• Korean Journal of Head & Neck Oncology
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• v.21 no.2
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• pp.178-182
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• 2005

Insular carcinoma(poorly differentiated thyroid cancer) is defined as a aggressive, follicular-derived thyroid carcinoma with behavior intermediate between follicular/papillary and anaplastic carcinomas. It was described by Carcangiu in 1984, but its prognosis, classification and the origin is not yet clear. And preoperative fine needle aspiration cytology of insular carcinoma has not been satisfactory. We experienced a case of advanced thyroid insular carcinoma with invasion of the sternum. So we intend to present the case with a review of the related literatures.

• The Korean Journal of Cytopathology
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• v.7 no.2
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• pp.111-121
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• 1996

Fine needle aspiration cytology(FNAC) is preferred because of simplicity, safety, and reliability in the evaluation of patients with thyroid nodule or hyperplasia. However, there are a few limitations such as false-negative or false-positive cases and non-diagnostic material. To evaluate the usefulness of FNAC in thyroid lesions, we reviewed 704 FNAC cases of thyroid nodules from 1988 to 1994 at Soonchunhyang University Hospital. The results are as follows. 1. Among 704 FNAC cases of thyroid gland, 571(81.1%) cases were benign, 12(1.7%) were suspicious, 71(10.1%) were malignancy, and 50(7.1%) were material insufficiency. The cytologic diagnoses of the benign lesions included 168 cases of follicular neoplasm, 139 cases of adenomatous goiter, 162 cases of follicular lesion such as follicular neoplasm or adenomatous goiter, 61 cases of Hashimoto's thyroiditis, 13 cases of subacute thyroiditis, and 28 cases of colloidal nodule or benign nodule. The malignant lesions included 68 cases of papillary carcinona, two medullary carcinomas and a case of metastatic colon cancer. 2. The average number of cytologic smear slides was $4.12{\pm}1.81$ in material insufficiency and $5.63{\pm}1.79$ in diagnostic cases. This difference was statistically significant(p<0.00001). 3. Histological assessment of 150 cases revealed 2 false negative and 1 false positive cases. The false negative cases were a case of marked sclerosis in papillary carcinoma and an occult case of papillary carcinoma. The false positive case resulted from pseudo-ground glass nuclei due to marked dry artifact. 4. Comparison between the FNAC and the histologic diagnosis revealed that FNAC had a sensitivity of 93.5%, a specificity of 99.2%, a false negative rate of 6.6%, a false positive rate of 0.8%, and an overall diagnostic accuracy of 98.0%. Therefore, FNAC of thyroid gland is a very reliable diagnostic method with excellent accuracy rate.

• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.3-8
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• 1999

Objective: The expression of Ki67, a proliferation marker, and p27, a cyclin dependent kinases(CDKs) inhibitor, has been studied in various human neoplasms. This study was carried out to determine whether these markers are useful in distinguishing benign from malignant lesions of the thyroid or predicting biologic behavior of malignant lesions. Material and Methods: Using immunohistochemical techniques with monoclonal antibodies to Ki67 and p27, we analyzed the expression of Ki67 and p27 in various thyroid disorders(25 follicular adenomas, 47 follicular carcinomas, 16 papillary carcinomas, 20 adenomatous goiters and 40 normal thyroid tissues). The labeling indices(LIs) were determined by counting cells expressing these markers in 1000 cells per immunostained slide. Results: Neoplastic thyroid diseases showed higher expression of Ki67 and lower expression of p27 than non-neoplastic diseases(p<0.05). The expression of p27 was significantly different between follicular adenomas($LI=55.4{\pm}5.7$) and follicular carcinomas($LI=23.2{\pm}10.2$). There was, however, no significant correlation between the degree of Ki67 and p27labeling indices and types of carcinoma or clinical aggressiveness of diseases. Conclusion: The degree of Ki67 and p27 expression was useful in distinguishing between benign from malignant thyroid lesions, particulary between follicular adenoma and follicular carcinoma, but was not directly proportional to the tumor aggressiveness.

• The Korean Journal of Nuclear Medicine
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• v.38 no.6
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• pp.511-515
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• 2004

Purpose: The sodium-iodide symporter (NIS) expression is an important factor in determining the sensitivity of radioiodine therapy in well-differentiated thyroid cancers. Several previous studies for the expression of NIS in thyroid tissues show diverse results. To investigate whether there is difference between methods in determining the expression of NIS in thyroid tissues of patients with thyroid nodules, we measured the expression ot NIS using two different methods (RT-PCR and immunoshistochemical staining) and compared the results. Materials & Methods: We measured the expression of NIS by reverse transcriptase-polymerase chain reaction (RT-PCR) and also by immunohistochemical staining using anti-NIS antibody in thyroid cancers and other benign thyroid diseases. We compared the results of each method. We included 19 papillary carcinomas, 1 follicular carcinoma, 7 medullary carcinoma, 4 adenomas and 7 nodular hyperplasias. Results: By RT-PCR analysis, 10 of 19 papillary carcinomas expressed NIS, but 1 follicular cancer didn't express NIS. By immunohistochemical staining, 15 of 19 papaillary carcinomas express NIS, but 1 follicular lancer didn't express NIS. There was a significant correlation between the semiquautitative results of RT-PCR and immunohistochemical staining of NIS expression. (p<0.01) Conclusion: Our data demonstrated that the expression of NIS in thyroid cancers and other benign diseases investigated by RT-PCR and immunohistochemical staining correlated well each other. However, by immunohistochemical staining, more NIS expression was found.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4619-4622
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• 2012

Whether it is beneficial to dissect level V in papillary thyroid cancer (PTC) patients with positive lateral neck lymph nodes at levels II-IV is still controversial, especially for low risk cases. In this study, we reviewed the medical records of 47 patients who underwent 47 ipsilateral selective lateral neck dissections (levels II-IV) for previously untreated papillary thyroid carcinomas between October 2006 and October 2008 to assist in establishing the optimal strategy for lateral neck dissection in low risk PTC patients with clinically negative level V nodes. All 47 patients were confirmed to have positive lymph nodes pathologically. Seventeen (36.12%), 36 (76.6%), and 34 (72.34%) patients had positive lymph nodes in levels II, III, and IV, respectively. The mean number of pathologically positive lymph nodes was 1.7 in level II, 2.9 in level III, 2.8 in level IV. No death and distant metastasis were recorded during follow up period. Just 2 patients exhibited recurrence to lymph nodes, and only one showed nodal recurrence in ipsilateral level V, who had positive lymph nodes in all of levels II, III, and IV at initial neck surgery. In conclusion, for PTC low risk patients with clinically negative lymph nodes in level V, non-performance of level V dissection would still achieve good survival results as traditional modified radical neck dissection, with a "wait and see" strategy to be recommended.

• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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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.

• Korean Journal of Head & Neck Oncology
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• v.13 no.2
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• pp.241-246
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• 1997

It has become evident in recent years that parathyroid adenoma and well differentiated thyroid cancer occur together more than would be expected by chance alone. However, the association between them is not well understood. We have experienced 4 cases of coexistent parathyroid adenoma and well-differentiated thyroid cancer during the past 16 years. None of them had a familial incidence or a history of radiation exposure. Three cases showed symptomatic hypercalcemia(including renal stones, bone pain, joint pain) and in two of them(patient 1 and patient 2), thyroid abnormalities were detected preoperatively by neck ultrasonography or neck CT for evaluation of parathyroid lesions. However, in patient 3, a parathyoid humor was identified and removed incidentally during the course of thyroidectomy. In 3 cases, surgeries for thyroid carcinoma and parathyroid adenoma were performed during the same exploration of the neck, but in patient 4, thyroidectomy preceded parathyroidectomy; The interval between thyroidectomy and subsequent parathyroidectomy was 11 yeras. The thyroid tumors in 3 cases were papillary carcinoma, the sizes of which ranged from 1.0 cm to 1.5 cm in greatest diameter. The remaining case(patient 4) was minimal invasive follicular carcinoma. Total or near-total thyroidectomy with various types of cervical lymphnode dissection and bilateral neck exploration for the parathyroid lesion was performed in 3 cases with papillary carcinoma. Ipsilateral lobectomy and contralateral partial thyroidectomy with consequent unilateral neck exploration for the parathyroid tumor was performed in the case of follicular cancer. In our experience, parathyroid adenoma and well-differentiated thyroid carcinomas can be coexistent and we felt that the attention to the hypercalcemic patients would be needed for detection of this rare condition.

• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.1-9
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• 2021

Thyroid cancer refers to various cancers arising from thyroid gland. Differentiated thyroid cancers (DTCs) include papillary, follicular, and Hurthle cell carcinomas and represent cancers retain normal thyroid functions such as iodine uptake. Radioactive iodine (RAI) is generally used for upfront treatment of metastatic DTCs, but RAI refractory DTCs remain to be clinical challenges. Sorafenib and lenvatinib were approved for the treatment of RAI refractory DTCs and more recently, genomics-based targeted therapies have been developed for NTRK and RET gene fusion-positive DTCs. Poorly differentiated and anaplastic thyroid cancers (ATCs) are extremely challenging diseases with aggressive courses. BRAF/MEK inhibition has been proven to be highly effective in BRAF V600E mutation-positive ATCs and immune checkpoint inhibitors have shown promising activities. Medullary thyroid cancers, which arise from parafollicular cells of thyroid, represent a unique subset of thyroid cancer and mainly driven by RET mutation. In addition to vandetanib and cabozantinib, highly specific RET inhibitors such as selpercatinib and pralsetinib have demonstrated impressive activity and are in clinical use.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6715-6717
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• 2015

Background: The purpose of this study was to provide epidemiological and histological data of thyroid cancers in Togo. Materials and Methods: This was a retrospective cross-sectional study of cases of thyroid cancers diagnosed from 2000 to 2014 (15 years) at the pathology laboratory of the Sylvanus Olympio Teaching Hospital of $Lom{\acute{e}}$. All cases of review of a thyroid sample (biopsies, surgical specimens) were collected from the data records of that laboratory. Results: Thyroid cancers represented 1.1% (7930cases) of all cancers registered during the study period. Mean age was $45.4{\pm}0.3$ years and the proportion of females was 78.3%. We identified 92.4% carcinomas and 7.6% lymphomas. Carcinomas were well differentiated in 80 cases and were dominated by the papillary type (47 cases). Metastasis was observed in 13% of patients. The pTNM classification evaluated in 18 cases showed a predominance of grade I (13 cases). Lymphomas were dominated by lymphoma diffuse large B-cell (5 cases). Conclusions: This study is the first global standard for thyroid cancer pathology in Togo. The high frequency of follicular form suggests an unrecognized iodine deficiency. The improvement of the technical platform of the LAP (immunohistochemistry) will increase the diagnosis of rare forms of thyroid cancer.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.64-68
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• 2008

Purpose：The chronic use of immunosuppressive therapy in transplant recipients can increase the long-term risk of carcinoma. The aim of this study was to determine the incidence, biological behaviors, and treatment outcomes in PTC(papillary thyroid carcinoma) in renal allograft recipients. Material and Methods：The present study examined the incidence and biological behavior of PTCs in RA recipients. A total of 1,739 RA patients treated between January 1986 and December 1999 were followed-up for a median 137(84-238) months. During the follow-up period, 129(7.4%) recipients were identified as having posttransplant malignancies. Of those, 12(0.7%) had PTCs, and these comprised six male and six female patients with a median age of 41(23-57) years. Results：Nine cases(incidentalomas) were diagnosed based on ultrasonography(US) screening. Eight of those nine were TNM stage I, and two of the three clinical carcinomas were TNM stage IVa. During a median follow-up of 94(18-159) months, two(16.7%) PTC patients developed loco-regional recurrence, but no patients showed distant metastasis. Posttransplant PTC showed no gender bias, and was often associated with aggressive lymphatic metastasis. However, most incidentalomas showed a favorable treatment outcome. Conclusion：In conclusion, routine surveillance of the thyroid gland using US screening is recommended to ensure early detection, treatment and favorable prognosis in RA patients with PTC.