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Iacobas DA, Iacobas S. Papillary Thyroid Cancer Remodels the Genetic Information Processing Pathways. Genes (Basel) 2024; 15:621. [PMID: 38790250 PMCID: PMC11120757 DOI: 10.3390/genes15050621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
The genetic causes of the differentiated, highly treatable, and mostly non-fatal papillary thyroid cancer (PTC) are not yet fully understood. The mostly accepted PTC etiology blames the altered sequence or/and expression level of certain biomarker genes. However, tumor heterogeneity and the patient's unique set of favoring factors question the fit-for-all gene biomarkers. Publicly accessible gene expression profiles of the cancer nodule and the surrounding normal tissue from a surgically removed PTC tumor were re-analyzed to determine the cancer-induced alterations of the genomic fabrics responsible for major functional pathways. Tumor data were compared with those of standard papillary and anaplastic thyroid cancer cell lines. We found that PTC regulated numerous genes associated with DNA replication, repair, and transcription. Results further indicated that changes of the gene networking in functional pathways and the homeostatic control of transcript abundances also had major contributions to the PTC phenotype occurrence. The purpose to proliferate and invade the entire gland may explain the substantial transcriptomic differences we detected between the cells of the cancer nodule and those spread in homo-cellular cultures (where they need only to survive). In conclusion, the PTC etiology should include the complex molecular mechanisms involved in the remodeling of the genetic information processing pathways.
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Affiliation(s)
- Dumitru Andrei Iacobas
- Personalized Genomics Laboratory, Undergraduate Medical Academy, Prairie View A&M University, Prairie View, TX 77446, USA
| | - Sanda Iacobas
- Department of Pathology, New York Medical College, Valhalla, NY 10595, USA;
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Chen X, Zhong Z, Song M, Yuan J, Huang Z, Du J, Liu Y, Wu Z. Predictive factors of contralateral occult carcinoma in patients with papillary thyroid carcinoma: a retrospective study. Gland Surg 2020; 9:872-878. [PMID: 32953595 PMCID: PMC7475348 DOI: 10.21037/gs-19-157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 06/12/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The surgical approach toward unilateral papillary thyroid carcinoma (PTC) has been in controversy. One of the concerns is the existence of contralateral occult carcinoma, which could cause relapse and even lead to re-operation if not dealt with. This study aims to find out risk factors related to contralateral occult PTC, in order to facilitate in surgical approach decision for PTC. METHODS A total of 921 PTC patients who underwent total/near-total thyroidectomy and central lymph node dissection (CND) with/without lateral lymph node dissection (LND) from January 2014 to Sept 2017 in Guangdong General Hospital were assessed retrospectively. The relations between contralateral occult PTC and clinicopathologic characteristics of PTC were analyzed by univariate and multivariate logistic regression. RESULTS The incidence of contralateral occult carcinoma in patients with PTC was 16.7% (154 of 921 cases). Univariate analysis showed that multifocality of the primary carcinoma (P=0.000), lymph node metastasis (P=0.001), pathologic tumor size (P=0.014) and contralateral benign nodule (P=0.000) were significantly associated with the increased incidence of contralateral occult PTC. No significant correlations were found between contralateral carcinoma and other variables such as gender (P=0.338), age (P=0.283), BRAF mutation (P=0.187) or extrathyroidal extension (P=0.423). Multivariate logistic regression analysis revealed that contralateral benign nodule (P=0.000), multifocality (P=0.000) and lymph node metastasis (P=0.009) were independent predictors of bilateral PTC of patients whose pre-operation ultrasound (US) show a unilateral carcinoma. CONCLUSIONS Lymph node metastasis, contralateral benign nodule and multifocality are independent predictors of contralateral occult PTC. For unilateral PTC patients with one or more of these factors, total/near-total thyroidectomy should be considered when making surgical approach decisions.
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Affiliation(s)
- Xiaohang Chen
- Department of General Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Zhenwei Zhong
- Department of General Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Muye Song
- Department of General Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- South China University of Technology, Guangzhou, China
| | - Jiru Yuan
- Department of General Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Ziyang Huang
- Department of General Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Jialin Du
- Department of General Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yongchen Liu
- Department of General Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zeyu Wu
- Department of General Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Clinicopathological Significance of Overall Frequency of Allelic Loss (OFAL) in Lesions Derived from Thyroid Follicular Cell. Mol Diagn Ther 2020; 23:369-382. [PMID: 30747408 PMCID: PMC6548761 DOI: 10.1007/s40291-019-00387-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Loss of heterozygosity (LOH) and microsatellite instability (MSI) are frequent molecular events in thyroid tumor etiopathogenesis occurring in several chromosomal critical areas, including 3p12–25.3, 7q21–31, 10q22–24, and 15q11–13, with loci of tumor suppressor genes. Objective We evaluated the usefulness of LOH/MSI as a diagnostic/prognostic biomarker in lesions derived from thyroid follicular cells: follicular thyroid carcinoma (FTC); follicular adenoma (FA), papillary thyroid carcinoma (PTC), and nodular goiter (NG). Methods We performed allelotyping (GeneMapper Software v. 4.0.) of ten microsatellite markers linked to the 1p31.2, 3p21.3, 3p24.2, 9p21.3, 11p15.5, and 16q22.1 region on DNA from 93 primary thyroid lesions then evaluated the LOH/MSI frequency and overall frequency of allelic loss (OFAL). Results We found regions with significantly increased frequency of LOH/MSI for specific histotypes: the 3p24.2 region for FA and 1p31.2 for FTC. LOH/MSI in 3p21.3 was significantly elevated in PTC and FTC. LOH/MSI in 3p21.3 was increased for small size tumors (T1a + T1b), tumors with no regional lymph node involvement (N0 + Nx), American Joint Committee on Cancer (AJCC) stage I tumors, and tumor diameter (Td) < 10 mm; in 1p31.2 for T2–3, N1, stage II–IV, and Td 10–30 mm; in 11p15.5 for T2–3, N1, stage II–IV, and Td > 30 mm. OFAL values were significantly higher in younger patients (< 40 years), in men, in those with T2–3 stage tumors, in those with increased Td, and in FA and FTC compared with NG and PTC. Conclusions We confirmed the occurrence of LOH/MSI in 3p21.3 at an early stage of tumorigenesis and mapped 1p31.2 and 11p15.5 as characteristic for advanced-stage tumors. The results of our study may enable consideration of OFAL, defined as LOH/MSI coincidence in various chromosomal regions, as a tumor progression marker. OFAL values were significantly higher in follicular neoplasms (FA and FTC) than in PTC or NG; hence, increased OFAL values can be regarded as a characteristic feature of the follicular phenotype.
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Naringin inhibits thyroid cancer cell proliferation and induces cell apoptosis through repressing PI3K/AKT pathway. Pathol Res Pract 2019; 215:152707. [DOI: 10.1016/j.prp.2019.152707] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/12/2019] [Accepted: 10/19/2019] [Indexed: 01/08/2023]
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Zhao L, Zhang X, Cui S. Matrine inhibits TPC-1 human thyroid cancer cells via the miR-21/PTEN/Akt pathway. Oncol Lett 2018; 16:2965-2970. [PMID: 30127885 PMCID: PMC6096072 DOI: 10.3892/ol.2018.9006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/31/2018] [Indexed: 12/21/2022] Open
Abstract
Papillary thyroid cancer (PTC) is the primary type of thyroid cancer and the most widespread endocrine malignancy. Matrine is a traditional Chinese medicine and has been demonstrated as a promising alternative drug for the treatment of TPC-1 human PTC. In the present study, the therapeutic effects and the underlying molecular mechanisms of matrine on TPC-1 cells were investigated. Treatment with matrine at the concentrations of 1, 2, 5, 10 and 20 mg/ml inhibited TPC-1 cell proliferation by up to 95.8% (for 20 mg/ml matrine). Flow cytometry indicated that treatment with 10 mg/ml matrine induced up to 61.8% apoptosis of the TPC-1 cells and the cell cycle was arrested at the G0/G1 phase following treatment with matrine (2, 5 and 10 mg/ml) for 48 h. Quantitative polymerase chain reaction indicated that the expression of microRNA (miR)-21 was downregulated and phosphatase and tensin homolog (PTEN) mRNA levels increased up to 1.66-fold following treatment with matrine, and RAC-α serine/threonine-protein kinase (Akt) mRNA levels were downregulated 0.34-fold following treatment with 5 mg/ml matrine, compared with the normal control group. Western blot analysis indicated that matrine at 2 and 5 mg/ml increased levels of the miR-21 target PTEN and decreased the levels of phosphorylated (p)Akt. Furthermore, miR-21 mimic transfection decreased the expression levels of PTEN and increased the levels of pAkt. These results suggested that the miR-21/PTEN/Akt pathway may be one of the mechanisms by which matrine induces apoptosis and cell cycle arrest in TPC-1 thyroid cancer cells. Matrine is an alternative potential drug for the treatment of thyroid cancer.
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Affiliation(s)
- Lina Zhao
- Department of Thyroid Surgery, Jilin University China-Japan Union Hospital, Changchun, Jilin 130033, P.R. China
| | - Xianyu Zhang
- Department of Hand Surgery, Jilin University China-Japan Union Hospital, Changchun, Jilin 130033, P.R. China
| | - Shusen Cui
- Department of Hand Surgery, Jilin University China-Japan Union Hospital, Changchun, Jilin 130033, P.R. China
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Cancer molecular markers: A guide to cancer detection and management. Semin Cancer Biol 2018; 52:39-55. [PMID: 29428478 DOI: 10.1016/j.semcancer.2018.02.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 11/04/2017] [Accepted: 02/05/2018] [Indexed: 02/07/2023]
Abstract
Cancer is generally caused by the molecular alterations which lead to specific mutations. Advances in molecular biology have provided an impetus to the study of cancers with valuable prognostic and predictive significance. Over the hindsight various attempts have been undertaken by scientists worldwide, in the management of cancer; where, we have witnessed a number of molecular markers which allow the early detection of cancers and lead to a decrease in its mortality rate. Recent advances in oncology have led to the discovery of cancer markers that has allowed early detection and targeted therapy of tumors. In this context, current review provides a detail outlook on various molecular markers for diagnosis, prognosis and management of therapeutic response in cancer patients.
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Perdas E, Stawski R, Nowak D, Zubrzycka M. The Role of miRNA in Papillary Thyroid Cancer in the Context of miRNA Let-7 Family. Int J Mol Sci 2016; 17:ijms17060909. [PMID: 27314338 PMCID: PMC4926443 DOI: 10.3390/ijms17060909] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 05/22/2016] [Accepted: 06/03/2016] [Indexed: 12/29/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy. RET/PTC rearrangement is the most common genetic modification identified in this category of cancer, increasing proliferation and dedifferentiation by the activation of the RET/PTC-RAS-BRAF-MAPK-ERK signaling pathway. Recently, let-7 miRNA was found to reduce RAS levels, acting as a tumor suppressor gene. Circulating miRNA profiles of the let-7 family may be used as novel noninvasive diagnostic, prognostic, treatment and surveillance markers for PTC.
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Affiliation(s)
- Ewelina Perdas
- Department of Experimental Physiology, Chair of Experimental and Clinical Physiology, Medical University of Lodz, Lodz 92-215, Poland.
| | - Robert Stawski
- Department of Clinical Physiology, Medical University of Lodz, Lodz 92-215, Poland.
| | - Dariusz Nowak
- Department of Clinical Physiology, Medical University of Lodz, Lodz 92-215, Poland.
| | - Maria Zubrzycka
- Department of Experimental Physiology, Chair of Experimental and Clinical Physiology, Medical University of Lodz, Lodz 92-215, Poland.
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Zhou H, Mody DR, Smith D, Lloyd MB, Kemppainen J, Houghton J, Wylie D, Szafranska-Schwarzbach AE, Takei H. FNA needle rinses preserved in Cytolyt are acceptable specimen type for mutation testing of thyroid nodules. J Am Soc Cytopathol 2015; 4:128-135. [PMID: 31051693 DOI: 10.1016/j.jasc.2015.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 01/03/2015] [Accepted: 01/05/2015] [Indexed: 06/09/2023]
Abstract
INTRODUCTION This study investigated the application of molecular testing to residual thyroid fine-needle aspiration material from needle rinses collected in Cytolyt. MATERIALS AND METHODS Two thyroid needle rinses from 135 patients were collected in Cytolyt during routine diagnostic workup in our institution. Molecular testing was performed to detect 14 genetic alterations in BRAF, K-, H-, N-RAS genes as well as RET/PTC1, RET/PTC3, and PAX8/PPARγ and verified by next generation sequencing and correlated with cytologic diagnoses. RESULTS Molecular testing revealed a total of 17 mutations across specimens with benign nodule (n = 5; HRAS, NRAS), Hürthle cell neoplasm (n = 2; BRAF, HRAS) and Papillary thyroid carcinoma (n = 10, 9 BRAF, 1 KRAS) cytology. No RNA gene rearrangements were detected. CONCLUSIONS Mutations and translocations associated with thyroid cancer can be detected in thyroid fine-needle aspiration needle rinses preserved in Cytolyt specimens collected during routine patient management, which are typically discarded when a diagnosis is attained.
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Affiliation(s)
- Haijun Zhou
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas
| | - Dina R Mody
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Debora Smith
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas
| | - Maura B Lloyd
- Asuragen Clinical Services Laboratory, Austin, Texas
| | | | | | - Dennis Wylie
- Asuragen Clinical Services Laboratory, Austin, Texas
| | | | - Hidehiro Takei
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York.
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Krajewska J, Handkiewicz-Junak D, Jarzab B. Sorafenib for the treatment of thyroid cancer: an updated review. Expert Opin Pharmacother 2015; 16:573-83. [PMID: 25605317 DOI: 10.1517/14656566.2015.1005601] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Sorafenib (Nexavar) is an oral multi-kinase inhibitor targeting B-type Raf kinase (BRAF) (both wild type and BRAF(V600E)), VEGFR1, VEGFR2, VEGFR3, PDGFRβ and RET (also RET/PTC) influencing both differentiated thyroid cancer (DTC) cell proliferation and angiogenesis. AREAS COVERED Encouraging results achieved in numerous Phase II trials were confirmed in a Phase III study conducted in radioiodine-refractory DTC. Sorafenib compared to placebo significantly prolongs progression-free survival, 10.8 versus 5.8 months, respectively. However, its administration resulted mainly in disease stabilization. No complete remission was obtained in any study. Beneficial effects were also demonstrated for medullary and anaplastic thyroid cancer; however further studies fulfilling evidence based medicine criteria are necessary. Its toxicity profile is convergent with other VEGFR inhibitors. The most common treatment-related side-effects involve skin toxicity (predominantly hand-foot skin reaction, different rashes and alopecia), gastrointestinal disturbances (diarrhea, abdominal pain), constitutional adverse reactions (anorexia, weight loss, fatigue) and hypertension. Although most adverse reactions are manageable, > 50% of patients required dose reduction. EXPERT OPINION Sorafenib constitutes the first line treatment option in advanced, radioiodine-refractory DTC. However, there are still no data on its efficacy in patients progressed after another tyrosine kinase inhibitor. Other applications of the drug, such as use as adjuvant therapy to 131-I treatment, requires further studies.
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Affiliation(s)
- Jolanta Krajewska
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Nuclear Medicine and Endocrine Oncology Department, Gliwice Branch , Gliwice , Poland + 48 32 2789301 ; +48 32 2789310 ;
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Brehar AC, Brehar FM, Bulgar AC, Dumitrache C. Genetic and epigenetic alterations in differentiated thyroid carcinoma. J Med Life 2013; 6:403-8. [PMID: 24868250 PMCID: PMC4034295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 09/19/2013] [Indexed: 10/28/2022] Open
Abstract
Differentiated thyroid carcinoma (DTC) has a favorable prognosis, but it is important to identify those patients who have a high risk of progressive disease and DTC-related death at the time of diagnosis. Analyzing genetic and epigenetic alterations in thyroid cancer may play a role in tumor diagnosis, prognostic and therapeutic strategies.
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Affiliation(s)
- AC Brehar
- “C.I. Parhon” National Institute of Endocrinology, Bucharest
| | - FM Brehar
- “Bagdasar Arseni” Emergency Hospital, Bucharest,”Carol Davila” University of Medicine and Pharmacy, Bucharest
| | - AC Bulgar
- “C.I. Parhon” National Institute of Endocrinology, Bucharest
| | - C Dumitrache
- “C.I. Parhon” National Institute of Endocrinology, Bucharest,”Carol Davila” University of Medicine and Pharmacy, Bucharest
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Boufraqech M, Patel D, Xiong Y, Kebebew E. Diagnosis of thyroid cancer: state of art. ACTA ACUST UNITED AC 2013; 7:331-42. [PMID: 23701167 DOI: 10.1517/17530059.2013.800481] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Thyroid cancer is the most common endocrine cancer in the USA and its incidence is increasing worldwide. Thyroid fine-needle aspiration biopsy (FNA) and cytologic analysis is the most cost-effective approach to distinguish between malignant and benign thyroid nodules. However, up to 30% of thyroid FNA biopsy results are inconclusive. AREAS COVERED In this article, the authors provide an update on the current status and emerging approaches for improving thyroid cancer diagnosis. This review covers imaging, genetic and genomic approaches being used or in development to help distinguish between malignant and benign thyroid nodules. EXPERT OPINION There has been considerable progress in improving thyroid cancer diagnosis. The molecular markers analysis to avoid diagnostic surgeries seems to be promising. However, the clinical utility and accuracy of some markers reported in this review are not conclusive and need to be validated as clinical diagnostic tool.
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Affiliation(s)
- Myriem Boufraqech
- National Cancer Institute, National Institutes of Health, Endocrine Oncology Branch, 10 Center Drive, Bethesda, MD 20892, USA
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Lee YM, Lee JB. Prognostic value of epidermal growth factor receptor, p53 and galectin-3 expression in papillary thyroid carcinoma. J Int Med Res 2013; 41:825-34. [PMID: 23569038 DOI: 10.1177/0300060513477312] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine the protein expression and prognostic value of epidermal growth factor receptor (EGFR), p53 and galectin-3 in papillary thyroid carcinoma (PTC). METHODS A retrospective analysis was performed using tumour specimens from patients with PTC who underwent thyroidectomy between July 2007 and December 2008. The percentages of tumour cells staining positively for EGFR, galectin-3 and p53 were determined by immunohistochemistry. Associations between protein expression and age, sex, extrathyroidal extension and lymph node metastasis were assessed, together with the total Metastasis, Age, Completeness of resection, Invasion, Size (MACIS) score (a marker of prognosis). MACIS prognostic scores were categorized into four groups. RESULTS Data from 168 patients with PTC (mean follow-up, 35 months) were included. EGFR expression was significantly associated with male sex and lymph node metastasis; p53 expression was higher in males than in females; galectin-3 expression was not significantly associated with age, sex, extrathyroidal extension, lymph node metastasis or total MACIS score category, however. CONCLUSION Immunohistochemical evaluation of EGFR and p53 expression in patients with PTC may be useful for determining prognosis, in PTC patients.
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Affiliation(s)
- Yu Mi Lee
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Controversies in the management and followup of differentiated thyroid cancer: beyond the guidelines. J Thyroid Res 2012; 2012:512401. [PMID: 23326756 PMCID: PMC3544283 DOI: 10.1155/2012/512401] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 12/12/2012] [Indexed: 01/21/2023] Open
Abstract
Thyroid cancer is among the most common endocrine malignancies. Genetic and environmental factors play an important role in the pathogenesis of differentiated thyroid cancer. Both have good prognosis but with frequent recurrences. Cancer staging is an essential prognostic part of cancer management. There are multiple controversies in the management and followup of differentiated thyroid cancer. Debate still exists with regard to the optimal surgical approach but trends toward a more conservative approach, such as lobectomy, are being more favored, especially in papillary thyroid cancer, of tumor sizes less than 4 cm, in the absence of other high-risk suggestive features. Survival of patients with well-differentiated thyroid cancer was adversely affected by lymph node metastases. Prophylactic central LN dissection did improve accuracy in staging and decrease postop TG level, but it had no effect on small-sized tumors. Conservative approach was more applied with regard to the need and dose of radioiodine given postoperatively. There have been several advancements in the management of radioiodine resistant advanced differentiated thyroid cancers. Appropriate followup is required based on risk stratification of patients postoperatively. Many studies are still ongoing in order to reach the optimal management and followup of differentiated thyroid cancer.
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Durable effect of radioactive iodine in a patient with metastatic follicular thyroid carcinoma. Case Rep Endocrinol 2012; 2012:231912. [PMID: 23050172 PMCID: PMC3461623 DOI: 10.1155/2012/231912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 08/16/2012] [Indexed: 11/17/2022] Open
Abstract
Objective. Thyroid cancer is the most common endocrine malignancy and fastest increasing of all cancers in both men and women in the United States. Traditionally, differentiated thyroid cancer (DTC) carries a good prognosis when diagnosed early, but increasingly patients are presenting with late-stage disease and bone metastasis which carries a poor prognosis. Treatment of DTC involves surgical resection followed by radioactive iodine (RAI), which conventionally is thought to reach maximal effectiveness between 6 and 12 months following treatment. We report a case and review the literature surrounding long-term effect of radioactive iodine treatment in metastatic thyroid carcinoma. Methods. Patient clinical encounter and the literature review. Results. We describe a 49-year-old woman with symptomatic metastatic follicular thyroid cancer (FTC) to the spine and radiographic evidence of spinal cord compression who was effectively treated with RAI. Her initial serum thyroglobulin (Tg) levels following total thyroidectomy were 1,343 ng/mL which dramatically dropped to less than 100 ng/mL following RAI. Forty-three months following treatment with RAI, she has experienced complete resolution of her symptoms and continues to maintain persistently low-thyroglobulin levels of less than 100 ng/mL. Conclusions. RAI is believed to reach peak efficacy within 6-12 months; however, little has been reported regarding the long-term duration of benefit. This case demonstrates that the benefits of RAI therapy may be enduring, even in patients with widely metastatic thyroid cancer. It suggests in clinically stable patients with declining thyroglobulin after treatment, that there may not be an immediate need for additional therapy as RAI treatment may provide lasting effects.
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Ferraz C, Rehfeld C, Krogdahl A, Precht Jensen EM, Bösenberg E, Narz F, Hegedüs L, Paschke R, Eszlinger M. Detection of PAX8/PPARG and RET/PTC rearrangements is feasible in routine air-dried fine needle aspiration smears. Thyroid 2012; 22:1025-30. [PMID: 23025542 PMCID: PMC3462388 DOI: 10.1089/thy.2011.0391] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The diagnostic limitations of fine needle aspiration (FNA), like the indeterminate category, can be partially overcome by molecular analysis. As PAX8/PPARG and RET/PTC rearrangements have been detected in follicular thyroid carcinomas (FTCs) and papillary thyroid carcinomas (PTCs), their detection in FNA smears could improve the FNA diagnosis. To date, these rearrangements have never been analyzed in routine air-dried FNA smears, but only in frozen tissue, formalin-fixed paraffin-embedded (FFPE) tissue, and in fresh FNA material. Fixed routine air-dried FNA samples have hitherto been judged as generally not suitable for testing these rearrangements in a clinical setting. Therefore, the objective of the present study was to investigate the feasibility of extracting RNA from routine air-dried FNA smears for the detection of these rearrangements with real-time polymerase chain reaction (RT-PCR). METHODS A new method for RNA extraction from routine air-dried FNA smears was established, which allowed analysis for the presence of four variants of PAX8/PPARG and RET/PTC 1 and RET/PTC 3, which were analyzed in 106 routine FNA smears and the corresponding surgically obtained FFPE tissues using real-time quantitative PCR (RT-qPCR). To assess RNA quality, an intron-spanning PAX8 cDNA was amplified. RESULTS Acceptable RNA quality was obtained from 95% of the FNA samples and 92% of the FFPE samples. PAX8/PPARG was detected in 4 of 96 FFPEs and in 6 of 96 FNAs. PAX8/PPARG was present in 4 of 10 FTCs and in 3 of 42 follicular adenomas (FAs). Similarly, RET/PTC was found in 3 of 96 FFPEs and in 4 of 96 FNAs. Two of 21 PTC samples and 3 of 42 FA samples carried this rearrangement. CONCLUSION These data are the first to show the feasibility of extracting RNA from routine air-dried FNA smears for the detection of PAX8/PPARG and RET/PTC rearrangements with RT-qPCR. These promising methodological advances, if confirmed in larger series of FNA and FFPE samples, may lead to the introduction of molecular analysis of routine air-dried FNA smears in everyday practice.
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Affiliation(s)
- Carolina Ferraz
- Division of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
- Department of Internal Medicine III, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Christian Rehfeld
- Division of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - Annelise Krogdahl
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | | | - Eileen Bösenberg
- Division of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | | | - Laszlo Hegedüs
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
| | - Ralf Paschke
- Division of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - Markus Eszlinger
- Division of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
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17
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Ashouri E, Dabbaghmanesh MH, Rowhanirad S, Bakhshayeshkaram M, Ranjbar Omrani G, Ghaderi A. Activating KIR2DS5 receptor is a risk for thyroid cancer. Hum Immunol 2012; 73:1017-22. [DOI: 10.1016/j.humimm.2012.07.325] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 06/02/2012] [Accepted: 07/14/2012] [Indexed: 01/14/2023]
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18
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Al-Faisal AHM, Al-Ramahi IJ, Abudl-Hassan IA, Hamdan AT, Barusrux S. Detection of heterozygous c.1708C>T and c.1978C>G thyroid peroxidase (TPO) mutations in Iraqi patients with toxic and nontoxic goiter. ACTA ACUST UNITED AC 2012; 23:69-75. [PMID: 24482635 PMCID: PMC3890059 DOI: 10.1007/s00580-012-1572-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 07/18/2012] [Indexed: 11/18/2022]
Abstract
Sixty-three Arabic patients (16 males and 47 females) with thyroid toxic and nontoxic goiter who attended the endocrinologist in Nuclear Medicine Hospital and Al Yarmok Nuclear Medicine Department in Baghdad, Iraq were examined for thyroid peroxidase (TPO) gene mutations. A total of ten heterozygous mutations have been identified in the human TPO gene associated with thyroid toxic and nontoxic goiter. These mutations involved transition or transversion of cysteine either by thymine or guanine at the position 1708 of the exon 10 (c.1708C>T) and the position 1978 of the exon 11 (c.1978C>G). From a total of ten detected mutations, two c.1978C>G mutations were detected in nontoxic goiter patients and eight (two c.1708C>T and six c.1978C>G mutations) were detected in toxic goiter. In conclusion, this study identified ten TPO mutations associated with toxic and nontoxic goiter that have not been yet reported in Iraq, and most of them are detected among females (90 %) and adults age between 30 and 50 years old (80 %).
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Affiliation(s)
- A H M Al-Faisal
- Genetic Engineering and Biotechnology Institute (GEBI), Baghdad, Iraq
| | - I J Al-Ramahi
- Research and Development of Medical Diagnostic Laboratories (CMDL), Al-Razi Centre for Medical Diagnostic kits Production, Ministry of Industry, Baghdad, Iraq
| | - I A Abudl-Hassan
- Genetic Engineering and Biotechnology Institute (GEBI), Baghdad, Iraq
| | - A T Hamdan
- Medical College, University of Basrah, Basrah, Iraq
| | - S Barusrux
- Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002 Thailand
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19
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Affiliation(s)
- Jason A Wexler
- Washington Hospital Center, Georgetown University School of Medicine, Washington, DC 20010, USA.
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