Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.215
Filtrar
1.
J Surg Res ; 245: 523-528, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31450040

RESUMO

BACKGROUND: The rate of thyroid cancer in patients with hyperthyroidism is reported to be rare, and patients with toxic thyroid nodules do not routinely undergo fine-needle aspiration (FNA) to evaluate for malignancy. However, higher rates of malignancy in hyperthyroid patients may exist than previously reported. This study examines the rate of malignancy in patients with hyperthyroidism who have undergone thyroidectomy. METHODS: A retrospective review of prospectively collected data of 138 patients with hyperthyroidism who underwent thyroidectomy at a single institution was performed. Patients were divided into three groups: Graves' disease (n = 80), toxic multinodular goiter (n = 46), and toxic solitary nodule (n = 12). Patients with previous thyroid surgery were excluded from the study. All patients had biochemical confirmation of hyperthyroidism with thyroid-stimulating hormone <0.1 mIU/L and clinical diagnosis by a referring physician. RESULTS: Of 138 patients, 22% (31/138) were found to have malignancy on final pathology. The breakdown of malignancy by hyperthyroid condition was as follows: 16% in Graves' disease, 24% in toxic multinodular goiter patients, and 50% in toxic solitary nodule patients. CONCLUSIONS: There is a clinically significant rate of malignancy seen in patients who undergo thyroidectomy for hyperthyroidism. Patients with distinct thyroid nodules in the presence of hyperthyroidism may have the highest rates of malignancy and should undergo appropriate workup with ultrasound and FNA to exclude underlying malignancy. In cases with suspicious ultrasound features and/or FNA cytopathology, surgical treatment should be considered as initial management.


Assuntos
Bócio Nodular/cirurgia , Doença de Graves/cirurgia , Achados Incidentais , Neoplasias da Glândula Tireoide/epidemiologia , Tireotoxicose/cirurgia , Bócio Nodular/complicações , Doença de Graves/complicações , Humanos , Incidência , Estudos Prospectivos , Estudos Retrospectivos , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia/estatística & dados numéricos , Tireotoxicose/complicações
2.
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
3.
Medicine (Baltimore) ; 98(44): e17735, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689818

RESUMO

BACKGROUND: Several studies have reported the association of Behcet disease (BD) with the risk of diverse kinds of cancers. However, its association is controversial. Therefore, we conducted a bioinformatics-analysis to explore any possible association. METHODS: We obtained relevant findings published before October 2018 through literature survey of the PubMed, EMBASE, and Web of Science databases. STATA 12.0 software was used for statistical analysis. RESULTS: After screening, the meta-analysis comprised 5 studies. We observed a significant positive association between BD and enhanced malignancy risk (pooled relative risk [RR], 1.19; 95% confidence interval [CI]: 1.09-1.30), especially for hematological cancer (pooled RR, 2.58; 95% CI: 1.61-3.55) and thyroid cancer (pooled RR, 1.25; 95% CI: 1.04-1.47). However, high heterogeneity was also observed in the results (I = 81.3%). Subgroup analysis indicated that female BD patients from Korean population are at highest predisposition to overall malignancy. Besides, publication bias was not observed with our choice of surveys. CONCLUSION: We conclude that patients suffering from BD have an overall increased risk for malignancy. Greater numbers of exhaustive temporal studies are essential for definitive inferences.


Assuntos
Síndrome de Behçet/complicações , Neoplasias Hematológicas/etiologia , Neoplasias/etiologia , Neoplasias da Glândula Tireoide/etiologia , Biologia Computacional , Feminino , Humanos , Masculino , Risco , Fatores de Risco
4.
Medicine (Baltimore) ; 98(41): e17539, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593131

RESUMO

Research on the relationship between iodine intake and thyroid cancer (TC) risk is limited, and the findings are inconclusive. The objective of this study was to provide emerging evidence for the association between iodine intake and TC risk in a Chinese population.An ecological study of epidemiology is used to compare the iodine intake among populations with different TC incidence in Zhoushan, China. Incidence rates of TC were investigated and compared among four counties of the Zhoushan Islands from 2014 to 2018. Iodized salt consumption rate and the level of urinary iodine concentration (UIC) were analyzed for pupils and pregnant women from four counties.During 2014 to 2018, a total of 2495 new cases of TC were diagnosed in Zhoushan Islands. The mean crude incidence rate of TC was 51.29 per 100,000 inhabitants, and the standardized (world population) incidence rate (SIR) was 31.34 per 100,000 population. Incidence rates (SIR and crude incidence rates) were significantly higher in women than in men (χ test, P < .05). Both male and female, the incidence of TC in Daishan County is higher than the other three counties of Zhoushan. Iodized salt consumption rate and median UIC in pupils and pregnant women in Daishan County was significantly lower than the other three counties (χ test and Kruskal-Wallis test, all P < .05). The population with high TC incidence has a lower iodized salt consumption and a lower level of UIC compare with the relative low TC incidence populations.The low consumption of iodized salt with mild iodine deficiency may contribute to explain the exceptionally high incidence of TC in Daishan County. Further subtle designed studies are needed to provide additional insights into the epidemiology and etiology of TC and help identify the safe limit of iodine intake for prevention.


Assuntos
Iodo/efeitos adversos , Neoplasias da Glândula Tireoide/epidemiologia , Adulto , China/epidemiologia , Ecologia , Economia/estatística & dados numéricos , Feminino , Humanos , Incidência , Iodo/administração & dosagem , Iodo/urina , Masculino , Pessoa de Meia-Idade , Gestantes , Cloreto de Sódio na Dieta/administração & dosagem , Cloreto de Sódio na Dieta/efeitos adversos , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/patologia , Oligoelementos/efeitos adversos , Oligoelementos/urina
5.
J Exp Clin Cancer Res ; 38(1): 346, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395086

RESUMO

BACKGROUND: RUNX2 is a Runt-related transcription factor required during embryogenesis for skeletal development and morphogenesis of other organs including thyroid and breast gland. Consistent evidence indicates that RUNX2 expression is aberrantly reactivated in cancer and supports tumor progression. The mechanisms leading to RUNX2 expression in cancer has only recently began to emerge. Previously, we showed that suppressing the activity of the epigenetic regulators HDACs significantly represses RUNX2 expression highlighting a role for these enzymes in RUNX2 reactivation in cancer. However, the molecular mechanisms by which HDACs control RUNX2 are still largely unexplored. Here, to fill this gap, we investigated the role of different HDACs in RUNX2 expression regulation in breast and thyroid cancer, tumors that majorly rely on RUNX2 for their development and progression. METHODS: Proliferation assays and evaluation of RUNX2 mRNA levels by qRT-PCR were used to evaluate the effect of several HDACi and specific siRNAs on a panel of cancer cell lines. Moreover, ChIP and co-IP assays were performed to elucidate the molecular mechanism underneath the RUNX2 transcriptional regulation. Finally, RNA-sequencing unveiled a new subset of genes whose transcription is regulated by the complex RUNX2-HDAC6. RESULTS: In this study, we showed that Class I HDACs and in particular HDAC1 are required for RUNX2 efficient transcription in cancer. Furthermore, we found an additional and cell-specific function of HDAC6 in driving RUNX2 expression in thyroid cancer cells. In this model, HDAC6 likely stabilizes the assembly of the transcriptional complex, which includes HDAC1, on the RUNX2 P2 promoter potentiating its transcription. Since a functional interplay between RUNX2 and HDAC6 has been suggested, we used RNA-Seq profiling to consolidate this evidence in thyroid cancer and to extend the knowledge on this cooperation in a setting in which HDAC6 also controls RUNX2 expression. CONCLUSIONS: Overall, our data provide new insights into the molecular mechanisms controlling RUNX2 in cancer and consolidate the rationale for the use of HDACi as potential pharmacological strategy to counteract the pro-oncogenic program controlled by RUNX2 in cancer cells.


Assuntos
Comunicação Celular , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Regulação Neoplásica da Expressão Gênica , Histona Desacetilases/metabolismo , Neoplasias/etiologia , Neoplasias/metabolismo , Comunicação Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Desacetilase 6 de Histona/metabolismo , Inibidores de Histona Desacetilases/farmacologia , Humanos , Modelos Biológicos , Complexos Multiproteicos , Neoplasias/patologia , Ligação Proteica , RNA Interferente Pequeno/genética , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/metabolismo , Neoplasias da Glândula Tireoide/patologia , Transcrição Genética
6.
Ital J Pediatr ; 45(1): 96, 2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387613

RESUMO

Thyroid cancer (TC) in childhood is a rare disease characterized by an excellent prognosis. Thyroid nodules in children, although less common than in adults, have a greater risk of malignancies, particularly in those cases associated with anamnestic, clinical and ultrasonographic risk factors.Among the factors, which have been found to be linked with an increased relative risk of TC in children, an important role seems to be possibly played by an underlying nodular Hashimoto's thyroiditis (HT) and by the serum levels of TSH.Aim of this Commentary was to specifically address this last point.According to the available pediatric literature on the relationships between these risk factors and phenotypical expression of TC in children, it is possible to conclude that: 1) It is not completely clarified if HT per se predisposes to malignancy or if it represents an incidental histologic finding in cases with TC or if it may be the result of an immune response against tumoral cells. 2) It is unclear whether phenotypic expression of TC is more severe in the cases with associated HT but normal TSH serum levels. 3) Persistently elevated TSH levels play an independent role as predictors of the likelihood of TC, especially in children but also in adults. 4) Patients with nodular HT and subclinical hypothyroidism need to be treated with Levothyroxine in order to prevent the development of both TC and severe thyroid dysfunctions.


Assuntos
Biomarcadores Tumorais/sangue , Doença de Hashimoto/complicações , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/etiologia , Nódulo da Glândula Tireoide/sangue , Nódulo da Glândula Tireoide/etiologia , Tireotropina/sangue , Criança , Humanos
8.
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
9.
Int J Mol Sci ; 20(10)2019 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-31109060

RESUMO

There is strong association between inflammatory processes and their main metabolic mediators, such as leptin, adiponectin secretion, and low/high-density lipoproteins, with the cancer risk and aggressive behavior of solid tumors. In this scenario, cancer cells (CCs) and cancer stem cells (CSCs) have important roles. These cellular populations, which come from differentiated cells and progenitor stem cells, have increased metabolic requirements when it comes to maintaining or expanding the tumors, and they serve as links to some inflammatory mediators. Although the molecular mechanisms that are involved in these associations remain unclear, the two following cellular pathways have been suggested: 1) the mesenchymal-epithelial transition (MET) process, which permits the differentiation of adult stem cells throughout the acquisition of cell polarity and the adhesion to epithelia, as well to new cellular lineages (CSCs); and, 2) a reverse process, termed the epithelial-mesenchymal transition (EMT), where, in pathophysiological conditions (tissue injury, inflammatory process, and oxidative stress), the differentiated cells can acquire a multipotent stem cell-like phenotype. The molecular mechanisms that regulate both EMT and MET are complex and poorly understood. Especially, in the thyroid gland, little is known regarding MET/EMT and the role of CCs or CSCs, providing an exciting, new area of knowledge to be investigated. This article reviews the progress to date in research on the role of inflammatory mediators and metabolic reprogramming during the carcinogenesis process of the thyroid gland and the EMT pathways.


Assuntos
Transição Epitelial-Mesenquimal , Mediadores da Inflamação/metabolismo , Transdução de Sinais , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/metabolismo , Animais , Biomarcadores , Diferenciação Celular , Linhagem Celular Tumoral , Proliferação de Células , Transformação Celular Neoplásica/metabolismo , Humanos , Lipoproteínas HDL/metabolismo , Lipoproteínas LDL/metabolismo , Mutação , Células-Tronco Neoplásicas/metabolismo , Células-Tronco Neoplásicas/patologia , Neoplasias da Glândula Tireoide/patologia
10.
Surgery ; 166(3): 356-361, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31104806

RESUMO

BACKGROUND: The suppressive effect of the increase in thyroid hormone in patients with toxic nodular goiter is thought to protect the extranodular thyroid tissue from thyroid malignancy. In this study, we aimed to evaluate the prevalence and features of thyroid cancer in patients with toxic nodular goiter who underwent thyroidectomy. METHODS: Medical data of patients who had solitary toxic or nontoxic nodules and underwent total thyroidectomy were reviewed retrospectively. We reviewed the clinical, laboratory, and histopathologic features of patients with toxic nodular goiter and nontoxic solitary nodules. RESULTS: There were 73 patients with toxic nodular goiter and 366 patients with nontoxic solitary nodules. Median age was greater in the toxic nodular goiter compared with nontoxic solitary nodules patients (50 years; range: 18-73 vs 42 years; range: 18-83, P < .001). Median nodule diameters were 40.9 mm (range: 11.0-98.0) and 23.3 mm (range: 4.9-99.0) in patients with toxic nodular goiter and nontoxic solitary nodules, respectively (P < .001). Histopathologic examination revealed thyroid cancer in 14 patients (19%) with toxic nodular goiter and 132 (36.1%) patients with nontoxic solitary nodules (P = .008). Median tumor diameters were 6 mm (range: 1-50) in toxic nodular goiter and 14 mm (range: 1-80) in nontoxic solitary nodules (P = .150). The malignant nodule was the hyperfunctioning nodule in 7 patients with toxic nodular goiter; 4 were follicular and 3 were papillary thyroid cancer. The other 7 malignant foci were located in the suppressed contralateral lobe, and all were papillary microcarcinomas. The incidence of thyroid cancer outside the main nodule was similar in 2 groups (P = .934). CONCLUSION: Thyroid cancer in patients operated for toxic nodular goiter was 19%, which is not as rare as previously thought. A careful histopathologic examination of both the hyperfunctioning nodule and the extranodular thyroid tissue might help to disclose an unexpected tumor foci when thyroidectomy is performed in patients with toxic nodular goiter.


Assuntos
Bócio Nodular/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Bócio Nodular/complicações , Bócio Nodular/cirurgia , Humanos , Hipertireoidismo , Masculino , Pessoa de Meia-Idade , Prevalência , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/prevenção & controle , Neoplasias da Glândula Tireoide/terapia , Tireoidectomia/efeitos adversos , Tireoidectomia/métodos , Adulto Jovem
11.
Ann Surg Oncol ; 26(6): 1751-1758, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30937662

RESUMO

OBJECTIVE: The aim of this study was to explore the impact of thyroid antibody status on central lymph node metastases (CLNM) in papillary thyroid carcinoma (PTC) patients with Hashimoto's thyroiditis (HT). METHODS: A retrospective analysis was performed on 346 PTC patients with HT who underwent thyroidectomy and ipsilateral central lymph node dissection (CLND). Histopathological characteristics of the tumor and serum levels of thyroid hormone, as well as antibodies, were collected and analyzed. RESULTS: The multivariate logistic regression analysis showed that being male [odds ratio (OR) 3.269, 95% confidence interval (CI) 1.240-8.619], tumor size > 1 cm [1 cm < diameter (D) ≤ 2 cm: OR 6.947, 95% CI 2.886-16.722; 2 cm < D: OR 5.880, 1.937-17.846], and antibody status [thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) double negative: OR 3.791, 95% CI 1.391-10.331; TPOAb and TgAb double positive: OR 4.047, 95% CI 1.509-10.856; TgAb single positive: OR 6.024, 95% CI 2.019-17.970] were independent risk factors for CLNM. Additionally, a risk-score scale, including sex, antibody status, and tumor size, was established to predict CLNM. The sensitivity, specificity, positive predictive value, and negative predictive value were 55.7%, 84.4%, 74.4%, and 70%, respectively, when the cut-off point was chosen as 3. CONCLUSIONS: Antibody status is a critical independent risk factor for CLNM in PTC patients with HT. For the CLND strategy, a more conservative option could be considered in a low-risk cohort with the following characteristics: female sex, smaller tumor size, and TPOAb single positive.


Assuntos
Autoanticorpos/sangue , Carcinoma Papilar/secundário , Doença de Hashimoto/complicações , Tireoglobulina/imunologia , Neoplasias da Glândula Tireoide/patologia , Autoanticorpos/imunologia , Carcinoma Papilar/sangue , Carcinoma Papilar/etiologia , Feminino , Seguimentos , Doença de Hashimoto/sangue , Doença de Hashimoto/imunologia , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/etiologia
12.
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
13.
Tumori ; 105(6): NP28-NP31, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30782103

RESUMO

PURPOSE: Two tyrosine kinase inhibitors (TKIs), vandetanib and cabozantinib, have been approved for recurrent/metastatic (R/M) medullary thyroid carcinoma (MTC). To date, it is still debated when and which TKI has to be started in R/M MTC patients. This is due to 1) TKI-related toxicity burden, 2) no overall survival benefit for either TKI, and 3) progression-free survival improvement in MTC subgroups (RETM918T and RAS mutations) treated with cabozantinib. Herein, we present a case of R/M MTC with a discordant disease behavior because of spontaneous regression of some parenchymal sites along with progression of bone metastases, putting into the question the best timing for starting TKIs in R/M MTC. METHODS: We report a 46-year-old man with relapse (lymph nodes in the neck and mediastinum) after curative treatment (total thyroidectomy plus central compartment and right neck dissection) for a locally advanced MTC with only somatic RETM918T mutation. Considering the low tumor burden, absence of symptoms, as well as the potential TKI-related side effects, we decided not to start systemic therapy when metastases first appeared. RESULTS: Some lymph nodes spontaneously regressed, while new symptomatic bone lesions appeared with need for palliative radiotherapy. In total, first-line systemic therapy (cabozantinib) was started after 2 years since first distant metastases appearance. CONCLUSIONS: Radiologic progression of disease alone seems not to be adequate for MTC patients' selection to be treated. The progression rate, the tumor burden, and the site of disease should also be taken into account for the clinical decision process.


Assuntos
Carcinoma Neuroendócrino/diagnóstico , Carcinoma Neuroendócrino/terapia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/terapia , Carcinoma Neuroendócrino/etiologia , Terapia Combinada , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Esvaziamento Cervical , Metástase Neoplásica , Estadiamento de Neoplasias , Proteínas Proto-Oncogênicas c-ret/genética , Neoplasias da Glândula Tireoide/etiologia , Tireoidectomia , Tempo para o Tratamento , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Carga Tumoral
14.
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
15.
Asian Pac J Cancer Prev ; 20(2): 355-367, 2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-30803193

RESUMO

Background: In French Polynesia, thyroid cancer mortality and incidence is reported to be the highest in the world. Excessive levels of non-essential trace elements (nETE) in the body are associated with several types of cancer. Objective: The present study aims to provide quantitative information on food contamination by mercury (Hg), lead (Pb), arsenic (As) and cadmium (Cd) in French Polynesia and its potential correlation with measurements performed in fingernails of Polynesians, and then to investigate the potential association between these nETE and different thyroid cancer risks. Methods: The study population included 229 interviewed cases and 373 interviewed controls We performed a descriptive analysis of Polynesian food and examined the association between thyroid cancer risk and daily intake levels of nETE and with fingernail nETE levels. Results: Hg contamination was mainly present in sea products, Pb contamination was present in almost all samples, Cd was detectable in starchy food and As was detectable in all sea products. No patient exceeded dietary contamination WHO limits for Pb, 2 participants exceeded it for Hg and 3 individuals (0.5%) for cadmium. In fingernail clippings, the most detectable pollutant was Pb (553 participants), then Hg (543 participants) then Cd (only in 130 participants). Thyroid cancer risk was increased more than 4 times by Pb daily intake in patients with a history of cancer in first-degree relatives than in ones without (p for interaction =0.01), and 2 times more in women with more than 3 pregnancies than in those with none or less (p for interaction =0.005); it was also increased following As intake by more than 30% in patients with a history of cancer in first-degree relatives than in ones without (p for interaction =0.05). Conclusion: Locally produced foods are not a source of nETE exposure in French Polynesia. Dieatry nETE exposure and fingernail nETE concentration are not associated to differentiated thyroid cancer risk. No correlation found between nETE dietary exposure and fingernail nETE concentration.


Assuntos
Exposição Dietética/efeitos adversos , Monitoramento Ambiental/métodos , Contaminação de Alimentos/análise , Unhas/metabolismo , Neoplasias da Glândula Tireoide/etiologia , Oligoelementos/efeitos adversos , Estudos de Casos e Controles , Exposição Dietética/análise , Suscetibilidade a Doenças , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Polinésia/epidemiologia , Prognóstico , Fatores de Risco , Neoplasias da Glândula Tireoide/epidemiologia , Oligoelementos/análise , Adulto Jovem
16.
Endocrinol Metab Clin North Am ; 48(1): 23-35, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30717905

RESUMO

The incidence of thyroid cancer worldwide has increased significantly over the past 3 decades, due predominantly to an increase in papillary thyroid cancer. Although most of these cancers are small and localized, population-based studies have documented a significant increase in thyroid cancers of all sizes and stages, in addition to incidence-based mortality for papillary thyroid cancer. This suggests that the increasing incidence of thyroid cancer is due in large part to increasing surveillance and overdiagnosis, but that there also appears to be a true increase in new cases of thyroid cancer.


Assuntos
Neoplasias da Glândula Tireoide/epidemiologia , Humanos , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/etiologia
17.
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
18.
J Clin Endocrinol Metab ; 104(1): 41-48, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30445441

RESUMO

Background: Children and adolescents exposed to radioactive iodine-131 (I-131) in fallout from the 1986 Chernobyl nuclear accident appear to be at increased risk of thyroid cancer and benign thyroid nodules. The prenatal period is also considered radiosensitive, and the fetal thyroid can absorb I-131 from the maternal circulation. Objectives: We aimed to estimate the risk of malignant and benign thyroid nodules in individuals exposed prenatally. Methods: We studied a cohort of 2582 subjects in Ukraine with estimates of I-131 prenatal thyroid dose (mean = 72.6 mGy), who underwent two standardized thyroid screening examinations. To evaluate the dose-response relationship, we estimated the excess OR (EOR) using logistic regression. Results: Based on a combined total of eight cases diagnosed at screenings from 2003 to 2006 and 2012 to 2015, we found a markedly elevated, albeit not statistically significant, dose-related risk of thyroid cancer (EOR/Gy = 3.91, 95% CI: -1.49, 65.66). At cycle 2 (n = 1,786), there was a strong and significant association between I-131 thyroid dose and screen-detected large benign nodules (≥10 mm) (EOR/Gy = 4.19, 95% CI: 0.68, 11.62; P = 0.009), but no significant increase in risk for small nodules (<10 mm) (EOR/Gy = 0.34, 95% CI: -0.67, 2.24; P = 0.604). Conclusions: The dose effect by nodule size, with I-131 risk for large but not small nodules, is similar to that among exposed children and adolescents in Belarus. Based on a small number of cases, there is also a suggestive effect of I-131 dose on thyroid cancer risk.


Assuntos
Acidente Nuclear de Chernobyl , Neoplasias Induzidas por Radiação/epidemiologia , Cinza Radioativa/efeitos adversos , Neoplasias da Glândula Tireoide/epidemiologia , Nódulo da Glândula Tireoide/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Relação Dose-Resposta à Radiação , Feminino , Humanos , Radioisótopos do Iodo , Masculino , Programas de Rastreamento , Neoplasias Induzidas por Radiação/diagnóstico por imagem , Gravidez , Efeitos Tardios da Exposição Pré-Natal , República de Belarus/epidemiologia , Medição de Risco , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/etiologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/etiologia , Ultrassonografia
19.
Ann Epidemiol ; 29: 39-45, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30446214

RESUMO

PURPOSE: This study aims to investigate the association between cell phone use and thyroid cancer. METHODS: A population-based case-control study was conducted in Connecticut between 2010 and 2011 including 462 histologically confirmed thyroid cancer cases and 498 population-based controls. Multivariate unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations between cell phone use and thyroid cancer. RESULTS: Cell phone use was not associated with thyroid cancer (OR: 1.05, 95% CI: 0.74-1.48). A suggestive increase in risk of thyroid microcarcinoma (tumor size ≤10 mm) was observed for long-term and more frequent users. Compared with cell phone nonusers, several groups had nonstatistically significantly increased risk of thyroid microcarcinoma: individuals who had used a cell phone >15 years (OR: 1.29, 95% CI: 0.83-2.00), who had used a cell phone >2 hours per day (OR: 1.40, 95% CI: 0.83-2.35), who had the most cumulative use hours (OR: 1.58, 95% CI: 0.98-2.54), and who had the most cumulative calls (OR: 1.20, 95% CI: 0.78-1.84). CONCLUSIONS: This study found no significant association between cell phone use and thyroid cancer. A suggestive elevated risk of thyroid microcarcinoma associated with long-term and more frequent uses warrants further investigation.


Assuntos
Uso do Telefone Celular/estatística & dados numéricos , Telefone Celular , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/etiologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Connecticut/epidemiologia , Campos Eletromagnéticos/efeitos adversos , Feminino , Glioma/epidemiologia , Glioma/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Fatores de Risco , Inquéritos e Questionários , Neoplasias da Glândula Tireoide/patologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA