The significance of serum thyroglobulin measurement before and after the treatment of toxic nodular goiter with 131I.

OBJECTIVES: Thyroglobulin is routinely used as a tumor marker in follow up of patients with thyroid carcinoma, but is also elevated in patients with toxic nodular goiter. The aim of this study was to evaluate the role of thyroglobulin measurement prior to and after the radioiodine therapy (RIT) in patients with toxic nodular goiter and to compare the results with the therapy outcome. PATIENTS AND METHODS: In 109 patients with toxic nodular goiter (102 females, 7 males, aged 45-85 years), 61 with multinodular toxic goiter and 48 with toxic adenoma, thyroglobulin level was measured before RIT and during the first 12 months after the treatment and compared to therapy outcome, defined as euthyroid, hypothyroid and persistent hyperthyroidism. RESULTS: In patients with euthyroid and hypothyroid outcome, a significant fall of thyroglobulin level was noted during the first 12 months after RIT, more prominent in the latter group. In patients with persistent hyperthyroidism, the initial thyroglobulin level was higher than in other two groups and no significant decrease was noted by the end of the first year after therapy, especially in patients with multinodular toxic goiter. CONCLUSIONS: The significant fall of thyroglobulin after RIT observed in patients in whom euthyroidism and hypothyroidism was achieved indicates that thyroglobulin values can be related to the treatment outcome. In patients with high initial thyroglobulin levels (above 400 ng/l), and possible unfavorable RIT outcome, higher radioiodine activities or other treatment options might be considered.Video abstract: http:/links.lww.com/NMC/A163.

[Analysis of sentinel lymph node in early breast cancer patient - Clinical Hospital Center Rijeka]. / Analiza limfnog cvora cuvara u bolesnica s ranim invazivnim rakom dojke - Klinicki bolnicki centar Rijeka.

Sentinel lymph node (SLN) biopsy is an accurate method for the detection of axillary metastases in early breast cancer patients and is of value as a replacement for axillary dissection. However, variations in the methods and protocols used for the pathological evaluation of SLN exist in everyday practice. Therefore, standardization how to detect, dissect, process, stain, assess and report SNL is required in order to stratify patients into adequate prognostic groups. The aim of this study was to present our experience in SLN analysis in patients with early breast cancer and clinical stage T1-2 and N0. In the period between 2003 and 2011, 1071 consecutive patients or 1915 SLN were analyzed. The protocol included intraoperative analysis of histological frozen sections and cytological imprint, followed by analysis of paraffin sections according to the protocol that included sections of whole SLN with the interval of 250 prm. According to the accepted protocol 75% of SLN were negative. The obtained results were correlated with literature data.