ABSTRACT
BACKGROUND: We aimed to evaluate the oncological impact of hypothyroidism and levothyroxine (LT) supplementation after hemithyroidectomy in patients with papillary thyroid carcinoma (PTC). METHODS: We retrospectively examined 401 patients who underwent hemithyroidectomy for classic PTC and who were postoperatively followed-up with ≥3 thyroid function measurements for ≥24 months. RESULTS: During 77.4 months of follow-up, 268/401 patients (66.8%) developed hypothyroidism and 19/401 patients (4.7%) showed recurrence. Recurrence rates did not differ between the euthyroidism and hypothyroidism development groups. Recurrence rates were significantly lower in the LT group than in the no-LT group, although mean postoperative thyroid-stimulating hormone (TSH) levels were not different between the two groups. Univariate and multivariate analysis showed that tumors sized >1 cm and lack of LT supplementation were significantly associated with recurrence. CONCLUSIONS: Postoperative hypothyroidism development was not a risk factor for PTC recurrence after hemithyroidectomy. Nevertheless, LT supplementation reduced recurrence risk without suppressing TSH.
Subject(s)
Hypothyroidism , Thyroid Neoplasms , Dietary Supplements , Humans , Hypothyroidism/drug therapy , Hypothyroidism/etiology , Neoplasm Recurrence, Local , Retrospective Studies , Thyroid Cancer, Papillary/surgery , Thyroid Neoplasms/surgery , Thyroidectomy/adverse effects , Thyrotropin , Thyroxine/therapeutic useABSTRACT
We analyzed insulin-like growth factor receptor I (IGF-IR) and insulin growth factor binding protein-3 (IGFBP-3) expression with respect to overall survival and relapse-free survival (RFS) in 460 patients with primary invasive breast cancer using immunohistochemistry. IGF-IR expression had a significant positive correlation with positive estrogen receptor (ER), positive progesterone receptor (PR) and Bcl-2 expression. Univariate analysis showed significantly better overall survival (p=0.000) and RFS (p=0.004), in the IGF-IR-positive group. Multivariate analysis showed a significant reduction in relative risk for overall survival (p=0.019, HR=0.221, 95% CI=0.062-0.780) and RFS (p=0.026, HR=0.462, 95% CI=0.234-0.913) in the IGF-IR-positive group. IGF-IR expression in primary breast cancer is an independent favorable prognostic factor. IGFBP-3 expression in breast cancer is associated with poor outcome.
Subject(s)
Biomarkers, Tumor/analysis , Breast Neoplasms/metabolism , Insulin-Like Growth Factor Binding Protein 3/biosynthesis , Receptor, IGF Type 1/biosynthesis , Adult , Aged , Aged, 80 and over , Breast Neoplasms/genetics , Breast Neoplasms/mortality , Disease-Free Survival , Female , Humans , Immunohistochemistry , Insulin-Like Growth Factor Binding Protein 3/genetics , Kaplan-Meier Estimate , Middle Aged , Prognosis , Receptor, IGF Type 1/genetics , Receptors, Estrogen/biosynthesis , Receptors, Estrogen/genetics , Receptors, Progesterone/biosynthesis , Receptors, Progesterone/genetics , Tissue Array Analysis , Young AdultABSTRACT
The role of human papilloma virus (HPV) infection in the development of cervical carcinoma is well established, however, the prevalence of HPV DNA in cervical adenocarcinoma varies from study to study. It appears to be caused by a number of factors, one of which is that cervical adenocarcinomas comprise a heterogeneous group of multiple subtypes. To clarify the impact of HPV infection on the development of cervical adenocarcinoma with diverse histological subtypes, we performed a population-based study in Korean women from 15 different institutes for the status of HPV infection in adenocarcinoma of uterine cervix. A total of 432 cervical adenocarcinomas from 1997 to 2001 were reviewed and classified according to the modified WHO classification. For 135 cases, HPV typing was performed with HPV DNA chip (82 cases) and PCR HPV typing (53 cases), using formalin-fixed, paraffin-embedded archival tissue. The overall prevalence of HPV infection in cervical adenocarcinoma was 90%. The infection of HPV 16 and/or HPV 18 accounted for 78% of HPV-positive adenocarcinomas. Multiple HPV types were found in 13% of the cases. The HPV DNA was rarely detected in minimal deviation adenocarcinoma. Interestingly, HPV 16 was a predominant type in endometrioid and villoglandular types, whereas HPV 16 and HPV 18 were detected with equal prevalence in other subtypes. In conclusion, HPV infection, mostly HPV 16 and HPV 18, is highly associated with most of the cervical adenocarcinomas, whereas endometrioid and villoglandular type have a different pattern of HPV infection status. Minimal deviation adenocarcinoma does not seem to be related with HPV infection.
