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Ahn SH, Lee YJ, Hong S, Park JW, Jeon YJ, Yoo BN, Ha YC, Bak JK, Kim HY, Lee YK. Risk of Fractures in Thyroid Cancer Patients With Postoperative Hypoparathyroidism: A Nationwide Cohort Study in Korea. J Bone Miner Res 2023; 38:1268-1277. [PMID: 37338940 DOI: 10.1002/jbmr.4871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 06/03/2023] [Accepted: 06/16/2023] [Indexed: 06/21/2023]
Abstract
Postoperative hypoparathyroidism (PO-hypoPT) is an uncommon complication of total thyroidectomy in thyroid cancer patients. Although long-term hypoPT causes characteristic changes in bone metabolism, the risk of fractures in hypoPT remains inconclusive. We investigated the risk of fractures in Korean thyroid cancer patients with PO-hypoPT. This was a retrospective cohort study using data from the Korea Central Cancer Registry and Korean National Health Insurance Service. We analyzed 115,821 thyroid cancer patients aged ≥18 years, who underwent total thyroidectomy between 2008 and 2016. The risk of any fractures, including vertebral, hip, humerus, and wrist fractures, according to parathyroid function after total thyroidectomy, was analyzed using the multivariable Cox proportional hazard model. The PO-hypoPT and preserved parathyroid function groups included 8789 (7.6%) and 107,032 (92.4%) patients, respectively. Over a mean follow-up duration of 4.8 years, 159 (1.8%) and 2390 (2.2%) fractures occurred in the PO-hypoPT and preserved parathyroid function groups, respectively. The risk of any fractures was significantly lower in the PO-hypoPT group than in the preserved parathyroid function group (hazard ratio [HR] = 0.83; 95% confidence interval [CI] 0.70-0.98; p = 0.037) after adjusting for confounders. Regarding the fracture site, only the risk of vertebral fractures was significantly lower in the PO-hypoPT group compared with the preserved parathyroid function group (HR = 0.67; 95% CI 0.47-0.96; p = 0.028) after adjusting for confounders. Subgroup analyses showed that bone mineral density measurements and calcium supplementation interacted with the relationship between PO-hypoPT and the risk of any fractures (p for interactions = 0.010 and 0.017, respectively). PO-hypoPT was associated with a lower risk of fractures in thyroid cancer patients, especially at the vertebra. The relatively low bone turnover caused by PO-hypoPT and appropriate management for PO-hypoPT with active vitamin D and calcium may prevent the deterioration of skeletal health in thyroid cancer patients who can easily be exposed to long-term overtreatment with levothyroxine. © 2023 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Seong Hee Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - You Jin Lee
- Department of Internal Medicine, Center for Thyroid Cancer, National Cancer Center, Goyang, South Korea
| | - Seongbin Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Jung Wee Park
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Ye Jhin Jeon
- Department of Statistics, Yonsei University, Seoul, South Korea
| | - Bit-Na Yoo
- National Evidence-based Healthcare Collaboration Agency (NECA), Seoul, South Korea
| | - Yong-Chan Ha
- Department of Orthopedic Surgery, BUMIN Hospital, Seoul, South Korea
| | - Jean Kyung Bak
- National Evidence-based Healthcare Collaboration Agency (NECA), Seoul, South Korea
| | - Ha Young Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
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Shin DW, Suh B, Lim H, Yun JM, Song SO, Park Y. J-Shaped Association Between Postoperative Levothyroxine Dosage and Fracture Risk in Thyroid Cancer Patients: A Retrospective Cohort Study. J Bone Miner Res 2018; 33:1037-1043. [PMID: 29447437 DOI: 10.1002/jbmr.3407] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/11/2018] [Accepted: 02/08/2018] [Indexed: 11/10/2022]
Abstract
Long-term administration of supraphysiologic dosages of levothyroxine can have detrimental effect on the bone. We aimed to investigate fracture incidence among post-thyroidectomy thyroid cancer patients compared with a matched comparison group, and explore the association between levothyroxine dosage and fracture risk. From the Korean National Health Insurance database, virtually all thyroid cancer patients who received thyroidectomy in Korea from January 1, 2004 to December 31, 2012 were included. Matched subjects were selected by 1:1 propensity score matching. Cox proportional hazards regression analysis was used to determine relative risk of osteoporotic fracture. Of 185,956 thyroid cancer patients identified, fracture events were observed in 1096 subjects (0.56%) over a mean 4.35 years of follow-up. Compared to the matched comparison group, thyroid cancer patients had no elevated risk of osteoporotic fracture (hazard ratio [HR] 1.03; 95% confidence interval [CI], 0.94 to 1.12); however, the highest dosage group (≥170 μg/day) showed significantly higher risk (HR 1.25; 95% CI, 1.07 to 1.45), while the second quartile dosage group (115-144 μg/day) showed lower risk (HR 0.71; 95% CI, 0.59 to 0.84) compared to a matched comparison group. When the second quartile dosage group was considered as reference, increased fracture risk was observed in those who took either lower (first quartile: adjusted HR 1.31; 95% CI, 1.08 to 1.59) or higher dosage of levothyroxine (third quartile: adjusted HR 1.50; 95% CI, 1.26 to 1.79; fourth quartile: adjusted HR 1.79; 95% CI, 1.51 to 2.13). Thyroid cancer patients were more likely to be treated with osteoporosis medication (HR 1.22; 95% CI, 1.18 to 1.26) than the matched comparison group. Both high and low dosage of levothyroxine treatment was associated with a higher risk for fractures in a J-shaped dose-dependent manner in post-thyroidectomy patients. Future studies are needed to determine how to optimize thyroid-stimulating hormone (TSH) suppression and how to screen and manage fracture risk. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Dong Wook Shin
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Seoul, Republic of Korea
| | | | - Hyunsun Lim
- Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Jae Moon Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sun Ok Song
- Division of Endocrinology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Youngmin Park
- Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea
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Huang JK, Ma L, Song WH, Lu BY, Huang YB, Dong HM, Ma XK, Zhu ZZ, Zhou R. LncRNA-MALAT1 Promotes Angiogenesis of Thyroid Cancer by Modulating Tumor-Associated Macrophage FGF2 Protein Secretion. J Cell Biochem 2017; 118:4821-4830. [PMID: 28543663 DOI: 10.1002/jcb.26153] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 05/19/2017] [Indexed: 02/06/2023]
Abstract
Tumor-associated macrophages (TAMs) in the tumor microenvironment have been associated with enhanced tumor progression. In this study, we investigated the role and molecular mechanisms of MALAT1 in TAMs derived from thyroid cancer. The expression of MALAT1 and FGF2 in thyroid cancer tissues and cells were measured by quantitative real-time PCR and Western blot. TAMs were transfected with indicated constructs. Then the culture medium (CM) from TAMs was harvested for assay. Secreted FGF2 protein levels and TNF-α, IL-12, and IL-10 levels were detected by ELISA. The cell proliferation, migration, and invasion of FTC133 cells were determined with a CCK-8 assay and a Transwell assay, respectively. In addition, HUVEC vasculature formation was measured by matrigel angiogenesis assay. The higher levels of MALAT-1 and FGF2 were observed in thyroid cancer tissues and in thyroid cancer cells compared to that in the control. Besides, in the presence of si-MALAT1, the levels of TNF-α and IL-12 were significantly up-regulated whereas IL-10 was down-regulated in the CM from TAMs. Moreover, down-regulation of MALAT1 in TAMs reduced proliferation, migration, and invasion of FTC133 cells and inhibited angiogenesis. However, overexpression of FGF2 blocked the effects of MALAT1 siRNAs on cell migration, invasion, and angiogenesis. Our results suggest that MALAT1-mediated FGF2 protein secretion from TAMs inhibits inflammatory cytokines release, promotes proliferation, migration, and invasion of FTC133 cells and induces vasculature formation. J. Cell. Biochem. 118: 4821-4830, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Jian-Kang Huang
- Department of Oncological Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, P. R. China
| | - Ling Ma
- Department of Gynecologic Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, P. R. China
| | - Wen-Hua Song
- Department of Oncological Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, P. R. China
| | - Bang-Yu Lu
- Department of Minimally Invasive Surgery, The First Affiliated Hospital of Guangxi University, Nanning, 530021, P. R. China
| | - Yu-Bin Huang
- Department of Minimally Invasive Surgery, The First Affiliated Hospital of Guangxi University, Nanning, 530021, P. R. China
| | - Hui-Ming Dong
- Department of Oncological Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, P. R. China
| | - Xiao-Kai Ma
- Department of Oncological Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, P. R. China
| | - Zheng-Zhi Zhu
- Department of Oncological Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, P. R. China
| | - Rui Zhou
- Department of Oncological Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, P. R. China
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Lithwick-Yanai G, Dromi N, Shtabsky A, Morgenstern S, Strenov Y, Feinmesser M, Kravtsov V, Leon ME, Hajdúch M, Ali SZ, VandenBussche CJ, Zhang X, Leider-Trejo L, Zubkov A, Vorobyov S, Kushnir M, Goren Y, Tabak S, Kadosh E, Benjamin H, Schnitzer-Perlman T, Marmor H, Motin M, Lebanony D, Kredo-Russo S, Mitchell H, Noller M, Smith A, Dattner O, Ashkenazi K, Sanden M, Berlin KA, Bar D, Meiri E. Multicentre validation of a microRNA-based assay for diagnosing indeterminate thyroid nodules utilising fine needle aspirate smears. J Clin Pathol 2016; 70:500-507. [PMID: 27798083 PMCID: PMC5484037 DOI: 10.1136/jclinpath-2016-204089] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 12/20/2022]
Abstract
AIMS The distinction between benign and malignant thyroid nodules has important therapeutic implications. Our objective was to develop an assay that could classify indeterminate thyroid nodules as benign or suspicious, using routinely prepared fine needle aspirate (FNA) cytology smears. METHODS A training set of 375 FNA smears was used to develop the microRNA-based assay, which was validated using a blinded, multicentre, retrospective cohort of 201 smears. Final diagnosis of the validation samples was determined based on corresponding surgical specimens, reviewed by the contributing institute pathologist and two independent pathologists. Validation samples were from adult patients (≥18 years) with nodule size >0.5 cm, and a final diagnosis confirmed by at least one of the two blinded, independent pathologists. The developed assay, RosettaGX Reveal, differentiates benign from malignant thyroid nodules, using quantitative RT-PCR. RESULTS Test performance on the 189 samples that passed quality control: negative predictive value: 91% (95% CI 84% to 96%); sensitivity: 85% (CI 74% to 93%); specificity: 72% (CI 63% to 79%). Performance for cases in which all three reviewing pathologists were in agreement regarding the final diagnosis (n=150): negative predictive value: 99% (CI 94% to 100%); sensitivity: 98% (CI 87% to 100%); specificity: 78% (CI 69% to 85%). CONCLUSIONS A novel assay utilising microRNA expression in cytology smears was developed. The assay distinguishes benign from malignant thyroid nodules using a single FNA stained smear, and does not require fresh tissue or special collection and shipment conditions. This assay offers a valuable tool for the preoperative classification of thyroid samples with indeterminate cytology.
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Affiliation(s)
| | - Nir Dromi
- Rosetta Genomics Ltd, Rehovot, Israel
| | - Alexander Shtabsky
- Pathology Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.,The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Sara Morgenstern
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pathology Institute, Rabin Medical Center, Petach Tikva, Israel
| | - Yulia Strenov
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pathology Institute, Rabin Medical Center, Petach Tikva, Israel
| | - Meora Feinmesser
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pathology Institute, Rabin Medical Center, Petach Tikva, Israel
| | - Vladimir Kravtsov
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pathology Institute, Meir Medical Center, Kfar Saba, Israel
| | - Marino E Leon
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Marián Hajdúch
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Syed Z Ali
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Xinmin Zhang
- Temple University Hospital, Philadelphia, Pennsylvania, USA.,Cooper University Hospital, Cooper Medical School of Rowan University at Camden, New Jersey, USA
| | - Leonor Leider-Trejo
- Pathology Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.,The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Asia Zubkov
- Pathology Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Sergey Vorobyov
- National Centre of Clinical and Morphological Diagnostics, St Petersburg, Russia
| | | | - Yaron Goren
- Rosetta Genomics Ltd, Rehovot, Israel.,Geha Mental Health Center, Petach Tikva, Israel
| | | | | | - Hila Benjamin
- Rosetta Genomics Inc, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | | | | | - Alexis Smith
- Rosetta Genomics Inc, Philadelphia, Pennsylvania, USA
| | | | | | - Mats Sanden
- Rosetta Genomics Inc, Philadelphia, Pennsylvania, USA
| | | | | | - Eti Meiri
- Rosetta Genomics Ltd, Rehovot, Israel
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Schopper HK, Stence A, Ma D, Pagedar NA, Robinson RA. Single thyroid tumour showing multiple differentiated morphological patterns and intramorphological molecular genetic heterogeneity. J Clin Pathol 2016; 70:116-119. [PMID: 27387987 DOI: 10.1136/jclinpath-2016-203821] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 01/28/2023]
Abstract
AIMS A 49-year-old man presented with a single thyroid tumour that showed a combination of conventional papillary carcinoma, follicular variant of papillary carcinoma, clear cell papillary carcinoma, columnar cell carcinoma and poorly differentiated carcinoma. As all of the morphologies have been associated with papillary carcinoma in the literature, we wished to determine if they contained identical or different molecular abnormalities. METHODS Targeted next generation sequencing (NGS) of each morphological component and metastases was performed. RESULTS NGS revealed a BRAF p.K601E mutation in both the clear cell papillary carcinoma and poorly differentiated carcinoma and a KRAS p.G12R mutation in the papillary carcinoma, follicular variant. Two different areas of columnar cell variant were tested, with one showing a KRAS p.G12D mutation but no mutation in the other area. A KRAS p.G12R mutation was seen in the metastatic clear cell variant. Two different lymph nodes had metastatic columnar cell carcinoma, one negative for mutations but the other with a compound KRAS p.G12R and KRAS p.G12V mutation on different alleles. No mutations including BRAF and KRAS were seen in the conventional papillary carcinoma. CONCLUSIONS Although all of the morphological patterns in this tumour have been reported as having aetiological or other association with one another, there was only partial concordance with their molecular signatures. There was significant molecular discordance, however, even with identical morphologies.
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Affiliation(s)
- Heather K Schopper
- Department of Pathology, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Aaron Stence
- Department of Pathology, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Deqin Ma
- Department of Pathology, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Nitin A Pagedar
- Otorhinolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Robert A Robinson
- Department of Pathology, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Mathieson W, Betsou F, Myshunina T, Pushkarev V, Pushkarev V, Shinkarkina A, Voskoboynyk L, Thomas GA. The effect of long-term -80°C storage of thyroid biospecimens on RNA quality and ensuring fitness for purpose. J Clin Pathol 2016; 69:1105-1108. [PMID: 27235537 DOI: 10.1136/jclinpath-2016-203697] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/04/2016] [Accepted: 05/08/2016] [Indexed: 11/03/2022]
Abstract
AIMS To establish whether RNA degrades in long-term storage at -80°C and whether RNA integrity numbers (RINs) determine 'fitness for purpose' in severely degraded RNA. METHODS RNA was extracted from 549 thyroid biospecimens stored at -80°C for 0.1-10.9 years then their RINs correlated with storage time. RT-PCR for 65, 265, 534 and 942 base pair amplicons of hydroxymethylbilane synthase was used to measure amplicon length in RNA from cryopreserved and FFPE biospecimens that were equally degraded according to RIN. RESULTS Storage time did not correlate with RIN. Longer amplicons were obtained from cryopreserved samples than FFPE samples with equal RINs. CONCLUSIONS RNA does not degrade in thyroid biospecimens stored for long periods of time at -80°C. Although RINs are known to predict amenability to analytical platforms in good quality samples, this prediction is unreliable in severely degraded samples.
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Affiliation(s)
- William Mathieson
- Department of Surgery and Cancer, Imperial College London, London, UK.,Integrated Biobank of Luxembourg, Luxembourg, Luxembourg
| | - Fay Betsou
- Integrated Biobank of Luxembourg, Luxembourg, Luxembourg
| | | | | | | | | | | | - Gerry A Thomas
- Department of Surgery and Cancer, Imperial College London, London, UK
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Decaussin-Petrucci M, Deladoëy J, Hafdi-Nejjari Z, Sassolas G, Borson-Chazot F, Abu-Khudir R, Fusco A, Descotes F, Cournoyer S, Sartelet H. Expression of CD133 in differentiated thyroid cancer of young patients. J Clin Pathol 2015; 68:434-40. [PMID: 25770162 DOI: 10.1136/jclinpath-2014-202625] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 02/04/2015] [Indexed: 01/17/2023]
Abstract
AIMS CD133 expression in cancer is frequently associated with poor outcome. Thyroid carcinomas are rare in childhood and adolescence and are associated with a higher risk of recurrence and more metastases than the adult tumours. The aim of the study was to assess whether the expression of CD133 in thyroid carcinomas of children, adolescents and young adults was correlated with clinical prognostic factors. METHODS Tissue microarrays were constructed with 235 tumours coming from 208 young adults with a median age of 28 years and 27 children with a median age of 13 years. An immunohistochemical study was performed with anti-CD133 antibody. CD133 expression was evaluated, using a semiquantitative score based on the percentage of positive cells. The mutation status of tumours was evaluated by reverse transcriptase PCR. Three cell lines were used to confirm CD133 expression by western blot. RESULTS CD133 expression was found in 43% of adult and 37% of child tumours and was confirmed by western blot in cell lines. In young adults, the expression of CD133 was significantly more frequent in patients with tumours >3 cm (p=0.04) and in patients with lymph node metastases (p=0.02). The expression of CD133 was more frequent in patients in whom the tumour presented a BRAF mutation (p=0.03). CONCLUSIONS CD133 expression is correlated with tumour size, lymph nodes metastases and BRAF mutations in young adults. The presence of these cancer stem cells could offer new therapeutic alternatives for aggressive thyroid cancers.
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Affiliation(s)
- Myriam Decaussin-Petrucci
- Department of Pathology, Lyon Sud Hospital Centre, Pierre Bénite, Hospices Civils de Lyon, University Lyon I, Lyon, France
| | - Johnny Deladoëy
- Department of Endocrinology, CHU Sainte Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Zakia Hafdi-Nejjari
- Registre Rhône Alpin des cancers thyroïdiens, Centre de Médecine Nucléaire, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - Geneviève Sassolas
- Registre Rhône Alpin des cancers thyroïdiens, Centre de Médecine Nucléaire, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - Françoise Borson-Chazot
- Registre Rhône Alpin des cancers thyroïdiens, Centre de Médecine Nucléaire, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France Department of Endocrinology, Hospices Civils de Lyon, Bron, Université Lyon I, Lyon, France
| | - Rasha Abu-Khudir
- Department of Endocrinology, CHU Sainte Justine, Université de Montréal, Montréal, Quebec, Canada Registre Rhône Alpin des cancers thyroïdiens, Centre de Médecine Nucléaire, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France Department of Endocrinology, Hospices Civils de Lyon, Bron, Université Lyon I, Lyon, France Faculty of Science, Chemistry Department (Biochemistry Branch), Tanta University, Tanta, Egypt
| | - Alfredo Fusco
- Department of Biology and Cellular and Molecular Pathology, Faculty of Medicine and Surgery, Institute of Endocrinology and Experimental Oncology of CNR, Universita degli studi di Napoli Federico II, Naples, Italy
| | - Francoise Descotes
- Department of Biochemistry, Lyon Sud Hospital Centre, Pierre Bénite, Hospices Civils de Lyon, Lyon, France
| | - Sonia Cournoyer
- Department of Pathology, CHU Sainte Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Hervé Sartelet
- Department of Pathology, CHU Sainte Justine, Université de Montréal, Montréal, Quebec, Canada Department of Pathology, Centre Hospitalier Universitaire Robert Debre, Université Paris 7, Paris, France
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Hakala T, Kholová I, Sand J, Saaristo R, Kellokumpu-Lehtinen P. A core needle biopsy provides more malignancy-specific results than fine-needle aspiration biopsy in thyroid nodules suspicious for malignancy. J Clin Pathol 2013; 66:1046-50. [PMID: 23863219 DOI: 10.1136/jclinpath-2013-201559] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND AIMS The most commonly used diagnostic method for the preoperative diagnosis of thyroid nodules is ultrasound-guided fine-needle aspiration biopsy (FNA), which often yields non-diagnostic or non-definitive results and seldom produces definite malignant diagnoses. To improve upon the malignancy-specific sensitivity, we tested core needle biopsies (CNBs) of thyroid lesions taken from surgical specimens. MATERIAL AND METHODS 52 consecutive patients with malignant or malignant-suspicious thyroid nodules were referred to Tampere University Hospital between May 2010 and December 2011. Preoperative FNAs were categorised as follicular neoplasm (48%), suspicion for malignancy (46%) or malignancy (6%). Intraoperative FNA and CNB samples were acquired from surgical specimens removed during surgery. The results of the needle biopsies were compared with the final pathological diagnosis. RESULTS CNBs had a high definitive sensitivity for malignancy (61%, CI 41% to 78%) whereas the definitive sensitivity for malignancy of FNAs was significantly lower (22%, CI 10% to 42%). CNB was not beneficial in the diagnosis of follicular thyroid lesions. When all suspected follicular tumours were excluded, the definitive sensitivity of CNB rose to 70% (CI 48% to 86%). CONCLUSIONS CNB may be beneficial for the diagnosis of papillary thyroid carcinoma and other non-follicular thyroid lesions. CNB may be considered as an additional diagnostic procedure in cases with FNA suspicious for malignancy.
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Affiliation(s)
- T Hakala
- Department of Surgery, Tampere University Hospital, , Tampere, Finland
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Abstract
The pathological diagnoses and classification schemes for thyroid carcinoma have changed over the past 20 years and continue to do so. New entities have been described and molecular analyses have suggested better characterisation and grouping of certain tumours. Because some of the lesions have been named differently by different authors, clinicians and patients may be confused as to what a specific patient's lesion represents. In this review, we discuss the thyroid tumours of follicular origin which are clinically unusual but important to recognise as their behaviour may be aggressive, they may not respond to radioiodine treatment and they may cause significant mortality. This paper describes these important but rare lesions, their pathological features, important clinicopathological correlations, molecular correlates and prognostic implications.
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Affiliation(s)
- Zubair Baloch
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, USA.
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