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1.
Medicine (Baltimore) ; 98(50): e18213, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852078

RESUMO

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.


Assuntos
Índice de Massa Corporal , Obesidade/complicações , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Tireoidectomia/métodos , Estudos de Casos e Controles , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Retrospectivos , Câncer Papilífero da Tireoide/etiologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/cirurgia
2.
Am J Otolaryngol ; 40(4): 536-541, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31036419

RESUMO

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.


Assuntos
Resultados Negativos , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia , Deficiência de Vitamina D , Adulto , Idoso , Biomarcadores Tumorais/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Fatores Socioeconômicos , Câncer Papilífero da Tireoide/etiologia , Neoplasias da Glândula Tireoide/etiologia , Vitamina D/sangue , Deficiência de Vitamina D/complicações
3.
Ear Nose Throat J ; 98(3): 136-138, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30938240

RESUMO

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.


Assuntos
Cisto Tireoglosso , Câncer Papilífero da Tireoide , Glândula Tireoide , Neoplasias da Glândula Tireoide , Tireoidectomia/métodos , Adolescente , Humanos , Masculino , Cisto Tireoglosso/complicações , Cisto Tireoglosso/patologia , Câncer Papilífero da Tireoide/etiologia , Câncer Papilífero da Tireoide/patologia , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/patologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ultrassonografia/métodos
4.
Orphanet J Rare Dis ; 14(1): 42, 2019 02 13.
Artigo em Inglês | MEDLINE | ID: mdl-30760283

RESUMO

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.


Assuntos
Resistência à Insulina/fisiologia , Distrofia Miotônica/diagnóstico , Distrofia Miotônica/etiologia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Adulto , Feminino , Bócio/diagnóstico , Bócio/etiologia , Bócio/genética , Humanos , Resistência à Insulina/genética , Masculino , Pessoa de Meia-Idade , Distrofia Miotônica/genética , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/etiologia , Câncer Papilífero da Tireoide/genética , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/genética
5.
World J Surg ; 43(5): 1243-1248, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30680499

RESUMO

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.


Assuntos
Hiperparatireoidismo Primário/complicações , Câncer Papilífero da Tireoide/etiologia , Neoplasias da Glândula Tireoide/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Hiperparatireoidismo Primário/cirurgia , Masculino , Sobremedicalização , Pessoa de Meia-Idade , Estudos Retrospectivos , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Adulto Jovem
6.
Intern Med ; 58(4): 497-504, 2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30333389

RESUMO

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.


Assuntos
Neoplasias das Glândulas Suprarrenais/sangue , Aldosterona/efeitos adversos , Aldosterona/sangue , Hiperaldosteronismo/sangue , Hiperaldosteronismo/complicações , Câncer Papilífero da Tireoide/sangue , Neoplasias da Glândula Tireoide/sangue , Neoplasias das Glândulas Suprarrenais/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Feminino , Humanos , Hiperaldosteronismo/fisiopatologia , Japão , Masculino , Pessoa de Meia-Idade , Prevalência , Renina/sangue , Câncer Papilífero da Tireoide/etiologia , Câncer Papilífero da Tireoide/fisiopatologia , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/fisiopatologia
7.
Eur Rev Med Pharmacol Sci ; 22(17): 5576-5582, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30229831

RESUMO

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.


Assuntos
RNA Longo não Codificante/fisiologia , Câncer Papilífero da Tireoide/etiologia , Neoplasias da Glândula Tireoide/etiologia , Via de Sinalização Wnt/fisiologia , Adulto , Idoso , Apoptose , Linhagem Celular Tumoral , Proliferação de Células , Humanos , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia
8.
Int J Biol Markers ; 33(4): 455-462, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30058426

RESUMO

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.


Assuntos
Apolipoproteínas A/sangue , Biomarcadores Tumorais/sangue , Complemento C3/análise , Proteômica/métodos , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Ativação do Complemento , Ensaio de Imunoadsorção Enzimática , Humanos , Mapas de Interação de Proteínas , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Câncer Papilífero da Tireoide/sangue , Câncer Papilífero da Tireoide/etiologia , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/etiologia
9.
Acta Otorhinolaryngol Ital ; 38(4): 310-315, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29498716

RESUMO

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.


Assuntos
Raios gama/efeitos adversos , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Exposição à Radiação/efeitos adversos , Câncer Papilífero da Tireoide/epidemiologia , Câncer Papilífero da Tireoide/etiologia , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/etiologia , Adolescente , Adulto , Acidente Nuclear de Chernobyl , Feminino , Grécia/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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