Ocena czynników ryzyka w odmianie wysokokomórkowej przerzutowego/ /nawrotowego raka brodawkowatego tarczycy

Introduction. Papillary thyroid carcinoma (PTC) is the most common malignant thyroid tumor. A great majority of the cases live a disease-free life with quite favorable prognosis. There are lots of variants of PTC and a few of them exhibit aggressive behaviour. Typical example is the tall cell variant (TCV). Patients experience a greater incidence of recurrence, nodal and extranodal metastases, tumor associated mortality than other variants of PTC. Studies related to TCV almost always compared it with its patient population of PTC according to risk factors and clinicopathologic features. The aim of this study is to evaluate the risk factors in metastatic/recurrent TCV. Materials and Methods. This is a retrospective cohort study of 1813 patients with differentiated thyroid carcinoma treated with radioiodine between 1992 and 2011. 56 of these patients are TCV. 34 of them developed metastasis/recurrence and 22 lived a disease-free life during the 23-year follow-up. We evaluated the risk factors in these metastatic and nonmetastatic subgroups. Results. We found tumor size, preablation thyroglobulin level, vascular invasion, preablation central and lateral cervical lymph node metastasis, preablation lung metastasis and stage independent risk factors. However age, preablation thyroglobulin level and stage appeared together as striking factors impacting metastasis in multivariate analysis. Conclusion. Higher ablation doses up to 250-300 mCi should be administered to TCV patients having advanced stage (III,IV), pretty high preablation thyroglobulin level (over 400 ng/ml) and older age (over 52 years) especially with large tumor size (over 3.5 cm) and initial cervical lymph node metastasis.Wstęp. Rak brodawkowaty tarczycy (papillary thyroid carcinoma, PTC) jest najczęstszym nowotworem złośliwym tego narządu. U przeważającej większości chorych możliwe jest całkowite wyleczenie, a rokowanie jest dobre. Występuje wiele odmian PTC, spośród których nieliczne są bardziej agresywne. Typowym przykładem takich nowotworów jest odmiana wysokokomórkowa (tall cell variant, TCV). Cechuje się ona częstszym występowaniem wznów, przerzutów do węzłów chłonnych i pozawęzłowych oraz większą śmiertelnością z powodu choroby nowotworowej niż inne odmiany PTC. Badania dotyczące TCV niemal zawsze mają na celu porównanie tej grupy chorych z populacją chorych na PTC w odniesieniu do czynników ryzyka oraz parametrów klinicznych i patomorfologicznych. Celem niniejszego badania jest ocena czynników ryzyka w przerzutowym/nawrotowym TCV. Materiał i metody. Było to retrospektywne badanie kohortowe obejmujące 1813 chorych ze zróżnicowanym rakiem tarczycy leczonych jodem promieniotwórczym w latach 1992–2011. U 56 osób z tej grupy rozpoznano TCV. U 34 z nich stwierdzono przerzut/nawrót, a w przypadku 22 chorych potwierdzono przeżycie wolne od choroby przez okres 4–23 lat. Autorzy ocenili czynniki ryzyka w podgrupach chorych z przerzutami i bez przerzutów. Wyniki. Stwierdzono, że niezależnymi czynnikami ryzyka są wielkość guza, stężenie tyreoglobuliny przed ablacją, unaczynienie guza, przerzuty to węzłów chłonnych szyjnych środkowych i tylnych oraz do płuc przed ablacją, a także stopień zaawansowania choroby. Jednak najważniejszymi czynnikami ryzyka przerzutów w analizie wieloczynnikowej okazały się wiek, stężenie tyreoglobuliny przed ablacją i stopień zaawansowania choroby nowotworowej. Wnioski. U chorych z TCV w zaawansowanym stadium (III, IV), z wysokimi stężeniami tyreoglobuliny (> 400 ng/ml) i w starszym wieku (> 52 lata), a zwłaszcza u osób z dużym rozmiarem guza (> 3,5 cm) i obecnymi przerzutami do węzłów chłonnych szyjnych, należy stosować wyższe dawki ablacyjne wynoszące do 250–300 mCi.

Clinical significance of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in the follow-up of colorectal cancer: searching off approaches increasing specificity for detection of recurrence

Nearly 40% of colorectal cancer (CRC) recurs within 2 years after resection of primary tumor. Imaging with fluorine-18-fluorodeoxyglucose (l8F-FDG) positron emission tomography/computed tomography (PET/CT) is the most recent modality and often applied for the evaluation of metastatic spread during the follow-up period. Our goal was to study the diagnostic importance of 18F-FDG-PET/CT data of maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and the difference of SUVmax on dual-time imaging in CRC

Evaluation of radiographic and metabolic changes in bone metastases in response to systemic therapy with 18FDG-PET/CT

Background. The aim of the study was to retrospectively evaluate radiographic and metabolic changes in bone metastases in response to systemic therapy with 18FDG-PET/CT and determine their roles on the evaluation of therapy response

The Relationship of the BRAF(V600E) Mutation and the Established Prognostic Factors in Papillary Thyroid Carcinomas

WOS: 000307518400001PubMed ID: 22767446It has been shown that BRAF(V600E) mutation in papillary thyroid carcinomas (PTC) is associated both with pathogenesis and poor prognosis. In this study, we aimed to investigate the relationship of the BRAF(V600E) mutation and the established prognostic factors in a cohort of Turkish patients with PTC. Forty-six cases of papillary thyroid carcinoma have been evaluated for the presence of BRAF(V600E) mutation. BRAF(V600E) has been examined by restriction fragment length polymorphism. BRAF(V600E) mutation status has been compared with well-known histopathological and clinical prognostic parameters such as invasion of thyroid capsule, extrathyroidal extension, and the presence of lymph node and/or distant metastasis. We have found that BRAF(V600E) mutation was present in the majority of our cases (40/46). Considering the stage of the disease, five of the negative cases were in stage 1 while the remaining one was in stage 2. Only one BRAF(V600E) negative case has shown extrathyroidal extension and lymph node metastasis. All four patients with distant metastasis had BRAF(V600E) mutation. Statistical analyses revealed that there are no significant relationship between the BRAF(V600E) mutation and the established prognostic factors. We found a relatively higher BRAF(V600E) mutation rate in classical type PTC than in other similar studies. We think that the limited number of our cases may either weaken or mask some potentially important relationship between BRAF(V600E) mutation and the established prognostic factors.Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [19816]The authors would like to thank to Scientific and Technological Research Council of Turkey (TUBITAK) for their support (Grant No: 19816). We also would like to express our sincere appreciation to FAVOR (FMF Arthritis Vasculitis and Orphan Diseases Research) laboratories at Gulhane Military Medical Academy, Institute of Health Sciences for their supports in conducting the experiments and invaluable guidance for the preparation of the manuscript

Uptake Patterns of Untreated Primary Gastrointestinal Extranodal Lymphomas on Initial Staging F-18-FDG PET/CT and Metabolic Tumor Parameters

Objective: Non-Hodgkin's lymphomas arising from tissues other than primary lymphatic sites are classified as primary extranodal lymphomas (PEL). PELs of the gastrointestinal system (PGISL) originate from the lymphatic tissues within the gastrointestinal tract. The prognostic value of F-18-FDG PET/CT in lymphomas is high in terms of both overall survival (OS) and disease-free survival (DFS). Our aim was to investigate the uptake patterns and properties of low-grade and high-grade PGISL on primary staging F-18-FDG PET/CT, as well as the prognostic significance of metabolic tumor parameters in high grade PGISL

Prognosis Estimation Under the Light of Metabolic Tumor Parameters on Initial Fdg-Pet/Ct in Patients with Primary Extranodal Lymphoma

Background Non-Hodgkin’s lymphomas arising from the tissues other than primary lymphatic organs are named primary extranodal lymphoma. Most of the studies evaluated metabolic tumor parameters in different organs and histopathologic variants of this disease generally for treatment response. We aimed to evaluate the prognostic value of metabolic tumor parameters derived from initial FDG-PET/CT in patients with a medley of primary extranodal lymphoma in this study. Patients and methods There were 67 patients with primary extranodal lymphoma for whom FDG-PET/CT was requested for primary staging. Quantitative PET/CT parameters: maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were used to estimate disease-free survival and overall survival. Results SUVmean, MTV and TLG were found statistically significant after multivariate analysis. SUVmean remained significant after ROC curve analysis. Sensitivity and specificity were calculated as 88% and 64%, respectively, when the cut-off value of SUVmean was chosen as 5.15. After the investigation of primary presentation sites and histo-pathological variants according to recurrence, there is no difference amongst the variants. Primary site of extranodal lymphomas however, is statistically important (p = 0.014). Testis and central nervous system lymphomas have higher recurrence rate (62.5%, 73%, respectively). Conclusions High SUVmean, MTV and TLG values obtained from primary staging FDG-PET/CT are potential risk factors for both disease-free survival and overall survival in primary extranodal lymphoma. SUVmean is the most significant one amongst them for estimating recurrence/metastasis.PubMedWoSScopu

Evaluation of Cutaneous Manifestations According to the Time in Renal Transplant Recipients

Background and Design: This study is conducted to determine the prevalence and clinical characteristics of cutaneous manifestations in renal transplant patients.Materials and Methods: Hospital records of 116 renal transplant patients were retrospectively investigated. The data obtained from patients who had 6 months follow-up period were evaluated. There were 68 (58.6%) males and 48 (41.4%) females aged between 10 and 68 years (mean=36.6 years). Detailed dermatologic examination was performed. The patients were grouped according to gender (male-female), posttransplant period (1-5 years, 5-10 years, >10 years) and the drugs used (cyclosporin, tacrolimus, other than these two immunosuppressant drugs).Results: The most common cutaneous manifestations were infectious. The dermatological findings were onychomycosis (13), tinea pedis (9), acneiform disorders (15), and warts (9). The clinical evaluation after 6 months has also demonstrated the same result. Among the evaluated patients, 7% showed premalignant or malignant manifestations on clinical examination. According to the results obtained from the patient groups, it was found that gender, length of post-transplant period, and use of immunosuppressant drugs do not influence the clinical manifestations of patients.Conclusion: Dermatologic examinations and long-term follow-up should be performed in renal transplant patients