• 생명과학회지
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• 제19권11호
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• pp.1514-1521
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• 2009

혈장 cathepsin B 활성도 측정이 갑상선암 및 결절성 증식증의 수술 전 진단에 도움이 되는지를 알아보고자 분화갑상선암 32례, 결절성 증식증 7례, 대조군 5례의 혈장 cathepsin B 발현양상을 대조군과 함께 관찰하였다. 수술시 제거된 여포선암의 암조직, 결절성 증식증 조직의 cathepsin B 발현을 정상 조직과 비교하였다. 혈장 Cathepsin B 활성도는 정상 대조군에서 $168.94{\pm}15.10$ (${\times}10^{-2}$, mU), 결절성 증식증에서 $255.45{\pm}95.68$ (${\times}10^{-2}$, mU), 악성종양에서 $284.87{\pm}79.32$ (${\times}10^{-2}$, mU)로써 악성종양군과 결절성 증식증군에서 cathepsin B 발현이 정상 대조군보다 비교적 높게 나타났다(p<0.05). 혈장 cathepsin B의 정량적 비교를 위한 immunoassay결과에서도 결절성 증식증군($17.64{\pm}7.49\;ng/ml$)과 악성종양군($15.50{\pm}7.86\;ng/ml$)에서 정상대조군($4.85{\pm}0.61\;ng/ml$)보다 높은 수치를 나타내었다(p<0.05). 결절성 증식증 및 악성종양군의 조직 내 cathepsin B mRNA발현이 정상 조직에서보다 높게 나타났다. 따라서 혈장 cathepsin B는 갑상선세포의 비정상적인 증식시에 증가됨을 알 수 있으며, 갑상선암 혹은 결절성 증식증을 스크리닝하는데 이용될 수 있을 것으로 사료된다.

• 대한두경부종양학회지
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• 제9권1호
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• pp.25-32
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• 1993

저자들은 배양에 성공한 결절성 갑상선종 2예와 유두성 갑상선암 2예에서 염색체 이상을 찾아내어 이러한 이상들이 서로 연관을 갖는지 여부를 연구하고자 본 실험을 시행하였다. 결절성 갑상선종의 염색체 형태는 매우 다양하게 나타나면서도 2예 모두가 특이적인 염색체 이상은 보이지 않았다. 제 1 예 : modal 염색체 슷자는 42에서 46범위 내였고 염색체 8, 19, 21, 22는 빈번한 결손을 보였다. 51개 분석 세포들 중에 9가지 구조적 변성이 관찰되었으나 집단 염색체 변화는 없었다. 제 2 예 : modal 염색체 수는 43이었고, 염색체 17과 19는 흔한 결손을 나타내었다. 이 두 결절성 갑상선종의 세포유전학적 특성은 저이배체(hypodiploidy)와 매우 다양한 염색체 양상을 나타내었다. 유두성 갑상선암에 대한 분석 결과는 다음과 같다. 제 3 예 : 다소의 숫적, 구조적 염색체 변화가 관찰되었으나 특이적인 염색체 이상은 찾아볼 수 없었다. 제 4 예 : 염색체 양상이 del(11)(q23)의 집단 염색체 변화를 수반하는 매우 다양한 이질적인 양상을 나타내었다. 유두성 갑상선암의 del(11)(q23) 염색체 변화는 이미 Eva Olah등이 1989년 보고한 바 있다. 아마도 갑상선에서 유두성 갑상선암의 암화과정에 11q 결손이 중요한 역할을 할 것으로 추정된다. 이상의 결과에 따르면 유두성 갑상선암과 결절성 갑상선종 둘 다 염색체 이상을 나타냈지만 양자간의 염색체의 특이적인 상관 관계를 발견할 수 없었다.

• 대한두경부종양학회지
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• 제17권2호
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• pp.155-161
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• 2001

Background and Objectives: Nitric oxide (NO) is generated in mammalian tissue by the conversion of L-arginine to L-citrulline. This reaction is catalyzed by nitric oxide synthase (NOS). NO is an important bioactive agent and a signalling molecule that mediates a variety of biologic actions such as vasodilation, neurotransmission, host defense, and iron metabolism but increased NO production may also contribute to the pathogenesis of a various of disorders, including cancer. Before now, the role of NO in thyroid gland is still investigated and it was supposed that NO mediate the angiogenesis in tumor growth. Others journal and works identified the expression of iNOS that involve by neutrophil and eNOS that involve in part in the vascular remodeling and to understand the role of NO in human thyroid gland. But authors revealed only eNOS in thyroid neoplasm. iNOS was identifed by inflammation in fault. Materials and Methods: Western blot analysis was performed, using a polyclonal antibody against eNOS (Rabbit polyclonal IgG). Using the same antibody, the distribution of eNOS was examined in 15 formalin-fixed paraffin embedded samples by immunohistochemistry. By NADPH consumption rate, NOS activity was estimated at nodular hyperplasia. Results: Western blot analysis exhibited that eNOS was significantly elevated in thyroid papillary carcinoma, compared to that in nodular hyperplasia and normal tissue. Immunohistochemistry showed that the immunoreacitivity was present more significantly in thyroid follicular epithelial cell layer than vascular endothelial cell. NOS activity increased in nodular hyperplasia. Conclusions: Thyroid papillary cancer without neutrophil invasion expressed only eNOS. The endothelial localization of eNOS may play an important role in pathogenensis of human thyroid nodular hyperplasia and the follicular localization of thyroid papillary carcinomas.

• 대한세포병리학회지
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• 제9권1호
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• pp.63-68
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• 1998

Fine needle aspiration cytology of "cold" nodules of the thyroid has proved to be of great value in their preoperative diagnosis. Most types of thyroid tumors are readily recognizable from characteristic cellular patterns in the smears of needle aspirates. But follicular neoplasms present some problems because the cytomorphology of the adenomas frequently is same as in carcinoma. For differentiation of benign from malignant follicular neoplasms of the thyroid we tested the usefulness of two objective parameters - nuclear area and perimeter - by morphometry. This study was made on fine needle aspirates from 30 cases with cytologic diagnosis of follicular neoplasm of thyroid. The histologic classification was follicular adenoma in 22 cases and follicular carcinoma in 8 cases. As a reference group we used seven caes with nodular hyperplasia. The smears of aspirates were stained by Papanicolaou method. On each slide 200 randomly selected cells with intact nuclei were measured. The mean value of nuclear area are $25.32{\pm}5.50{\mu}m^2,\;34.08{\pm}7.50{\mu}m^2\;and\;39.97{\pm}6.63{\mu}m^2$ in nodular hyperplasia, follicular adenoma, and follicular carcinoma, respectively. The mean value of perimeter are $19.48{\pm}2.26{\mu}m,\;22.95{\pm}2.65{\mu}m\;and\;24.78{\pm}2.23{\mu}m$ in nodular hyperplasia, follicular adenoma and follicular carcinoma, respectively. The mean nuclear areas and perimeters of cells from follicular adenoma were significantly larger than those from nodular hyperplasia (p<0.05). The mean nuclear areas and perimeters of cells from follicular carcinoma were larger than those from follicular adenoma but the differences are not significant statistically(p>0.05). Therefore, morphometric assessment alone is inadequate to predict malignancy in thyroid aspirates.

• International journal of thyroidology
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• 제11권2호
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• pp.123-129
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• 2018

Background and Objectives: Hypermethylation of the tumor suppressor gene RASSF1A and activating mutation of BRAF gene have been recently reported in thyroid cancers. To investigate the role of these two epigenetic and genetic alterations in thyroid tumor progression, methylation of RASSF1A and BRAF mutation were examined in thyroid tumors. Materials and Methods: During 2007 to 2017, 69 papillary carcinomas, 18 nodular hyperplasia, 3 follicular carcinomas, and 13 follicular adenomas were selected. The methylation-specific polymerase chain reaction (MSP) technique was used in detecting RASSF1A methylation and polymerase chain reaction (PCR)-single-stranded conformation polymorphism and sequencing were used for BRAF gene mutation study. Results: The hypermethylation of the RASSF1A gene was found in 84.6%, 100% and 57.9% of follicular adenomas, follicular carcinomas, and papillary carcinomas, respectively. Nodular hyperplasia showed a hypermethylation in 33.3%. The BRAF mutation at V600E was found in 60.7% of papillary carcinoma and 27.0% of nodular hyperplasia, but none of follicular neoplasms. The BRAF mutation was correlated with the lymph node metastasis and MACIS clinical stage. There is an inverse correlation between RASSF1A methylation and BRAF mutation in thyroid lesions. Conclusion: Epigenetic inactivation of RASSF1A through aberrant methylation is considered to be an early step in thyroid tumorigenesis, and the BRAF mutation plays an important role in the carcinogenesis of papillary carcinoma, providing a genetic marker.

• Journal of Chest Surgery
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• 제42권4호
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• pp.537-539
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• 2009

47세 여자 환자가 이전부터 있던 흉골상 절흔부에 종괴를 제거하기 위해 내원하였다. 흉부 CT에서 종괴는 상전종격동에 위치하고 있었다. 경부 절개 후에 종괴를 제거하였고 병리학적 검사상 종괴는 결절성 과형성(nodular hyperplasia)을 함유한 이소성 갑상선 조직으로 진단되었다. 저자들은 드문 종격동 이소성 값상선 조직을 치험하였기에 보고하는 바이다.

• 대한두경부종양학회지
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• 제21권1호
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• pp.15-20
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• 2005

Objectives: The hepatocyte growth factor(HGF)/c-Met pathway may play various roles in the carcinogenesis of various organs. Although HGF/c-Met signalling pathway has been shown to demonstrate various cellular responses including mitogenic, proliferative, morphogenic and angiogenic activities, the study on their expression related to clinicopathological parameters in thyroid tumor is relatively rare. So we want to find out the clinical significance of the c-Met in thyroid tumor. Materials and Methods: We assess the mRNA and protein expression of the c-Met genes by means of RT-PCR method and the immunohistochemical stain in 100 cases of thyroid tumors(50 papillary carcinomas, 10 follicular carcinomas, 20 follicular adenomas, 20 nodular hyperplasia). Results: By RT-PCR, c-Met mRNA was detected in 43(86%) in papillary carcinoma, 4(40%) in follicular carcinoma, 4(20%) in follicular adenoma and 2(10%) in nodular hyperplasia cases. By immunohistochemistry, c-Met protein expression was detected in 44(88%), 2(20%), 3(15%) and 1(5%). Expression of the c-Met mRNA and protein expression was significantly highly recognized in papillary carcinoma. The c-Met protein overexpression was significantly correlated with the grade of the differentiation. Conclusion: These results suggest that c-Met expression may be associated with thyroid papillary cancer progression. The differential expression of c-Met protein and mRNA suggests that these molecules may be a reliable diagnostic marker in thyroid papillary cancer.

• 대한두경부종양학회지
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• 제17권1호
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• pp.38-41
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• 2001

Background and Objectives: Thyroid nodules can be diagnosed by FNAB, neck sonography, CT scan, or frozen section with relative accuracy. But some cases, which show no malignancy with those methods, are proved differentiated carcinomas on permanent sections. These false negative results of those diagnostic methods pose difficulties in the surgeon's decision-making process. We analyzed completion thyroidectomies retrospectively in order to make a treatment guideline for thyroid nodules. Materials and Methods: During the last six years, we performed 243 thyroid lobectomies, no evidence of malignancy with preoperative or intraoperative diagnostic methods at the Department of Otolaryngology-Head and Neck Surgery, Ansan and Anam Korea University Hospital. Among these cases, 23 patients (male 6, female 17, mean age 33.4 year old) were proved differentiated thyroid carcinomas on permanent section and we performed completion thyroidectomies. Results: Preoperative FNAB showed seven cases of nodular hyperplasia, 11 cases of follicular adenoma, and five cases of inadequate specimen. Among total 15 cases on frozen section, five cases were nodular hyperplasias, and 10 cases were follicular adenomas. Pathologic results of the permanent section were six cases of papillary cell carcinoma and 17 cases of follicular cell carcinoma. Completion thyroidectomy was performed on all these cases. Conclusion: FNAB and frozen section cannot be sufficient to make the diagnosis of thyroid nodule, we consider that completion thyroidectomy should be performed at the moment with malignant evidence on permanent section.

• 대한두경부종양학회지
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• 제14권1호
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• pp.88-93
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• 1998

In order to review the clinicopathologic characteristics of the thyroid cancer associated with benign thyroid disease, we evaluated 47 patients treated between January, 1993 and September, 1997 at the Chonnam National University Hospital. In those period, we had operated a total of 690 thyroidectomy of which 320 were diagnosed as thyroid cancer. Forty three(91.4%)occurred in women and four(8.5%)occurred in men. The mean age at operation was 46.7years(range, 15 to 76 years). Forty three of the 47 cancers(91.4%) were papillary carcinomas while 4(8.5%)were follicular. Twenty four of the 47 patients (51%) were occult thyroid carcinomas measured less than 1 cm in diameter. The concurrent benign disease were nodular goiter(n=17), Hashimoto's thyroiditis(n=16), follicular adenoma(n=10), Graves' disease(n=2) and diffuse hyperplasia(n=2). Thirty one patients were diagnosed by preoperative FNAC and they underwent total thyroidectomy. Three were diagnosed by frozen section examination at the time of operation. Among them, one underwent total thyroidectomy and two underwent subtotal thyroidectomy. Eight cases revealed lymph node metastases and 2 cases extended to surrounding muscles. In conclusion, concurrent thyroid cancers and benign thyroid disease are not uncommon and a regular ultrasonic follow-up with selective aspiration cytologic examination is recommaned to enhance their diagnostic accuracy.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5565-5570
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• 2014

Objectives: This study aimed to characterize the histopathological pattern of thyroid lesions among Saudi patients and to highlight the age and gender variations of these lesions as base line data. Materials and Methods: We retrospectively analyzed the data from thyroid specimens received at the Department of Pathology, King Fahad Hospital, Madinah, Saudi Arabia from January 2006 to December 2013. Results: The 292 thyroidectomy specimens received during the study period came from 230 (78.8%) females and 62 (21.2%) males giving a female: male ratio of 3.7:1. Age of the patients ranged from 14 to 95 years with a mean age 39.7 years. Two hundred and eleven (72.3%) cases were found to be non-neoplastic and 81 (27.7%) cases were neoplastic. The non-neoplastic group included: colloid goiter, including both diffuse and nodular goiter (170 cases; 58.2%), nodular hyperplasia (28 cases; 9.6%), Hashimoto/chronic lymphocytic thyroiditis (12 cases; 4.1%), and Grave's disease (1 case; 0.3%). In neoplastic lesions, there were 7 benign tumors and 74 malignant tumors. Among the benign tumors, 5 were follicular adenomas and 2 were Hurthle cell adenomas. Papillary carcinoma was the commonest malignant tumor accounting for 87.8% of all thyroid malignancies, followed by lymphoma, follicular carcinoma and medullary carcinoma. The size of papillary carcinoma was more than 2 cm in 40 cases (76.9%). Conclusions: Non-neoplastic thyroid lesions were more common than neoplastic ones. Colloid goiter was the most common lesion. Follicular adenoma was the commonest benign tumor and papillary carcinoma was the commonest malignant lesion. There appears to be a slightly increased trend of papillary carcinoma diagnosis, most being diagnosed at an advanced stage.