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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.
Arch Endocrinol Metab ; 63(5): 536-544, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31482959

RESUMO

Thyroid cancer has been rapidly increasing in prevalence among humans in last 2 decades and is the most prevalent endocrine malignancy. Overall, thyroid-cancer patients have good rates of long-term survival, but a small percentage present poor outcome. Thyroid cancer aggressiveness is essentially related with thyroid follicular cell loss of differentiation and metastasis. The discovery of oncogenes that drive thyroid cancer (such as RET, RAS, and BRAF), and are aligned in the MAPK/ERK pathway has led to a new perspective of thyroid oncogenesis. The uncovering of additional oncogene-modulated signaling pathways revealed an intricate and active signaling cross-talk. Among these, microRNAs, which are a class of small, noncoding RNAs, expanded this cross-talk by modulating several components of the oncogenic network - thus establishing a new layer of regulation. In this context, TGFß signaling plays an important role in cancer as a dual factor: it can exert an antimitogenic effect in normal thyroid follicular cells, and promote epithelial-to-mesenchymal transition, cell migration, and invasion in cancer cells. In this review, we explore how microRNAs influence the loss of thyroid differentiation and the increase in aggressiveness of thyroid cancers by regulating the dual function of TGFß. This review provides directions for future research to encourage the development of new strategies and molecular approaches that can improve the treatment of aggressive thyroid cancer.


Assuntos
MicroRNAs/metabolismo , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Fator de Crescimento Transformador beta/metabolismo , Transformação Celular Neoplásica , Progressão da Doença , Humanos , Invasividade Neoplásica , Metástase Neoplásica , Transdução de Sinais , Neoplasias da Glândula Tireoide/metabolismo
3.
Zhonghua Jie He He Hu Xi Za Zhi ; 42(8): 591-595, 2019 Aug 12.
Artigo em Chinês | MEDLINE | ID: mdl-31378020

RESUMO

Objective: To explore the change of hypothalamic-pituitary-thyroid axis hormones and it's role in depression in obstructive sleep apnea-hypopnea syndrome. Methods: Seventy-three male OSAHS patients [age (39±11) years] and 13 male controls [age (36±7.5) years] were enrolled from August 2013 to May 2017 in the 1(st) Hospital of China Medical University. Overnight polysomnography and depression were assessed. The serum TRH, TSH, FT4 and FT3 levels were measured on the next morning. The relationship between depression and hypothalamic-pituitary-thyroid axis was analyzed. Results: Compared with the control group, severe hypoxia group had higher serum FT3 level [(4.5±0.6) ng/L vs. (5.4±0.7)ng/L, P<0.05)] and depression score (30±7 vs. 40±10, P<0.05). Further analysis revealed that serum FT3 level (5.0±0.5 ng/L vs. 5.5±0.7ng/L, P<0.05) and FT4 level [(16.2±1.9) ng/L vs. (18.2±2.3) ng/L, P<0.05] were lower in the patients with depression than those without. Conclusion: The decrease of serum FT3 and FT4 levels in OSAHS patients with severe hypoxia was closely related to the occurrence of depression.


Assuntos
Depressão/psicologia , Sistema Hipotálamo-Hipofisário/patologia , Apneia Obstrutiva do Sono/psicologia , Glândula Tireoide/patologia , China , Humanos , Masculino , Polissonografia , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
4.
J Clin Pathol ; 72(11): 771-777, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31375535

RESUMO

AIMS: The 2017 Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) recommends subclassification of atypia of undetermined significance (AUS)/follicular lesion of undetermined significance (FLUS) into six subcategories. The present study evaluates the risk of malignancy (ROM) and risk of neoplasm (RON) among these. METHODS: All thyroid aspirates reported as AUS/FLUS over a 4.5-year period, with available histology, were reviewed and subclassified as per TBSRTC. ROM and RON were calculated and compared. RESULTS: Of 2554 thyroid aspirates, 281 (11.0%) were AUS/FLUS. Eighty-one with available histology were evaluated. ROM was 51.8%. Cytologic and architectural atypia (AUS-C&A) was the most prevalent (62.9%), followed by Hürthle cell type (19.6%), AUS-A (11.1%), AUS-not otherwise specified (NOS) (7.4%), cytologic atypia (AUS-C) (4.9%) and atypical lymphoid cells (1.2%). Papillary thyroid carcinoma (PTC) and adenomatous goitre (AG) were the most common histological diagnoses (27% each). On histology, AUS-C had 2/4 PTC and 2/4 AG on histology. AUS-A had 4/9 follicular neoplasm (FN) and 2/9 non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) while AUS C&A had 18/51 PTC, 13/51 AG, 11/51 NIFTP and 5/51 FN. ROM and RON were similar across subcategories, ROM was the highest for AUS-C&A (58.8%), AUS-C (50%) and AUS-NOS (50%). NIFTP reclassification as non-malignant reduced ROM to 35.8% (absolute reduction of 16% and a relative decrease of 31%) with the greatest relative decrease seen in AUS-A (50%), followed by AUS-C&A (37%), and none in others. CONCLUSIONS: AUS/FLUS subcategorisation helped to indicate risk for the more likely neoplasm, whether PTC or FN. ROM was the highest for cases with cytological atypia but did not differ significantly across different subcategories. NIFTP changed the ROM of AUS-A and AUS-C&A, since both NIFTP and FN have microfollicles.


Assuntos
Centros de Atenção Terciária , Doenças da Glândula Tireoide/patologia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Criança , Diagnóstico Diferencial , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Doenças da Glândula Tireoide/classificação , Doenças da Glândula Tireoide/cirurgia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/classificação , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Adulto Jovem
5.
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
6.
J Laryngol Otol ; 133(8): 696-699, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31290382

RESUMO

OBJECTIVE: To explore the use of fluorescence lifetime imaging microscopy in thyroid tissues, and to investigate how different thyroid lesions affect fluorescence lifetime. METHOD: Fluorescence lifetime measurements were taken of fresh frozen thyroid surgical specimens stained with fluorescein isothiocyanate tagged anti-thyroglobulin monoclonal antibodies. RESULTS: The mean fluorescence lifetime measurements in 12 patients - 3 with multinodular goitre, 4 with follicular adenoma, 4 with papillary thyroid carcinoma and 1 with follicular carcinoma - were 3.16 ns (range, 2.66-3.52 ns), 3.75 ns (range, 2.99-4.57 ns), 2.97 ns (range, 2.57-3.21 ns) and 3.61 ns, respectively. The fluorescence lifetime of follicular adenoma patients was higher than that of papillary thyroid carcinoma patients by 26 per cent (p = 0.058). The fluorescence lifetime in the follicular carcinoma patient was similar to the follicular adenoma group, but higher than in the papillary thyroid carcinoma group by 22 per cent (p = 0.01). CONCLUSION: Fluorescence lifetime measurements varied in different thyroid pathologies, possibly because of tissue-scale structural influences.


Assuntos
Adenoma/diagnóstico por imagem , Bócio Nodular/diagnóstico por imagem , Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Adenoma/metabolismo , Feminino , Fluoresceína-5-Isotiocianato/farmacologia , Técnica Direta de Fluorescência para Anticorpo , Bócio Nodular/metabolismo , Humanos , Masculino , Microscopia de Fluorescência , Tireoglobulina/antagonistas & inibidores , Glândula Tireoide/patologia
8.
Environ Monit Assess ; 191(7): 454, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31222463

RESUMO

It is well-known that the metamorphosis process in amphibians is dependent on thyroid hormones. Laboratory studies have shown that several environmental contaminants can affect the function of thyroid hormones leading to alterations in the amphibian metamorphosis. The basic idea of the present study was to elucidate if the amphibian metamorphosis might be a useful tool as biomarker for effect-based environmental monitoring, examining wild tadpoles for potential thyroid hormone disruption. A laboratory test was performed to identify the responses from exposure to 6-propylthiouracil (PTU), which has a well-known mechanism on the thyroid system, on Swedish tadpoles from the Rana genus. This was followed by an environmental monitoring study where tadpoles of Rana arvalis, R. temporaria, and Bufo bufo were sampled from various sites in Sweden. Morphological data such as body weight, histopathological measurements of the thyroid glands, and environmental parameters were recorded. The results revealed that Rana tadpoles respond similar as other amphibians to PTU exposure, with interrupted development and increased size relative to the developmental stage. Data on some wild tadpoles showed similar features as the PTU exposed, such as high body weight, thus suggesting potential thyroid disrupting effects. However, histological evaluation of thyroid glands and pesticide analyses of the water revealed no clear evidence of chemical interactions. To a minor degree, the changes in body weight may be explained by natural circumstances such as pH, forest cover, and temperature. The present study cannot fully explain whether the high body weights recorded in some tadpoles have natural or chemical explanations. However, the study reveals that it is clearly achievable to catch tadpoles in suitable stages for the use in this type of biomonitoring and that the use of these biomarkers for assessment of thyroid disruption seems to be highly relevant.


Assuntos
Antitireóideos/toxicidade , Bufonidae/embriologia , Monitoramento Ambiental/métodos , Larva/crescimento & desenvolvimento , Praguicidas/toxicidade , Propiltiouracila/toxicidade , Ranidae/embriologia , Glândula Tireoide/patologia , Animais , Metamorfose Biológica , Suécia , Glândula Tireoide/efeitos dos fármacos , Hormônios Tireóideos/metabolismo
9.
Anal Bioanal Chem ; 411(20): 5007-5012, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31147760

RESUMO

MALDI-MSI represents an ideal tool to explore the spatial distribution of proteins directly in situ, integrating molecular and cytomorphological information, enabling the discovery of potential diagnostic markers in thyroid cytopathology. However, red cells present in the fine needle aspiration biopsy (FNAB) specimens caused ion suppression of other proteins during the MALDI-MSI analysis due to large amount of haemoglobin. Aim of this study was to set up a sample preparation workflow able to manage this haemoglobin interference. Three protocols were compared using ex vivo cytological samples collected from fresh thyroid nodules of 9 patients who underwent thyroidectomy: (A) conventional air-dried smears, (B) cytological smears immediately fixed in ethanol, and (C) ThinPrep liquid-based preparation. Protocols C and A were also evaluated using real FNABs. Results show that protocol C markedly decreased the amount of haemoglobin, with respect to protocols A and B. Protein profiles obtained with protocols A and B were characterised by high inter-patient variability, probably related to the abundance of the haemoglobin, whereas similar spectra were observed for protocol C, where haemoglobin contents were lower. Our findings suggest protocol C as the sample preparation method for MALDI-MSI analysis. Graphical abstract.


Assuntos
Biópsia por Agulha/métodos , Hemoglobinas/análise , Proteômica/métodos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Glândula Tireoide/patologia , Artefatos , Humanos , Tireoidectomia
10.
Nat Commun ; 10(1): 2764, 2019 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-31235699

RESUMO

Anaplastic thyroid cancer (ATC) and advanced differentiated thyroid cancers (DTCs) show fatal outcomes, unlike DTCs. Here, we demonstrate mutational landscape of 27 ATCs and 86 advanced DTCs by massively-parallel DNA sequencing, and transcriptome of 13 ATCs and 12 advanced DTCs were profiled by RNA sequencing. TERT, AKT1, PIK3CA, and EIF1AX were frequently co-mutated with driver genes (BRAFV600E and RAS) in advanced DTCs as well as ATC, but tumor suppressors (e.g., TP53 and CDKN2A) were predominantly altered in ATC. CDKN2A loss was significantly associated with poor disease-specific survival in patients with ATC or advanced DTCs, and up-regulation of CD274 (PD-L1) and PDCD1LG2 (PD-L2). Transcriptome analysis revealed a fourth molecular subtype of thyroid cancer (TC), ATC-like, which hardly reflects the molecular signatures in DTC. Furthermore, the activation of JAK-STAT signaling pathway could be a potential druggable target in RAS-positive ATC. Our findings provide insights for precision medicine in patients with advanced TCs.


Assuntos
Regulação Neoplásica da Expressão Gênica/genética , Carcinoma Anaplásico da Tireoide/genética , Neoplasias da Glândula Tireoide/genética , Transcriptoma/genética , Adulto , Idoso , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Linhagem Celular Tumoral , Progressão da Doença , Feminino , Perfilação da Expressão Gênica , Genômica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Janus Quinases/metabolismo , Masculino , Pessoa de Meia-Idade , Mutação , Medicina de Precisão/métodos , Fatores de Transcrição STAT/metabolismo , Transdução de Sinais/genética , Análise de Sobrevida , Carcinoma Anaplásico da Tireoide/mortalidade , Carcinoma Anaplásico da Tireoide/patologia , Carcinoma Anaplásico da Tireoide/terapia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/mortalidade , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/terapia , Regulação para Cima
11.
Environ Sci Pollut Res Int ; 26(18): 18017-18031, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31062236

RESUMO

The aim of this review was to investigate the effects of possible harmful waves from either cell phone use or being within the range of the cell phone from 450 to 3800 MHz on the thyroid cells and hormones. Eight electronic datasets were systematically searched using MeSH terms, including "cell phone," "mobile phone," "GSM," "radio frequency," "smartphone," "triiodothyronine," "thyroxin," "thyroid-stimulating hormone," "T3," "T4," "TSH," and "morphological" and all possible combinations, to identify relevant studies published up to Dec 2018. We also manually searched the reference lists of potentially selected studies to identify further relevant publications. About 161 relevant studies were initially found. After screening titles and abstracts, 139 studies were excluded, and finally 22 studies (comprising 7182 cases) were included in the qualitative synthesis. Of the 22 included studies, 11 studies reported changes in T3 and T4 levels (six reported a decrease in T3 levels and one reported increase in it); moreover, five found decreased T4 levels and two studies an increased level. In other 10 studies, TSH alteration was reported. Of these, two studies reported a decrease in TSH level and one reported an increase in the hormone levels, while in the remaining studies non-significant changes were reported. Finally, seven studies examined histological changes in the thyroid gland follicles and showed that the volume of these cells was reduced. Based on the evidence discussed above, the reduction in diameter of thyroid follicles is potentially linked with cell phone radiation. Exposure may negatively influence the iodine uptake in the thyroid gland or increases temperature effect on the thyroid gland. However, further research are needed in order to show that the level of TSH and thyroid hormone suppression by microwave.


Assuntos
Telefone Celular , Radiação Eletromagnética , Glândula Tireoide/efeitos da radiação , Hormônios Tireóideos/sangue , Humanos , Glândula Tireoide/metabolismo , Glândula Tireoide/patologia
12.
J Pediatr Endocrinol Metab ; 32(5): 471-478, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31042644

RESUMO

Background Thyroid dysfunction is the most common hormonal abnormality in obesity. It should actually be considered as an adaptation response to fat excess. However, little has been reported on the morphology of the thyroid gland, and no data regarding the relationship between thyroid gland changes and metabolic parameters are available in obese adolescents. Objective The study aimed to evaluate the frequency of non-autoimmune thyroiditis in obese adolescents and compare the metabolic status of patients with or without thyroiditis. Methods A total of 218 obese children and 49 age-matched control healthy children were included. Thyroid ultrasonography (USG) was performed in all participants, as well as thyroid hormone levels, thyroid antibodies (Abs), lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR) and high-sensitivity C-reactive protein (HsCRP) were determined. Obese children were divided into three groups according to the presence of thyroid autoantibodies and USG findings of thyroiditis (Group-1: Abs [-], normal thyroid morphology/Group-2: Abs [+], abnormal thyroid morphology/Group-3: Abs [-], abnormal thyroid morphology). The relationship between body mass index, metabolic parameters and thyroid gland status was analyzed. Results Seventy-two of 218 obese patients (33%) had non-autoimmune thyroiditis (Group-3). The rate of insulin resistance was significantly higher in Group-3 than in Group-1 (p = 0.024). Similarly, the frequency of metabolic syndrome (MS) was higher in Group-3 (44.3%) than in Group-1 (27.1%) (p = 0.014). Conclusions Obese adolescents with non-autoimmune thyroiditis had a higher incidence of insulin resistance. This finding supported the hypothesis that insulin resistance may have an effect on thyroid morphology. Further randomized trials investigating this relationship are required.


Assuntos
Resistência à Insulina , Fígado/patologia , Obesidade Pediátrica/complicações , Glândula Tireoide/patologia , Tireoidite/etiologia , Adolescente , Biomarcadores/análise , Estudos de Casos e Controles , Criança , Feminino , Seguimentos , Humanos , Fígado/diagnóstico por imagem , Masculino , Prognóstico , Glândula Tireoide/diagnóstico por imagem , Tireoidite/diagnóstico por imagem , Tireoidite/patologia , Ultrassonografia
13.
BMC Pulm Med ; 19(1): 83, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31053123

RESUMO

BACKGROUND: Rosai-Dorfman disease (RDD) is a rare histiocytosis which involves principally lymph nodes. Thyroid involvement in RDD is a very rare situation, and lung involvement is even rarer. CASE PRESENTATION: We report the case of a 46-year-old woman presenting a painless mass in the right side of the neck and subacute dyspnoea. Computerised tomography (CT) scans of the neck and thorax showed a large thyroid mass causing tracheal stenosis and multiple cystic lesions in both lungs. Subtotal thyroidectomy with a tracheal segment resection and histological analysis confirmed the diagnosis of nodal and extranodal (thyroid, tracheal and probably lung) Rosai-Dorfman disease (RDD) with the presence of increased numbers of IgG4-bearing plasma cells. Clinical, functional and radiological follow up 4 years after surgery without medical treatment did not show any disease progression. CONCLUSIONS: This case report indicates a benign course of nodal RDD with thyroid and tracheal infiltration following surgical resection, association of typical histological signs of RDD (emperipolesis) with IgG4-related disease features, and that lung cysts might be a manifestation of RDD.


Assuntos
Histiocitose Sinusal/patologia , Histiocitose Sinusal/cirurgia , Linfonodos/patologia , Glândula Tireoide/patologia , Cistos/patologia , Diagnóstico Diferencial , Feminino , Humanos , Imunoglobulina G/sangue , Imuno-Histoquímica , Pulmão/patologia , Pessoa de Meia-Idade , Plasmócitos/patologia , Glândula Tireoide/crescimento & desenvolvimento , Tireoidectomia , Tomografia Computadorizada por Raios X , Estenose Traqueal/etiologia
14.
Medicine (Baltimore) ; 98(22): e15866, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31145341

RESUMO

RATIONALE: Hürthle cell adenoma (HCA) of the thyroid is a rare thyroid tumor, and there are limited studies on the contrast-enhanced computed tomography (CT). PATIENT CONCERNS: We report the case of a 63-year-old woman with gradual enlargement of the thyroid over 10 years. DIAGNOSES: Preoperative contrast-enhanced CT revealed typical lesion characteristics of HCA, confirmed by postoperative pathology. INTERVENTIONS: Left thyroidectomy and partial right thyroidectomy were performed on the patient after general anesthesia. OUTCOMES: At follow-up of 12 months after surgery, the patient was in good health without recurrence. LESSONS: The typical imaging features of HCA on contrast-enhanced CT are helpful for the early diagnosis of thyroid eosinophilic adenoma. This will provide an important basis for the preoperative diagnosis and treatment strategy of HCA of the thyroid in future.


Assuntos
Adenoma Oxífilo/diagnóstico por imagem , Adenoma/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adenoma/patologia , Adenoma Oxífilo/patologia , Meios de Contraste , Feminino , Humanos , Pessoa de Meia-Idade , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia
15.
Arch Endocrinol Metab ; 63(3): 300-305, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31038598

RESUMO

OBJECTIVE: Hürthle cell carcinomas (HCCs) of the thyroid have been recently reclassified as a separate entity due to their distinct clinical and molecular profiles. Few studies have assessed the ability of preoperative characteristics in differentiating HCCs from Hürthle cell adenomas (HCAs) due to the low prevalence of both lesions. This study aimed to compare the preoperative features of HCCs and HCAs and evaluate the diagnostic performance of ultrasound in distinguishing between both. SUBJETCS AND METHODS: Retrospective study including 101 patients (52 HCCs and 49 HCAs) who underwent thyroid surgery from 2000 to 2016. Clinical, ultrasonographic, and histological data were reviewed. Diagnostic performance of suspicious sonographic features was analyzed in 51 cases (24 HCCs and 27 HCAs). RESULTS: Hürthle cell neoplasms were predominant in females. Subjects ≥ 55 years represented 58% of the cases of HCCs and 53% of those of HCAs. Carcinomas were significantly larger (p < 0.001), and a tumor size ≥ 4 cm significantly increased the risk of malignancy (odds ratio 3.67). Other clinical, cytologic, and sonographic data were similar between HCCs and HCAs. Among the HCCs, the lesions were purely solid in 54.2%, hypoechoic in 37.5%, and had coarse calcifications in 12.5%, microcalcifications in 8.3%, irregular contours in 4.2%, and a taller-than-wide shape in 16.7%. Predominantly/exclusive intranodular vascularization was observed in 52.6%. Overall, 58% of the HCCs were classified as TI-RADS 4 or 5 compared with 48% of the HCAs. TI-RADS 4 or 5 had a specificity of only 51.8% and a positive likelihood ratio of 1.21. CONCLUSIONS: Apart from the lesion size, no other preoperative feature adequately distinguished HCCs from HCAs. Sonographic characteristics raising suspicion for malignancy, which are mostly present in papillary carcinomas, were infrequent in HCCs. New tools must be developed to improve preoperative diagnosis and deferral of surgery in cases of adenomas.


Assuntos
Adenoma/diagnóstico por imagem , Carcinoma Papilar, Variante Folicular/diagnóstico por imagem , Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Adenoma/patologia , Adenoma/cirurgia , Adulto , Idoso , Carcinoma Papilar, Variante Folicular/patologia , Carcinoma Papilar, Variante Folicular/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia
16.
Arch Endocrinol Metab ; 63(3): 199-207, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31066757

RESUMO

OBJECTIVE: Determine the milk quality effect during lactation on the metabolic and thyroid programming of hypothyroid offspring. MATERIALS AND METHODS: Ten-week-old female Wistar rats were divided into two groups: euthyroid and thyroidectomy-caused hypothyroidism. The rats were matted and, one day after birth, the pups were divided into three groups: euthyroid offspring (EO), hypothyroid offspring (HO) and hypothyroid with a euthyroid replacement wet nurse (HRO). During lactation, the milk quality and offspring body length were evaluated. The body weight and energy intake were determined on a weekly basis, as well as the metabolic profile at the prepubertal (P35-36) and postpubertal (P55-56) ages. At P56, the animals were sacrificed, the adipose tissues were weighed and the thyroid glands were dissected for histological processing. RESULTS: The milk of the hypothyroid wet nurse decreases proteins (16-26%), lipids (22-29%) and lactate (22-37%) with respect to euthyroid. The HO has a lower body weight gain (23-33%), length (11-13%) and energy intake (15-21%). In addition, HO presents impaired fasting glucose and dyslipidemia, as well as a reduction in seric thyroid hormone (18-34%), adipose reserves (26-68%) and thyroid gland weight (25-34%). The HO present thyroid gland cytoarchitecture alteration. The HRO develop the same metabolic alterations as the HO. However, the thyroid gland dysfunction was partially prevented because the HRO improved under about 10% of the serum thyroid hormone concentration, the thyroid gland weight although histological glandular changes presented. CONCLUSIONS: The replacement of hypothyroid offspring with a euthyroid wet nurse during lactation can improve the thyroid programming without modifying metabolic programming.


Assuntos
Hipotireoidismo Congênito/metabolismo , Lactação/metabolismo , Fenômenos Fisiológicos da Nutrição Materna , Hormônios Tireóideos/metabolismo , Animais , Modelos Animais de Doenças , Feminino , Ratos , Ratos Wistar , Glândula Tireoide/patologia
17.
Ecotoxicol Environ Saf ; 179: 151-159, 2019 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-31035249

RESUMO

Tetrabromobisphenol A bis(2,3-dibromopropyl ether) (TBBPA-BDBPE) and 1,2-bis(2,4,6-tribromophenoxy)ethane (BTPBE) are both brominated flame retardants (BFRs) that have been detected in birds; however, their potential biological effects are largely unknown. We assessed the effects of embryonic exposure to TBBPA-BDBPE and BTBPE in a model avian predator, the American kestrel (Falco sparverius). Fertile eggs from a captive population of kestrels were injected on embryonic day 5 (ED5) with a vehicle control or one of three doses within the range of concentrations that have been detected in biota (nominal concentrations of 0, 10, 50 or 100 ng/g egg; measured concentrations 0, 3.0, 13.7 or 33.5 ng TBBPA-BDBPE/g egg and 0, 5.3, 26.8 or 58.1 ng BTBPE/g egg). Eggs were artificially incubated until hatching (ED28), at which point blood and tissues were collected to measure morphological and physiological endpoints, including organ somatic indices, circulating and glandular thyroid hormone concentrations, thyroid gland histology, hepatic deiodinase activity, and markers of oxidative stress. Neither compound had any effects on embryo survival through 90% of the incubation period or on hatching success, body mass, organ size, or oxidative stress of hatchlings. There was evidence of sex-specific effects in the thyroid system responses to the BTBPE exposures, with type 2 deiodinase (D2) activity decreasing at higher doses in female, but not in male hatchlings, suggesting that females may be more sensitive to BTBPE. However, there were no effects of TBBPA-BDBPE on the thyroid system in kestrels. For the BTPBE study, a subset of high-dose eggs was collected throughout the incubation period to measure changes in BTBPE concentrations. There was no decrease in BTBPE over the incubation period, suggesting that BTBPE is slowly metabolized by kestrel embryos throughout their ∼28-d development. These two compounds, therefore, do not appear to be particularly toxic to embryos of the American kestrel.


Assuntos
Bromobenzenos/toxicidade , Desenvolvimento Embrionário/efeitos dos fármacos , Poluentes Ambientais/toxicidade , Falconiformes/crescimento & desenvolvimento , Retardadores de Chama/toxicidade , Óvulo/efeitos dos fármacos , Bifenil Polibromatos/toxicidade , Animais , Relação Dose-Resposta a Droga , Desenvolvimento Embrionário/fisiologia , Falconiformes/metabolismo , Feminino , Iodeto Peroxidase/metabolismo , Fígado/efeitos dos fármacos , Fígado/enzimologia , Masculino , Tamanho do Órgão/efeitos dos fármacos , Óvulo/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Glândula Tireoide/efeitos dos fármacos , Glândula Tireoide/metabolismo , Glândula Tireoide/patologia , Hormônios Tireóideos/metabolismo
18.
J Pharm Biomed Anal ; 170: 321-326, 2019 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-30954022

RESUMO

Thyroid follicular nodules are quite common in the population, however only a small proportion is malignant. Thyroid cancer differs from adenoma by features of cellular atypia, angioinvasiveness and possibility of metastasis via blood vessels mainly in the lungs and bones. Pathomorphological examination of the postoperative material plays a significant role in the diagnosis of cystic thyroid lesions. De facto, there is no possibility to determine with certainty whether the lesion is benign or malignant before surgery, therefore new methods are being sought to meet clinical needs. The study aimed to investigate if Fourier-transform infrared spectroscopy (FTIR) spectroscopy and Raman spectroscopy combined with multidimensional analysis can be a useful tool in distinguishing between thyroid adenomas and carcinomas. The obtained results indicate quantitative and qualitative alterations within proteins and fats derived from patients' tissues samples. Raman spectroscopy additionally shows significant changes in the amount of tissue collagen due to the pathogenic process. In the spectra of the second FTIR derivative, shifts of vibrations corresponding to the ß-sheet and α-helix structure are observed towards the lower rates of wave numbers in the case of neoplastic tissues. Using the leave-one-out cross-validation, sensitivity and specificity calculated with Principal Component Analysis-Linear Discriminant Analysis (PCA-LDA) clearly shows the possibility to distinguish between pathologically changed and normal thyroid tissue as well as differentiate follicular thyroid adenoma (FTA) from widely invasive follicular thyroid carcinoma (WI-FTC) tissues.


Assuntos
Adenocarcinoma Folicular/diagnóstico , Adenocarcinoma Folicular/patologia , Adenoma/diagnóstico , Adenoma/patologia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Discriminante , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Componente Principal , Sensibilidade e Especificidade , Espectroscopia de Infravermelho com Transformada de Fourier/métodos , Análise Espectral Raman/métodos
19.
BMC Cancer ; 19(1): 325, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-30953466

RESUMO

BACKGROUND: For progressive metastatic medullary thyroid carcinoma (MTC), the available treatment options with tyrosine kinase inhibitors result in grade 3-4 adverse events in a large number of patients. Peptide Receptor Radionuclide Therapy (PRRT), which has also been suggested to be a useful treatment for MTC, is usually well tolerated, but evidence on its effectivity is very limited. METHODS: Retrospective evaluation of treatment effects of PRRT in a highly selected group of MTC patients, with progressive disease or refractory symptoms. In addition, a retrospective evaluation of uptake on historical 111In-DTPA-octreotide scans was performed in patients with detectable tumor size > 1 cm. RESULTS: Over the last 17 years, 10 MTC patients were treated with PRRT. Four out of 10 patients showed stable disease at first follow-up (8 months after start of therapy) whereas the other 6 were progressive. Patients with stable disease were characterized by a combination of both a high uptake on 111In-DTPA-octreotide scan (uptake grade ≥ 3) and a positive somatostatin receptor type 2a (SSTR2a) expression of the tumor by immunohistochemistry. Retrospective evaluation of historical 111In-DTPA-octreotide scans of 35 non-treated MTC patients revealed low uptake (uptake grade 1) in the vast majority of patients 31/35 (89%) with intermediate uptake (uptake grade 2) in the remaining 4/35 (11%). CONCLUSIONS: PRRT using 177Lu-octreotate could be considered as a treatment in those patients with high uptake on 111In-DTPA-octreotide scan (uptake grade 3) and positive SSTR2a expression in tumor histology. Since this high uptake was present in a very limited number of patients, this treatment is only suitable in a selected group of MTC patients.


Assuntos
Carcinoma Neuroendócrino/radioterapia , Octreotida/análogos & derivados , Radioimunoterapia/métodos , Receptores de Somatostatina/metabolismo , Neoplasias da Glândula Tireoide/radioterapia , Adulto , Idoso , Carcinoma Neuroendócrino/diagnóstico por imagem , Carcinoma Neuroendócrino/mortalidade , Carcinoma Neuroendócrino/patologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Octreotida/administração & dosagem , Octreotida/uso terapêutico , Seleção de Pacientes , Ácido Pentético/administração & dosagem , Ácido Pentético/análogos & derivados , Intervalo Livre de Progressão , Cintilografia/métodos , Estudos Retrospectivos , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/mortalidade , Neoplasias da Glândula Tireoide/patologia , Adulto Jovem
20.
Indian J Pathol Microbiol ; 62(2): 206-210, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30971541

RESUMO

Context: Thyroid cancers are the most common malignancy of the endocrine system. Over-expression of trophoblast cell-surface antigen 2 (TROP-2) in various tumors has been found to correlate with poor prognosis and aggressive tumor behavior. Aims: The aim of this study was to evaluateTROP-2 expression in thyroid neoplasms. Subjects and Methods: This study contained 152 cases, including 48 follicular nodular disease (FND), 29 follicular adenoma (FA), 57 papillary thyroid carcinoma (PTC), 12 follicular thyroid carcinoma (FTC), 3 medullary thyroid carcinoma (MTC), 2 poorly differentiated thyroid carcinoma (PDTC) and 1 undifferentiated thyroid carcinoma (UDTC). TROP-2 expression was investigated via immunohistochemistry in sections prepared from paraffin blocks of the cases. Results: The cases comprised 32 (21%) males and 120 (79%) females with a mean age of 46.8 years (range, 15-85 years). TROP-2 expression was observed in 74.6% of the malignant lesions of the thyroid except for medullary carcinoma, poorly differentiated and undifferentiated thyroid carcinoma. Immunoreactivity was 3.4% in FA, 41.7% of cases with FTC and 81.8% in PTC follicular variant (PTC fv). The difference between FA/FTC and FA/PTC follicular variant were both significant (P < 0.005, P < 0.001, respectively). There was no difference between FTC/PTC fv (P = 0.089). Conclusion: TROP-2 can be considered a useful marker for distinguishing PTC fv cases from follicular nodular disease and follicular adenoma cases because of its high sensitivity in the identification of papillary carcinomas of the thyroid.


Assuntos
Adenocarcinoma Folicular/diagnóstico , Antígenos de Neoplasias/genética , Moléculas de Adesão Celular/genética , Câncer Papilífero da Tireoide/diagnóstico , Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Neuroendócrino/diagnóstico , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/diagnóstico , Adulto Jovem
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