 (normal-weight), 24 ≤ BMI < 28 (overweight) and BMI ≥ 28(obese). The impacts of high BMI on prevalence and clinicopathological parameters of PTC were retrospectively analyzed in both univariate and multivariate binary logistic regression analysis.For every 5-unit increase in body mass, the odds of risk-adjusted malignance increased by 36.6%. The individuals who were obese and overweight were associated with high risk of thyroid cancer [odds ratio (OR)= 1.982, P < .001; OR= 1.377, P < .001; respectively] compared to normal weight patients, and this positive association was found in both genders. Obesity was independent predictors for tumors larger than 1 cm (OR = 1.562, P < .001) and multifocality (OR = 1.616, P < .001). However, there was no difference in cervical lymph node (LN) metastasis among BMI groups. Crude analysis showed BMI was associated with advanced tumor-node-metastasis (TNM) stage (relative risk, approximately 1.23 per 5 BMI units, P < .001), but this association disappeared after adjusting for confounding factors.Obesity was significantly associated with the risk of PTC in a large, operative population. Higher BMI was significantly associated with larger tumor size and multifocal tumor.


Asunto(s)
Índice de Masa Corporal , Obesidad/complicaciones , Cáncer Papilar Tiroideo/diagnóstico , Neoplasias de la Tiroides/diagnóstico , Tiroidectomía/métodos , Estudios de Casos y Controles , China/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Estudios Retrospectivos , Cáncer Papilar Tiroideo/etiología , Cáncer Papilar Tiroideo/cirugía , Neoplasias de la Tiroides/etiología , Neoplasias de la Tiroides/cirugía
2.
J Surg Res ; 244: 96-101, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31280000

RESUMEN

BACKGROUND: Obesity and thyroid cancer has increased in recent decades. Thyroid malignancy is linked with elevated thyroid-stimulating hormone (TSH) levels, which may have a positive association with body mass index (BMI). This study examines obesity and TSH level effect on papillary thyroid cancer (PTC) risk in a surgical population. METHODS: A retrospective review of prospectively collected data for 991 patients who underwent thyroidectomy at a single institution was performed. Patients were stratified according to BMI into three groups: nonobese (18.5-29.9 kg/m2), obese (30-39.9 kg/m2), and morbidly obese (≥40 kg/m2). Further subdivisions into benign and malignant outcomes based on final pathology were compared with preoperative TSH levels. Subanalyses according to sex were also performed. RESULTS: Of 517 patients with PTC, rate of malignancy (ROM) decreased (55% versus 48% versus 41%, P < 0.05) as BMI increased with a concomitant decrease in average TSH levels (1.75 versus 1.69 versus 1.41 mU/L), respectively. According to sex, decreased ROM (53% versus 44% versus 42%, P < 0.05) and TSH (1.79 versus 1.70 versus 1.33 mU/L), respectively, with increased BMI was identified in women. However, decrease of ROM was not significant in men with increasing TSH levels as BMI increased. Male sex was associated with increased PTC risk (OR, 1.916; 95% CI, 1.331-2.759), whereas obesity with reduced PTC risk (OR, 0.736; 95% CI, 0.555-0.976). CONCLUSIONS: Higher BMI correlates with decreased PTC rates and lower TSH levels and suggests other factors may be involved in thyroid tumorigenesis. Obese patients with thyroid cancer should not be managed differently compared with nonobese patients.


Asunto(s)
Índice de Masa Corporal , Obesidad/sangre , Cáncer Papilar Tiroideo/epidemiología , Neoplasias de la Tiroides/epidemiología , Tirotropina/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/diagnóstico , Periodo Preoperatorio , Estudios Prospectivos , Estudios Retrospectivos , Medición de Riesgo , Factores Sexuales , Cáncer Papilar Tiroideo/etiología , Cáncer Papilar Tiroideo/cirugía , Neoplasias de la Tiroides/etiología , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Adulto Joven
3.
Am J Otolaryngol ; 40(4): 536-541, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31036419

RESUMEN

PURPOSE: As imaging technology improves and more thyroid nodules and malignancies are identified, it is important to recognize factors associated with malignancy and poor prognosis. Vitamin D has proven useful as a prognostic tool for other cancers and may be similarly useful in thyroid cancer. This study explores the relationship of Vitamin D to papillary thyroid carcinoma stage while accounting for socioeconomic covariates. MATERIALS AND METHODS: The medical records of all patients who underwent thyroidectomy at one institution between 2000 and 2015 were reviewed. Subjects with non-papillary thyroid cancer pathology, prior malignancy, and without Vitamin D levels were excluded. The remaining 334 patient records were examined for cancer stage, Vitamin D levels, Vitamin D deficiency listed in history, and demographic and comorbid factors. RESULTS: Vitamin D laboratory values showed no significant relationship to cancer stage (p = 0.871), but patients with Vitamin D deficiency documented in the medical record were more likely to have advanced disease (28.6% versus 14.7%; p = 0.028). The patients with documented Vitamin D deficiency also had lower 25-hydroxyvitamin D nadirs (21.5 ng/mL versus 26.5 ng/mL, p = 0.008) and were more likely to be on Vitamin D supplementation (92.6% versus 41.8%, p < 0.001). CONCLUSIONS: The results suggest that Vitamin D deficiency may have value as a negative prognostic indicator in papillary thyroid cancer and that pre-operative laboratory evaluation may be less useful. This is important because Vitamin D deficiency is modifiable. While different racial subgroups had different rates of Vitamin D deficiency, neither race nor socioeconomic status showed correlation with cancer stage.


Asunto(s)
Resultados Negativos , Cáncer Papilar Tiroideo/patología , Neoplasias de la Tiroides/patología , Tiroidectomía , Deficiencia de Vitamina D , Adulto , Anciano , Biomarcadores de Tumor/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Factores Socioeconómicos , Cáncer Papilar Tiroideo/etiología , Neoplasias de la Tiroides/etiología , Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones
4.
Ear Nose Throat J ; 98(3): 136-138, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30938240

RESUMEN

Papillary thyroid carcinoma in a thyroglossal duct cyst is very rare. We present the case of a teenage boy with a large thyroglossal duct cyst containing papillary thyroid carcinoma. There was no evidence of carcinoma within the thyroid gland, making this an important case of primary thyroglossal duct cyst carcinoma.


Asunto(s)
Quiste Tirogloso , Cáncer Papilar Tiroideo , Glándula Tiroides , Neoplasias de la Tiroides , Tiroidectomía/métodos , Adolescente , Humanos , Masculino , Quiste Tirogloso/complicaciones , Quiste Tirogloso/patología , Cáncer Papilar Tiroideo/etiología , Cáncer Papilar Tiroideo/patología , Glándula Tiroides/diagnóstico por imagen , Glándula Tiroides/cirugía , Neoplasias de la Tiroides/etiología , Neoplasias de la Tiroides/patología , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Ultrasonografía/métodos
5.
Cancer Res Treat ; 51(4): 1392-1399, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30786705

RESUMEN

PURPOSE: The association between tobacco smoking and thyroid cancer remains uncertain. We evaluated the associations of active and passive smokingwith the risk of papillary thyroid cancer (PTC), the most common type of thyroid cancer, and with the BRAFV600E mutation, the most common oncogenic mutation in PTC related to poor prognosis. Materials and Methods: We conducted this study with newly diagnosed PTC patients (n=2,142) and community controls (n=21,420) individually matched to cases for age and sex. Information on active and passive smoking and potential confounders were obtained from structured questionnaires, anthropometric measurements, and medical records. BRAFV600E mutation status was assessed in PTC patients. We evaluated the associations of active and passive smoking with PTC and BRAFV600E mutation risk using conditional and unconditional logistic regression models, respectively. RESULTS: We did not find associations between exposure indices of active and passive smoking and PTC risk in both men and women, except for the association between current smoking and lower PTC risk. Cumulative smoking ≥ 20 pack-years was associated with lower BRAFV600E mutation risk in male PTC patients (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.30 to 1.00). The CI for the association was wider in female PTC patients (OR, 0.23; 95% CI, 0.02 to 2.62), possibly owing to a smaller sample size in this stratum. CONCLUSION: We did not find consistent associations between active and passive smoking and PTC risk. Cumulative smoking ≥ 20 pack-years was associated with lower BRAFV600E mutation risk in male PTC patients.


Asunto(s)
Mutación , Proteínas Proto-Oncogénicas B-raf/genética , Fumar/epidemiología , Cáncer Papilar Tiroideo/epidemiología , Neoplasias de la Tiroides/epidemiología , Contaminación por Humo de Tabaco/efectos adversos , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Pronóstico , Tamaño de la Muestra , Factores Sexuales , Fumar/efectos adversos , Fumar/genética , Cáncer Papilar Tiroideo/etiología , Neoplasias de la Tiroides/etiología
6.
Orphanet J Rare Dis ; 14(1): 42, 2019 02 13.
Artículo en Inglés | MEDLINE | ID: mdl-30760283

RESUMEN

BACKGROUND: Myotonic dystrophy (DM1), a neuromuscular disease related to DMPK gene mutations, is associated to endocrine disorders and cancer. A routine endocrine work-up, including thyroid ultrasound (US), was conducted in 115 genetically-proven DM1 patients in a neuromuscular reference center. The aim of this study was to determine the prevalence and the causes of US thyroid abnormalities in DM1. RESULTS: In the whole population (age 45.1 ± 12.2 years, 61.7% female), palpable nodules or goiters were present in 29.2%. The percentage of US goiter (thyroid volume > 18 mL) and US nodules were, respectively, 38.3 and 60.9%. Sixteen of the 115 patients had a thyroidectomy, after 22 fine-needle aspiration cytology guided by thyroid imaging reporting and data system (TIRADS) classification. Six micro- (1/6 pT3) and 3 macro-papillary thyroid carcinoma (PTCs) (2/3 intermediate risk) were diagnosed (7.9% of 115). Thyroid US led to the diagnosis of 4 multifocal and 2 unifocal (including 1 macro-PTC) non-palpable PTCs. Ultrasound thyroid volume was positively correlated to body mass index (BMI) (p = 0.015) and parity (p = 0.036), and was inversely correlated to TSH (p < 0.001) and vitamin D levels (p = 0.023). The BMI, the frequencies of glucose intolerance and PTC were significantly higher in UsGoiter versus non-UsGoiter groups. CONCLUSION: In this systematically screened DM1 cohort, the frequency of UsGoiter, mainly associated to BMI, was about 40%, US nodules 60%, thyroidectomies 13-14%, and PTCs 8%, two-thirds of them being micro-PTCs with good prognosis. Therefore, a systematic screening remains debatable. A targeted US screening in case of clinical abnormality or high BMI seems more appropriate.


Asunto(s)
Resistencia a la Insulina/fisiología , Distrofia Miotónica/diagnóstico , Distrofia Miotónica/etiología , Glándula Tiroides/patología , Neoplasias de la Tiroides/diagnóstico , Adulto , Femenino , Bocio/diagnóstico , Bocio/etiología , Bocio/genética , Humanos , Resistencia a la Insulina/genética , Masculino , Persona de Mediana Edad , Distrofia Miotónica/genética , Cáncer Papilar Tiroideo/diagnóstico , Cáncer Papilar Tiroideo/etiología , Cáncer Papilar Tiroideo/genética , Neoplasias de la Tiroides/etiología , Neoplasias de la Tiroides/genética
7.
World J Surg ; 43(5): 1243-1248, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30680499

RESUMEN

BACKGROUND: To investigate the relationship between primary hyperparathyroidism (pHPT) and papillary thyroid cancer (PTC). METHODS: The perioperative findings of 275 patients with pHPT who underwent surgery between January 2014 and December 2017 were retrospectively reviewed. Thirty-one patients were diagnosed with pHPT and PTC concurrently. Pathology results and demographic findings of these patients were compared with 186 patients who underwent thyroidectomy and diagnosed with PTC at the same time interval. RESULTS: The co-occurrence of pHPT and PTC was 11.3% (31/275). The median ages of the pHPT, pHPT + PTC, and PTC groups were 55, 57, and 50 years old, respectively (p < 0.001). The diameter of tumor was smaller in the pHPT + PTC group [median 7 mm (range 0.5-25 mm) vs. 15 mm (range 1-100 mm)], with higher rates of microcarcinomas (p < 0.001), than the patients in the PTC group. Examination of tumor morphology showed higher rates of tumor capsule invasion and multicentricity in the pHPT + PTC group than those in the isolated PTC group (p = 0.02, p = 0.04, respectively). CONCLUSION: The pHPT + PTC group had significantly smaller tumor diameter than the PTC group. This result may support the idea that pHPT leads to overdiagnosis of PTC. However, observation of high rates of tumor capsule invasion and multicentricity in the pHPT + PTC group may suggest an associative etiology with more aggressive PTC.


Asunto(s)
Hiperparatiroidismo Primario/complicaciones , Cáncer Papilar Tiroideo/etiología , Neoplasias de la Tiroides/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Hiperparatiroidismo Primario/cirugía , Masculino , Uso Excesivo de los Servicios de Salud , Persona de Mediana Edad , Estudios Retrospectivos , Cáncer Papilar Tiroideo/diagnóstico por imagen , Cáncer Papilar Tiroideo/patología , Cáncer Papilar Tiroideo/cirugía , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Tiroidectomía/métodos , Adulto Joven
8.
Intern Med ; 58(4): 497-504, 2019 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-30333389

RESUMEN

Objective The association of primary aldosteronism (PA) with thyroid disease has already been suggested. The aim of this study was to examine the presence of PA in patients with papillary thyroid carcinoma (PC) and to characterize such PC patients with PA. Methods We examined the presence of PA in 81 consecutive patients with PC, whose random sitting blood pressure (BP) was ≥140/90 mmHg in the office (n= 68), who had an incidental adrenal tumor or adrenal enlargement (n=9), or who showed hypokalemia (n=4). Thirty-one of these 81 patients had been treated with anti-hypertensive drugs. The plasma aldosterone concentration (PAC) and plasma renin activity (PRA) were first measured before operation in 16 patients and after operation in 65 patients. PA was diagnosed according to the guidelines of the Japan Endocrine Society. Results Forty patients with PC with a random PAC/PRA ratio of over 200 were subjected to a further study (12 of these patients had been treated with anti-hypertensive drugs). Ultimately, 15 patients with PC were diagnosed with PA. Adrenal venous sampling was done in 9 out of 15 patients with PC associated with PA. No patients were diagnosed as having unilateral lesions. Among the 15 patients, white-coat hypertension was observed in 5 patients, and normotension was observed in 1 patient. Conclusion These findings suggest that the prevalence of PA may be high among patients with PC. An active examination is needed to detect PA, as its signs and symptoms may be mild in patients with PC associated with hypertension.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales/sangre , Aldosterona/efectos adversos , Aldosterona/sangre , Hiperaldosteronismo/sangre , Hiperaldosteronismo/complicaciones , Cáncer Papilar Tiroideo/sangre , Neoplasias de la Tiroides/sangre , Neoplasias de las Glándulas Suprarrenales/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Femenino , Humanos , Hiperaldosteronismo/fisiopatología , Japón , Masculino , Persona de Mediana Edad , Prevalencia , Renina/sangre , Cáncer Papilar Tiroideo/etiología , Cáncer Papilar Tiroideo/fisiopatología , Neoplasias de la Tiroides/etiología , Neoplasias de la Tiroides/fisiopatología
9.
Eur Rev Med Pharmacol Sci ; 22(17): 5576-5582, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-30229831

RESUMEN

OBJECTIVE: To explore whether lncRNA UCA1 (long non-coding RNA urothelial carcinoma associated 1) could promote the development of papillary thyroid carcinoma (PTC) via Wnt pathway and its underlying mechanism. PATIENTS AND METHODS: UCA1 expression in PTC tissues, paracancerous tissues, and thyroid cancer cells were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). UCA1 lentivirus was then constructed for the following in vitro experiments. Proliferative ability of MTC and SW579 cells was detected by cell counting kit-8 (CCK-8) and colony formation assay. Cell apoptosis after altering UCA1 expression in MTC and SW579 cells was detected by flow cytometry and Western blot. Invasive ability of MTC and SW579 cells was detected by transwell and wound healing assay. Finally, protein expressions of Wnt pathway-related genes were detected by Western blot. RESULTS: UCA1 was overexpressed in PTC tissues and thyroid cancer cells. UCA1 expression was positively correlated to tumor size, tumor stage, and metastasis of PTC. Overexpressed UCA1 promoted proliferation and invasion, whereas inhibited apoptosis of thyroid cancer cells via Wnt pathway. CONCLUSIONS: Overexpressed UCA1 promotes PTC development by stimulating proliferation, migration, and anti-apoptosis of thyroid cancer cells via activating Wnt pathway.


Asunto(s)
ARN Largo no Codificante/fisiología , Cáncer Papilar Tiroideo/etiología , Neoplasias de la Tiroides/etiología , Vía de Señalización Wnt/fisiología , Adulto , Anciano , Apoptosis , Línea Celular Tumoral , Proliferación Celular , Humanos , Persona de Mediana Edad , Cáncer Papilar Tiroideo/patología , Neoplasias de la Tiroides/patología
10.
Int J Biol Markers ; 33(4): 455-462, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30058426

RESUMEN

BACKGROUND:: Thyroid carcinomas have comprised the fastest rising incidence of cancer in the past decade. Currently, the diagnosis of thyroid tumors is performed by the fine-needle aspiration biopsy (FNAB) method, which still holds some challenges and limitations, mostly in discriminating malignant and benign lesions. Therefore, the development of molecular markers to distinguish between these lesion types are in progress. METHODS:: A 2D-PAGE separation of proteins was performed followed by tandem mass spectrometry with the aim of discovering potential serum protein markers for papillary thyroid carcinoma and multinodular goiter. Protein-protein interaction network analysis revealed the most important pathways involved in the progression of papillary thyroid cancer. The enzyme-linked immunosorbent assay method was used to confirm a part of the results. RESULTS:: The significantly altered proteins included C3, C4A, GC, HP, TTR, APOA4, APOH, ORM2, KRT10, AHSG, IGKV3-20, and IGKC. We also confirmed that increased complement component 3 and decreased apolipoprotein A4 occurred in papillary thyroid cancer. Network investigations demonstrated that complement activation cascades and PPAR signaling might play a role in the pathogenesis of thyroid cancer. CONCLUSION:: The results demonstrated that serum proteomics could serve as a viable method for proposing novel potential markers for thyroid tumors. Surely, further research must be performed in larger cohorts to validate the results.


Asunto(s)
Apolipoproteínas A/sangre , Biomarcadores de Tumor/sangre , Complemento C3/análisis , Proteómica/métodos , Cáncer Papilar Tiroideo/diagnóstico , Neoplasias de la Tiroides/diagnóstico , Activación de Complemento , Ensayo de Inmunoadsorción Enzimática , Humanos , Mapas de Interacción de Proteínas , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Cáncer Papilar Tiroideo/sangre , Cáncer Papilar Tiroideo/etiología , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/etiología
11.
Acta Otorhinolaryngol Ital ; 38(4): 310-315, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29498716

RESUMEN

The mean gamma-ray distribution in Crete during the years after the nuclear accident at Chernobyl and its correlation with the Papillary Thyroid Cancer (PTC) distribution was identified. A total of 4285 patients underwent total thyroidectomy in our centre between 1990 and 2012. Data of gamma-ray (nSv/h) distribution were selected from the Greek Statistical Authorisation. A geo-spatial statistical model was used to estimate the expected number of patients with PTC and Kriging interpolation prediction model to estimate their distribution. Geographical weighted regression was performed to estimate the risk of PTC in relation to gamma ray distribution. All factors that were examined were found to be statistically significant for PTC distribution in Crete. Gamma-ray was determined as a significant risk factor (OR = 2.89; 95% CI = 1.682-4.989; p value = 0.03). There is a significant correlation between gamma-ray exposure and the increased prevalence of the PTC suggesting that the former may have been a significant risk factor.


Asunto(s)
Rayos gamma/efectos adversos , Neoplasias Inducidas por Radiación/epidemiología , Neoplasias Inducidas por Radiación/etiología , Exposición a la Radiación/efectos adversos , Cáncer Papilar Tiroideo/epidemiología , Cáncer Papilar Tiroideo/etiología , Neoplasias de la Tiroides/epidemiología , Neoplasias de la Tiroides/etiología , Adolescente , Adulto , Accidente Nuclear de Chernóbil , Femenino , Grecia/epidemiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Adulto Joven
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