Increased expression of PIN1 gene in papillary thyroid carcinoma

<p>Abstract</p> <p>Background</p> <p>Peptidyl-prolyl <it>cis/trans </it>isomerase (Pin1), encoded by <it>PIN1 </it>gene with <it>locus </it>in chromosome 19p13, is an enzyme that catalytically induces conformational changes in proteins after phosphorylation on serine or threonine residues preceding proline (pSer/Thr-Pro motifs); in this way, it has an influence on protein interactions and intracellular localizations of proteins. The aim of the study were: 1) an assessment of <it>PIN1 </it>gene expression level in benign and malignant thyroid lesions; 2) the evaluation of possible correlations between gene expression and histopathological variants of papillary thyroid carcinoma (PTC) or tumour size, classified according to TNM classification of primary tumours (in case of PTC only); 3) the estimation of possible relationships between expression of the gene in question and patients' sex or age.</p> <p>Methods</p> <p>Seventy (70) tissue samples were analyzed: 32 cases of PTC, 7 cases of medullary thyroid carcinoma (MTC), 7 cases of follicular adenoma (FA), and 24 cases of nodular goitre (NG). In real-time polymerase chain reaction (real-time PCR), two-step RT-PCR (reverse transcriptase-polymerase chain reaction) in an ABI PRISM 7500 Sequence Detection System was employed. The <it>PIN1 </it>gene expression level was assessed, calculating the mean relative quantification rate (RQ rate) increase for each sample.</p> <p>Results</p> <p>The level of <it>PIN1 </it>gene expression (compared to that in macroscopically unchanged thyroid tissue) was higher in PTC group than those in FA, MTC and/or NG groups, but the statistical significance was noted for difference between PTC and NG groups only. On the other hand, the differences of RQ rate value between different PTC variants were statistically insignificant. No correlations were found between RQ values and tumour size, as well as between RQ values and patients' sex or age in PTC group.</p> <p>Conclusions</p> <p>The <it>PIN1 </it>gene expression may have - in future - an important meaning in the diagnostics of PTC and in understanding its pathogenesis. However, our results - mostly due to the small number of cases - do not yet allow considering <it>PIN1 </it>gene as a prognostic molecular PTC marker.</p

Nowotwory wtórne ujawniane podczas BAC tarczycy — analiza częstości występowania i charakterystyka obrazu ultrasonograficznego

  Introduction: Metastases to the thyroid are revealed at autopsy with a frequency of 2–24%; however, clinically they appear less frequently, at 0.1–3%. The aim of the study was analysis of the frequency of revealing metastases to the thyroid (TM) and to the regional lymph nodes (NM) (neoplasms other than primary thyroid tumours) in preoperative diagnostics of the thyroid in patients with positive (C+) and negative (C–) history of cancer; analysis of ultrasound (US) images of metastases. Material and methods: Results of US/fine needle aspiration (FNA) of the thyroid in 1276 C+ patients and 18,947 C- patients. Results: TM and NM were diagnosed/suspected in 57 patients (0.3% of all examined; 40 TM, 22 NM, 5 both), and their frequency was higher in the C+ group (2.9% vs. 0.1% in C–, p &lt; 0.0001). In the C+ group, diagnosis of metastasis accounted for 72.3% of FNA results from the category “malignant neoplasm”; in the C– group it was 9.5% (p &lt; 0.0001). The highest relative frequency of TM was found for cancers infiltrating thyroid by direct extension (&gt; 10%), lymphomas (7.7%), and kidney (5.3%) and lung (4.9%) cancers. The mean age of patients with metastasis (63.9 ± 11.7 years) was similar to that of the C+ group and higher than the C- group (53.9 ± 14.8 years, p &lt; 0.0001). The proportion of males among the patients with metastasis was three-fold higher than in the patients without metastasis (p &lt; 0.0001). TM lesions presented suspicious borders in US twice as often as primary cancers . Conclusions: Metastases to the thyroid are rare; however, for patients with a history of cancer, their presence is more likely than primary thyroid cancer. US/FNA imaging of metastases allows the selection of patients requiring further diagnostics and treatment. (Endokrynol Pol 2015; 66 (6): 495–503)    Wstęp: Przerzuty do tarczycy ujawnia się podczas autopsji z częstością 2–24%, jednak klinicznie stwierdza się je rzadziej: 0,1–3%. Celem pracy była analiza częstości ujawniania podczas diagnostyki tarczycy przerzutów do tarczycy (TM) i węzłów chłonnych szyi (NM) (nowotworów innych niż pierwotne tarczycy) u osób z dodatnim (C+) i ujemnym (C–) wywiadem nowotworowym; analiza obrazu ultrasonograficznego przerzutów. Materiały i metody: Wyniki US/FNA tarczycy 1276 osób z grupy C+ oraz 18947 z grupy C-. Wyniki: TM lub NM rozpoznano/podejrzewano u 57 osób (0,3% wszystkich badanych; 40 TM, 22 NM, 5 oba), częstość ich ujawniania była wyższa w grupie C+ niż C– (2,9% vs. 0,1%, p &amp;lt; 0,0001). W grupie C+ rozpoznania przerzutu stanowiły 72,3% wyników FNA należących do kategorii nowotwór złośliwy, w grupie C–: 9,5% (p &lt; 0,0001). Najwyższą względną częstość ujawniania przerzutów stwierdzono dla nowotworów naciekających tarczycę przez ciągłość (&gt; 10%), chłoniaków (7,7%), raków nerki: 5,3% i płuca 6,2% (4,9% bez NM). Średni wiek pacjentów z przerzutem: 63,9 ± 11,7 lat był podobny do wieku osób z grupy C+ i wyższy od wieku osób z grupy C– (53,9 ± 14,8, p &lt; 0,0001). Odsetek mężczyzn wśród osób z przerzutem był 3-krotnie wyższy niż wśród osób bez przerzutu (p &lt; 0,0001). Ogniska TM — 2-krotnie częściej niż pierwotnych raków tarczycy miały podejrzane granice w US. Wnioski: Przerzuty do tarczycy są rzadkie, jednak u pacjentów z dodatnim wywiadem nowotworowym ich obecność jest bardziej prawdopodobna niż pierwotnych raków tarczycy. Obraz US/FNA przerzutów umożliwia wyodrębnienie pacjentów wymagających dalszej diagnostyki i leczenia. (Endokrynol Pol 2015; 66 (6): 495–503)

Analiza znaczenia klinicznego niejednoznacznych wyników biopsji tarczycy ze szczególnym uwzględnieniem kategorii ZPBN na podstawie 5 lat stosowania nowej klasyfikacji rozpoznań cytologicznych

  Introduction: The diagnostic category of follicular lesion of undetermined significance (FLUS) was intended to allow selection of cases with low risk of malignancy from all smears with indeterminate, suspicious cytology (ISC), which can potentially take advantage from repeat fine-needle aspiration (rFNA). Aim of the study was a comparison of the risk of malignancy related to FLUS nodules and other nodules with ISC: suspected follicular neoplasm (SFN) and suspected malignancy (SM), as well as analysis of the usefulness of assessing ultrasonographic malignancy risk features (UMRF) in nodules with ISC. Material and methods: We analysed UMRF, rFNA, and results of histopathological examination (H) in 441 FLUS, 135 SFN, and 72 SM nodules. Results: The frequency of exposing cancer in H in FLUS nodules was 5.9%, and when cytological follow up was also included it was 2.9%. rFNAs made the diagnosis more precise in 72.7% of FLUS, and in 5.2% it was diagnosis/suspicion of cancer. The incidence of cancer in SFN nodules was 8.2%, in SM nodules with suspicion of papillary cancer — 61.1%, and in nodules with suspicion of other or unspecified malignancy — 53.8% (p &lt; 0.0001 FLUS vs. both groups). The presence of calcifications is the only independent UMRF for nodules with ISC (OR 4.7). Features of importance are also microcalcifications (OR 3.8), especially in the SM group, and taller-than-wide-shape (OR 2.2). FLUS and SFN nodules are characterised by particularly low value of assessing suspicious margins; analysis of hypoechogenicity is of low value in SFN nodules, like suspected vascularisation in SFN and SM nodules. Conclusions: The risk of cancer in FLUS and SFN nodules is lower than in SM nodules. rFNAs of FLUS nodules make the diagnosis more precise in more than 70% of cases and are effective in revealing cancers. UMRFs present variable diagnostic value depending on the subcategory of ISC. (Endokrynol Pol 2016; 67 (1): 23–34)    Wstęp: Rozpoznanie zmiana pęcherzykowa bliżej nieokreślona (FLUS) miało wyodrębnić spośród rozmazów z niejednoznaczną, podejrzaną cytologią (ISC) przypadki z niskim ryzykiem złośliwości i potencjalną korzyścią z wykonania powtórnej FNA (rFNA). Celem pracy było porównanie ryzyka złośliwości guzków FLUS i innych guzków z ISC: podejrzenie nowotworu pęcherzykowego (SFN) i podejrzenie złośliwości (SM) oraz analiza przydatności oceny ultrasonograficznych cech ryzyka złośliwości (UMRF) w guzkach z ISC. Materiał i metody: Analizowano UMRF, rFNA i wyniki badania histopatologicznego (H) 441 guzków FLUS, 135 SFN i 72 SM. Wyniki: Częstość ujawniania raka w H w guzkach FLUS wynosiła 5,9%, a uwzględniając także cytologiczny follow up 2,9%. rFNAs uściśliły rozpoznanie w 72,7% guzków FLUS, w 5,2% ich wynik zawierał rozpoznanie/podejrzenie raka. Częstość raka w guzkach SFN wynosiła 8,2%, w guzkach SM z podejrzeniem raka brodawkowatego 61,1%, a z podejrzeniem innego nowotworu złośliwego lub bez określenia jego typu 53,8% (p &lt; 0,0001 vs. FLUS w obu przypadkach). Obecność zwapnień jest jedyną niezależną UMRF dla guzków z kategorii ISC (OR 4,7). Ponadto znaczenie mają ocena mikrozwapnień (OR 3,8), szczególnie w grupie SM, i podejrzanego kształtu (OR 2,2). W grupach FLUS i SFN szczególnie niską wartość ma ocena podejrzanych granic, ponadto w grupie SFN analiza hipoechogeniczności, a w grupie SFN i SM — podejrzanego unaczynienia. Wnioski: Ryzyko raka w guzkach FLUS i SFN jest niższe niż w kategorii SM. rFNA guzków FLUS uściśla rozpoznanie w ponad 70% przypadków i jest skuteczna w ujawnianiu raków. UMRF mają zróżnicowaną wartość diagnostyczną w zależności od podkategorii ISC. (Endokrynol Pol 2016; 67 (1): 23–34)

Role of endoscopic submucosal dissection in treatment of rectal gastroenteropancreatic neuroendocrine neoplasms

Introduction : A significant rise in incidence of rectal gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) has been observed in the last decade. Most detected gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are well differentiated and less than 2 cm in diameter. Endoscopic submucosal dissection (ESD) is a new method for endoscopic treatment of such tumors, difficult to resect by conventional endoscopic techniques and thus subject to surgical treatment. Aim: To present the results of the endoscopic treatment of GEP NET tumors in the rectum using ESD in single academic center. Material and methods : From June 2013 to April 2014, 4 cases of GEP-NET in the rectum were treated by ESD in our center. Effectiveness of dissection, complications and tumor recurrence after 3 months of treatment were then retrospectively investigated. Results : The group contained 2 patients with primary rectal GEP-NET (1 male, 1 female; age range: 48–60 years) and 2 with scars after incomplete polypectomy of rectal GEP-NET (1 male, 1 female; 61–65 years). Primary rectal GEP-NET diameters were 0.6 cm and 1.5 cm. Scar resection specimen diameters were 0.7 cm and 1 cm. Mean resection time was 28 min. The en bloc resection rate was 100% (2 of 2) and the histologically complete resection was confirmed in both cases. No foci of neuroendocrine neoplasia were reported in dissected scars. No complications were observed. After 3 months, 3 patients underwent follow-up colonoscopy – no local recurrence was reported. Conclusions : Endoscopic submucosal dissection of rectal GEP-NET should be recommended as a treatment of choice when dealing with lesions over 1 cm in diameter without invasion of the muscle layer. Due to technical difficulties, performing this procedure should be reserved for centers with appropriately trained endoscopic staff