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1.
Medicine (Baltimore) ; 98(38): e17192, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567964

RESUMO

BACKGROUND: Previous clinical studies have reported that ultrasound-guided fine needle aspiration cytology (UGFNAC) can be used for the diagnosis of thyroid nodules (TN) effectively. However, no study has systematically explored its diagnosis accuracy in patients with TN. Thus, this study will assess its diagnosis accuracy for TN. METHODS: We will perform a comprehensive literature search from the following databases from their inceptions to the present without language restrictions: MEDILINE, EMBASE, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. We will consider all case-controlled studies investigating the impacts of UGFNAC diagnosis for patients with TN for inclusion. Two authors will independently carry out study selection, data collection, and methodological quality assessment. Quality Assessment of Diagnostic Accuracy Studies tool will be used for methodological quality evaluation. We will use RevMan V.5.3 and Stata V.12.0 software to perform statistical analysis. RESULTS: We will apply sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio to judge the diagnostic accuracy of UGFNAC for TN. CONCLUSION: The results of this study will provide latest evidence for the diagnostic accuracy of UGFNAC for TN. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019138805.


Assuntos
Biópsia por Agulha Fina , Nódulo da Glândula Tireoide/diagnóstico , Ultrassonografia de Intervenção , Biópsia por Agulha Fina/métodos , Humanos , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Ultrassonografia de Intervenção/métodos
2.
Medicine (Baltimore) ; 98(39): e17286, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574847

RESUMO

BACKGROUND: This study aims to systematically investigate the impact of ultrasound angiography (UA) combined with fine needle aspiration (FNA) for the diagnosis of thyroid nodules (TNs). METHODS: The following electronic databases will be searched: MEDLINE, EMBASE, Cochrane Library, PsycINFO, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. We will search them from their inceptions to the present without language limitations. We will consider all case-controlled studies on investigating the impact of diagnosis UA combined FNA for TNs. We will apply Quality Assessment of Diagnostic Accuracy Studies tool to assess methodological quality for all eligible studies. RESULTS: In this study, outcomes consist of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. All these outcomes will be analyzed to evaluate the diagnostic accuracy of UA combined with FNA for TNs. CONCLUSION: This study will provide evidence of the diagnostic accuracy of UA combined with FNA for TNs. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019138884.


Assuntos
Angiografia/estatística & dados numéricos , Biópsia por Agulha Fina/estatística & dados numéricos , Biópsia Guiada por Imagem/estatística & dados numéricos , Nódulo da Glândula Tireoide/diagnóstico , Ultrassonografia/estatística & dados numéricos , Angiografia/métodos , Biópsia por Agulha Fina/métodos , Estudos de Casos e Controles , Humanos , Biópsia Guiada por Imagem/métodos , Razão de Chances , Projetos de Pesquisa , Sensibilidade e Especificidade , Revisão Sistemática como Assunto , Glândula Tireoide/diagnóstico por imagem , Ultrassonografia/métodos
3.
An Bras Dermatol ; 94(4): 452-454, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644620

RESUMO

Proliferating trichilemmal cyst is an uncommon neoplasm arising from the follicular isthmus, whose histopathological hallmark is the presence of trichilemmal keratinization. We describe a case of proliferating trichilemmal cyst in a 57-year-old woman with a broad clinical, radiological, macroscopic and microscopic correlation.


Assuntos
Cisto Epidérmico/diagnóstico por imagem , Cisto Epidérmico/patologia , Couro Cabeludo/diagnóstico por imagem , Couro Cabeludo/patologia , Biópsia por Agulha Fina , Diagnóstico Diferencial , Cisto Epidérmico/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Couro Cabeludo/cirurgia , Ultrassonografia
4.
Medicina (B Aires) ; 79(4): 271-275, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31487246

RESUMO

There is much controversy about the benefits of the use of serum calcitonin (CT) in the initial evaluation of patients with thyroid nodules. The objective of the study was to early identify medullary thyroid carcinoma (MTC) through the routine measurement of CT in thyroid nodular pathology in a large cohort of patients from Buenos Aires, Argentina. Consecutive patients with nodular thyroid disease (n=1017) were studied. CT was measured by chemiluminescence, normal value: up to 18 pg/ml in men and 12 pg/ml in women. In two patients, hypercalcitoninemia was confirmed in repeated measurements. Fine needle aspiration with CT measurement in the needle wash fluid identified MTC in nodules with citology abnormalities. The genetic study was positive in one patient (mutation exon 14, Val804Met, MTC familiar). The other presented a polymorphism (exon 13 L769L heterozygous - exon 15 S904S heterozygous). In both cases, CT was normalized 3 months after surgery and remained normal after 6 years of follow-up. The routine measurement of CT in thyroid nodular pathology was useful to detect two cases of MTC, one of them sporadic and the other familiar in this cohort. The prevalence of MTC was 0.2%.


Assuntos
Calcitonina/sangue , Carcinoma Neuroendócrino/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Biópsia por Agulha Fina , Carcinoma Neuroendócrino/sangue , Carcinoma Neuroendócrino/patologia , Estudos de Coortes , Diagnóstico Precoce , Feminino , Humanos , Imuno-Histoquímica , Luminescência , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/sangue , Adulto Jovem
5.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(4): 517-523, 2019 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-31484615

RESUMO

To analyze the potential associations of ultrasound-guided fine-needle aspiration(FNA),BRAF V600E gene mutation detection,and the combination of these two techniques with the clinicopathological features of papillary thyroid cancer(PTC). Methods Patients with PTC confirmed by surgery from April 2016 to July 2017 were included in this study.The relationship between clinicopathological features and BRAF V600E mutation,FNA results,and the combination of them were explored. Results The sensitivity of FNA was 86.3%(227/263)and the mutation rate of BRAF V600E was 85.9%(226/263)in 263 patients with PTC.The mutation rate of papillary thyroid microcarcinoma(PTMC)was 91.1%(153/168)and that of non-PTMC was 76.8%(73/95).A total of 225 patients underwent lymph node dissection.The lymph node metastasis rate was 35.6%(80/225),and it was 23.8%(34/143)in PTMC,56.1%(46/82)in non-PTMC;in addition,9.9%(26/263)of PTC patients had extracapsular invasion.BRAF V600E mutation rate was higher in patients with the following features:aged over 45 years(P=0.043);the tumor was FNA diagnosed as malignant or suspected malignant(P=0.011);the tumor had a maximum diameter of ≤1 cm(P=0.001);and the primary tumor was in stage T1(P=0.039);however,there was no significant difference in BRAF V600E mutation rate among patients with different sex,capsule invasion,or lymph node metastasis.The diagnostic sensitivity of FNA was not statistically different under different clinical and pathological characteristics.The clinicopathologic features of FNA and BRAF V600E double-positive patients were not significantly different from those of other patients. Conclusion FNA-confirmed malignancy,BRAF V600E gene mutation,and their double-positive results are not correlated with the invasive pathological features of PTC,and thus their roles in guiding an extended operation(or not)are limited.


Assuntos
Biópsia por Agulha Fina , Proteínas Proto-Oncogênicas B-raf/genética , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Humanos , Metástase Linfática , Mutação , Câncer Papilífero da Tireoide/genética , Neoplasias da Glândula Tireoide/genética
7.
Orv Hetil ; 160(36): 1417-1425, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31492087

RESUMO

Introduction: Twenty-five percent of fine-needle aspiration biopsy samples of thyroid nodules produce indeterminate cytological results. Genetic testing of nodules can contribute to accurate diagnosis. Aim: Developing the first gene panel in Europe utilizing the 23 most relevant thyroid oncogenes with 568 mutations. Method: Examination of the isolated DNA from biopsy samples by Ion Torrent new generation sequencing. Results: The validation of our method was performed on tumor tissue samples, in which 127 genetic variations were identified, yet unknown in thyroid tumors. AXIN1 was the most polymorphic gene, while BRAF c.1799T>A (V600E) was the most frequently identified mutation. We detected 36 clinically relevant variants, 75% of which have not been described in the literature. Six of our 8 cytologically malignant and 8 of our 14 indeterminate as well as 20 of our 28 cytologically benign samples were identified as containing pathologic variants in a driver gene (BRAF c.1799T>A, NRAS c.181C>A). Conclusion: We have developed a validated, reliable new generation sequencing-based method with high positive predictive value (89%) and sensitivity (79%), suitable for the early detection of malignant lesions in the thyroid. Orv Hetil. 2019; 160(36): 1417-1425.


Assuntos
Testes Genéticos/métodos , Patologia Molecular/métodos , Proteínas Proto-Oncogênicas B-raf/genética , Neoplasias da Glândula Tireoide/genética , Nódulo da Glândula Tireoide/genética , Biópsia por Agulha Fina/métodos , Análise Mutacional de DNA , Europa (Continente) , Humanos , Mutação , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/patologia
8.
Pol J Pathol ; 70(2): 139-143, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31556565

RESUMO

We report on a breast carcinoma with medullary features diagnosed by core needle biopsy in a 72-year-old woman. Both the primary tumour and its fine needle aspiration-proven, rapidly growing axillary metastasis regressed completely in less than 2 months, by the time surgery was performed. The biopsy of the primary tumour demonstrated a dense stromal infiltrate of CD8+/granzyme B+ activated cytotoxic T-cells suggestive of a robust antitumour immune response. Paradoxically, both tumour cells and tumour infiltrating immune cells demonstrated a diffuse PD-L1 expression, revealing that antitumour immune response has the ability to spontaneously overcome inhibitory mechanisms induced by cancerous growth.


Assuntos
Carcinoma/diagnóstico , Metástase Linfática , Neoplasias de Mama Triplo Negativas/diagnóstico , Idoso , Antígeno B7-H1/metabolismo , Biópsia por Agulha Fina , Biópsia com Agulha de Grande Calibre , Carcinoma/imunologia , Feminino , Humanos , Linfócitos do Interstício Tumoral , Linfócitos T Citotóxicos/imunologia , Neoplasias de Mama Triplo Negativas/imunologia
9.
Arch Endocrinol Metab ; 63(5): 456-461, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31482953

RESUMO

The indolent evolution of low-risk papillary thyroid microcarcinoma (mPTC) in adult patients and the consequences of thyroidectomy require a revision of the management traditionally recommended. Aiming to spare patients unnecessary procedures and therapies and to optimize the health system in Brazil, we suggest some measures. Fine-needle aspiration of nodules ≤ 1 cm without extrathyroidal extension on ultrasonography should be performed only in nodules classified as "very suspicious" (i.e., high suspicion according to ATA, high risk according to AACE, TI-RADS 5) and in selected cases [age < 40 years, nodule adjacent to the trachea or recurrent laryngeal nerve (RLN), multiple suspicious nodules, presence of hypercalcitoninemia or suspicious lymph nodes]. Active surveillance (AS) rather than immediate surgery should be considered in adult patients with low-risk mPTC. Lobectomy is the best option in patients with unifocal low-risk mPTC who are not candidates for AS because of age, proximity of the tumor to the trachea or RLN, or because they opted for surgery. The same applies to patients who started AS but had a subsequent surgical indication not due to a suspicion of tumor extension beyond the gland or multicentricity. Molecular tests are not necessary to choose between AS and surgery or, in the latter case, between lobectomy and total thyroidectomy. The presence of RAS or other RAS-like mutations or BRAFV600E or other BRAF V600E-like mutations should not modify the management cited above; however, the rare cases of mPTC exhibiting high-risk mutations, like in the TERT promoter or p53, are not candidates for AS.


Assuntos
Carcinoma Papilar/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Biópsia por Agulha Fina , Carcinoma Papilar/cirurgia , Prova Pericial , Humanos , Neoplasias da Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/cirurgia , Tireoidectomia
10.
Medicine (Baltimore) ; 98(34): e16954, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31441894

RESUMO

Optimal antibiotic management of patients with osteomyelitis remains a challenge for many clinicians. Although image-guided bone biopsy (IGB) remains the gold standard, its role in confirming diagnosis and guiding antibiotic management is not clear in patients with non-vertebral osteomyelitis.To determine the diagnostic yield of IGB and its impact on antibiotic management in non-vertebral osteomyelitis.Retrospective cohort study.Urban academic medical center.Patients admitted for non-vertebral osteomyelitis who underwent image-guided bone biopsy.Primary outcomes were microbiologic and histopathological results. We evaluated the impact of IGB on clinician-initiated changes in antibiotic regimen before and after biopsy.We evaluated 203 bone biopsies in 185 patients with clinical suspicion of osteomyelitis. 79% of patient received antibiotics prior to biopsy. Bone cultures were positive in 28% and histopathology confirmed osteomyelitis in 29%, but concordance was poor. Furthermore, clinical suspicion of infection was much higher, given that 68% received empiric antibiotics. Leukocytosis was significantly associated with positive cultures in multivariate analysis. There was no statistically significant correlation between antibiotic management and bone culture results. When culture yielded an organism, empiric regimens were kept the same, broadened or narrowed with equal frequency; targeted regimens were chosen only in 4 cases. Despite negative cultures in 98/138 cases having received empiric treatment, antibiotics were discontinued in only 8 cases. Even when empiric treatment was not given, negative cultures did not dissuade clinicians from eventual antibiotic use in a significant number of cases (17/48). In 46/71 patients whose final regimen included vancomycin, there was no evidence of current or past infection with MRSA.In patients with non-vertebral osteomyelitis, the diagnostic yield of image-guided bone biopsy is low, and clinicians frequently make decisions regarding antibiotic management that are not aligned with culture results.


Assuntos
Biópsia por Agulha Fina/métodos , Osso e Ossos/microbiologia , Biópsia Guiada por Imagem/métodos , Osteomielite/microbiologia , Adulto , Idoso , Antibacterianos/uso terapêutico , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Osteomielite/diagnóstico , Osteomielite/tratamento farmacológico , Estudos Retrospectivos
11.
Pan Afr Med J ; 33: 65, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448027

RESUMO

This study aimed to determine the diagnostic value of fine needle aspiration biopsy (FNAB) and of its contribution to the management of parotid tumors. We conducted a retrospective study of 47 patients who had undergone parotidectomy as well as preoperative fine needle aspiration biopsy. The study highlighted that eighty one percent of patients had a benign tumor while 19% of patients had a malignant tumor. The sensitivity and specificity of FNAB were 78% and 92% respectively. Parotid tumors were correctly classified as malignant or benign in 89% of cases, overall accuracy was 64.4%. FNAB is a reliable examination providing preoperative informations about the treatment plan and the postoperative course.


Assuntos
Biópsia por Agulha Fina/métodos , Neoplasias Parotídeas/diagnóstico , Humanos , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/cirurgia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
12.
Pan Afr Med J ; 33: 77, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448039

RESUMO

We report the case of a 45-year old woman with a 15-day history of anterior cervical swelling increasing very quickly in size associated with a 7-day history of local inflammation. Clinical examination showed voluminous tender and fixed swelling occupying all the anterior cervical region. The skin's surface was inflammed with permeation nodule (Figure 1, A). The patient was febrile at 38° with good overall physical condition Cervical ultrasound showed voluminous right laterocervical mass that, given the size, made surgical exploration difficult. CT scan showed voluminous thyroid mass, multi-cystic in the superficial tissues, compressing the trachea and the esophagus and pressing the vascular axis of the neck (Figure 1, B and C). Laboratory tests showed leukocytosis 13500 cells/ml, anemia to 8.3 g/dl, CRP 42mg/L and normal thyroid test. Fine needle aspiration biopsy showed purulent and very inflammed material without cytologic signs of malignancy. The patient underwent surgery. Surgical exploration showed several superficial cystic and haemorrhagic cubicles with, in depth, tumor tissue infiltrating the trachea. The tumor laterally invaded the right vascular axis and spread to the suprahyoid muscles, the right submandibular region and the twelfth cranial nerve. Total extended thyroidectomy was performed. Histological examination showed papillary thyroid carcinoma measuring 11cm along its longer axis. Based on our literature review, this is the first case of locally invasive papillary cystic carcinoma of the thyroid revealed by subacute infection.


Assuntos
Celulite (Flegmão)/diagnóstico , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Tireoidectomia/métodos , Biópsia por Agulha Fina , Celulite (Flegmão)/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Pescoço , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tomografia Computadorizada por Raios X
13.
Medicine (Baltimore) ; 98(35): e16832, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464909

RESUMO

INTRODUCTION: Ectopic thyroid occurs due to aberrant development of the thyroid gland during its migration to the pretracheal region. Intrapulmonary ectopic thyroid is extremely rare and its benign transformation (microfollicular adenoma) has never been reported. This paper reports a case of ectopic thyroid microfollicular adenoma in the lung mimicking metastatic pelvic tumors. PATIENT CONCERNS: A 76-year old female presented to our hospital because of transient unconsciousness. Pelvic ultrasound (US) and chest computed tomography (CT) showed pelvic tumors and pulmonary nodules. DIAGNOSIS AND INTERVENTIONS: The patient underwent pelvic tumors resection and CT-guided fine-needle aspiration cytology (FNAC) at the largest pulmonary nodule. Pathological description revealed bilateral ovarian serous cystadenoma and endometrioma in pelvic, and ectopic thyroid microfollicular adenoma in lung. In view of the patient's age and physical conditions, it is unanimously decided by the physicians and the family members of the patient to closely follow up this benign pulmonary lesion. OUTCOMES: During the 12-month follow-up, no pelvic tumor recurrence or metastasis was found. CT review of pulmonary nodules showed no remarkable changes. The patient was asymptomatic and euthyroid after being discharged from the hospital. CONCLUSION: Ectopic thyroid microfollicular adenoma in the lung is extremely rare and can be easily mistaken for pulmonary metastases from other sites. The case reported in this paper highlights that ectopic intrapulmonary thyroid tumor should not be overlooked.


Assuntos
Adenoma/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/diagnóstico , Neoplasias Pélvicas/diagnóstico por imagem , Disgenesia da Tireoide/diagnóstico , Adenoma/cirurgia , Idoso , Biópsia por Agulha Fina , Diagnóstico Diferencial , Feminino , Humanos , Nódulos Pulmonares Múltiplos/patologia , Neoplasias Pélvicas/cirurgia , Tomografia Computadorizada por Raios X
14.
Pan Afr Med J ; 32: 135, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31303908

RESUMO

Fine needle aspiration cytology (FNAC) findings are the basis upon which decision and type surgery is made. Therefore the diagnostic accuracy and utility of FNAC being such an integral tool in management of thyroid lesions must be evaluated for cyto-histologic discrepancy from time to time as a quality assurance measure. The objective was to compare thyroid fine-needle aspiration cytology (FNAC) with final histopathological findings at in patients undergoing thyroidectomy. This was a cross-sectional retrospective study at Aga Khan university hospital, Nairobi. Cyto-histologic discrepancy was found in 19(25%) of cases with false positive and negative rates at 9% and 16%. False positive results constituted 7(9%) while 12(16%) were false negative findings. The higher cyto-histological discordancy than seen previous studies could be due to sampling error and cytological mis-interpretation. Our study found higher than expected cyto-histologic discrepancy.


Assuntos
Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Biópsia por Agulha Fina/métodos , Estudos Transversais , Reações Falso-Negativas , Reações Falso-Positivas , Hospitais Universitários , Humanos , Quênia , Estudos Retrospectivos , Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia
15.
Medicine (Baltimore) ; 98(28): e16343, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305422

RESUMO

To estimate the BRAFV600E mutation frequency in Chinese patients with papillary thyroid carcinoma (PTC), and the diagnostic value of BRAFV600E mutation status in thyroid nodules with indeterminate TBSRTC categories.A total of 4875 consecutive samples for thyroid ultrasound-guided fine-needle aspiration cytology (FNAC) and BRAF mutation analysis were collected from patients at Jiangsu Province Hospital on Integration of Chinese and Western Medicine. Among all the cases, 314 underwent thyroidectomy. According to TBSRTC categories, FNAC was performed for a preoperative diagnosis. ROC of the subject was constructed to evaluate the diagnostic value of these 2 methods and their combination.BRAF mutation in FNAC of thyroid nodules occurred in 2796 samples (57.35%). Of 353 nodule samples from 314 patients with thyroid operation, 333 were pathologically diagnosed as PTC. Of these PTC patients, 292 (87.69%) were found to have BRAF mutation in their preoperative FNAC. In 175 cytologically indeterminate thyroid nodules, BRAF mutation identified 88% of PTC. According to ROC data, BRAF mutation testing had an obviously higher sensitivity (87.69%) and specificity (100.00%) than TBSRTC. Combining BRAF mutation testing and TBSRTC achieved the largest AUC (0.954). For 41 PTC with a negative BRAF mutation in preoperative evaluation, the repeated BRAF mutation testing found out 12 samples with BRAF mutation. The true BRAF mutation rate of Chinese PTC patients was 91.29%.Chinese patients with PTC have a higher frequency of BRAF mutation. The BRAF mutation testing affords a high diagnostic value in thyroid nodules with indeterminate cytology.


Assuntos
Mutação , Proteínas Proto-Oncogênicas B-raf/genética , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/metabolismo , Nódulo da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/genética , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Biópsia por Agulha Fina , Criança , China , Análise Mutacional de DNA , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Proteínas Proto-Oncogênicas B-raf/metabolismo , Sensibilidade e Especificidade , Câncer Papilífero da Tireoide/genética , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/terapia , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/terapia , Tireoidectomia , Ultrassonografia de Intervenção , Adulto Jovem
17.
Medicine (Baltimore) ; 98(26): e15954, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261501

RESUMO

Early diagnosis of pancreatic cancer (PC) is based on endoscopic ultrasound (EUS). However, EUS is invasive and requires a high level of technical skill. Recently, liquid biopsies have achieved the same sensitivity and specificity for the diagnosis of numerous pathologies, including cancer. Insulin-promoting factor 1 (PDX1) and Msh-homeobox 2 (MSX2), 2 homeotic genes, have been confirmed to be related to pancreatic oncogenesis.The aim of this study is to establish the diagnostic utility of circulating serum levels of MSX2 and PDX1 expression in patients with PC.A prospective study was conducted from January 2014 to February 2017. Patients with a suspected diagnosis of PC who underwent fine needle aspiration biopsy guided by EUS (EUS-FNA) were included in the study, in addition to non-PC control subjects. Both tissue and blood serum samples were submitted to histopathological analysis and measurement of PDX1 and MSX2 gene expression by means of qRT-PCR.Patients were divided into non-PC, malignant pathology (MP), or benign pathology (BP) groups. Significant differences in both MSX2 [2.05 (1.66-4.60) vs 0.83 (0.49-1.60), P = .006] and PDX1 [2.59 (1.28-10.12) vs 1.02 (0.81-1.17), P = .036] gene expression were found in blood samples of PC compared with non-PC subjects. We also observed a significant increase in MSX2 transcripts in tissue biopsy samples of patients diagnosed with MP compared with those with BP [1.98 (1.44-4.61) and 0.66 (0.45-1.54), respectively, P = .012]. The ROC curves indicate a sensitivity and specificity of 80% for PDX1 and 86% for MSX2.Gene expression of MSX2 in tissue samples obtained by EUS-FNA and serum expression of MSX2 and PDX1 were higher in patients with PC.


Assuntos
Proteínas de Homeodomínio/metabolismo , Neoplasias Pancreáticas/metabolismo , Transativadores/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Biópsia por Agulha Fina , Estudos de Casos e Controles , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Feminino , Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/metabolismo , Pâncreas/patologia , Neoplasias Pancreáticas/patologia , Estudos Prospectivos , Sensibilidade e Especificidade
18.
Prensa méd. argent ; 105(6): 370-373, Jul 2019. tab, graf, fig
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1023792

RESUMO

The authors present a study of prenatal diagnostic interventions in a public hospital. The invasive prenatal diagnosis can be achieved by means of threee methods, aspirative punction of chorionic villous, extraction of amniotic fluid and fetal blood sample. Samples of chorionic villus are empoyed for citogenetic study, determination of the fetal cariotype or realization of a specific determination through technic FISH (Fluorescence in situ hybridization) or molecular genetics. Sample of amniotic fluid consists in the aspirative puncture under direct sonographic control of the amniotic cavity. During the period of the study, 9457 obstetric sonographies were performed with 121 genetic consultations of whom 46 resulted in invasive prenatal diagnostics. The results obtained are discussed (AU)


Assuntos
Humanos , Feminino , Gravidez , Diagnóstico Pré-Natal , Amostra da Vilosidade Coriônica , Epidemiologia Descritiva , Estudos Retrospectivos , Estudos Longitudinais , Ultrassonografia , Gestantes , Biópsia por Agulha Fina
19.
Surg Clin North Am ; 99(4): 571-586, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31255192

RESUMO

This is a brief overview of the initial workup of patients with thyroid nodules. Most nodules are incidentally discovered, benign, and do not require surgery, but the clinician's job is to determine which nodules are concerning and what the appropriate workup should be. Ultrasound examination is the best imaging modality to evaluation thyroid nodules and, when biopsy is indicated, fine needle aspiration is the proper technique to sample thyroid nodules.


Assuntos
Biópsia por Agulha Fina/métodos , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico , Ultrassonografia/métodos , Diagnóstico Diferencial , Humanos
20.
Surg Clin North Am ; 99(4): 587-598, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31255193

RESUMO

Cytologically indeterminate thyroid nodules are associated with a broad range (5%-75%) of malignant risk and accurately informing definitive management poses a challenge. Advancements in molecular testing of fine-needle aspiration biopsies have improved preoperative diagnostic accuracy and prognostication. For indeterminate nodules, such testing ideally will reduce the need for surgery for benign nodules and potentially guide appropriate extent of initial surgery for malignancy.


Assuntos
Biomarcadores Tumorais/análise , Tomada de Decisões , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico , Biópsia por Agulha Fina , Diagnóstico Diferencial , Humanos , Neoplasias da Glândula Tireoide/metabolismo , Nódulo da Glândula Tireoide/metabolismo
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