The negative prognostic impact of bone metastasis with a tumor mass

OBJECTIVE: Typically, bone metastasis causes osteolytic and osteoblastic lesions resulting from the interactions of tumor cells with osteoclasts and osteoblasts. In addition to these interactions, tumor tissues may grow inside bones and cause mass lesions. In the present study, we aimed to demonstrate the negative impact of a tumor mass in a large cohort of patients with bone metastatic cancer. METHODS: Data from 335 patients with bone metastases were retrospectively reviewed. For the analysis, all patients were divided into three subgroups with respect to the type of bone metastasis: osteolytic, osteoblastic, or mixed. The patients were subsequently categorized as having bone metastasis with or without a tumor mass, and statistically significant differences in median survival and 2-year overall survival were observed between these patients (the median survival and 2-year overall survival were respectively 3 months and 16% in patients with a tumor mass and 11 months and 26% in patients without a tumor mass;

Does the use of recombinant TSH in preparation for I-131 scintigraphy scan affect hearing function?

Objective: The objective of this study was to examine the effect of hypothyroidism on hearing function in patients surgically treated for differentiated thyroid cancer and subsequently experienced hypothyroidism during preparation for follow up I-131 scintigraphy scan by either recombinant human thyroid stimulating hormone (rhTSH) treatment or thyroid hormone withdrawal (THW). Methods: A total of 55 patients undergoing I-131 scintigraphy scan following surgeries for differentiated thyroid cancer were included in the study, including 25 patients prepared by administration of recombinant TSH (rhTSH Group) and 30 patients by thyroid hormone withdrawal (THW Group). Results: Air conduction thresholds at 1, 2 and 4 kHz for both ears were higher during hypothyroid period than during euthyroid period for patients in the THW group (p < 0.05) but not for patients in the rhTSH group. Conclusion: Sensorineural hearing loss was detected, especially at low frequencies, in patients with DTC after surgical treatment whose hormone replacement therapy was withdrawn but not in those receiving rhTSH. It is therefore preferred to use rhTSH when preparing for I-131 scintigraphy scan in patients at risk for hearing loss

The Relatin Between Serum Galecti-3 and Diffrentil Thyroid Cancers

Amaç: Diferensiye tioid kanserli (DTK) hastalarda total tioidektomi sonrası risk skorlamasına göre verilenI-131 (radyoiyot) ile ablasyon, tüm dünyada ve ülkemizde sıklıkla kullanılan bir tedavi yöntemidir. Kansergelişimindeki rolü açıklanamamakla birlikte, Galekti-3’ün artmış ekspresyonunun tümör hücrelerinin adhezyon ve motiitelerini değiştierek metastaz potansiyelini artıdıkları bildirilmektedir. Araştımalara göreGalekti-3 (Gal-3) özellikle papiller tioid kanserlerinde olmak üzere DTK’da pozititr.Bu çalışmada amacımız, DTK nedeniyle total tioidektomili, ardından yüksek doz radyoiyot ablasyon tedavisialma amacı olan hastalarda ölçülen serum Galekti-3 (sGal-3) seviyelerinin, hastaların tüm vücut taramasintirafieri ile değerlendirilerek prognosti ilişkisinin varlığının araştıılmasıdır.Gereç ve Yöntem: sGal-3 seviyeleri Abbot i sistem otoanalizörde çalışıldı. İyi prognoz göstergesi ve ablasyonbaşarısı; TSH stiüle durumda iken, serum Tg seviyeleri ölçülemeyecek kadar düşük düzeyde (stiüle Tg0.05).Sonuç: Bu çalışmada ablasyon başarısı ile sGal-3 düzeyleri arasında anlamlı ilişki bulunamadı. Bunun nedeni,sGal-3’ün tümör dokusundan kaynaklanması ve ancak sGal-3 ölçümü için yapılan örnekleme sırasında anlamlı tümör yükünün bulunmaması olabilir. Bu nedenle, sGal-3’ün normal seviyelerde olmasının iyi prognozgöstergesi olduğunu düşünmekteyiz.Aim: I-131 (radioiodine) ablatin following total thyroidectomy in patints with diffrentil thyroid cancer (DTC) is a routie treatment method. Increased expression of Galecti-3 in tumor cells has been shown to alter adhesion and motiity resultig with increased metastati potentil although its role in cancer development has not been demonstrated yet. Galecti-3 (Gal-3) was declared positie in DTC, especially in papillary thyroid carcinomas. The aim of study is to investiate whether there is a prognosti associatin between serum Galecti-3 levels measured in patints with total thyroidectomy due to DTC, followed by high-dose radioiodine ablatin therapy and whole body screening scintiraphy. Materials and Methods: sGal-3 levels were studied in the Abbot i system autoanalyzer. Success of ablatin and good prognosis were defied via too low Tg levels under TSH stiulatin, normal physical examinatin fidings and/or post-ablatin negatie low dose whole body radioiodine scintiraphy 8 to 12 months aftr ablatin, absence of any fidings suggestig lymph node and distant metastasis in radiological or clinical evaluatin. Findings: Forty-eight patints were included in the study. sGal-3 levels were within the normal range in whole patints of whom two had values close to upper limit. Immunohistochemically, Galecti-3 was positie in 25 of the patints, whereas negatie in other 23. There was no correlatin between immunohistochemically evaluated levels of Gal-3 and sGal-3 (p = 0.663). The relatinship between ablatin success and sGal-3 was not statitially signifiant (p> 0.05). Conclusion: There was no signifiant relatinship between ablatin success and sGal-3. A possible explanatin for this result might be excretin of sGal-3 from the tumor tisue and absence of tumour tisue at the tie of sampling for sGal-3 in the study populatin. In conclusion, the authors suggest that sGal-3 is a good prognosti indicator when it is at normal levels during ablatin

Can We Predict the Sites of the Recurrence of Ovarian Cancer by F-18 FDG PET/CT Depending on CA-125 Level?

Objectives: The purpose of the study is predicting the sites of the recurrence with PET/CT by serum CA-125 level and detecting the cut-off value of CA-125 for metastatic ovarian cancer (OC) in comparison with Fluorine-18 FDG PET/CT. Materials & Methods: For 38 patients with histological stage III-IV OC, F-18 FDG PET/CT studies (n=59) referred for suspicion of relapsing of OC were conducted. PET/CT images were assessed as positive/negative in 4 categories based on similar location as local recurrence, peritoneal metastasis, lymph node metastases and distant metastases. Patients were divided into five groups according to the levels of CA-125. The results of PET/CT imaging were compared with the level of CA-125. Results: Recurrence was confirmed in all FDG-PET/CT studies. In 7 of them (11.9%) CA-125 levels were normal (mean: 18.9 +/- 5.9) whereas in 52 of them (88%) were high (mean: 433.9 +/- 798.3). Moderate but highly significant positive correlation between CA-125 level and the number of metastatic foci detected by PET/CT was found. There was no statistically significant difference between CA-125 level subgroups and metastatic sites. However, the difference between CA-125 levels and location of metastasis was statistically significant only for distant metastasis and peritoneal metastasis with moderate accuracy (71% and %66, respectively). Conclusion: Since CA-125 has moderate but highly significant positive correlation with the number of metastatic foci, it is important in clinical management of OC patients. However, it may not predict the localization of the recurrence. When suspicious findings were reported at radiodiagnostic techniques in OC patients, FDG-PET is a useful technique for detecting recurrent ovarian carcer regardless of CA-125 level

Does hepatic visualisation show residual/metastatic thyroid tissue in differentiated thyroid cancer?

Aim: Diffuse homogen hepatic uptake in whole-body scan (WBS) after radioiodine remnant ablation (RRA) suggests that there is occult or visible remnant thyroid tissue and/or tumor tissue. It is thought that the reason is hepatic metabolization of radioiodine (1311) marked thyroglobulin fragments which are secreted by remnant/tumor tissue. The aims of this study were to investigate whether the hepatic visualisation after radioiodine remnant ablation showed the presence of metastatic or residual disease in patients with differentiated thyroid cancer and also to investigate whether early or late WBS after RRA (RxWBS) had an effect on the physiological hepatic uptake. Material and Method: 201 DTC patients were evaluated (F/M: 152/49; mean age: 49.61 +/- 13 years (range: 18-85 years)) who referred for RRA. The therapeutic 1311 dose ranged from 100mCi to 200mCi. RxWBS was performed earlier (in 1-4th-day after RRA) in 106 patients (Group 1) and was performed later (in 5-9th-day after RRA) in 95 patients (Group 2). Results: Diffuse hepatic uptake were seen only in three patients (2.8%) and was not seen in 103 patients (97.2%) in Group 1. However, in Group 2 diffuse hepatic uptake was seen in 93 patients (97.9%) (p<0.05) and not seen only in 2 patients (2.1%). There is not a statistically significant relationship between the hepatic uptake and serum Tg. LT4 and TSH level. There is a statistically significant relationship between anti-Tg level and hepatic uptake. Discussion: Physiological diffuse hepatic uptake of radioiodine in WBS after RRA may not be seen during the early WBS. Thus, metastatic foci may be missed with early scanning. We conclude that RxWBS after RRA should be done in late period

Akciğer Kanserinde serum anti-p53 antikor düzeyinin tanısal ve prognostik önemi var mı?

Amaç: Akciğer kanseri dünya genelinde kansere bağlı ölümlerin önde gelen nedenidir. Tanısal cihazlar ve teknolojik gelişmelere bağlı tedavi seçeneklerinde ilerlemeye rağmen, akciğer kanseri hastalarında genel mortalite oranı hala yüksektir. Akciğer kanseri hastalarında sağkalım oranları, özellikle ilerlemiş inoperabl hastalıkta, immunoterapi gibi yeni tedavi seçeneklerine rağmen düşüktür. p53, kanser hastalarının %60-70'inde mutasyona uğramaktadır ve bu nedenle son zamanlarda yapılan çalışmalar göstermektedir ki, serum anti-p53 antikorunun, over, özefagus, meme ve akciğer kanseri gibi bazı kanser türlerinin dedekte edilmesinde biyobelirteç olarak dikkate alınabilir. Bu çalışmada, akciğer kanseri hastalarında, serum anti-p53antikor düzeylerinin tanısal ve prognostik önemini araştırmayı amaçladık. Yöntem: Çalışmaya akciğer kanseri (AK) tanısı nedeniyle evreleme için 18F-FDG-PET / BT görüntüleme amacı ile bölümümüze sevk edilen hastalar, toraks BT'sinde şüpheli pulmoner nodül olup, patolojik FDG birikimi göstermeyen hastalar (NAPN= Non-avid FDG gösteren pulmoner nodül) ve sağlıklı gönüllüler dahil edildi. Serum anti-p53antikor düzeyleri tüm hastalarda ELISA yöntemi ile ölçüldü. Hastaların ortalama takip süresi 13 ay idi. Bulgular: Çalışmaya toplam 65 AK hastası (58E/7K), 47 NAPN hastası (20E/27K) ve 34 sağlıklı gönüllü (26E /8K) dahil edildi. Ortalama serum anti-p53antikor seviyeleri AK hastalarında 3.4ng/mL, NAPN hastalarında 3.77ng /mL, sağlıklı gönüllülerde 3.07 ng/ mL idi. AK hastaları ile NAPN hastaları arasında serum anti-p53antikor düzeyi için istatistiksel olarak anlamlı fark yoktu (p = 0.678). Hatta, hastalar ve sağlıklı gönüllüler arasında serum anti-p53Ab düzeyi için istatistiksel olarak anlamlı fark yoktu (p = 0.377). Hastaların iki yıllık medyan sağkalımı 14 aydı. Hastaların sağkalım hızında, serum anti-p53Ab düzeyinin > 3.4 ng/ mL veya <=3.4 ng/ mL olmasının herhangi bir etkisinin olmadığı bulundu (p = 0.652). Sonuç: Anti-p53antikoru, karsinogeneziste çok önemli olmasına rağmen, serum anti-p53antikor düzeyinin akciğer kanseri tanısında ve sağkalım oranlarında tek başına önemli olmadığını düşünüyoruz. Karsinogeneziste birden fazla faktör vardır ve bu durumun nedeni olabilir. Akciğer kanseri hastalarının teşhisi için serum anti-p53antikor düzeylerinin bilinen bir katof değeri yoktur. Bu nedenle, bu antikorun tümör spesifikliği olmadığını ve serum anti-p53antikor düzeyinin akciğer kanseri taraması için uygun olmadığını düşünüyoruz.Objective: Lung cancer is the leading cause of cancer-related deaths worldwide. Despite advancement in diagnostic tools and treatment options with technological developments, overall mortality rates in lung cancer patients remains high. Survival rates in lung cancer patients is low especially in advanced diseased inoperable patients in spite of new treatment options like immunotherapy. p53 is mutated in 60-70% of cancer patients and for this reason has been extensively studied recent researches suggest that serum anti-p53Ab can be considered as biomarkers to detect many types of cancers; as ovarian cancer, esophageal cancer, breast cancer and lung cancer. In this study we aimed that are there any diagnostic and prognostic importance of serum anti-p53Ab levels in lung cancer patients. Method: Patients were included who were referred to our department with the purpose of 18F-FDG-PET/CT imaging for staging due to lung cancer diagnosis (LC) and patients who were performed 18F-FDG-PET/CT for diagnosis in the cause of the suspected pulmonary nodule in thorax CT but not detected pathologic FDG accumulation (NAPN=pulmonary nodule with non-avid-FDG) and healthy volunteers. Serum anti-p53Ab levels were measured with ELISA method in the all patients. Mean follow up time of patients were 13 months. Results: A total of 65 LC patients (58M/7F), 47 patients with NAPN (20M/27F), and a total of 34 healthy volunteers (26M/8F) were included in this study. Median serum anti-p53Ab levels are 3.4ng/mL in LC patients, 3.77ng/mL in NAPN patients, 3.07ng/mL in healthy volunteers. There is no statistically significant difference for serum anti-p53Ab level between LC patients and NAPN patients (p=0.678). Moreover there is no statistically significant difference for serum anti-p53Ab level between patients and healthy volunteers (p=0.377). Two-year median survival of patients was 14 month. It has been found that there is no effect of serum anti-p53Ab level whether &gt;3.4 or &lt;=3.4 on the patient survival rate (p=0.652). Conclusions: Even though anti-p53Ab is very important in carcinogenesis, we think that serum anti-p53Ab level by itself is not important in lung cancer diagnosis and survival rates. There are multiple factors in carcinogenesis and this may be the reason of this situation. There is no known cut off value of serum anti-p53 Ab levels for diagnosis of lung cancer patients. Therefore we think that this antibody is not tumor spesific and serum anti-p53 Ab level measurement is not appropriate for lung cancer screening