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1.
Harefuah ; 159(11): 809-814, 2020 Nov.
Artigo em Hebraico | MEDLINE | ID: mdl-33210851

RESUMO

INTRODUCTION: Anaplastic thyroid cancer (ATC) is accepted as transformation of a pre-existing glandular papillary thyroid carcinoma (PTC). Anaplastic transformation within a neck PTC metastasis is extraordinary. We present a patient with an exceptional timeline of an untreated neck PTC recurrence and its rare anaplastic transformation. In 2010, a 68-year-old patient with PTC and neck metastasis, (Stage III/Stage II 7th/8th AJCC, respectively) underwent thyroidectomy and neck dissection followed with radioiodine treatment (150 mCi). In 2012, he received an additional 150 mCi following an iodine scan suggested right neck recurrence. In late 2013, ultrasound revealed a 2.3 cm, suspicious right neck lymph node (level II-III). Only in 2017, after growing to 2.7 cm, the patient consented to undergoing a fine needle aspiration. PTC was verified, yet intervention was declined. In June 2018, he presented with a rapid growing neck mass occupying right levels II,III, carotid artery encasement and jugular vein involvement. A large bore needle biopsy revealed a highly malignant tumor, surrounded by necrosis, positive for cytokeratin (CK MNF 116), thyroid lineage marker (PAX8), negative for TTF-1 and thyroglobulin, i.e., ATC. The patient passed away in November 2018. In comparison, a patient with an identical primary staging received equivalent primary treatment. Yet, among the PTC nodular metastasis found in the neck specimen, one had ATC transformation. Over a 12-year follow-up there was no recurrence. To conclude, untreated PTC neck recurrence may have long-term consequences, such as rare anaplastic transformation. Although a case study, it advocates treating PTC neck recurrence.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Idoso , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/cirurgia , Humanos , Radioisótopos do Iodo , Linfonodos , Metástase Linfática , Masculino , Recidiva Local de Neoplasia , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
2.
Am Fam Physician ; 102(5): 298-304, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32866364

RESUMO

Thyroid nodules can be detected by ultrasonography in up to 68% of the general population. They are typically benign and are often discovered incidentally. The primary goal of thyroid nodule evaluation is to determine whether it is malignant. After thyroid ultrasonography has been performed, the next step is measurement of serum thyroid-stimulating hormone. If levels are low, a radionuclide thyroid uptake scan is indicated. Hyperfunctioning nodules are rarely malignant and do not require tissue sampling. Nonfunctioning nodules and nodules in a patient with a normal or high thyroid-stimulating hormone level may require fine-needle aspiration based on ultrasound characteristics and size. Nodules with suspicious features and solid hypoechoic nodules 1 cm or larger require aspiration. The Bethesda System (categories 1 through 6) is used to classify samples. Molecular testing can be used to guide treatment when aspiration yields an indeterminate result. Molecular testing detects mutations associated with thyroid cancer and can help inform decisions about surgical excision vs. continued ultrasound monitoring. Treatment of pregnant women with nonfunctioning thyroid nodules and of children with thyroid nodules is similar to that for nonpregnant adults, with the exception of molecular testing, which has not been validated in these populations.


Assuntos
Adenocarcinoma Folicular/diagnóstico , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico , Adenocarcinoma Folicular/genética , Adenocarcinoma Folicular/patologia , Adenocarcinoma Folicular/terapia , Antitireóideos , Biópsia por Agulha Fina , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/genética , Carcinoma Papilar/patologia , Humanos , Radioisótopos do Iodo , Técnicas de Diagnóstico Molecular , Mutação , Valor Preditivo dos Testes , 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 , Nódulo da Glândula Tireoide/genética , Nódulo da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/terapia , Tireoidectomia , Carga Tumoral , Ultrassonografia , Conduta Expectante
3.
J Cancer Res Ther ; 16(3): 624-629, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32719278

RESUMO

Objective: Thyroglobulin antibodies (TgAb) are detected in thyroid cancer patients up to 25%. We investigated the prognostic value of TgAb positivity in patients with papillary thyroid carcinoma (PTC) after initial therapy. Patients and Methods: A database of 109 consecutive patients who underwent total thyroidectomy and therapeutic lateral neck dissection followed by remnant ablation for PTC between January 1989 and December 2014 was reviewed We recorded the patients' all serum Tg and TgAb levels over time to establish changing trends. Patients were classified as either positive or negative according to serum TgAb levels. The recurrence or persistence rates in both groups were compared. Results: Of the 109 patients enrolled 14 patients had TgAb positivity. Thirty-two (29.3%) showed disease recurrence or persistent disease during 101 months of follow-up. Twenty-seven of 95 patients (28.4%) with negative TgAb had persistent or recurrent disease, whereas 5 of 14 patients (35.7%) with positive TgAb had persistence or recurrence (P = 0.57). No significant difference in disease-free survival (115.3 ± 10.8 vs. 224.1 ± 16.6 months, P = 0.78) and overall survival (P = 0.59) was observed between TgAb positive and TgAb negative patients. Conclusions: TgAb status is not useful as a prognostic and predictive factor for clinical outcomes in patients with PTC in our experience.


Assuntos
Autoanticorpos/sangue , Carcinoma Papilar/sangue , Recidiva Local de Neoplasia/sangue , Tireoglobulina/imunologia , Câncer Papilífero da Tireoide/sangue , Adolescente , Adulto , Idoso , Autoanticorpos/imunologia , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/imunologia , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/imunologia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/imunologia , Adulto Jovem
4.
PLoS One ; 15(7): e0236257, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32692768

RESUMO

BACKGROUND: It is estimated that one of the potential cause of the increasing prevalence of thyroid cancer (TC) is the easier and widespread access to diagnostic tools. If an individual evaluates the thyroid gland due to a mentioned mechanism without considering TC risk factors or symptoms, we can describe this phenomenon as cancer screening activity (CSA). AIM OF THE STUDY: We 1) estimated what types of TC were diagnosed due to CSA, 2) analyzed what clinicopathological features were characteristic of TCs diagnosed by CSA, 3) determined if these features were characteristic of indolent cases, and finally we 4) assessed whether CSA could have resulted in the increasing incidence of potentially indolent papillary thyroid cancer (PTC). MATERIALS AND METHODS: A retrospective review of 4,701 medical records of patients admitted and surgically treated at one surgical center between 2008 and 2017 was performed. Among the enrolled patients, 569 (12.1%) had thyroid malignancy, and 514 (10.9%) were diagnosed with PTC. We divided these patients into two groups: 1) patients in whom TC diagnostics were performed without considering any TC risk factors or symptoms (CSA-yes) and 2) those in whom TC was diagnosed due to TC risk factors or symptoms (CSA-no). We then compared the clinicopathological features of these two groups. RESULTS: The most common type of TC diagnosed in the CSA-group was PTC (p = 0.024). CSA-yes patients showed a significantly lower degree of Tumor-Node-Metastasis (TNM) staging and demonstrated a significantly lower rate of multifocality, but not of bilaterality (p<0.0001 and p = 0.198, respectively). In the CSA-yes group, the number of TC foci was significantly lower than that in the CSA-no group (p<0.0001). All clinicopathological features characteristic of aggressive cases of TC were absent in CSA-yes patients (p<0.0001), while all features observed in CSA-yes patients were characteristic of indolent cases (p<0.0001). CONCLUSIONS: The use of CSA results in the diagnosis of indolent cases of PTC and may be one of the potential causes of overdiagnosis and overtreatment of this malignancy.


Assuntos
Detecção Precoce de Câncer , Sobremedicalização , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/terapia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia
5.
Eur J Endocrinol ; 183(1): 83-93, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32487777

RESUMO

Objective: The characteristics of metastatic lymph nodes (MLNs) have been investigated as important predictors of recurrence and progression in papillary thyroid cancer (PTC). However, clinically applicable risk stratification systems are limited to the assessment of size and number of MLNs. This study investigated the predictive value of detailed characteristics of MLNs in combination with currently used risk stratification systems. Design and methods: We retrospectively characterized 2811 MLNs from 9014 harvested LNs of 286 patients with N1 PTC according to the maximum diameter of MLN (MDLN), maximum diameter of metastatic focus (MDMF), ratio of both diameters (MDMFR), lymph node ratio (LNR, number of MLNs/number of total harvested LNs), presence of extranodal extension (ENE), desmoplastic reaction (DR), cystic component, and psammoma body. Results: Factors related to the size and number of MLNs were associated with increased risk of recurrence and progression. Extensive presence of ENE (>40%) and DR (≥50%) increased the risk of recurrence/progression. The combination of MDLN, LNR, ENE, and DR had the highest predictive value among MLN characteristics. Combination of these parameters with ATA risk stratification or 1-year response to therapy improved the predictive power for recurrence/progression from a Harrell's C-index of 0.781 to 0.936 and 0.867 to 0.960, respectively. Conclusions: The combination of currently used risk stratification systems with detailed characterization of MLNs may improve the predictive accuracy for recurrence/progression in N1 PTC patients.


Assuntos
Metástase Linfática/diagnóstico , Metástase Linfática/patologia , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Adulto , Feminino , Humanos , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco
7.
Arkh Patol ; 82(3): 24-30, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32593263

RESUMO

AIM OF STUDY: A comparison of papillary cancer variants diagnosed on the basis of cytological findings of pre-surgery puncture biopsies with a histological variant of papillary cancer. MATERIALS AND METHODS: The findings of two experts specializing in cytological diagnostics of thyroid nodules that diagnosed a possible variant of papillary cancer were compared with histological findings based on the study of material from surgically removed neoplasms. RESULTS: It was shown that the cytological examination at the pre-surgery stage has significant limitations in diagnosing the histological variant of the tumor, despite high sensitivity of method in diagnosing papillary cancer in general. The variability of results of the cytological determination of papillary cancer variant between the two experts was not so significant, it concerned small fluctuations in the frequency of the diagnosing og normal, follicular, cystic and Uortino-like variants. Based on the data of cytological method, it is not possible to establish the encapsulated variant and papillary microcarcinoma; there are limitations in the diagnosis of follicular and high tumor cell variants. CONCLUSIONS: Currently, the advisability of the recommendation to determine the variant of papillary cancer using the cytological method is questionable. However, this does not mean that it is necessary to stop the search for reliable cellular and molecular genetic characteristics of clinically aggressive variants of papillary cancer.


Assuntos
Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Adenocarcinoma Folicular , Biópsia por Agulha Fina , Humanos , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico
8.
PLoS One ; 15(6): e0234843, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32542018

RESUMO

BACKGROUND: The beneficial effects of radioactive iodine (RAI) ablation for intermediate-risk papillary thyroid cancer (PTC) patients are still controversial. MATERIALS AND METHODS: To determine the impact of RAI therapy on disease-specific survival (DSS) in patients with intermediate-risk PTC, we retrospectively analyzed the data of 23107 intermediate-risk PTC patients who underwent primary thyroidectomy with or without RAI in the Surveillance, Epidemiology, and End Results (SEER) database. RESULTS: RAI therapy was significantly associated with improved DSS (adjusted HR = 0.65, P = 0.017) in intermediate-risk PTC patients after multivariate adjusting for clinicopathological characteristics. However, subgroup analyses demonstrated that RAI ablation was only associated with improved DSS in patients with male gender (adjusted HR = 0.47, P = 0.005), age ≥ 45 years (adjusted HR = 0.34, P < 0.001) and tumor size > 20 mm (adjusted HR = 0.58, P = 0.007). CONCLUSION: RAI decision-making should be considered on an individual basis rather than "one size fits all" in intermediate-risk PTC patients; only patients with male gender, age ≥ 45 years, and tumor size > 20 mm may benefit from RAI therapy.


Assuntos
Técnicas de Ablação , Radioisótopos do Iodo/uso terapêutico , Câncer Papilífero da Tireoide/radioterapia , Neoplasias da Glândula Tireoide/radioterapia , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico
9.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(5): 317-325, mayo 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-191307

RESUMO

INTRODUCCIÓN: La incidencia del microcarcinoma papilar de tiroides (MCPT) está aumentando en los últimos años, especialmente en pacientes intervenidos por enfermedad tiroidea presumiblemente benigna. El objetivo de este estudio es analizar las diferencias entre el MCPT de diagnóstico incidental y de diagnóstico clínico preoperatorio, así como su pronóstico a largo plazo. MATERIAL Y MÉTODOS: La población a estudio la constituyen los pacientes con diagnóstico histológico de MCPT. Se excluyeron los pacientes con cirugía tiroidea previa, con otras enfermedades tiroideas o extratiroideas malignas sincrónicas y localización ectópica del MCPT. Se compararon 2 grupos: pacientes con diagnóstico incidental (grupo 1) y con diagnóstico clínico (grupo 2). Se realizó un análisis multivariante de los factores diferenciadores. RESULTADOS: El MCPT de diagnóstico clínico presentó mayor frecuencia de hipotiroidismo (4,6% vs.18,9%; p = 0,004), invasión extracapsular (5,7% vs.17,6%; p = 0,018), adenopatías metastásicas (1,1% vs.18,9%; p < 0,001) y tiroiditis linfocitaria (5,7% vs.27%; p < 0,001). En el análisis multivariante la presencia de adenopatías metastásicas (OR: 22,011; IC 95%: 2,621-184,829; p = 0,004) y la tiroiditis linfocitaria (OR: 4,949; IC 95%: 1,602-15,288; p = 0,005) se asociaron con el diagnóstico clínico del MCPT. Durante un seguimiento medio de 119,8 ± 65,1 meses se detectó una recidiva en el grupo 2 (0 vs.1,4%; p = 0,460). Ningún paciente falleció debido a la enfermedad. CONCLUSIONES: El MCPT de diagnóstico clínico, aunque presenta características histopatológicas más agresivas (invasión extracapsular y de adenopatías metastásicas), su pronóstico a largo plazo es similar al MCPT incidental. La presencia de adenopatías metastásicas y tiroiditis linfocitaria fueron factores independientes asociados al MCPT de diagnóstico clínico


INTRODUCTION: The incidence of papillary thyroid microcarcinoma (PTMC) has increased in recent years, especially in patients operated on for presumably benign thyroid disease. The aim of this study was to analyze the differences between PTMC incidentally diagnosed and PTMC clinically diagnosed, as well as its long-term prognosis. MATERIAL AND METHODS: The study population consisted of patients with a histological diagnosis of PTMC. Patients with previous thyroid surgery, other synchronous thyroid or extrathyroid malignancies and an ectopic location of PTMC were excluded. Two groups were compared: patients with PTMC incidentally diagnosed (group 1) and patients with PTMC clinically diagnosed (group 2). A multivariate analysis of differentiating factors was performed. RESULTS: PTMC clinically diagnosed had a high frequency of hypothyroidism (4.6% vs.18.9%; P = .004), extrathyroidal extension (5.7% vs.17.6%; P = .018), metastatic lymph nodes (1.1% vs.18.9%; P < .001) and lymphocytic thyroiditis (5.7% vs.27%; P < .001). In the multivariate analysis, metastatic lymph nodes (OR: 22.011, IC 95%: 2.621-184.829; P = .004) and lymphocytic thyroiditis (OR: 4.949; IC 95%: 1.602-15.288; P = .005) were associated with the clinical diagnosis of PTMC. During a mean follow-up of 119.8 ± 65.1 months, one recurrence was detected in group 2 (0% vs.1,4%; P = .460). No patient died due to the disease. CONCLUSIONS: PTMC clinically diagnosed, although it has more aggressive histopathological characteristics (extrathyroidal extension and metastatic lymph nodes), presents a long-term prognosis similar to the PTMC incidentally diagnosed. The presence of metastatic lymph nodes and lymphocytic thyroiditis were independent factors associated with PTMC clinically diagnosed


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/diagnóstico , Prognóstico , Achados Incidentais , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Análise Multivariada , Razão de Chances
10.
Pol J Pathol ; 71(1): 1-6, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32429648

RESUMO

One of the key parameters in the diagnosis of papillary thyroid carcinoma (PTC) are true nuclear pseudoinclusions (NPs), which constitute invaginations of the cytoplasm into the nucleus. On the other hand, strong cytoplasmic expression of CK19 is a well-known attribute of PTC tumor cells. We analyzed NPs using CK19 immunohistochemistry in histological sections of 52 PTCs and seven noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTPs). Strong CK19+ NPs were present in 77% of PTCs, whereas NPs in hematoxylin and eosin (HE)-stained slides (HE NPs) were identified in only 48% of PTCs. Detection of CK19+ NPs enabled easier and objective recognition of NPs and better discrimination of NPs from pseudo-pseudoinclusions than detection of HE NPs. In the 15 of the 27 (55.5%) PTCs in which we could not discern HE NPs, strong CK19+ NPs could be identified reliably, quickly and easily. Moreover, all NIFTPs were negative for both CK19+ NPs and HE NPs. Detection of CK19+ NPs may refine the assessment of this important diagnostic feature and, hence, the microscopic diagnostic criteria of PTC. Thus, these findings may have implications for the accurate diagnosis of PTC and NIFTP.


Assuntos
Queratina-19/análise , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Biomarcadores Tumorais/análise , Núcleo Celular , Humanos , Imuno-Histoquímica , Corpos de Inclusão Intranuclear
11.
Gan To Kagaku Ryoho ; 47(3): 505-506, 2020 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-32381930

RESUMO

Intraoperative identification of the parathyroid gland is very important during thyroid and parathyroid surgery.Recently, intrinsic fluorescence of the parathyroid gland was identified and reported.We report the case of a 45-year-old woman with thyroid papillary cancer.Before surgery, neck and chest CT showed a thyroid tumor(20mm)of the right lobe and an aberrant right subclavian artery.Her thyroid cancer(T1N1M0, Stage Ⅰ)was resected in December 2017(right lobectomy and lymph node dissection).During surgery, her parathyroid glands were visually inspected by the surgeon as well as by a ready-made photodynamic eye(PDE-neo)system.Diagnosis was performed using the intraoperative fast pathological method.Her inferior laryngeal nerve was non-recurrent(Toniato ⅡA).This photodynamic eye(PDE-neo)system is an effective and useful method that decreases the operation time and enables faster detection of the parathyroid gland.


Assuntos
Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Feminino , Fluorescência , Humanos , Pessoa de Meia-Idade , Glândulas Paratireoides , Nervo Laríngeo Recorrente , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico
12.
Arch Biochem Biophys ; 685: 108353, 2020 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-32234499

RESUMO

OBJECTIVE: Despite of previous report regarding the aberrant overexpression of hsa_circ_0011290 in thyroid cancer, the regulatory mechanism and mechanistic involvements of which were still elusive currently in papillary thyroid cancer (PTC). Here we set out to characterize expression status and functional contributions of hsa_circ_0011290 in this disease especially through mode-of-action of sponging RNA. METHODS: Relative expression of hsa_circ_0011290, microRNA (miR)-1252 and FSTL1 was quantified by real-time polymerase chain reaction. Glucose metabolism was determined by examination of glucose uptake, lactate production and ATP contents. The regulatory effects of miR-1252 on both hsa_circ_0011290 and Follistatin Like 1 (FSTL1) were interrogated by luciferase reporter assay. Direct binding between miR-1252 with hsa_circ_0011290 and FSTL1 transcripts were analyzed by RNA pulldown assay. Protein levels of FSTL1 was examined by Western blots. RESULTS: Aberrant over-expression of hsa_circ_0011290 was associated with advanced stage and unfavorable prognosis of PTC. Knockdown of hsa_circ_0011290 greatly inhibited cell viability, proliferation and stimulated cell apoptosis in PTC cells. Meanwhile, glucose metabolism was significantly switched with decreased glucose uptake and lactate production, and increased ATP contents. We identified miR-1252 as target miR of hsa_circ_0011290, and miR-1252 evidently inhibited expressions of both luciferase reporter and endogenous hsa_circ_0011290, and miR-1252 was negatively regulated by hsa_circ_0011290 vice versa. We further suggested that FSTL1 as direct target of miR-1252, and provided direct evidences in support of binding between miR-1252 with both hsa_circ_0011290 and FSTL1. Through sponging miR-1252, hsa_circ_0011290 was capable of positively modulate FSTL1 expression. Notably, inhibition of miR-1252 completely reversed phenotypic effects of hsa_circ_0011290 knockdown including cell viability, proliferation, apoptosis and glucose metabolisms. CONCLUSION: Our study uncovered the oncogenic contributions of hsa_circ_0011290-miR-1252-FSTL1 in PTCs.


Assuntos
Apoptose/fisiologia , Proliferação de Células/fisiologia , RNA Circular/metabolismo , Transdução de Sinais/fisiologia , Câncer Papilífero da Tireoide/metabolismo , Apoptose/genética , Linhagem Celular Tumoral , Proliferação de Células/genética , Proteínas Relacionadas à Folistatina/metabolismo , Técnicas de Silenciamento de Genes , Glicólise/fisiologia , Humanos , MicroRNAs/metabolismo , Prognóstico , RNA Circular/análise , RNA Circular/genética , Transdução de Sinais/genética , Câncer Papilífero da Tireoide/diagnóstico
14.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 73-79, Jan.-Mar. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1090558

RESUMO

Abstract Introduction Papillary and follicular thyroid carcinoma are common head and neck cancers. This cancer expresses a thyroid stimulating hormone (TSH) receptor that plays a role as a cancer stimulant substance. This hormone has a diagnostic value in the management of thyroid carcinoma. Objective The present study aimed to determine the difference in TSH levels between differentiated thyroid carcinoma and benign thyroid enlargement. Methods The present research design was a case-control study. The subjects were patients with thyroid enlargement who underwent thyroidectomies at the Dr. Sardjito General Hospital, Yogyakarta, Indonesia. Thyroid stimulating hormone levels were mea- sured before the thyroidectomies. The inclusion criteria for the case group were: 1) differentiated thyroid carcinoma, and 2) complete data; while the inclusion criteria for the control group were: 1) benign thyroid enlargement, and 2) complete data. The exclusion criteria for both groups were: 1) patients suffering from thyroid hormone disorders requiring therapy before thyroidectomy surgery, 2) patients receiving thyroid suppression therapy before the thyroidectomy was performed, and 3) patients suffering from severe chronic diseases such as renal insufficiency, and severe liver disease. Results There were 40 post-thyroidectomy case group patients and 40 post-thyroidect- omy control group patients. There were statistically significant differences in TSH levels between the groups with differentiated thyroid carcinoma and benign thyroid enlargement (p = 0.001; odds ratio [OR] = 8.42; 95% confidence interval [CI]: 3.19-36.50). Conclusion Based on these results, it can be concluded that there were significant differences in TSH levels between the groups with differentiated thyroid carcinoma and benign thyroid enlargement.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias da Glândula Tireoide/diagnóstico , Tireotropina/sangue , Adenocarcinoma Folicular/diagnóstico , Câncer Papilífero da Tireoide/diagnóstico , Tireoidectomia , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Biomarcadores Tumorais/sangue , Estudos de Casos e Controles , Adenocarcinoma Folicular/patologia , Diagnóstico Diferencial , Câncer Papilífero da Tireoide/patologia
15.
Eur J Surg Oncol ; 46(6): 967-975, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32098735

RESUMO

BACKGROUND: The management of papillary thyroid carcinoma (PTC) is changed after introduction of sentinel lymph node biopsy (SNB) technique for nodal staging. Some debate still surrounds the accuracy of this procedure in terms of wide heterogeneity of sentinel lymph node detection and false-negative findings. AIM: to identify the key issues which make it difficult the usefulness of SNB in PTC. METHODS: A comprehensive computer literature search of meta-analyses published in PubMed/MEDLINE and Cochrane library database until June 30, 2019 was conducted. We used a search algorithm based on this combination of terms: (i) "thyroid neoplasm" or "thyroid cancer" or "thyroid carcinoma" or "thyroid malignancy" or "meta-analysis" or "systematic review") AND (ii) "sentinel lymph node biopsy". RESULTS: Comparing 4 written meta-analyses published in the literature, the diagnostic performance of SNB technique in PTC has been summarized. Relatively high false-negative rates (FNR) were reported for each SNB methods: vital-dye (VD: 12.7%; 7%; 0-38%), 99mTc-nanocolloid planar lymphoscintigraphy with the use of intraoperative hand-held gamma probes (LS: 11.3%; 16%; 0-40%), combined LS with VD (LS+VD: 0%; 0-17%), LS with the additional contribution of preoperative SPECT/CT (7-8%). CONCLUSION: Evidence-based data about the diagnostic performance of SNB in PTC are increasing. The nuclear medicine community should reach a consensus on the operational definition of the SLN to better guide the surgeon in identifying the lymph nodes most likely contain metastatic cells. Standardization of SLN identification, removal and analysis are required.


Assuntos
Biópsia de Linfonodo Sentinela/métodos , Câncer Papilífero da Tireoide/secundário , Neoplasias da Glândula Tireoide/patologia , Reações Falso-Negativas , Humanos , Metástase Linfática , Câncer Papilífero da Tireoide/diagnóstico
16.
Sci Rep ; 10(1): 1724, 2020 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-32015423

RESUMO

S100A12 belongs to the S100 family and acts as a vital regulator in different types of tumors. However, the function of S100A12 in thyroid carcinoma has not yet been investigated. In this study, we analyzed the expression of S100A12 in human papillary thyroid cancer (PTC) samples and two PTC cell lines. In addition, we explored the effects of S100A12 on PTC cell progression in vitro and in vivo. Our results showed that S100A12 was significantly upregulated in PTC specimens. Moreover, silencing S100A12 markedly inhibited PTC cell proliferation, migration, invasion and cell cycle progression. In addition, knockdown of S100A12 significantly reduced the expression of CyclinD1, CDK4 and p-ERK in PTC cells. An in vivo study also showed that silencing S100A12 dramatically suppressed tumor cell growth and decreased Ki67 expression in a xenograft mouse model. This study provides novel evidence that S100A12 serves as an oncogene in PTC. Knockdown of S100A12 suppressed PTC cell proliferation, migration, and invasion and induced G0/G1 phase arrest via the inhibition of the ERK signaling pathway. Therefore, S100A12 may be a potent therapeutic target for PTC.


Assuntos
Biomarcadores Tumorais/metabolismo , Proteína S100A12/metabolismo , Câncer Papilífero da Tireoide/diagnóstico , Glândula Tireoide/metabolismo , Neoplasias da Glândula Tireoide/diagnóstico , Animais , Carcinogênese , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células/genética , Regulação da Expressão Gênica , Humanos , Sistema de Sinalização das MAP Quinases , Camundongos , Invasividade Neoplásica/genética , RNA Interferente Pequeno/genética , Proteína S100A12/genética , Regulação para Cima , Ensaios Antitumorais Modelo de Xenoenxerto
17.
Ann Endocrinol (Paris) ; 81(1): 28-33, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32081363

RESUMO

INTRODUCTION: NIFTP (non-invasive follicular thyroid neoplasm with papillary-like nuclear features, formerly non-invasive encapsulated follicular variant of papillary thyroid carcinoma) has been removed from the carcinoma category because of its indolent character and good prognosis. This change impacts clinical and surgical management, since these tumors no longer require total thyroidectomy, or complementary radioactive iodine therapy for <4cm tumor. The aim of the present study was to identify preoperative ultrasound and cytological differences between NIFTP and papillary thyroid carcinoma (PTC). MATERIALS AND METHODS: A retrospective study included 81 patients who underwent total thyroidectomy or thyroid lobectomy with histologic diagnosis of PTC, NIFTP or invasive follicular variant of PTC (IFVPTC) between January 1st, 2016 and May 31st, 2018. Ultrasound and cytological data were analyzed and compared between NIFTP and non-NIFTP (PTC and invasive follicular variant of PTC). RESULTS: Fourteen NIFTPs, 67 PTCs, including 20 IFVPTCs, were included. In comparison with non-NIFTP PTC, nodules in NIFTP were more often isoechoic (69.2% vs. 17.4%; P=0.0007), with smooth borders (92.3% vs. 31.1%; P=0.0001) and TI-RADS score 2, 3 or 4a. Cytologically, NIFTPs were mainly in categories AUS/FLUS, FN and SusM of the Bethesda System for Reporting Thyroid Cytopathology. Only nuclear pseudo-inclusions were significantly associated with non-NIFTP (P=0.0031). CONCLUSION: NIFTP appears non-suspect on preoperative ultrasound and indeterminate on cytology. These differences with respect to PTC can guide diagnosis and surgical treatment.


Assuntos
Adenocarcinoma Folicular/diagnóstico , Adenocarcinoma Folicular/patologia , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Adenocarcinoma Folicular/cirurgia , Adulto , Idoso , Biópsia por Agulha Fina , Núcleo Celular/patologia , Citodiagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Câncer Papilífero da Tireoide/cirurgia , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Ultrassonografia
18.
World J Surg ; 44(5): 1506-1513, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31915977

RESUMO

BACKGROUND: Whether chronic lymphocytic thyroiditis (CLT) influences the risk of development and the progression of papillary thyroid cancer (PTC) remains uncertain. We investigated the effects of CLT on the clinicopathologic features and prognosis of PTC. METHODS: Two thousand nine hundred twenty-eight consecutive patients with PTC treated between 2009 and 2017 were divided into two groups: one with chronic lymphocytic thyroiditis and one without; 1174 (40%) of the patients had coincident CLT. RESULTS: In univariate analysis, CLT correlated positively with small tumor size, frequent extrathyroidal extension, multifocal diseases, and p53 but negatively with central lymph node (LN) metastasis and BRAF mutation. In multivariate analysis, CLT was associated with extrathyroidal extension and multifocal disease; however, it was not a prognostic factor for recurrence even though it was associated with two aggressive factors. Compared with patients with PTC alone, there were more retrieved central LNs in the PTC + CLT group, and these patients also underwent more invasive diagnostic tests such as fine needle aspiration cytology and frozen biopsy of LN. CONCLUSIONS: The CLT patients with PTC had better behavior features and prognoses than did those with PTC alone despite frequent multifocality and extrathyroidal extension. However, precaution may be necessary to avoid performing invasive diagnostic procedures for lateral LN metastasis and to manage the patients appropriately.


Assuntos
Doença de Hashimoto/patologia , Recidiva Local de Neoplasia/patologia , Lesões Pré-Cancerosas/patologia , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto , Idoso , Estudos de Casos e Controles , Progressão da Doença , Feminino , Doença de Hashimoto/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/imunologia , Lesões Pré-Cancerosas/imunologia , Prognóstico , Estudos Retrospectivos , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/imunologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/imunologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
19.
Endocr Pract ; 26(5): 499-507, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31968190

RESUMO

Objective: The eighth edition of the American Joint Committee on Cancer (AJCC) guideline on the tumor-node-metastasis staging system has been applied in clinical practice for thyroid cancer since 2018. However, using these criteria, a few studies have shown no significant difference between stage III and IV diseases amongst the differentiated thyroid cancer (DTC) patients. Thus, we aimed to study the underlying reason behind this observation. Methods: Patients were selected from the Surveillance, Epidemiology, and End Results database between 2004 and 2015. The Cox proportional hazards regression model was used for the univariate and multivariate analyses to plot the Kaplan-Meier survival curves for overall survival (OS) and disease-specific survival (DSS). Results: A total of 1,431 patients had a median tumor size of 3.0 cm (range: 0.1 to 50 cm). When stratified by tumor size (≤2 cm, 2 to 4 cm, and >4 cm), lower survival rates were observed in patients with stage III (T4a) cancer and large tumor size than in those with stage IVA (T4b) cancer and small tumor size. Univariate and multivariate analyses showed that tumor size (≤4 cm versus >4 cm) is an independent prognostic factor for OS (P<.001) and DSS (P<.001) in DTC patients with T4a and T4b diseases. Conclusion: Tumor size is an independent prognostic factor for OS and DSS in DTC patients with T4 disease; tumor size-related modification of the T4 category can improve the AJCC staging system for DTC patient with stage III-IV diseases. Abbreviations: AJCC = American Joint Committee on Cancer; CI = confidence interval; DSS = disease-specific survival; DTC = differentiated thyroid cancer; FTC = follicular thyroid cancer; HR = hazard ratio; OS = overall survival; PTC = papillary thyroid cancer; SEER = Surveillance, Epidemiology, and End Results; TNM = tumor-node-metastasis.


Assuntos
Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Humanos , Estadiamento de Neoplasias , Prognóstico , Taxa de Sobrevida , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico
20.
J Clin Neurosci ; 72: 460-463, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31889644

RESUMO

Blepharospasm is a type of focal dystonia depicted by periodic and spontaneous closure of the orbicularis oculi and surrounding muscles. Typical secondary etiologies of blepharospasm may include ophthalmologic and structural brain lesions. In this article, we report a novel case of a patient with a biopsy-proven concurrent papillary carcinoma of the thyroid gland and adenoma of the parathyroid gland with blepharospasm as an exceptionally unique initial manifestation. This report showed that a diagnostic work-up for causes of blepharospasm may include a search for these neoplasm and surgical removal of these masses may offer significant symptomatic control of the focal dystonia.


Assuntos
Adenoma/diagnóstico , Blefarospasmo/diagnóstico , Carcinoma Papilar/diagnóstico , Neoplasias das Paratireoides/diagnóstico , Câncer Papilífero da Tireoide/diagnóstico , Adenoma/patologia , Carcinoma Papilar/patologia , Distúrbios Distônicos , Pálpebras , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias das Paratireoides/patologia , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico
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