1
|
Li S, Ren C, Gong Y, Ye F, Tang Y, Xu J, Guo C, Huang J. The Role of Thyroglobulin in Preoperative and Postoperative Evaluation of Patients With Differentiated Thyroid Cancer. Front Endocrinol (Lausanne) 2022; 13:872527. [PMID: 35721746 PMCID: PMC9200986 DOI: 10.3389/fendo.2022.872527] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/29/2022] [Indexed: 12/02/2022] Open
Abstract
Thyroglobulin (Tg) is secreted by thyroid follicular cells and stored in the thyroid follicular lumen as a component of thyroid hormone. It is known that both benign and well-differentiated malignant thyroid tissue can secrete Tg. In recent years, growing lines of evidence have shown that Tg plays an important role in the diagnosis and metastasis of preoperative differentiated thyroid carcinoma (DTC). The levels of Tg, whether in the serum or in a fine-needle aspiration washout fluid, are usually viewed as an excellent indicator in the monitoring of postoperative DTC, including the guidance and evaluation of radioactive iodine ablation. Nevertheless, some factors limit the application of Tg, such as the method used to measure Tg and the presence of Tg antibodies. This review aimed to summarize the role of Tg in the preoperative and postoperative evaluation of patients with DTC, and the factors influencing Tg. This review could provide a reference for a more accurate application of Tg in patients with DTC.
Collapse
Affiliation(s)
| | - Chutong Ren
- *Correspondence: Jiangsheng Huang, ; Chutong Ren,
| | | | | | | | | | | | | |
Collapse
|
2
|
Discrimination of malignant from benign thyroid lesions through neural networks using FTIR signals obtained from tissues. Anal Bioanal Chem 2021; 413:2163-2180. [PMID: 33569645 DOI: 10.1007/s00216-021-03183-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/11/2021] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
The current gold standard in cancer diagnosis-the microscopic examination of hematoxylin and eosin (H&E)-stained biopsies-is prone to bias since it greatly relies on visual examination. Hence, there is a need to develop a more sensitive and specific method for diagnosing cancer. Here, Fourier transform infrared (FTIR) spectroscopy of thyroid tumors (n = 164; 76 malignant, 88 benign) was performed and five (5) neural network (NN) models were designed to discriminate the obtained spectral data. PCA-LDA was used as classical benchmark for comparison. Each NN model was evaluated using a stratified 10-fold cross-validation method to avoid overfitting, and the performance metrics-accuracy, area under the curve (AUC), positive predictive value (PPV), negative predictive value (NPV), specificity rate (SR), and recall rate (RR)-were averaged for comparison. All NN models were able to perform excellently as classifiers, and all were able to surpass the LDA model in terms of accuracy. Among the NN models, the RNN model performed best, having an AUC of 95.29% ± 6.08%, an accuracy of 98.06% ± 2.87%, a PPV of 98.57% ± 4.52%, a NPV of 93.18% ± 7.93%, a SR value of 98.89% ± 3.51%, and a RR value of 91.25% ± 10.29%. The RNN model outperformed the LDA model for all metrics except for the AUC, NPV, and RR. In conclusion, NN-based tools were able to predict thyroid cancer based on infrared spectroscopy of tissues with a high level of diagnostic performance in comparison to the gold standard.
Collapse
|
3
|
Melik M, Baskonus I, Yilmaz L. Assessment of preoperative thyroglobulin levels in papillary thyroid cancer. J Cancer Res Ther 2021; 18:1042-1044. [DOI: 10.4103/jcrt.jcrt_1268_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
4
|
Sondorp LH, Ogundipe VM, Groen AH, Kelder W, Kemper A, Links TP, Coppes RP, Kruijff S. Patient-Derived Papillary Thyroid Cancer Organoids for Radioactive Iodine Refractory Screening. Cancers (Basel) 2020; 12:E3212. [PMID: 33142750 PMCID: PMC7692469 DOI: 10.3390/cancers12113212] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/22/2020] [Accepted: 10/29/2020] [Indexed: 12/23/2022] Open
Abstract
Patients with well-differentiated thyroid cancer, especially papillary thyroid cancer (PTC), are treated with surgical resection of the thyroid gland. This is followed by post-operative radioactive iodine (I131), resulting in total thyroid ablation. Unfortunately, about 15-33% of PTC patients are unable to take up I131, limiting further treatment options. The aim of our study was to develop a cancer organoid model with the potential for pre-treatment diagnosis of these I131-resistant patients. PTC tissue from thirteen patients was used to establish a long-term organoid model. These organoids showed a self-renewal potential for at least five passages, suggesting the presence of cancer stem cells. We demonstrated that thyroid specific markers, a PTC marker, and transporters/receptors necessary for iodine uptake and thyroid hormone production were expressed on a gene and protein level. Additionally, we cultured organoids from I131-resistant PTC material from three patients. When comparing PTC organoids to radioactive iodine (RAI)-refractory disease (RAIRD) organoids, a substantial discordance on both a protein and gene expression level was observed, indicating a treatment prediction potential. We showed that patient-derived PTC organoids recapitulate PTC tissue and a RAIRD phenotype. Patient-specific PTC organoids may enable the early identification of I131-resistant patients, in order to reduce RAI overtreatment and its many side effects for thyroid cancer patients.
Collapse
Affiliation(s)
- Luc H.J. Sondorp
- Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (L.H.J.S.); (A.H.G.)
- Department of Biomedical Sciences of Cell & Systems–Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;
| | - Vivian M.L. Ogundipe
- Department of Biomedical Sciences of Cell & Systems–Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Andries H. Groen
- Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (L.H.J.S.); (A.H.G.)
- Department of Biomedical Sciences of Cell & Systems–Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;
| | - Wendy Kelder
- Department of Surgery, Martini Hospital, 9728 NT Groningen, The Netherlands;
| | - Annelies Kemper
- Department of Surgery, Treant Hospital, 7909 AA Hoogeveen, The Netherlands;
| | - Thera P. Links
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;
| | - Robert P. Coppes
- Department of Biomedical Sciences of Cell & Systems–Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Schelto Kruijff
- Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (L.H.J.S.); (A.H.G.)
| |
Collapse
|
5
|
Chung JK, Kim HW, Youn H, Cheon GJ. Sodium Iodide Symporter (NIS) in the Management of Patients with Thyroid Carcinoma. Nucl Med Mol Imaging 2018; 52:325-326. [PMID: 30344779 DOI: 10.1007/s13139-018-0540-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/03/2018] [Accepted: 08/08/2018] [Indexed: 01/25/2023] Open
Abstract
Although radioiodine has been applied in thyroid diseases including carcinoma for over 70 years, it was only in 1996 that the basic molecular mechanism of iodine uptake was identified. Iodide is actively transported into the thyroid via a membrane glycoprotein known as sodium iodide symporter (NIS). NIS mediates radioiodine uptake into thyroid normal and cancer cells. The knowledge on NIS expression has provided scientific background to the empirical management of thyroid carcinoma. Based on recent studies of the NIS gene, this paper provides current clinical applications and future studies.
Collapse
Affiliation(s)
- June-Key Chung
- Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyun Woo Kim
- Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Haewon Youn
- Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
6
|
Kolahdouzan M, Sadeghi M, Kalidari B, Sanei B, Mostafapour E, Aminorroaya A. The Role of Intraoperative Thyroglobuline Level of Lymph Node in the Management of Papillary Thyroid Cancer (Determination of a Cutoff Point). Adv Biomed Res 2017; 6:99. [PMID: 28900610 PMCID: PMC5583626 DOI: 10.4103/abr.abr_145_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Some studies have shown that a preoperative high concentration of thyroglobulin (Tg) in wash out of fine-needle aspiration cytology of cervical lymph nodes mandate therapeutic lymph node dissection. However, there is disagreement about the minimum concentration of Tg which could have diagnostic value. Hence, according to our literature review, this study is the first one which designed to do intraoperatively. Therefore, this study was conducted and aimed to determine the clinical diagnostic value of Tg lymph nodes in the diagnosis of metastatic thyroid cancer. Methods: In a cross-sectional study, 65 patients with papillary thyroid carcinoma (PTC) who were thyroidectomy candidates were chosen and during surgery, before the removal of lymph nodes in the neck, fine-needle sampling was performed and the level of Tg in the samples, nature of the sample sent for biopsy and Tg levels in affected and unaffected lymph nodes were determined. Results: The mean levels of washout Tg in malignant and nonmalignant lymph nodes were 622.1 ± 66.2 and 1.38 ± 0.43 ng/ml, respectively, and the difference between the two groups was significant (P < 0.001). The Tg cut-off point for the detection of lymph node metastases was 0.7 ng/dl, and according to it, Tg washout sensitivity was 93.8%, specificity of 92.4%, false positives 7.76%, false negatives 6.3%, positive predictive value was 92.3%, and negative predictive value was 93.8% and accuracy was 93.1%. Conclusion: Based on the results, Tg level of cervical lymph nodes in patients with PTC is a suitable criterion for the diagnosis of lymph node which can be determined through fine-needle biopsy. Therefore, it is suggested that in patients with suspicion of lymph nodes involvement during surgery, fine-needle biopsy and determination of the Tg level performed.
Collapse
Affiliation(s)
- Mohsen Kolahdouzan
- Department of Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Sadeghi
- Department of Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Kalidari
- Department of Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behnam Sanei
- Department of Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elyas Mostafapour
- Department of Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | |
Collapse
|
7
|
Samadi R, Ghanbari M, Shafiei B, Gheibi S, Azizi F, Ghasemi A. High dose of radioactive iodine per se has no effect on glucose metabolism in thyroidectomized rats. Endocrine 2017; 56:399-407. [PMID: 28283939 DOI: 10.1007/s12020-017-1274-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/23/2017] [Indexed: 12/28/2022]
Abstract
PURPOSE Thyroid concentrates radioactive iodine by sodium-iodide symporter; this is used for treating hyperthyroidism and thyroid cancer. Pancreas expresses NIS and radioactive iodine uptake may damage pancreatic beta-cells and predispose patients to type 2 diabetes. The aim of this study was to determine whether radioactive iodine is associated with glucose metabolism in thyroidectomized rats. METHODS Forty male Wistar rats were divided into four groups (n = 10/each); control, thyroidectomized, thyroidectomized-treated with 131-I (TX+I), and thyroidectomized-treated with 131-I and L-thyroxine (TX+I+T4). At the end of study, serum fasting glucose, insulin, thyroid-stimulating hormone, and free tetraiodothyronine were measured, intraperitoneal glucose tolerance test was performed, and homeostasis model assessment-insulin resistance was calculated. In in vitro experiments, glucose-stimulated insulin secretion from pancreatic islets and sodium-iodide symporter mRNA expression in thyroid and islets were determined. RESULTS Compared to control group, free tetraiodothyronine was lower by 41 and 77% and thyroid-stimulating hormone was higher by 36 and 126% in thyroidectomized and TX+I groups, respectively. Compared to controls, rats in TX+I group had glucose intolerance as assessed using the area under curve of intraperitoneal glucose tolerance test (12,376 ± 542 vs. 20,769 ± 1070, P < 0.001) and L-thyroxine replacement therapy restored the value (14,286 ± 328.24) to near normal. Fasting insulin and homeostasis model assessment-insulin resistance were comparable in all groups, however fasting glucose was higher in TX+I group. In in vitro experiments, glucose-stimulated insulin secretion from islets did not differ between groups. CONCLUSION Radioactive iodine therapy per se had no effect on glucose metabolism, just intensified thyroid hormone deficiency and the alterations on glucose metabolism in thyroidectomized rats. L-thyroxine therapy restored the glucose intolerance observed in radioactive iodine-treated thyroidectomized rats.
Collapse
Affiliation(s)
- Roghaieh Samadi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Ghanbari
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Babak Shafiei
- Department of Nuclear Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sevda Gheibi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asghar Ghasemi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
8
|
Samadi R, Shafiei B, Azizi F, Ghasemi A. Radioactive Iodine Therapy and Glucose Tolerance. CELL JOURNAL 2017; 19:184-193. [PMID: 28670511 PMCID: PMC5413587 DOI: 10.22074/cellj.2016.4251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 07/19/2016] [Indexed: 11/09/2022]
Abstract
Radioactive iodine therapy is commonly used as an adjuvant therapy in follicular and
papillary thyroid carcinoma (PTC) and in the treatment of Graves’ disease (GD). The
basis of this therapy is the accumulation of radioactive iodine by the sodium-iodide
symporter (NIS) in the thyroid gland. Expression of NIS by extrathyroidal tissues such
as islets of pancreas has been reported. Radioactive iodine uptake by pancreatic
beta-cells can potentially damage these cells. In this study, we discuss the possible
associations between radioactive iodine and glucose intolerance. Overall, radioactive
iodine uptake by the pancreas may damage beta-cells and predispose patients to
glucose intolerance or type 2 diabetes, particularly in patients exposed to radioactive
iodine therapy following total thyroidectomy. Further studies are needed to clarify and
confirm this association.
Collapse
Affiliation(s)
- Roghaieh Samadi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Babak Shafiei
- Department of Nuclear Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asghar Ghasemi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Schmid KW. [Lymph node and distant metastases of thyroid gland cancer. Metastases in the thyroid glands]. DER PATHOLOGE 2016; 36 Suppl 2:171-5. [PMID: 26357953 DOI: 10.1007/s00292-015-0071-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The different biological features of the various major entities of thyroid cancer, e.g. papillary, follicular, poorly differentiated, anaplastic and medullary, depend to a large extent on their different metastatic spread. Papillary thyroid cancer (PTC) has a propensity for cervical lymphatic spread that occurs in 20-50 % of patients whereas distant metastasis occurs in < 5 % of cases. Cervical lymphadenopathy may be the first symptom particularly of (micro) PTC. In contrast follicular thyroid cancer (FTC) has a marked propensity for vascular but not lymphatic invasion and 10-20 % of FTC develop distant metastases. At the time of diagnosis approximately one third of medullary thyroid cancer (MTC) cases show lymph node metastases, in 10-15 % distant metastases and 25 % develop metastases during the course of the disease. Poorly differentiated (PDTC) and anaplastic thyroid cancer (ATC) spread via both lymphatic and vascular invasion. Thus distant metastases are relatively uncommon in DTC and when they occur, long-term stable disease is the typical clinical course. The major sites of distant metastases are the lungs and bone. Metastases to the brain, breasts, liver, kidneys, muscle and skin are relatively rare or even rare. The thyroid gland itself can be a site of metastases from a variety of other tumors. In autopsy series of patients with disseminated cancer disease, metastases to the thyroid gland were found in up to 10 % of cases. Metastases from other primary tumors to the thyroid gland have been reported in 1.4-3 % of patients who have surgery for suspected cancer of the thyroid gland. The most common primary cancers that metastasize to the thyroid gland are renal cell (48.1 %), colorectal (10.4 %), lung (8.3 %) and breast cancer (7.8 %) and surprisingly often sarcomas (4.0 %).
Collapse
Affiliation(s)
- K W Schmid
- Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland.
| |
Collapse
|
10
|
Kim BH. Differentiated Thyroid Cancer in Asians. Endocrinol Metab (Seoul) 2016; 31:62-3. [PMID: 26996424 PMCID: PMC4803562 DOI: 10.3803/enm.2016.31.1.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Bo Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea.
| |
Collapse
|
11
|
Chung JK, Cheon GJ. Radioiodine therapy in differentiated thyroid cancer: the first targeted therapy in oncology. Endocrinol Metab (Seoul) 2014; 29:233-9. [PMID: 25309780 PMCID: PMC4192819 DOI: 10.3803/enm.2014.29.3.233] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Iodide uptake across the membranes of thyroid follicular cells and cancer cells occurs through an active transport process mediated by the sodium-iodide symporter (NIS). The rat and human NIS-coding genes were cloned and identified in 1996. Evaluation of NIS gene and protein expression is critical for the management of thyroid cancer, and several approaches to increase NIS levels have been tried. Identification of the NIS gene has provided a means of expanding its role in radionuclide therapy and molecular target-specific theragnosis (therapy and diagnosis using the same molecular target). In this article, we describe the relationship between NIS expression and the thyroid carcinoma treatment using I-131 and alternative therapeutic approaches.
Collapse
Affiliation(s)
- June-Key Chung
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
12
|
Gallop K, Kerr C, Simmons S, McIver B, Cohen EEW. A qualitative evaluation of the validity of published health utilities and generic health utility measures for capturing health-related quality of life (HRQL) impact of differentiated thyroid cancer (DTC) at different treatment phases. Qual Life Res 2014; 24:325-38. [PMID: 25106505 DOI: 10.1007/s11136-014-0776-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2014] [Indexed: 01/22/2023]
Abstract
PURPOSE This study explored the impact of differentiated thyroid cancer (DTC) on health-related quality of life (HRQL) at different treatment phases and evaluated the validity of published DTC utilities and generic health utility measures (EQ-5D and SF-6D) for economic evaluation of treatments for radio-iodine (RAI) refractory DTC. METHODS Focus groups and interviews were conducted with DTC patients grouped by treatment phase. Qualitative thematic analysis was conducted on interview/focus group transcripts. A thematic coding framework was developed to compare experiences between treatment phases and inform development of a conceptual model. Model concepts were mapped to EQ-5D and SF-6D domains/items. RESULTS Eight focus groups and 11 individual interviews were conducted with 52 DTC patients. Fifty symptoms and HRQL concepts were identified. The impact of DTC and DTC treatment on emotional and cognitive functioning was reported across the treatment phases. The impact on daily activities, mobility, and energy levels was greatest for patients with recurring/persistent or RAI-refractory DTC. Of the 50 concepts, 25 and 27 mapped directly onto domains/items in the EQ-5D and SF-6D, respectively. The SF-6D covered a broader range of DTC impact on emotional/physical problems and daily/social activities than did the EQ-5D. CONCLUSIONS The conceptual model summarizes the wide-ranging impact of DTC and its treatment on patients' HRQL, particularly for those with recurring/persistent or RAI-refractory DTC. Findings suggest that published DTC utilities lack validity for RAI-refractory DTC and that the SF-6D may be more sensitive to HRQL impact of DTC than the EQ-5D.
Collapse
Affiliation(s)
- Katy Gallop
- ICON Patient Reported Outcomes, Seacourt Tower, West Way, Oxford, OX2 0JJ, UK
| | | | | | | | | |
Collapse
|
13
|
Romitti M, Ceolin L, Siqueira DR, Ferreira CV, Wajner SM, Maia AL. Signaling pathways in follicular cell-derived thyroid carcinomas (review). Int J Oncol 2012; 42:19-28. [PMID: 23128507 DOI: 10.3892/ijo.2012.1681] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 08/24/2012] [Indexed: 11/06/2022] Open
Abstract
Thyroid carcinoma is the most common malignant endocrine neoplasia. Differentiated thyroid carcinomas (DTCs) represent more than 90% of all thyroid carcinomas and comprise the papillary and follicular thyroid carcinoma subtypes. Anaplastic thyroid carcinomas correspond to less than 1% of all thyroid tumors and can arise de novo or by dedifferentiation of a differentiated tumor. The etiology of DTCs is not fully understood. Several genetic events have been implicated in thyroid tumorigenesis. Point mutations in the BRAF or RAS genes or rearranged in transformation (RET)/papillary thyroid carcinoma (PTC) gene rearrangements are observed in approximately 70% of papillary cancer cases. Follicular carcinomas commonly harbor RAS mutations and paired box gene 8 (PAX8)-peroxisome proliferator-activated receptor γ (PPARγ) rearrangements. Anaplastic carcinomas may have a wide set of genetic alterations, that include gene effectors in the mitogen-activated protein kinase (MAPK), phosphatidylinositol 3-kinase (PI3K) and/or β-catenin signaling pathways. These distinct genetic alterations constitutively activate the MAPK, PI3K and β-catenin signaling pathways, which have been implicated in thyroid cancer development and progression. In this context, the evaluation of specific genes, as well as the knowledge of their effects on thyroid carcinogenesis may provide important information on disease presentation, prognosis and therapy, through the development of specific tyrosine kinase targets. In this review, we aimed to present an updated and comprehensive review of the recent advances in the understanding of the genetic basis of follicular cell-derived thyroid carcinomas, as well as the molecular mechanisms involved in tumor development and progression.
Collapse
Affiliation(s)
- Mírian Romitti
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | | | | |
Collapse
|
14
|
Englund EE, Neumann S, Eliseeva E, McCoy JG, Titus S, Zheng W, Southall N, Shin P, Leister W, Thomas CJ, Inglese J, Austin CP, Gershengorn MC, Huang W. The Synthesis and Evaluation of Dihydroquinazolin-4-ones and Quinazolin-4-ones as Thyroid Stimulating Hormone Receptor Agonists. MEDCHEMCOMM 2011; 2:1016-1020. [PMID: 22408719 PMCID: PMC3293179 DOI: 10.1039/c1md00145k] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We herein describe the rapid synthesis of a diverse set of dihydroquinazolin-4-ones and quinazolin-4-ones, their biological evaluation as thyroid stimulating hormone receptor (TSHR) agonists, and SAR analysis. Among the compounds screened, 8b was 60-fold more potent than the hit compound 1a, which was identified from a high throughput screen of over 73,000 compounds.
Collapse
Affiliation(s)
- Erika E Englund
- NIH Chemical Genomics Center, 9800 Medical Center Drive, Building B, Bethesda MD, 20892-3371
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Francis CL, Nalley C, Fan C, Bodenner D, Stack BC. 18F-fluorodeoxyglucose and 131I radioguided surgical management of thyroid cancer. Otolaryngol Head Neck Surg 2011; 146:26-32. [PMID: 21952355 DOI: 10.1177/0194599811423007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe a technique that assists in the surgical management of recurrent local regional well-differentiated thyroid cancer (WDTC). STUDY DESIGN Case series with chart review. SETTING Two academic health centers from 2001 to 2009. SUBJECTS AND METHODS Patients operated upon by the senior surgeon (BCS) for recurrent WDTC. RESULTS Thirteen patients with recurrent WDTC were operated upon with radioguided surgical (RGS) technique to indentify recurrence for excision. Eight patients had iodine avid disease and were candidates for RGS with (131)I. The remaining 5 patients had cancer with a proven loss of iodine avidity and were, therefore, operated upon with a fluorodeoxygluocose (FDG) RGS technique. CONCLUSION RGS is a feasible approach to identify recurrent disease in an operated field and ensure its successful excision. Although focal disease may be identified with this technique, this is not a tool for limited excisions ("berry picking").
Collapse
Affiliation(s)
- Carrie L Francis
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | | | | | | | | |
Collapse
|
16
|
Youn H, Jeong JM, Chung JK. A new PET probe, (18)F-tetrafluoroborate, for the sodium/iodide symporter: possible impacts on nuclear medicine. Eur J Nucl Med Mol Imaging 2010; 37:2105-7. [PMID: 20821208 DOI: 10.1007/s00259-010-1601-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Accepted: 08/11/2010] [Indexed: 11/28/2022]
|
17
|
Wang W, Wang H, Teng X, Wang H, Mao C, Teng R, Zhao W, Cao J, Fahey TJ, Teng L. Clonal analysis of bilateral, recurrent, and metastatic papillary thyroid carcinomas. Hum Pathol 2010; 41:1299-309. [DOI: 10.1016/j.humpath.2010.02.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Revised: 02/09/2010] [Accepted: 02/25/2010] [Indexed: 10/19/2022]
|
18
|
Chung JK, Youn HW, Kang JH, Lee HY, Kang KW. Sodium iodide symporter and the radioiodine treatment of thyroid carcinoma. Nucl Med Mol Imaging 2010; 44:4-14. [PMID: 24899932 PMCID: PMC4042960 DOI: 10.1007/s13139-009-0016-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 12/09/2009] [Indexed: 11/29/2022] Open
Abstract
Since the specific accumulation of iodide in thyroid was found in 1915, radioiodine has been widely applied to diagnose and treat thyroid cancer. Iodide uptake occurs across the membrane of the thyroid follicular cells and cancer cells through an active transporter process mediated by the sodium iodide symporter (NIS). The NIS coding genes were cloned and identified from rat and human in 1996. Evaluation of the NIS gene and protein expression is critical in the management of thyroid cancer, and several approaches have been tried to increase NIS levels. Identification of the NIS gene has provided a means of expanding its role in the radionuclide gene therapy of nonthyroidal cancers as well as thyroid cancer. In this article, we explain the relationship between NIS expression and the treatment of thyroid carcinoma with I-131, and we include a review of the results of our experimental and clinical trials.
Collapse
Affiliation(s)
- June-Key Chung
- />Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Jongro-gu, Seoul, 110-744 Korea
- />Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- />Tumor Immunity Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
- />Research Center of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hye Won Youn
- />Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Jongro-gu, Seoul, 110-744 Korea
- />Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- />Tumor Immunity Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
- />Research Center of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Joo Hyun Kang
- />Molecular Imaging Research Center, KIRAMS, Seoul, Korea
| | - Ho Young Lee
- />Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Jongro-gu, Seoul, 110-744 Korea
- />Research Center of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Keon Wook Kang
- />Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Jongro-gu, Seoul, 110-744 Korea
- />Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- />Tumor Immunity Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
- />Research Center of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
19
|
Kim JY, Jung EJ, Jeong SH, Jeong CY, Ju YT, Lee YJ, Hong SC, Choi SK, Ha WS, Park ST. Clinical Characteristics and Prognosis of Multifocal Papillary Thyroid Carcinoma. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2010. [DOI: 10.4174/jkss.2010.79.6.442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Eun-Jung Jung
- Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Sang-Ho Jeong
- Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young-Joon Lee
- Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Soon-Chan Hong
- Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Sang-Kyung Choi
- Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Woo-Song Ha
- Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Soon-Tae Park
- Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| |
Collapse
|
20
|
Maizlin ZV, Wiseman SM, Vora P, Kirby JM, Mason AC, Filipenko D, Brown JA. Hurthle cell neoplasms of the thyroid: sonographic appearance and histologic characteristics. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2008; 27:751-759. [PMID: 18424651 DOI: 10.7863/jum.2008.27.5.751] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The purpose of this study was to determine the sonographic features of Hürthle cell neoplasms (HCNs) of the thyroid. METHODS We retrospectively analyzed the sonographic appearance of 15 histologically proven HCNs in 15 patients aged 16 to 70 years (mean age, 44 years). Sonographic features that were reviewed included the size and echogenicity of the tumors, the presence of cystic areas or calcifications, and detectable blood flow on color Doppler imaging. Correlation of sonographic findings with pathologic results was performed. RESULTS The tumors ranged from 0.4 to 7 cm in diameter, but most were less than 3 cm in diameter. Four (27%) of the 15 tumors were homogeneously hypoechoic. Two tumors (13%) were predominantly hypoechoic with isoechoic areas to thyroid parenchyma. Two (13%) neoplasms were isoechoic to thyroid parenchyma. Four (27%) tumors were predominantly isoechoic, containing hypoechoic areas, and 3 (20%) tumors were hyperechoic. Three neoplasms contained cystic components. None of the tumors contained calcifications. One tumor was avascular on Doppler examination. One neoplasm showed only peripheral blood flow. Thirteen tumors showed internal vascularity, 7 of them with peripheral blood flow. Twelve HCNs were benign, and 3 were malignant on pathologic examination. CONCLUSIONS Hürthle cell neoplasms show a spectrum of sonographic appearances from predominantly hypoechoic to hyperechoic lesions and from peripheral blood flow with no internal flow to extensively vascularized lesions. Pathologic criteria differentiating benign and malignant HCNs (absence or presence of a capsular breach, vascular or extrathyroidal tissue invasion, nodal involvement, and distant metastasis) are beyond the resolution of sonography and fine-needle aspiration biopsy and require removal of the entire lesion. This precludes diagnosis and characterization of HCNs by sonography.
Collapse
Affiliation(s)
- Zeev V Maizlin
- Department of Radiology, McMaster University Medical Center, Hamilton ON L8N 3Z5, Canada.
| | | | | | | | | | | | | |
Collapse
|
21
|
Titus S, Neumann S, Zheng W, Southall N, Michael S, Klumpp C, Yasgar A, Shinn P, Thomas CJ, Inglese J, Gershengorn MC, Austin CP. Quantitative high-throughput screening using a live-cell cAMP assay identifies small-molecule agonists of the TSH receptor. ACTA ACUST UNITED AC 2008; 13:120-7. [PMID: 18216391 DOI: 10.1177/1087057107313786] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The thyroid-stimulating hormone (TSH; thyrotropin) receptor belongs to the glycoprotein hormone receptor subfamily of 7-transmembrane spanning receptors. TSH receptor (TSHR) is expressed mainly in thyroid follicular cells and is activated by TSH, which regulates the growth and function of thyroid follicular cells. Recombinant TSH is used in diagnostic screens for thyroid cancer, especially in patients after thyroid cancer surgery. Currently, no selective small-molecule agonists of the TSHR are available. To screen for novel TSHR agonists, the authors miniaturized a commercially available cell-based cyclic adenosine 3',5' monophosphate (cAMP) assay into a 1536-well plate format. This assay uses an HEK293 cell line stably transfected with the TSHR coupled to a cyclic nucleotide gated ion channel as a biosensor. From a quantitative high-throughput screen of 73,180 compounds in parallel with a parental cell line (without the TSHR), 276 primary active compounds were identified. The activities of the selected active compounds were further confirmed in an orthogonal homogeneous time-resolved fluorescence cAMP-based assay. Forty-nine compounds in several structural classes have been confirmed as the small-molecule TSHR agonists that will serve as a starting point for chemical optimization and studies of thyroid physiology in health and disease.
Collapse
Affiliation(s)
- Steve Titus
- National Institutes of Health Chemical Genomics Center, National Human Genome Research Institute, NIH, Bethesda, MD 20892-3370, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Die Schilddrüse nach Stammzelltransplantation im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2007. [DOI: 10.1007/s00112-005-1250-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
23
|
Tien HC, Tremblay LN, Rizoli SB, Gelberg J, Spencer F, Caldwell C, Brenneman FD. Radiation Exposure From Diagnostic Imaging in Severely Injured Trauma Patients. ACTA ACUST UNITED AC 2007; 62:151-6. [PMID: 17215747 DOI: 10.1097/ta.0b013e31802d9700] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Trauma patients often require multiple imaging tests, including computed tomography (CT) scans. CT scanning, however, is associated with high-radiation doses. The purpose of this study was to measure the radiation doses trauma patients receive from diagnostic imaging. METHODS A prospective cohort study was conducted from June 1, 2004 to March 31, 2005 at a Level I trauma center in Toronto, Canada. All trauma patients who arrived directly from the scene of injury and who survived to discharge were included. Three dosimeters were placed on each patient (neck, chest, and groin) before radiologic examination. Dosimeters were removed before discharge. Surface doses in millisieverts (mSv) at the neck, chest, and groin were measured. Total effective dose, thyroid, breast, and red bone marrow organ doses were then calculated. RESULTS Trauma patients received a mean effective dose of 22.7 mSv. The standard "linear no threshold" (LNT) model used to extrapolate from effects observed at higher dose levels suggests that this would result in approximately 190 additional cancer deaths in a population of 100,000 individuals so exposed. In addition, the thyroid received a mean dose of 58.5 mSv. Therefore, 4.4 additional fatal thyroid cancers would be expected per 100,000 persons. In all, 22% of all patients had a thyroid dose of over 100 mSv (mean, 156.3 mSv), meaning 11.7 additional fatal thyroid cancers per 100,000 persons would result in this subgroup. CONCLUSION Trauma patients are exposed to significant radiation doses from diagnostic imaging, resulting in a small but measurable excess cancer risk. This small individual risk may become a greater public health issue as more CT examinations are performed. Unnecessary CT scans should be avoided.
Collapse
Affiliation(s)
- Homer C Tien
- Trauma Program and the Departments of Surgery Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
| | | | | | | | | | | | | |
Collapse
|
24
|
Szporn AH, Yuan S, Wu M, Burstein DE. Cellular swirls in fine needle aspirates of papillary thyroid carcinoma: a new diagnostic criterion. Mod Pathol 2006; 19:1470-3. [PMID: 16951672 DOI: 10.1038/modpathol.3800669] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
No single cytologic feature is specifically diagnostic for papillary thyroid carcinoma. We report herein the presence of swirl-like cellular aggregates in fine needle aspirates of papillary thyroid carcinoma but not in other thyroid entities. Cellular swirls are defined as concentrically organized aggregates of tumor cells in which many of the most peripherally situated cells have ovoid rather than round nuclei that are oriented perpendicular to the radius of the swirl. One hundred Papanicolaou- and/or Diff-Quik-stained FNAs of the thyroid diagnosed as papillary carcinoma, including seven fine needle aspirates of cervical lymph nodes showing metastatic papillary carcinoma, with or without cell blocks, were reviewed for the presence of cellular swirls. An additional 100 thyroid FNAs, similarly stained and prepared, diagnosed as nodular goiter, Hashimoto's thyroiditis and follicular neoplasm were also reviewed for the presence of cellular swirls. Cellular swirls were easily observed at screening magnification and confirmed at high magnification. Seventeen of 100 FNAs (17%) of papillary carcinoma contained cellular swirls. No cases diagnosed as nodular goiter, Hashimoto's thyroiditis or follicular neoplasm contained these structures. Thirteen cases with swirls had histologic follow-up. These comprised seven papillary carcinomas with classical histopathology, two designated 'differentiated papillary carcinoma,' two with follicular variant histopathology; one with a minor component of follicular variant histopathology; one papillary carcinoma metastatic to a cervical lymph node with classic histopathology. Swirls occurred in cases with relatively little pleomorphism, or in well-differentiated regions of papillary carcinoma that also displayed less well-differentiated components. Cellular swirls are a finding that is highly specific to papillary thyroid carcinoma. They are easily seen at screening magnification. Their presence in a FNA specimen may be helpful in cases where classic criteria for papillary thyroid carcinoma are scarce, particularly in well-differentiated papillary thyroid carcinoma. While the size and scope of this study are insufficient to conclude that cellular swirls alone are diagnostic of papillary thyroid carcinoma in the absence of other criteria, we believe these structures should be added to the list of diagnostic criteria.
Collapse
Affiliation(s)
- Arnold H Szporn
- Division of Cytopathology, Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA
| | | | | | | |
Collapse
|
25
|
McCarthy RP, Wang M, Jones TD, Strate RW, Cheng L. Molecular Evidence for the Same Clonal Origin of Multifocal Papillary Thyroid Carcinomas. Clin Cancer Res 2006; 12:2414-8. [PMID: 16638846 DOI: 10.1158/1078-0432.ccr-05-2818] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Patients with papillary thyroid carcinoma often have two or more distinct papillary tumors at thyroidectomy. Whether these multifocal papillary lesions are clonally related or whether they arise independently is unknown as previous studies have shown conflicting results. Molecular analysis of microsatellite alterations and X-chromosome inactivation status in separate tumors from the same patient can be used to define the genetic relationships among the multiple coexisting tumors. EXPERIMENTAL DESIGN We examined 64 separate tumors from 22 female patients who underwent thyroidectomy for thyroid carcinoma. All patients had multiple and separate papillary carcinomas (range, two to six). Genomic DNA samples were prepared from formalin-fixed, paraffin-embedded tissue sections using laser-capture microdissection. Loss of heterozygosity assays for three microsatellite polymorphic markers for putative tumor suppressor genes on chromosomes 3p25 (D3S1597), 9p21 (D9S161), and 18p11.22-p11 (D18S53) were done. In addition, X-chromosome inactivation analysis was done on the tumors from all patients. RESULTS Twenty of 22 (91%) cases showed allelic loss in one or more of the papillary lesions in at least one of the three polymorphic markers analyzed. Concordant allelic loss patterns between coexisting papillary tumors were seen in 20 of 23 (87%) cases. A concordant pattern of nonrandom X-chromosome inactivation in the multiple coexisting papillary lesions was seen in all informative cases. CONCLUSION Our data suggest that the multifocal tumors in patients with papillary thyroid carcinoma often arise from the same clone. Thus, intrathryoid metastasis may play an important role in the spread of papillary thyroid carcinoma, a finding that has important therapeutic, diagnostic, and prognostic implications.
Collapse
Affiliation(s)
- Ryan P McCarthy
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | | | | | | |
Collapse
|
26
|
Pu RT, Yang J, Wasserman PG, Bhuiya T, Griffith KA, Michael CW. Does Hurthle cell lesion/neoplasm predict malignancy more than follicular lesion/neoplasm on thyroid fine-needle aspiration? Diagn Cytopathol 2006; 34:330-4. [PMID: 16604553 DOI: 10.1002/dc.20440] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Thyroid fine-needle aspiration (FNA) is a standard procedure for the clinical triage of thyroid nodules. The diagnosis of an adequately sampled thyroid FNA is generally grouped into three categories: benign, malignant, and indeterminate. The latter group usually includes follicular neoplasm, follicular lesion, and sometimes a more specific diagnosis such as Hurthle cell neoplasm or follicular lesion/neoplasm with Hurthle cell change. Whether a FNA diagnosis of Hurthle cell lesion/neoplasm (HLN) denotes a worse clinical outcome than follicular lesion/neoplasm (FLN) remains controversial. A cohort of 303 thyroid FNA cases with follow-up thyroidectomy in our institutes was identified, with the follow-up excision diagnosis compared to the FNA diagnosis in order to address this issue. Of this cohort, 87 cases had an FNA diagnosis of HLN while 216 cases had a diagnosis of FLN. Upon excision, the FNA diagnosis of HLN group had 14 cases of goiter/nodular hyperplasia (16%), 46 cases of adenoma (12 follicular adenoma (14%) and 34 cases of Hurthle cell adenoma (39%)), and 27 cases of carcinoma (31%, 12 papillary carcinoma and 15 Hurthle cell carcinoma). The FLN group had 74 cases of goiter/nodular hyperplasia (34.3%), 8 cases of Hashimoto thyroiditis (3.7%), 73 cases of follicular adenoma (33.8%), one case of granular cell tumor, and 60 cases of carcinoma (27.8%, 46 papillary carcinoma, 12 follicular carcinoma, and 1 Hurthle cell carcinoma and 1 parathyroid carcinoma) upon excision. There is no significant difference in predicting cancer between the two cytology diagnosis groups (HLN versus FLN, 31% versus 27.8%, P = 0.5771). When sorting all the cases by the surgical diagnosis, while comparable for age at diagnosis, the cancer group having the higher proportion of male patients than the non-cancer group (28.7% versus 16.7%, P = 0.0259). Hurthle cell carcinoma patients are typically older than patients with other cancer diagnoses (59 versus 44, P = 0.0077). Our results suggest that an FNA diagnosis of HLN does not predict more malignancy than FLN. Males and older patients with a HLN FNA diagnosis carry a higher risk of Hurthle cell carcinoma upon thyroidectomy.
Collapse
MESH Headings
- Adenocarcinoma, Follicular/pathology
- Adenocarcinoma, Follicular/surgery
- Adenocarcinoma, Papillary/pathology
- Adenocarcinoma, Papillary/surgery
- Adenoma/pathology
- Adenoma/surgery
- Adenoma, Oxyphilic/pathology
- Adenoma, Oxyphilic/surgery
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biopsy, Fine-Needle/methods
- Cohort Studies
- Female
- Goiter, Nodular/pathology
- Goiter, Nodular/surgery
- Humans
- Hyperplasia/pathology
- Hyperplasia/surgery
- Male
- Middle Aged
- Oxyphil Cells/pathology
- Prognosis
- Thyroid Neoplasms/pathology
- Thyroid Neoplasms/surgery
- Thyroid Nodule/pathology
- Thyroid Nodule/surgery
- Thyroidectomy
Collapse
Affiliation(s)
- Robert T Pu
- Department of Pathology, Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan, USA.
| | | | | | | | | | | |
Collapse
|