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1.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(6): 1098-1101, 2020 Dec 18.
Artigo em Chinês | MEDLINE | ID: mdl-33331320

RESUMO

OBJECTIVE: To summarize and analyze the clinical data and prognosis of the patients with Hürthle cell tumor (HCT) in order to raise the clinicians' awareness of the disease. METHODS: The clinical data on patients with histopathologically proven HCT, without other thyroid carcinomas, were collected retrospectively in Peking University First Hospital from January 2001 to February 2017. All the patients underwent surgery due to thyroid nodules. The follow-up information was also collected. RESULTS: A total of 100 patients were enrolled in the current study. All of them were diagnosed with Hürthle cell adenoma (HCA). There were 77 females and 23 males, with the male-to-female ratio of 1 : 3.3. The average age of these patients was (52±14) years at the time of operation. Fifty-one patients were found their thyroid nodules accidentally by ultrasonography during their health check-ups. 69.4% of the 49 symptomatic patients presented with painless cervical nodules. 83.0% HCA patients were combined with multinodular goiters (MNGs). 88.4% (76/86) patients were euthyroid and 53.8% (21/39) had increasing thyroglobulin levels. The mean longest diameter of HCAs was (3.2±1.5) cm (range: 0.9-7.3 cm) on ultrasonography. There were a series of sonographic features of HCA, such as larger, solidity, hypoecho, a smooth outline, intranodular vascularization, perinodular vascularization, absence of calcification in nodules and absence of enlarged cervical lymph nodes. Compared with the histological diagnosis, the diagnostic accuracy by frozen section (FS) during operation was 97.4%. Twenty-nine patients were followed up with an average period of (49.2±22.1) months and none of them had local recurrence or cervical lymph node metastasis. Six patients accepted thyroid hormone replacement treatment and one had thyrotoxicosis due to over-dose. CONCLUSION: HCA is more common in women. It is often found accidentally by ultrasonography during their health check-ups or presented with painless cervical nodules. It is combined with MNG frequently. HCA exhibits numerous sonographic features but not unique. FS during operation is a reliable method to identify HCA with high diagnostic accuracy. Patients with thyroid hormone administration should be monitored for thyroid function after thyroid surgery.


Assuntos
Adenoma Oxífilo , Neoplasias da Glândula Tireoide , Adenoma Oxífilo/diagnóstico , Adenoma Oxífilo/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/epidemiologia , Células Oxífilas , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/cirurgia
2.
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
3.
Ther Umsch ; 77(9): 457-465, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33146093

RESUMO

Surgical aspects of multiple endocrine neoplasia type 2 Abstract. The multiple endocrine neoplasia type 2 (MEN 2) is an autosomal-dominant hereditary tumor-syndrome. The subtypes show clinically specific disease manifestations. In MEN 2a, medullary thyroid carcinoma, pheochromocytoma, and primary hyperparathyroidism occur, while in familial medullary thyroid carcinoma, the medullary thyroid carcinoma is the only clinical manifestation. In MEN 2b medullary thyroid carcinoma and pheochromocytoma are the clinically dominant manifestations. All MEN-2-specific disease is treated primarily surgically. It is of utmost importance to identify the individual gene carrier in order to enable timely intervention before malignancy develops (prophylactic surgery) or to reach surgical cure as well as to identify relatives that are MEN 2 gene-carriers. Typical MEN 2 manifestations and clinical signs important for surgery are outlined. In case MEN 2 is suspected, it may be vital to exclude underlying pheochromocytoma before diagnostic or surgical interventions are started to forego hyperadrenergic crisis unprepared.


Assuntos
Neoplasias das Glândulas Suprarrenais , Carcinoma Medular , Neoplasia Endócrina Múltipla Tipo 2a , Neoplasia Endócrina Múltipla Tipo 2b , Neoplasias da Glândula Tireoide , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/genética , Neoplasias das Glândulas Suprarrenais/cirurgia , Humanos , Neoplasia Endócrina Múltipla Tipo 2a/diagnóstico , Neoplasia Endócrina Múltipla Tipo 2a/genética , Neoplasia Endócrina Múltipla Tipo 2a/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/cirurgia
4.
Ther Umsch ; 77(9): 419-425, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33146096

RESUMO

From thyroid nodules to thyroid cancer Abstract. The prevalence of thyroid nodules is around 1 % per life year, whereas 5 % of the nodules are malignant. Primary diagnostics consist of examination of TSH and cervical ultrasound. Depending on the findings, additional laboratory investigations, a scintigraphy or a biopsy are indicated. In case of thyroid cancer, the primary treatment is usually surgery. There are at least nine different clinical guidelines worldwide to provide a standardized perioperative management, whereas the guidelines of the German Association of Endocrine Surgeons (CAEK) and the American Thyroid Association (ATA) are most frequently used in the German speaking part of Europe. Individual therapy concepts are determined at the interdisciplinary endocrinological tumour boards. The indication for postoperative radioiodine treatment or thyroid hormone supplementation in TSH suppression dose in case of differentiated (papillary or follicular) thyroid cancer is evaluated according to the American Thyroid Association (ATA) risk stratification.


Assuntos
Adenocarcinoma Folicular , Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Europa (Continente) , Humanos , Radioisótopos do Iodo , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/terapia , Nódulo da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/terapia , Estados Unidos
5.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 55(11): 1057-1062, 2020 Nov 07.
Artigo em Chinês | MEDLINE | ID: mdl-33210886

RESUMO

Objective: To analyze the malignant probability of thyroid nodules with the diagnosis of atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) determined by fine-needle aspiration (FNA) and to explore the value of the combined application of BRAFV600E gene detection for the diagnosis of benign and malignant thyroid nodules. Methods: A total of 114 patients including 20 males and 94 females, aged 16-76 years old with thyroid nodules underwent FNA examination and surgical treatment in the Affiliated Cancer Hospital of Zhengzhou University from October 2018 to November 2019 were retrospectively analyzed. Postoperative histopathological results were used as the gold standard for the diagnosis of malignant thyroid nodules. The malignant rate of thyroid nodules with the diagnosis of AUS/FLUS was evaluated. Differential diagnostic efficacy of preoperative FNA combined with BRAFV600E gene detection for papillary thyroid carcinoma (PTC) was analyzed by McNemer test and diagnostic test evaluation method. Results: The mutation rate of BRAFV600E gene was 84.76% (89/105) in PTC. PTC accounted for 57.14% (12/21) of the patients with the diagnoses of AUS/FLUS determined by FNA. The specificity, sensitivity, positive predictive value and negative predictive value of BRAFV600E mutation examination for the diagnosis of malignant thyroid nodules determined preoperatively as AUS/FLUS were 9/9, 5/12, 5/5 and 9/16, respectively. BRAFV600E mutation examination could improve the detection rate of PTC in patients with AUS/FLUS (OR=0.438, 95%CI=0.251-0.763, P=0.016). Conclusion: FNA combined with BRAFV600E mutation examination can significantly improve the detection rate of malignant thyroid nodules diagnosed preoperatively as AUS/FLUS.


Assuntos
Adenocarcinoma Folicular , Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Adolescente , Adulto , Idoso , Biópsia por Agulha Fina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/genética , Nódulo da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/genética , Adulto Jovem
6.
Pan Afr Med J ; 37: 18, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33062120

RESUMO

Carcinoma of the thyroid gland is one of the most commonly encountered endocrine malignancies. Papillary carcinoma is the most common histological type and its pattern of metastasis are usually lymphatic. Lymphatic metastasis to parapharyngeal space is rare and have been reported, so we report the case of a 50-year-old male patient who had an occult papillary carcinoma of the thyroid presented as right lateral node of the neck and a nodal involvement of the right parapharyngeal space.


Assuntos
Carcinoma Papilar/diagnóstico , Neoplasias Faríngeas/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Carcinoma Papilar/patologia , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Faríngeas/patologia , Neoplasias Faríngeas/secundário , Neoplasias da Glândula Tireoide/patologia
7.
Sci Rep ; 10(1): 16275, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004987

RESUMO

We analyzed 1196 proteins in longitudinal plasma samples from participants in a commercial wellness program, including samples collected pre-diagnosis from ten cancer patients and 69 controls. For three individuals ultimately diagnosed with metastatic breast, lung, or pancreatic cancer, CEACAM5 was a persistent longitudinal outlier as early as 26.5 months pre-diagnosis. CALCA, a biomarker for medullary thyroid cancer, was hypersecreted in metastatic pancreatic cancer at least 16.5 months pre-diagnosis. ERBB2 levels spiked in metastatic breast cancer between 10.0 and 4.0 months pre-diagnosis. Our results support the value of deep phenotyping seemingly healthy individuals in prospectively inferring disease transitions.


Assuntos
Biomarcadores Tumorais/sangue , Neoplasias/sangue , Idoso , Neoplasias da Mama/sangue , Neoplasias da Mama/diagnóstico , Antígeno Carcinoembrionário/sangue , Carcinoma Neuroendócrino/sangue , Carcinoma Neuroendócrino/diagnóstico , Estudos de Casos e Controles , Proteínas Ligadas por GPI/sangue , Promoção da Saúde/estatística & dados numéricos , Humanos , Estudos Longitudinais , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/sangue , Neoplasias/diagnóstico , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/diagnóstico , Estudos Prospectivos , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/diagnóstico , Fatores de Tempo
8.
Eur J Endocrinol ; 183(6): R197-R215, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33112280

RESUMO

An increased calcitonin serum level is suggestive of a medullary thyroid cancer (MTC), but is not pathognomonic. The possibility of false positives or other calcitonin-secreting neuroendocrine neoplasms (NENs) should be considered. Serum calcitonin levels are generally assessed by immunoradiometric and chemiluminescent assays with high sensitivity and specificity; however, slightly moderately elevated levels could be attributable to various confounding factors. Calcitonin values >100 pg/mL are strongly suspicious of malignancy, whereas in patients with moderately elevated values (10-100 pg/mL) a stimulation test may be applied to improve diagnostic accuracy. Although the standard protocol and the best gender-specific cut-offs for calcium-stimulated calcitonin are still controversial, the fold of the calcitonin increase after stimulation seems to be more reliable. Patients with MTC show stimulated calcitonin values at least three to four times higher than the basal values, whereas calcitonin-secreting NENs can be distinguished from a C-cell disease by the absence of or

Assuntos
Peptídeo Relacionado com Gene de Calcitonina/sangue , Calcitonina/sangue , Carcinoma Neuroendócrino/diagnóstico , Neoplasias das Glândulas Endócrinas/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Biomarcadores Tumorais/sangue , Diagnóstico Diferencial , Reações Falso-Positivas , Feminino , Humanos , Janus Quinases/sangue , Masculino , Pessoa de Meia-Idade , Valores de Referência , Sensibilidade e Especificidade
9.
J Cancer Res Ther ; 16(5): 1056-1062, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33004747

RESUMO

Context: We analyzed the clinical features and ultrasound image features of follicular thyroid carcinoma (FTC) and follicular thyroid adenoma (FTA). Aims: This study aimed to identify ultrasonographic differences and correlations between FTC and FTA. Meanwhile, ultrasonographic manifestations of thyroid follicular tumor were also retrospectively analyzed. Settings and Design: Using pathological results as the gold standard, the clinical and ultrasonic image characteristics of FTA and FTC were statistically analyzed, and the differences were analyzed. Materials and Methods: A total of 304 patients who were diagnosed with FTC or FTA by pathology after thyroidectomy from March 2009 to March 2018 were enrolled in this study. Their ultrasonic images were analyzed; image features were extracted and correlation analyses for these features were conducted. Differences in ultrasonic images between FTC and FTA were also compared. Statistical Analysis Used: Independent sample t-test; Wilcoxon rank sum test; A Chi-square test: Univariate and multivariate logistic regression analyses. Results: When performing ultrasound diagnosis, attention should be paid to identify FTC and FTA in terms of age, nodular goiter conditions, nodular boundary conditions, internal echo, calcification, blood flow signals, thyroid imaging reporting and data system (TI-RADS) grading and cystic solidity conditions. Moreover, a multivariate logistic regression showed that the boundaries were unclear, and cystic degeneration, TI-RADS, hypoecho, nodular goiter, macrocalcification and microcalcification were associated with FTC. Among them, macrocalcification is a protective factor for thyroid follicular tumors, and other indicators are risk factors. Conclusion: Ultrasound can provide valuable information for the identification of follicular neoplasms, but further research in this area is still necessary.


Assuntos
Adenocarcinoma Folicular/diagnóstico , Adenoma/diagnóstico , Diagnóstico Diferencial , Neoplasias da Glândula Tireoide/diagnóstico , Ultrassonografia/métodos , Adenocarcinoma Folicular/diagnóstico por imagem , Adenocarcinoma Folicular/cirurgia , Adenoma/diagnóstico por imagem , Adenoma/cirurgia , Sistemas de Apoio a Decisões Clínicas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/métodos
10.
Radiol Clin North Am ; 58(6): 1009-1018, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33040844

RESUMO

Thyroid nodules are a common clinical problem encountered in an endocrine practice. More and more thyroid nodules are now being detected on unrelated imaging studies, leading to an increased diagnosis of low-risk thyroid cancers. There is therefore a greater emphasis on risk assessment based on clinical and sonographic features to avoid morbidity secondary to unnecessary therapy. Molecular diagnostics are also being widely used to further characterize indeterminate nodules. The American Thyroid Association and American College of Radiology-Thyroid Imaging Reporting and Data System guidelines are the most commonly used in clinical practice for risk assessment.


Assuntos
Guias de Prática Clínica como Assunto , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico , Ultrassonografia Doppler/métodos , Biópsia por Agulha , Feminino , Humanos , Incidência , Masculino , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Medição de Risco , Sociedades Médicas , Análise de Sobrevida , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/epidemiologia , Nódulo da Glândula Tireoide/patologia , Estados Unidos
12.
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
13.
Chirurgia (Bucur) ; 115(4): 441-447, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32876017

RESUMO

Background: Receptor-binding cancer antigen (RCAS1) is a membrane protein, regarded as a tumor-associated antigen. Cancer cells evade immune response with RCAS1 up-regulation, inducing apoptosis to tumor infiltrating lymphocytes. Thyroid cancer incidence is rising and its accurate diagnosis in early stage is targeted. The aim of this study is to access RCAS1 expression in benign and malignant thyroid pathology. Methods: This is a retrospective study of 110 patients, who had thyroidectomy in a single tertiary referral centre between January 2008 until December 2014. Immunohistochemistry study for RCAS1 expression was carried out and correlation with clinical and histopathological data is attempted. Results: RCAS1 immunostaining was found positive in 81 out of 110 cases. Notably it was deemed positive in all malignant thyroid tissue samples (p 0.001). In thyroid malignancy, tumor size, thyroid capsule invasion and positive lymph nodes status were positively correlated with moderate and strong expression of RCAS1. For papillary thyroid carcinoma, the vast majority (35/37 cases, 94.6%) were also classified as having moderate or strong RCAS1 expression. Conclusions: RCAS1 expression can aid in differential diagnosis between benign and malignant thyroid pathology, while its strong expression correlates with worse oncological features.


Assuntos
Antígenos de Neoplasias/biossíntese , Neoplasias da Glândula Tireoide/metabolismo , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Prognóstico , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Resultado do Tratamento
14.
APMIS ; 128(11): 563-572, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32794589

RESUMO

Neuroendocrine tumors (NETs) are often diagnosed from the metastases of an unknown primary tumor. Specific immunohistochemical (IHC) markers indicating the location of a primary tumor are needed. The proprotein convertase subtilisin/kexin type 2 (PCSK2) is found in normal neural and neuroendocrine cells, and known to express in NETs. We investigated the tissue microarray (TMA) of 86 primary tumors from 13 different organs and 9 metastatic NETs, including primary tumor-metastasis pairs, for PCSK2 expression with polymer-based IHC. PCSK2 was strongly positive in all small intestine and appendiceal NETs, the so-called midgut NETs, in most pheochromocytomas and paragangliomas, and in some of the typical and atypical pulmonary carcinoid tumors. NETs showing strong positivity were re-evaluated in larger tumor cohorts confirming the primary observation. In the metastases, the expression of PCSK2 mirrored that of the corresponding primary tumors. We found negative or weak staining in NETs from the thymus, gastric mucosa, pancreas, rectum, thyroid, and parathyroid. PCSK2 expression did not correlate with Ki-67 in well-differentiated NETs. Our data suggest that PCSK2 positivity can indicate the location of the primary tumor. Thus, PCSK2 could function in the IHC panel determined from screening metastatic NET biopsies of unknown primary origins.


Assuntos
Neoplasias das Glândulas Suprarrenais/genética , Carcinoma Neuroendócrino/genética , Neoplasias Gastrointestinais/genética , Neoplasias Pulmonares/genética , Tumores Neuroendócrinos/genética , Paraganglioma/genética , Feocromocitoma/genética , Pró-Proteína Convertase 2/genética , Adenocarcinoma/diagnóstico , Adenocarcinoma/genética , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/patologia , Neoplasias das Glândulas Suprarrenais/cirurgia , Biomarcadores Tumorais/genética , Carcinoma Neuroendócrino/diagnóstico , Carcinoma Neuroendócrino/patologia , Carcinoma Neuroendócrino/cirurgia , Cromogranina A/genética , Feminino , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/patologia , Neoplasias Gastrointestinais/cirurgia , Expressão Gênica , Humanos , Imuno-Histoquímica , Antígeno Ki-67/genética , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Metástase Linfática , Masculino , Estadiamento de Neoplasias , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/patologia , Tumores Neuroendócrinos/cirurgia , Paraganglioma/diagnóstico , Paraganglioma/patologia , Paraganglioma/cirurgia , Feocromocitoma/diagnóstico , Feocromocitoma/patologia , Feocromocitoma/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia
15.
Ann Endocrinol (Paris) ; 81(5): 482-486, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32822652

RESUMO

BACKGROUND: In acromegaly, chronic growth hormone (GH) and insulin-like growth factor-1 (IGF-1) exacerbate comorbidities in multiple organs. Differentiated thyroid carcinoma (DTC) has been reported as being a comorbid condition in acromegaly. Acromegaly is usuallysporadic, but 5% of cases may be genetic. The most frequent inheritable form of acromegaly is related to germline mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene. Epidemiological data on the relationship between active acromegaly, its familial forms and DTC are sparse. We present the investigation of a FIPA family (familial isolated pituitary adenoma) with homogeneous acromegaly and 6 sporadic acromegaly patients with DTC. PATIENTS AND METHODS: A study of 59 acromegaly patients assessed thyroid nodules on ultrasound and fine-needle aspiration biopsy following the ATA 2015 criteria. We diagnosed 7 differentiated thyroid carcinomas. Resected thyroid carcinoma tissues were stained using an anti-AIP antibody. Analysis of germline and tumor-derived DNA for variants in the AIP and MEN1 genes were performed in the FIPA kindred. RESULTS: We describe one FIPA patient and 6 sporadic acromegaly cases with DTC. The FIPA family (AIP mutation negative) consisted of two sisters, one of whom had a DTC with intermediate risk and incomplete structural response to therapy. In our study, DTC in sporadic acromegaly had a low recurrence rate (6/6), and excellent response to therapy (6/6). Immunohistochemistry for AIP showed similar or increased staining intensity in DTC versus normal thyroid tissue. CONCLUSION: In our cohort of sporadic and familial forms of acromegaly with DTC, AIP did not appear to influence thyroid cancer progression.


Assuntos
Acromegalia/epidemiologia , Adenocarcinoma/epidemiologia , Adenoma/epidemiologia , Adenoma Hipofisário Secretor de Hormônio do Crescimento/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia , Acromegalia/diagnóstico por imagem , Acromegalia/etiologia , Acromegalia/patologia , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Adenoma/complicações , Adenoma/diagnóstico por imagem , Adenoma/patologia , Adulto , Idoso , Argentina/epidemiologia , Biópsia por Agulha Fina , Estudos de Coortes , Comorbidade , Progressão da Doença , Feminino , Mutação em Linhagem Germinativa , Adenoma Hipofisário Secretor de Hormônio do Crescimento/complicações , Adenoma Hipofisário Secretor de Hormônio do Crescimento/diagnóstico por imagem , Adenoma Hipofisário Secretor de Hormônio do Crescimento/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Ultrassonografia
16.
Chirurg ; 91(12): 999-1006, 2020 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-32813026

RESUMO

The clinical term of differentiated thyroid carcinoma (DTC) includes follicular (FTC) and papillary thyroid carcinomas (PTC). In diagnostic thyroid pathology, however, the term differentiated carcinoma (NOS) is used only very rarely for tumors with morphological features of both FTC and PTC. The current World Health Organization (WHO) classification of thyroid tumors introduced the entity of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). As a result, the diagnostic criteria for PTC had to be adjusted (compulsory histological demonstration of invasion and/or papillae), which also significantly limited the diagnostic potential of a fine needle biopsy (FNB) of the thyroid. The FTC is now divided into three distinct subgroups. Moreover, the WHO classification also established the diagnostic criteria of poorly differentiated thyroid carcinoma (PDTC), which has to be distinguished from both differentiated carcinomas and benign adenomas. This article also summarizes the current diagnostic status of molecular pathological analyses of thyroid tumors.


Assuntos
Adenocarcinoma Folicular , Neoplasias da Glândula Tireoide , Adenocarcinoma Folicular/genética , Biópsia por Agulha Fina , Humanos , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/genética
17.
Sci Rep ; 10(1): 13310, 2020 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-32764626

RESUMO

To compare the clinicopathological characteristics and survival outcomes of children and adult diagnosed with medullary thyroid carcinoma (MTC). MTC patients were extracted from the Surveillance, Epidemiology and End Results (SEER) database from 1998 to 2016, followed by stratification into pediatric (< 20 years) or adult (≥ 20 years) groups. In total, 2,197 patients (110 pediatric and 2087 adult) with MTC were identified. Pediatric patients were more likely to have localized stage (70.0% vs. 51.6%), negative regional nodes (48.2% vs. 30.8%) and receive total/subtotal thyroidectomy surgery (97.3% vs. 85.3%). Moreover, CSS and OS rates were significantly higher in pediatric patients (both P < 0.001). Multivariable Cox regression analysis revealed that adult patients were significantly correlated with worse CSS and OS rates [(CSS: HR 11.60, 95% CI 1.62-83.02, P = 0.015); (OS: HR 5.63, 95% CI 2.08-15.25, P = 0.001)]. Further stratified analysis indicated that pediatric group might have significant better CSS and OS for patients with more advanced stage. Patients in the pediatric group were more likely to have earlier stage. Moreover, the prognosis of pediatric MTC patients was significantly better than that in adult patients.


Assuntos
Carcinoma Neuroendócrino/epidemiologia , Programa de SEER , Neoplasias da Glândula Tireoide/epidemiologia , Adolescente , Adulto , Carcinoma Neuroendócrino/diagnóstico , Carcinoma Neuroendócrino/patologia , Carcinoma Neuroendócrino/terapia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Análise Multivariada , Análise de Sobrevida , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/terapia , Adulto Jovem
18.
Life Sci ; 259: 118248, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32791153

RESUMO

INTRODUCTION: Unlike most mutation-driven cancers, thyroid cancer is thought to be highly dependent on changes in human hormone levels. It has become research hotspot using the change of gene expression level as a detection and diagnostic marker. The internal relationship between two genes and disease development is used to avoid the instability caused by single gene fluctuation. Aim It is possible to achieve early diagnosis in thyroid cancer during tumorigenesis and recurrence using IGPS (immune gene pairs). METHODS: We extracted thyroid cancer data from The Cancer Genome Atlas (TCGA), using CIBERSORT algorithm to infiltrate out 22 immune cells types. We screened out IGPS that differ significantly between different groups, then used LinearSVC model to learn and screen features, combined with deep learning neural network model to predict benign and malignant cancer as well as patients at different groups. KEY FINDINGS: There are significant differences of immune cell ratio in tumor stages and relapse samples. We screen out 42 and 64 IGPS for in normal-tumor and non-relapsed groups respectively, for example ASCC3-MAP3K7 and ATF2-SOCS5, have significant correlation in IGPS expression. Then we use the IGPS to train the tumor diagnostic classifier, obtain average AUC are both 0.99 after ten times cross-validation. SIGNIFICANCE: The IGPS gives us new insight to explore immune cell infiltration of thyroid cancer, deep learning model can be further used in early diagnosis of thyroid cancer and estimation of the risk of recurrence.


Assuntos
Carcinogênese/genética , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/imunologia , Área Sob a Curva , Biomarcadores Tumorais/genética , Carcinogênese/imunologia , Bases de Dados Genéticas , Aprendizado Profundo , Humanos , Modelos Teóricos , Recidiva Local de Neoplasia/genética , Redes Neurais de Computação , Neoplasias da Glândula Tireoide/diagnóstico , Transcriptoma/genética , Transcriptoma/imunologia , Microambiente Tumoral/genética , Microambiente Tumoral/imunologia
19.
Am Surg ; 86(9): 1148-1152, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32853031

RESUMO

BACKGROUND: The 2015 American Thyroid Association Management Guidelines for patients with thyroid nodules recommended a comprehensive sonographic evaluation of thyroid nodules' characteristics and the presence of any suspicious cervical lymph nodes (LNs) in the central and lateral compartments. This detailed sonographic assessment is still not routinely performed. We hypothesized that an endocrine surgeon-performed ultrasound (SUS) significantly enhances the management of thyroid cancer patients when compared with referral ultrasound (RUS). METHODS: We conducted a retrospective review of 267 consecutive thyroid surgery patients who were diagnosed with thyroid cancer on final pathology. All patients had undergone a SUS, but only 130 cohorts with both RUS and SUS were included. Features of thyroid nodules and LN and changes in the management plan were recorded. RESULTS: Based on SUS assessment, 26 patients (20%) were noted to have suspicious thyroid nodules which warranted a fine-needle aspiration (FNA) and were missed in RUS. On FNA, there were 12 patients with Bethesda categories III/IV and 14 patients with Bethesda V/VI. Those 26 patients were found to have a malignancy in the final pathology assessment. Thirty-eight patients (29.2%) were noted to have suspicious central/lateral neck findings on SUS but were not reported in RUS. Additionally, 8 patients (6.1%) were found to have a parathyroid adenoma by SUS and required concurrent parathyroidectomy. DISCUSSION: A comprehensive neck ultrasound in thyroid cancer patients, performed by their endocrine surgeon, could enhance management planning and outcomes. This finding highlights the critical need for education and improvement of routine neck ultrasonographic examination performed in the community.


Assuntos
Estadiamento de Neoplasias/métodos , Cirurgiões , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Ultrassonografia/métodos , Humanos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/diagnóstico , Resultado do Tratamento
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