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INTRODUCTION: Familial non-medullary thyroid carcinoma (FNMTC) is defined by the presence of 2 or more first-degree family members with differentiated thyroid carcinoma (DTC). The aim of this study is to compare clinicopathological features and prognosis of FNMTC and sporadic carcinoma (SC). MATERIALS AND METHODS: Retrospective study of DTC included in the hospital database during the period 1990-2018. RESULTS: A total of 927 patients were analyzed, 61 of them were FNMTC, with a mean follow-up of 9.7⯱â¯6.5 years. The prevalence of FNMTC was 6.6%, with a lower TNM staging presentation (Pâ¯=â¯0.003) consequence of a higher proportion of tumors smaller than 2â¯cm (Pâ¯=â¯0.003), combined with a greater multifocality (Pâ¯=â¯0.034) and papillary histologic subtype (Pâ¯=â¯0.022) compared to SC. No significant differences in age at diagnosis (Pâ¯=â¯0.347), gender (Pâ¯=â¯0.406), neither in other aggressiveness markers (bilaterality, extrathyroidal extension, lymph node involvement and metástasis) were detected. Rate of persistence/recurrence (Pâ¯=â¯0.656), disease-free survival (Pâ¯=â¯0.929) and mortality caused by the tumor itself (Pâ¯=â¯0.666) were comparable. Families with ≥3 affected relatives, had smaller tumors (Pâ¯=â¯0.005), more multifocality (Pâ¯=â¯0.040) and bilaterality (Pâ¯=â¯0.002), as well as a higher proportion of males (Pâ¯=â¯0.020). Second generation patients present earlier FNMTC compared to those of the first generation (Pâ¯=â¯0.001). CONCLUSION: In our study FNMTC presents a lower TNM staging, higher multifocality and papillary variant, with similar aggressiveness and prognosis compared to SC.
Assuntos
Carcinoma Papilar , Carcinoma , Neoplasias da Glândula Tireoide , Carcinoma/diagnóstico , Carcinoma/epidemiologia , Carcinoma/genética , Carcinoma Papilar/patologia , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Câncer Papilífero da Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/genéticaRESUMO
INTRODUCTION: Familial non-medullary thyroid carcinoma (FNMTC) is defined by the presence of 2or more first-degree family members with differentiated thyroid carcinoma (DTC). The aim of this study is to compare clinicopathological features and prognosis of FNMTC and sporadic carcinoma (SC). MATERIALS AND METHODS: Retrospective study of DTC included in the hospital database during the period 1990-2018. RESULTS: A total of 927 patients were analyzed, 61 of them were FNMTC, with a mean follow-up of 9.7±6.5 years. The prevalence of FNMTC was 6.6%, with a lower TNM staging presentation (P=.003) consequence of a higher proportion of tumors smaller than 2 centimeters (P=.003), combined with a greater multifocality (P=.034) and papillary histologic subtype (P=.022) compared to SC. No significant differences in age at diagnosis (P=.347), gender (P=.406), neither in other aggressiveness markers (bilaterality, extrathyroidal extension, lymph node involvement and metástasis) were detected. Rate of persistence/recurrence (P=.656), disease-free survival (P=.929) and mortality caused by the tumor itself (P=.666) were comparable. Families with ≥3 affected relatives, had smaller tumors (P=.005), more multifocality (P=.040) and bilaterality (P=.002), as well as a higher proportion of males (P=.020). Second generation patients present earlier FNMTC compared to those of the first generation (P=.001). CONCLUSION: In our study FNMTC presents a lower TNM staging, higher multifocality and papillary variant, with similar aggressiveness and prognosis compared to SC.
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Assuntos
Humanos , Masculino , Adulto , Diarreia/etiologia , Carcinoma Medular/patologia , Neoplasias da Glândula Tireoide/secundário , Tumores Neuroendócrinos/patologia , Doença Crônica , Infecções por Helicobacter/diagnóstico , Metástase Neoplásica/patologia , Biomarcadores Tumorais/análiseAssuntos
Carcinoma Medular/secundário , Diarreia/etiologia , Neoplasias da Glândula Tireoide/diagnóstico , Adulto , Biomarcadores Tumorais/sangue , Calcitonina/sangue , Antígeno Carcinoembrionário/sangue , Carcinoma Medular/sangue , Carcinoma Medular/complicações , Carcinoma Medular/diagnóstico por imagem , Doença Crônica , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Masculino , Proteínas de Neoplasias/sangue , Proteínas de Neoplasias/genética , Proteínas Proto-Oncogênicas c-ret/genética , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Introducción: El objetivo de este estudio es conocer la prevalencia de alteraciones hidrocarbonadas en pacientes diagnosticados de acromegalia y evaluar qué ocurre a los 2 años del tratamiento. También se pretende valorar qué factores se asocian a la aparición de estas alteraciones. Material y métodos: Se incluyeron 66 pacientes diagnosticados de acromegalia en nuestro centro. Se clasificó a los pacientes en función del metabolismo glucémico: normal, prediabetes y diabetes. A los 2 años del tratamiento de la acromegalia se analizó de nuevo la prevalencia de alteraciones hidrocarbonadas, en función del estado del paciente (curado, controlado con tratamiento médico o no controlado). Resultados: Al diagnóstico de acromegalia, el 27,3% de los pacientes tenían diabetes (n=18), el 39,4% prediabetes (n=26) y el 33,3% no presentaba alteraciones (n=22). Se encontraron diferencias significativas en los niveles de IGF-1 y z-score de IGF-1 (mediana de 18,1 en diabéticos y 10,6 en no diabéticos, p=0,005) entre los 3 grupos. A los 2 años del tratamiento, se observa una importante reducción de la prevalencia de diabetes y prediabetes en los pacientes curados (del 29,2 al 8,3% y del 45,8 al 16,7% respectivamente, p=0,003) pero no en los pacientes controlados con tratamiento médico o no controlados. Conclusión: En nuestro centro, el 66,6% de los pacientes con acromegalia presentan alteraciones en el metabolismo hidrocarbonado al diagnóstico, con una prevalencia de diabetes del 27,3%. A los 2 años del tratamiento de la acromegalia, se objetiva un descenso de la prevalencia de diabetes y prediabetes en el grupo de pacientes curados (AU)
Introduction: The aim of this study was to ascertain the prevalence of carbohydrate changes in patients diagnosed with acromegaly, and to evaluate what happens two years after treatment. It was also intended to assess which factors are associated to the occurrence of such changes. Material and methods: Sixty-six patients diagnosed with acromegaly at our center were enrolled and divided into groups with normal glucose metabolism, prediabetes, and diabetes. After 2 years of treatment of acromegaly, prevalence carbohydrate changes was assessed again depending on the patient condition (cured, controlled with medical treatment, or uncontrolled). Results: At the time of diagnosis of acromegaly, 27.3% of the patients had diabetes (n=18), 39.4% had prediabetes (n=26), and 33.3% had no changes (n=22). Significant differences were found in IGF-1 and z-score of IGF-1 (median of 18.1 in diabetics and 10.6 in non-diabetics, P=.005). Two years after treatment, there was a significant decrease in the prevalence of diabetes and prediabetes in cured patients (from 29.2% to 8.3% and from 45.8% to 16.7%, respectively, P=.003), but not in patients controlled with medical treatment or not controlled. Conclusion: At our center, 66.6% of patients with acromegaly had changes in carbohydrate metabolism at diagnosis, with a prevalence of diabetes of 27.3%. Two years after treatment of acromegaly, prevalence of diabetes and prediabetes decreased in cured patients (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Índice Glicêmico , Acromegalia/diagnóstico , Acromegalia/terapia , Metabolismo Basal , Transtornos do Metabolismo de Glucose/complicações , Transtornos do Metabolismo de Glucose/diagnóstico , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/epidemiologiaRESUMO
INTRODUCTION: The aim of this study was to ascertain the prevalence of carbohydrate changes in patients diagnosed with acromegaly, and to evaluate what happens two years after treatment. It was also intended to assess which factors are associated to the occurrence of such changes. MATERIAL AND METHODS: Sixty-six patients diagnosed with acromegaly at our center were enrolled and divided into groups with normal glucose metabolism, prediabetes, and diabetes. After 2 years of treatment of acromegaly, prevalence carbohydrate changes was assessed again depending on the patient condition (cured, controlled with medical treatment, or uncontrolled). RESULTS: At the time of diagnosis of acromegaly, 27.3% of the patients had diabetes (n=18), 39.4% had prediabetes (n=26), and 33.3% had no changes (n=22). Significant differences were found in IGF-1 and z-score of IGF-1 (median of 18.1 in diabetics and 10.6 in non-diabetics, P=.005). Two years after treatment, there was a significant decrease in the prevalence of diabetes and prediabetes in cured patients (from 29.2% to 8.3% and from 45.8% to 16.7%, respectively, P=.003), but not in patients controlled with medical treatment or not controlled. CONCLUSION: At our center, 66.6% of patients with acromegaly had changes in carbohydrate metabolism at diagnosis, with a prevalence of diabetes of 27.3%. Two years after treatment of acromegaly, prevalence of diabetes and prediabetes decreased in cured patients.
Assuntos
Acromegalia/metabolismo , Transtornos do Metabolismo de Glucose/metabolismo , Glucose/metabolismo , Acromegalia/etiologia , Acromegalia/cirurgia , Adenoma/complicações , Adenoma/cirurgia , Adulto , Idoso , Glicemia/análise , Metabolismo dos Carboidratos , Feminino , Seguimentos , Transtornos do Metabolismo de Glucose/etiologia , Hemoglobinas Glicadas/análise , Adenoma Hipofisário Secretor de Hormônio do Crescimento/metabolismo , Adenoma Hipofisário Secretor de Hormônio do Crescimento/cirurgia , Humanos , Fator de Crescimento Insulin-Like I/análise , Masculino , Pessoa de Meia-Idade , Carga TumoralAssuntos
Carcinoma Papilar/secundário , Neoplasias Hepáticas/secundário , Neoplasias Ovarianas/patologia , Neoplasias Peritoneais/secundário , Estruma Ovariano/secundário , Antineoplásicos/uso terapêutico , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/tratamento farmacológico , Diferenciação Celular , Cisplatino/administração & dosagem , Terapia Combinada , Doxorrubicina/administração & dosagem , Evolução Fatal , Feminino , Humanos , Histerectomia , Radioisótopos do Iodo/uso terapêutico , Neoplasias Hepáticas/tratamento farmacológico , Pessoa de Meia-Idade , Neoplasias Ovarianas/cirurgia , Neoplasias Peritoneais/tratamento farmacológico , Estruma Ovariano/tratamento farmacológico , Estruma Ovariano/cirurgia , TireoidectomiaRESUMO
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