• Title/Summary/Keyword: Thyroid malignancy

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Clinical Prognostic Score for Predicting Disease Remission with Differentiated Thyroid Cancers

  • Somboonporn, Charoonsak;Mangklabruks, Ampica;Thakkinstian, Ammarin;Vatanasapt, Patravoot;Nakaphun, Suwannee
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2805-2810
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    • 2016
  • Background: Differentiated thyroid cancer is the most common endocrine malignancy with a generally good prognosis. Knowing long-term outcomes of each patient helps management planning. The study was conducted to develop and validate a clinical prognostic score for predicting disease remission in patients with differentiated thyroid cancer based on patient, tumor and treatment factors. Materials and Methods: A retrospective cohort study of 1,217 differentiated thyroid cancer patients from two tertiary-care hospitals in the Northeast of Thailand was performed. Associations between potential clinical prognostic factors and remission were tested by Cox proportional-hazards analysis in 852 patients (development cohort). The prediction score was created by summation of score points weighted from regression coefficients of independent prognostic factors. Risks of disease remission were estimated and the derived score was then validated in the remaining 365 patients (validation cohort). Results: During the median follow-up time of 58 months, 648 (76.1%) patients in the development cohort had disease remission. Five independent prognostic factors were identified with corresponding score points: duration from thyroid surgery to $^{131}I$ treatment (0.721), distant metastasis at initial diagnosis (0.801), postoperative serum thyroglobulin level (0.535), anti-thyroglobulin antibodies positivity (0.546), and adequacy of serum TSH suppression (0.293). The total risk score for each patient was calculated and three categories of remission probability were proposed: ${\leq}1.628$ points (low risk, 83% remission), 1.629-1.816 points (intermediate risk, 87% remission), and ${\geq}1.817$ points (high risk, 93% remission). The concordance (C-index) was 0.761 (95% CI 0.754-0.767). Conclusions: The clinical prognostic scoring model developed to quantify the probability of disease remission can serve as a useful tool in personalized decision making regarding treatment in differentiated thyroid cancer patients.

Morphometric Study on Fine Needle Aspirates from Follicular Adenoma and Follicular Carcinoma of the Thyroid (세침흡인된 갑상선의 여포상 선종과 여포상 암종의 형태계측학적 연구)

  • Chu, Young-Chae;Cha, Hee-Jung;Min, Soo-Kee;Kim, Joon-Mee;Hwang, Tae-Sook
    • The Korean Journal of Cytopathology
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    • v.9 no.1
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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.

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A Clinical Study of Surgically Treated 194 Cases of the Thyroid Cancer (외과적 절제술로 치험한 갑상선암 194예의 임상적 고찰)

  • Lee Suk-Jae;Kim Sung-Bae;Kim Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.1
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    • pp.50-55
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    • 2002
  • Objectives: Thyroid cancer is the most common endocrine malignancy with favorable histologic and prognostic characteristics. Total or near total thyroidectomy has been used as a standard surgical procedure. The aims of this study are to determine the extent of resection of thyroid gland and to find the influencing factors of lymph node metastasis. Materials and Methods: The authors reviewed the records of 194 patients of thyroid cancer surgically treated at Department of General Surgery, Inje University Busan Paik Hospital from January, 1996 to December, 2000. Pathologic classifications, surgical procedures, and lymph node metastasis were analyzed. Results: There were 163 women and 31 men. The age ranged from 12 to 79 years old (mean age 43.2 years). The histological classifications of 194 cases revealed papillary cancer in 171 cases (88.1%), follicular cancer in 17 cases (8.8%), undifferentiated cancer in 3 cases (1.6%), medullary cancer in 2 cases (1.0%) and mixed cancer in 1 case (0.5%). Among the 194 patients, lobectomy was perfomed in 31 patients, subtotal thyroidectomy in 30 patients, near total thyroidectomy in 82 patients and total thyroidectomy in 51 patients. In the subgroup of papillary carcinoma 141 cases with lymph node dissection, lymph node metastasis had no statistical significance according to sex, age and primary tumor size. Conclusions: The mainly performed surgical procedures were total thyroidectomy and near total thyroidectomy. In thyroid cancer surgery, the extent of resection was influenced by age, differentiation and primary tumor size. The lymph node dissection should be decided by lymph node metastasis identified by preoperative radiologic evaluation or intraoperative lymph node findings.

A Clinical Study of Thyroid Diseases (갑상선 질환에 관한 임상적 관찰)

  • Min Byoung-Sam;Nam Young-Soo;Park Chan-Heun;Pai Soo-Tong
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.112-121
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    • 1994
  • During the 7 years period from March 1987 to Febrary 1994, 344 patients with thyroid nodules, were admitted and operated at Department of Surgery, Collage of Medicine, Hallym university. We obtained following results: 1) The thyroid nodules were prevalent in female with ratio 1:17.1, both benign and malignant nodules were prevalent in the forth decade(37.8%:25.8%). 2) The duration of illness within 6 months was most common: 47.1% and within 1 years was 66.6%. 3) The most prominent symptoms & sign were palpable mass in anterior neck(96.8%). 4) The right-sided thyroid nodules were most common. 5) Thyroid scaning and thyroid function test were found to be not much value in differentiating malignancy. 6) Accuracy of the fine needle aspiration cytology was 75.5%. 7) There were 251 cases(73.0%) of benign and 93 cases(27.0%) of malignant nodules: most frequent benign nodule was adenomatous goiter(67.7%) and the most frequent malignant nodule was papillary adenocarcinoma (86.0%). 8) The most commonly performed surgical procedure was unilateral lobectomy with isthmectomy in both benign(41.0%) and malignant(33.3%). 9) Postoperative complications are as follows: transient hypothyroidism 22cases, transient hoaseness 16 cases, hypothyroidism 6 cases, wound infection 4 cases, hematoma 3 cases, permanent hoaseness 2 cases.

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Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma in a Child: A Case Report (소아의 미만성 경화 변종 갑상선 유두암: 증례 보고)

  • Seung Hee Byun;Sun Kyoung You;Seong Su Kang;Kyung Sook Shin;Jeong Eun Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1250-1254
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    • 2020
  • The diffuse sclerosing variant of papillary thyroid carcinoma (DSPTC) is uncommon. Herein, we report a rare case of DSPTC in a 9-year-old girl who initially presented with a painless diffuse goiter. Thyroid peroxidase antibody testing yielded positive results, and the initial clinical diagnosis was Hashimoto's thyroiditis. However, thyroid ultrasonography revealed characteristic findings of DSPTC, which was confirmed through the postoperative histopathological diagnosis. Although thyroid cancers are rare in the pediatric population, DSPTC should be included in the differential diagnosis of goiter in these patients. Moreover, ultrasonography may prevent a diagnostic delay and facilitate the detection of a concomitant malignancy.

Treatment of Human Thyroid Carcinoma Cells with the G47delta Oncolytic Herpes Simplex Virus

  • Wang, Jia-Ni;Xu, Li-Hua;Zeng, Wei-Gen;Hu, Pan;Rabkin, Samuel D.;Liu, Ren-Rin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1241-1245
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    • 2015
  • Background: Thyroid carcinoma is the most common malignancy of the endocrine organs. Although the majority of thyroid cancer patients experience positive outcomes, anaplastic thyroid carcinoma is considered one of the most aggressive malignancies. Current therapeutic regimens do not confer a significant survival benefit, and new therapies are urgently needed. Oncolytic herpes simplex virus (oHSV) may represent a promising therapy for cancer. In the present study, we investigated the therapeutic effects of a third-generation HSV vector, $G47{\Delta}$, on various human thyroid carcinoma cell lines in vitro. Two subcutaneous (s.c.) models of anaplastic thyroid carcinoma were also established to evaluate the in vivo anti-tumor efficacy of $G47{\Delta}$. Materials and Methods: The human thyroid carcinoma cell line ARO, FRO, WRO, and KAT-5, were infected with $G47{\Delta}$ at different multiplicities of infection (MOIs) in vitro. The survival rates of infected cells were calculated each day. Two s.c. tumor models were established using ARO and FRO cells in Balb/c nude mice, which were intratumorally (i.t.) treated with either $G47{\Delta}$ or mock. Tumor volumes and mouse survival times were documented. Results: $G47{\Delta}$ was highly cytotoxic to different types of thyroid carcinomas. For ARO, FRO, and KAT-5, greater than 30% and 80% of cells were killed at MOI=0.01 and MOI=0.1, respectively on day 5. WRO cells displayed modest sensitivity to $G47{\Delta}$, with only 21% and 38% of cells killed. In the s.c. tumor model, both of the anaplastic thyroid carcinoma cell lines (ARO and FRO) were highly sensitive to $G47{\Delta}$; $G47{\Delta}$ significantly inhibited tumor growth and prolonged the survival of mice bearing s.c. ARO and FRO tumors. Conclusions: The oHSV $G47{\Delta}$ can effectively kill different types of human thyroid carcinomas in vitro. $G47{\Delta}$ significantly inhibited growth of anaplastic thyroid carcinoma in vivo and prolonged animal survival. Therefore, $G47{\Delta}$ may hold great promise for thyroid cancer patients.

Lymphocyte Rich Papillary Oxyphilic Carcinoma of Thyroid - A Case Report - (림프구 침윤이 풍부한 갑상선 유두상 호산성세포 암종 - 1예 보고 -)

  • Kim, Soon-Ran;Sohn, Jin-Hee
    • The Korean Journal of Cytopathology
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    • v.8 no.2
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    • pp.150-154
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    • 1997
  • Lymphoid infiltration can be seen in some lesions such as Hashimoto's thyroiditis, subacute thyroiditis and several neoplasm of the thyroid. In case of malignancy, there are a few reports of lymphoid infiltration in the diffuse sclerosing variant of papillary carcinoma. But heavy lymphoid infiltraton without evidence of sclerosis is uncommon. We experienced a case of papillary oxyphilic carcinoma with massive lymphoid infiltration, which looks like Warihin tumor of salivary gland. However cytological feature of epithelial cells exhibit that of papillary carcinoma.

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Evaluate Utility of Thyroid Cancer Discrimination by 18F-FDG PET/CT Delay Scan Images (18F-FDG PET/CT검사에서 지연영상을 이용한 갑상선암 진단의 유용성 평가)

  • Lee, Hyeon-Guck;Han, Man-Seok;Kim, Yong-Kyun;Seo, Sun-Youl;Jeon, Min-Cheol;Kim, Tae-Hyung;Hong, Seong-Jong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.6
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    • pp.2958-2965
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    • 2013
  • Purpose : To evaluate the degree of malignancy of incident thyroid lesion found in 18F-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods : A retrograde study was conducted of 25 patients(1 exception) who were admitted in E hospital to receive 18F-FDG PET/CT examination until Janaary and April of 2008. 18F-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal 18F-FDG PET/CT image(1hr) and then 1hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid 18F-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1hr later, we took a 1 bed-delayed image and then made a comparative study between measured maxSUV of 1hr-abnormal uptake image and that of 2hr-delayed image. Results : In this 18F-FDG PET/CT study among the patients who showed incidental 18F-FDG thyroidal uptake the number of thyroid cancer was 5(20.8%), all of then showed benign findings. a comparison of results for 18F-FDG PET/CT. the benign patient measured maxSUV in the PET/CT. image(1hr) mean value 5.06maxSUV and delay image(2hr) mean value 5.23maxSUV differences of two value is 0.19maxSUV and the malignantIt patient measured maxSUV in the PET/CT. image(1hr) mean value 9.63maxSUV and delay image(2hr) mean value 10.65maxSUV differences of two value is 10.65maxSUV in Thyroid abnormal uptake patients. Conclusion : in the case of incidental 18F-FDG uptake in thyroid, max SUV of focal thyroid lesion is above 5.0 if 18F-FDG PET/CT examine the delayed images to add, You could see that reasonable diagnostic method useful. to differentiate whether lesions of malignant.

Two Cases of Papillary Carcinoma Arising from Thyroglossal Duct Cyst (TGDC) (갑상설관낭종에서 기원한 유두상 암종 2례)

  • Jeong, Yong Jun;Yum, Gun Hwee;Kwon, Soon Young;Oh, Kyoung Ho
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.189-193
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    • 2018
  • A thyroglossal duct cyst (TGDC) is the most common congenital anomaly of the neck. However, carcinoma arising from TGDC is extremely rare. We report 2 cases of TGDC carcinoma. In the first case, a 21-year-old male patient complained of an anterior cervical mass; computed tomography (CT) and sonography revealed cystic mass that was suspected to be a TGDC. Sistrunk operation was performed. Papillary carcinoma was confirmed in pathologic examination. Additionally, he underwent total thyroidectomy and central neck dissection. After radioactive iodine ablation (RAI) was performed. In the second case, a 28-year-old male patient visited our out-patient department complaining of submental mass. He had already been diagnosed TGDC carcinoma 13 years ago and had undergone Sistrunk operation and total thyroidectomy. Malignancy was confirmed using fine-needle aspiration; thus, lateral neck dissection was performed and following this, he underwent RAI. Till date, no evidence of recurrence has been observed in these patients.

Platelet-Derived Growth Factor Receptor-α Subunit Targeting Suppresses Metastasis in Advanced Thyroid Cancer In Vitro and In Vivo

  • Lin, Ching-Ling;Tsai, Ming-Lin;Chen, Yu-hsin;Liu, Wei-Ni;Lin, Chun-Yu;Hsu, Kai-Wen;Huang, Chien-Yu;Chang, Yu-Jia;Wei, Po-Li;Chen, Shu-Huey;Huang, Li-Chi;Lee, Chia-Hwa
    • Biomolecules & Therapeutics
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    • v.29 no.5
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    • pp.551-561
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    • 2021
  • Thyroid cancer is the most common endocrine malignancy. Patients with well-differentiated thyroid cancers, such as papillary and follicular cancers, have a favorable prognosis. However, poorly differentiated thyroid cancers, such as medullary, squamous and anaplastic advanced thyroid cancers, are very aggressive and insensitive to radioiodine treatment. Thus, novel therapies that attenuate metastasis are urgently needed. We found that both PDGFC and PDGFRA are predominantly expressed in thyroid cancers and that the survival rate is significantly lower in patients with high PDGFRA expression. This finding indicates the important role of PDGF/PDGFR signaling in thyroid cancer development. Next, we established a SW579 squamous thyroid cancer cell line with 95.6% PDGFRA gene insertion and deletions (indels) through CRISPR/Cas9. Protein and invasion analysis showed a dramatic loss in EMT marker expression and metastatic ability. Furthermore, xenograft tumors derived from PDGFRA geneedited SW579 cells exhibited a minor decrease in tumor growth. However, distant lung metastasis was completely abolished upon PDGFRA gene editing, implying that PDGFRA could be an effective target to inhibit distant metastasis in advanced thyroid cancers. To translate this finding to the clinic, we used the most relevant multikinase inhibitor, imatinib, to inhibit PDGFRA signaling. The results showed that imatinib significantly suppressed cell growth, induced cell cycle arrest and cell death in SW579 cells. Our developed noninvasive apoptosis detection sensor (NIADS) indicated that imatinib induced cell apoptosis through caspase-3 activation. In conclusion, we believe that developing a specific and selective targeted therapy for PDGFRA would effectively suppress PDGFRA-mediated cancer aggressiveness in advanced thyroid cancers.