Can procalcitonin be useful for medullary thyroid cancer?

INTRODUCTION: Calcitonin, the best known marker for medullary thyroid cancer (MTC), has several laboratory limitations which limit its use in the routines of non-specialized laboratories. Procalcitonin, the precursor of calcitonin, is free from these drawbacks. The aim of this study was to compare calcitonin and procalcitonin levels in MTC patients with active disease or in remission, and in patients with non-toxic nodular goiter (NTNG). MATERIAL AND METHODS: Forty-three serum samples, obtained from 40 patients (6 MTC active disease patients, 23 MTC patients in remission, and 11 NTNG patients), were tested for calcitonin and procalcitonin levels. The levels of both markers were measured in 2 MTC patients with active disease before and after surgery. One was re-operated due to neck relapse, the other one due to liver metastases. RESULTS: Both procalcitonin and calcitonin levels were considerably higher in all MTC patients with the active disease. In two re-operated patients, the levels of both markers decreased after surgery but remained above the reference range. In the remission group of MTC patients, 18 had both markers within the reference range, 2 had slightly elevated calcitonin, and 3 patients exhibited both markers slightly increased. In the NTNG group, all but one patient had normal procalcitonin and calcitonin levels. Analysis revealed a significant correlation between procalcitonin and calcitonin levels (r = 0.7383; p < 0.0001). CONCLUSIONS: Procalcitonin has a similar distribution of values as calcitonin and may be used for evaluation of MTC status in some situations when accurate CT estimation is not achievable.

Own experience in the treatment of major salivary gland tumors.

INTRODUCTION: The paper aims to demonstrate the Clinic's and own research in the treatment of major salivary gland tumors. MATERIAL AND METHOD: In the years 2013-2019, there were 95 salivary gland surgeries, including 45 performed in women (47.36%) aged between 24 and 82 and in 50 men (52.64%) aged 29 to 86. Diagnostics of major salivary glands included: patient history, otolaryngological examination, ultrasound and fine needle aspiration (BACC) (of tumor), laboratory tests (morphology, CRP) and computed tomography (CT) or magnetic resonance imaging (MRI) to accurately assess salivary glands, location of lesion and lymph nodes prior to elective surgery. Research results: In the analyzed material patients with major salivary gland tumors were most frequently operated on at the age of 61-70 (34.7%) and 51-60 years (23.2%). Most patients with tumors were hospitalized in the last 4 years between 2016-2019, which accounted for 77.8% of all operated cases. Among the operated lesions, benign neoplasms and tumors occurred in 93.7%, of which the most frequent findings in histopathological examination were Warthin tumor in 50.5%, and multiform adenoma in 26.3%. The remaining tumors and benign neoplasms constituted only 16.9% and were observed in isolated cases, including eosinophilic adenoma, lymphoepithelial cyst, myoepithelial adenoma, lipofibrosarcoma, congestive cyst, air cyst, tubular adenoma, basal cell carcinoma, cyst with squamous metaplasia features, vascular malformation. Malignant salivary gland tumors were found in 6.3%, including the following malignant tumors were revealed histopathologically: adenocarcinoma, mucoepidermal carcinoma, acinocellular carcinoma, epithelialmyoepithelial carcinoma, ductal carcinoma. CONCLUSIONS: The majority of operated salivary gland tumors were benign (93.7%), of which the most common histopathologically were: Warthin tumor (50.5%) and multiform adenoma (26.3%), while malignant tumors occurred in 6.3%. Tumors were localized mainly in the parotid gland in as many as 93.7% cases, of which the most common localization concerned the superficial lobe in 56.8%. The most frequent surgical technique used in the Clinic was extracapsular dissection of the tumor in 88.4%, and other methods were used rarely.

Evaluation of selected parameters of the coagulation system during the perioperative period in patients undergoing endoscopic surgery of the paranasal sinuses.

INTRODUCTION: The aim of the study was to evaluate selected parameters of the coagulation system during the perioperative period in patients undergoing endoscopic sinus surgery. MATERIAL AND METHODS: The study involved 121 patients: group I - 42 patients who did not receive anticoagulatory or antiplatelet medications, qualified for endoscopic sinus surgery under total intravenous anaesthesia (TIVA); group II - 40 patients who received in the perioperative period low-molecular-weight heparins, qualified for endoscopic sinus surgery under TIVA; group III - 39 patients diagnosed according to a schedule, due to vertigo or loss of hearing. All the patients received a full laryngological examination and detailed audiological and otoneurological diagnostics, and examination of selected haemostatic parameters before the surgery/diagnostics. RESULTS: The analysis of concentrations of coagulation parameters in groups I and II revealed a statistically significantly higher international normalized ratio value before surgery (I - 1.11; II - 1.08) and 48 h following surgery (I - 1.15; II - 1.10) in group I. The concentration of coagulation factor VII in the study patients was considerably higher in group I for all three measurements (481.93; 443.13; 486.02). The concentration of fibrinogen (coagulation factor I) was significantly lower in group I before surgery (3.2) and at 6 h after surgery (2.84). A significantly lower level of von Willebrand factor was found in group I before surgery (2.94). Comparing test results of groups I and III, who did not receive antiaggregants, statistically significant differences were observed in both tests for factors VII and VIII. CONCLUSIONS: Concentrations of von Willebrand factor and prothrombin revealed statistically significant differences in between groups.

Evaluation of risk factors for oral cavity and oropharynx cancers in patients under the week activity program of head and neck cancers prevention in Lodz.

INTRODUCTION: The aim of the study was to evaluate risk factors for oral cavity and oropharynx cancers in patients under the week activity program of head and neck cancers prevention in Lodz. MATERIAL AND METHODS: 104 people reported to preventive examinations under the week activity program of head and neck cancers prevention in Lodz (25-th of September, 2015): 33 women aged 21-68 and 38 men aged 23-71. Before ENT examination, subjects completed the questionnaire, which concerned: the degree of education, source of information about preventive examinations, symptoms, smoking, number of smoked cigarettes, alcohol, number of life sexual partners, number of oral sex partners and family history of head and neck cancers. RESULTS AND CONCLUSIONS: The analysis showed that people who reported to preventive examination were mostly in the age group of 51-60 and over 60, respectively 71,2% of women and 57,9% of men. Patients were at the age, that predispose to oral cavity and oropharynx cancers. In our own material, 15,9% of women and 23,6% of men have smoked. Most of them have smoked 10-20 cigarettes daily. On the other hand, 40,9% of women and 10,5% of men didn't consume alcohol. In our study, both women and men had, at life, 1-3 sexual partners the most often, respectively 78,9% and 60,5%. The oral sex was cultivated by 45,5% of women and 60,5% of men, the most often with 1-3 partners, respectively 95,8% and 70,0%. Based on complete ENT examination and the presence of risk factors for oral cavity and oropharynx cancers, 14,4% of patients were qualified to further oncological examinations including: videolaryngostroboscopy, neck ultrasound with fine-needle biopsy, neck CT and HPV test.

Sensitivity evaluation in air and water caloric stimulation of the vestibular organs using videonystagmography.

INTRODUCTION: The aim of the study was to compare air and water caloric stimulation of the vestibular organs using videonystagmography (VNG). MATERIAL AND METHODS: The study covered 18 women aged 21-63 and 11 men aged 21-74 years hospitalized at the ENT, without complaints for vertigo and/or balance disorders. The alternate binaural bithermal caloric test with cool 30°C and warm 44°C air or water irrigations (after 2h interval for the recordings) with the use of VNG was done. RESULTS: All parameters of air and water vestibular caloric stimulations, assessed in the VNG, differed significantly but were within the normal range. The research showed a statistically significant difference between canal paresis but only for the left ear at 30°C and 44°C. Absolute directional preponderance, relative directional preponderance, vestibular excitability, slow component velocity, frequency were different statistically for both ears at both temperatures. CONCLUSIONS: Our study showed that both air and water caloric stimulations were able to distinguish physiological and impaired vestibular function. The obtained results showed statistically higher response for water than air stimulation.