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3.
G Ital Nefrol ; 41(4)2024 Aug 26.
Article in Italian | MEDLINE | ID: mdl-39243410

ABSTRACT

This article constitutes a review of the existing literature on the potential correlation between autosomal dominant polycystic kidney disease (ADPKD) and intraductal papillary mucinous neoplasms (IPMN) of the pancreas. Additionally, it presents a clinical case where familiarity for both pathologies was observed, derived from the direct experience of our clinic, reinforcing the hypothesis of a possible common pathogenetic pathway. The review focuses on the potential genetic correlation between these two pathologies within the realm of ciliopathies, emphasizing the importance of targeted screening and monitoring strategies to detect pancreatic complications early in patients with ADPKD. Furthermore, it highlights the complexity in the clinical management of these rare conditions and underscores the importance of early diagnosis in optimizing clinical outcomes.


Subject(s)
Adenocarcinoma, Mucinous , Carcinoma, Papillary , Pancreatic Intraductal Neoplasms , Polycystic Kidney, Autosomal Dominant , Humans , Adenocarcinoma, Mucinous/complications , Adenocarcinoma, Mucinous/diagnosis , Adenocarcinoma, Mucinous/pathology , Carcinoma, Papillary/complications , Carcinoma, Papillary/diagnosis , Carcinoma, Papillary/pathology , Pancreatic Intraductal Neoplasms/complications , Pancreatic Intraductal Neoplasms/diagnosis , Pancreatic Intraductal Neoplasms/pathology , Polycystic Kidney, Autosomal Dominant/complications , Polycystic Kidney, Autosomal Dominant/genetics
4.
Int J Mol Sci ; 25(17)2024 Aug 29.
Article in English | MEDLINE | ID: mdl-39273308

ABSTRACT

Genetic alterations are well known to be related to the pathogenesis and prognosis of papillary thyroid carcinoma (PTC). Some miRNA expression dysregulations have previously been described in the context of cancer development including thyroid carcinoma. In our study, we performed original molecular diagnostics on tissue samples related to our own patients. We aimed to identify all dysregulated miRNAs in potential association with PTC development via sequencing much higher numbers of control-matched PTC tissue samples and analyzing a wider variety of miRNA types than previous studies. We analyzed the expression levels of 2656 different human miRNAs in the context of 236 thyroid tissue samples (118 tumor and control pairs) related to anonymized PTC cases. Also, KEGG pathway enrichment analysis and GO framework analysis were used to establish the links between miRNA dysregulation and certain biological processes, pathways of signaling, molecular functions, and cellular components. A total of 30 significant differential miRNA expressions with at least ±1 log2 fold change were found related to PTC including, e.g., miR-551b, miR-146b, miR-221, miR-222, and miR-375, among others, being highly upregulated, as well as miR-873 and miR-204 being downregulated. In addition, we identified miRNA patterns in vast databases (KEGG and GO) closely similar to that of PTC including, e.g., miRNA patterns of prostate cancer, HTLV infection, HIF-1 signaling, cellular responses to growth factor stimulus and organic substance, and negative regulation of gene expression. We also found 352 potential associations between certain miRNA expressions and states of clinicopathological variables. Our findings-supported by the largest case number of original matched-control PTC-miRNA relation research-suggest a distinct miRNA expression profile in PTC that could contribute to a deeper understanding of the underlying molecular mechanisms promoting the pathogenesis of the disease. Moreover, significant miRNA expression deviations and their signaling pathways in PTC presented in our study may serve as potential biomarkers for PTC diagnosis and prognosis or even therapeutic targets in the future.


Subject(s)
Gene Expression Profiling , Gene Expression Regulation, Neoplastic , MicroRNAs , Thyroid Cancer, Papillary , Thyroid Neoplasms , Humans , MicroRNAs/genetics , MicroRNAs/metabolism , Thyroid Cancer, Papillary/genetics , Thyroid Cancer, Papillary/pathology , Thyroid Cancer, Papillary/metabolism , Thyroid Neoplasms/genetics , Thyroid Neoplasms/metabolism , Thyroid Neoplasms/pathology , Male , Female , Middle Aged , Adult , Biomarkers, Tumor/genetics , Biomarkers, Tumor/metabolism , Signal Transduction/genetics , Carcinoma, Papillary/genetics , Carcinoma, Papillary/pathology , Gene Regulatory Networks
5.
Investig Clin Urol ; 65(5): 501-510, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39249924

ABSTRACT

PURPOSE: Urothelial carcinoma has various molecular subtypes, each with different tumor characteristics. Although it is known that molecular changes occur during tumor progression, little is known about the specifics of these changes. In this study, we performed transcriptional analysis to understand the molecular changes during tumor progression. MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded tumor tissues were obtained from 12 patients with muscle-invasive bladder cancer (MIBC). The invasive and non-invasive papillary areas were identified in papillary urothelial carcinoma specimens. Immunohistochemistry (IHC) and mRNA sequencing were performed for each tumor area. RESULTS: Patients with CK5/6-negative and CK20-positive non-invasive papillary areas were selected and classified into the IHC switch subgroup (CK5/6-positive and CK20-negative in the invasive area) and the IHC unchanged subgroup (CK5/6-negative and CK20-positive in the invasive area) according to the IHC results of the invasive area. We identified differences in the mRNA expression between the non-invasive papillary and invasive areas of the papillary MIBC tissue samples. In both the non-invasive papillary and invasive areas, the IHC switch subgroup showed basal subtype gene expression, while the IHC unchanged subgroup demonstrated luminal subtype gene expression. CONCLUSIONS: The non-invasive papillary area showed a gene expression pattern similar to that of the invasive area. Therefore, even if the non-invasive papillary area exhibits a luminal phenotype on IHC, it can have a basal subtype gene expression depending on the invasive area.


Subject(s)
Carcinoma, Papillary , Carcinoma, Transitional Cell , Disease Progression , Urinary Bladder Neoplasms , Humans , Urinary Bladder Neoplasms/genetics , Urinary Bladder Neoplasms/pathology , Male , Female , Carcinoma, Papillary/pathology , Carcinoma, Papillary/genetics , Aged , Carcinoma, Transitional Cell/genetics , Carcinoma, Transitional Cell/pathology , Middle Aged , Immunophenotyping , Neoplasm Invasiveness , Keratin-20/genetics , Immunohistochemistry , Aged, 80 and over
6.
Pathol Int ; 74(9): 520-529, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39119938

ABSTRACT

Although there are clear morphologic criteria for the diagnosis of papillary thyroid carcinoma (PTC), when the morphology is untypical or overlaps, accurate diagnostic indicators are necessary. Since few studies investigated the role of down-regulated genes in PTC, this article aims to further explore the molecular markers associated with PTC. We conducted bioinformatics analysis of gene microarrays of PTC and normal adjacent tissues. Besides, quantitative real-time quantitative polymerase chain reaction array and immunohistochemical staining were used to investigate the expression of the major down-regulated genes. The results indicated that several important down-regulated genes, including TLE1, BCL2, FHL1, GHR, KIT, and PPARGC1A were involved in the process of PTC. Compared to normal adjacent tissues, the mRNA expression of the major genes was down-regulated in PTC (p<0.05). Immunohistochemically, FHL1 shows negative or low expression in PTC tissues (p<0.05). BCL2 did not show a significant difference between PTC and normal thyroid tissues (p > 0.05). TLE1, KIT, PPARGC1A and GHR showed negative expression in both tumor and normal tissues. These results suggested that FHL1 could serve as a novel tumor marker for precise diagnosis of PTC.


Subject(s)
Biomarkers, Tumor , Intracellular Signaling Peptides and Proteins , LIM Domain Proteins , Muscle Proteins , Thyroid Cancer, Papillary , Thyroid Neoplasms , Humans , Biomarkers, Tumor/metabolism , Biomarkers, Tumor/analysis , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/pathology , Thyroid Neoplasms/metabolism , Thyroid Neoplasms/genetics , Thyroid Cancer, Papillary/diagnosis , Thyroid Cancer, Papillary/pathology , Thyroid Cancer, Papillary/metabolism , Thyroid Cancer, Papillary/genetics , LIM Domain Proteins/metabolism , LIM Domain Proteins/genetics , Male , Female , Intracellular Signaling Peptides and Proteins/metabolism , Intracellular Signaling Peptides and Proteins/genetics , Muscle Proteins/metabolism , Muscle Proteins/genetics , Middle Aged , Adult , Aged , Gene Expression Regulation, Neoplastic , Immunohistochemistry , Carcinoma, Papillary/diagnosis , Carcinoma, Papillary/pathology , Carcinoma, Papillary/metabolism
7.
World J Surg Oncol ; 22(1): 225, 2024 Aug 27.
Article in English | MEDLINE | ID: mdl-39192321

ABSTRACT

PURPOSE: To summarize the abdominal computed tomography (CT) imaging and clinicopathological data of patients with SPNs of the pancreas and analyze the accuracy of preoperative CT diagnosis and features. MATERIALS AND METHODS: Between June 2006 and June 2023, CT images of 120 histopathologically proven SPNs in the pancreas were retrospectively reviewed. Fifteen features, including age, sex, and CT-determined features, were included in a multiple stepwise regression analysis. The correlations between features and SPNs, including odds ratios (ORs) and 95% confidence intervals (CIs), were evaluated. RESULTS: Among the 120 patients, the diagnostic accuracy of CT was 43.3%. The baseline CT results of patients with a correct diagnosis and misdiagnosis revealed significant differences in sex (P = 0.043), age (P = 0.004), boundary (P = 0.037) and encapsulation (P = 0.002) between the two groups. The preoperative imaging diagnostic accuracy was significantly greater in females than in males (47.9% vs. 25.0%, P = 0.043). The immunohistochemical indices did not significantly differ between the two groups. The results of univariate analysis revealed significant differences in sex (P = 0.048), age (P = 0.014), tumor length (P = 0.023), tumor boundaries (P = 0.039) and capsule type (P = 0.003). The results of multivariate analysis revealed that encapsulation was closely related to the diagnostic accuracy of CT (P = 0.04). CONCLUSIONS: The accuracy of CT in the diagnosis of SPNs is low, but a length‒diameter ratio of the tumor approaching 1.0, encapsulation and clear boundaries are important CT-determined features. The capsule is an independent CT predictor in the diagnosis of SPNs.


Subject(s)
Pancreatic Neoplasms , Tomography, X-Ray Computed , Humans , Male , Female , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms/surgery , Tomography, X-Ray Computed/methods , Retrospective Studies , Adult , Middle Aged , Young Adult , Adolescent , Prognosis , Aged , Follow-Up Studies , Carcinoma, Papillary/diagnostic imaging , Carcinoma, Papillary/pathology , Carcinoma, Papillary/surgery , Carcinoma, Papillary/diagnosis
8.
Cancer Med ; 13(16): e70123, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39194351

ABSTRACT

BACKGROUND: Papillary thyroid microcarcinoma (PTMC) management has evolved, with active surveillance (AS) gaining prominence as a management option. However, a key concern for both clinicians and patients is the potential for patient loss to follow-up during AS. AIMS: This study aimed to determine adherence and loss-to-follow-up rates in low-risk PTMC patients undergoing AS versus surgical intervention, in order to gain insights into clinical pathways and safety profiles. MATERIALS AND METHODS: This cohort study analyzed the 2016 data from a single registered institution of Japan's public National Cancer Registry. RESULTS: We identified and retrospectively analyzed the cases of 327 patients diagnosed with low-risk PTMC; 227 patients chose to undergo AS while the other 100 underwent PTMC surgery. Main outcomes were the adherence rate and loss-to-follow-up rate of each group, factors influencing discontinuation, and safety considerations. The rate of AS adoption was substantial in the complete series of 327 low-risk PTMC patients (69.4%). There was a significantly higher loss-to-follow-up rate at 5 years in the AS group (28.6%) compared to the Surgery group (17.8%) (HR 1.62, 95% CI: 1.01-2.61; p = 0.046). Both univariate and multivariate analyses confirmed the significantly higher loss-to-follow-up rate in the AS group as well as in older patients. No deaths due to PTMC progression were observed in the cases lost to follow-up. CONCLUSION: Despite concerns about loss to follow-up, active surveillance remains a safe option for low-risk PTMCs. Consistent follow-up strategies are crucial, and further research is needed to enhance patient counseling and care for the management of patients with PTMC.


Subject(s)
Carcinoma, Papillary , Thyroid Neoplasms , Thyroidectomy , Watchful Waiting , Humans , Thyroid Neoplasms/surgery , Thyroid Neoplasms/pathology , Female , Male , Middle Aged , Carcinoma, Papillary/surgery , Carcinoma, Papillary/pathology , Adult , Retrospective Studies , Thyroidectomy/methods , Lost to Follow-Up , Japan/epidemiology , Aged , Registries
9.
World J Surg Oncol ; 22(1): 224, 2024 Aug 27.
Article in English | MEDLINE | ID: mdl-39192289

ABSTRACT

PURPOSE: Although the potential association between autoimmune thyroiditis and papillary thyroid cancer (PTC) has been acknowledged, whether the clinicopathological features of PTC will be affected by thyroid autoantibodies remains unknown. PATIENTS AND METHODS: We conducted a case-control study to investigate the association of thyroid autoantibodies with clinicopathological characteristics of PTC in 15,305 patients (including 11,465 females and 3,840 males) from 3 medical centers in the central province of China. Logistic regression and restricted cubic spline models were performed to analyze the association of thyroid autoantibodies with clinicopathological features of PTC. RESULTS: In total, out of the 15,305 patients enrolled in this study, 10,087 (65.9%) had negative thyroid autoantibodies, while 5,218(34.1%) tested positive thyroid autoantibodies. Among these individuals, 1,530(10.0%) showed positivity for TPOAb only, 1,247(8.2%) for TGAb only and a further 2,441(15.9%) exhibited dual positivity for both TPOAb and TGAb combined. Thyroid autoantibodies level demonstrated significant correlations with certain aggressive features in PTC. Specifically, TGAb level displayed a direct correlation to an increased likelihood of multifocality, bilateral tumor, extrathyroidal extension, lymph node metastasis, as well as more than five affected lymph nodes. However, TPOAb level exhibited an inverse association with the risk associated with extrathyroidal extension, lymph node metastasis, and more than five affected lymph nodes. CONCLUSION: Elevated level of TGAb were positively correlated with the risk of aggressive features in PTC, while high level of TPOAb were inversely associated with the risk of extrathyroidal extension and lymph node metastasis.


Subject(s)
Autoantibodies , Thyroid Neoplasms , Humans , Female , Case-Control Studies , Male , Autoantibodies/immunology , Autoantibodies/blood , Middle Aged , Thyroid Neoplasms/immunology , Thyroid Neoplasms/pathology , Thyroid Neoplasms/blood , Adult , Prognosis , Follow-Up Studies , Thyroid Cancer, Papillary/immunology , Thyroid Cancer, Papillary/pathology , Lymphatic Metastasis , Carcinoma, Papillary/immunology , Carcinoma, Papillary/pathology , Carcinoma, Papillary/blood , China/epidemiology , Biomarkers, Tumor/immunology , Biomarkers, Tumor/blood , Young Adult , Aged
10.
Thyroid ; 34(9): 1126-1136, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39212950

ABSTRACT

Background: Active surveillance (AS) of papillary thyroid microcarcinomas (PTMC) is emerging as an alternative to immediate surgery. While thermal ablation has also shown promise for low-risk PTMC, it has not been prospectively studied in patients appropriate for AS. This study aimed to evaluate the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) for tumor control and quality of life (QoL) management in patients with PTMC who favored AS over immediate surgery. Methods: This prospective clinical trial was conducted at a single tertiary referral hospital from 2018 to 2021. Of 227 adult patients aged ≤60 years with low-risk unifocal PTMC favoring AS over immediate surgery, 100 patients underwent RFA for their management. The primary endpoint was the disease progression rate, and secondary endpoints were technical success, volume reduction rate (VRR), complication rates, and QoL. Results: The median age of the study population was 42 years (range, 27-59 years), and 83% (83/100, [CI: 66.1-100]) were female. The median follow-up was 30 months (range, 12-56 months). All 100 patients underwent RFA with technical success. Most of the ablation zones showed continuous volume reduction, and 95.9% (94/98, [CI: 77.5-100.0]) showed complete disappearance at the last follow-up. The median VRR was 100.0% at 1-year follow-up and persisted throughout the last follow-up. The cumulative disease progression rate among 98 patients who underwent at least 1-year follow-up was 3.1% (3/98, [CI: 0.6-9.0]); one patient had lymph node metastasis (treated with surgery), and two patients had new PTMC (1 treated with RFA, 1 ongoing AS). Major complications were not observed. Psychological (baseline vs. last follow-up, 7.3 vs. 8.0, p = 0.002) and social (8.0 vs. 8.7, p = 0.005) QoL scores significantly improved during follow-up without compromising physical QoL (8.6 vs. 8.5, p = 0.99). Conclusions: RFA can be a reasonable strategy for effectively and safely controlling tumors and improving QoL in non-elderly patients with low-risk PTMC appropriate for AS. Clinical Trial registration: This trial is registered with ClinicalTrials.gov: NCT03432299.


Subject(s)
Carcinoma, Papillary , Quality of Life , Radiofrequency Ablation , Thyroid Neoplasms , Watchful Waiting , Humans , Female , Male , Middle Aged , Adult , Prospective Studies , Thyroid Neoplasms/surgery , Thyroid Neoplasms/pathology , Carcinoma, Papillary/surgery , Carcinoma, Papillary/pathology , Treatment Outcome , Disease Progression , Ultrasonography, Interventional , Thyroidectomy
11.
BMC Cancer ; 24(1): 992, 2024 Aug 12.
Article in English | MEDLINE | ID: mdl-39129012

ABSTRACT

BACKGROUND: Invasive micropapillary carcinoma (IMPC) was first proposed as an entity by Fisher et al. In the 2003 World Health Organization (WHO) guidelines for histologic classification of the breast tumors. IMPC was recognized as a distinct, rare histological subtype of breast cancer. IMPC is emerging as a surgical and oncological challenge due to its tendency to manifest as a palpable mass, larger in size and higher in grade than IDC with more rate of lymphovascular invasion (LVI) and lymph node (LN) involvement, which changes the surgical and adjuvant management plans to more aggressive, with comparative prognosis still being a point of ongoing debate. AIM OF THE STUDY: In this study, we compared the clinicopathological characteristics, survival and surgical management of breast cancer patients having invasive micropapillary carcinoma pathological subtype in comparison to those having invasive duct carcinoma. METHOD: This is a comparative study on female patients presented to Baheya center for early detection and treatment of breast cancer, in the period from 2015 to 2022 diagnosed with breast cancer of IMPC subtype in one group compared with another group of invasive duct carcinoma. we analyzed 138 cases of IMPC and 500 cases of IDC. RESULTS: The incidence of LVI in the IMPC group was 88.3% in comparison to 47.0% in the IDC group (p < 0.001). IMPC had a higher incidence of lymph node involvement than the IDC group (68.8% and 56% respectively). IMPC had a lower rate of breast conserving surgery (26% vs.37.8%) compared with IDC. The survival analysis indicated that IMPC patients had no significant difference in overall survival compared with IDC patients and no differences were noted in locoregional recurrence rate and distant metastasis rate comparing IMPCs with IDCs. CONCLUSION: The results from our PSM analysis suggested that there was no statistically significant difference in prognosis between IMPC and IDC patients after matching them with similar clinical characteristics. However, IMPC was found to be more aggressive, had larger tumor size, greater lymph node metastasis rate and an advanced tumor stage.


Subject(s)
Breast Neoplasms , Carcinoma, Ductal, Breast , Carcinoma, Papillary , Humans , Female , Breast Neoplasms/pathology , Breast Neoplasms/mortality , Breast Neoplasms/surgery , Middle Aged , Prognosis , Carcinoma, Ductal, Breast/pathology , Carcinoma, Ductal, Breast/mortality , Carcinoma, Ductal, Breast/surgery , Carcinoma, Ductal, Breast/therapy , Aged , Carcinoma, Papillary/pathology , Carcinoma, Papillary/mortality , Carcinoma, Papillary/surgery , Adult , Lymphatic Metastasis , Neoplasm Invasiveness
12.
BMC Cancer ; 24(1): 1069, 2024 Aug 29.
Article in English | MEDLINE | ID: mdl-39210289

ABSTRACT

BACKGROUND: Thyroid cancer is a common thyroid malignancy. The majority of thyroid lesion needs intraoperative frozen pathology diagnosis, which provides important information for precision operation. As digital whole slide images (WSIs) develop, deep learning methods for histopathological classification of the thyroid gland (paraffin sections) have achieved outstanding results. Our current study is to clarify whether deep learning assists pathology diagnosis for intraoperative frozen thyroid lesions or not. METHODS: We propose an artificial intelligence-assisted diagnostic system for frozen thyroid lesions that applies prior knowledge in tandem with a dichotomous judgment of whether the lesion is cancerous or not and a quadratic judgment of the type of cancerous lesion to categorize the frozen thyroid lesions into five categories: papillary thyroid carcinoma, medullary thyroid carcinoma, anaplastic thyroid carcinoma, follicular thyroid tumor, and non-cancerous lesion. We obtained 4409 frozen digital pathology sections (WSI) of thyroid from the First Affiliated Hospital of Sun Yat-sen University (SYSUFH) to train and test the model, and the performance was validated by a six-fold cross validation, 101 papillary microcarcinoma sections of thyroid were used to validate the system's sensitivity, and 1388 WSIs of thyroid were used for the evaluation of the external dataset. The deep learning models were compared in terms of several metrics such as accuracy, F1 score, recall, precision and AUC (Area Under Curve). RESULTS: We developed the first deep learning-based frozen thyroid diagnostic classifier for histopathological WSI classification of papillary carcinoma, medullary carcinoma, follicular tumor, anaplastic carcinoma, and non-carcinoma lesion. On test slides, the system had an accuracy of 0.9459, a precision of 0.9475, and an AUC of 0.9955. In the papillary carcinoma test slides, the system was able to accurately predict even lesions as small as 2 mm in diameter. Tested with the acceleration component, the cut processing can be performed in 346.12 s and the visual inference prediction results can be obtained in 98.61 s, thus meeting the time requirements for intraoperative diagnosis. Our study employs a deep learning approach for high-precision classification of intraoperative frozen thyroid lesion distribution in the clinical setting, which has potential clinical implications for assisting pathologists and precision surgery of thyroid lesions.


Subject(s)
Deep Learning , Frozen Sections , Thyroid Cancer, Papillary , Thyroid Neoplasms , Humans , Thyroid Neoplasms/pathology , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/surgery , Thyroid Cancer, Papillary/pathology , Thyroid Cancer, Papillary/diagnosis , Thyroid Cancer, Papillary/surgery , Carcinoma, Papillary/pathology , Carcinoma, Papillary/surgery , Carcinoma, Papillary/diagnosis , Adenocarcinoma, Follicular/pathology , Adenocarcinoma, Follicular/diagnosis , Adenocarcinoma, Follicular/surgery , Thyroid Gland/pathology , Thyroid Gland/surgery , Carcinoma, Neuroendocrine/pathology , Carcinoma, Neuroendocrine/diagnosis , Carcinoma, Neuroendocrine/surgery , Female , Male , Middle Aged , Adult , Intraoperative Period , Thyroid Carcinoma, Anaplastic/pathology , Thyroid Carcinoma, Anaplastic/diagnosis , Thyroid Carcinoma, Anaplastic/surgery
13.
Korean J Radiol ; 25(9): 851-858, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39197830

ABSTRACT

OBJECTIVE: This study investigates the long-term efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) for treating locally recurrent papillary thyroid cancer (PTC). MATERIALS AND METHODS: We retrospectively analyzed 39 consecutive patients with 61 locally recurrent PTCs (14 males, 25 females; mean ± standard deviation age, 52.8 ± 16.7 years; range 21-92 years) who underwent US-guided RFA with curative intent between September 2008 and April 2012. A subgroup of 24 patients with 37 recurrent PTCs who had a follow-up of at least 10 years were analyzed separately. All patients were followed for changes in lesion size on US and thyroglobulin (Tg) levels at 1, 3, 6, and 12 months after RFA, with follow-up every 6-12 months thereafter. Any complications were documented during the follow-up period. Recurrence-free survival (RFS) rates were assessed using Kaplan-Meier estimates. Long-term outcomes were evaluated in patients with follow-up of at least 10 years. RESULTS: The follow-up period ranged from 7 to 180 months (median 133 months). The RFS rates for the 39 patients at 3, 5, and 10 years were 86.8%, 75.5%, and 60.6%, respectively. Among the 24 patients with 37 recurrent PTCs followed for more than 10 years, the volume reduction rate was 99.9% (range 96%-100%), and the complete tumor disappearance rate was 91.9%. The mean serum Tg level also decreased significantly, from 2.66 ± 86.5 mIU/L before ablation to 0.43 ± 0.73 mIU/L (P < 0.001) at the final follow-up. In 14 (58.3%) of the 24 patients, Tg levels were undetectable (below 0.08 mIU/L) at the last follow-up. No life-threatening or delayed complications were observed during the 10-year follow-up period. CONCLUSION: The high RFS throughout the follow-up period, with efficacy and safety lasting beyond 10 years, supports US-guided RFA as a valuable option for local control of recurrent PTCs.


Subject(s)
Carcinoma, Papillary , Neoplasm Recurrence, Local , Radiofrequency Ablation , Thyroid Cancer, Papillary , Thyroid Neoplasms , Ultrasonography, Interventional , Humans , Middle Aged , Female , Male , Adult , Aged , Thyroid Neoplasms/surgery , Thyroid Neoplasms/pathology , Neoplasm Recurrence, Local/surgery , Retrospective Studies , Thyroid Cancer, Papillary/surgery , Thyroid Cancer, Papillary/pathology , Aged, 80 and over , Radiofrequency Ablation/methods , Treatment Outcome , Carcinoma, Papillary/surgery , Carcinoma, Papillary/pathology , Carcinoma, Papillary/diagnostic imaging , Follow-Up Studies , Carcinoma/surgery , Carcinoma/diagnostic imaging , Carcinoma/pathology
15.
Bull Exp Biol Med ; 177(3): 353-358, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39134811

ABSTRACT

The association of clinical, pathological, and immunohistochemical characteristics of papillary thyroid cancer with cause-specific mortality was analyzed in a case-control study within a cohort of patients from the Altai Regional Oncology Center. According to multivariate analysis, the independent predictors of fatal outcome within 10 years after surgery in patients living in Altai region are nuclear pattern of Hsp70 expression, thyroid capsular invasion, Ki-67 expression index >7%, and patient's age >45 years for men and >50 years for women. The prognostic model based on these features contributes to a significant improvement in the individual prognostic performance for papillary thyroid cancer in the modeling sample. The model has high statistical significance (χ2=64.73; p<0.001) and discriminative power (AUC=0.950, prediction accuracy 88.5%).


Subject(s)
Ki-67 Antigen , Thyroid Cancer, Papillary , Thyroid Neoplasms , Humans , Female , Male , Middle Aged , Thyroid Cancer, Papillary/mortality , Thyroid Cancer, Papillary/pathology , Thyroid Cancer, Papillary/surgery , Thyroid Cancer, Papillary/metabolism , Thyroid Neoplasms/mortality , Thyroid Neoplasms/pathology , Thyroid Neoplasms/metabolism , Thyroid Neoplasms/surgery , Case-Control Studies , Adult , Ki-67 Antigen/metabolism , Ki-67 Antigen/genetics , Prognosis , Multivariate Analysis , HSP70 Heat-Shock Proteins/metabolism , Carcinoma, Papillary/pathology , Carcinoma, Papillary/mortality , Carcinoma, Papillary/surgery , Carcinoma, Papillary/metabolism , Immunohistochemistry , Aged , Biomarkers, Tumor/metabolism
16.
Article in Chinese | MEDLINE | ID: mdl-39118509

ABSTRACT

Objective:To explore the risk factors of lymph node metastasis and multiple lymph node metastasis in patients with stage CN0 papillary thyroid carcinoma. Methods:The clinical case data of 3 099 patients with CN0 papillary thyroid cancer who underwent lymph node dissection at Xijing Hospital of Air Force Medical University from January 2013 to December 2022 were retrospectively analyzed, univariate and multivariate logistic regression were used to analyze the risk factors of lymph node metastasis and multiple lymph node metastasis. Results:Male gender, age<55 years, multifocal lesions, and lesion size ≥2 cm were independent risk factors for lymph node metastasis in CN0 patients(P<0.05), while diabetes was an independent protective factor for lymph node metastasis(P<0.05).Age<55 years, capsular invasion, and multifocal lesions were independent risk factors for the presence of ≥3 lymph nodes with metastasis (P<0.05). Conclusion:In CN0 stage PTC patients, special attention should be given to the possibility of lymph node metastasis when they are male, aged <55 years, have multifocal lesions, or have lesion size >2 cm.


Subject(s)
Lymph Nodes , Lymphatic Metastasis , Thyroid Cancer, Papillary , Thyroid Neoplasms , Humans , Male , Thyroid Neoplasms/pathology , Female , Middle Aged , Thyroid Cancer, Papillary/pathology , Risk Factors , Retrospective Studies , Lymph Nodes/pathology , Carcinoma, Papillary/pathology , Neoplasm Staging , Adult , Logistic Models , Lymph Node Excision
17.
Article in English | MEDLINE | ID: mdl-39147446

ABSTRACT

Papillary thyroid carcinoma (PTC) is a common endocrine cancer with a good prognosis. Radioactive iodine is thought to be useful for individuals who have had a total or almost total thyroidectomy, but its effects are still controversial. The effects of radioactive iodine-131 (I-131) treatment on oxidative and chromosomal damage in PTC patients were examined in this study, which was carried out with 16 patients newly diagnosed with PTC and 20 healthy control subjects with similar age and gender. Blood samples were taken from patients with PTC at five sampling times (before total thyroidectomy, after total thyroidectomy, and seven days, six months, and one year after treatment) and from control subjects. The cytokinesis block micronucleus cytome (CBMN-cyt) assay parameters in peripheral blood lymphocytes of patients with PTC and controls were evaluated and plasma 8-hydroxydeoxyguanosine (8-OHdG) levels were measured. Furthermore, genome instability and oxidative DNA damage in peripheral blood lymphocytes and plasma of patients with PTC were evaluated before total thyroidectomy (n=16), after total thyroidectomy (before I-131 treatment) (n=16), seven days (n=10), six months (n=5), and one year after treatment (n=5). The numbers of CBMN-cyt assay parameters (micronucleus; MN and nucleoplasmic bridges; NPB) and 8-OHdG levels in patients with PTC were determined to be significantly higher than in those of the control subjects and these values significantly decreased after total thyroidectomy (before I-131 treatment). While the number of MN, apoptotic, and necrotic cells increased after I-131 treatment, it significantly decreased after six months and one year after treatment. The results achieved in this study suggest that I-131 treatment may pose a threat to cells and that radioactive iodine therapy should be avoided (if possible) for patients with PTC after total thyroidectomy.


Subject(s)
DNA Damage , Iodine Radioisotopes , Oxidative Stress , Thyroid Cancer, Papillary , Thyroid Neoplasms , Thyroidectomy , Humans , Iodine Radioisotopes/therapeutic use , Iodine Radioisotopes/adverse effects , Thyroid Neoplasms/blood , Thyroid Neoplasms/radiotherapy , Thyroid Neoplasms/pathology , Thyroid Neoplasms/genetics , Female , Male , Adult , Middle Aged , Thyroid Cancer, Papillary/blood , Thyroid Cancer, Papillary/radiotherapy , Oxidative Stress/drug effects , Micronucleus Tests , Carcinoma, Papillary/blood , Carcinoma, Papillary/pathology , Carcinoma, Papillary/radiotherapy , Carcinoma/radiotherapy , Carcinoma/blood , Carcinoma/genetics , Lymphocytes/radiation effects , Lymphocytes/drug effects , 8-Hydroxy-2'-Deoxyguanosine/blood , Deoxyguanosine/analogs & derivatives , Deoxyguanosine/blood , Case-Control Studies , Genomic Instability
18.
Ann Afr Med ; 23(4): 623-627, 2024 Oct 01.
Article in French, English | MEDLINE | ID: mdl-39138962

ABSTRACT

CONTEXT: Fine-needle aspiration cytology (FNAC) is widely utilized for thyroid lesion diagnosis but faces challenges such as sample inadequacy and overlapping cytological features. This study examines how accurately these patterns correlate with histopathological diagnoses, shedding light on FNAC's limitations and diagnostic potential. AIMS: To study the application of the architectural pattern of follicular cells in the interpretation of thyroid lesions and to demonstrate the diagnostic accuracy (DA) of FNAC. SETTINGS AND DESIGN: Cross-sectional study carried over 1 year. SUBJECTS AND METHODS: A total of 110 cases were reviewed by the cytopathologists. The prominent follicular cell architecture, namely macrofollicular, microfollicular, papillary, trabecular, three-dimensional clusters, and dispersed cells, was described in each case. In addition to these patterns, cellular morphology and background features were also noted, and a final cytological diagnosis was established. The cytology diagnosis was correlated with the histopathological diagnosis. STATISTICAL ANALYSIS USED: Sensitivity, specificity, positive predictive value, negative predictive value, DA of FNAC in diagnosing nonneoplastic and neoplastic lesions. RESULTS: Macrofollicular pattern was seen in 80.26% of colloid goiter cases. Microfollicular pattern was observed in 72.2% of follicular neoplasm. About 62.5% of papillary thyroid carcinomas showed a papillary pattern. The trabecular pattern was seen in 42.86% of chronic lymphocytic thyroiditis and 16.67% of follicular neoplasms. The sensitivity and specificity of FNAC in diagnosing neoplastic lesions was 92.59% and 97.59%, respectively. CONCLUSIONS: FNAC is a simple, rapid, definite, and cost-effective primary diagnostic tool for thyroid evaluation. Cell architecture pattern is a simple and appropriate approach that complements cell morphology and background details in arriving at the final cytological diagnosis of thyroid lesions.


Résumé Contexte:La cytologie par aspiration à l'aiguille fine (FNAC) est largement utilisée pour le diagnostic des lésions thyroïdiennes, mais elle est confrontée à des défis tels que l'insuffisance des échantillons et des caractéristiques cytologiques qui se chevauchent. Cette étude examine avec quelle précision ces modèles sont en corrélation avec les diagnostics histopathologiques, l'excrétion lumière sur les limites et le potentiel diagnostique de la FNAC.Objectifs:Étudier l'application du modèle architectural des cellules folliculaires dans le interprétation des lésions thyroïdiennes et démontrer la précision diagnostique (DA) de la FNAC.Paramètres et conception:étude transversale réalisée sur 1 an.Sujets et méthodes:Au total, 110 cas ont été examinés par les cytopathologistes. L'architecture cellulaire folliculaire proéminente, à savoir des amas macrofolliculaires, microfolliculaires, papillaires, trabéculaires, tridimensionnels et des cellules dispersées, ont été décrits dans chaque cas. Dans En plus de ces modèles, la morphologie cellulaire et les caractéristiques de fond ont également été notées, et un diagnostic cytologique final a été établi. Le Le diagnostic cytologique était corrélé au diagnostic histopathologique.Analyse statistique utilisée:sensibilité, spécificité, prédictif positif valeur, valeur prédictive négative, DA de la FNAC dans le diagnostic des lésions non néoplasiques et néoplasiques.Résultats:un schéma macrofolliculaire a été observé dans 80,26 % des cas de goitre colloïde. Un profil microfolliculaire a été observé dans 72,2 % des néoplasmes folliculaires. Environ 62,5 % de la thyroïde papillaire les carcinomes présentaient un aspect papillaire. L'aspect trabéculaire a été observé dans 42,86 % des thyroïdites lymphoïdes chroniques et 16,67 % des cas folliculaires néoplasmes. La sensibilité et la spécificité du FNAC dans le diagnostic des lésions néoplasiques étaient respectivement de 92,59 % et 97,59 %.Conclusions:FNAC est un outil de diagnostic primaire simple, rapide, précis et rentable pour l'évaluation de la thyroïde. Le modèle d'architecture cellulaire est simple et approprié approche qui complète la morphologie cellulaire et les détails de base pour parvenir au diagnostic cytologique final des lésions thyroïdiennes.


Subject(s)
Sensitivity and Specificity , Thyroid Gland , Thyroid Neoplasms , Humans , Biopsy, Fine-Needle/methods , Cross-Sectional Studies , Female , Male , Thyroid Neoplasms/pathology , Thyroid Neoplasms/diagnosis , Middle Aged , Adult , Thyroid Gland/pathology , Adenocarcinoma, Follicular/pathology , Adenocarcinoma, Follicular/diagnosis , Aged , Predictive Value of Tests , Cytodiagnosis/methods , Adolescent , Carcinoma, Papillary/pathology , Carcinoma, Papillary/diagnosis , Young Adult , Thyroid Nodule/pathology , Thyroid Nodule/diagnosis , Cytology
19.
J Cancer Res Ther ; 20(3): 1029-1031, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-39023611

ABSTRACT

ABSTRACT: Langerhans cell histiocytosis (LCH) is a rare clonal neoplasm derived from Langerhans-type cells that express CD 1a, langerin, and S 100 on immunohistochemistry. LCH usually involves multiple sites and multiple systems or multiple sites in a single system. Solitary LCH commonly involves the bones (especially the skull), lymph nodes, skin, and lungs. Solitary LCH of the thyroid is an extremely rare disease with a few reported cases in the indexed literature and poses a diagnostic dilemma for both the clinician and pathologist. Histopathology along with ancillary tests forms the gold standard for diagnosis. Surgical resection alone offers a good prognosis once multisystemic involvement has been ruled out. Herein is reported one such case of solitary LCH in a young male patient who remains disease-free after 2 years of follow-up.


Subject(s)
Histiocytosis, Langerhans-Cell , Thyroid Cancer, Papillary , Humans , Male , Histiocytosis, Langerhans-Cell/diagnosis , Histiocytosis, Langerhans-Cell/pathology , Histiocytosis, Langerhans-Cell/surgery , Diagnosis, Differential , Thyroid Cancer, Papillary/diagnosis , Thyroid Cancer, Papillary/pathology , Thyroid Cancer, Papillary/surgery , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/pathology , Thyroid Neoplasms/surgery , Adult , Thyroid Gland/pathology , Thyroid Gland/surgery , Carcinoma, Papillary/diagnosis , Carcinoma, Papillary/pathology , Carcinoma, Papillary/surgery
20.
J Cancer Res Ther ; 20(3): 1071-1073, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-39023621

ABSTRACT

ABSTRACT: Intracystic papillary carcinoma breast is an uncommon breast cancer consisting of 0.5-1.0% of all breast cancers. Papillary carcinoma is further subdivided into intraductal and intracystic papillary carcinoma. Intracystic papillary carcinoma is further divided into pure intracystic papillary carcinoma or associated with in situ carcinoma. The clinical and radiological features of intracystic papillary carcinoma are not specific, hence a high chance of misdiagnosis. Here we report a case of intracystic papillary carcinoma of both breasts which created a diagnostic dilemma.


Subject(s)
Breast Neoplasms , Carcinoma, Papillary , Humans , Female , Breast Neoplasms/pathology , Breast Neoplasms/diagnosis , Carcinoma, Papillary/pathology , Carcinoma, Papillary/diagnosis , Carcinoma, Papillary/surgery , Carcinoma, Papillary/diagnostic imaging , Middle Aged , Mammography
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