• Advances in pediatric surgery
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• v.12 no.2
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• pp.183-191
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• 2006

Thyroid nodules are less common in children than in adults and their management is still controversial. The clinical presentations, operations, complications, histopathologic findings, and postoperative progressions of 34 pediatric patients that underwent thyroidectomy for palpable thyroid nodule at the Department of Surgery, Seoul National University Children Hospital between 1986 and 2003 were studied retrospectively by reviewing medical records and telephone interviews. The mean age of the patients was 11.8 years old. There were 23 females (67.6 %) and 11 males (32.4 %). Surgical indications were clinical need of histological confirmation (n=15), unresponsiveness to thyroxin replacement therapy (n=10), suggestion of the carcinoma on fine needle aspiration cytology (n=5), cosmetic purpose-a huge benign nodule (n=2), completion thyroidectomy for medullary thyroid carcinoma (n=1), and prophylactic thyroidectomy in a MENIIpatient (n=1). Unilateral Lobectomy was performed in 20 patients (57.1 %), subtotal thyroidectomy in 8 (22.9 %), total thyroidectomy in 5 (14.7 %), and completion thyroidectomy in 1 (2.9 %). Lymph node dissection was performed in 9 cases. Benign tumor was found in 23 patients (67.6 %), adenomatous goiter (n=18) and follicular adenoma (n=5). Malignant tumor was found in 11 children (32.4 %), 9 papillary carcinomas (26.5 %), and 2 medullary carcinomas (5.9 %). Of the 9 papillary carcinomas, 7 cases (77.8 %) had lymph node metastasis. No lymph node metastasis was found in 2 medullary carcinomas. Complications developed in 5 cases - transient hypocalcaemia (n=2), and temporary hoarseness (n=3). There was no mortality. Median follow-up period was 7.4 years (0.5-18 years). One patient showed recurrence in cervical lymph nodes 10 years after surgery and modified radical neck dissection was performed. Because of the high incidence of malignancy and advanced stage at initial presentation, more meticulous diagnostic work up is necessary for children with thyroid nodule, and more radical surgical treatment should be performed when malignant nodule is suggested.

• Korean Journal of Clinical Laboratory Science
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• v.41 no.4
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• pp.180-188
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• 2009

Plakoglobin (PKG) is a protein linking cadherin adhesion receptors to the actin cytoskeleton and its overexpression has been known to suppress cell proliferation and tumorigenesis in thyroid cancer. We investigated the effect of 5-aza-2'-deoxycytidine (5-Aza-CdR), a DNA methyltransferase inhibitor, on the methylation status of the promoter and the expression of the plakoglobin gene in a thyroid carcinoma cell line (ARO) and papillary thyroid carceinoma. In cultures of ARO cell line incubated without 5-Aza-2'-deoxycytidine (5-Aza-CdR), five of the fifteen CpG sites in the promoter spanning -225 and -54 were methylated at 4.2 - 12.5%. When the cells were treated with 5-Aza-CdR, all the methylated CpG sites were induced to be demethylated except one. In addition, a new methylation at one CpG site, CpG4, was identified at level of 12.0%. The expression level of PKG decreased approximately 10-fold in the 5-Aza-CdR treated cells compared to untreated cells. Different pattern of promoter methylation and expression of PKG was also observed in the tissue samples. CpG10 and CpG12 sites were methylated at 9.0-27.0% in normal tissues. However, in cancer tissues, CpG5 and CpG10 sites were methylated at 10.0-22.0%. Three of ten normal thyroid tissue samples and one of thirteen papillary carcinoma tumor samples showed increased PKG mRNA expression level. PKG protein expression analyzed by the immunohistochemical staining showed higher expression in the tumor compared with normal.

• International journal of thyroidology
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• v.10 no.2
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• pp.96-101
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• 2017

Background and Objectives: Anaplastic thyroid carcinoma (ATC) is commonly related with concurrent differentiated thyroid carcinoma (DTC). We aimed to examine the clinicopathologic characteristics, prognosis and gene expression of DTC with anaplastic foci. Materials and Methods: Eighteen patients with DTC with anaplastic foci were enrolled in this study. To compare the clinicopathologic characteristics and prognosis of anaplastic foci subjects with conventional ATC or DTC, we additionally included 12 ATC and 1030 DTC patients who diagnosed during same period. Immunohistochemistry was performed to check the gene expression in anaplastic foci and DTC component. Results: In anaplastic foci group, tumor size was larger ($2.5{\pm}1.3$ vs. $1.2{\pm}0.9cm$, p=0.001), distant metastasis was more frequent (11.1 vs. 0%, p=0.000) and 1-year survival rate was low (88.9 vs. 100%, p=0.000) than DTC group. In contrast, compared with ATC group, anaplastic foci group showed younger age at diagnosis ($50{\pm}16$ vs. $63{\pm}18years$, p=0.039), smaller tumor size ($2.5{\pm}1.3$ vs. $3.8{\pm}1.4cm$, p=0.027), less distant metastasis (11.1 vs. 41.7%, p=0.084) and longer 1-year survival rate (88.9 vs. 25.0%, p=0.001). Expression of p53 protein was observed in 100% of anaplastic foci, ATC and 12.5% of papillary thyroid carcinoma component. Conclusion: DTC with foci of anaplastic transformation has a worse prognosis than DTC, but a better prognosis than ATC. Our results support that DTC with anaplastic foci was intermediate state from DTC to ATC.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2671-2674
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• 2015

Thyroid cancer is the most prevalent endocrine cancer and is evident in nearly 5% of thyroid nodules. The correlation between mean platelet volume (MPV) and many other cancer types has been investigated previously. However, the correlation between papillary thyroid carcinoma (PTC) and MPV has not yet been studied in detail. The aim of this study was to examine whether MPV would be a useful inflammatory marker to differentiate PTC patients from cases of benign goiter and healthy controls. Preoperative MPV levels in patients with PTC were found to be significantly higher when compared with benign goiter patients and healthy controls ((respectively, 8.05 femtoliter (fl), 7.57 fl, 7.36 fl, p=0.001). After surgical treatment of PTC patients, a significant decrease in MPV levels was seen (8.05 fl versus 7.60 fl, p=0.005). ROC analysis suggested 7.81 as the cut-off value for MPV (AUC=0.729, sensitivity 60%, specificity 80%). In conclusion, maybe changes in MPV levels can be used as an easily available biomarker for monitoring the risk of PTC in patients with thyroid nodules, enabling early diagnosis of PTC.

• Korean Journal of Head & Neck Oncology
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• v.20 no.2
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• pp.128-134
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• 2004

Background and Objectives: Angiogenesis is the process of new blood vessel development from preexisting vessel. Angiogenenesis has been considered to be essential for the growth and expansion of a solid tumor. Vascular endothelial growth factor (VEGF), known as one of the most important vascular permeability factors, induces proliferation of endothelial cells, stiumulates angiogenesis, and increases vascular permeability. Several recents reports have documented that VEGF overexpression is associated with poor clinical outcomes in many maligmancies. The aims of this study were to determine whether microvessel density and VEGF expression are related to clinicopathologic factors such as age, sex, tumor size, tumor stage, and prognostic factors and to evaluate the relationship between VEGF expression and angiogenesis in benign and malignant thyroid tumors. Materials and Methods: The subjects were 65 patients (27 with papillary carcinoma, 27 with adenomatous hyperplasia, 11 with follicular adenoma) who underwent thyroidectomy from 1995 to 2001. Imuunohistochemistry was used to detect VEGF expression and microvessel density (MVD) in paraffin-embedded thryoid tumor specimens. Results: The intensity of the VEGF expression did not show stastically difference between benign and malignant thyroid tumors. There was no apparent correlation between VEGF expression and age, tumor size, T stage or scores of the AGES, AMES and MACIS systems. The neo-microvessel density was higher in the maligant tumor than the benign tumors. Also, higher neo-microvessel density was associated with metastases of the lymph nodes and scores of the AMES and AGES systems. Conclusion: Our results suggest that neo-microvessel vessel density may be a significant prognostic factor in the thyroid papillary carcinoma. But the VEGF expression does not appear to be an significant independent prognostic factor for thyroid papillary carcinoma.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.47-52
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• 2008

Purpose：The incidence of papillary thyroid microcarcinoma(PTMC) has increased due to the widespread use of high resolution ultrasonography and fine-needle aspiration biopsy. However, the clinical and biologic behaviors of PTMC is debatable. The aim of this study was to describe clinicopathologic features of PTMC and to suggest whether tumor size(5mm) might prove the useful parameter for determining the surgical strategy in PTMC. Material and Methods：From Jan. 2000 to Dec. 2005, 1355 of 2678 patients with papillary thyroid carcinoma were identified as having PTMC, based on tumor size${\leq}$10mm(50.6%). Among patients with PTMC, we further separated tumors<5mm(minute group：group M) from those 5 to 10mm(tiny group：group T). We compared the clinicopathological characteristics and the TNM stagings between two groups. Results：There were 114(8.4%) men and 1241(91.6%) women with a median age of 47 years(range；13-79). During a mean follow-up of 47.3(range；22-93), 13 patients(1.0%) developed locoregional recurrences and 3 patients(0.2%) showed distant metastases at initial presentation. Statistical analysis revealed that the presence of extracapsular invasion(p<0.0001), invasion to adjacent structure(p<0.0001), multifocality(p<0.0001), central lymph node metastasis(p<0.0001), and lateral lymph node metastasis(p<0.0001) were all significantly higher in tiny group(tumor${\geq}$5mm). Furthermore, minute group demonstrated a significantly lower tumor stage(AJCC TNM classification) compared with tiny group(p<0.0001). Conclusion：Patients with PTMC have a favorable treatment outcomes, although the distinction needs to be made with reference to the clinicopathologic behaviors. It would be reasonable to consider that tumor size(5mm) would be useful parameter for the treatment strategy of PTMC.

• Korean Journal of Head & Neck Oncology
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• v.9 no.1
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• pp.33-41
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• 1993

A multivariate analysis of the prognostic factors and five year survival rate was carried out on a series of 72 thyroid cancers treated surgically from 1980 to 1987 and followed for 1 to 11 years. The prognosis of the disease was significantly influenced by age at diagnosis, extracapsular invasion, angioinvasion and pathologic type, but the disease was not influenced by sex, lymph node metastasis, and 'risk' category. The overall five year survival rate was 89.7%. Six patients were dead of tumor after surviving for six months to two and half years, and the cause of death was local recurrence in three, lung metastasis in two and bone metastasis in one patient. Five year survival rate in age above fifty, presence of capsule and angioinvasion, follicular carcinoma, and extrathyroidal lesion was significantly shorter than that of patients with age below fifty, absence of capsule and angioinvasion, papillary carcinoma, and intrathyroidal lesion. Patients at low risk or with small carcinomas had long survival over 5 years with only lobectomy. Lymph node dissection was done with a limited type in no jugular metastasis, radical neck disscetion was performed only therapeutically in proved jugular node metastasis. Thyroid hormone was administered for the period of 3 to 5 years to suppress endogenous TSH production.

• Korean Journal of Head & Neck Oncology
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• v.20 no.2
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• pp.143-146
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• 2004

Background and Object: The role of fine needle aspiration cytology (FNAC) and frozen section (FS) in management of thyroid neoplasms continues to generate considerable controversy. We reviewed our current experience to determine the clinical utility of FNAC and FS in our surgical management and investigated reliability of FNAC and FS in planning the extent of thyroid resection. Material and Method: 212 patients who had operations for thyroid disease from May 1996 to November 2003 were included our retrospective study. FNAC was undertaken in 175 patients and FS was done in 148 patients. Result: The sensitivity and specificity of FNAC were 72.1% and 100%, respectively, and those of FS were 67.2% and 100%. The results of FNAC were benign (n=72) , malignancy (n=31), indeterminate (n=9), and nondiagnostic (n=63). The results of FS were benign (n=95), and malignancy (n=53). The 9 indeterminate cases on FNAC were benign (n=6) and malignancy (n=3) on final pathology, and benign (n=7) and malignancy (n=2) on FS. The false negative of FNAC were micro papillary carcinoma (n=6) and follicular carcinoma (n=6). The false negative of FS were micropapillary carcinoma (n=10) and follicular carcinoma (n=2). Conclusion: When results of FNAC are interpreted as indeterminate, FS is a valuable tool. FS is helpful in determining the extent of thyroidectomy when results of FNAC were follicular neoplasm. However we always concerned about micropapillary carcinoma and follicular carcinoma although FNAC and FS were benign.

• 대한세포병리학회:학술대회논문집
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• 1992.11a
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• pp.18.1-18.1
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• 1992

• Proceedings of the KOR-BRONCHOESO Conference
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• 2002.12a
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• pp.6-6
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• 2002