RESUMEN
A female papillary thyroid cancer patient with diffuse micronodular pulmonary metastases was confirmed only by post radioactive iodine (RAI) therapy whole body scan (RxWBS). Her diagnostic iodine-131 whole body scan (DxWBS), chest CT and 18FDG PET/CT scan were all negative. Attention and pitfalls of this case concerning surgical and RAI dose management are against current international guidelines on thyroid cancer.
Asunto(s)
Adulto , Femenino , Humanos , Carcinoma , Carcinoma Papilar , Fluorodesoxiglucosa F18 , Radioisótopos de Yodo , Usos Terapéuticos , Imagen Multimodal , Métodos , Tomografía de Emisión de Positrones , Neoplasias de la Tiroides , Diagnóstico , Radioterapia , Tomografía Computarizada por Rayos XRESUMEN
<p><b>OBJECTIVE</b>To compare the efficacy of different expression vectors, target genes, and immunization procedures in transfecting mice via liposome to construct murine model of Graves disease.</p><p><b>METHODS</b>We linked pCDNA3.1(+) and pUBC to full-length human TSHR and TSHR A subunit cDNA to yield four plasmids, which were later injected intramascularly or subcutaneously into female Balb/c mice via liposome. The blood anti-TSHR antibody (TRAb) were determined and the body weight were measured after each immunization. Serum thyroid hormone levels were measured after the animals were sacrificed.</p><p><b>RESULTS</b>In mice immunized with pUBC, no significant variance with control in weight nor serum TRAb concentration was observed. Weight gain in pCDNA3.1(+) group was significantlyly slower than controls (p<0.05), and serum TRAb concentration was also significantly elevated. In pCDNA group, animals immunized with TSHR A subunit (TSHRA subgroup) as the target gene revealed even significantly slower weight gain (p<0.001) and even faster TRAb elevation than those immunized with full length TSHR. Significantly higher FT4 (p=0.023) was observed in TSHRA and TSHR subgroups, which was reversely correlated to weight gain, but no significant difference (p>0.05) in FT3 was observed. Weight gain and TRAb concentration mainly varied in the later period of immunization.</p><p><b>CONCLUSIONS</b>Immunization with pCDNA3.1(+) and TSHR A subunit gene together with higher immunization frequency increases the chance of model induction. Furthermore, FT4 is a better indicator for assessing the thyroid function in this model.</p>