External Beam Radiation in Differentiated Thyroid Carcinoma

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Salem Billan

2016-01-01

Full Text Available The treatment of differentiated thyroid carcinoma (DTC is surgery followed in some cases by adjuvant treatment, mostly with radioactive iodine (RAI. External beam radiotherapy (EBRT is less common and not a well-established treatment modality in DTC. The risk of recurrence depends on three major prognostic factors: extra-thyroid extension, patient’s age, and tumor with reduced iodine uptake. Increased risk for recurrence is a major factor in the decision whether to treat the patient with EBRT. Data about the use of EBRT in DTC are limited to small retrospective studies. Most series have demonstrated an increase in loco-regional control. The risk/benefit from giving EBRT requires careful patient selection. Different scoring systems have been proposed by different investigators and centers. The authors encourage clinicians treating DTC to become familiarized with those scoring systems and to use them in the management of different cases. The irradiated volume should include areas of risk for microscopic disease. Determining those areas in each case can be difficult and requires detailed knowledge of the surgery and pathological results, and also understanding of the disease-spreading pattern. Treatment with EBRT in DTC can be beneficial, and data support the use of EBRT in high-risk patients. Randomized controlled trials are needed for better confirmation of the role of EBRT.

AHR over-expression in papillary thyroid carcinoma: clinical and molecular assessments in a series of Italian acromegalic patients with a long-term follow-up.

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Caterina Mian

Full Text Available Acromegaly reportedly carries an increased risk of malignant and benign thyroid tumors, with a prevalence of thyroid cancer of around 3-7%. Germline mutations in the aryl-hydrocarbon receptor (AHR interacting protein (AIP have been identified in familial forms of acromegaly. The molecular and endocrine relationships between follicular thyroid growth and GH-secreting pituitary adenoma have yet to be fully established. Our aim was to study the prevalence of differentiated thyroid cancer (DTC in acromegaly, focusing on the role of genetic events responsible for the onset of thyroid cancer.Germline mutations in the AIP gene were assessed in all patients; BRAF and H-N-K RAS status was analyzed by direct sequencing in thyroid specimens, while immunohistochemistry was used to analyze the protein expression of AIP and AHR. A set of PTCs unrelated to acromegaly was also studied.12 DTCs (10 papillary and 2 follicular carcinomas were identified in a cohort of 113 acromegalic patients. No differences in GH/IGF-1 levels or disease activity emerged between patients with and without DTC, but the former were older and more often female. BRAF V600E was found in 70% of the papillary thyroid cancers; there were no RAS mutations. AIP protein expression was similar in neoplastic and normal cells, while AHR protein was expressed more in PTCs carrying BRAF mutations than in normal tissue, irrespective of acromegaly status.The prevalence of DTC in acromegaly is around 11% and endocrinologists should bear this in mind, especially when examining elderly female patients with uninodular goiter. The DTC risk does not seem to correlate with GH/IGF-1 levels, while it may be associated with BRAF mutations and AHR over-expression. Genetic or epigenetic events probably play a part in promoting thyroid carcinoma.

Beyond clinical utility: The multiple values of DTC genetics

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Mauro Turrini

2016-03-01

Full Text Available One point of consensus in the otherwise very controversial discussion about the benefits and dangers of DTC genetics in the health domain is the lack of substantial clinical utility. At the same time, both the empirical and conceptual literature indicate that health-related DTC tests can have value and utility outside of the clinic. We argue that a broader and multi-faceted conceptualization of utility and value would enrich the ethical and social discussion of DTC testing in several ways: First, looking at ways in which DTC testing can have personal and social value for users – in the form of entertainment, learning, or a way to relate to others – can help to explain why people still take DTC tests, and will, further down the line, foster a more nuanced understanding of secondary and tertiary uses of DTC test results (which could very well unearth new ethical and regulatory challenges. Second, considering the economic value and broader utility of DTC testing foregrounds wider social and political aspects than have been dominant in the ethical and regulatory debates surrounding DTC genetics so far. These wider political aspects include the profound power asymmetries that characterize the collection and use of personal genetic data in many contexts.

Biological dosimetry in patients with differenced thyroid carcinoma treated with Iodine-131

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Vallerga, M.; Taja, Maria R.; Radl, A.; Rojo, Ana M.; Deluca, G.; Di Giogio, Marina; Fadel, A.; Chebel, G.; Oneto, A.; Cabrejas, Mariana

2007-01-01

The differentiated thyroid carcinoma (DTC), constitutes the 90 % of the thyroid gland cancers. 80% of patients are cured after the initial therapy and 12% remained disease-free after successive treatments. The 24 patients included in this study represent a sample of the aforementioned 12% and 8%, with recurrence in the first decade post-treatment (local disease and/or recurrence at distance). The internal radiotherapy with 131 I in patients with DTC is used within the therapeutic schema as a step post-thyroidectomy. The success of the therapy is to get a lethal dose in the tumor tissue, which depends on the therapeutic activity and the retention of 131 I, without exceeding the dose of tolerance in healthy tissues. The most widespread way of administration is the empirical prescription which considers the clinical and laboratory parameters for its determination. In this work, the treatment protocol applied incorporates assessment by biological (DB) and internal (DI) dosimetry for estimating absorbed dose to the whole body and bone marrow to manage a personalized therapeutic dose for each patient. The biological dose estimation is based on the quantification of chromosomal aberrations, which is often referred to a dose-response curve in which lymphocytes are irradiated in vitro with 131 I, allowing to determine the dose in vivo of circulating lymphocytes patients [es

Prognostic indicators of outcomes in patients with lung metastases from differentiated thyroid carcinoma during long-term follow-up.

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Sohn, Seo Young; Kim, Hye In; Kim, Young Nam; Kim, Tae Hyuk; Kim, Sun Wook; Chung, Jae Hoon

2018-02-01

Distant metastases, although uncommon, represent maximum disease-related mortality in differentiated thyroid carcinoma (DTC). Lungs are the most frequent sites of metastases. We aimed to evaluate long-term outcomes and identify prognostic factors in metastatic DTC limited to the lungs. This retrospective study included 89 patients with DTC and metastases limited to the lungs, who were treated between 1996 and 2012 at Samsung Medical Center. Progression-free survival (PFS) and cancer-specific survival (CSS) rates were evaluated according to clinicopathologic factors. Cox regression analysis was used to identify independent factors associated with structural progressive disease (PD) and cancer-specific death. With a median follow-up of 84 months, the 5- and 10-year CSS rates were 78% and 73%, respectively. Older age at diagnosis (≥55 years), radioactive iodine (RAI) nonavidity, preoperative or late diagnosis of metastasis and macro-nodular metastasis (≥1 cm) were predictive of decreased PFS and CSS. Multivariate analysis identified older age (P = .002), RAI nonavidity (P = .045) and preoperative (P = .030) or late diagnosis (P = .026) as independent predictors of structural PD. RAI avidity was also independent predictor of cancer-specific death (P = .025). Patients with DTC and metastatic disease limited to the lungs had favourable long-term outcomes. Age, RAI avidity and timing of metastasis were found to be major factors for predicting prognosis. © 2017 John Wiley & Sons Ltd.

Noticeable rise in incidence of Hurthle cell carcinoma - Are we paying the Chernobyl toll ?

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Vojicic, J.; Popadic, S.; Malesevic, M.; Kermeci, K.; Peter, A.

2004-01-01

Full text: The Institute of Oncology in Sremska Kamenica is a reference centre for radioiodine treatment of different thyroid cancer (DTC) in our country. The majority of patients operated for DTC throughout the country are sent to us for further diagnostics and/or therapy. In our practice, we noticed a rising incidence of Hurthle cell cancer (HCC) during the past several years. We wanted to determine if there is statistically significant difference in the incidence of Hurthle cell cancer between several previous years. Data from the patients referred to our institution for 131-I whole body scanning and/or therapy between January 1998 and August 2003 were used to determine the incidence of HCC, which was presented as the percentage of total number of patients who were diagnosed to have DTC in the specific year. χ 2 test was used to test for significance of differences between the years. In the aforementioned period, there was a total number of 394 DTC patients among whom 17 with follicular carcinoma of oxyphyllic type (so called Hurthle cell carcinoma). Presented in percentage, the distribution of HCC throughout the years is as follows: 1998-0%; 1999-0%; 2000-3.85%; 2001-4.55%; 2002-5.3%; 2003-7.6%. We found significant difference (p<0.05 or less) between the incidence of HCC in year 2003 and all the previous years; also between years 1998 and 1999 and year of 2002 (p<0.05). These results show a rising incidence of Hurthle cell carcinoma over the past several years, with a significant peak in the year of 2003. Since these tumors also tend to show more aggressive clinical behaviour than they used to, our belief is that we might now be paying the toll of the Chernobyl accident. (author)

Clinical utility of an automated immunochemiluminometric thyroglobulin assay in differentiated thyroid carcinoma

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Persoon, ACM; Van den Ouweland, JMW; Wilde, J; Kema, IP; Wolffenbuttel, BHR; Links, TP

Background: Thyroglobulin (Tg) measurements are important in the follow-up of patients with differentiated thyroid carcinoma (DTC). We evaluated the analytical and clinical performance of a new automated immunochemiluminometric assay for Tg (Tg-ICMA; Nichols Advantage Tg; Nichols Institute

Survival and death causes in differentiated thyroid carcinoma

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Eustatia-Rutten, Carmen F. A.; Corssmit, Eleonora P. M.; Biermasz, Nienke R.; Pereira, Alberto M.; Romijn, Johannes A.; Smit, Johannes W.

2006-01-01

Survival studies in differentiated thyroid carcinoma (DTC) may be biased because they have been performed in heterogeneous populations. In addition, specific death causes in DTC have not been documented well in the literature. The aim of our study was to investigate survival and specific death

Diagnostic value of Tg and TgAb for metastasis following ablation in patients with differentiated thyroid carcinoma coexistent with Hashimoto thyroiditis.

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Chai, Hong; Zhu, Zhao-Jin; Chen, Ze-Quan; Yu, Yong-Li

2016-08-01

This study was designed to investigate the clinical value of serum thyroglobulin (Tg) and antithyroglobulin antibody (TgAb) measurements and the cutoff value after ablation in differentiated thyroid carcinoma (DTC) complicated by Hashimoto thyroiditis (HT) with metastasis. We measured serum Tg and TgAb levels and evaluated the disease status in 164 cases of DTC coexistent with HT in pathologically confirmed patients after surgery and post-remnant ablation during a 3-year follow-up. All Tg and TgAb levels were assessed by chemiluminescent immunoassay (IMA). Receiver operating characteristic (ROC) curve analysis was used to evaluate the prognostic value of Tg and TgAb for disease metastasis. The relationship between Tg and TgAb was analyzed using the scatter diagram distribution method. We found that the cutoff values of Tg and TgAb were 1.48 µg/L and 45 kIU/L, respectively. The area under the ROC curve (AUC) of Tg and TgAb was 0.907 and 0.650, respectively. In DTC coexistent with HT patients, the optimal cutoff value correlated with metastasis in Tg and TgAb was 1.48 µg/L and 45 kIU/L, respectively.

Anastomosis in the absence of a suprahyoid release following circumferential sleeve resection is feasible in differentiated thyroid carcinoma patients with tracheal invasion.

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Chen, Wanjun; Zou, Shujuan; Wang, Liang; Wu, Changhua; Wang, Zhiqi; Li, Ke; Zhang, Shuguang

2017-09-01

Invasion of the trachea is observed in ~6% of patients with differentiated thyroid carcinoma (DTC), and surgery is accepted as the treatment of choice. However, surgical procedures can be challenging and are associated with various risks. The authors of the present study performed a retrospective study of patients with DTC and tumor invasion of the trachea. Outcomes from patients that received circumferential sleeve resection (CSR) of the trachea followed by anastomosis in the absence of suprahyoid release (n=21; CSR group) and patients that underwent tangential resections [n=103; tangential 'shave' resection (TSR) group) were analyzed. In the CSR group, 4 to 8 tracheal rings were circumferentially resected. All patients underwent end-to-end anastomosis in the absence of suprahyoid release following CSR, and 7 patients developed cancer metastasis following surgery. With the exception of 2 patients that succumbed to disease, the remaining patients in the CSR group survived without cancer recurrence. In the TSR group, all of the patients experienced cancer recurrence within five years post-surgery. A total of 61 patients developed metastases in the three years following surgery, and 71 patients succumbed to cancer metastasis within five years. The survival rate of the CSR group was significantly increased compared with the TSR group. The results of the present study suggest that in DTC patients with defects involving up to 8 tracheal rings, it may be appropriate to perform anastomosis without suprahyoid tissue release as it is associated with a reduced incidence of perioperative morbidity.

Open loop thanks to direct torque control (DTC). Motor control without feedback loop; Open loop dank direkter Drehmomentregelung (DTC). Hochwertige Motorregelung ohne Rueckfuehrung

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Link, Michael [ABB Automation Products GmbH, Ladenburg (Germany)

2009-07-01

Servo drives are used in various applications. The range of applications is huge and thus also requirements to the drive system. Mainly, a fast torque and speed control is required. This is the domaine of direct torque control (DTC). In many applications DTC can meet this challenge to control the motor with full torque at zero speed. The servo converter based on DTC technology provides a control concept for synchronous and asynchronous motors for both closed loop and open loop control. DTC controlled drives support the whole range from open loop up to high performance motion control applications. (orig.)

Prognostic factors for differentiated thyroid carcinoma in young patients

International Nuclear Information System (INIS)

Handkiewicz-Junak, D.; Kalemba, B.; Roskosz, J.; Kukulska, A.; Puch, Z.; Jarzab, B.; Wloch, J.; Lange, D.

2001-01-01

Standard therapy of differentiated thyroid cancer (DTC) comprises thyroid surgery, radioiodine treatment and L-thyroxine suppressive treatment. However, in the case of young patients the extent of surgery and the need for radioiodine treatment are questioned by some authors on the basis of the overall good prognosis in this group. The aim of the study was to perform a retrospective analysis of prognostic factors for differentiated thyroid cancer in patients in the first three decades of their life. The study included 274 patients who were younger than 28 years at the day of diagnosis of DTC and were observed for a mean time of 5 years. Uni- and multivariate analysis of prognostic factors for disease - free survival was performed with Cox's regression method. The actuarial survival rate was 100%, the 5 and 10-year actuarial disease free survival was 85% and 75%, respectively. In a multivariate analysis lymph node metastases, the extent of surgery and radioiodine therapy were estimated as statistically significant, independent prognostic factors for DTC relapse. Radical treatment of DTC more advanced than pT1NOMO should include total thyroidectomy and postoperative complementary radioiodine therapy. Such procedure is also justified in young patients, as it ensures a decrease of the risk of recurrence. (author)

Improvement the DTC system for electric vehicles induction motors

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Arif Ali

2010-01-01

Full Text Available A three-phase squirrel-cage induction motor is used as a propulsion system of an electric vehicle (EV. Two different control methods have been designed. The first is based on the conventional DTC Scheme adapted for three level inverter. The second is based on the application of fuzzy logic controller to the DTC scheme. The motor is controlled at different operating conditions using a FLC based DTC technique. In the simulation the novel proposed technique reduces the torque and current ripples. The EV dynamics are taken into account.

A presença de tireoidite linfocitária crônica influencia o estadiamento tumoral do carcinoma diferenciado da tireoide? Does chronic lymphocytic thyroiditis influence the staging of differentiated thyroid carcinoma?

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Marcos Antonio Nemetz

2011-02-01

Full Text Available A associação entre carcinoma diferenciado de tireoide (CDT e tireoidite linfocitária crônica (TLC tem sido relatada na literatura. OBJETIVO: Avaliar a incidência desta associação e determinar se a TLC pode influenciar no estadiamento tumoral do CDT quando associada a outras variáveis de risco. FORMA DE ESTUDO: Coorte histórica (retrospectiva. MATERIAL E MÉTODO: Avaliaram-se 52 prontuários e laudos de pacientes portadores de CDT, no período de 1999 a 2009, divididos em dois grupos. O primeiro, composto de 35 pacientes portadores de CDT sem TLC; o segundo, com 17 pacientes, associado à TLC. O tratamento instituído para todos os pacientes foi a tireoidectomia total. Variáveis comuns a ambos os grupos como idade, gênero, padrão histológico, diâmetro tumoral, metástase locorregional e à distância, invasão extratireoidiana, multifocalidade e presença de cápsula tumoral foram comparadas. Aplicou-se os testes t-Student e Qui-quadrado para análise dos dados. RESULTADOS: A incidência de CDT isolado foi maior do que a de CDT+TLC (p=0,0126. Nenhuma diferença estatística quanto às variáveis comuns analisadas foi observada. CONCLUSÕES: A presença de TLC ocorreu em 33% dos pacientes com CDT. Todos os casos de CDT eram em estádios iniciais.The association between differentiated thyroid carcinoma (DTC and chronic lymphocytic thyroiditis (CLT has been reported in literature. AIM: To evaluate the incidence of this association and to determine whether the CLT may influence on the early initial staging of DTC when associated with other variable risks. STUDY DESIGN: Historical (retrospective cohort. MATERIALS AND METHODS: Fifty two patients with DTC were evaluated from 1999 to 2009. They were divided into two groups. The first group had 35 patients with DTC without DLT; the second had 17 patients with CLT. Total thyroidectomy was the treatment chosen for all patients. Similarities shared in both groups such as age, gender

The efficacy of radioiodine remnant ablation for differentiated thyroid carcinoma patients with an incomplete thyroidectomy

International Nuclear Information System (INIS)

FU, Hongliang; MA, Chao; LI, Jianing; FENG, Fang; WU, Shuqi; YE, Zhiyi; WANG, Hui

2016-01-01

The aim of this study was to evaluate the efficacy of radioiodine remnant ablation (RRA) for differentiated thyroid carcinoma (DTC) patients with an incomplete thyroidectomy. The medical histories of post surgical DTC patients who accepted RRA between 2010 and 2012 were retrospectively reviewed. Among them, 113 patients who had undergone a total or near-total thyroidectomy comprised the complete thyroidectomy group (CT group) and the remaining 40 patients who had undergone a lobectomy or sub-total thyroidectomy comprised the incomplete thyroidectomy group (ICT group). The difference in the patients’ age, gender, histology, serum TSH level and 24hr radioactive iodine uptake (RIU) between the two groups was analyzed by χ2 Test or ANOVA. The efficacy of RRA in ICT group was evaluated by comparing its rate of complete ablation after the first RRA and its cumulative rate of complete ablation after the second RRA to the rate of complete ablation after the first RRA in CT group respectively by χ2 Test. Of all the clinical characteristics, only serum TSH level and 24hr RIU have significant difference between two groups (P<0.01 for both). The rate of complete ablation after the first RRA was 67.26% in CT group. The rate of complete ablation after the first RRA and the cumulative rate of complete ablation after the second RRA was 27.50% and 67.50% respectively in ICT group. The ablative rate of the first RRA between the two groups was compared by χ2 Test and the difference was significant (P<0.01). The ablative rate of the first RRA in CT group was compared with the cumulative rate of the second RRA in ICT group and the difference was not significant (P=0.978). Although the efficacy of RRA in DTC patients with an incomplete thyroidectomy is not as good as that of patients with a complete thyroidectomy after the first RRA, a higher ablative rate can still be achieved after the second or third RRA.

Ability of the rhTSH stimulation test to predict relapse in patients with differentiated thyroid carcinoma, after long-term follow-up

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MARCELINO, MAFALDA; LOPES, ANA FILIPA; MADUREIRA, DEOLINDA; FERREIRA, TERESA C.; LIMBERT, EDWARD; LEITE, VALERIANO

2015-01-01

The analysis of serum thyroglobulin (Tg) following thyroid-stimulating hormone (TSH) stimulation (sTg) has been recommended in the follow-up of differentiated thyroid carcinoma (DTC) patients, however, its routine use remains controversial. The aim of the current study was to evaluate the accuracy of sTg testing following recombinant human (rh) TSH stimulation in DTC patients, with a follow-up of 12.4 years. Retrospective studies were conducted of 125 DTC patients, who underwent rhTSH stimulation testing between 1999 and 2002. The exclusion criteria were: Patients with anti-Tg antibodies, Tg levels >1 ng/ml under TSH suppression and the absence of radioactive iodine (RAI) ablation therapy following surgery. In total, 49 patients were included in the study and all had been previously treated with total or near total thyroidectomy (with or without central neck dissection) and RAI, postoperatively. The Tg functional sensitivity was 1.0 ng/ml. The follow-up for patients was performed annually. During the median follow-up of 12.4 years after the rhTSH stimulation test, nine patients exhibited recurrence (18.4%). Of the nine patients, six exhibited sTg levels >2 ng/ml (positive result) and three exhibited levels <2 ng/ml (negative result). Relapse occurred at a mean of 5.9 years following the rhTSH stimulation test. The positive predictive value and negative predictive value (NPV) of positive sTg were 50 and 91.9%, respectively, with a sensitivity of 66.6% and a specificity of 85.0%. The rhTSH-stimulated Tg levels have a high NPV, allowing the identification of the patients who are free of the tumour. These results are consistent with the previously published data; however, to the best of our knowledge, this is the study with the longest follow-up duration after rhTSH stimulation. PMID:25663898

Sensorless-adaptive DTC of double star induction motor

International Nuclear Information System (INIS)

Khedher, Adel; Faouzi Mimouni, Mohamed

2010-01-01

This paper presents a study of extension of the Direct Torque Control approach (DTC) developed by Takahashi for a double star induction motor (DSIM) and a new DTC-Space vector modulation (DTC-SVM) strategy around two dead-beat controllers. The suggested control is performed by using a sliding mode stator flux observer (SMSFO). This last allow to estimating the mechanical speed and the electromagnetic torque. To adapt in real time the rotor resistance variations according to temperature effect, the sensorless method is performed by using an adaptive algorithm which is based on the Lyapunov stability theory. Moreover, this paper treats the study of the system stability under the new suggested control. The simulation results for various scenarios operation show the high performances of the proposed control in terms of piloting effectiveness, precision, rapidity and stability for the high powers DSIM operating at variable speeds.

Thyroid remnant ablation success and disease outcome in stage III or IV differentiated thyroid carcinoma: recombinant human thyrotropin versus thyroid hormone withdrawal.

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Vallejo Casas, Juan A; Mena Bares, Luisa M; Gálvez Moreno, Maria A; Moreno Ortega, Estefanía; Marlowe, Robert J; Maza Muret, Francisco R; Albalá González, María D

2016-06-01

Most publications to date compare outcomes after post-surgical thyroid remnant ablation stimulated by recombinant human thyrotropin (rhTSH) versus thyroid hormone withholding/withdrawal (THW) in low-recurrence risk differentiated thyroid carcinoma (DTC) patients. We sought to perform this comparison in high-risk patients. We retrospectively analyzed ~9-year single-center experience in 70 consecutive adults with initial UICC (Union for International Cancer Control) stage III/IV, M0 DTC undergoing rhTSH-aided (N.=54) or THW-aided (N.=16) high-activity ablation. Endpoints included ablation success and DTC outcome. Assessed ≥1 year post-ablation, ablation success comprised a) no visible scintigraphic thyroid bed uptake or pathological extra-thyroidal uptake; b) undetectable stimulated serum thyroglobulin (Tg) without interfering autoantibodies; c) both criteria. DTC outcome, determined at the latest visit, comprised either 1) "no evidence of disease" (NED): undetectable Tg, negative Tg autoantibodies, negative most recent whole-body scan, no suspicious findings clinically, on neck ultrasonography, or on other imaging; 2) persistent disease: failure to attain NED; or 3) recurrence: loss of NED. After the first ablative activity, ablation success by scintigraphic plus biochemical criteria was 64.8% in rhTSH patients, 56.3% in THW patients (P=NS). After 3.5-year versus 6.2-year median follow-up (P<0.05), DTC outcomes were NED, 85.2%, persistent disease, 13.0%, recurrence, 1.9%, in the rhTSH group and NED, 87.5%, persistent or recurrent disease, 6.3% each, in the THW group (P=NS). In patients with initial stage III/IV, M0 DTC, rhTSH-aided and THW-assisted ablation were associated with comparable remnant eradication or DTC cure rates.

Papillary carcinoma

International Nuclear Information System (INIS)

Shah, D.H.; Samuel, A.M.

1999-01-01

Papillary carcinoma of the thyroid (PTC) constitutes a major proportion of all thyroid cancers and is generally believed to be a slow growing tumor with an indolent course. The diagnosis of PTC often makes the physician overly optimistic and complacent and yet this tumor can be aggressive in a subset of patients leading to death in a few months. The fundamental but subtle differences underlying the extremes in biologic behaviour of this complex and fascinating tumor remain poorly understood. Although there is a general agreement among the investigators regarding prognostic factors, controversy exists about the management of the disease. There is divided opinion with respect to the type and extent of surgery and the need for radioiodine (1 31 I) treatment in case of PTC. The experiences at Radiation Medicine Centre (RMC) of 1904 cases of differentiated thyroid carcinoma (DTC) registered during the period 1963-1990 are reviewed

Fatigue and fatigue-related symptoms in patients treated for different causes of hypothyroidism.

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Louwerens, Marloes; Appelhof, Bente C; Verloop, Herman; Medici, Marco; Peeters, Robin P; Visser, Theo J; Boelen, Anita; Fliers, Eric; Smit, Johannes W A; Dekkers, Olaf M

2012-12-01

Research on determinants of well-being in patients on thyroid hormone replacement therapy is warranted, as persistent fatigue-related complaints are common in this population. In this study, we evaluated the impact of different states of hypothyroidism on fatigue and fatigue-related symptoms. Furthermore, the relationship between fatigue and the TSH receptor (TSHR)-Asp727Glu polymorphism, a common genetic variant of the TSHR, was analyzed. A cross-sectional study was performed in 278 patients (140 patients treated for differentiated thyroid carcinoma (DTC) and 138 with autoimmune hypothyroidism (AIH)) genotyped for the TSHR-Asp727Glu polymorphism. The multidimensional fatigue inventory (MFI-20) was used to assess fatigue, with higher MFI-20 scores indicating more fatigue-related complaints. MFI-20 scores were related to disease status and Asp727Glu polymorphism status. AIH patients scored significantly higher than DTC patients on all five MFI-20 subscales (P<0.001), independent of clinical and thyroid hormone parameters. The frequency of the TSHR-Glu727 allele was 7.2%. Heterozygous DTC patients had more favorable MFI-20 scores than wild-type DTC patients on four of five subscales. The modest effect of the TSHR-Asp727Glu polymorphism on fatigue was found in DTC patients only. AIH patients had significantly higher levels of fatigue compared with DTC patients, which could not be attributed to clinical or thyroid hormone parameters. The modest effect of the TSHR-Asp727Glu polymorphism on fatigue in DTC patients should be confirmed in other cohorts.

The disease related deaths due to differentiated thyroid carcinomas treated multidisciplinary, including radioiodine

International Nuclear Information System (INIS)

Stefanovic, Lj.; Kermeci, K.; Malesevic, M.; Mihailovic, J.; Srbovan, D.; Popadic, S.

2002-01-01

Aim: To analyse the disease related deaths of differentiated thyroid carcinoma (DTC) patients treated multidisciplinary, including radioiodine. Patients and Methods: 364 DTC patients were treated from 1977 to the end of 2000. All patients were operated, treated by radioiodine and by hormonal therapy, external radiotherapy was applied in 22 and chemotherapy in 6 of them. 54 treated patients were lost from the follow-up. The course of disease and outcomes are known in 310 patients, among them 53 patients died. The disease related deaths occurred in 33 (10.6%) patients. Results: Between 33 patients whose deaths were in relation with DTC the disease progression was the cause of deaths in 30 (9.7% of treated) patients (the locoregional disease in 10, distant metastases /M1/ in 17, locoregional disease + M1 in 3 patients). From the late complications of treatment died 3 (1%) patients (all of them were in complete remission to the deaths). The mean survival of these 33 patients from the diagnosis to the end of the life was 6.9 years, median 5.1 years, range 2 months to 23.9 years. The five years survived 54.6% of them, 10 years 21.2% and more than 20 years 3%. M1 had 72.7% of patients (lung and/or bone M1 were present in 91.7% of them), N1 had 69.7% and in 30.3% local tumor was T4. In relation to all treated patients died 14.6% men compared to 9% women (p<0.05), 15.7% of patients 45 years old or older compared to 4.4% of younger then 45 years (p<0.001) and 21.3% of patients with follicular type of DTC compared to 7.3% with papillary type (p<0.001). From all patients without radioiodine accumulation in tumor tissue died 60%. Conclusion: The DTC related deaths were the consequence of M1 and less frequently the result of locoregional disease (T4 and/or N1) in about 1/10 of all treated patients. The deaths as result of the late complications of treatment were exceptional. The deaths were significantly more frequent between males, patients 45 years old or older and patients

Multicenter study differentiated thyroid carcinoma (MSDS). Diminished acceptance of adjuvant external beam radiotherapy

International Nuclear Information System (INIS)

Biermann, M.; Pixberg, M.K.; Schober, O.; Schuck, A.; Willich, N.; Heinecke, A.; Koepke, W.; Schmid, K.W.; Dralle, H.

2003-01-01

Aim: The Multicenter Study Differentiated Thyroid Carcinoma (MSDS) is an ongoing study in Germany, Austria, and Switzerland on the clinical benefit of adjuvant external beam radiotherapy (RTx) for locally invasive differentiated thyroid carcinoma (DTC) in TNM stages pT4 pNO/1/xMO/x (5th ed. 1997). Methods: MSDS was designed as a prospective randomized trial. Patients receive thyroidectomy, radioiodine therapy (RIT) to ablate the thyroid remnant, and TSH-suppressive L-thyroxine therapy with or without RTx after documented elimination of cervical iodine-131 uptake (http://msds-studie.uni-muenster.de). Results: 311 patients were enrolled between January 2000 and March 2003. 279 patients met the trial's inclusion criteria. 45 consented to randomization, of whom 17 were randomized into treatment arm A (RTx) and 18 into arm B (no RTx). Advised by the trial's independent Data Monitoring and Safety Committee, the MSDS steering committee decided to terminate randomization in April 2003 and continue MSDS as a prospective cohort study. 23 of the 234 patients in the observation arm of the trial were prescribed RTx by their physicians. Thus, 14% of the trial cohort were randomized or assigned to receive RTx (intention-to-treat analysis). In contrast, at least 44% of all patients with pT4 papillary DTC in Germany in the nationwide PCES study underwent RTx in 1996 (p 2 -test). Conclusions: Acceptance of external beam RTx as a treatment modality for DTC has receded to a degree that accrual of a sufficient number of patients for a randomized trial has been impossible. Observation of the trial cohort is continued in order to assess clinical event rates with and without RTx and chronic RTx toxicity. (orig.) [de

Lithium as adjuvant to radioiodine therapy in differentiated thyroid carcinoma: clinical and in vitro studies

NARCIS (Netherlands)

Liu, Y. Y.; van der Pluijm, G.; Karperien, M.; Stokkel, M. P. M.; Pereira, A. M.; Morreau, J.; Kievit, J.; Romijn, J. A.; Smit, J. W. A.

2006-01-01

Lithium has been reported to increase radioactive iodine (RaI) doses in benign thyroid disease and in differentiated thyroid carcinoma (DTC). It is not known whether lithium influences the outcome of RaI therapy in DTC. We therefore studied the clinical effects of RaI without and with lithium

99mTc-EDDA/HYNIC-TOC in the diagnosis of differentiated thyroid carcinoma refractory to radioiodine treatment.

Science.gov (United States)

Czepczyński, Rafał; Gryczyńska, Maria; Ruchała, Marek

2016-01-01

In majority of cases of differentiated thyroid carcinoma (DTC), the ablative radioiodine treatment shows high efficacy. In a small number of patients, mechanism of selective iodine uptake by the DTC cells is insufficient and alternative methods of diagnosis and treatment are needed. As demonstrated in vitro, DTC cells show expression of somatostatin recep-tors. Radiolabeled somatostatin analogs are widely used in the diagnosis of neuroendocrine tumors. The aim of the study was to evaluate the utility of peptide receptor scintigraphy with the use of 99mTc-EDDA/HYNIC-TOC in the diagnosis of DTC in patients with elevated thyroglobulin concentrations (Tg), negative WBS and no effect of the consecutive radioiodine therapies. Whole body scintigraphy as well as SPECT of neck and chest were performed 3 and 24 h after i.v. administration of 740 MBq 99mTc-EDDA/HYNIC-TOC. The obtained images were compared with other radionuclide and ra-diological imaging methods. Forty-three patients with DTC after surgery and ablative radioiodine treatment with negative WBS and elevated Tg were qualified. Patients' age: 18-83 years (mean 58.0). SRS showed foci of tracer accumulation in 29 cases (67.4%). Sensitivity was 69.0% specificity 78.6%. SRS correctly identified local recurrence in 8 pts., metastatic lymph nodes in 19 pts., lung metastases in 12 pts. and bone metastases in 5 pts. SRS showed high sensitivity in the detection of metastatic lymph nodes (100%) and bone metastases (83.3%) and lung metastases (63.2%). Positive SRS was found in pts. with higher Tg concentrations (130 ± 144 vs. 30 ± 54 ng/ml). Scintigraphy with the use of the studied technetium-99m-labeled somatostatin analog is useful in the evaluation of patients with advanced DTC. It shows relatively good sensitivity and specificity but not high enough to be recommended as a routine imaging method. The role of somatostatin receptor scintigraphy in DTC is complementary to other imaging modalities.

Gastrointestinal Side Effects of the Radioiodine Therapy for the Patients with Differentiated Thyroid Carcinoma Two Days after Prescription

International Nuclear Information System (INIS)

Pashnehsaz, Mehran; Takavar, Abbas; Izadyar, Sina; Zakariaee, Seyed Salman; Mahmoudi, Mahmoud; Paydar, Reza; Geramifar, Parham

2016-01-01

Iodine-131 (I-131) therapy is one of the conventional approaches in the treatment of patients with differentiated thyroid carcinoma (DTC). The radioiodine agents also accumulate in the other organs that cause pain and damage to the patients. Radioiodine therapy is associated with various gastrointestinal (GI) toxicities. In this study, GI side effects of the radioiodine therapy were investigated. GI toxicities of the radioiodine therapy were studied in 137 patients with histologically proven DTC in Jun-Nov 2014. All the patients were treated by radioiodine agents in the research institute of Shariati Hospital, Tehran, Iran. The patients were examined 48 h after prescription (before discharge) and their GI side effects were registered. Correlation of the age, gender, administered dose, administered dose per body weight as the independent factors, and GI side effects were analyzed using the Pearson correlation test with Statistical Package for the Social Sciences (SPSS) version 20. Regression coefficients and linearity of the variable were investigated by MATLAB software. Line fitting was performed using MATLAB curve-fitting toolbox. From the subjects, 38 patients had GI complaints (30.4%). Significant factors influencing GI side effects were dose per body weight and administered doses. There was no significant correlation between age and gender as the independent parameters and GI complaints. The most prevalent GI side effect was nausea that occurs in 26.4% of the patients. From the results, it could be concluded that the GI side effects could be prevented by administering a safe radioiodine dose value less than 5,550 MBq

Isolation time determination of patients with differentiated thyroid carcinoma treated with therapeutic doses of 131 radioiodine

International Nuclear Information System (INIS)

Sierralta, M.P.; Lillo, R.; Massardo, T.; Jofre, M.J.

2002-01-01

Isolation time determination of patients with differentiated thyroid carcinoma treated with therapeutic doses of 131 radioiodine. Introduction: The coadyuvant treatment with 131 I had proven to be useful in patients with differentiated thyroid carcinoma (DTC). Due to the physical characteristics of this radioisotope these patients must be absolutely isolated in order to reduce the radioactive exposure to other individuals. The aim of the study was to determine the time required to reach the maximum permissible radiation exposure level (0,25mR/h) to general public. Material between August 1999 and May 2000, 30 patients with DTC diagnosis in the University of Chile Clinical Hospital Nuclear Medicine Centre were studied, 25 women (83%) and 5 men (17%), mean age 45 years old (15-71 range). Tumoral histology was 86% papillary and 14% follicular types. Thirty one doses of 131 I were administered ( one patient received 2 doses): 24 of 100 mCi (77%), 5 of 150 mCi (16%) and 2 of 200 mCi (7%); afterwards the 1 m exposition rate in air was measured at neck level with a Geiger-Mueller detector. The procedure was repeated on day 4 and every day following until the predicted radiation exposure levels were reached. Results: The average exposure rate at day 0 ( after given the radiopharmaceutical) was 20,12 mR/h (4-32 range). At day 4 the average rate was 0,21 mR/h (0,08-0,34 ), and 61% (n=19) of the patients reached 0,25 mR/h within that day. On day 5 10% (n=3) reached 0,25 mR/h (0,25-0,26), on day 6 16% (n=5) reached 0,25 mR/h (0,2-0,28), on day 7 6% (n=2) reached 0,39 mR/h (0,25-0,48) and the remaining 7% on day 13 and day 17 (n=2). Conclusion After a treatment dose of 131 iodine over 60% of the cases can finish the isolation on day 4, and 90% on day 7. The measurement of 131 I uptake after 24 hours will help to determine the evolution of post treatment levels

Isolation time determination of patients with differentiated thyroid carcinoma treated with therapeutic doses of 131 radioiodine

Energy Technology Data Exchange (ETDEWEB)

Sierralta, M P [University of Chile Clinical Hospital Nuclear Medicine Centre, Santiago (Chile); Military Hospital Nuclear Medicine Department , Santiago (Chile); Lillo, R; Massardo, T [University of Chile Clinical Hospital Nuclear Medicine Centre, Santiago (Chile); Jofre, M J [Military Hospital Nuclear Medicine Department, Santiago (Chile)

2002-09-01

Isolation time determination of patients with differentiated thyroid carcinoma treated with therapeutic doses of 131 radioiodine. Introduction: The coadyuvant treatment with 131 I had proven to be useful in patients with differentiated thyroid carcinoma (DTC). Due to the physical characteristics of this radioisotope these patients must be absolutely isolated in order to reduce the radioactive exposure to other individuals. The aim of the study was to determine the time required to reach the maximum permissible radiation exposure level (0,25mR/h) to general public. Material between August 1999 and May 2000, 30 patients with DTC diagnosis in the University of Chile Clinical Hospital Nuclear Medicine Centre were studied, 25 women (83%) and 5 men (17%), mean age 45 years old (15-71 range). Tumoral histology was 86% papillary and 14% follicular types. Thirty one doses of 131 I were administered ( one patient received 2 doses): 24 of 100 mCi (77%), 5 of 150 mCi (16%) and 2 of 200 mCi (7%); afterwards the 1 m exposition rate in air was measured at neck level with a Geiger-Mueller detector. The procedure was repeated on day 4 and every day following until the predicted radiation exposure levels were reached. Results: The average exposure rate at day 0 ( after given the radiopharmaceutical) was 20,12 mR/h (4-32 range). At day 4 the average rate was 0,21 mR/h (0,08-0,34 ), and 61% (n=19) of the patients reached 0,25 mR/h within that day. On day 5 10% (n=3) reached 0,25 mR/h (0,25-0,26), on day 6 16% (n=5) reached 0,25 mR/h (0,2-0,28), on day 7 6% (n=2) reached 0,39 mR/h (0,25-0,48) and the remaining 7% on day 13 and day 17 (n=2). Conclusion After a treatment dose of 131 iodine over 60% of the cases can finish the isolation on day 4, and 90% on day 7. The measurement of 131 I uptake after 24 hours will help to determine the evolution of post treatment levels.

The Preliminary Research for Implementation of Improved DTC Scheme of High Performance PMSM Drives

Directory of Open Access Journals (Sweden)

Tole Sutikno

2008-12-01

Full Text Available The direct torque control (DTC is one of control approache that is used commonly in PMSM control system. This method supports a very quick and precise torque response. However, the DTC method is not perfect and has some disadvantages. Many researchers have been proposed to modify the basic DTC scheme for PMSM drive. All this contributions allow performance to be improved, but at the same time they lead to more complex schemes. Furthermore, the PMSM drive control systems are usually based on microcontroller and DSP. Some researchers also have been used DSP and FPGA together to develop DTC for AC drives. These allow improving the performance, but they will increase cost. For the reason above, this paper proposed a new DTC scheme to apply only based on FPGA. The preliminary research showed that the proposed DTC sheme can reduce torque and flux ripples significantly. Therefore, this paper also recomend to realize proposed DTC scheme based on FPGA in order to support to execute very fast computation.The implementation is hoped that it will very potential to replace not only the induction motor but also the DC servo motor in a number of industrial process, commercial, domestic and modern military applications of high-performance drive.

Inhibition of miR-146b expression increases radioiodine-sensitivity in poorly differential thyroid carcinoma via positively regulating NIS expression

Energy Technology Data Exchange (ETDEWEB)

Li, Luchuan; Lv, Bin; Chen, Bo [Department of General Surgery, Shandong University Qilu Hospital, Jinan, Shandong 250012 (China); Guan, Ming [Department of General Surgery, Qihe People' s Hospital, Qihe, Shandong 251100 (China); Sun, Yongfeng [Department of General Surgery, Licheng District People' s Hospital, Jinan, Shandong 250115 (China); Li, Haipeng [Department of General Surgery, Caoxian People' s Hospital, Caoxian, Shandong 274400 (China); Zhang, Binbin; Ding, Changyuan; He, Shan [Department of General Surgery, Shandong University Qilu Hospital, Jinan, Shandong 250012 (China); Zeng, Qingdong, E-mail: qingdz0201@163.com [Department of General Surgery, Shandong University Qilu Hospital, Jinan, Shandong 250012 (China)

2015-07-10

Dedifferentiated thyroid carcinoma (DTC) with the loss of radioiodine uptake (RAIU) is often observed in clinical practice under radioiodine therapy, indicating the challenge for poor prognosis. MicroRNA (miRNA) has emerged as a promising therapeutic target in many diseases; yet, the role of miRNAs in RAIU has not been generally investigated. Based on recent studies about miRNA expression in papillary or follicular thyroid carcinomas, the expression profiles of several thyroid relative miRNAs were investigated in one DTC cell line, derived from normal DTC cells by radioiodine treatment. The top candidate miR-146b, with the most significant overexpression profiles in dedifferentiated cells, was picked up. Further research found that miR-146b could be negatively regulated by histone deacetylase 3 (HDAC3) in normal cells, indicating the correlation between miR-146b and Na{sup +}/I{sup −} symporter (NIS)-mediated RAIU. Fortunately, it was confirmed that miR-146b could regulate NIS expression/activity; what is more important, miR-146b interference would contribute to the recovery of radioiodine-sensitivity in dedifferentiated cells via positively regulating NIS. In the present study, it was concluded that NIS-mediated RAIU could be modulated by miR-146b; accordingly, miR-146b might serve as one of targets to enhance efficacy of radioactive therapy against poorly differential thyroid carcinoma (PDTC). - Highlights: • Significant upregulated miR-146b was picked up from thyroid relative miRNAs in DTC. • MiR-146b was negatively regulated by HDAC3 in normal thyroid carcinoma cells. • NIS activity and expression could be regulated by miR-146b in thyroid carcinoma. • MiR-146b inhibition could recover the decreased radioiodine-sensitivity of DTC cells.

Distinguishing synchronous from metachronous manifestation of distant metastases: a prognostic feature in differentiated thyroid carcinoma

Energy Technology Data Exchange (ETDEWEB)

Sabet, Amir [University Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany); Saarland University Hospital, Department of Nuclear Medicine, Homburg (Germany); Binse, Ina; Koch, Andrea; Rosenbaum-Krumme, Sandra J. [University Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany); Dogan, Semih; Biersack, Hans-Juergen [University Hospital, Department of Nuclear Medicine, Bonn (Germany); Biermann, Kim [University Hospital, Department of Nuclear Medicine, Bonn (Germany); Confessional Hospital ' ' Barmherzige Brueder' ' , Department of Radiology and Nuclear Medicine, Trier (Germany); Ezziddin, Samer [Saarland University Hospital, Department of Nuclear Medicine, Homburg (Germany); University Hospital, Department of Nuclear Medicine, Bonn (Germany)

2017-02-15

Distant metastasis has a negative impact on survival in differentiated thyroid carcinoma (DTC). The timing of this manifestation, however, is of unknown prognostic relevance. The aim of this retrospective study was to investigate the potential significance of discriminating synchronous versus metachronous distant metastases (SDM vs. MDM) for the outcome of patients with DTC. We retrospectively analyzed a consecutive cohort of n = 89 patients with distant metastases of DTC (43 with follicular, 46 with papillary DTC histology; mean age 52.6 ± 17.7 years) undergoing radioiodine treatment at our institution. All patients were treated with the same protocol consisting of ablative radioiodine therapy (RIT, 3.7 GBq) and one post-ablation treatment after 3 months (3.7-11.1 GBq). Further cycles of RIT were administered for recurrent, progressive or newly developed metastatic disease. We distinguished 2 types of distant metastases according to the time of manifestation: SDM (within ≤12 months after DTC diagnosis) and MDM (occurring >12 months after diagnosis). Tumor-related survival was analyzed using the Kaplan-Meier method. Uni- and multivariate analyses including the Cox proportional hazards model were performed with a significance level of p < 0.05. The mean follow-up period was 13.8 ± 1.2 years. SDM were present in 49 (55.1 %), MDM in 40 (44.9 %) patients. MDM were associated with shorter tumor-related survival (p = 0.002). 5-year and 10-year survival rates were 68.5 % and 34.8 % for MDM, and 84.3 % and 66.9 % for SDM, respectively. Within both age subgroups of <45 and ≥45 years, SDM were also linked with longer survival. No effect on tumor-related survival was found for the co-variables sex, lymph node metastases and histologic type. Distinguishing synchronous from metachronous manifestation of distant metastases may add an important prognostic feature to risk stratification in DTC, as proven metachronous appearance is associated with impaired survival. (orig.)

Testicular impact of the treatment with I-131 in patients with differentiated thyroid carcinoma

International Nuclear Information System (INIS)

Chebel, G.; Gutierrez, S.; Fadel, A.; Suarez, S.; Levalle, O.

2007-01-01

Young patients carriers differentiated thyroid carcinoma (DTC) are treated with high doses of I-131 for much of his life with very good prognosis and projects with paternity. However, there is scarce information on the effect of radioiodine on the male gonad and their future fertility. This therapy may compromise on a temporary and / or definitively the role of the germinal cells. The testicular irradiation depends on the blood flow, the dose of I-131 administered and of the presence or absence of metastasis pelvic near to the gonads. A single dose of 100 mCi of I-131 throws an absorbed dose at gonadal level of 50-150 cGy. It has been reported that absorbed doses of 50 cGy can produce transitory decrease spermatogenesis and higher doses can also affect the function of the Leydig cells [es

An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department

Energy Technology Data Exchange (ETDEWEB)

Jofre, M J; Sierralta, M P [Military Hospital Nuclear Medicine Department, Santiago (Chile); Del Campo, G; Ide, A; Wiener, R [Department of Endocrinology of the Military Hospital, Santiago (Chile)

2002-09-01

An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department. Since the beginning of Nuclear Medicine, the thyroid gland has been an important subject for study. In the fifties, the complimentary use of 131 radioiodine after differentiated thyroid carcinoma (DTC) surgery was postulated. The aim of the study was to analyze our experience of the management of patients with DTC. Material and methods: An 18-year retrospective analysis was made including 109 patients with previous diagnosis of DTC, 90 % females, mean age 47 +/- 17 y.o. (range: 19-85 y.o). Tumoral histology was 67 % papillary, 28 % follicular and 5% non-determined in the medical record. First doses of 131 radioiodine were between 50 and 200 mCi. In all, 156 radioiodine doses were given and 6 patients received 4 doses or more, with total doses between 300 and 570 mCi. Results: The distribution of first and total radioiodine doses is presented in the table below. Of the group of patients who received a first radioiodine dose of less than 100 mCi post surgery, 79% were treated before 1990. Those who received 150mCi or more had cervical ganglionar compromise, trachea invasion or subtotal thyroidectomy. In 50% of the patients who received 4 or more doses, the first two doses were 50 mCi. It is important to mention that there was one patient who received 8 radioiodine doses in 4 years , seven of them were 50 mCi ( total dose 438 mCi). This patient presented trachea and larynx invasion in the early stages, with a persistent focus in the left supraclavicular region. She later developed pulmonary fibrosis, for which she was treated with complimentary radiotherapy (30 Gy), before dying. Distribution of radioiodine doses is presented. Conclusion: It is important to emphasize the validity of a first 131 radioiodine dose after surgery of DTC patients of 100 mCi or more, to obtain the ablation of the remaining thyroid tissue. This

An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department

International Nuclear Information System (INIS)

Jofre, M.J.; Sierralta, M.P.; Del Campo, G.; Ide, A.; Wiener, R.

2002-01-01

An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department. Since the beginning of Nuclear Medicine, the thyroid gland has been an important subject for study. In the fifties, the complimentary use of 131 radioiodine after differentiated thyroid carcinoma (DTC) surgery was postulated. The aim of the study was to analyze our experience of the management of patients with DTC. Material and methods: An 18-year retrospective analysis was made including 109 patients with previous diagnosis of DTC, 90 % females, mean age 47 +/- 17 y.o. (range: 19-85 y.o). Tumoral histology was 67 % papillary, 28 % follicular and 5% non-determined in the medical record. First doses of 131 radioiodine were between 50 and 200 mCi. In all, 156 radioiodine doses were given and 6 patients received 4 doses or more, with total doses between 300 and 570 mCi. Results: The distribution of first and total radioiodine doses is presented in the table below. Of the group of patients who received a first radioiodine dose of less than 100 mCi post surgery, 79% were treated before 1990. Those who received 150mCi or more had cervical ganglionar compromise, trachea invasion or subtotal thyroidectomy. In 50% of the patients who received 4 or more doses, the first two doses were 50 mCi. It is important to mention that there was one patient who received 8 radioiodine doses in 4 years , seven of them were 50 mCi ( total dose 438 mCi). This patient presented trachea and larynx invasion in the early stages, with a persistent focus in the left supraclavicular region. She later developed pulmonary fibrosis, for which she was treated with complimentary radiotherapy (30 Gy), before dying. Distribution of radioiodine doses is presented. Conclusion: It is important to emphasize the validity of a first 131 radioiodine dose after surgery of DTC patients of 100 mCi or more, to obtain the ablation of the remaining thyroid tissue. This

Reduction of torque ripple in DTC induction motor drive with discrete voltage vectors

Directory of Open Access Journals (Sweden)

Rosić Marko

2014-01-01

Full Text Available This paper presents а practical implementation of direct torque control (DTC of an induction machine on MSK2812 DSP platform, and the analysis of possibilities for reduction of torque ripple. Basic theoretical background relating the DTC was primarily set and the obtained experimental results have been given. It is shown that the torque ripple can be reduced by adjusting the intensity of voltage vectors and by modification of hysteresis comparator, while the simplicity of the basic DTC algorithm has been maintained. [Projekat Ministarstva nauke Republike Srbije, br. TR33016

Age differences in how consumers behave following exposure to DTC advertising.

Science.gov (United States)

DeLorme, Denise E; Huh, Jisu; Reid, Leonard N

2006-01-01

This study was conducted to provide additional evidence on how consumers behave following direct-to-consumer (DTC) advertising exposure and to determine if there are differences in ad-prompted acts (drug inquiry and drug requests) between different age groups (i.e., older, mature, and younger adults). The results suggest that younger, mature, and older consumers are all moved to act by DTC drug ads, but that each age group behaves in different ways. Somewhat surprisingly, age was not predictive of ad-prompted behavior. DTC advertising was no more effective at moving older consumers to behave than their younger counterparts. These results suggest that age does not matter that much when it comes to the "moving power" of prescription drug advertising, even though research indicates that older consumers are more vulnerable to the persuasive effects of communication.

A Sensitive Tg Assay or rhTSH Stimulated Tg : What's the Best in the Long-Term Follow-Up of Patients with Differentiated Thyroid Carcinoma?

NARCIS (Netherlands)

Persoon, Adrienne C. M.; Jager, Pieter L.; Sluiter, Wim J.; Plukker, John T. M.; Wolffenbuttel, Bruce H. R.; Links, Thera P.

2007-01-01

Sensitivity of thyroglobulin (Tg) measurement in the follow-up of differentiated thyroid carcinoma (DTC) can be optimized by using a sensitive Tg assay and rhTSH stimulation. We evaluated the diagnostic yield of a sensitive Tg assay and rhTSH stimulated Tg in the detection of recurrences in the

Pediatric differentiated thyroid carcinoma in stage I: risk factor analysis for disease free survival

International Nuclear Information System (INIS)

Wada, Nobuyuki; Rino, Yasushi; Masuda, Munetaka; Ito, Koichi; Sugino, Kiminori; Mimura, Takashi; Nagahama, Mitsuji; Kitagawa, Wataru; Shibuya, Hiroshi; Ohkuwa, Keiko; Nakayama, Hirotaka; Hirakawa, Shohei

2009-01-01

To examine the outcomes and risk factors in pediatric differentiated thyroid carcinoma (DTC) patients who were defined as TNM stage I because some patients develop disease recurrence but treatment strategy for such stage I pediatric patients is still controversial. We reviewed 57 consecutive TNM stage I patients (15 years or less) with DTC (46 papillary and 11 follicular) who underwent initial treatment at Ito Hospital between 1962 and 2004 (7 males and 50 females; mean age: 13.1 years; mean follow-up: 17.4 years). Clinicopathological results were evaluated in all patients. Multivariate analysis was performed to reveal the risk factors for disease-free survival (DFS) in these 57 patients. Extrathyroid extension and clinical lymphadenopathy at diagnosis were found in 7 and 12 patients, respectively. Subtotal/total thyroidectomy was performed in 23 patients, modified neck dissection in 38, and radioactive iodine therapy in 10. Pathological node metastasis was confirmed in 37 patients (64.9%). Fifteen patients (26.3%) exhibited local recurrence and 3 of them also developed metachronous lung metastasis. Ten of these 15 achieved disease-free after further treatments and no patients died of disease. In multivariate analysis, male gender (p = 0.017), advanced tumor (T3, 4a) stage (p = 0.029), and clinical lymphadenopathy (p = 0.006) were risk factors for DFS in stage I pediatric patients. Male gender, tumor stage, and lymphadenopathy are risk factors for DFS in stage I pediatric DTC patients. Aggressive treatment (total thyroidectomy, node dissection, and RI therapy) is considered appropriate for patients with risk factors, whereas conservative or stepwise approach may be acceptable for other patients

The number of {sup 131}I therapy courses needed to achieve complete remission is an indicator of prognosis in patients with differentiated thyroid carcinoma

Energy Technology Data Exchange (ETDEWEB)

Thies, Elena-Daphne [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); University of Wuerzburg, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Wuerzburg (Germany); Tanase, Karina; Buck, Andreas K.; Haenscheid, Heribert; Reiners, Christoph [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Maeder, Uwe [University of Wuerzburg, Comprehensive Cancer Center Mainfranken, Wuerzburg (Germany); Luster, Markus [University Hospital of Marburg, Department of Nuclear Medicine, Marburg (Germany); Verburg, Frederik A. [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); RWTH University Hospital Aachen, Department of Nuclear Medicine, Aachen (Germany)

2014-12-15

To assess the risk of differentiated thyroid cancer (DTC) recurrence, DTC-related mortality and life expectancy in relation to the number of courses of {sup 131}I therapy (RIT) and cumulative {sup 131}I activities required to achieve complete remission (CR). The study was a database review of 1,229 patients with DTC, 333 without and 896 with CR (negative TSH-stimulated thyroglobulin and negative {sup 131}I diagnostic whole-body scintigraphy) after one or more courses of RIT. The median follow-up was 9.0 years (range 0.1 - 31.8 years) after CR. Recurrence rates at 5 years, 10 years and the end of follow-up were 1.0 ± 0.3 %, 4.0 ± 0.7 % and 6.2 ± 1.1 %, and DTC-related mortality was 0.1 ± 0.1 %, 0.5 ± 0.3 % and 3.4 ± 1.1 %, respectively. Recurrence rates also increased with an increasing number of RIT courses required (p = 0.001). DTC-related mortality increased from four RIT courses. In patients with CR after one RIT course, there were no differences in recurrence or DTC-related mortality rates between low-risk and high-risk patients. In patients requiring two RIT courses these rates remain elevated in high-risk patients. Recurrence and DTC-related mortality rates were only significantly elevated in those requiring a cumulative activity over 22.2 GBq (600 mCi) from multiple RIT courses for CR. Regardless of the number of RIT courses or activity needed, life expectancy was not significantly lowered. If more than one RIT course is needed to achieve CR, higher recurrence and DTC-related mortality rates are observed, especially in high-risk patients. Patients requiring >22.2 GBq {sup 131}I for CR should be followed in the same way as patients in whom CR is never reached as long-term mortality rates are similar. (orig.)

Three Level Diode Clamped Inverter Fed Induction Motor with Dtc-Svm

OpenAIRE

V. Ranjith Kumar

2013-01-01

This project presents a three-level diode-clamped inverter feeding an asynchronous motor drive with direct torque control (DTC). The control method is based on DTC operating principles. The stator voltage vector reference is computed from the stator flux and torque errors imposed by the flux and torque controllers. This voltage reference is then generated using a diode-clamped inverter, where each phase of the inverter can be implemented using a dc source, which would be available from fuel c...

Uptake of 131-I in maxillary bones mimicking salivary glands. False- positive images in patients with differentiated thyroid carcinoma (DTC )

International Nuclear Information System (INIS)

Degrossi, Osvaldo J.; Degrossi, E.B.; Levi de Cabrejas, Mariana

2008-01-01

In the whole body scans (WBS) with 131-I in the follow-up or treatment of patients bearing DTC it is observed frequently fixation areas of the tracer apparently in relation with salivary glands. These areas generally belong to the salivary glands and are present during the first 48/72 hours, but others are kept during more than 3 weeks. These latter ones were considered as possible uptake in ectopic thyroid cells in the mouth floor, iodized proteins, retention of salivary glands and other assertions. Valdivieso et al. (Cong. Arg. Biol. Med. Nuclear, 1996) and Gutierrez et al. (SLAT,Chile, 1997) considered that the fixation took place also in maxillary bones probably in areas in relation with dental illness (inflammation, pulpitis, dental caries, perionditis, periapical granuloma, periapical cyst and resorption of surrounding bone seen radiologically as periapical radiolucency). This presumption was sustained for two publications (Clin. Nucl. Med. 1998;23. 747-749, and Clin. Nucl. Med. 2000; 23; 314-315). This end the review of 638 131-I WBS carried out between January 1st, 2002 and December 31st of 2007 in 502 patients that were studied for ablation, treatment of metastasis or relapses or follow up. In 31,5% of the patients were observed areas of activity in maxilla. The intensity of concentration of the tracer was 0.3 to 1.2 % of the activity administered. In 10 patients was determinate the effective T 1/2 and in 5 a panoramic Rx of the maxilla and a bone scintigraphy with 99m-Tc-MDP; there were correlation between both images, the 131-I one an the 99m-Tc-MDP with radiology. The effective T 1/2 mean value was 6,87 days ± 0,94 (S.D.) very close to the physical T 1/2 of the radioiodine tracer indicating a strongly labeled molecule. In 6 patients treated with high activities of radioiodine (5,55 to 11,1 MBq - 150 to 300 mCi) actinic lesions were observed in mouth and lingual mucous membrane, including ulcers. The intensity of the images and of the lesions correlate

Application of the DTC control in the photovoltaic pumping system

International Nuclear Information System (INIS)

Moulay-Idriss, Chergui; Mohamed, Bourahla

2013-01-01

Highlights: ► To improve the efficiency of PV systems, under different temperature and irradiance conditions. ► The MPPT and different control method for the induction motor were applied. ► The DTC in PV pumping system introduced and performance studied. ► The introductions of DTC in PV systems are very promising. ► Optimizing the water pumping system speed response characteristic by DTC. - Abstract: We aim to find a better control and optimization among the different functions of a solar pumping system. The photovoltaic panel can provide a maximum power only for defined output voltage and current. In addition, the operation to get the maximum power depends on the terminals of load, mostly a non-linear load like induction motor. In this work, we propose an intelligent control method for the maximum power point tracking of a photovoltaic system under variable temperature and irradiance conditions. The system was tested without maximum power point tracking, with the use of Scalar-Based control motor, but we cannot maintain the speed optimal. Next, we developed several methods for the control. Finally, we have chosen the Direct Torque Control.

Does remnant from differentiated thyroid micro-carcinoma patients really not be treated with Iodine-131 ablation?

International Nuclear Information System (INIS)

D'Antuono, F.; Gallicchio, R.; Venetucci, A.; Giacomobono, S.; Tempone, A.; Di Leo, A.; Storto, G.; Nardelli, A.; Pellegrino, T.; Gattozzi, D.

2015-01-01

Full text of publication follows. Aim: Remnant ablation by radioiodine is generally not recommended in patients presenting uni- or multifocal cancer <1 cm, without other higher risk features. We retrospectively studied low-risk patients (pts) with differentiated thyroid cancer (DTC) less than 1 cm recruited for radioiodine therapy (RAI). Methods: 91 pts (79 women, age 49.4 ± 10 years) with DTC were recruited for RAI. Pts underwent pre-therapy ultrasonography (US), those with suspected/ambiguous lymph-nodes were excluded and proposed for cytology. Treated pts underwent post-therapeutic whole body scan (WBSt) completed by neck/chest SPECT-CT, when necessary (e.g. evidence of uptake outside of thyroid bed). A target lesion on SPECT-CT was defined as an identifiable lymph-nodal site presenting a matched significant iodine uptake. Patients were followed up for 13 ± 2 months thereafter. Results: All pts/cancers were pT1. Mean histological diameter was (0.66 ± 0.25) cm. Six patients were excluded because of clear nodal involvement at US. Thirty (35%) out of 85 pts had suspicious WBSt as per lymph-nodal involvement which was confirmed at the following SPECT-CT acquisition in most part of pts (25/30; 83 %). Overall detected target lesions was 34, ten (29%) had interim positive fine needle cytology. Conclusions: a significant part of low risk DTC patients, for whom RAI is not recommended, presents an incidental evidence of lymph-nodal involvement at WBSt confirmed by SPECT-CT, when performed. Such setting would have not been treated by I-131. Indications for RAI in DTC low risk patients could be revised at least considering a different dimensional cut-off for the primary lesion. (authors)

Axitinib treatment in advanced RAI-resistant differentiated thyroid cancer (DTC) and refractory medullary thyroid cancer (MTC).

Science.gov (United States)

Capdevila, Jaume; Trigo, José Manuel; Aller, Javier; Manzano, José Luís; Adrián, Silvia García; Llopis, Carles Zafón; Reig, Òscar; Bohn, Uriel; Cajal, Teresa Ramón Y; Duran-Poveda, Manuel; Astorga, Beatriz González; López-Alfonso, Ana; Martínez, Javier Medina; Porras, Ignacio; Reina, Juan Jose; Palacios, Nuria; Grande, Enrique; Cillán, Elena; Matos, Ignacio; Grau, Juan Jose

2017-10-01

Axitinib, an antiangiogenic multikinase inhibitor (MKI), was evaluated in the compassionate use programme (CUP) in Spain (October 2012-November 2014). 47 patients with advanced radioactive iodine (RAI)-refractory differentiated thyroid cancer (DTC, n  = 34) or medullary thyroid cancer (MTC, n  = 13) with documented disease progression were treated with axitinib 5 mg b.i.d. The primary efficacy endpoint was objective response rate (ORR) by Response Evaluation Criteria In Solid Tumors (RECIST) v1.1. Progression-free survival (PFS) and adverse events (AEs) were secondary objectives. Regulatory authorities validated the CUP, and all patients signed informed consent form. Axitinib was administered as first-line therapy in 17 patients (36.2%), as second-line in 18 patients (38.3%) and as third/fourth-line in 12 patients (25.5%). With a median follow-up of 11.5 months (0-24.3), ORR was 27.7% (DTC: 29.4% and MTC: 23.1%) and median PFS was 8.1 months (95% CI: 4.1-12.2) (DTC: 7.4 months (95% CI: 3.1-11.8) and MTC: 9.4 months (95% CI: 4.8-13.9)). Better outcomes were reported with first-line axitinib, with an ORR of 53% and a median PFS of 13.6 months compared with 16.7% and 10.6 months as second-line treatment. Twelve (25.5%) patients required dose reduction to 3 mg b.i.d. All-grade AEs included asthenia (53.2%), diarrhoea (36.2%), hypertension (31.9%) and mucositis (29.8%); grade 3/4 AEs included anorexia (6.4%), diarrhoea (4.3%) and cardiac toxicity (4.3%). Axitinib had a tolerable safety profile and clinically meaningful activity in refractory and progressive thyroid cancer regardless of histology as first-line therapy. To our knowledge, this is the first time that cross-resistance between MKIs is suggested in thyroid cancer, highlighting the importance of prospective sequential clinical studies. © 2017 European Society of Endocrinology.

[The value of multimodal imaging by single photon emission computed tomography associated to X ray computed tomography (SPECT-CT) in the management of differentiated thyroid carcinoma: about 156 cases].

Science.gov (United States)

Mhiri, Aida; El Bez, Intidhar; Slim, Ihsen; Meddeb, Imène; Yeddes, Imene; Ghezaiel, Mohamed; Gritli, Saïd; Ben Slimène, Mohamed Faouzi

2013-10-01

Single photon emission computed tomography combined with a low dose computed tomography (SPECT-CT), is a hybrid imaging integrating functional and anatomical data. The purpose of our study was to evaluate the contribution of the SPECTCT over traditional planar imaging of patients with differentiated thyroid carcinoma (DTC). Post therapy 131IWhole body scan followed by SPECTCT of the neck and thorax, were performed in 156 patients with DTC. Among these 156 patients followed for a predominantly papillary, the use of fusion imaging SPECT-CT compared to conventional planar imaging allowed us to correct our therapeutic approach in 26.9 % (42/156 patients), according to the protocols of therapeutic management of our institute. SPECT-CT is a multimodal imaging providing better identification and more accurate anatomic localization of the foci of radioiodine uptake with impact on therapeutic management.

High Ripples Reduction in DTC of Induction Motor by Using a New Reduced Switching Table

Science.gov (United States)

Mokhtari, Bachir; Benkhoris, Mohamed F.

2016-05-01

The direct torque and flux control (DTC) of electrical motors is characterized by ripples of torque and flux. Among the many solutions proposed to reduce them is to use modified switching tables which is very advantageous; because its implementation is easy and requires no additional cost compared to other solutions. This paper proposes a new reduced switching table (RST) to improve the DTC by reducing harmful ripples of torque and flux. This new switching table is smaller than the conventional one (CST) and depends principally at the flux error. This solution is studied by simulation under Matlab/Simulink and experimentally validated on a testbed with DSPACE1103. The results obtained of a DTC with RST applied to a three-phase induction motor (IM) show a good improvement and an effectiveness of proposed solution, the torque ripple decreases about 47% and 3% for the stator flux compared with a basic DTC.

Difficulties in deciding whether to ablate patients with putatively "low-intermediate-risk" differentiated thyroid carcinoma: do guidelines mainly apply in the centres that produce them? Results of a retrospective, two-centre quality assurance study.

Science.gov (United States)

Frangos, Savvas; Iakovou, Ioannis P; Marlowe, Robert J; Eftychiou, Nicolaos; Patsali, Loukia; Vanezi, Anna; Savva, Androulla; Mpalaris, Vassilis; Giannoula, Evanthia I

2015-12-01

We determined the reasons for radioiodine thyroid remnant ablation, and the procedure's necessity based on postsurgical remnant size, in patients with putatively "low-intermediate-risk" differentiated thyroid carcinoma (DTC). We identified key clinicopathological, treatment and remnant characteristics, and factors associated with remnant size in 336 patients with pT1/2, M0 DTC ablated during the period September 2010 to October 2013 at one Cypriot or one Greek referral centre. Clinicopathological/treatment characteristics were compiled from charts. Experienced nuclear medicine physicians rated the numbers/intensities of uptake foci in the thyroid bed on postablation planar scintigrams using scales of 0-4 points and 0-3 points, respectively. The product of these scores was taken as the "remnant score" that ranged from 0 (no remnant) to 12 (multiple remnants, intense uptake). DTC was predominantly papillary. The median [25th-75th percentile] longest primary tumour diameter was 1.0 cm [0.7-1.5 cm]. Despite favourable histotypes and primary tumour classifications, patients often had preablation characteristics suggesting elevated or uncertain risk: 31.0% of patients (104 of 336) had primary tumour multifocality, 22.0% (74) had confirmed cervical lymph node metastases, 37.2% (125) had unknown nodal status, and 38.1% (128) had antithyroglobulin antibody seropositivity. The median [25th-75th percentile] remnant score was 4 [2-6]; 39.9% of patients (134 of 336) had scores ≥6. For the entire cohort, T or N stages (r ≤ 0.174, P ≤ 0.05) correlated positively with the remnant score in a univariate Spearman analysis. The numbers of patients referred by the surgeon, cervical lymph nodes excised and metastatic nodes excised correlated negatively (r ≤ 0.243, P ≤ 0.038) with the remnant score, and the first two factors independently predicted the remnant score (P ≤ 0.037) in a multivariate analysis. Patients with putatively "low

Gene therapy of thyroid carcinoma

International Nuclear Information System (INIS)

Zheng Wei; Tan Jian

2007-01-01

Normally, differentiated thyroid carcinoma(DTC) is a disease of good prognosis, but about 30% of the tumors are dedifferentiate, which are inaccessible to standard therapeutic procedures such as 'operation, 131 I therapy and thyroid hormone'. Both internal and abroad experts are researching a new therapy of dedifferentiated thyroid carcinoma--gene therapy. Many of them utilize methods of it, but follow different strategies: (1) transduction of the thyroid sodium/iodide transporter gene to make tissues that do not accumulate iodide treatable by 131 I therapy; (2) strengthening of the anti-tumor immune response; (3) suicide gene therapy; (4) depression the generation of tumor cells; (5) gene therapy of anti- vascularization. (authors)

Clinical aspects of endogenous hypothyroidism and subclinical hyperthyroidism in patients with differentiated thyroid carcinoma

NARCIS (Netherlands)

Heemstra, Karen Anne

2009-01-01

Patients with DTC are initially treated with a total thyroidectomy and radioiodine therapy. Hereafter, all patients are treated with high doses of thyroxin aiming at significantly suppressing thyrotropin (TSH) levels, resulting in a subclinical hyperthyroid state. The rationale of this approach is

DSP Based Direct Torque Control of Permanent Magnet Synchronous Motor (PMSM) using Space Vector Modulation (DTC-SVM)

DEFF Research Database (Denmark)

Swierczynski, Dariusz; Kazmierkowski, Marian P.; Blaabjerg, Frede

2002-01-01

DSP Based Direct Torque Control of Permanent Magnet Synchronous Motor (PMSM) using Space Vector Modulation (DTC-SVM)......DSP Based Direct Torque Control of Permanent Magnet Synchronous Motor (PMSM) using Space Vector Modulation (DTC-SVM)...

Preoperative TSH level and risk of thyroid cancer in patients with nodular thyroid disease: nodule size contribution.

Science.gov (United States)

Zafón, Carles; Obiols, Gabriel; Mesa, Jordi

2015-01-01

Many reports have supported the relationship between high preoperative TSH levels and risk of thyroid cancer in nodular thyroid disease (NTD). We investigated whether TSH levels are related to the risk of differentiated thyroid carcinoma (DTC) in patients who have undergone total thyroidectomy for NTD. The relationship between TSH and size of malignant nodule was investigated. Finally, we assessed whether TSH levels are related to DTC and presence of additional benign nodules. A retrospective study of 980 patients was conducted. Variables included age at diagnosis, TSH level, nodule size, gender, final histology (benign versus DTC), and type of malignancy. Malignancy was present in 261 (26.6%) patients. These patients had higher median TSH levels as compared to those with no malignancy (1.61 mU/L (0.9-2.5) versus 0.9 mU/L (0.3-1.6); p-value<0.001). TSH was higher in patients with DTC in whom the largest nodule was malignant than in patients in whom the largest nodule was benign (1.80 mU/L (1.1-2.6) versus 1.38 mU/L (0.7-2.1) respectively; p-value=0.025). A significant correlation was seen between malignant nodule size and TSH level, but not between TSH levels and size of the largest benign nodule. Our study supported an association between preoperative TSH levels and risk of DTC in patients with NTD. There was also a direct relationship between malignant nodule size and TSH levels. By contrast, no relationship was found between the size of benign nodules and TSH levels. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.

Risky business: risk perception and the use of medical services among customers of DTC personal genetic testing.

Science.gov (United States)

Kaufman, David J; Bollinger, Juli M; Dvoskin, Rachel L; Scott, Joan A

2012-06-01

Direct-to-consumer genetic testing has generated speculation about how customers will interpret results and how these interpretations will influence healthcare use and behavior; however, few empirical data on these topics exist. We conducted an online survey of DTC customers of 23andMe, deCODEme, and Navigenics to begin to address these questions. Random samples of U.S. DTC customers were invited to participate. Survey topics included demographics, perceptions of two sample DTC results, and health behaviors following DTC testing. Of 3,167 DTC customers invited, 33% (n = 1,048) completed the survey. Forty-three percent of respondents had sought additional information about a health condition tested; 28% had discussed their results with a healthcare professional; and 9% had followed up with additional lab tests. Sixteen percent of respondents had changed a medication or supplement regimen, and one-third said they were being more careful about their diet. Many of these health-related behaviors were significantly associated with responses to a question that asked how participants would perceive their colon cancer risk (as low, moderate, or high) if they received a test result showing an 11% lifetime risk, as compared to 5% risk in the general population. Respondents who would consider themselves to be at high risk for colon cancer were significantly more likely to have sought information about a disease (p = 0.03), discussed results with a physician (p = 0.05), changed their diet (p = 0.02), and started exercising more (p = 0.01). Participants' personal health contexts--including personal and family history of disease and quality of self-perceived health--were also associated with health-related behaviors after testing. Subjective interpretations of genetic risk data and personal context appear to be related to health behaviors among DTC customers. Sharing DTC test results with healthcare professionals may add perceived utility to the tests.

Diagnostic value of positron emission tomography/computed tomography with fluorine-18 fluorodeoxyglucose in patients with differentiated thyroid gland carcinoma, high thyroglobulin serum levels and negative iodine whole body scan; Valor diagnostico da tomografia por emissao de positrons/tomografia computadorizada (PET-CT) com fluor-18 fluordeoxiglicose (FDG-{sup 18}F) em pacientes com carcinoma diferenciado da tireoide, niveis sericos de tireoglobulina elevados e pesquisa de corpo inteiro com iodo negativa

Energy Technology Data Exchange (ETDEWEB)

Yamaga, Lilian Yuri Itaya; Cunha, Marcelo Livorsi da; Wagner, Jairo; Thom, Annelise Fischer; Daniel, Mauro Miguel; Funari, Marcelo B. de Gusmao [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil). Dept. de Imagem]. E-mail: itaya@einstein.br

2007-06-15

Purpose: To evaluate the role of PET-CT with FDG-{sup 18}F in the detection of recurrence and/or metastasis of differentiated thyroid carcinoma (DTC) in patients with elevated levels of thyroglobulin (TG) and negative whole body scan (WBS). Patients and method: PET-CT findings of 25 patients were compared to histopathology evaluation and conventional imaging (CI). Results: PET-CT scan was positive in 16 patients finding 14 true-positive and 2 false-positive cases (positive predictive value 87.5%). Nine patients had negative PET-CT; two had decrease of TG to undetectable levels. One patient had residual disease detected by post-therapeutic WBS. Six patients had no evidence of tumor during follow-up (mean time 16 months). PET-CT was concordant with CI in 52%, partially concordant in 12% and discordant in 36% (6 false-negatives and 3 false-positive of CI). We observed a tendency of increasing proportion of positive PET-CT with increasing TG. Conclusion: PET-CT scan with FDG-{sup 18}F is useful in the detection of recurrence and/or metastases of DTC with high TG levels but negative WBS. It presents elevated positive predictive value and is superior to CI being more effective as higher the serum TG levels. (author)

Photoisomerization action spectroscopy of the carbocyanine dye DTC+ in the gas phase.

Science.gov (United States)

Adamson, Brian D; Coughlan, Neville J A; da Silva, Gabriel; Bieske, Evan J

2013-12-19

Molecular photoisomerization plays a crucial role in diverse biological and technological contexts. Here, we combine ion mobility spectrometry and laser spectroscopy to characterize the photoisomerization of molecular cations in the gas phase. The target molecular ions, polymethine dye cations 3,3'-diethylthiacarbocyanine (DTC(+)), are propelled through helium buffer gas by an electric field and are photoisomerized by light from a tunable laser. Photoexcitation over the 450-570 nm range converts trans-DTC(+) to cis-DTC(+), noticeably modifying the ions' arrival time distribution. The photoisomerization action spectrum, which has a maximum at 535 nm, resembles the absorption spectrum of DTC(+) in solution but is shifted 25 nm to shorter wavelength. Comparisons between measured and calculated mobilities suggest that the photoisomer involves a twist about the second C-C bond in the methine chain (8,9-cis isomer) rather than a twist about the first methine C-C bond (2,8-cis isomer). It is postulated that the excited gas-phase ions internally convert from the S1 Franck-Condon region to the S0 manifold and explore the conformational landscape as they cool through He buffer gas collisions. Master equation simulations of the relaxation process in the S0 manifold suggest that the 8,9-cis isomer is preferred over the 2,8-cis isomer because it lies lower in energy and because it is separated from the trans isomer by a substantially higher barrier. The study demonstrates that the photoisomerization of molecular ions can be probed selectively in the gas phase, providing insights into photoisomerization mechanisms and information on the solvent-free absorption spectrum.

Clinical utility of {sup 18}F-FDG PET/CT in the follow-up of a large cohort of patients with high-risk differentiated thyroid carcinoma

Energy Technology Data Exchange (ETDEWEB)

Yang, Ji H.; Maciel, Rui M.B.; Nakabashi, Claudia C.D.; Janovsky, Carolina C.P.S.; Padovani, Rosalia P.; Macellaro, Danielle; Camacho, Cléber P.; Biscolla, Rosa Paula M., E-mail: rui.maciel@unifesp.br [Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, SP (Brazil). Escola Paulista de Medicina; Osawa, Akemi; Wagner, Jairo [Hospital Israelita Albert Einstein (HIAE), São Paulo, SP (Brazil). Departamento de Imagem

2017-09-15

Objective: To evaluate the clinical utility of {sup 18}F-FDG PET/CT in patients with high-risk DTC. Subjects and methods: Single-center retrospective study with 74 patients with high-risk differentiated thyroid cancer (DTC), classified in 4 groups. Group 1: patients with positive sTg or TgAb, subdivided in Group 1A: negative RxWBS and no foci of metastases identified at conventional image (n = 9); Group 1B: RxWBS not compatible with suspicious foci at conventional image or not proportional to sTg level (n = 13); Group 2: patients with histological findings of aggressive DTC variants (n = 21) and Group 3: patients with positive RxWBS (n = 31). Results: {sup 18}F-FDG PET/CT identified undifferentiated lesions and helped restage the disease in groups 1B and 2. The scan helped guide clinical judgment in 9/13 (69%) patients of group 1B, 10/21 (48%) patients of group 2 and 2/31 (6%) patients of group 3. There was no clinical benefit associated with group 1A. {sup 18}F-FDG PET/CT was associated with progressive disease. Conclusion: {sup 18}F-FDG PET/CT is a useful tool in the follow-up of patients with high-risk DTC, mainly in the group of RxWBS not compatible with suspicious foci at conventional image or not proportional to sTg level and in those with aggressive DTC variants. Additionally, this study showed that {sup 18}F-FDG PET/CT was associated with progression and helped display undifferentiated lesions guiding clinical assessments regarding surgeries or expectant treatments. (author)

Last improvements of the DTC 1000 spectrophotometer

International Nuclear Information System (INIS)

Blanc, F.

1988-01-01

The DTC 1000 spectrophotometer, based on optical fibers and photodiode array was developed for Pu(IV) measurement in fuel reprocessing. The apparatus takes advantage of experience acquired in optical fibers instrumentation and of the study of gamma radiation effects on fibers. This paper give the complete evolution of these last months (memory, hardware, software, background noise). But the principle of the apparatus and examples of results obtained on americium and plutonium on a previous version of the apparatus are recalled. 17 figs., 6 refs [fr

Direct-to-consumer (DTC) antidepressant advertising and consumer misperceptions about the chemical imbalance theory of depression: the moderating role of skepticism.

Science.gov (United States)

Park, Jin Seong; Ahn, Ho-Young Anthony

2013-01-01

Based on a survey with members of an online consumer panel (N= 699), this study revealed that: (a) a substantial percentage of consumers held misperceptions about the chemical imbalance theory of depression; (b) personal and interpersonal experiences with depression positively related to such misperceptions; (c) overall, exposure to direct-to-consumer (DTC) antidepressant advertising did not significantly relate to misperceptions; and (d) DTC exposure magnified misperceptions when consumers were highly trustful of DTC advertising, whereas exposure diluted misperceptions when consumers were highly skeptical. Theoretical and practical implications of the research are discussed, especially in light of the social responsibility of DTC advertising.

Partial response to sorafenib treatment associated with transient grade 3 thrombocytopenia in a patient with locally advanced thyroid cancer

Energy Technology Data Exchange (ETDEWEB)

Pitoia Fabian; Abelleira, Erika; Jerkovich, Fernando; Urciuoli, Carolina; Cross, Graciela, E-mail: fpitoia@intramed.net [Division de Endocrinologia, Hospital de Clinicas, Universidad de Buenos Aires Buenos Aires (Argentina)

2015-08-15

Advanced radioactive refractory and progressive or symptomatic differentiated thyroid carcinoma (DTC) is a rare condition. Sorafenib was recently approved for the treatment of these patients. We present the case of a 67 year old woman diagnosed with DTC who underwent a total thyroidectomy with central, lateral-compartment neck dissection and shaving of the trachea and esophagus due to tumor infiltration. A local recurrence was detected 14 months later requiring, additionally, two tracheal rings resection. The patient received a cumulative {sup 131}I dose of 650 mCi and developed dysphagia and dyspnea 63 months after initial surgery. A {sup 18}FGD-PET/CT showed progression of the local mass associated to hypermetabolic pulmonary nodules. Sorafenib 800 mg/day was then prescribed. A dose reduction to 400 mg/day was necessary due to grade 3 thrombocytopenia that appeared four months after drug prescription. Platelet count went to normal after this dose reduction. Five months after initiation of sorafenib, a partial response of the local mass with significant intra-tumoral necrosis was observed. We conclude that sorafenib is a valid option for locally advanced DTC and that the platelet count should be evaluated regularly because it seems that thrombocytopenia might be more frequently observed in DTC than in other types of tumors. (author)

Lenvatinib in Advanced Radioiodine-Refractory Thyroid Cancer - A Retrospective Analysis of the Swiss Lenvatinib Named Patient Program.

Science.gov (United States)

Balmelli, Catharina; Railic, Nikola; Siano, Marco; Feuerlein, Kristin; Cathomas, Richard; Cristina, Valerie; Güthner, Christiane; Zimmermann, Stefan; Weidner, Sabine; Pless, Miklos; Stenner, Frank; Rothschild, Sacha I

2018-01-01

Purpose: Differentiated thyroid cancer (DTC) accounts for approximately 95% of thyroid carcinomas. In the metastatic RAI-refractory disease, chemotherapy has very limited efficacy and is associated with substantial toxicity. With increasing knowledge of the molecular pathogenesis of DTC, novel targeted therapies have been developed. Lenvatinib is a tyrosine kinase inhibitor (TKI) with promising clinical activity based on the randomized phase III SELECT trial. In Switzerland, a Named Patient Program (NPP) was installed to bridge the time gap to Swissmedic approval. Here, we report the results from the Swiss Lenvatinib NPP including patients with metastatic RAI-refractory DTC. Methods: Main inclusion criteria for the Swiss NPP were RAI-refractory DTC, documented disease progression, Eastern Cooperative Oncology Group (ECOG) performance status 0-3. The number of previous therapies was not limited. The Swiss Lenvatinib NPP was initiated in June 2014 and was closed in October 2015 with the approval of the drug. Results: Between June 2014 and October 2015, 13 patients with a median age of 72 years have been enrolled. Most patients (69%) had at least one prior systemic therapy, mainly sorafenib. 31% of patients showed a PR and 31% SD. Median progression free survival was 7.2 months and the median overall survival was 22.7 months. Dose reduction due to adverse events was necessary in 7 patients (53%). At the time of analysis 6 patients (47%) were still on treatment with a median time on treatment of 9.98 months. Conclusions: Our results show that lenvatinib has reasonable clinical activity in unselected patients with RAI-refractory thyroid cancer with nearly two-third of patients showing clinical benefit. The toxicity profile of lenvatinib is manageable.

Difficulties in deciding whether to ablate patients with putatively ''low-intermediate-risk'' differentiated thyroid carcinoma: do guidelines mainly apply in the centres that produce them? Results of a retrospective, two-centre quality assurance study

Energy Technology Data Exchange (ETDEWEB)

Frangos, Savvas; Eftychiou, Nicolaos; Patsali, Loukia; Vanezi, Anna; Savva, Androulla [Bank of Cyprus Oncology Centre, Department of Nuclear Medicine, Strovolos, Nicosia (Cyprus); Iakovou, Ioannis P.; Mpalaris, Vassilis; Giannoula, Evanthia I. [Aristotle University, Papageorgiou Hospital, Department of Nuclear Medicine, Thessaloniki (Greece); Marlowe, Robert J. [Spencer-Fontayne Corporation, Jersey City, NJ (United States)

2015-12-15

We determined the reasons for radioiodine thyroid remnant ablation, and the procedure's necessity based on postsurgical remnant size, in patients with putatively ''low-intermediate-risk'' differentiated thyroid carcinoma (DTC). We identified key clinicopathological, treatment and remnant characteristics, and factors associated with remnant size in 336 patients with pT1/2, M0 DTC ablated during the period September 2010 to October 2013 at one Cypriot or one Greek referral centre. Clinicopathological/treatment characteristics were compiled from charts. Experienced nuclear medicine physicians rated the numbers/intensities of uptake foci in the thyroid bed on postablation planar scintigrams using scales of 0-4 points and 0-3 points, respectively. The product of these scores was taken as the ''remnant score'' that ranged from 0 (no remnant) to 12 (multiple remnants, intense uptake). DTC was predominantly papillary. The median [25th-75th percentile] longest primary tumour diameter was 1.0 cm [0.7-1.5 cm]. Despite favourable histotypes and primary tumour classifications, patients often had preablation characteristics suggesting elevated or uncertain risk: 31.0 % of patients (104 of 336) had primary tumour multifocality, 22.0 % (74) had confirmed cervical lymph node metastases, 37.2 % (125) had unknown nodal status, and 38.1 % (128) had antithyroglobulin antibody seropositivity. The median [25th-75th percentile] remnant score was 4 [2-6]; 39.9 % of patients (134 of 336) had scores ≥6. For the entire cohort, T or N stages (r ≤ 0.174, P ≤ 0.05) correlated positively with the remnant score in a univariate Spearman analysis. The numbers of patients referred by the surgeon, cervical lymph nodes excised and metastatic nodes excised correlated negatively (r ≤ 0.243, P ≤ 0.038) with the remnant score, and the first two factors independently predicted the remnant score (P ≤ 0.037) in a multivariate analysis. Patients with

Difficulties in deciding whether to ablate patients with putatively ''low-intermediate-risk'' differentiated thyroid carcinoma: do guidelines mainly apply in the centres that produce them? Results of a retrospective, two-centre quality assurance study

International Nuclear Information System (INIS)

Frangos, Savvas; Eftychiou, Nicolaos; Patsali, Loukia; Vanezi, Anna; Savva, Androulla; Iakovou, Ioannis P.; Mpalaris, Vassilis; Giannoula, Evanthia I.; Marlowe, Robert J.

2015-01-01

We determined the reasons for radioiodine thyroid remnant ablation, and the procedure's necessity based on postsurgical remnant size, in patients with putatively ''low-intermediate-risk'' differentiated thyroid carcinoma (DTC). We identified key clinicopathological, treatment and remnant characteristics, and factors associated with remnant size in 336 patients with pT1/2, M0 DTC ablated during the period September 2010 to October 2013 at one Cypriot or one Greek referral centre. Clinicopathological/treatment characteristics were compiled from charts. Experienced nuclear medicine physicians rated the numbers/intensities of uptake foci in the thyroid bed on postablation planar scintigrams using scales of 0-4 points and 0-3 points, respectively. The product of these scores was taken as the ''remnant score'' that ranged from 0 (no remnant) to 12 (multiple remnants, intense uptake). DTC was predominantly papillary. The median [25th-75th percentile] longest primary tumour diameter was 1.0 cm [0.7-1.5 cm]. Despite favourable histotypes and primary tumour classifications, patients often had preablation characteristics suggesting elevated or uncertain risk: 31.0 % of patients (104 of 336) had primary tumour multifocality, 22.0 % (74) had confirmed cervical lymph node metastases, 37.2 % (125) had unknown nodal status, and 38.1 % (128) had antithyroglobulin antibody seropositivity. The median [25th-75th percentile] remnant score was 4 [2-6]; 39.9 % of patients (134 of 336) had scores ≥6. For the entire cohort, T or N stages (r ≤ 0.174, P ≤ 0.05) correlated positively with the remnant score in a univariate Spearman analysis. The numbers of patients referred by the surgeon, cervical lymph nodes excised and metastatic nodes excised correlated negatively (r ≤ 0.243, P ≤ 0.038) with the remnant score, and the first two factors independently predicted the remnant score (P ≤ 0.037) in a multivariate analysis. Patients with

The medicine selection process in four large university hospitals in Brazil: Does the DTC have a role?

Directory of Open Access Journals (Sweden)

Elisangela da Costa Lima-Dellamora

2015-03-01

Full Text Available Knowledge about evidence-based medicine selection and the role of the Drug and Therapeutics Committee (DTC is an important topic in the literature but is scarcely discussed in Brazil. Our objective, using a qualitative design, was to analyze the medicine selection process performed in four large university hospitals in the state of Rio de Janeiro. Information was collected from documents, interviews with key informants and direct observations. Two dimensions were analyzed: the structural and organizational aspects of the selection process and the criteria and methods used in medicine selection. The findings showed that the DTC was active in two hospitals. The structure for decision-making was weak. DTC members had little experience in evidence-based selection, and their everyday functions did not influence their participation in DTC activities. The methods used to evaluate evidence were inadequate. The uncritical adoption of new medicines in these complex hospital facilities may be hampering pharmaceutical services, with consequences for the entire health system. Although the qualitative approach considerably limits the extent to which the results can be extrapolated, we believe that our findings may be relevant to other university hospitals in the country.

A study of the web as DTC drug marketing agent.

Science.gov (United States)

Lorence, Daniel; Churchill, Rick

2007-12-01

The growth of direct-to-consumer (DTC) marketing of pharmaceuticals in the USA has spawned the generation of web sites for consumer information and discussion, related to specific medical conditions and the efficacy of specific drugs. In such an environment consumers often find and act upon health information of variable quality, with little input from health professionals. Some health policy analysts argue that the emergence of such consumer "drug networks" will lead to unnecessary expenditure of money on prescription drugs, as consumers see ads and then demand that their providers prescribe that drug. Others say that an intelligent consumer will be able to research the information and narrow down a drug that will likely work for them personally, rather than having the provider "experiment" with different medications. There exist few cross-disciplinary evaluative frameworks for assessing such health information, especially within commercial search engines. This study serves as an exploratory technology assessment that examines the prevalence of web-based DTC for a popular prescription drug and the impact on healthcare consumers.

A study on the improved DTC method for estimations of radionuclide activity in radwaste containers

International Nuclear Information System (INIS)

Kang, Sang Hee; Hwang, Ki Ha; Lee, Sang Chul; Lee, Kun Jai; Kim, Tae Wook; Kim, Kyoung Deok; Herr, Young Hoi; Song, Myung Jae

2004-01-01

Disposal of rad waste containers requires the assessment of the radioactive contents of each container. Some containers can not be assessed by the γ nuclide analyzer because of time constraint and economical burden. One alternative method, dose to curie conversion (DTC) method can provide an estimate of the container activity. This study evaluates the impact of voids, the chemical composition and density of the material and the distribution of the source related to surface dose rate and the development of the improved DTC method for more accurate assessment

Clinical aspects of endogenous hypothyroidism and subclinical hyperthyroidism in patients with differentiated thyroid carcinoma

OpenAIRE

Heemstra, Karen Anne

2009-01-01

Patients with DTC are initially treated with a total thyroidectomy and radioiodine therapy. Hereafter, all patients are treated with high doses of thyroxin aiming at significantly suppressing thyrotropin (TSH) levels, resulting in a subclinical hyperthyroid state. The rationale of this approach is based on the potential harmful effects of TSH on tumor recurrence. Furthermore, thyroxin replacement therapy can be transiently stopped in these patients to detect residual or recurrent disease by T...

Merkel cell carcinoma in an immunosuppressed patient.

Science.gov (United States)

Góes, Heliana Freitas de Oliveira; Lima, Caren Dos Santos; Issa, Maria Cláudia de Almeida; Luz, Flávio Barbosa; Pantaleão, Luciana; Paixão, José Gabriel Miranda da

2017-01-01

Merkel cell carcinoma is an uncommon neuroendocrine carcinoma with a rising incidence and an aggressive behavior. It predominantly occurs in older patients, with onset occurring at a mean age of 75-80 years. Recognized risk factors are ultraviolet sunlight exposure, immunosuppression, and, more recently, Merkel cell polyomavirus. We report a case of Merkel cell carcinoma in a young HIV positive patient with Merkel Cell polyomavirus detected in the tumor.

The rate of depression and its risk stratification in patients with differentiated thyroid cancers treated with radioactive iodine

International Nuclear Information System (INIS)

Eftekhari, M.; Fallahi, B.; Ansari, S.; Izadian, E.S.; Esfahani, A.F.; Beiki, D.; Saghari, M.

2005-01-01

Full text: Depression is a common disease in general population and may be more frequent in the cases of malignant diseases. Diagnosis and treatment of depressions in such patients may improve the quality of life. The aim of this study was to determine the risk of depression in patients diagnosed as differentiated thyroid cancers (DTC) and treated with radioactive iodine ( 131 I). In a historical Cohort study, 390 DTC patients, 312 female and 78 male, 18-68 years with median age of 41 years who were treated with 131 I and 390 control cases selected from the patients' relatives and matched with DTC cases by age, sex, wedding state and socioeconomic status were entered the study. Each patient and his/her control were concurrently assessed with Beck's questionnaire for diagnosis of depression. The data was analyzed to detect the rate, severity and relative risk of depression and the effect of some variables on the severity of depression in these patients. Of 390 patients, 179(45.9%) showed some degree of depression, 20.3% mild, 14.1% moderate, 11% partially severe and 0.5% severe according to Beck score, while the proportional frequency of different grades of depression among the control group was 15.5% and overall relative risk of depression in DTC patients was 2.96. The frequency of depression in female patients, 47.8% was lesser than male, 38.5% (p=0.013) and in married female (46.2%) was greater than single (14.3%) but lesser than divorced or widow female patients (82.4%), (p<0.0001). Depression was more prevalent and more severe in cases of papillary, 47.9% than follicular carcinoma, 33.3% (p=0.014) and also was more predominant in less-educated than in high-educated patients (p<0.0001). In DTC patients with history of radio-iodine therapy, the rate of depression is almost three times of the general population, so screening and treatment of depression especially in high risk patients like married or divorced female and less-educated patients may be of great

Pre-therapeutic blood dosimetry in patients with differentiated thyroid carcinoma using 124-iodine. Predicted blood doses correlate with changes in blood cell counts after radioiodine therapy and depend on modes of TSH stimulation and number of preceding radioiodine therapies

International Nuclear Information System (INIS)

Hartung-Knemeyer, V.; Nagarajah, J.; Jentzen, W.; Ruhlmann, M.; Freudenberg, L.S.; Stahl, A.R.; Bockisch, A.; Rosenbaum-Krumme, S.J.

2012-01-01

Pre-therapeutic blood dosimetry prior to a high-dose radioiodine therapy (RAIT) is recommended and a blood dose of 2 Gy is considered to be safe. In this study, changes in the blood cell count after radioiodine therapy of high risk differentiated thyroid carcinoma (DTC) were analyzed and compared with the results of the pre-therapeutic blood dosimetry using 124 I. Moreover, the influence of different modes of TSH stimulation and the number of preceding radioiodine therapies on the blood dose were assessed. 198 patients with locally advanced or metastasized DTC received a pre-therapeutic blood dosimetry using 124 I. To analyze the influence of the modes of TSH stimulation and the number of preceding RAITs on blood dose subgroups were built as follows: patients with endogenous TSH stimulation versus patients with exogenous TSH stimulation and patients with no preceding RAIT versus patients with at least one preceding RAIT. In 124/198 patients subsequent RAIT was performed. In 73/124 patients, hemograms were performed from day 2 to 12 month after RAIT. There was no high-grade bone marrow toxicity (id est (i.e.) ≥grade 3) in patients receiving less than 2 Gy blood dose-independent of the therapeutic history. Within the first month after radioiodine therapy, there was an overall decrease in the white blood cell and platelet counts. The erythrocyte count was essentially stable. There was a correlation between cell count decrease and predicted blood doses (Spearman's correlation coefficient >-0.6 each) for the white cell line and the platelets. With regard to the subgroups, the blood dose per administered 131 I activity (BDpA) was significantly higher in patients with endogenous TSH stimulation (median 0.08 Gy/GBq) than in patients with exogenous TSH stimulation (0.06 Gy/GBq) and in patients with no previous RAIT (0.08 Gy/GBq) compared to patients who had previously undergone at least one RAIT (0.07 Gy/GBq). The range of BDpA among DTC patients is rather wide. Our

Usefulness of recombinant human TSH-aided radioiodine doses administered in patients with differentiated thyroid carcinoma Administración de dosis terapéuticas de radioyodo luego de TSH recombinante en pacientes con carcinoma diferenciado de tiroides

Directory of Open Access Journals (Sweden)

Fabián Pitoia

2006-04-01

Full Text Available The published studies confirming the safety and efficacy of rhTSH for diagnostic purposes have led to an increased interest in its use for preparation for radioiodine (RI dose administration in patients with recurrent or persistent differentiated thyroid carcinoma (DTC. In order to establish the efficacy of RI therapy after rhTSH, we have reviewed 39 rhTSH-aided radioiodine treatment in a series of 28 DTC patients. Patients were divided into two groups: GI (n=17, with previous thyroid bed uptake and undetectable thyroglobulin (Tg levels under levothyroxine treatment and GII (n=11, with proven metastatic local or distant disease. Median follow-up after the first rhTSH-aided radioiodine treatment was 32 ± 13 months (range 8 to 54 months. Sixteen patients (94% in GI were rendered disease free and one patient was shown to have persistent disease. In GII, the post therapy whole body scan showed pathological uptakes in all cases: in four patients in lungs, in four in mediastinum and in three in lateral neck. In two patients with mediastinum uptake, Tg levels were undetectable after rhTSH. In the follow-up, two patients with lateral neck uptake were rendered disease free, four patients died (three due to thyroid cancer and five out of the remaining patients have persistent disease. In conclusion, rhTSH aided therapy was helpful to eliminate normal thyroid bed remnants in 16/17 (94% patients (GI. rhTSH stimulated Tg was undetectable in two patients with mediastinal metastasis. We believe that rhTSH is a good alternative to levothyroxine withdrawal for the treatment of DTC with radioactive iodine, increasing the quality of life in these patients. Caution should be recommended in the follow-up of unselected DTC patients only with stimulated Tg levels.Los estudios publicados que confirman la seguridad y eficacia de la TSH recombinante (rhTSH llevaron a un incremento en el interés para su uso como adyuvante terapéutico en el CDT (ablación o tratamiento

'Only a click away - DTC genetics for ancestry, health, love…and more: A view of the business and regulatory landscape'.

Science.gov (United States)

Phillips, Andelka M

2016-03-01

I provide an overview of the current state of the direct-to-consumer (DTC) genetic testing industry and the challenges that different types of testing pose for regulation. I consider the variety of services currently available. These range from health and ancestry tests to those for child talent, paternity, and infidelity. In light of the increasingly blurred lines among different categories of testing, I call for a broader discussion of DTC governance. I stress the importance of shifting our attention from the activities of the most prominent companies to viewing DTC genetics as an industry with a wide spectrum of services and raising a wide variety of issues. These issues go beyond questions of clinical utility and validity to those of data security, personal identity, race, and the nature of the family. Robust DTC testing has the power to provide meaningful clinical, genealogical and even forensic information to those who want it; in unscrupulous hands, however, it also has the power to deceive and exploit. I consider approaches to help ensure the former and minimize the latter.

Perforated gastric carcinoma in a young-age patient

Directory of Open Access Journals (Sweden)

Feng-Hsu Wu

2018-06-01

Full Text Available Perforation is a rare complication of gastric carcinoma, and it occurs in less than 5% of all gastric carcinoma cases and in less than 1% within all acute abdomen cases. The diagnosis of malignancy is usually not validated preoperatively. In previous reported English literature, all patients with perforated gastric cancer have the feature of old age. This feature might be able to guide the surgeon to impress the differential diagnosis of malignancy before or during the emergent operation of gastric perforation.This 32-year-old male patient suffered from sudden onset of epigastric pain. We performed emergent operation under the impression of hollow organ perforation. The postoperative pathologic report of gastric ulcer revealed gastric carcinoma. We performed second-stage operation of total gastrectomy with D2 lymphadenectomy smoothly 7 days later. As we know, this is the youngest patient having the condition of perforated gastric carcinoma reported in the literature. This case reminds us that it is possible for perforated gastric carcinoma to occur in young-age patients. Keywords: Gastric cancer, Acute abdomen, Gastric perforation

Guidelines on radioiodine therapy for differentiated thyroid carcinoma. Impact on clinical practice

International Nuclear Information System (INIS)

Biermann, M.; Pixberg, M.K.; Schober, O.; Doerr, U.; Dietlein, M.; Schlemmer, H.; Grimm, J.; Zajic, T.; Nestle, U.; Ladner, S.; Sepehr-Rezai, S.; Rosenbaum, S.; Puskas, C.; Fostitsch, P.; Heinecke, A.; Schuck, A.; Willich, N.; Schmid, K.W.; Dralle, H.

2005-01-01

Aim: For the examination of the impact on clinical practice of the guidelines for differentiated thyroid carcinoma (DTC), treatment data from the ongoing multicenter study differentiated thyroid carcinoma (MSDS) were analyzed. Patients, methods: patients were randomized to adjuvant external beam radiotherapy (RTx) or no RTx in addition to standard therapy in TNM stages pT4 pNO/1/x MO/x (UICC, 5 th ed. 1997). All patients were to receive the same treatment regimen consisting of thyroidectomy, ablative radioiodine therapy (RIT), and a diagnostic 131 I whole-body scintigraphy (WBS) 3-4 months after RIT. Results: Of 339 eligible patients enrolled between January 2000 and March 2004, 273 could be analyzed. Guideline recommendations by the German Society for Nuclear Medicine from 1999 and 1992 were complied with within 28% and 82% with regard to the interval between surgery and RIT (4 vs. 4-6 weeks), in 33% and 84% with regard to 131 I activity for RIT (1-3 vs. 1-4 GBq; ±10%), and in 16% and 60% with regard to 131 I activity for WBS (100-300 vs. 100-400 MBq; ±10%). Conclusions: the 1999 guideline revision appears to have had little impact on clinical practice. Further follow-up will reveal if guideline compliance had an effect on outcomes. (orig.)

Performance Improvement of DTC-SVM for Matrix Converter Drives Using an Overmodulation Strategy

DEFF Research Database (Denmark)

Lee, Kyo-Beum; Blaabjerg, Frede

2005-01-01

In this paper, an improved direct torque control (DTC) method for matrix converter drives is proposed which enables to minimize torque ripple and to obtain unity input power factor, while maintaining constant switching frequency and fast torque dynamics. It is possible to combine the advantages o...

A Simple DTC-SVM method for Matrix Converter Drives Using a Deadbeat Scheme

DEFF Research Database (Denmark)

Lee, Kyo-Beum; Blaabjerg, Frede; Lee, Kwang-Won

2005-01-01

In this paper, a simple direct torque control (DTC) method for sensorless matrix converter drives is proposed, which is characterized by a simple structure, minimal torque ripple and unity input power factor. Also a good sensorless speed-control performance in the low speed operation is obtained,...

‘Only a click away — DTC genetics for ancestry, health, love…and more: A view of the business and regulatory landscape’

Directory of Open Access Journals (Sweden)

Andelka M. Phillips

2016-03-01

Full Text Available I provide an overview of the current state of the direct-to-consumer (DTC genetic testing industry and the challenges that different types of testing pose for regulation. I consider the variety of services currently available. These range from health and ancestry tests to those for child talent, paternity, and infidelity. In light of the increasingly blurred lines among different categories of testing, I call for a broader discussion of DTC governance. I stress the importance of shifting our attention from the activities of the most prominent companies to viewing DTC genetics as an industry with a wide spectrum of services and raising a wide variety of issues. These issues go beyond questions of clinical utility and validity to those of data security, personal identity, race, and the nature of the family. Robust DTC testing has the power to provide meaningful clinical, genealogical and even forensic information to those who want it; in unscrupulous hands, however, it also has the power to deceive and exploit. I consider approaches to help ensure the former and minimize the latter.

Hepatocellular carcinoma in Danish patients

DEFF Research Database (Denmark)

Stefansdottir, Jenna; Christensen, Erik; Schiødt, Frank Vinholt

2017-01-01

OBJECTIVE: Hepatocellular carcinoma (HCC) is a common cause of cancer, and most HCC patients have underlying cirrhosis. Retrospectively, we aimed to characterize patients with newly diagnosed HCC at a Danish hospital and to investigate survival and identify predictive factors for survival. METHODS...

Novel clinical staging for patients with end-stage gastrointestinal carcinoma.

Science.gov (United States)

Yasuda, Naokuni; Nakashima, Osamu; Ohnaka, Toru; Kamisaka, Koji; Tsunoda, Akira; Kusano, Mitsuo

2006-01-01

We created a new clinical staging system for end-stage gastrointestinal (GI) carcinoma to clarify the therapeutic goals for these patients. Data were obtained from a retrospective review of medical charts. Based on daily clinical observation of 144 patients with end-stage GI carcinoma, we classified the terminal stages as A, B, C, and D. The mean durations of terminal stages A, B, C, and D were 19, 16.6, 6.6, and 1.8 days, respectively, in patients with end-stage gastric cancer and 28.5, 9.1, 5.4, and 1.9 days, respectively, in patients with colorectal cancer. Moreover, 88.0% of patients with gastric carcinoma and 82.6% of patients with colorectal carcinoma passed through terminal stages A, B, C, and D sequentially. The patients in terminal stage B experienced temporary relief of symptoms, but those in terminal stage C did not (P terminal stages can easily be judged by clinical observation and may be an effective new tool with which to manage patients with end-stage GI carcinoma and their families.

LYMPHOCYTIC THYROIDITIS IS ASSOCIATED WITH INCREASED NUMBER OF BENIGN CERVICAL NODES AND FEWER CENTRAL NECK COMPARTMENT METASTATIC LYMPH NODES IN PATIENTS WITH DIFFERENTIATED THYROID CANCER.

Science.gov (United States)

Donangelo, Ines; Walts, Ann E; Bresee, Catherine; Braunstein, Glenn D

2016-10-01

Whether or not autoimmune thyroid disease influences the progression of differentiated thyroid cancer (DTC) remains controversial. Findings of previous studies are influenced by lead time bias and/or procedure bias selection. These biases can be reduced by studying a single-institution patient population that underwent a similar extent of surgical resection. From a cohort of 660 patients with DTC who underwent thyroidectomy, we retrospectively studied 357 patients who underwent total thyroidectomy and central compartment node dissection (CCND) for DTC between 2003 and 2013. Forty-one percent (140/345) of study patients had lymphocytic thyroiditis (LT), and 30% (91/301) had serum positive for thyroglobulin antibody (TgAb). LT was reported in 78% of the TgAb-positive cases. Sixty percent (213/357) of cases had metastatic thyroid carcinoma in 1 or more neck lymph nodes (55% [198/357] central compartment, and 22% [77/356] lateral compartment). Patients with LT had fewer metastatic cervical lymph nodes than those with no LT (2.7 ± 4.7 vs 3.5 ± 4.8, respectively, P = .0285). Patients with positive TgAb and thyroiditis had a larger number of benign cervical lymph nodes removed than those with negative TgAb or no LT. No significant difference was observed in age, tumor size, multifocality, extrathyroidal extension, vascular invasion, or frequency of cervical lymph node metastasis between TgAb-negative and -positive cases or between cases with and without LT. Lymphocytic thyroiditis is associated with fewer central neck compartment metastatic lymph nodes and a larger number of excised reactive benign cervical lymph nodes. Whether this association indicates a protective role of thyroid autoimmunity in lymph node spreading remains unclear. CCND = central compartment node dissection DTC = differentiated thyroid cancer HT = Hashimoto thyroiditis LT = lymphocytic thyroiditis TgAb = thyroglobulin antibody TPO = thyroid peroxidase.

Resected Hepatocellular Carcinoma in a Patient with Crohn's Disease on Azathioprine

Science.gov (United States)

Heron, Valérie; Fortinsky, Kyle Joshua; Spiegle, Gillian; Hilzenrat, Nir; Szilagyi, Andrew

2016-01-01

Hepatocellular carcinoma rarely occurs in patients without underlying cirrhosis or liver disease. While inflammatory bowel disease has been linked to certain forms of liver disease, hepatocellular carcinoma is exceedingly rare in these patients. We report the twelfth case of hepatocellular carcinoma in a patient with Crohn's disease. The patient is a 61-year-old with longstanding Crohn's disease who was treated with azathioprine and was found to have elevated liver enzymes and a new 3-cm liver mass on ultrasound. A complete workup for underlying liver disease was unremarkable and liver biopsy revealed hepatocellular carcinoma. The patient underwent a hepatic resection, and there is no evidence of recurrence at the 11-month follow-up. The resection specimen showed no evidence of cancer despite the initial biopsy revealing hepatocellular carcinoma. This case represents the third biopsy-proven complete spontaneous regression of hepatocellular carcinoma. Although large studies have failed to show a definite link between azathioprine and hepatocellular carcinoma, the relationship remains concerning given the multiple case reports suggesting a possible association. Clinicians should exercise a high degree of suspicion in patients with Crohn's disease who present with elevated liver enzymes, especially those on azathioprine therapy. PMID:27403102

A modified DTC-SVM for sensorless matrix converter drives using a simple deadbeat scheme

DEFF Research Database (Denmark)

Lee, Kyo-Beum; Blaabjerg, Frede

2005-01-01

In this paper, a modified direct torque control (DTC) for matrix converter drives is proposed which enables to minimize torque ripple and to obtain unity input power factor, while maintaining constant switching frequency. It is possible to combine the advantages of matrix converters with the adva...

HPV Carcinomas in Immunocompromised Patients

Directory of Open Access Journals (Sweden)

Nicole M. Reusser

2015-01-01

Full Text Available Human papillomavirus (HPV infection is the most common sexually transmitted disease worldwide and can result in pre-malignancies or overt malignancies of the skin and mucosal surfaces. HPV-related illnesses are an important personal and public health problem causing physical, mental, sexual and financial detriments. Moreover, this set of malignancies severely affects the immunosuppressed population, particularly HIV-positive patients and organ-transplant recipients. There is growing incidence of HPV-associated anogenital malignancies as well as a decrease in the average age of affected patients, likely related to the rising number of high-risk individuals. Squamous cell carcinoma is the most common type of HPV-related malignancy. Current treatment options for HPV infection and subsequent disease manifestations include imiquimod, retinoids, intralesional bleomycin, and cidofovir; however, primary prevention with HPV vaccination remains the most effective strategy. This review will discuss anogenital lesions in immunocompromised patients, cutaneous warts at nongenital sites, the association of HPV with skin cancer in immunocompromised patients, warts and carcinomas in organ-transplant patients, HIV-positive patients with HPV infections, and the management of cutaneous disease in the immunocompromised patient.

Studies on the cellular immune response in patients with upper urinary tract carcinoma compawed with those in patients with bladder carcinoma and it's postoperative change

International Nuclear Information System (INIS)

Sakai, Shunsuke

1980-01-01

Non-specific cellular immunity of patients with upper urinary tract carcinoma was studied by PPD reaction (in vivo or in vitro), lymphocytes subpopulation and macrophage migration inhibition test and the results were compared with those of patients with bladder carcinoma or benign urological diseases. 1) The preoperative cellular immunity of the malignant tumor group gave low values as compared to that in the benign disease group. Although the cellular immunity of patients with renal cell carcinoma showed no difference in the points of their grade and stage, significant differences were noted in patients with bladder carcinoma. The patients with renal pelvic and ureter carcinoma appeared to be similar to the patients with bladder carcinoma in the aspects of immune reactions. 2) In the majority of patients with upper urinary tract and bladder carcinoma, the cellular immunity after complete removal of the carcinoma gave an increased value of each marker as compared to the preoperative value. 3) The cellular immunity after irradiation decreased in the majority of the cases in terms of PPD reaction and T-cell ratio in lymphocyte subpopulation. Irradiation of 4000 - 6000 Rad. showed greater influence on T-cell than on B-cell, but influence of irradiation on cellular immunity was not different by irradiation dose. 4) The cellular immunity indicated decreased values for one to two months after discontinuation of irradiation, but then it showed a tendency to increase in terms of PPD and lymphocytes subpopulation in the patients with satisfactory postoperative courses. 5) Through the pre and postoperative courses, the immunity of the carcinomatous stage seems to be reflected better by the T-cell ratio than by the absolute number of T-cell. It is likely that macrophage migration inhibition test shows much sharper reaction than PPD reaction. (author)

Clinical outcomes of adjuvant external-beam radiotherapy for differentiated thyroid cancer. Results after 874 patient-years of follow-up in the MSDS-trial

Energy Technology Data Exchange (ETDEWEB)

Biermann, M. [Haukeland University Hospital, Bergen (Norway). Dept. of Radiology; Pixberg, M.K.; Riemann, B.; Schober, O. [Muenster Univ. (Germany). Dept. of Nuclear Medicine; Schuck, A.; Willich, N. [Muenster Univ. (Germany). Dept. of Radiooncology; Heinecke, A. [Muenster Univ. (Germany). Dept. of Biometrics; Schmid, K.W. [University Hospital of Essen, West German Cancer Center (Germany). Inst. of Pathology and Neuropathology; Dralle, H. [Halle-Wittenberg Univ. (Germany). Dept. of General Surgery

2009-07-01

Evaluate the clinical benefit of external beam radiotherapy (RTx) for locally invasive thyroid carcinoma with follicular cell differentiation (DTC). The Multicentre Study on Differentiated Thyroid Cancer (MSDS) was planned as a prospective multicenter trial on the benefit of adjuvant RTx in locally invasive DTC (pT4; UICC 1997) with or without lymph node metastases and no known distant metastases. All patients were treated with thyroidectomy, {sup 131}I-therapy, and TSH-suppression and were randomized to receive additional RTx or not. In 4/2003 the trial became a prospective cohort study after only 45 of then 311 patients had consented to randomization. 351 of 422 patients met the trial's inclusion criteria. Age was 48 {+-} 12 years (mean {+-} SD). 25% were men. Tumours were papillary in 90% and follicular in 10%. Of 47 patients randomized or allocated to RTx, 26 actually received RTx. Mean follow-up was 930 days. In an actual treatment analysis, 96% (25/26) of the RTx-patients reached complete remission (CR) vs. 86% in the non-RTx patients. Recurrences occurred in 0 vs. 3 % of patients: 6 reoperated for regional lymph node metastases, 1 tracheal invasion treated with tracheoplasty, 1 local invasion necessitating laryngectomy, 2 distant metastases (1 lung, 1 lung + bone). Serious chronic RTx toxicity occurred in 1/26 patients. The MSDS trial showed low mortality and recurrence rates and a weak benefit of RTx in terms of local control that did however not reach statistical significance. Routine RTx in locally invasive DTC can no longer be recommended. (orig.)

Clinical outcomes of adjuvant external-beam radiotherapy for differentiated thyroid cancer. Results after 874 patient-years of follow-up in the MSDS-trial

International Nuclear Information System (INIS)

Biermann, M.; Pixberg, M.K.; Riemann, B.; Schober, O.; Schuck, A.; Willich, N.; Heinecke, A.; Schmid, K.W.; Dralle, H.

2009-01-01

Evaluate the clinical benefit of external beam radiotherapy (RTx) for locally invasive thyroid carcinoma with follicular cell differentiation (DTC). The Multicentre Study on Differentiated Thyroid Cancer (MSDS) was planned as a prospective multicenter trial on the benefit of adjuvant RTx in locally invasive DTC (pT4; UICC 1997) with or without lymph node metastases and no known distant metastases. All patients were treated with thyroidectomy, 131 I-therapy, and TSH-suppression and were randomized to receive additional RTx or not. In 4/2003 the trial became a prospective cohort study after only 45 of then 311 patients had consented to randomization. 351 of 422 patients met the trial's inclusion criteria. Age was 48 ± 12 years (mean ± SD). 25% were men. Tumours were papillary in 90% and follicular in 10%. Of 47 patients randomized or allocated to RTx, 26 actually received RTx. Mean follow-up was 930 days. In an actual treatment analysis, 96% (25/26) of the RTx-patients reached complete remission (CR) vs. 86% in the non-RTx patients. Recurrences occurred in 0 vs. 3 % of patients: 6 reoperated for regional lymph node metastases, 1 tracheal invasion treated with tracheoplasty, 1 local invasion necessitating laryngectomy, 2 distant metastases (1 lung, 1 lung + bone). Serious chronic RTx toxicity occurred in 1/26 patients. The MSDS trial showed low mortality and recurrence rates and a weak benefit of RTx in terms of local control that did however not reach statistical significance. Routine RTx in locally invasive DTC can no longer be recommended. (orig.)

SUCCESSFUL SURGICAL-TREATMENT OF PARATHYROID CARCINOMA IN 2 HEMODIALYSIS-PATIENTS

NARCIS (Netherlands)

RADEMAKER, P; MEIJER, S; OOSTERHUIS, JW; VERMEY, A; ZWIERSTRA, R; VANDERHEM, G; GEERLINGS, W

Parathyroid carcinoma is rare, occurring in less than 2-3% of the patients with clinical features of primary hyperparathyroidism. In haemodialysis patients parathyroid carcinoma has only once been described, although secondary hyperparathyroidism in these patients is common. We discuss two female

Adenoid cystic carcinoma of uterine cervix in a young patient

Directory of Open Access Journals (Sweden)

Seth Ankit

2009-10-01

Full Text Available Adenoid cystic carcinoma of uterine cervix is a rare tumor. Its origin is debatable. It has a high incidence in postmenopausal women but rarely can develop in patients under 40. An association with squamous cell carcinoma has been described. We report a case of adenoid cystic carcinoma of the endocervical canal with foci of squamous cell carcinoma in a 34-year-old suffering from menorrhagia associated with blood-stained vaginal discharge. Per vaginum and per speculum examination revealed a growth. Cervical biopsy showed bits of tissue, suggesting adenoid cystic carcinoma. Patient was operated upon and uterus with cervix sent for histopathological examination. We report this case because of its rarity, particularly in young patients, with description of illustrative pathology and discussion on the histological diagnosis.

Acknowledging gray areas: 2015 vs. 2009 American Thyroid Association differentiated thyroid cancer guidelines on ablating putatively low-intermediate-risk patients.

Science.gov (United States)

Frangos, Savvas; Iakovou, Ioannis P; Marlowe, Robert J; Eftychiou, Nicolaos; Patsali, Loukia; Vanezi, Anna; Savva, Androulla; Mpalaris, Vassilis; Giannoula, Evanthia I

2017-02-01

Typically formulated by investigators from "world centres of excellence," differentiated thyroid carcinoma (DTC) management guidelines may have more limited applicability in settings of less expert care and fewer resources. Arguably the world's leading DTC guidelines are those of the American Thyroid Association, revised in 2009 ("ATA 2009") and 2015 ("ATA 2015"). To further explore the issue of "real-world applicability" of DTC guidelines, we retrospectively compared indications for ablation using ATA 2015 versus ATA 2009 in a two-centre cohort of ablated T1-2, M0 DTC patients (N = 336). Based on TNM status and histology, these patients were low-intermediate risk, but many ultimately had other characteristics suggesting elevated or uncertain risk. Working by consensus, two experienced nuclear medicine physicians considered patient and treatment characteristics to classify each case as having "no indication," a "possible indication," or a "clear indication" for ablation according to ATA 2009 or ATA 2015. The physicians also identified reasons for classification changes between ATA 2015 versus ATA 2009. Classification was unblinded, but the physicians had cared for only 138/336 patients, and the charts encompassed September 2010-October 2013, several years before the classification was performed. One hundred of 336 patients (29.8 %) changed classification regarding indication for ablation using ATA 2015 versus ATA 2009. Most reclassified patients (70/100) moved from "no indication" or "clear indication" to "possible indication." Reflecting this phenomenon, "possible indication" became the largest category according to the ATA 2015 classification (141/336, 42.0 %, versus 96/336, 28.6 %, according to ATA 2009). Many reclassifications were attributable to multiple clinicopathological characteristics, most commonly, stimulated thyroglobulin or anti-thyroglobulin antibody levels, multifocality, bilateral involvement, or capsular/nodal invasion. Regarding

BIOCHEMICAL NUTRITIONAL PROFILE OF LIVER CIRRHOSIS PATIENTS WITH HEPATOCELLULAR CARCINOMA

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Gabriela Zanatta PORT

2014-03-01

Full Text Available Context Liver cirrhosis patients with hepatocellular carcinoma present nutritional alterations and metabolic disorders that negatively impact the prognosis. Objective The objective is to identify alterations in the metabolism of macro and micronutrients among liver cirrhosis patients with and without hepatocellular carcinoma and their relation to the Child-Turcote-Pugh score and Barcelona Clinic Liver Cancer staging. Methods Analytical transversal study, with 31 hepatocellular carcinoma patients and 48 liver cirrhosis patients. Laboratorial exams were carried out. The existence of an association between the biochemical parameters and the disease severity as well as the presence of hepatocellular carcinoma was assessed. Results The metabolic-nutritional profile of liver cirrhosis patients caused by the hepatitis C virus and hepatocellular carcinoma showed alterations, specifically the lipid (total cholesterol, HDL and triglycerides, protein (albumin, creatinine and uric acid, iron (transferrin, iron and ferritin saturation, hematocrit and hemoglobin, zinc and B12 vitamin profiles. There is a relation between nutritional biochemical markers and the Child-Turcote-Pugh, as well as Barcelona Clinic Liver Cancer staging. Conclusions Considering the existence of alterations in the metabolism of nutrients in liver cirrhosis patients with and without hepatocellular carcinoma, and also that conventional nutritional assessment methods present limitations for this population, the biochemical laboratorial exams are valid to complement the diagnosis of the nutritional state in a quick and practical manner.

Effect of smoking on survival of patients with hepatocellular carcinoma.

Science.gov (United States)

Kolly, Philippe; Knöpfli, Marina; Dufour, Jean-François

2017-11-01

Lifestyle factors such as smoking, obesity and physical activity have gained interest in the field of hepatocellular carcinoma. These factors play a significant role in the development of hepatocellular carcinoma. Several studies revealed the impact of tobacco consumption on the development of hepatocellular carcinoma and its synergistic effects with viral etiologies (hepatitis B and C). The effects of smoking on survival in patients with a diagnosed hepatocellular carcinoma have not yet been investigated in a Western cohort where hepatitis C infection is a major risk factor. Using data from a prospective cohort of patients with hepatocellular carcinoma who were followed at the University Hospital of Bern, Switzerland, survival was compared by Kaplan-Meier analysis in smokers and nonsmokers, and multivariate Cox regression was applied to control for confounding variables. Of 238 eligible hepatocellular carcinoma patients, 64 were smokers at the time of inclusion and 174 were nonsmokers. Smokers had a significant worse overall survival than nonsmokers (hazard ratio 1.77, 95% confidence interval: 1.22-2.58, P=.003). Analysis of patients according to their underlying liver disease, revealed that smoking, and not nonsmoking, affected survival of hepatitis B virus and C virus-infected patients only. In this subgroup, smoking was an independent predictor for survival (hazard ratio 2.99, 95% confidence interval: 1.7-5.23, Phepatocellular carcinoma. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Clinicopathological comparison of colorectal and endometrial carcinomas in patients with Lynch-like syndrome versus patients with Lynch syndrome.

Science.gov (United States)

Mas-Moya, Jenny; Dudley, Beth; Brand, Randall E; Thull, Darcy; Bahary, Nathan; Nikiforova, Marina N; Pai, Reetesh K

2015-11-01

Screening for DNA mismatch repair (MMR) deficiency in colorectal and endometrial carcinomas identifies patients at risk for Lynch syndrome. Some patients with MMR-deficient tumors have no evidence of a germline mutation and have been described as having Lynch-like syndrome. We compared the clinicopathological features of colorectal and endometrial carcinomas in patients with Lynch-like syndrome and Lynch syndrome. Universal screening identified 356 (10.6%) of 3352 patients with colorectal carcinoma and 72 (33%) of 215 patients with endometrial carcinoma with deficient DNA MMR. Sixty-six patients underwent germline mutation analysis with 45 patients (68%) having evidence of a germline MMR gene mutation confirming Lynch syndrome and 21 patients (32%) having Lynch-like syndrome with no evidence of a germline mutation. Most patients with Lynch-like syndrome had carcinoma involving the right colon compared to patients with Lynch syndrome (93% versus 45%; P Lynch syndrome confirmed by germline mutation analysis. Synchronous or metachronous Lynch syndrome-associated carcinoma was more frequently identified in patients with Lynch syndrome compared to Lynch-like syndrome (38% versus 7%; P = .04). There were no significant differences in clinicopathological variables between patients with Lynch-like syndrome and Lynch syndrome with endometrial carcinoma. In summary, 32% of patients with MMR deficiency concerning Lynch syndrome will have Lynch-like syndrome. Our results demonstrate that patients with Lynch-like syndrome are more likely to have right-sided colorectal carcinoma, less likely to have synchronous or metachronous Lynch syndrome-associated carcinoma, and less likely to demonstrate isolated loss of MSH6 expression within their tumor. Copyright © 2015 Elsevier Inc. All rights reserved.

On Line Stator Resistance Tuning of DTC Control CSI Fed IM Drives

OpenAIRE

PANNEER SELVAM

2012-01-01

Current source inverter (CSI) fed drives are employed in high power applications. The conventional CSI drives suffer from drawbacks such as harmonic resonance, unstable operation at low speed ranges, and torque pulsation. CSI fed drives with Direct Torque Control (DTC) has drawn the attention of the motor drives designers because its implementation requires no position sensor. Crucial to the success of this scheme is the estimation of electromagnetic torque and stator flux linkages using the ...

Disseminated tumor cells as selection marker and monitoring tool for secondary adjuvant treatment in early breast cancer. Descriptive results from an intervention study

International Nuclear Information System (INIS)

Synnestvedt, Marit; Schirmer, Cecilie; Nesland, Jahn Martin; Naume, Bjørn; Borgen, Elin; Wist, Erik; Wiedswang, Gro; Weyde, Kjetil; Risberg, Terje; Kersten, Christian; Mjaaland, Ingvil; Vindi, Lise

2012-01-01

Presence of disseminated tumor cells (DTCs) in bone marrow (BM) after completion of systemic adjuvant treatment predicts reduced survival in breast cancer. The present study explores the use of DTCs to identify adjuvant insufficiently treated patients to be offered secondary adjuvant treatment intervention, and as a surrogate marker for therapy response. A total of 1121 patients with pN1-3 or pT1c/T2G2-3pN0-status were enrolled. All had completed primary surgery and received 6 cycles of anthracycline-containing chemotherapy. BM-aspiration was performed 8-12 weeks after chemotherapy (BM1), followed by a second BM-aspiration 6 months later (BM2). DTC-status was determined by morphological evaluation of immunocytochemically detected cytokeratin-positive cells. If DTCs were present at BM2, docetaxel (100 mg/m 2 , 3qw, 6 courses) was administered, followed by DTC-analysis 1 month (BM3) and 13 months (BM4) after the last docetaxel infusion. Clinical follow-up (FU) is still ongoing. Here, the descriptive data from the study are presented. Of 1085 patients with a reported DTC result at both BM1 and BM2, 94 patients (8.7%) were BM1 positive and 83 (7.6%) were BM2 positive. The concordance between BM1 and BM2 was 86.5%. Both at BM1 and BM2 DTC-status was significantly associated with lobular carcinomas (p = 0.02 and p = 0.03, respectively; chi-square). In addition, DTC-status at BM2 was also associated with pN-status (p = 0.009) and pT-status (p = 0.03). At BM1 28.8% and 12.8% of the DTC-positive patients had ≥2 DTCs and ≥3 DTCs, respectively. At BM2, the corresponding frequencies were 47.0% and 25.3%. Of 72 docetaxel-treated patients analyzed at BM3 and/or BM4, only 15 (20.8%) had persistent DTCs. Of 17 patients with ≥3 DTCs before docetaxel treatment, 12 patients turned negative after treatment (70.6%). The change to DTC-negativity was associated with the presence of ductal carcinoma (p = 0.009). After docetaxel treatment, the majority of patients experienced

Disseminated Tumor Cells in Prostate Cancer Patients after Radical Prostatectomy and without Evidence of Disease Predicts Biochemical Recurrence

Science.gov (United States)

Morgan, Todd M.; Lange, Paul H.; Porter, Michael P.; Lin, Daniel W.; Ellis, William J.; Gallaher, Ian S.; Vessella, Robert L.

2011-01-01

Purpose Men with apparently localized prostate cancer often relapse years after radical prostatectomy (RP). We sought to determine if epithelial-like cells identified from bone marrow (BM) in patients after RP (commonly called disseminated tumor cells, DTC) were associated with biochemical recurrence (BR). Experimental Design We obtained BM aspirates from 569 men prior to RP and from 34 healthy men with PSA<2.5 ng/ml to establish a comparison group. Additionally, an analytic cohort consisting of 98 patients after RP with no evidence of disease (NED) was established to evaluate the relationship between DTC and BR. Epithelial cells in the BM were detected by magnetic bead enrichment with antibodies to CD45 and CD61 (negative selection) followed by antibodies to human epithelial antigen (positive selection) and confirmation with FITC-labeled anti-BerEP4 antibody. Results DTC were present in 72% (408/569) of patients prior to RP. There was no correlation with pathologic stage, Gleason grade, or pre-operative PSA. Three of 34 controls (8.8%) had DTC present. In patients NED post-RP, DTC were present in 56/98 (57%). DTC were detected in 12/14 (86%) NED patients post-RP who subsequently suffered BR. Presence of DTC in NED patients was an independent predictor of recurrence (HR 6.9, CI 1.03–45.9). Conclusions Approximately 70% of men undergoing RP had DTC detected in their BM prior to surgery, suggesting that these cells escape early in the disease. Though pre-operative DTC status does not correlate with pathologic risk factors, persistence of DTC after RP in NED patients was an independent predictor of recurrence. PMID:19147774

Cytogenetic and dosimetric effects of {sup 131}I in patients with differentiated thyroid carcinoma: comparison between stimulation with rhTSH and thyroid hormone withdrawal treatments

Energy Technology Data Exchange (ETDEWEB)

Silva, Marcia Augusta da; Gomes Silva Valgode, Flavia; Carvalho Pinto Ribela, Maria Teresa; Bartolini, Paolo; Okazaki, Kayo [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Comissao Nacional de Energia Nuclear (CNEN), IPEN-CNEN/SP, Centro de Biotecnologia, Sao Paulo (Brazil); Armiliato Gonzalez, Julia; Calil Cury Guimaraes, Maria Ines; Buchpiguel, Carlos Alberto [Faculdade de Medicina da Universidade de Sao Paulo, Centro de Medicina Nuclear, Sao Paulo (Brazil); Yoriyaz, Helio [Instituto de Pesquisas Energeticas e Nucleares, IPEN-CNEN/SP, Centro de Engenharia Nuclear, Sao Paulo (Brazil)

2016-08-15

A study directed to the cytogenetic and dosimetric aspects of radionuclides of medical interest is very valuable, both for an accurate evaluation of the dose received by the patients, and consequently of the genetic damage, and for the optimization of therapeutic strategies. Cytogenetic and dosimetric effects of {sup 131}I in lymphocytes of thyroidectomized differentiated thyroid cancer (DTC) patients were evaluated through chromosome aberration (CA) technique: Euthyroid patients submitted to recombinant human thyroid-stimulating hormone (rhTSH) therapy (group A) were compared with hypothyroid patients left without levothyroxine treatment (group B). CA analysis was carried out prior to and 24 h, 1 week, 1 month and 1 year after radioiodine administration (4995-7030 MBq) in both groups. An activity-response curve of {sup 131}I (0.074-0.740 MBq/mL) was elaborated, comparing dicentric chromosomes in vivo and in vitro in order to estimate the absorbed dose through Monte Carlo simulations. In general, radioiodine therapy induced a higher total CA rate in hypothyroid patients as compared to euthyroid patients. The frequencies of dicentrics obtained in DTC patients 24 h after treatment were equivalent to those induced in vitro (0.2903 ± 0.1005 MBq/mL in group A and 0.2391 ± 0.1019 MBq/mL in group B), corresponding to absorbed doses of 0.65 ± 0.23 Gy and 0.53 ± 0.23 Gy, respectively. The effect on lymphocytes of internal radiation induced by {sup 131}I therapy is minimal when based on the frequencies of CA 1 year after the treatment, maintaining a higher quality of life for DTC patients receiving rhTSH-aided therapy. (orig.)

A novel unified DTC-SVM for sensorless induction motor drives fed by a matrix converter

DEFF Research Database (Denmark)

Lee, Kyo-Beum; Blaabjerg, Frede

2005-01-01

In this paper, a simple direct torque control (DTC) method for sensorless matrix converter drives is proposed, which is characterized by a simple structure, minimal torque ripple and unity input power factor. It is possible to combine the advantages of matrix converters with the advantages of the...

No survival difference after successful {sup 131}I ablation between patients with initially low-risk and high-risk differentiated thyroid cancer

Energy Technology Data Exchange (ETDEWEB)

Verburg, Frederik Anton [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Stokkel, Marcel P.M.; Verkooijen, Robbert B.T. [Leiden University Medical Center, Department of Radiology, Division of Nuclear Medicine, Leiden (Netherlands); Dueren, Christian; Reiners, Christoph [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Maeder, Uwe [University of Wuerzburg, Comprehensive Cancer Center, Wuerzburg (Germany); Isselt, Johannes W. van [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Marlowe, Robert J. [Spencer-Fontayne Corporation, Jersey City, NJ (United States); Smit, Johannes W. [Leiden University Medical Center, Department of Endocrinology, Leiden (Netherlands); Luster, Markus [University of Ulm, Department of Nuclear Medicine, Ulm (Germany)

2010-02-15

To compare disease-specific survival and recurrence-free survival (RFS) after successful {sup 131}I ablation in patients with differentiated thyroid carcinoma (DTC) between those defined before ablation as low-risk and those defined as high-risk according to the European Thyroid Association 2006 consensus statement. Retrospective data from three university hospitals were pooled. Of 2009 consecutive patients receiving ablation, 509 were identified as successfully ablated based on both undetectable stimulated serum thyroglobulin in the absence of antithyroglobulin antibodies and a negative diagnostic whole-body scan in a follow-up examination conducted 8.1{+-}4.6 months after ablation. Of these 509 patients, 169 were defined as high-risk. After a mean follow-up of 81{+-}64 months (range 4-306 months), only three patients had died of DTC, rendering assessment of disease-specific survival differences impossible. Of the 509 patients, 12 (2.4%) developed a recurrence a mean 35 months (range 12-59 months) after ablation. RFS for the duration of follow-up was 96.6% according to the Kaplan-Meier method. RFS did not differ between high-risk and low-risk patients (p=0.68). RFS differed slightly but significantly between those with papillary and those with follicular thyroid carcinoma (p=0.03) and between those aged {<=}45 years those aged >45 years at diagnosis (p=0.018). After (near) total thyroidectomy and successful {sup 131}I ablation, RFS does not differ between patients classified as high-risk and those classified as low-risk based on TNM stage at diagnosis. Consequently, the follow-up protocol should be determined on the basis of the result of initial treatment rather than on the initial tumour classification. (orig.)

Intraoperative radiation therapy for patients with pancreatic carcinoma

International Nuclear Information System (INIS)

Abe, Tetsuo; Itoh, Kei; Agawa, Senichiro; Ishihara, Yukio; Konishi, Toshiro

2001-01-01

We studied the efficacy and complications of intraoperative radiation therapy (IORT) in 40 subjects with unresected pancreatic carcinoma (Group A) and 8 with resected pancreatic carcinoma (Group B). These 2 groups were compared to groups not treated by IORT; 59 subjects with unresected pancreatic carcinoma (Group C) and 55 with resected pancreatic carcinoma (Group D). The 6-month survival in Group A was 55%, and 1-year survival 26% compared to 20% 6-month survival and 9% 1-year survival in Group C with a median survival of 7 months in Group A and 4 months in group C; all statistically significant. Pain control was 81.8% in Group A, reduction in tumor size was 50% and reduction of tumor marker, CA19-9 was 56.3% in Group A. Survival in Groups B and D did not differ significantly. The histological efficacy of IORT in Group A was confirmed in autopsy of fibrosis and scar formation in radiation fields of the pancreas. Two patients in Group B had major morbidity leading to death; 1 from leakage in the pancreatojejunal anastomosis accompanied by pancreatic necrosis and the other from duodenal perforation with rupture of the portal vein and hepatic artery. This study demonstrates the efficacy of IORT in patients with unresected pancreatic carcinoma. Prophylactic bypass and shielding of the residual pancreas with lead or reducing the IORT or external beam radiation therapy (EBRT) dose should be considered in patients with unresected or resected pancreatic carcinoma, however, to prevent serious complications due to radiation injury of the duodenum and pancreas. (author)

Differences in serum thyroglobulin measurements by 3 commercial immunoradiometric assay kits and laboratory standardization using Certified Reference Material 457 (CRM-457).

Science.gov (United States)

Lee, Ji In; Kim, Ji Young; Choi, Joon Young; Kim, Hee Kyung; Jang, Hye Won; Hur, Kyu Yeon; Kim, Jae Hyeon; Kim, Kwang-Won; Chung, Jae Hoon; Kim, Sun Wook

2010-09-01

Serum thyroglobulin (Tg) is essential in the follow-up of patients with differentiated thyroid carcinoma (DTC). However, interchangeability and standardization between Tg assays have not yet been achieved, even with the development of an international Tg standard (Certified Reference Material 457 [CRM-457]). Serum Tg from 30 DTC patients and serially diluted CRM-457 were measured using 3 different immunoradiometric assays (IRMA-1, IRMA-2, IRMA-3). The intraclass correlation coefficient (ICC) method was used to describe the concordance of each IRMA to CRM-457. The serum Tg measured by 3 different IRMAs correlated well (r > .85, p CRM-457, showed the best ICC (p(1) = .98) for the CRM-457. Hospitals caring for patients with DTC should either set their own cutoffs for IRMAs for Tg based on their patient pools, or adopt IRMAs standardized to CRM-457 and calibrate their laboratory using CRM-457.

Regional lymphadonectomy in uterine cervix carcinoma patients after radiotherapy

International Nuclear Information System (INIS)

Bokhman, Ya.V.; Kuznetsov, V.V.

1981-01-01

A group of patients with uterine cervix carcinoma with metastatic indices in regional lymphatic vessels detected on lymphograms is studied. It is established that after radiation treatment the relative resistance of lymphogenic metastases to the ionizing radiation is found in 14.9% patients. Extraperitoneal removal of regional lymphatic collectors after a complete course of combined radiation therapy in patients with uterine cervix carcinoma with histologically proved metastases improves 3-year results of survival up to 40%. In the case of multiple and bilateral metastatic injury of regional lymph nodes the therapeutic value of extraperitoneal lymphadenectomy reduces sharply. The diagnostic value of X-ray contrast lymphography not only for defining regional metastases, but for planning and carrying out the treatment of patients with uterine cervix carcinoma is pointed out [ru

Anal carcinoma in HIV-infected patients in the period 1995-2009

DEFF Research Database (Denmark)

Legarth, Rebecca; Helleberg, Marie; Kronborg, Gitte

2013-01-01

Abstract Background: Several studies have demonstrated an increased risk of non-AIDS cancers in HIV patients and, for some cancers, also in relatives of HIV patients. We aimed to estimate (1) the risk of anal carcinoma among HIV patients and their parents, and (2) the mortality after a diagnosis...... 1995-2009, and (2) parents of HIV patients compared with parents of controls for the period 1978-2009. Cancer diagnoses were identified from The Danish Cancer Registry. We further estimated the mortality rate ratios (MRR) of HIV patients compared with controls after the diagnosis of anal carcinoma....... Results: Thirty-six HIV patients versus 8 population controls were diagnosed with anal carcinoma. HIV patients had an increased risk of anal carcinoma (IRR 77.9, 95% CI 36.2-167.7), especially among men who have sex with men (MSM) (IRR 101.4, 95% CI 39.3-261.5). Fathers of HIV patients had an increased...

Comparison of FDG Uptake with Pathological Parameters in the Well-differentiated Thyroid Cancer

International Nuclear Information System (INIS)

Choi, Woo Hee; Chung, Yong An; Kim, Ki Jun; Park, Chang Suk; Jung, Hyun Suk; Sohn, Hyung Sun; Chung, Soo Kyo; Yoo, Chang Young

2009-01-01

Differentiated thyroid cancer (DTC) has variable degree of F-18 FDG avidity. The purpose of this study was to evaluate the relationship between F-18 FDG uptake and pathological or immunohistochemical features of DTC. DTC patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included in the study. Maximum standardized uptake values (SUVmax) of primary tumor were calculated. If the primary tumor showed no perceptibly increased F-18 FDG uptake, region of interest was drawn based on finding of CT portion of the PET/CT images. Pathological and immunohistochemical markers such as presence of lymph node (LN) metastasis and underlying thyroiditis, tumor size, Ki-67 labeling index, expressions of EGFR, COX-2, and Galectin-3 were evaluated. Total of 106 patients was included (102 papillary carcinomas, 4 follicular carcinomas). The mean SUVmax of the large tumors (above 1 cm) was significantly higher than the mean SUVmax of small (equal to or less than 1 cm) ones (7.8±8.5 vs. 3.6±3.1, p=0.004). No significant difference in F-18 FDG uptake was found according to the presence or absence of LN metastasis and underlying thyroiditis, or the degree of Ki-67 labeling index, expression of EGFR, COX-2 and Galectin-3. In conclusion, the degree of F-18 FDG uptake in DTC was associated with the size of primary tumor. But there seem to be no relationship between F-18 FDG uptake of DTC and expression of Ki-67, EGFR, COX-2 and Galectin-3

Comparison of FDG Uptake with Pathological Parameters in the Well-differentiated Thyroid Cancer

Energy Technology Data Exchange (ETDEWEB)

Choi, Woo Hee; Chung, Yong An; Kim, Ki Jun; Park, Chang Suk; Jung, Hyun Suk; Sohn, Hyung Sun; Chung, Soo Kyo; Yoo, Chang Young [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

2009-02-15

Differentiated thyroid cancer (DTC) has variable degree of F-18 FDG avidity. The purpose of this study was to evaluate the relationship between F-18 FDG uptake and pathological or immunohistochemical features of DTC. DTC patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included in the study. Maximum standardized uptake values (SUVmax) of primary tumor were calculated. If the primary tumor showed no perceptibly increased F-18 FDG uptake, region of interest was drawn based on finding of CT portion of the PET/CT images. Pathological and immunohistochemical markers such as presence of lymph node (LN) metastasis and underlying thyroiditis, tumor size, Ki-67 labeling index, expressions of EGFR, COX-2, and Galectin-3 were evaluated. Total of 106 patients was included (102 papillary carcinomas, 4 follicular carcinomas). The mean SUVmax of the large tumors (above 1 cm) was significantly higher than the mean SUVmax of small (equal to or less than 1 cm) ones (7.8{+-}8.5 vs. 3.6{+-}3.1, p=0.004). No significant difference in F-18 FDG uptake was found according to the presence or absence of LN metastasis and underlying thyroiditis, or the degree of Ki-67 labeling index, expression of EGFR, COX-2 and Galectin-3. In conclusion, the degree of F-18 FDG uptake in DTC was associated with the size of primary tumor. But there seem to be no relationship between F-18 FDG uptake of DTC and expression of Ki-67, EGFR, COX-2 and Galectin-3.

Influence of the thyroid remnant in the elevation of the serum thyroglobulin after thyroidectomy in differentiated thyroid carcinoma. Importance of the diagnostic iodine total-body scanning

International Nuclear Information System (INIS)

Caballero-Calabuig, Elisa; Cano-Terol, Carmen; Sopena-Monforte, Ramon; Reyes-Ojeda, Dolores; Abreu-Sanchez, Pedro; Ferrer-Rebolleda, Jose; Sopena-Novales, Pablo; Plancha-Mansanet, Carmen; Felix-Fontestad, Jesus

2008-01-01

Stimulated thyroglobulin (Tg) and 131 I total-body scan (TBS) have been the mainstays of differentiated thyroid carcinoma (DTC), but now diagnostic TBS has been eliminated from some follow-up protocols. Nevertheless, Tg can be negative in the presence of thyroid tissue, and moderately elevated Tg poses management problems. The purpose of this study was to check how many patients have Tg negative but visible thyroid tissue and if diagnostic TBS could be clinically useful. Retrospective review of 317 exams (stimulated Tg and TBS) of 128 patients with DTC. Patients with high-grade criteria and/or positive autoantibodies are excluded. Tg is considered positive if higher than the sensitivity level of the technique. TBS is positive if thyroid remnant, lymphatic node or metastases are detected. Results are classified in Tg and TBS concordant or discordant. Discordant 131 I TBS and Tg were found in 74/317 studies (23.3%), 48 (65%) being TBS positive and Tg negative. None of 128 patients had a first post-surgery negative scan, but 13 (10%) were Tg negative, even two patients with lymph node uptake. One year after radioiodine treatment, 26 out of 115 patients (initially Tg and TBS concordant positive) showed Tg negative and TBS still positive due to cervical remnants (20 patients), lymph node uptake (one) and metastasis (five); 20 patients remained Tg and TBS positive, but 14 of them only showed thyroid remnants. We propose to perform periodic diagnostic TBS to improve Tg specificity, at least while neck thyroid activity is detected, even if Tg is negative. (orig.)

Influence of the thyroid remnant in the elevation of the serum thyroglobulin after thyroidectomy in differentiated thyroid carcinoma. Importance of the diagnostic iodine total-body scanning

Energy Technology Data Exchange (ETDEWEB)

Caballero-Calabuig, Elisa; Cano-Terol, Carmen; Sopena-Monforte, Ramon; Reyes-Ojeda, Dolores; Abreu-Sanchez, Pedro; Ferrer-Rebolleda, Jose; Sopena-Novales, Pablo; Plancha-Mansanet, Carmen; Felix-Fontestad, Jesus [Hospital Universitario Dr. Peset - Medicina Nuclear, Valencia, Valencia (Spain)

2008-08-15

Stimulated thyroglobulin (Tg) and {sup 131}I total-body scan (TBS) have been the mainstays of differentiated thyroid carcinoma (DTC), but now diagnostic TBS has been eliminated from some follow-up protocols. Nevertheless, Tg can be negative in the presence of thyroid tissue, and moderately elevated Tg poses management problems. The purpose of this study was to check how many patients have Tg negative but visible thyroid tissue and if diagnostic TBS could be clinically useful. Retrospective review of 317 exams (stimulated Tg and TBS) of 128 patients with DTC. Patients with high-grade criteria and/or positive autoantibodies are excluded. Tg is considered positive if higher than the sensitivity level of the technique. TBS is positive if thyroid remnant, lymphatic node or metastases are detected. Results are classified in Tg and TBS concordant or discordant. Discordant {sup 131}I TBS and Tg were found in 74/317 studies (23.3%), 48 (65%) being TBS positive and Tg negative. None of 128 patients had a first post-surgery negative scan, but 13 (10%) were Tg negative, even two patients with lymph node uptake. One year after radioiodine treatment, 26 out of 115 patients (initially Tg and TBS concordant positive) showed Tg negative and TBS still positive due to cervical remnants (20 patients), lymph node uptake (one) and metastasis (five); 20 patients remained Tg and TBS positive, but 14 of them only showed thyroid remnants. We propose to perform periodic diagnostic TBS to improve Tg specificity, at least while neck thyroid activity is detected, even if Tg is negative. (orig.)

Resected Hepatocellular Carcinoma in a Patient with Crohn’s Disease on Azathioprine

Directory of Open Access Journals (Sweden)

Valérie Heron

2016-05-01

Full Text Available Hepatocellular carcinoma rarely occurs in patients without underlying cirrhosis or liver disease. While inflammatory bowel disease has been linked to certain forms of liver disease, hepatocellular carcinoma is exceedingly rare in these patients. We report the twelfth case of hepatocellular carcinoma in a patient with Crohn’s disease. The patient is a 61-year-old with longstanding Crohn’s disease who was treated with azathioprine and was found to have elevated liver enzymes and a new 3-cm liver mass on ultrasound. A complete workup for underlying liver disease was unremarkable and liver biopsy revealed hepatocellular carcinoma. The patient underwent a hepatic resection, and there is no evidence of recurrence at the 11-month follow-up. The resection specimen showed no evidence of cancer despite the initial biopsy revealing hepatocellular carcinoma. This case represents the third biopsy-proven complete spontaneous regression of hepatocellular carcinoma. Although large studies have failed to show a definite link between azathioprine and hepatocellular carcinoma, the relationship remains concerning given the multiple case reports suggesting a possible association. Clinicians should exercise a high degree of suspicion in patients with Crohn’s disease who present with elevated liver enzymes, especially those on azathioprine therapy.

Liver transplantation in patients with hepatocellular carcinoma

NARCIS (Netherlands)

Polak, Wojciech G.; Soyama, Akihiko; Slooff, Maarten J. H.

2008-01-01

Liver transplantation has a definitive place in the treatment of patients with hepatocellular carcinoma (HCC) in a cirrhotic liver. Patients with a tumor load within the Milan criteria have excellent survival comparable to survival in patients with benign indications. When tumor load exceeds the

Glucose tolerance and lipid profile in longterm exogenous subclinical hyperthyroidism and the effects of restoration of euthyroidism, a randomised controlled trial

NARCIS (Netherlands)

Heemstra, K. A.; Smit, J. W. A.; Eustatia-Rutten, C. F. A.; Heijboer, A. C.; Frölich, M.; Romijn, J. A.; Corssmit, E. P. M.

2006-01-01

The impact of prolonged subclinical hyperthyroidism on glucose and lipid metabolism is unclear. Therefore, we evaluated glucose and lipid metabolism in patients with differentiated thyroid carcinoma (DTC) on TSH suppressive thyroxine therapy as a model for subclinical hyperthyroidism and

Calculation of Blood Dose in Patients Treated With 131I Using MIRD, Imaging, and Blood Sampling Methods.

Science.gov (United States)

Piruzan, Elham; Haghighatafshar, Mahdi; Faghihi, Reza; Entezarmahdi, Seyed Mohammad

2016-03-01

Radioiodine therapy is known as the most effective treatment of differentiated thyroid carcinoma (DTC) to ablate remnant thyroid tissue after surgery. In patients with DTC treated with radioiodine, internal radiation dosimetry of radioiodine is useful for radiation risk assessment. The aim of this study is to describe a method to estimate the absorbed dose to the blood using medical internal radiation dosimetry methods. In this study, 23 patients with DTC with different administrated activities, 3.7, 4.62, and 5.55 GBq after thyroidectomy, were randomly selected. Blood dosimetry of treated patients was performed with external whole body counting using a dual-head gamma camera imaging device and also with blood sample activity measurements using a dose calibrator. Absorbed dose to the blood was measured at 2, 6, 12, 24, 48, and 96 hours after the administration of radioiodine with the 2 methods. Based on the results of whole body counting and blood sample activity dose rate measurements, 96 hours after administration of 3.7, 4.62, and 5.55 GBq of radioiodine, absorbed doses to patients' blood were 0.65 ± 0.20, 0.67 ± 0.18, 0.79 ± 0.51 Gy, respectively. Increasing radioiodine activity from 3.7 to 5.55 GBq increased blood dose significantly, while there was no significant difference in blood dose between radioiodine dosages of 3.7 and 4.62 GBq. Our results revealed a significant correlation between the blood absorbed dose and blood sample activity and between the blood absorbed dose and whole body counts 24 to 48 hours after the administration of radioiodine.

Efficacy of 131I SPECT/CT in the initial nodal staging in patients with differentiated thyroid carcinoma at the first ablative radioiodine therapy

International Nuclear Information System (INIS)

Kisiel, N.; Garcia-Burillo, A.; Barios, M.; Dellepiane, F.; Castell-Conesa, J.

2015-01-01

Full text of publication follows. Background: after the first radioiodine ablative dose, planar Whole-Body Scanning (WBS) offers the possibility for detecting thyroid remnant, loco-regional node involvement and distant metastases. Nevertheless, available anatomic information is scarce and the high activity of thyroid remnants can interfere with the detection of cervical lymphatic nodes. Objective: to determine the additional value of the SPECT-CT over planar WBS, performed seven days after ablative treatment with 131 I, in patients who were operated on for Differentiated Thyroid Cancer (DTC). Methods: from January 2009 to December 2012, 132 patients with DTC were admitted for radio-ablation with 131 I after thyroidectomy. All of them underwent WBS seven days after ablation, and 91 had an additional SPECT-CT, 71 women and 20 men, with ages ranged from 15 to 89 years (mean, age 54 years). All patients had histological confirmed DTC (73 papillary, 17 follicular -2 cases with double tumour, papillary and follicular-, and 1 insular type). In addition to the thyroidectomy, lymph node dissection was performed in 54 patients (59%): 20 patients were classified as N0 and 29 as N1. The remaining 42 patients were classified as Nx. Planar and tomographic images were independently evaluated by two experienced nuclear medicine physicians. Results: 195 cervical focal uptake were observed in the 91 planar WBSs. No additional foci were observed in SPECT-CT. Findings: Planar WBS........... SPECT-CT........... Number of Foci Thyroid remnant...... Thyroid remnant..........51........... LNM...........0 Indeterminate.......... Thyroid remnant..........84............. LNM............5 LNM............ Thyroid remnant.........12............ Indeterminate.............0............ LNM..........43. Total Number of Foci............. 195. Compared to the nodal staging prior to ablation based on the histopathological diagnosis, we had an upstaging from N0 to N1 in 4 of 20 patients and from Nx to

Cerrobend shielding stents for buccal carcinoma patients

Directory of Open Access Journals (Sweden)

Karma Yangchen

2016-01-01

Full Text Available Buccal carcinoma is one of the most common oral malignant neoplasms, especially in the South Asian region. Radiotherapy, which plays a significant role in the treatment of this carcinoma, has severe adverse effects. Different types of prosthesis may be constructed to protect healthy tissues from the adverse effects of treatment and concentrate radiation in the region of the tumor mass. However, the technique for fabrication of shielding stent with Lipowitz's alloy (cerrobend/Wood's alloy has not been well documented. This article describes detailed technique for fabrication of such a stent for unilateral buccal carcinoma patients to spare the unaffected oral cavity from potential harmful effects associated with radiotherapy.

Quality of life in longterm exogenous subclinical hyperthyroidism and the effects of restoration of euthyroidism, a randomized controlled trial

NARCIS (Netherlands)

Eustatia-Rutten, C. F. A.; Corssmit, E. P. M.; Pereira, A. M.; Frölich, M.; Bax, J. J.; Romijn, J. A.; Smit, J. W. A.

2006-01-01

The impact of prolonged subclinical hyperthyroidism on quality of life is unclear. Therefore, we evaluated quality of life in patients with differentiated thyroid carcinoma (DTC) on TSH-suppressive thyroxine therapy as a model for subclinical hyperthyroidism and we investigated whether restoration

Metastatic papillary carcinoma of the thyroid in a patient previously ...

African Journals Online (AJOL)

Incidental papillary carcinoma of the thyroid in patients treated surgically for benign thyroid diseases including Graves' disease is a known phenomenon. However, the management of these patients remains an issue of concern and controversy for those who care for them. We report a case of metastatic paillary carcinoma of ...

Peculiarities of immune status in uterine cervix carcinoma patients

International Nuclear Information System (INIS)

Dekster, L.I.

1981-01-01

On the basis of investigating the peripheral blood lymphocytes the immunologic state in 81 patients with uterine cervix carcinoma is estimated. It is established that there is a considerable decrease of indices in the T-immune system in patients with uterine cervix carcinoma. The detection of reductions in the immunogram indices in the initial stage plays a definte diagnostic role in the detection of metastases, permits to forecast the process generalization, and consequently, to determine the treatment tactics. It is established that under the effect of combined radiation treatment the T-system is mostly injured. Consequently, pronounced postradiation depression is prognostically unfavourable. The examination of another group of patients has shown that the probability of development of lymphogenic metastases in uterine cervix carcinoma is mainly determined by immuno-morphological peculiarities of regional lymph nodes [ru

The role of thyrotropin suppression in patients with differentiated thyroid carcinoma.

LENUS (Irish Health Repository)

Deasy, J

2010-07-01

Thyroid carcinoma is the commonest endocrine malignancy. The majority of these are differentiated thyroid carcinomas, which have a good overall prognosis. Treatment includes surgical excision, radio-iodine ablation and long-term thyrotropin suppression. The degree and length of suppression required, as well as the potential side-effect remain controversial. Therefore, the aim of this study was to establish the degree of thyrotropin suppression achieved in a cohort of patients with differentiated thyroid carcinoma. A retrospective review was performed of a prospectively maintained database. All patients with a diagnosis of differentiated thyroid carcinoma between January 1998 and January 2008 were identified. Demographic data, pathological stage and the treatment that the patient received was documented. TSH and free T4 levels were identified at specific time points post-operatively. Eighty-eight patients with differentiated thyroid carcinoma were identified. Seventy patients (79.5%) were female. The mean age was 55, with a range of 18 to 79 years. The majority of patients underwent a total thyroidectomy (n=79; 89.7%) and of those 29 (32.9%) had an associated modified neck dissection. Accurate follow-up was available on forty-nine patients. TSH and free T4 were measured at 3 and 6 months, as well as at 1 and 2 years post-operatively. Adequate TSH suppression was taken at a level < 0.1 mU\\/L. The majority of patients (69.5%) had achieved adequate TSH suppression at 2 years. However, 65% of these same patients had a high free T4 at 2 years indicating a degree of hyperthyroidism. This study has demonstrated that TSH suppression is being adequately achieved in the majority of patients with differentiated thyroid carcinoma. However, this must be carefully weighed against the potential detrimental side-effects of long-term sub-clinical hyperthyroidism.

Basal Cell Carcinomas in Gorlin Syndrome: A Review of 202 Patients

International Nuclear Information System (INIS)

Jones, E. A.; Shenton, A.; Evans, D. G.; Sajid, M. I.

2011-01-01

Gorlin syndrome (Naevoid Basal Cell Carcinoma Syndrome) is a rare autosomal dominant syndrome caused by mutations in the PTCH gene with a birth incidence of approximately 1 in 19,000. Patients develop multiple basal cell carcinomas of the skin frequently in early life and also have a predisposition to additional malignancies such as medulloblastoma. Gorlin Syndrome patients also have developmental defects such as bifid ribs and other complications such as jaw keratocysts. We studied the incidence and frequency of basal cell carcinomas in 202 Gorlin syndrome patients from 62 families and compared this to their gender and mutation type. Our data suggests that the incidence of basal cell carcinomas is equal between males and females and the mutation type cannot be used to predict disease burden

The role of postoperative Tc-99m pertechnetate scintigraphy in estimation of remnant mass and prediction of successful ablation in patients with differentiated thyroid cancer.

Science.gov (United States)

Ozdemir, Didem; Cuhaci, Fatma N; Ozdemir, Elif; Aydin, Cevdet; Ersoy, Reyhan; Turkolmez, Seyda; Cakir, Bekir

2016-06-01

Surgery and radioactive iodine (RAI) ablation constitute the mainstay of the treatment of differentiated thyroid carcinoma (DTC). In this study, we aimed to evaluate the diagnostic value of postoperative early Tc-99m pertechnetate scanning to detect remnant thyroid tissue and predict ablation success. DTC patients evaluated with postoperative Tc-99m pertechnetate scintigraphy and treated with RAI between January 2007 and December 2014 were recruited. The results of Tc-99m pertechnetate scanning were compared with therapeutic I-131 whole-body scanning (TxWBS) and diagnostic I-131 whole-body scanning (DxWBS) performed 6-9 months after RAI. There were 154 (21.5%) male and 563 (78.5%) female patients, with a mean age of 49.11±12.35 years. Postoperative Tc-99m pertechnetate scanning was positive in 499 patients (69.6%) and negative in 218 (30.4%) patients. There were 673 (93.9%) patients with a positive TxWBS scan and 44 (6.1%) patients with negative TxWBS scan. Considering TxWBS as the standard test, sensitivity, specificity, positive predictive value, and negative predictive value of Tc-99m pertechnetate scanning were 72.2, 70.5, 97.4, and 14.2%, respectively. DxWBS was positive in 57 (9.0%) and negative in 564 (91%) patients. Ablation dose was higher and preablation thyroglobulin was lower in patients with negative DxWBS (P=0.001 and 0.04, respectively). Overall, 171 (92.9%) of 184 patients with negative Tc-99m pertechnetate had negative DxWBS. Postoperative Tc-99m pertechnetate scintigraphy has a high positive predictive value to detect remnant tissue in patients with DTC. Although negative Tc-99m pertechnetate scanning does not indicate removal of all thyroid tissue, it is related to successful ablation in more than 90% of patients.

Dynamic thiol/disulphide homeostasis in patients with basal cell carcinoma.

Science.gov (United States)

Demirseren, Duriye Deniz; Cicek, Cagla; Alisik, Murat; Demirseren, Mustafa Erol; Aktaş, Akın; Erel, Ozcan

2017-09-01

The aim of this study is to measure and compare the dynamic thiol/disulphide homeostasis of patients with basal cell carcinoma and healthy subjects with a newly developed and original method. Thirty four patients attending our outpatient clinic and clinically and histopathologically diagnosed as nodular basal cell carcinoma, and age and gender matched 30 healthy individuals have been involved in the study. Thiol/disulphide homeostasis tests have been measured with a novel automatic spectrophotometric method developed and the results have been compared statistically. Serum native thiol and disulphide levels in the patient and control group show a considerable variance statistically (p = 0.028, 0.039, respectively). Total thiol levels do not reveal a considerable variation (p = 0.094). Disulphide/native thiol ratios and native thiol/total thiol ratios also show a considerable variance statistically (p = 0.012, 0.013, 0.010, respectively). Thiol disulphide homeostasis in patients with basal cell carcinoma alters in the way that disulphide gets lower and thiols get higher. Thiol/disulphide level is likely to have a role in basal cell carcinoma pathogenesis.

Chronic lymphocytic thyroiditis is associated with invasive characteristics of differentiated thyroid carcinoma in children and adolescents.

Science.gov (United States)

Iliadou, Paschalia K; Effraimidis, Grigoris; Konstantinos, Michalakis; Grigorios, Panagiotou; Mitsakis, Periklis; Patakiouta, Frideriki; Pazaitou-Panayiotou, Kalliopi

2015-12-01

The association between chronic lymphocytic thyroiditis (CLT) and thyroid cancer is an interesting topic. The aim of the present study was to evaluate if demographic and histological characteristics as well as the long-term outcome of thyroid cancer was different in children and adolescents with and without CLT. The medical records of children and adolescents (≤21 years old) were reviewed. The following data were recorded: gender, year and age at diagnosis, family history of thyroid cancer, history of external radiation therapy, histological type (papillary and variants, follicular and variants), tumour size, multifocality, infiltration of thyroid parenchyma or surrounding soft tissues, vascular invasion, presence of lymph node and distant metastases. Information about the presence of TgAb and TPOAb was also collected. One hundred eight children and adolescents (median age 19.0, interquartile range 4.0 years) were diagnosed with differentiated thyroid carcinoma (DTC); 31 patients (28.7%) presented histological characteristics compatible with CLT. Infiltration of thyroid parenchyma was more frequent in patients with CLT compared to patients without (74.2% vs 48.1% respectively, P=0.024). Familial papillary thyroid carcinoma (PTC) was more frequent in patients with CLT compared to those without CLT (20.7% vs 2.8% respectively, P=0.009). There was no better outcome with respect to the presence of CLT or not. Children and adolescents with CLT present more frequently familial PTC as well as thyroid cancer with invasive characteristics. © 2015 European Society of Endocrinology.

Parathyroid Carcinoma in Patients that Have Undergone Surgery for Primary Hyperparathyroidism.

Science.gov (United States)

Libánský, Petr; Adámek, Svatopluk; Broulík, Petr; Fialová, Martina; Kubinyi, Josef; Lischke, Robert; Naňka, Ondřej; Pafko, Pavel; Šedý, Jiří; Bobek, Vladimír

2017-01-01

Parathyroid carcinoma is a rare clinical entity, which represents one of the main reasons, why surgery should be performed in specialized centres. Preoperatively, it is very difficult to distinguish between benign and malignant hyperparathyroidism. During the years 1996-2016, we performed 2,220 operations in 2,075 patients with a diagnosis of primary hyperparathyroidism. Among these 2,220 operations, there were 16 operations for parathyroid carcinoma. These 16 operations, including reoperations, were performed in four patients. Two patients had no reoperation, but another 2 patients required 14 reoperations in total. Parathyroid carcinoma was described in 0.2% of all patients with a diagnosis of primary hyperparathyroidism. The number of operations was 0.73% of all operations of primary hyperparathyroidism in years 1996-2016. Prognosis of parathyroid carcinoma is quite favourable, patients evidence a long-term survival rate after the primary operation. However, every reoperation increases the number of possible complications, including recurrent laryngeal nerve injury. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Evaluation of matrix metalloproteinase-9 expressions in nasopharyngeal carcinoma patients

Science.gov (United States)

Farhat; Asnir, R. A.; Yudhistira, A.; Daulay, E. R.; Puspitasari, D.; Yulius, S.

2018-03-01

Nasopharyngeal carcinoma (NPC) is one of head and neck cancer with a poor prognosis because of the position of the tumor adjacent to the skull base and vital structures. Degradation of extracellular matrix that will cause tumor cells to invade surrounding tissues, vascular or lymphatic vessels. One that plays a role in the extracellular matrix degradation process is matrix metalloproteinase-9 (MMP-9). MMP-9 plays a role in tumor invasion process, metastasis and induction of tumor tissue vascularization. To determine the expression of MMP-9 in patients with nasopharyngeal carcinoma, a descriptive study was conducted by examining immunohistochemistry MMP-9 in 30 NPC tissues that had never received radiotherapy, chemotherapy or combination. Frequency distribution of NPC patient mostly in the age group 41-50 years old and 51-60 years were nine people (30.0%); men (73.3%) and non-keratinizing squamous cell carcinoma (53.3%) histopathology type. The overexpression of MMP-9 in patients with nasopharyngeal carcinoma were mostly found in advance stage.

Incidence of thyroid carcinoma in patients with Hashimoto's thyroiditis and solitary cold nodules

International Nuclear Information System (INIS)

Ott, R.A.; Calandra, D.B.; McCall, A.; Shah, K.H.; Lawrence, A.M.; Paloyan, E.

1985-01-01

The reported incidence of thyroid carcinoma in Hashimoto's thyroiditis varies widely. For this reason the specific subpopulation of patients with Hashimoto's thyroiditis and a solitary cold nodule was analyzed. Between 1972 and 1984 we operated on 146 consecutive patients with solitary cold nodules and Hashimoto's thyroiditis. There were 47 carcinomas, for an incidence of 32%. The mean age of the 146 patients was 43 1/2 years (median 44 years), with 126 females and 20 males. There was a history of prior head and neck radiation exposure in 54 patients, with a 33% incidence of thyroid carcinoma. The 92 patients without a history of radiation exposure had a 31.5% incidence of carcinoma. The frequency of multicentricity (bilateralism) was 33% in the group that underwent radiation and 24% in the group that did not. To date, with a mean follow-up of 4.7 years, there have been no deaths and no evidence of recurrence. In conclusion, we report a 32% incidence of thyroid carcinoma in patients with Hashimoto's thyroiditis and a solitary cold nodule, with no apparent difference between the patients with or without a history of radiation exposure, although there was a higher incidence of bilateralism (33% versus 24%) in the carcinomas of the patients with a history of head and neck irradiation. We suggest that the operative management of these patients is total thyroidectomy for those with a history of head and neck radiation and thyroid lobectomy for patients with no history of radiation, followed by contralateral lobectomy if a carcinoma is demonstrated

Basal Cell Carcinomas in Gorlin Syndrome: A Review of 202 Patients

Directory of Open Access Journals (Sweden)

Elizabeth A. Jones

2011-01-01

Full Text Available Gorlin syndrome (Naevoid Basal Cell Carcinoma Syndrome is a rare autosomal dominant syndrome caused by mutations in the PTCH gene with a birth incidence of approximately 1 in 19,000. Patients develop multiple basal cell carcinomas of the skin frequently in early life and also have a predisposition to additional malignancies such as medulloblastoma. Gorlin Syndrome patients also have developmental defects such as bifid ribs and other complications such as jaw keratocysts. We studied the incidence and frequency of basal cell carcinomas in 202 Gorlin syndrome patients from 62 families and compared this to their gender and mutation type. Our data suggests that the incidence of basal cell carcinomas is equal between males and females and the mutation type cannot be used to predict disease burden.

Diagnostic performance of tumor markers AFP and PIVKA-II in Chinese hepatocellular carcinoma patients.

Science.gov (United States)

Huang, Shujing; Jiang, Feifei; Wang, Ying; Yu, Yanhua; Ren, Siqian; Wang, Xiaowei; Yin, Peng; Lou, Jinli

2017-06-01

Alpha-fetoprotein is an effective biomarker as an aid in hepatocellular carcinoma detection in many countries. However, alpha-fetoprotein has its limitations, especially in early hepatocellular carcinoma diagnosis. Protein induced by vitamin K absence or antagonist-II is another biomarker that is used for hepatocellular carcinoma detection. The aim of this study is to compare the diagnostic performance of alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II alone and in combination to explore improving biomarker performance as an aid in early hepatocellular carcinoma detection. In this study a total of 582 serum samples including 132 hepatocellular carcinoma patients, 250 non-hepatocellular carcinoma patients, and 200 healthy volunteers were collected. Alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II levels were measured by both chemiluminescent enzyme immunoassay on LUMIPULSE platform and by chemiluminescent microparticle immunoassay on ARCHITECT platform. Receiver operation characteristic curve analyses were performed for each biomarker and in combination. The results showed that Alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II in combination have shown higher area under the curve compared to alpha-fetoprotein alone for diagnosis in whole patients (0.906 vs 0.870) in hepatocellular carcinoma early-stage patients (0.809 vs 0.77) and in hepatitis B virus-related hepatocellular carcinoma patients (0.851 vs 0.788) with ARCHITECT platform. Protein induced by vitamin K absence or antagonist-II showed higher area under the curve than alpha-fetoprotein for diagnosis of hepatitis B virus-related hepatocellular carcinoma patients (0.901 vs 0.788).We conclude that Combining alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II may improve the diagnostic value for early detection of hepatocellular carcinoma. Protein induced by vitamin K absence or antagonist-II performs better

Lesion dose in differentiated thyroid carcinoma metastases after rhTSH or thyroid hormone withdrawal: {sup 124}I PET/CT dosimetric comparisons

Energy Technology Data Exchange (ETDEWEB)

Freudenberg, Lutz Stefan; Jentzen, Walter; Brandau, Wolfgang; Bockisch, Andreas [University of Duisburg/Essen, Department of Nuclear Medicine, Essen (Germany); Petrich, Thorsten; Knapp, Wolfram H. [Hanover University School of Medicine, Department of Nuclear Medicine, Hanover (Germany); Froemke, Cornelia [Hanover University School of Medicine, Institute of Biometry, Hanover (Germany); Marlowe, Robert J. [Spencer-Fontayne Corporation, Jersey City, NJ (United States); Heusner, Till [University of Duisburg/Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany)

2010-12-15

Renal radioiodine excretion is {proportional_to}50% faster during euthyroidism versus hypothyroidism. We therefore sought to assess lesion dose/GBq of administered {sup 131}I activity (LDpA) in iodine-avid metastases (IAM) of differentiated thyroid carcinoma (DTC) in athyreotic patients after recombinant human thyroid-stimulating hormone (rhTSH) versus after thyroid hormone withdrawal (THW). We retrospectively compared mean LDpA between groups of consecutive patients (N = 63) receiving {sup 124}I positron emission tomography/computed tomography ({sup 124}I PET/CT) aided by rhTSH (n = 27) or THW (n = 36); we prospectively compared LDpA after these stimulation methods within another individual. Data derived from serial PET scans and one CT scan performed 2-96 h post-{sup 124}I ingestion. A mixed model analysis of covariance (ANCOVA) calculated the treatment groups' mean LDpAs adjusting for statistically significant baseline intergroup differences: non-IAM were more prevalent, median IAM count/patient lower in cervical lymph nodes and higher in distant sites, median stimulated thyroglobulin higher, mean cumulative radioiodine activity greater and prior diagnostic scintigraphy more frequent in the rhTSH patients. Mean LDpAs were: rhTSH group (n = 71 IAM), 30.6 Gy/GBq; THW group (n = 66 IAM), 51.8 Gy/GBq. The difference in group means (rhTSH less THW), -21.2 Gy/GBq, was statistically non-significant (p = 0.1667). However, the 95% confidence interval of that difference (-51.4 to + 9 Gy/GBq) suggested a trend favouring THW. The within-patient comparison found 2.9- to 10-fold higher LDpAs under THW. We found some suggestions, but no statistically significant evidence, that rhTSH administration results in a lower radiation dose to DTC metastases than does THW. A large, well-controlled, prospective within-patient study should resolve this issue. (orig.)

Culture and Characterization of Circulating Endothelial Progenitor Cells in Patients with Renal Cell Carcinoma.

Science.gov (United States)

Gu, Wenyu; Sun, Wei; Guo, Changcheng; Yan, Yang; Liu, Min; Yao, Xudong; Yang, Bin; Zheng, Junhua

2015-07-01

Although emerging evidence demonstrates increased circulating endothelial progenitor cells in patients with solid tumors, to our knowledge it is still unknown whether such cells can be cultured from patients with highly angiogenic renal cell carcinoma. We cultured and characterized circulating endothelial progenitor cells from patients with renal cell carcinoma. The circulating endothelial progenitor cell level (percent of CD45(-)CD34(+) VEGF-R2(+) cells in total peripheral blood mononuclear cells) was quantified in 47 patients with renal cell carcinoma and 40 healthy controls. Peripheral blood mononuclear cells were then isolated from 33 patients with renal cell carcinoma and 30 healthy controls to culture and characterize circulating endothelial progenitor cells. The circulating endothelial progenitor cell level was significantly higher in patients with renal cell carcinoma than in healthy controls (0.276% vs 0.086%, p cells first emerged significantly earlier in patient than in control preparations (6.72 vs 14.67 days, p culture success rate (87.8% vs 40.0% of participants) and the number of colonies (10.06 vs 1.83) were significantly greater for patients than for controls (each p cell level correlated positively with the number of patient colonies (r = 0.762, p Cells cultured from patients and controls showed a similar growth pattern, immunophenotype, ability to uptake Ac-LDL and bind lectin, and form capillary tubes in vitro. However, significantly more VEGF-R2(+) circulating endothelial progenitor cells were found in preparations from patients with renal cell carcinoma than from healthy controls (21.1% vs 13.4%, p cell colonies, a higher cell culture success rate and more colonies were found for patients with renal cell carcinoma than for healthy controls. Results indicate the important significance of VEGF-R2(+) circulating endothelial progenitors in patients with renal cell carcinoma. Copyright © 2015 American Urological Association Education and Research

Fijación de radioyodo en huesos maxilares simulando metástasis en pacientes con Carcinoma Diferenciado de Tiroides (CDT): False- Positive images in patients with Differentiated Thyroid Carcinoma. (DTC)

OpenAIRE

Degrossi, O. J.; Gutiérrez, S.; Fadel, A.; Degrossi, E. B.; Valdivieso, M. C.; Balbuena, R. L.; Alak, M. del C.; de Cabrejas, M.

2008-01-01

En estudios centellográficos con 131I (CCT) para seguimiento, postablación o tratamiento de pacientes portadores de carcinoma diferenciado de tiroides (CDT) se observan frecuentemente en tiempos precoces áreas de captación del radiotrazador en macizo facial. Estas áreas corresponden, generalmente, a glándulas salivares y extremo anterior de mucosa nasal y se mantienen durante las primeras 48 horas y no son observadas generalmente a las 72 horas. Pero con menor frecuencia se presentan otras qu...

A Case of Primary Gastric Small-Cell Carcinoma in an Elderly Patient

Directory of Open Access Journals (Sweden)

Fa-Chang Yu

2012-03-01

Full Text Available We report a case of primary small-cell carcinoma of the stomach in a 75-year-old man. The patient was admitted to our hospital with a 1-week history of intermittent tarry stool. An upper gastrointestinal examination revealed a large stage A2 ulcer in the greater curvature of the body of the stomach, and pathological findings from biopsy specimens revealed small-cell carcinoma. The tumor cells were small-sized, composed of hyperchromatic nuclei with scant cytoplasm, and stained positive for cytokeratin, synaptophysin, and chromogranin A. The patient was diagnosed with primary small-cell carcinoma of the stomach. He declined further evaluation and received palliative management. This is a rare carcinoma of the stomach, with aggressive manifestations and a poor prognosis. The mean survival of patients with primary gastric small-cell carcinoma is reported to be 7 months. The choice of treatment for this disease is still controversial. This rare gastric tumor should be listed in the differential diagnosis of gastric carcinoma in the elderly.

Management of the Patient with Aggressive and Resistant Papillary Thyroid Carcinoma

Science.gov (United States)

Miftari, Rame; Topçiu, Valdete; Nura, Adem; Haxhibeqiri, Valdete

2016-01-01

Purpose: Papillary carcinoma is the most frequent type of thyroid cancer and was considered the most benign of all thyroid carcinomas, with a low risk of distant metastases. However, there are some variants of papillary thyroid carcinoma that have affinity to spread in many organs, such as: lymph nodes, lungs and bones. Aim: The aim of this study was presentation of a case with papillary carcinoma of the thyroid gland, very persistent and resistant in treatment with I 131. Material and results: A man 56 years old were diagnosed with papillary carcinoma of thyroid gland. He underwent a surgical removal of the tumor and right lobe of thyroid gland. With histopathology examination, were confirmed follicular variant of papillary carcinoma pT4. Two weeks later he underwent total thyroidectomy and was treated with 100 mCi of J 131. Six months later, the value of thyroglobulin was found elevated above upper measured limits (more than 500 ng/ml). Patient underwent surgical removal of 10 metastatic lymph nodes in the left side of the neck and has been treated with 145 mCi of radioiodine I 131. The examination after 5 months shows elevation of thyroglobulin, more than 20000 ng/ml and focally uptake of J 131 in the left lung. Patient was treated once again with 150 mCi radioiodine J 131. Whole body scintigraphy was registered focal uptake of radioiodine in the middle of the left collarbone. After a month, patient refers the enlargement of the lymph node in the right side of the neck. Currently patient is being treated with kinase inhibitor drug sorafenib and ibandronate. We have identified first positive response in treatment. Enlarged lymph node in the neck was reduced and the patient began feeling better. Conclusion: This study suggests that some subtypes of papillary thyroid carcinoma appear to have more aggressive biological course. Subtypes of papillary thyroid carcinoma such as diffuse sclerosing carcinoma, tall cell or columnar cell and insular variants, appears to

Hepatocellular carcinoma with neuroendocrine differentiation: clinical and imaging findings in five patients

International Nuclear Information System (INIS)

Park, Seong Hoon; Kang, Myeong Jin; Cho, Jin Han

2008-01-01

To describe the clinical and imaging findings of hepatocellular carcinoma with neuroendocrine differentiation, which is an extremely rare variant of hepatocellular carcinoma. We collected five patients who had histopathologically proven hepatocellular carcinoma with neuroendocrine differentiation, and described morphologic feature, enhancement pattern of tumors, extrahepatic manifestation and clinical findings. At CT, the tumor size ranged from 8 to 17 cm (mean: 12 cm) in maximum diameter. The tumor margin was well-defined and smooth in four patients and all tumors were heterogeneously hypoattenuating. Four tumor showed rim enhancement on arterial and portal phases. Local invasion to the portal vein, intrahepatic duct and gallbladder were seen. Extrahepatic manifestations included hepatic metastases, lymph node metastasis. At ultrasonography, the tumor showed heterogeneously hyperechoic in all patients and hypoechoic rim was found in four patients. Of four patients who were followed up, one survived for 16 months after initial diagnosis, while the other three died within 3 months after initial diagnosis. As described above, clinical and imaging findings of hepatocellular carcinoma with neuroendocrine differentiation were not specific. However, this rare variant of hepatocellular carcinoma could be considered when hepatic tumor is found in an advanced stage and shows persistent rim enhancement at CT

Sunitinib efficacy in the treatment of metastatic skin adnexal carcinomas: report of two patients with hidradenocarcinoma and trichoblastic carcinoma.

Science.gov (United States)

Battistella, M; Mateus, C; Lassau, N; Chami, L; Boukoucha, M; Duvillard, P; Cribier, B; Robert, C

2010-02-01

Adnexal carcinomas are rare and diverse cutaneous tumours. They are locally aggressive and have the potential for distant metastasis. Metastatic adnexal carcinomas are very resistant to conventional chemotherapies. Sunitinib, an oral tyrosine kinase inhibitor, is reportedly effective for the treatment of various solid cancers. Its use in adnexal carcinomas has never been reported. The first patient had metastatic clear cell hidradenocarcinoma and was stabilized over 8 months with sunitinib, before she relapsed. The second patient had a metastatic malignant hair follicle tumour (trichoblastic carcinoma) and achieved a partial remission with sunitinib, and disease stabilized after 10 months. Dynamic contrast-enhanced ultrasound (DCE-US) performed to evaluate tumour vascularization during treatment depicted a dramatic and early decrease in the tumour blood volume. Sunitinib was effective in controlling the disease in our two patients. DCE-US using linear raw data may have an early predictive value for tumour response to sunitinib. Further studies involving larger cohorts of patients are warranted in order to confirm the efficacy of sunitinib in these rare tumours.

Success of the postoperative 131I therapy in young Belarusian patients with differentiated thyroid cancer after Chernobyl depends on the radiation absorbed dose to the blood and the thyroglobulin level

International Nuclear Information System (INIS)

Haenscheid, Heribert; Verburg, Frederik Anton; Diessl, Stefanie; Biko, Johannes; Reiners, Christoph; Demidchik, Yuri E.; Drozd, Valentina

2011-01-01

Differentiated thyroid carcinoma (DTC) in children and young adults is rare but often aggressive and in an advanced stage at diagnosis. In a cohort of young Belarusian patients with advanced DTC after Chernobyl we retrospectively studied parameters influencing the success of the postoperative 131 I therapy. Included in the study were 136 patients (83 female, 53 male; median age 14.3 years, range 9.4-22.8 years) who had had total thyroidectomy in Belarus and subsequent 131 I therapy and follow-up in Germany. Of the 136 patients, 34 were classified as M1 and 102 as M0 (N0 1, N1 101). The median weight-adjusted 131 I activity administered after thyroid hormone withdrawal was 52 MBq/kg (range 24-74 MBq/kg). TNM stage, gender, administered activity, whole-body residence time and blood dose during ablation, Tg and TSH levels, date, and age at time of treatment were tested for their effect on the rate of complete remission (CR). CR was defined as a negative scan and a stimulated Tg level of 0.3). The regression model was able to correctly predict CR in 82 of 102 patients (80.4%). In children and young adults with advanced DTC, the rate of CR after postoperative 131 I therapy is dependent on the preablative Tg level and the radiation absorbed dose to the blood. Though the present results must be confirmed in a prospective study, they imply that preablative dosimetry may improve rates of CR. (orig.)

Does age affect prognosis in salivary gland carcinoma patients?

DEFF Research Database (Denmark)

Bjørndal, Kristine; Larsen, Stine R; Therkildsen, Marianne H

2016-01-01

in the young group were WHO performance status 0 and in disease stage I + II, and they presented with significantly more histological low grade tumors. In multivariate analysis, chronological age seemed to be of no prognostic significance to salivary gland carcinoma patients as opposed to performance status......, disease stage and histological grade. CONCLUSIONS: Salivary gland carcinoma patients over the age of 70 years have a poor prognosis compared to younger patients, which can be explained by higher disease stages, more histological high grade subtypes and a poorer performance status at the time of diagnosis.......AIM: To compare incidence, histology, treatment modalities, disease stages, and outcome in elderly patients (≥70 years) compared to younger (

Decreased staging of differentiated thyroid cancer in patients with chronic lymphocytic thyroiditis.

Science.gov (United States)

Borowczyk, M; Janicki, A; Dworacki, G; Szczepanek-Parulska, E; Danieluk, M; Barnett, J; Antonik, M; Kałużna, M; Bromińska, B; Czepczyński, R; Bączyk, M; Ziemnicka, K; Ruchała, M

2018-04-04

The biological association between chronic lymphocytic thyroiditis (CLT) and differentiated thyroid cancer (DTC) has not been elucidated yet. The aim of the study was to assess whether the presence of CLT exerts any influence on clinical or histological presentation of DTC. Nine hundred and seven consecutive patients with DTC treated in the years 1998-2016 were divided into two groups according to the presence or absence of concomitant CLT. The statistical differences were analysed. Out of 907 patients included in the study, 331 were diagnosed with DTC and CLT (studied group), while 576 patients with DTC but without CLT constituted a control group. The distribution of papillary and follicular thyroid cancer did not differ. In CLT group, the prevalence of pT1 was greater than for pT2-pT4 DTC (P = 0.0003; OR = 1.69, 95% CI 1.27-2.24) compared to controls (68.3 vs. 56.1%, respectively). The presence of multifocal lesions was similar. The thyroid capsule infiltration without extrathyroidal invasion (P CLT (P = 0.004; OR = 1.66; 95% CI 1.17-2.34) as well as nodal involvement (P = 0.048; OR = 0.65, 95% CI 0.42-0.99). The collected data indicate a protective role of CLT in preventing the spread of the DTC. The presence of CLT might limit tumour growth to the primary site.

Radiation-Induced Differentiated Thyroid Cancer Is Associated with Improved Overall Survival but Not Thyroid Cancer-Specific Mortality or Disease-Free Survival.

Science.gov (United States)

White, Michael G; Cipriani, Nicole A; Abdulrasool, Layth; Kaplan, Sharone; Aschebrook-Kilfoy, Briseis; Angelos, Peter; Kaplan, Edwin L; Grogan, Raymon H; Onel, Kenan

2016-08-01

Radiation is a well-described risk factor for differentiated thyroid carcinoma (DTC). Although the natural history of DTC following nuclear disasters and in healthcare workers with chronic radiation exposure (RE) has been described, little is known about DTC following short-term exposure to therapeutic medical radiation for benign disease. This study compares DTC morphology and outcomes in patients with and without a prior history of therapeutic external RE. A retrospective review was performed of patients with DTC treated at The University of Chicago between 1951 and 1987, with a median follow-up of 27 years (range 0.3-60 years). Patients were classified as either having (RE+) or not having (RE-) a history of therapeutic RE. Variables examined included sex, age at RE, dose of RE, indication for RE, DTC histology, and outcome. Morphology was determined by blinded retrospective review of all available histologic slides. Outcomes were assessed using Cox proportional hazards model and Kaplan-Meier curves. Of 257 DTC patients, 165 (64%) were RE- and 92 (36%) were RE+, with males comprising a greater proportion of the RE+ group (43.5% vs. 27.3%; p = 0.01). A total of 94.2% of DTC cases were classic papillary cancers; histology did not differ between RE+ and RE- cohorts (p = 0.73). RE was associated with an increased median overall survival (OS; 43 years vs. 38 years; hazard ratio [HR] = 0.55 [confidence interval (CI) 0.34-0.89]; p = 0.01). Survival for males in the RE- group was significantly worse than it was for RE- females (HR = 1.78 [CI 1.05-3.03]; p = 0.03) or RE+ males (HR = 2.98 [CI 1.39-6.38]; p = 0.01). Recurrence did not differ between the RE+ and RE- groups (HR = 0.85 [CI 0.52-1.41]; p = 0.54), nor did DTC-specific mortality (HR = 0.54 [CI 0.21-1.37]; p = 0.20). While DTC following RE has historically been considered a more aggressive variant than DTC in the absence of RE, the present data indicate that RE+ DTC

Assessment of genetic mutations in the XRCC2 coding region by high resolution melting curve analysis and the risk of differentiated thyroid carcinoma in Iran

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Shima Fayaz

2012-01-01

Full Text Available Homologous recombination (HR is the major pathway for repairing double strand breaks (DSBs in eukaryotes and XRCC2 is an essential component of the HR repair machinery. To evaluate the potential role of mutations in gene repair by HR in individuals susceptible to differentiated thyroid carcinoma (DTC we used high resolution melting (HRM analysis, a recently introduced method for detecting mutations, to examine the entire XRCC2 coding region in an Iranian population. HRM analysis was used to screen for mutations in three XRCC2 coding regions in 50 patients and 50 controls. There was no variation in the HRM curves obtained from the analysis of exons 1 and 2 in the case and control groups. In exon 3, an Arg188His polymorphism (rs3218536 was detected as a new melting curve group (OR: 1.46; 95%CI: 0.432-4.969; p = 0.38 compared with the normal melting curve. We also found a new Ser150Arg polymorphism in exon 3 of the control group. These findings suggest that genetic variations in the XRCC2 coding region have no potential effects on susceptibility to DTC. However, further studies with larger populations are required to confirm this conclusion.

Management of hypocalcemia following total thyroidectomy

International Nuclear Information System (INIS)

Pahuja, D.N.; Patwardhan, U.N.; Samuel, A.M.

1999-01-01

A retrospective analysis of calcemic status of 500 randomly selected patients, who underwent total thyroidectomy (TTx) for differentiated thyroid carcinoma (DTC) was studied. These patients were followed up from a minimum of 2-3 years, to a maximum of 15-20 years, and calcemic status was ascertained at varying times following their surgery and radioiodine ( 131 ) therapy

131I Treatment of differentiated thyroid carcinoma in children and adolescents

International Nuclear Information System (INIS)

Qu Yuan; Huang Rui; Li Lin

2014-01-01

The occurrence rate of DTC in children and adolescents is not high. However, DTC in these patients has some distinct characteristics different from those in adult, such as larger tumor volume at diagnosis, early invasion of neck lymph nodes and early distant metastases, high NIS expression, high recurrence but higher overall survival rate. 131 I ablation is still one of the important treatment methods after surgery. Currently, there are 3 major dosage regimens adopted for 131 I treatment: prescribed dose without causing bone marrow suppression/toxicity, dose aiming at tumor ablation, and empirically fixed dose. (authors)

Endocavitary radiotherapy in patients with rectal carcinoma. Endokavitaer straalebehandling ved cancer recti

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Tanum, G.; Tveit, K.M.; Giercksky, K.E. (Det Norske Radiumhospital, Oslo (Norway))

1992-05-01

Most patients with rectal carcinomas undergo surgery, either a resection with anastomosis or Miles' operation with permanent colostomy. Endocavitary radiotherapy is an alternative to surgery in patients with small carcinomas (Dukes' A) or adenovillous adenomas. The treatment is cheap, simple, gives good local tumour control, has low morbidity and does not require hosptialization. The Norwegian Radium Hospital has recently startet to use this method in selected cases of rectal carcinomas. 12 refs., 1 fig.

Speed Regulated Continuous DTC Induction Motor Drive in Field Weakening

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MATIC, P.

2011-02-01

Full Text Available The paper describes sensorless speed controlled continuous Direct Torque Control (DTC Induction Motor (IM drive in the field weakening regime. Drive comprises an inner torque loop and an outer speed loop. Torque control is based on Proportional - Integral (PI controller with adaptive Gain Scheduling (GS parameters. The GS PI control provides full DC link voltage utilization and a robust disturbance rejection along with a fast torque response. Outer speed loop has a PI regulator with the gains selected so as to obtain a fast and strictly aperiodic response. Proposed drive fully utilizes the available DC bus voltage. The paper comprises analytical considerations, simulation results, and detailed description of the implementation steps. Experimental verification of the proposed solution is conducted on a fixed point Digital Signal Processor (DSP platform.

High risk factors in patient with carcinoma esophagus

International Nuclear Information System (INIS)

Afridi, S.P.; Khan, A.; Waheed, I.

2000-01-01

This study was conducted to identify the presence of high risk factors in carcinoma esophagus from February, 1992 to August, 1995 at Surgical unit 1, Jinnah Postgraduate Medical Centre (JPMC), Karachi. In all 37 patients, 22 males and 15 females, were included in the study through outpatient department, surgical emergency and those referred from other cities of the country. All patients were cachectic. Diagnosis was made by detailed history, examination and laboratory investigations. Diagnosis was confirmed on barium swallow and endoscopic biopsy. Highest number of patients were in their 6th decade of life. History of snuff inhalation and opium was present in 2.7% cases each. Lower 3rd of the esophagus was affected in 62.16% middle third in 21.62% and upper third in 16.21% cases. Smoking, pan chewing, naswar eating and snuff inhalation were identified as high risk factors among patients of carcinoma esophagus. (author)

Merkel cells carcinoma of the aged patient

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Levy, A.; Assouline, A.; Mazeron, J.J.; Chargari, C.; Krzisch, C.

2009-01-01

The carcinoma at Merkel cells is a rare and aggressive skin cancer, principally of the aged adult. The surgery is the fundamental treatment. The interest of the adjuvant radiotherapy is discussed for the aged patient. In the limits of this retrospective analysis, the postoperative radiotherapy appeared to bring a similar benefit as for younger patients. (N.C.)

Outcome of Patients With Metastatic Sarcomatoid Renal Cell Carcinoma: Results From the International Metastatic Renal Cell Carcinoma Database Consortium

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Kyriakopoulos, Christos E; Chittoria, Namita; Choueiri, Toni K

2015-01-01

BACKGROUND: Sarcomatoid renal cell carcinoma is associated with poor prognosis. Data regarding outcome in the targeted therapy era are lacking. PATIENTS AND METHODS: Clinical, prognostic, and treatment parameters in metastatic renal cell carcinoma patients with and without sarcomatoid histology......% intermediate risk, and 40% vs. 24% poor risk; P system metastases (6...... of second- (P = .018) and third-line (P systemic therapy. The median progression-free survival (PFS)/overall survival (OS) was 4.5/10.4 months in sRCC patients and 7.8/22.5 months in non-sRCC patients (P

Changes of serum prolactin level in patients with oral cavity squamous cell carcinoma

International Nuclear Information System (INIS)

Zheng Jian; Li Hairu; Chen Yaming; Tang Guihong; Xu Yalan

2004-01-01

To investigate the change of serum prolactin (PRL) level in patients with oral cavity squamous cell carcinoma, serum PRL level in 79 normal person and 68 cases of patient s was measured by RIA. The result showed that serum PRL level was significantly higher in 26 patients (38.2%, 26/68) than that in the control (P 0.05) between the sex and region of lesion. The above results indicated that proportion of patient with oral cavity squamous cell carcinoma was hyperprolactinaemia and the change of PRL was related to the development in oral cavity squamous cell carcinoma. (authors)

Anogenital squamous cell carcinoma in neglected patient.

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Svecova, D; Havrankova, M; Weismanova, E; Babal, P

2012-01-01

Skin squamous cell carcinomas (SCCs) are arguably the second most common carcinoma of the skin and are responsible for the majority of non-melanoma skin cancer deaths. Gynecologist treated a Caucasian 56-years old female patient for genital wart with podophyllotoxin cream. She did not achieve complete response and therefore she has interrupted the therapy and the collaboration with the gynecologist. At the time of evaluation the lesion had a size of man's palm in anogenital region and showed characteristic features of neoplasm. The regional lymph nodes have produced infiltrated painful bubo. PCR analysis for HPV proved negative. Histopathology revealed well-differentiated squamous cell keratinizing carcinoma from the tumor as well as from the regional lymph node packet. Staging computed tomography scans proved negative and pelvis scans disclosed regional lymphadenopathy underlying the tumor. Palliative radiation therapy (by linear accelerator) was administered for the oversized tumor to the total TD 50.0Gy. The patient died 6 months after diagnostic assessment from cardio-respiratory failure. Staging computed tomography before her death did not disclose distinct metastases in her inner organs. Well-differentiated squamous cell keratinizing carcinoma could be growing endophytically affecting the underlying adipose tissue and musculature, with spreading into the regional lymph nodes. The rate of metastases into inner organs seems to vary according to the aggressiveness and metastatic behavior of each SCC. The case report calls for attention to the importance of collaboration among various specialists assisting in the diagnosis and management of skin neoplasm (Fig. 5, Ref. 12). Full Text in PDF www.elis.sk.

An Improved DTC-SVM Method for Sensorless Matrix Converter Drives Using an Overmodulation Strategy and a Simple Nonlinearity Compensation

DEFF Research Database (Denmark)

Lee, Kyo Beum; Blaabjerg, Frede

2007-01-01

In this paper, an improved direct torque control (DTC) method for sensorless matrix converter drives is proposed, which is characterized by minimal torque ripple, unity input power factor, and good sensorless speed-control performance in the low-speed operation, while maintaining constant switchi...

Combined effect of angioinfarction with immunotherapy in patients with stage IV renal cell carcinoma

International Nuclear Information System (INIS)

Oh, Joo Hyeong; Yoon, Yup; Jeong, Yu Mee; Ko, Young Tae; Chang, Sung Goo

1994-01-01

To assess the combined effectiveness of angioinfarction and immunotherapy for improving survival in patients with stage IV renal cell carcinoma. During the past 3 years, 13 patients of stage IV renal cell carcinoma were treated with angioinfarction and immunotherapy. Angioinfarction was performed on these 13 patients using absolute ethanol and occlusive balloon catheter. After angioinfarction, Interferon alpha was used for immunotherapy. For our analysis, 12 control patients of stage IV renal cell carcinoma without treatment were included in the study. Survival has been calculated according to the Kaplan and Meier method. The 1 year survival rate and median survival time in patients treated with angioinfarction and immunotherapy, were 46% and 13 months and in patients without treatment, 16% and 4 months, respectively. The combined treatment of angioinfarction and immunotherapy is of considerable value for improving survival in patients with stage IV renal cell carcinoma

Non-transplant therapies for patients with hepatocellular carcinoma and Child-Pugh-Turcotte class B cirrhosis.

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Granito, Alessandro; Bolondi, Luigi

2017-02-01

Underlying liver cirrhosis is present in most patients with hepatocellular carcinoma, and liver transplantation is the only treatment strategy to cure both diseases. All other hepatocellular carcinoma treatment strategies have to take into account residual liver function that concurs with the patient's prognosis and might limit their feasibility. In patients with hepatocellular carcinoma and Child-Pugh-Turcotte class B (CPT-B), owing to borderline liver function, any intervention might be offset by liver function deterioration. In this setting, the decision for hepatocellular carcinoma treatment requires a comprehensive assessment of liver function, not restricted to the CPT classification, in addition to a careful evaluation of the prognostic effect of hepatocellular carcinoma compared with cirrhosis. In this Review, we provide an overview of the literature regarding the benefits and harms of non-transplant therapies in patients with hepatocellular carcinoma and CPT-B cirrhosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Radioiodine Thyroid Remnant Ablation after Recombinant Human Thyrotropin or Thyroid Hormone Withdrawal in Patients with High-Risk Differentiated Thyroid Cancer

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Fabián Pitoia

2012-01-01

Full Text Available To supplement limited relevant literature, we retrospectively compared ablation and disease outcomes in high-risk differentiated thyroid carcinoma (DTC patients undergoing radioiodine thyroid remnant ablation aided by recombinant human thyrotropin (rhTSH versus thyroid hormone withdrawal/withholding (THW. Our cohort was 45 consecutive antithyroglobulin antibody- (TgAb- negative, T3-T4/N0-N1-Nx/M0 adults ablated with high activities at three referral centers. Ablation success comprised negative (<1 μg/L stimulated serum thyroglobulin (Tg and TgAb, with absent or <0.1% scintigraphic thyroid bed uptake. “No evidence of disease” (NED comprised negative unstimulated/stimulated Tg and no suspicious neck ultrasonography or pathological imaging or biopsy. “Persistent disease” was failure to achieve NED, “recurrence,” loss of NED status. rhTSH patients (n=18 were oftener ≥45 years old and higher stage (P=0.01, but otherwise not different than THW patients (n=27 at baseline. rhTSH patients were significantly oftener successfully ablated compared to THW patients (83% versus 67%, P<0.02. After respective 3.3 yr and 4.5 yr mean follow-ups (P=0.02, NED was achieved oftener (72% versus 59% and persistent disease was less frequent in rhTSH patients (22% versus 33% (both comparisons P=0.03. rhTSH stimulation is associated with at least as good outcomes as is THW in ablation of high-risk DTC patients.

Radioiodine thyroid remnant ablation after recombinant human thyrotropin or thyroid hormone withdrawal in patients with high-risk differentiated thyroid cancer.

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Pitoia, Fabián; Marlowe, Robert J; Abelleira, Erika; Faure, Eduardo N; Bueno, Fernanda; Schwarzstein, Diego; Lutfi, Rubén Julio; Niepomniszcze, Hugo

2012-01-01

To supplement limited relevant literature, we retrospectively compared ablation and disease outcomes in high-risk differentiated thyroid carcinoma (DTC) patients undergoing radioiodine thyroid remnant ablation aided by recombinant human thyrotropin (rhTSH) versus thyroid hormone withdrawal/withholding (THW). Our cohort was 45 consecutive antithyroglobulin antibody- (TgAb-) negative, T3-T4/N0-N1-Nx/M0 adults ablated with high activities at three referral centers. Ablation success comprised negative (<1 μg/L) stimulated serum thyroglobulin (Tg) and TgAb, with absent or <0.1% scintigraphic thyroid bed uptake. "No evidence of disease" (NED) comprised negative unstimulated/stimulated Tg and no suspicious neck ultrasonography or pathological imaging or biopsy. "Persistent disease" was failure to achieve NED, "recurrence," loss of NED status. rhTSH patients (n = 18) were oftener ≥45 years old and higher stage (P = 0.01), but otherwise not different than THW patients (n = 27) at baseline. rhTSH patients were significantly oftener successfully ablated compared to THW patients (83% versus 67%, P < 0.02). After respective 3.3 yr and 4.5 yr mean follow-ups (P = 0.02), NED was achieved oftener (72% versus 59%) and persistent disease was less frequent in rhTSH patients (22% versus 33%) (both comparisons P = 0.03). rhTSH stimulation is associated with at least as good outcomes as is THW in ablation of high-risk DTC patients.

Two patients with rare mixed adenoneuroendocrine carcinomas of the rectum.

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Gül-Klein, Safak; Sinn, Marianne; Jurmeister, Philipp Sebastian; Biebl, Matthias; Weiß, Sascha; Rau, Beate; Bläker, Hendrik; Pratschke, Johann; Aigner, Felix

2018-01-01

Mixed adenoneuroendocrine carcinomas of the gastrointestinal tract are until today poorly understood and thus very challenging for interdisciplinary therapy. We herewith report the first case series of patients with a primary mixed adenoneuroendocrine carcinoma of the rectum. Both cases were initially diagnosed as adenocarcinoma and only secondarily with mixed adenoneuroendocrine carcinoma and had a poor outcome due to a rapid tumor progression and resistance to chemotherapy. A 65-year-old female presented with local tumor recurrence and hepatopulmonary metastasis 1 year after primary surgery for adenocarcinoma of the rectum and consecutive radiochemotherapy regimen. Fluorouracil (5-FU) was followed by bevacizumab- and capecitabine-based chemotherapy but had to be discontinued due to side effects and progressive disease. Progressive local pain syndrome accompanied by recurrent bleeding episodes led to a local tumor-debulking operation. Afterward, mixed adenoneuroendocrine carcinoma as the underlying diagnosis in the final histopathological examination was detected. The patient died 3 months after the operation in the context of a fulminant tumor progress. A 63-year-old male patient underwent neoadjuvant radiochemotherapy and laparoscopic rectum resection. After 5 months, postoperative oxaliplatin/capecitabine-based adjuvant chemotherapy was switched to carboplatin/etopsid due to a progressive polyneuropathy and biopsy-proven pulmonary metastasis. The patient then had to be switched to local radiation of cerebral metastases and Topotecan due to cerebral bleeding episodes but died 18 months after the initial diagnosis. In conclusion of our case series, mixed adenoneuroendocrine carcinomas of the rectum should be considered as a rare but aggressive tumor entity. An early and detailed histopathological diagnosis is required in order to establish an individual interdisciplinary treatment concept.

Hepatic uptake of radioiodine in patients with thyroid cancer: the good, the bad and the aesthetically impaired

International Nuclear Information System (INIS)

Roman, M.; Larcos, G.; Gruenewald, S.; Devadas, M.; Boyages, S.

2002-01-01

Full text: There is debate over the prognostic significance of diffuse hepatic uptake (DHU) of radioiodine in patients with thyroid cancer (DTC). Accordingly we compared outcome in DTC patients with and without DHU and no abnormality on their radioiodine scan. We reviewed 408 studies in 198 patients who underwent radioiodine scanning (treatment or surveillance) for DTC over a five-year period. Of these 234 (57%) showed DHU; 100/408 showed no evidence of functioning thyroid tissue. These were 22 high dose I 131 treatments, 48 I 131 and 30 I 123 surveillance scans in 72 patients (54 women, 18 men, age: 43( 14 years; tumour type: 88% papillary, 10% follicular, 2% other; mean follow-up 12.2 (11.1 months). Outcome was assessed by clinical, pathological (thyroglobulin or histopathology) and/or radioiodine scanning. Of the 100 scans there were 17 (17%) that had DHU (group A) and 83 (83%) that were negative (group B). In group A, eight of 17 (47%) had or developed residual functioning thyroid tissue or DTC versus 29 of 83 (35%) in group B (p=ns). The only factor associated with DHU was high dose I 131 (p<0.001) but not the gender, age or type of cancer. We conclude that (a) DHU is common in patients with DTC; (b) if there is otherwise physiological distribution of radioiodine, DHU does not indicate an adverse short term outcome in DTC patients. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

Prognostic significance of lymphangiogenesis in pharyngolaryngeal carcinoma patients

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Garcia-Carracedo, Darío; Rodrigo, Juan Pablo; Astudillo, Aurora; Nieto, Carlos Suarez; Gonzalez, Maria Victoria

2010-01-01

Lymphatic vessel spread is considered a major route for head and neck squamous cell carcinoma metastasis. Formation of new lymphatic vessels could facilitate the process, raising the malignant potential of these tumours. Recent identification of lymphatic markers allows the study of the lymphangiogenesis phenomenon. We searched for molecular events involved in the lymphangiogenic process that could have prognostic value in laryngeal/pharyngeal carcinoma patients. 104 paraffin-embedded pharyngeal/laryngeal tumour samples were studied. Immunohistochemical analysis of podoplanin and double immunofluorescence analysis of Ki-67 and D2-40 were performed. Lymph vessel density (inside the tumour mass, at its periphery or considered as a whole) and the presence of tumour emboli inside lymphatics were recorded. The proliferative state of endothelial lymphatic cells was evaluated. Lymphatic vessels were detected inside the tumour mass (75%) and in the surrounding tissue (80%); some of them in a proliferative state. Tumour emboli were detected in a high proportion of the cases (45%). Lymphatic vessel density was higher in the pharyngeal cases (p = 0.0029), in greater size (p = 0.039), more advanced stage primary tumours (p = 0.006) and in carcinomas of patients with affected nodes (p = 0.019). The presence of tumour emboli and a high global vessel density were indicators of poor prognosis (recorded as death from tumour) in the laryngeal group (p = 0.015 and p = 0.027, respectively), but notably not in the pharyngeal one. Interestingly, high global vessel density showed a negative prognostic value among pathologically staged N0 laryngeal carcinomas (p = 0.03). The lymphangiogenic process correlated with aggressive tumour features (pN category, tumour size, tumour stage), but might play different roles in tumours arising from different anatomic sites. Our results suggest that detection of tumour emboli and assessment of global vessel density using the D2-40 antibody, may be

Role of 18F-F.D.G. PET/CT in management of patients with differentiated thyroid cancer

International Nuclear Information System (INIS)

Sibille, L.; Guillemard, S.; Eberle-Pouzeratte, M.C.; Espitalier-Riviere, C.; Faurous, P.; Artus, J.C.; Thezenas, S.; Lamy, P.J.; Rossi, M.

2010-01-01

18 F-F.D.G. PET/CT by combining both metabolic and anatomical information has proven to be an effective modality for detecting many types of cancer. Some differentiated forms of cancer like differentiated thyroid carcinoma (D.T.C.) are less F.D.G. avid and thus less easily detectable. Nevertheless 18 F-F.D.G. PET/CT has been proved useful in D.T.C. especially in case of suspected recurrent disease with negative whole-body radioiodine scintigraphy ( 131 I W.B.S.) and elevated thyroglobulin (Tg) or thyroglobulin autoantibodies (AbTg) levels. Impact on clinical management after 18 F-F.D.G. PET/CT examinations has been analyzed in patients with suspected recurrent D.T.C. in this retrospective study. Methodology. Fifty-five 18 F-F.D.G. PET/CT were performed in 45 patients with suspected recurrent or residual disease either because of elevated Tg/AbTg levels (n 45) or uncertain conventional imaging (n = 10) including 131 I W.B.S., cervical echography and CT scan if necessary. 18 F-F.D.G. PET/CT results were compared with histopathology and/or clinical follow-up with evaluation of impact on clinical management. Results. Twenty-nine exams were positive (53 %). There were 20 true-positive (T.P.) (14 locoregional relapses and six with distant metastases) and nine false-positive (F.P.) (all cervical). SUV max median values of hyper-metabolic foci were significantly higher in T.P. (5.1) than in F.P. (2.8). Overall, 20 (36 %) 18 F-F.D.G. PET/CT directly affected clinical management resulting in 13 (65 %) new surgical operations. Sensitivity, specificity, predictive positive value, predictive negative value and accuracy of 18 F-F.D.G. PET/CT were estimated for the whole group (respectively 83 %, 71 %, 69 %, 85 % and 76 %) and for two subgroups depending on Tg level (less or more than 1.2 ng/ml). Discussion and conclusion. 18 F-F.D.G. PET/CT is a powerful and useful tool in patients with suspected D.T.C. recurrence or residual disease and should be systematically performed when

Treatment recommendations in patients diagnosed with high-risk cutaneous squamous cell carcinoma

International Nuclear Information System (INIS)

Veness, M.J.

2005-01-01

Non-melanoma cutaneous cancers occur at an epidemic rate in Australia. With an ageing population, more Australians will develop these cancers and at an increasing rate. In the majority of cases local treatment is highly curative. However, a subset of the population will be diagnosed with a high-risk cutaneous squamous cell carcinoma. These can be defined as patients at risk of having subclinical metastases to regional lymph nodes based on unfavourable primary lesion features (including inadequately excised and recurrent lesions), patients with metastatic squamous cell carcinoma to regional lymph nodes, and squamous cell carcinoma in immunosuppressed patients. The mortality and morbidity associated with high-risk cutaneous squamous cell carcinoma is usually as a consequence of uncontrolled metastatic nodal disease and, to a lesser extent, distant metastases. Radiotherapy has an essential role in treating these patients and in many cases the addition of adjuvant radiotherapy may be life saving. It is therefore important that all clinicians treating skin cancers have an understanding and awareness of the optimal approach to these patients. The aim of this article is to present treatment recommendations based on an overview of the current published literature. Copyright (2005) Blackwell Science Pty Ltd

Radioimmunoassay of tumor markers in serum of patients with renal carcinoma

International Nuclear Information System (INIS)

Cordoni-Voutsas, M.; Glaubitt, D.; Wagner, W.; Lichtenberg, T.

1984-01-01

Having noted an increased serum level of TPA and CEA in patients with renal carcinoma the authors extended these studies by using a larger number of tumor markers. In 15 patients (11 men and 4 women after menopause) aged 33 to 74 years who had renal carcinoma, among them 3 with tumor metastases, the serum concentration of TPA, CA 12-5, CEA, AFP, ferritin, prolactin, β-HCG, and β/sub 2/-microglobulin was measured by radioimmunoassay. Monoclonal antibodies were used in the determination of serum CA 12-5 and CEA. In all patients surgical treatment, irradiation, or cytostatic therapy had not been performed. In serum the normal range was exceeded by TPA in 7 patients, CA 12-5 in 3, CEA and AFP in one each, ferritin in 12, prolactin in 2, and β/sub 2/-microglobulin in 10 patients. In one man serum prolactin was reduced. Serum β-HCG was normal in all patients. According to these results serum ferritin, TPA, and β/sub 2/-microglobulin are of great value as tumor markers in patients with renal carcinoma. In several patients the increase of serum β/sub 2/-microglobulin may be ascribed partly to deterioration of renal function. As no consistent patterns of tumor markers in serum were observed it is recommended to determine several tumor markers and not only one of them during the follow-up of patients. Radioimmunoassays for measuring the serum level of tumor markers, especially ferritin, TPA, and β/sub 2/-microglobulin, may considerably assist in the management of patients with renal carcinoma by providing early information about tumor recurrence or metastases

Screening for carcinoma in situ of the contralateral testis in patients with germinal testicular cancer

DEFF Research Database (Denmark)

Berthelsen, J G; Skakkebaek, N E; von der Maase, H

1982-01-01

Two hundred and fifty biopsy specimens from the contralateral testis in patients with unilateral germinal testicular cancer were analysed by light microscopy for carcinoma-in-situ changes. Changes were found in 13 (5.2%) patients. One-third of patients with an atrophic contralateral testis (volume...... of cryptorchidism or both had been screened. Since the natural course of carcinoma in situ in the contralateral testis of patients with germinal testicular cancer has not been established, the patients are being re-evaluated frequently. To date two patients with carcinoma in situ have developed a second cancer....

Renal cell carcinoma in patient with crossed fused renal ectopia

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Ozgur Cakmak

2016-01-01

Full Text Available Primary renal cell carcinomas have rarely been reported in patients with crossed fused renal ectopia. We presented a patient with right to left crossed fused kidney harbouring renal tumor. The most frequent tumor encountered in crossed fused renal ectopia is renal cell carcinoma. In this case, partial nephrectomy was performed which pave way to preservation of the uninvolved both renal units. Due to unpredictable anatomy, careful preoperative planning and meticulous delineation of renal vasculature is essential for preservation of the uninvolved renal units.

Radiation therapy for patients with obstructive jaundice caused by carcinoma of the extrahepatic biliary system

International Nuclear Information System (INIS)

Kawamura, Masashi; Nakagawa, Hirofumi; Kataoka, Masaaki

1992-01-01

From February 1980 through September 1990, 92 patients with obstructive jaundice resulting from biliary tract cancer were registered at Shikoku Cancer Center Hospital or Ehime University Hospital. Radiation therapy (RT) was used to treat 38 of these patients (30 with carcinoma of the extrahepatic bile duct, excluding ampulla of Vater, and eight patients with carcinoma of the gallbladder). Of 38 patients, 11 underwent intraoperative radiation therapy (IORT), and 27 were treated by external radiation therapy (ERT) alone. In contrast, 54 patients (39 with carcinoma of the extrahepatic bile duct and eight with carcinoma of the gallbladder) were not treated by RT. All jaundiced patients received external and/or internal biliary drainage of some kind. Among patients undergoing biliary drainage with a catheter, 21 patients who underwent RT (four with IORT) survived significantly longer than 19 patients who did not (generalized Wilcoxon test: p<0.05). There were no significant differences in survival between 7 patients with recanalization and 11 patients with no recanalization. Concerning the survival of laparotomized patients, excluding those with complete resection or perioperative death, eight patients treated with postoperative ERT survived longer than 12 patients who did not have postoperative ERT (not significant). Eleven patients underwent IORT. A patient with unresectable carcinoma of the hilar bile duct survived 2 years and 3 months after a combination treatment of ERT and IOTR. In four of eight autopsied patients, radiation effects of Grade II were observed (Oboshi and Shimosato's evaluation system for the histological effects of radiation therapy). Our experience suggests that RT is effective in patients with obstructive jaundice caused by carcinoma of the biliary system. (author)

Incidence of thyroid carcinoma in patients with Hashimoto's thyroiditis and solitary cold nodules

Energy Technology Data Exchange (ETDEWEB)

Ott, R.A.; Calandra, D.B.; McCall, A.; Shah, K.H.; Lawrence, A.M.; Paloyan, E.

1985-12-01

The reported incidence of thyroid carcinoma in Hashimoto's thyroiditis varies widely. For this reason the specific subpopulation of patients with Hashimoto's thyroiditis and a solitary cold nodule was analyzed. Between 1972 and 1984 we operated on 146 consecutive patients with solitary cold nodules and Hashimoto's thyroiditis. There were 47 carcinomas, for an incidence of 32%. The mean age of the 146 patients was 43 1/2 years (median 44 years), with 126 females and 20 males. There was a history of prior head and neck radiation exposure in 54 patients, with a 33% incidence of thyroid carcinoma. The 92 patients without a history of radiation exposure had a 31.5% incidence of carcinoma. The frequency of multicentricity (bilateralism) was 33% in the group that underwent radiation and 24% in the group that did not. To date, with a mean follow-up of 4.7 years, there have been no deaths and no evidence of recurrence. In conclusion, we report a 32% incidence of thyroid carcinoma in patients with Hashimoto's thyroiditis and a solitary cold nodule, with no apparent difference between the patients with or without a history of radiation exposure, although there was a higher incidence of bilateralism (33% versus 24%) in the carcinomas of the patients with a history of head and neck irradiation. We suggest that the operative management of these patients is total thyroidectomy for those with a history of head and neck radiation and thyroid lobectomy for patients with no history of radiation, followed by contralateral lobectomy if a carcinoma is demonstrated.

Axillary basal cell carcinoma in patients with Goltz-Gorlin syndrome: report of basal cell carcinoma in both axilla of a woman with basal cell nevus syndrome and literature review.

Science.gov (United States)

Cohen, Philip R

2014-08-17

Basal cell carcinoma of the axilla, an area that is not usually exposed to the sun, is rare. Individuals with basal cell nevus syndrome, a disorder associated with a mutation in the patch 1 (PTCH1) gene, develop numerous basal cell carcinomas. To describe a woman with basal cell nevus syndrome who developed a pigmented basal cell carcinoma in each of her axilla and to review the features of axillary basal cell carcinoma patients with Goltz-Gorlin syndrome. Pubmed was used to search the following terms: axillary basal cell carcinoma and basal cell nevus syndrome. The papers and their citations were evaluated. Basal cell nevus syndrome patients with basal cell carcinoma of the axilla were observed in two women; this represents 2.5% (2 of 79) of the patients with axillary basal cell carcinoma. Both women had pigmented tumors that were histologically nonaggressive. The cancers did not recur after curettage or excision. Basal cell carcinoma of the axilla has only been described in 79 individuals; two of the patients were women with pigmented tumors who had basal cell nevus syndrome. Similar to other patients with axillary basal cell carcinoma, the tumors were histologically nonaggressive and did not recur following treatment. Whether PTCH1 gene mutation predisposes basal cell nevus patients to develop axillary basal cell carcinomas remains to be determined.

Significance of detecting circulating hepatocellular carcinoma cells in peripheral blood of hepatocellular carcinoma patients by nested reverse transcription-polymerase chain reaction and its clinical value: a retrospective study.

Science.gov (United States)

Liu, Yang; Wang, Yue-ru; Wang, Long; Song, Rui-mei; Zhou, Bo; Song, Zhen-shun

2014-01-01

Circulating hepatocellular carcinoma cells may be detected by reverse transcription-polymerase chain reaction. We investigated the relationship between circulating hepatocellular carcinoma cells and hepatoma patient survival after different managements and survival periods. Peripheral vein blood (5 ml) samples were obtained from 113 patients with hepatocellular carcinoma and from 33 control subjects (9 with liver cirrhosis after hepatitis B, 14 with chronic hepatitis B, 10 healthy individuals) between January 1, 2009, and December 31, 2013. To detect circulating hepatocellular carcinoma cells in peripheral blood, alpha-fetoprotein messenger RNA was amplified from total RNA extracted from whole blood by reverse transcription-polymerase chain reaction. Alpha-fetoprotein messenger RNA was detected in 59 blood samples from the hepatocellular carcinoma patients (59/113, 52.2%). In contrast, there were no clinical control subjects whose samples showed detectable alpha-fetoprotein messenger RNA. The presence of alpha-fetoprotein messenger RNA in blood seemed to be correlated with the stage (by TNM classification) of hepatocellular carcinoma, serum alpha-fetoprotein value, and the presence of intrahepatic metastasis, portal vein thrombosis, tumor diameter and/or distant metastasis. In addition, alpha-fetoprotein messenger RNA was detected in the blood of 25 patients showing distant metastasis at extrahepatic organs (100%), in contrast to 32 of 88 cases without metastasis (36.4%). All the patients with hepatocellular carcinoma were followed. Seventeen patients with resection of a T 2 stage hepatocellular carcinoma had a survival of 3.2 years after surgical management, 38 cases with resection of a T3 stage hepatocellular carcinoma had a 1.3-year survival, and only 37 cases with T4 stage disease after different treatments except surgery survived for 0.6 years (P <0.01). The presence of alpha-fetoprotein messenger RNA in peripheral blood may be an indicator of circulating

A Minimization of Speed Ripple of Sensorless DTC for controlled Induction Motors used in Electric Vehicles

OpenAIRE

Khoucha , Farid; Marouani , Khoudir; Kheloui , Abdelaziz; Benbouzid , Mohamed

2006-01-01

International audience; The main theme of this paper is to present different switching techniques in DTC induction motor drives for electric vehicle applications, witch insert zero-voltage vector and/or more non zero-voltage vectors to the conventional switching table associated to full adaptive flux and speed observer. Those techniques are quite effective in reducing the torque pulsation and the speed ripples of the motors, as demonstrated in experimental results.

Association of Papillary Thyroid Carcinoma and Graves' Disease. Unexpected Development and Efficiency of Ablative Dose with Recombinant Human Thyrotropin (rhTSH)

International Nuclear Information System (INIS)

Pacenza, N.A.; Groppo, N.; Guibourg, H.C.

2013-01-01

Differentiated thyroid cancer (DTC) associated with Graves' disease (GD) is a relatively rare disease, occurring in 0.3 % to 9.8 % of GD patients. Some studies suggest an increased aggressiveness of DTC in GD patients, apparently related to thyroid stimulating antibodies. We report the case of a patient with DTC and GD, describing his peculiar evolution. Case report: 22-year-old male who presented with obesity. History of a cousin with DTC and grandmother and mother with goiter. Physical examination: Weight: 116.4 kg, height: 1.73 m, BMI: 38.9. Clinically euthyroid. Thyroid palpation was difficult due to his thick neck. Initial analysis: T3, T4 and TSH within normal range. Thyroid ultrasound (US) showing 11 x 10 mm hypoechoic nodule in right lobe (RL). US-guided fine-needle aspiration (FNA) was requested. Four months later, the patient returned with clinical symptoms of hyperthyroidism (diarrhea, palpitations, insomnia, tremors, cramps and difficulty walking). Laboratory: T3: 557 ng/dl, T4: 18.8 mcg/dl, FT4: 3.73 ng/dl, TSH <0.01 μIU/mL, TPOA: 186 IU/mL, TGA: 965 IU/mL. US-guided FNA: 'Cytological findings are related to papillary thyroid cancer . Thyroid Scan: D iffuse enlargement of the gland, 'warm' nodule in RL . I 131 uptake was: 1st hour: 12 %, 24 hours: 58 %. He received methimazole 20 mg daily. He was operated on 2 months later ( t otal thyroidectomy ) . Pathology: F ollicular variant of papillary thyroid carcinoma in right lobe and classical variant of papillary carcinoma in area of the left lobe . Thirty-five days after surgery (S) (without levothyroxine): TSH <0.01 μIU/mL, Thyroglobulin (Tg) 32.1 ng/mL. Sixty days after S: TSH <0.1 μIU/mL, FT4 1.2 ng/dL, T3 1.3 ng/dL. Clinically euthyroid with normal neck palpation. Chest Computed axial tomography (CT): N ormal . US of the neck: B ilateral thyroid lodge is free . Ninety days later: TSH 0.32 μIU/mL, TRAb 29 % (normal: until 15 %). Thyroid Scan with 99m Tc pertechnetate: P

No evidence of chromosome damage in children and adolescents with differentiated thyroid carcinoma after receiving {sup 131}I radiometabolic therapy, as evaluated by micronucleus assay and microarray analysis

Energy Technology Data Exchange (ETDEWEB)

Federico, Giovanni; Fiore, Lisa; Massart, Francesco; Saggese, Giuseppe [Azienda Ospedaliero-Universitaria Pisana, Department of Pediatrics, Unit of Pediatric Endocrinology and Diabetes, Pisa (Italy); Boni, Giuseppe; Lazzeri, Patrizia; Mariani, Giuliano [Azienda Ospedaliero-Universitaria Pisana, Unit of Nuclear Medicine, Pisa (Italy); Fabiani, Barbara; Verola, Carmela; Scarpato, Roberto [University of Pisa, Department of Biology, Unit of Genetics, Mutagenesis and Environmental Epidemiology, Pisa (Italy); Traino, Claudio [Azienda Ospedaliero-Universitaria Pisana, Health Physics Service, Pisa (Italy)

2008-11-15

As {sup 131}I therapy, used to achieve ablation of thyroid gland remnant, can cause chromosome damage in cultured peripheral lymphocytes especially, we investigated whether administration of radioiodine may induce early genome damage in peripheral T lymphocytes of adolescents with differentiated thyroid carcinoma (DTC). We studied 11 patients, aged 14.8 {+-} 3.1 years, who assumed {sup 131}I (range: 1.11-4.44 GBq) to ablate thyroid remnant. A blood sample for micronucleus assay and for evaluating expression of some genes involved in the DNA repair or the apoptosis pathways was obtained from each patient 1 h before (T{sub 0}) and 24 (T{sub 1}) and 48 h (T{sub 2}) post-radioiodine administration. Compared to T{sub 0}, we did not find any difference in the number of micronucleated cells at both T{sub 1} and T{sub 2} in any subject. Nine out of 11 patients had altered expression levels in a majority of the DNA repair and apoptosis genes at T{sub 1}, which decreased at T{sub 2}. We demonstrated for the first time that peripheral cells of DTC children and adolescents who received {sup 131}I at a mean dosage of 3.50 {+-} 0.37 GBq did not show chromosome damage within 48 h from the end of radiometabolic therapy. This may be due to a prompt activation of the cell machinery that maintains the integrity of the genome to prevent harmful double-strand breaks from progressing to chromosome mutations, either by repairing the lesions or by eliminating the most seriously damaged cells via apoptosis. (orig.)

Clinical outcome of patients with oropharyngeal squamous cell carcinoma

International Nuclear Information System (INIS)

Mikami, Yasukazu; Tsukuda, Mamoru; Mochimatsu, Izumi; Arai, Yasuhiro; Kawai, Satoshi; Enomoto, Hiroyuki

2001-01-01

Sixty patients with squamous cell carcinoma of the oropharynx treated at our hospital from 1991 through 1999 were analyzed. In terms of curative treatments, definitive radiotherapy or curative surgery after neoajuvant chemotherapy had been mainly applied for advanced cases until 1997. Since 1998, advanced cases have been treated with concomitant chemoradiotherapy. The cause-specific survival rate at 5 years for the 60 patients was 50% (stage I, II, 100%; III, 45%; IV A, 36%; IV B, 0%). In the 35 patients with operable advanced-stage disease, the 5-year cause-specific survival rate was 35% in cases treated with definitive radiotherapy, and 66% in those treated with curative surgery, respectively. All 12 operable patients treated with concomitant chemoradiotherapy showed complete response, and 10 patients in this group are disease-free now. However, many problems in definitive treatment modalities, including concomitant chemoradiotherapy for advanced cases with oropharyngeal carcinoma, have not been clarified yet. (author)

Bone scanning in patients with breast carcinoma

International Nuclear Information System (INIS)

Inoue, Y.; Nishi, T.; Hirose, T.; Schichijo, Y.; Ibukuro, K.

1985-01-01

Skeletal imaging using radionuclides has proved to be a sensitive method for the detection of early bony metastases from breast carcinoma. Recent studies have found a relatively low rate of abnormal scans in patients with stage I and II breast cancers, and therefore it is open to question whether bone scanning should be part of the preoperative evaluation of any patient prior to breast surgery. We reviewed our experience with bone scans in 329 patients out of 406 histologically proven breast cancer patients to determine if any or all patients should have this procedure done routinely prior to breast surgery. (orig.) [de

Direct-to-consumer pharmaceutical advertising: physician and public opinion and potential effects on the physician-patient relationship.

Science.gov (United States)

Robinson, Andrew R; Hohmann, Kirsten B; Rifkin, Julie I; Topp, Daniel; Gilroy, Christine M; Pickard, Jeffrey A; Anderson, Robert J

2004-02-23

Previous studies have shown that direct-to-consumer (DTC) pharmaceutical advertising can influence consumer behavior and that many physicians have negative views of these advertisements. Physician and public opinions about these advertisements and how they may affect the physician-patient relationship are not well established. Mail survey of 523 Colorado physicians and 261 national physicians and telephone survey of 500 Colorado households asking respondents to rate their agreement with statements about DTC advertising. Most physicians tended to view DTC advertisements negatively, indicating that such advertisements rarely provide enough information on cost (98.7%), alternative treatment options (94.9%), or adverse effects (54.8%). Most also believed that DTC advertisements affected interactions with patients by lengthening clinical encounters (55.9%), leading to patient requests for specific medications (80.7%), and changing patient expectations of physicians' prescribing practices (67.0%). Only 29.0% of public respondents agreed that DTC advertising is a positive trend in health care and 28.6% indicated that advertisements make them better informed about medical problems; fewer indicated that advertisements motivated them to seek care (10.5%) or led them to request specific medications from their physicians (13.3%). Most physicians have negative views of DTC pharmaceutical advertising and see several potential effects of these advertisements on the physician-patient relationship. Many public respondents have similarly negative views, and only a few agree that they change their expectations of or interactions with physicians. While these advertisements may be influencing only a few consumers, it seems that the impact on physicians and their interactions with patients may be significant.

Histological pattern of Merkel cell carcinoma sentinel lymph node metastasis improves stratification of Stage III patients.

Science.gov (United States)

Ko, Jennifer S; Prieto, Victor G; Elson, Paul J; Vilain, Ricardo E; Pulitzer, Melissa P; Scolyer, Richard A; Reynolds, Jordan P; Piliang, Melissa P; Ernstoff, Marc S; Gastman, Brian R; Billings, Steven D

2016-02-01

Sentinel lymph node biopsy is used to stage Merkel cell carcinoma, but its prognostic value has been questioned. Furthermore, predictors of outcome in sentinel lymph node positive Merkel cell carcinoma patients are poorly defined. In breast carcinoma, isolated immunohistochemically positive tumor cells have no impact, but in melanoma they are considered significant. The significance of sentinel lymph node metastasis tumor burden (including isolated tumor cells) and pattern of involvement in Merkel cell carcinoma are unknown. In this study, 64 Merkel cell carcinomas involving sentinel lymph nodes and corresponding immunohistochemical stains were reviewed and clinicopathological predictors of outcome were sought. Five metastatic patterns were identified: (1) sheet-like (n=38, 59%); (2) non-solid parafollicular (n=4, 6%); (3) sinusoidal, (n=11, 17%); (4) perivascular hilar (n=1, 2%); and (5) rare scattered parenchymal cells (n=10, 16%). At the time of follow-up, 30/63 (48%) patients had died with 21 (33%) attributable to Merkel cell carcinoma. Patients with pattern 1 metastases had poorer overall survival compared with patients with patterns 2-5 metastases (P=0.03), with 22/30 (73%) deaths occurring in pattern 1 patients. Three (10%) deaths occurred in patients showing pattern 5, all of whom were immunosuppressed. Four (13%) deaths occurred in pattern 3 patients and 1 (3%) death occurred in a pattern 2 patient. In multivariable analysis, the number of positive sentinel lymph nodes (1 or 2 versus >2, PMerkel cell carcinoma, the pattern of sentinel lymph node involvement provides important prognostic information and utilizing this data with other clinicopathological features facilitates risk stratification of Merkel cell carcinoma patients who may have management implications.

Dependence of radiotherapeutic results on tumor size in patients with cervix uteri carcinoma

International Nuclear Information System (INIS)

Gabelov, A.A.; Zharinov, G.M.

1981-01-01

A method is suggested that permits specifying the primary tumor size on the basis of clinical examination of patients with cervix uteri carcinoma. The values of tumor size have been correlated with long-term results of concomitant radiotherapy in 1358 patients with cervix uteri carcinoma. The data obtained have shown that the primary tumor size is a factor that determines to a large extent radiotherapeutic results in patients with cervix uteri carcinoma. The specification of tumor size values makes it possible to considerably lessen prognostic uncertainty of present-day staging classifications. The structure of radiotherapeutic failures also turned out to be closely associated with the primary tumor size

Examining recombinant human TSH primed 131I therapy protocol in patients with metastatic differentiated thyroid carcinoma: comparison with the traditional thyroid hormone withdrawal protocol

International Nuclear Information System (INIS)

Rani, Deepa; Kaisar, Sushma; Awasare, Sushma; Kamaldeep; Abhyankar, Amit; Basu, Sandip

2014-01-01

Recombinant human thyroid-stimulating hormone (rhTSH)-based protocol is a promising recent development in the management of differentiated thyroid carcinoma (DTC). The objectives of this prospective study were: (1) to assess the feasibility and efficacy of the rhTSH primed 131 I therapy protocol in patients with DTC with distant metastatic disease, (2) to perform lesional dosimetry in this group of patients compared to the traditional protocol, (3) to document the practical advantages (patient symptoms and hospital stay) of the rhTSH protocol compared to the traditional thyroid hormone withdrawal protocol, (4) to document and record any adverse effect of this strategy, (5) to compare the renal function parameters, and (6) to compare the serum TSH values achieved in either of the protocols in this group of patients. The study included 37 patients with metastatic DTC having lung or skeletal metastases or both. A comparison of lesional radiation absorbed dose, hospital stay, renal function tests, and symptom profile was undertaken between the traditional thyroid hormone withdrawal protocol and rhTSH-based therapy protocol. Dosimetric calculations of metastatic lesions were performed using lesion uptake and survey meter readings for calculation of effective half-life. Non-contrast-enhanced CT was used for assessment of tumor volume. Quality of life was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QOL forms. A comparison of pretreatment withdrawal thyroglobulin (TG) was done with the withdrawal TG level 3 months after treatment. The mean effective half-life of 131 I in metastatic lesions was less during the rhTSH protocol (29.49 h) compared to the thyroid hormone withdrawal protocol (35.48 h), but the difference was not statistically significant (p = 0.056). The mean 24-h % uptake of the lesions during the traditional protocol (4.84 %) was slightly higher than the 24-h % uptake during the rhTSH protocol (3.56 %), but the

Nasopharyngeal carcinomas: analysis of patient, tumor and treatment characteristics determining outcome

International Nuclear Information System (INIS)

Erkal, Haldun S.; Serin, Meltem; Cakmak, Ahmet

2001-01-01

Purpose: The present study reviews the experience in treatment of 447 patients with nasopharyngeal carcinomas, analyzing patient, tumor and treatment characteristics determining outcome. Materials and methods: There were 322 males and 125 females, their ages ranging from 7 to 85 years (median, 45 years). Two-hundred and seventy-two patients had World Health Organization (WHO) type 3 carcinomas, 123 patients had T4 tumors and 320 patients had metastatic cervical lymph nodes. Three-hundred and eight patients were treated with radiation therapy alone and 139 patients with chemotherapy in combination with radiation therapy. Cumulative radiation dose to primary tumor ranged from 50 to 76 Gy (median, 70 Gy) and radiation dose to metastatic cervical lymph nodes ranged from 46 to 74 Gy (median, 66 Gy). Results: Follow-up ranged from 0.1 to 19.5 years (mean, 7.6 years). Local complete response was achieved in 357 patients. In multivariate analysis, T-classification, cumulative radiation dose to primary tumor and treatment with chemotherapy in combination with radiation therapy predicted local response. Nodal complete response was achieved in 272 patients. In multivariate analysis, N-classification and radiation dose to metastatic cervical lymph nodes predicted nodal response. Local failure was observed in 70 patients, nodal failure in 35 patients and systemic failure in 114 patients. Overall survival, disease-free survival and disease-specific survival were 33, 32 and 37%, respectively, at 10 years. In multivariate analysis, age, T-classification, N-classification, radiation dose and treatment with chemotherapy in combination with radiation therapy predicted overall survival whereas T-classification, N-classification, radiation dose and treatment with chemotherapy in combination with radiation therapy predicted both disease-free survival and disease-specific survival. Conclusions: Radiation therapy alone appears to be an adequate and viable treatment for patients with early

Gingival squamous cell carcinoma: imaging analysis of seven patients

International Nuclear Information System (INIS)

Souza, Ricardo Pires de; Moreira, Paulo de Tarso Barbosa; Paes Junior, Ademar Jose de Oliveira; Pacheco Netto, Mario C.; Rapoport, Abrao; Soares, Aldemir Humberto

2003-01-01

The authors studied seven patients with gingival carcinoma attended at the Head and Neck Surgery and Otorrhinolaryngology Service and the Diagnostic Imaging Service of 'Complexo Hospitalar Heliopolis', Sao Paulo, SP, Brazil, between 1985 and 1996. Squamous cell type carcinomas were identified in all cases. All patients were male (100%) aged 48-72 years. Computed tomography was performed in six patients (85.6%). Four patients (57.1%) had not received any treatment before imaging examination whereas three patients (42.8%) had already been submitted to surgery or radiotherapy. The authors analyzed the primary site of the tumor and its extension to the mandible (5/7 cases; 71.4%), the floor of the mouth (3/7 cases; 42.8%), the floor of the maxillary sinus (1/7 cases; 14.2%) and the retromolar trigonum (1/7 cases; 14.2%). Metastatic lymph nodes were observed in five patients (71.4%). Diagnosis was confirmed by biopsy and histopathological examination in all cases. Comparison with surgical findings was possible in five cases (71.4%). (author)

Antinuclear antibodies in the sera of patients with nasopharyngeal carcinoma

Energy Technology Data Exchange (ETDEWEB)

Takimoto, T.; Ishikawa, S.; Masuda, K.; Tanaka, S.; Yoshizaki, T.; Umeda, R. (Kanazawa Univ. (Japan))

1989-11-01

We studied the production of heterophile antinuclear antibodies (ANAs) in the sera of 50 patients, 20 with nasopharyngeal carcinoma (NPC) and 30 with other head and neck cancers (laryngeal cancer and maxillary cancer), before and after radiation therapy. A higher incidence of ANAs was found in the sera of patients with NPC and ANA production in these patients was higher after radiation therapy. We therefore performed in vitro experiments to explore the mechanisms of ANA production in the serum of postirradiated NPC patients. X-ray-irradiated NPC-derived cells (NPC-KT) produced a large amount of Epstein-Barr virus (NPC EBV) compared with non-irradiated NPC-KT cells. Nasopharyngeal carcinoma EBV-infected lymphocytes produced high levels of ANAs. These data suggest that lymphocytes infected by EBV from NPC cells may produce ANAs in the sera of NPC patients.

High endothelin-converting enzyme-1 expression independently predicts poor survival of patients with esophageal squamous cell carcinoma.

Science.gov (United States)

Wu, Ching-Fang; Lee, Ching-Tai; Kuo, Yao-Hung; Chen, Tzu-Haw; Chang, Chi-Yang; Chang, I-Wei; Wang, Wen-Lun

2017-09-01

Patients with esophageal squamous cell carcinoma have poor survival and high recurrence rate, thus an effective prognostic biomarker is needed. Endothelin-converting enzyme-1 is responsible for biosynthesis of endothelin-1, which promotes growth and invasion of human cancers. The role of endothelin-converting enzyme-1 in esophageal squamous cell carcinoma is still unknown. Therefore, this study investigated the significance of endothelin-converting enzyme-1 expression in esophageal squamous cell carcinoma clinically. We enrolled patients with esophageal squamous cell carcinoma who provided pretreated tumor tissues. Tumor endothelin-converting enzyme-1 expression was evaluated by immunohistochemistry and was defined as either low or high expression. Then we evaluated whether tumor endothelin-converting enzyme-1 expression had any association with clinicopathological findings or predicted survival of patients with esophageal squamous cell carcinoma. Overall, 54 of 99 patients with esophageal squamous cell carcinoma had high tumor endothelin-converting enzyme-1 expression, which was significantly associated with lymph node metastasis ( p = 0.04). In addition, tumor endothelin-converting enzyme-1 expression independently predicted survival of patients with esophageal squamous cell carcinoma, and the 5-year survival was poorer in patients with high tumor endothelin-converting enzyme-1 expression ( p = 0.016). Among patients with locally advanced and potentially resectable esophageal squamous cell carcinoma (stage II and III), 5-year survival was poorer with high tumor endothelin-converting enzyme-1 expression ( p = 0.003). High tumor endothelin-converting enzyme-1 expression also significantly predicted poorer survival of patients in this population. In patients with esophageal squamous cell carcinoma, high tumor endothelin-converting enzyme-1 expression might indicate high tumor invasive property. Therefore, tumor endothelin-converting enzyme-1 expression

Platinum-based chemotherapy with or without thoracic radiation therapy in patients with unresectable thymic carcinoma

International Nuclear Information System (INIS)

Nakamura, Yoichi; Kunitoh, Hideo; Kubota, Kaoru

2000-01-01

Thymic carcinoma is a rare mediastinal neoplasm with poor prognosis. Although the clinical benefit of chemotherapy for thymic carcinoma is controversial, cisplatin-based chemotherapy with or without radiation therapy is ordinarily adopted in advanced cases. We evaluated the clinical outcome of platinum-based chemotherapy with or without radiation therapy in unresectable thymic carcinoma patients. Ten patients with unresectable thymic carcinoma were treated with platinum-based chemotherapy with or without radiation therapy in the National Cancer Center Hospital between 1989 and 1998. We reviewed the histological type, treatment, response and survival of these patients. Four of the 10 patients responded to chemotherapy and both the median progression-free survival period and the median response duration were 6.0 months. The median survival time was 11.0 months. There was no relationship between histological classification and prognosis. Platinum-based chemotherapy with or without thoracic radiation is, regardless of tumor histology, marginally effective in advanced thymic carcinoma patients, giving only a modest tumor response rate and short response duration and survival. (author)

Self-expandable metallic stents for patients with recurrent esophageal carcinoma after failure of primary chemoradiotherapy

Energy Technology Data Exchange (ETDEWEB)

Muto, Manabu; Ohtsu, Atsushi; Boku, Narikazu; Yoshida, Shigeaki [National Cancer Center, Kashiwa, Chiba (Japan). Hospital East; Miyata, Yoshinori; Shioyama, Yasukazu

2001-06-01

Recent advances in chemoradiotherapy for esophageal carcinoma have resulted in improved survival rates. However, there are few options for recurrent dysphagia due to refractory carcinoma after failure of primary chemoradiotherapy. The aim of this study was to evaluate the safety and efficacy of self-expandable metallic stent placement for patients with recurrent esophageal carcinoma where definitive chemoradiotherapy has failed. Thirteen consecutive patients with recurrent squamous cell carcinoma of the esophagus, in whom self-expandable metallic stents were placed after failure of primary chemoradiotherapy, were studied retrospectively. All patients had esophageal obstruction or malignant fistula. The oral alimentation status of nine of 13 patients (69%) improved after successful placement of the stent. Following placement of the stent, fever (>38 deg C) and severe chest pain occurred in 85% (11/13) of the patients. In all patients examined, C-reactive protein was elevated within 1 week of the operation. Esophageal perforation occurred in three patients. Stent-related mediastinitis and pneumonia developed in six (46%) and three (23%) patients, respectively. Seven of the 13 patients (54%) died of stent-related pulmonary complications. Although the placement of a self-expandable metallic stent for patients with recurrent esophageal carcinoma after failure of chemoradiotherapy improved their oral alimentation status, we found that this treatment increases the risk of life-threatening pulmonary complications. (author)

Self-expandable metallic stents for patients with recurrent esophageal carcinoma after failure of primary chemoradiotherapy

International Nuclear Information System (INIS)

Muto, Manabu; Ohtsu, Atsushi; Boku, Narikazu; Yoshida, Shigeaki; Miyata, Yoshinori; Shioyama, Yasukazu

2001-01-01

Recent advances in chemoradiotherapy for esophageal carcinoma have resulted in improved survival rates. However, there are few options for recurrent dysphagia due to refractory carcinoma after failure of primary chemoradiotherapy. The aim of this study was to evaluate the safety and efficacy of self-expandable metallic stent placement for patients with recurrent esophageal carcinoma where definitive chemoradiotherapy has failed. Thirteen consecutive patients with recurrent squamous cell carcinoma of the esophagus, in whom self-expandable metallic stents were placed after failure of primary chemoradiotherapy, were studied retrospectively. All patients had esophageal obstruction or malignant fistula. The oral alimentation status of nine of 13 patients (69%) improved after successful placement of the stent. Following placement of the stent, fever (>38 deg C) and severe chest pain occurred in 85% (11/13) of the patients. In all patients examined, C-reactive protein was elevated within 1 week of the operation. Esophageal perforation occurred in three patients. Stent-related mediastinitis and pneumonia developed in six (46%) and three (23%) patients, respectively. Seven of the 13 patients (54%) died of stent-related pulmonary complications. Although the placement of a self-expandable metallic stent for patients with recurrent esophageal carcinoma after failure of chemoradiotherapy improved their oral alimentation status, we found that this treatment increases the risk of life-threatening pulmonary complications. (author)

Treatment patterns, health state, and health care resource utilization of patients with radioactive iodine refractory differentiated thyroid cancer

International Nuclear Information System (INIS)

Gianoukakis, Andrew G; Flores, Natalia M; Pelletier, Corey L; Forsythe, Anna; Wolfe, Gregory R; Taylor, Matthew H

2016-01-01

Patients with differentiated thyroid cancer (DTC) often respond well to treatment but some become refractory to radioactive iodine (RAI) treatment, and treatment options are limited. Despite the humanistic and economic burden RAI refractory disease imposes on patients, published research concerning treatment patterns and health care resource utilization is sparse. Data were collected from an online retrospective chart review study in the US and five European Union (EU) countries (France, Germany, Italy, Spain, and UK) with physicians recruited from an online panel. Physicians (N=211) provided demographics, disease history, treatment information, and health care resource utilization for one to four of their patients with radioactive iodine refractory differentiated thyroid cancer (RR-DTC). The majority of the patients with RR-DTC (N=623) were female (56%), and their mean age was 58.2 years. In this sample, 63.2% had papillary thyroid cancer and 57.0% were in Stage IV when deemed RAI refractory. Patients with RR-DTC experienced regional recurrence in the thyroid bed/central neck area (25.3%) and had distant metastatic disease (53.6%). At the time data were collected, 50.7% were receiving systemic treatment. Of those, 78.5% were on first-line treatment and 62.7% were receiving multikinase inhibitors. Regional differences for prescribed treatments were observed; the US was more likely to have patients receiving multikinase inhibitors (79.2%) compared with UK (41.2%) and Italy (17.1%). Additional details regarding treatment patterns and resource utilization are discussed. The current study aimed to obtain a greater understanding of RR-DTC treatment globally. These results can assist in the development and implementation of treatment guidelines and ultimately enhance the care of patients with RR-DTC

Oat cell carcinoma of esophagus: a report of six British patients with a review of the literature

International Nuclear Information System (INIS)

Doherty, M.A.; McIntyre, M.; Arnott, S.J.

1984-01-01

This paper presents 6 British patients with a diagnosis of oat cell carcinoma of the esophagus. Sixty-six patients have previously been reported in the literature, the majority (30) being British. Approximately two-thirds of these tumors have been reported as pure oat cell carcinoma of the esophagus. Four other histological patterns have been described: oat cell carcinoma with squamous carcinoma in situ; oat cell carcinoma with squamous carcinoma; oat cell carcinoma with adenocarcinoma; and oat cell carcinoma with carcinoid differentiation. A preponderance of males has also been noted, although this series shows a 2:1 female:male ratio. The tumor arises most commonly in the mid or lower esophagus. The cell of origin of these tumors is considered to be the Kulchitsky or APUD cell of neuroectodermal derivation. They may show neurosecretory granules on electron microsopy. Polypeptides have been identified within the tumor cells. One previous report describes a patient with primary oat cell carcinoma of the esophagus and hypercalcemia. A patient with the syndrome of inappropriate anti-diuretic hormone secretion is described in this paper. Survival is poor following radiotherapy, with a median survival of 3 months in this series. On reviewing the records of the Radiation Oncology Unit in Edinburgh, no patient with oat cell carcinoma of the esophagus was reported before 1972. This suggests that awareness of this tumor is increasing and, although rare, its incidence is greater than previously reported

Applicability of 3D-CT facial reconstruction for forensic individual identification Aplicabilidade da reconstrução facial em 3D-TC para identificação individual forense

Directory of Open Access Journals (Sweden)

Sara dos Santos Rocha

2003-03-01

Full Text Available Computed tomography (CT is used in several clinical dentistry applications even by axial slices and two and three-dimensional reconstructed images (2D-CT and 3D-CT. The purpose of the current study is to assess the precision of linear measurements made in 3D-CT using craniometric patterns for individual identification in Forensic Dentistry. Five cadaver heads were submitted to a spiral computed tomography using axial slices, and 3D-CT reconstructions were obtained by volume rendering technique with computer graphics tools. Ten (10 craniometric measurements were determined in 3D-CT images by two examiners independently, twice each, and the standard error of intra- and inter-examiner measurements was assessed. The results demonstrated a low standard error of those measurements, from 0.85% to 3.09%. In conclusion, the linear measurements obtained in osseous and soft tissue structures were considered to be precise in 3D-CT with high imaging quality and resolution.A tomografia computadorizada (TC tem sido utilizada em diversas áreas clínicas da Odontologia; utilizam-se tanto seus cortes originais quanto as reconstruções em duas e três dimensões (2D-TC e 3D-TC. O presente estudo propõe avaliar a precisão das medidas lineares realizadas na 3D-TC, utilizando a craniometria, para fins de identificação individual na Odontologia Forense. Cinco cabeças de cadáveres foram submetidas a tomografia computadorizada em espiral por meio de cortes axiais e reconstruções em 3D-TC foram obtidas por meio da técnica de volume, utilizando recursos da computação gráfica. Medidas craniométricas (n = 10 foram determinadas nas imagens em 3D-TC por dois examinadores independentemente, duas vezes cada um, e uma análise de erro padrão percentual das medidas intra- e inter-examinadores foi realizada. Os resultados demonstraram um erro padrão percentual baixo apresentado por essas medidas, variando entre 0,85% e 3,09%. Em conclusão, as medidas lineares

Contribution of computed tomography in patients with lung metastases of differentiated thyroid carcinoma not apparent on plain radiography who were treated with radioiodine

International Nuclear Information System (INIS)

Rosario, Pedro W.S.; Purisch, Saulo; Barroso, Alvarao L.; Rezende, Leonardo L.; Padrao, Eduardo L.

2008-01-01

Computed tomography (CT or CAT Scan) of the chest is more sensitive than radiography in the detection of lung metastases of differentiated thyroid cancer (DTC), but little information is available regarding the aggregated value of this method. The present study evaluated the response of patients with lung metastases of DTC not apparent on radiography to treatment with 131 I and the value of CT in these cases. Twenty-five patients with lung metastases not apparent on radiography, who initially received 100-200 mCi I 151 , were evaluated and those presenting pulmonary uptake on post-therapy WBS were submitted to a new treatment after 6 to 12 months, and so on. The chance of detection of pulmonary uptake on post-therapy WBS did not differ between patients with negative and positive CT (100% versus 91.5%). Mean serum Tg levels were higher in patients with positive CT (108 ng/ml versus 52 ng/ml). Negative post-therapy WBS was achieved in 82% of patients with positive CT and in 92.3% with negative CT and the cumulative I 131 activity necessary to achieve this outcome did not differ between the two groups (mean = 300 mCi). Stimulated Tg was undetectable in 47% of patients with negative CT at the end of treatment, but in none of the patients whose CT continued to be positive. In patients with elevated Tg, the CT result apparently did not change the indication of therapy or the I 131 activity to be administered. In cases with lung metastases, the persistence of micronodules on CT was associated with the persistence of detectable Tg in patients presenting negative post-therapy WBS. (author)

Hypercalcaemia in a patient with fatal adenosquamous carcinoma of the colon

International Nuclear Information System (INIS)

Links, M.; Ho, Happy; Clingan, Ph.; Diamond, T.

1994-01-01

This article reports a rare manifestation of metastatic adenosquamous carcinoma of the colon in a patient presenting with humoral hypercalcaemia of malignancy mediated by parathyroid hormone related peptide (PTHrP). A 58-year-old man with metastatic adenosquamous carcinoma of the colon presented with hypercalcaemia. A technetium bone scan was performed and excluded osteolytic bone secondaries. A negative parathyroid subtraction scan and a low serum immunoreactive parathyroid hormone level made the diagnosis of primary hyperparathyroidism unlikely. The diagnosis of humoral hypercalcaemia of malignancy was considered on the basis of an elevated serum PTHrP level and positive tumour immunoreactivity to PTHrP antiserum. The hypercalcaemia was effectively treated on two occasions with intravenous administration of aminohydroxy propilidene diphosphonate. Despite interventional chemotherapy, the patient died of progressive carcinomatosis. It is concluded that hypercalcaemia is an extremely rare occurrence in carcinoma of the colon, This being the first documented case of humoral hyper-calcaemia of malignancy associated with adenosquamous carcinoma of the colon mediated by PTHrP. 11 refs., 1 fig

[A Distal Bile Duct Carcinoma Patient Who Underwent Surgical Resection for Liver Metastasis].

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Komiyama, Sosuke; Izumiya, Yasuhito; Kimura, Yu; Nakashima, Shingo; Kin, Syuichi; Kawakami, Sadao

2018-03-01

A 70-year-old man with distal bile duct carcinoma underwent a subtotal stomach-preserving pancreaticoduodenectomy without adjuvant chemotherapy. One and a half years after the surgery, elevated levels of serum SPan-1(38.1 U/mL)were observed and CT scans demonstrated a solitary metastasis, 25mm in size, in segment 8 of the liver. The patient received 2 courses of gemcitabine-cisplatin combination chemotherapy. No new lesions were detected after chemotherapy and the patient underwent a partial liver resection of segment 8. The pathological examination revealed a metachronous distant metastasis originating from the bile duct carcinoma. Subsequently, the patient received S-1 adjuvant chemotherapy for 6 months. Following completion of all therapies, the patient survived without tumor recurrence for 3 years and 10 months after the initial operation. Thus, surgical interventions might be effective in improving prognosis among selected patients with postoperative liver metastasis of bile duct carcinoma.

Management of Merkel cell carcinoma: Role of radiotherapy in elderly patients

International Nuclear Information System (INIS)

Assouline, A.; Krzisch, C.; Assouline, A.; Levy, A.; Mazeron, J.J.; Mazeron, J.J.; Chargari, C.

2010-01-01

Purpose Merkel cell carcinoma carcinoma (M.C.C.) or primary cutaneous neuroendocrine carcinoma is a rare and aggressive malignancy affecting elderly. Optimal therapeutic strategy has not yet been established in elderly patients. Patients and methods From March 1996 to March 2007, 29 patients with Merkel cell carcinoma of were treated at the University Hospital of Amiens, France. Adjuvant radiotherapy (R.T.) was performed for 14 patients (50%) on the tumor bed with margins of 3 to 5 cm, an average dose of 46 Gy (30-60 Gy), by 2 Gy per fraction. Ten of them also received R.T. to the lymph node area at mean dose of 44.3 Gy (26-50 Gy). Duration of R.T. was 35 days. A retrospective analysis was conducted to better evaluate survival and prognostic factors. Results Median overall survival (O.S.) was 18.9 months (3-122) and the median time to progression (M.T.P.) 5.5 months (1-26). At 5 years, O.S. for irradiated patients was 47% (IC95: 12-82%) versus 27% (IC95: 5-49%) in cases of surgery alone (p = 0.032). The most frequent sites of recurrence were nodal (34.5%), local (24.1%) and metastatic (17.2%). For patients over 70 years, eight (36.5%) were free of disease at last news, 8 (36.5%) had died from cancer and six from other causes (27%). In this subgroup, M.T.P. was 6 months (2-19) and median O.S. of 19 months (4-87). There was no acute toxicity greater than grade 2. Conclusion Although limited by a retrospective analysis, this report suggests an advantage of postoperative R.T. for patients with M.C.C.. It combined low toxicity and improvement of survival. Prospective multicenter trials are needed to clarify and validate the optimal strategy. (authors)

Patient Benefit-Risk Tradeoffs for Radioactive Iodine-Refractory Differentiated Thyroid Cancer Treatments

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Ateesha F. Mohamed

2015-01-01

Full Text Available Background. The aims of this study were to assess patients’ preferences to wait or start systemic treatment and understand how patients would make tradeoffs between certain severe adverse events (AEs and additional months of progression-free survival (PFS. Materials and Methods. Adults in France, Germany, and Spain with a diagnosis of DTC and who have had at least one RAI treatment completed a direct-elicitation question and a discrete-choice experiment (DCE online. The direct-elicitation question asked respondents whether they would opt out of treatment when their tumor is RAI-R. In the DCE, respondents chose between 12 pairs of hypothetical RAI-R DTC treatment profiles. Profiles were defined by magnitudes of efficacy (PFS and safety (severe hand-foot skin reaction [HFSR], severe proteinuria, and severe hypertension. A main-effects random-parameters logit model was estimated. Results. 134 patients completed the survey. Most patients (86.6% opted for treatment rather than “wait and see” decision. Patients placed a greater weight on the risk of severe hypertension than the risk of proteinuria and HFSR. Conclusions. DTC patients showed preference toward treatment for RAI-R DTC over watchful waiting. Patients’ concerns about the risk of severe hypertension appeared to have had a greater effect on patients’ choice than severe proteinuria or HFSR.

Should patients with extrapulmonary small-cell carcinoma receive prophylactic cranial irradiation?

LENUS (Irish Health Repository)

Naidoo, Jarushka

2013-09-01

Extrapulmonary small-cell carcinoma (EPSCC) is a rare disease. Management is based on small-cell lung carcinoma. Prophylactic cranial irradiation (PCI) is not routinely administered in EPSCC. This study investigates the role of PCI in EPSCC, by analyzing the incidence, treatment, and survival of patients with brain metastases in a national cohort. Disease biology and epidemiology are also investigated.

Disease-Specific Mortality of Differentiated Thyroid Cancer Patients in Korea: A Multicenter Cohort Study

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Min Ji Jeon

2017-11-01

Full Text Available BackgroundLittle is known regarding disease-specific mortality of differentiated thyroid cancer (DTC patients and its risk factors in Korea.MethodsWe retrospectively reviewed a large multi-center cohort of thyroid cancer from six Korean hospitals and included 8,058 DTC patients who underwent initial surgery between 1996 and 2005.ResultsMean age of patients at diagnosis was 46.2±12.3 years; 87% were females. Most patients had papillary thyroid cancer (PTC; 97% and underwent total thyroidectomy (85%. Mean size of the primary tumor was 1.6±1.0 cm. Approximately 40% of patients had cervical lymph node (LN metastases and 1.3% had synchronous distant metastases. During 11.3 years of follow-up, 150 disease-specific mortalities (1.9% occurred; the 10-year disease-specific survival (DSS rate was 98%. According to the year of diagnosis, the number of disease-specific mortality was not different. However, the rate of disease-specific mortality decreased during the study period (from 7.7% to 0.7%. Older age (≥45 years at diagnosis, male, follicular thyroid cancer (FTC versus PTC, larger tumor size (>2 cm, presence of extrathyroidal extension (ETE, lateral cervical LN metastasis, distant metastasis and tumor node metastasis (TNM stage were independent risk factors of disease-specific mortality of DTC patients.ConclusionThe rate of disease-specific mortality of Korean DTC patients was 1.9%; the 10-year DSS rate was 98% during 1996 to 2005. Older age at diagnosis, male, FTC, larger tumor size, presence of ETE, lateral cervical LN metastasis, distant metastasis, and TNM stages were significant risk factors of disease-specific mortality of Korean DTC patients.

[Care pathway of patients with hepatocellular carcinoma in France: State of play in 2017].

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Costentin, Charlotte; Ganne-Carrié, Nathalie; Rousseau, Benoit; Gérolami, René; Barbare, Jean-Claude

2017-09-01

Hepatocellular carcinoma is a major public health problem with one of the highest overall mortality compared to other cancers. The median overall survival in France in a hospital population with hepatocellular carcinoma is 9.4 months. Several publications reported a positive impact of hepatocellular carcinoma screening on diagnosis at an early-stage, eligibility for curative treatment and overall survival. However, the identification of patients to be included in a hepatocellular carcinoma screening program and the application of screening recommendations are not optimal. Other studies suggest a potentially negative impact of delayed diagnosis or treatment initiation on the patient's prognosis. Finally, marked variations between French regions and departments have been described in terms of access to curative treatment and overall survival. In this review article, we propose a state of play of the hepatocellular carcinoma patient's care pathway in France with the aim of identifying potential breaking points with negative impact on prognosis and of developing proposals for improvement. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Clinical management and outcomes in patients with hyperfunctioning distant metastases from differentiated thyroid cancer after total thyroidectomy and radioactive iodine therapy.

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Qiu, Zhong-Ling; Shen, Chen-Tian; Luo, Quan-Yong

2015-02-01

Hyperfunctioning distant metastasis (HFDM) from differentiated thyroid cancer (DTC) is a rare entity. This study aimed to assess the outcomes of DTC patients presenting with HFDM after total thyroidectomy and radioactive iodine therapy. A total of 5367 DTC patients treated with (131)I after total thyroidectomy were analyzed retrospectively from January 1991 to June 2013. Therapeutic efficacy was evaluated based on changes in serum thyroglobulin (Tg) and anatomical imaging changes in metastatic lesions. The relationships between survival time and several variables were assessed by univariate and multivariate analyses using the Kaplan-Meier method and Cox's proportional hazards model respectively. Thirty-eight patients with HFDM from DTC were diagnosed, including four with hyperthyroidism, four with subclinical hyperthyroidism, and three with subclinical hypothyroidism. The remaining 27 were euthyroid. Of 25 patients with lung metastases, 84% (21/25) showed disappearance or shrinkage of lung nodules; of 24 patients with bone metastases, 66.67% (16/24) exhibited no obvious imaging changes in metastatic bone lesions after (131)I therapy. Serum Tg decreased significantly in 81.58% (31/38) and increased in 18.42% (7/38) after (131)I therapy. The 10-year survival rate of DTC patients with HFDM was 65.79% (25/38). Multivariate analyses identified age at occurrence of distant metastases (thyroid cancer (PTC; p=0.032, NA, and 0.043) as independent predictors of survival. The response of hyperfunctioning lung metastases to (131)I treatment was better than that of non-hyperfunctioning lung metastases in DTC, while hyperfunctioning bone metastases responded similarly compared to non-hyperfunctioning bone metastases. Patients younger than 45 years at occurrence of distant metastases, those with only lung metastases, and patients with PTC had better prognoses.

Clinicopathologic Predictive Factors of Cervical Lymph Node Metastasis in Differentiated Thyroid Cancer.

Science.gov (United States)

Sun, Ronghao; Zhang, Hua; Liu, Kun; Fan, Jinchuan; Li, Guojun; Song, Xicheng; Li, Chao

Cervical lymph node metastasis (LNM) has been proven to be a predictor for locoregional recurrence in differentiated thyroid carcinoma (DTC). Clinicopathological features could be effective predictive factors for central and lateral LNM of DTC, and provide references to surgeons for cervical neck dissection. Retrospective analysis of clinicopathological data was performed on 420 patients who underwent initial surgery from 2010 to 2015. The incidence of central and lateral LNM was calculated. Of 420 patients, 247 (58.8%) exhibited central LNM, and 185 (44.1%) exhibited lateral LNM. There were 29 (6.9%) cases confirmed to have skip metastasis. Univariate and multivariate analysis revealed that tumour location, tumour size, multifocality, capsular invasion, affected lobes, and age were independent predictors of central LNM. Tumour location, capsular invasion, affected lobes, and tumour size were independent predictors of lateral LNM. Our findings suggest that tumour location, affected lobes, capsular invasion, age, tumour size and multifocality may be taken as predictive factors for cervical LNM of DTC. Meticulous perioperative evaluation of cervical LNM and prophylactic cervical lymph node dissection that aims to remove the occult lymph nodes may be an option for DTC with risk factors. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Universal Point of Care Testing for Lynch Syndrome in Patients with Upper Tract Urothelial Carcinoma.

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Metcalfe, Michael J; Petros, Firas G; Rao, Priya; Mork, Maureen E; Xiao, Lianchun; Broaddus, Russell R; Matin, Surena F

2018-01-01

Patients with Lynch syndrome are at risk for upper tract urothelial carcinoma. We sought to identify the incidence and most reliable means of point of care screening for Lynch syndrome in patients with upper tract urothelial carcinoma. A total of 115 consecutive patients with upper tract urothelial carcinoma without a history of Lynch syndrome were universally screened during followup from January 2013 through July 2016. We evaluated patient and family history using AMS (Amsterdam criteria) I and II, and tumor immunohistochemistry for mismatch repair proteins and microsatellite instability. Patients who were positive for AMS I/II, microsatellite instability or immunohistochemistry were classified as potentially having Lynch syndrome and referred for clinical genetic analysis and counseling. Patients with known Lynch syndrome served as positive controls. Of the 115 patients 16 (13.9%) screened positive for potential Lynch syndrome. Of these patients 7.0% met AMS II criteria, 11.3% had loss of at least 1 mismatch repair protein and 6.0% had high microsatellite instability. All 16 patients were referred for germline testing, 9 completed genetic analysis and counseling, and 6 were confirmed to have Lynch syndrome. All 7 patients with upper tract urothelial carcinoma who had a known history of Lynch syndrome were positive for AMS II criteria and at least a single mismatch repair protein loss while 5 of 6 had high microsatellite instability. We identified 13.9% of upper tract urothelial carcinoma cases as potential Lynch syndrome and 5.2% as confirmed Lynch syndrome at the point of care. These findings have important implications for universal screening of upper tract urothelial carcinoma, representing one of the highest rates of undiagnosed genetic disease in a urological cancer. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

PET imaging in differentiated thyroid cancer: where does it fit and how do we use it?; Imagem por PET no cancer diferenciado de tiroide: onde ele se encaixa e como usa-lo?

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Hall, Nathan C. [The Ohio State University, Columbus, OH (United States). Div. of Nuclear Medicine; Kloos, Richard T. [The Ohio State University, Columbus, OH (United States). Diabetes and Metabolism and Nuclear Medicine]. E-mail: richard.kloos@osumc.edu

2007-07-15

Positron emission tomography (PET) is a rapidly evolving imaging modality that has gained widespread acceptance in oncology, with several radionuclides applicable to thyroid cancer. Thyroid cancer patients have been studied most commonly using {sup 18}F-Fluorodeoxyglucose (FDG)-PET, with perhaps the greatest utility being the potential localization of tumor in differentiated thyroid cancer (DTC) patients who are radioiodine whole body scan (WBS) negative and thyroglobulin (Tg) positive. Also of value is the identification of patients unlikely to benefit from additional {sup 131}I therapy and identification of patients at highest risk of disease-specific mortality, which may prompt more aggressive therapy or enrollment in clinical trials. Emerging data suggest that PET/CT fusion studies provide increased accuracy and modify the treatment plan in a significant number of DTC cases when compared to PET images alone. However, studies documenting improvements in survival and tumor recurrence attributable to FDG-PET imaging in thyroid cancer patients are lacking. Specific case examples of thyroid cancer patients who appear to have benefited from FDG-PET imaging do exist, while less data are available in the setting of anaplastic or medullary thyroid carcinoma. This article reviews the utility and limitations of FDG-PET in DTC management, and offers practical recommendations. (author)

Direct-acting antiviral therapy decreases hepatocellular carcinoma recurrence rate in cirrhotic patients with chronic hepatitis C.

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Virlogeux, Victor; Pradat, Pierre; Hartig-Lavie, Kerstin; Bailly, François; Maynard, Marianne; Ouziel, Guillaume; Poinsot, Domitille; Lebossé, Fanny; Ecochard, Marie; Radenne, Sylvie; Benmakhlouf, Samir; Koffi, Joseph; Lack, Philippe; Scholtes, Caroline; Uhres, Anne-Claire; Ducerf, Christian; Mabrut, Jean-Yves; Rode, Agnès; Levrero, Massimo; Combet, Christophe; Merle, Philippe; Zoulim, Fabien

2017-08-01

Arrival of direct-acting antiviral agents against hepatitis C virus with high-sustained virological response rates and very few side effects has drastically changed the management of hepatitis C virus infection. The impact of direct-acting antiviral exposure on hepatocellular carcinoma recurrence after a first remission in patients with advanced fibrosis remains to be clarified. 68 consecutive hepatitis C virus patients with a first hepatocellular carcinoma diagnosis and under remission, subsequently treated or not with a direct-acting antiviral combination, were included. Clinical, biological and virological data were collected at first hepatocellular carcinoma diagnosis, at remission and during the surveillance period. All patients were cirrhotic. Median age was 62 years and 76% of patients were male. Twenty-three patients (34%) were treated with direct-acting antivirals and 96% of them achieved sustained virological response. Median time between hepatocellular carcinoma remission and direct-acting antivirals initiation was 7.2 months (IQR: 3.6-13.5; range: 0.3-71.4) and median time between direct-acting antivirals start and hepatocellular carcinoma recurrence was 13.0 months (IQR: 9.2-19.6; range: 3.0-24.7). Recurrence rate was 1.7/100 person-months among treated patients vs 4.2/100 person-months among untreated patients (P=.008). In multivariate survival analysis, the hazard ratio for hepatocellular carcinoma recurrence after direct-acting antivirals exposure was 0.24 (95% confidence interval: 0.10-0.55; PHepatocellular carcinoma recurrence rate was significantly lower among patients treated with direct-acting antivirals compared with untreated patients. Given the potential impact of our observation, large-scale prospective cohort studies are needed to confirm these results. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Decreased UV-induced DNA repair synthesis in peripheral leukocytes from patients with the nevoid basal cell carcinoma syndrome

International Nuclear Information System (INIS)

Ringborg, U.; Lambert, B.; Landergen, J.; Lewensohn, R.

1981-01-01

The uv-induced DNA repair synthesis in peripheral leukocytes from 7 patients with the nevoid basal cell carcinoma syndrome was compared to that in peripheral leukocytes from 5 patients with basal cell carcinomas and 39 healthy subjects. A dose response curve was established for each individual, and maximum DNA repair synthesis was used as a measure of the capacity for DNA repair. The patients with the nevoid basal cell carcinoma syndrome had about 25% lower level of maximum DNA repair synthesis as compared to the patients with basal cell carcinomas and control individuals. The possibility that DNA repair mechanisms may be involved in the etiology to the nevoid basal cell carcinoma syndrome is discussed

Effect of radiotherapy on lymphocyte subpopulations in patients with carcinoma of the breast and uterine cervix

International Nuclear Information System (INIS)

Guha Thakurta, S.; De, M.; Roy Chowdhury, J.

1983-01-01

Immune competence was evaluated in 43 patients of carcinoma breast, 77 patients of cancer cervix, as compared to 30 normal healthy women. The study also included 25 women from the two carcinoma groups, who had undergone radiotherapy. A reduction in the white blood cell count, absolute lymphocyte count, active T-cell count and absolute T-cell count were observed in patients with carcinoma of the breast and cervix prior to irradiation. Radiation therapy resulted in a striking reduction of all the three parameters in both the carcinoma groups. Substantial recovery was observed within a year after cessation of therapy. Increased number of peripheral B lymphocytes was observed in carcinoma of the breast as well as the cervix prior to irradiation. At completion of radiation, the number decreased markedly in both groups of patients. Gradual recovery took place within a year. The reduction in lymphocyte numbers and its subpopulations could not be attributed to thymic irradiation, since patients receiving pelvic and mediastinal (including thymic) radiotherapy showed similar changes. (author)

99mTc labelled cationic lipophilic complexes in malignant and benign tumors: the role of SPET and pinhole-SPET in breast cancer, differentiated thyroid carcinoma and hyperparathyroidism

International Nuclear Information System (INIS)

Schillaci, O.; Spanu, A.; Madeddu, G.

2005-01-01

Single photon emission tomography (SPET) represents an indispensable diagnostic tool in nuclear medicine. Due to better contrast resolution, cross sectional and 3D images, SPET plays a useful complementary tool to bidimensional planar scintigraphy in certain clinical conditions, while representing the procedure of choice in others. However, high resolution SPET with pinhole collimator (P-SPET) can improve conventional SPET sensitivity with parallel hole collimators. This review summarized data on the employment of conventional SPET and P-SPET in breast cancer, differentiated thyroid cancer (DTC) and hyperparathyroidism patients, using the cationic lipophilic complexes ( 99m Tc )metoxy isobutyl isonitrile (sestaMIBI) and ( 99m Tc )tetrofosmin as oncotropic radiotracers. In breast cancer patients, SPET with these radiotracers can play an important complementary role to planar scintimammography in detecting primary tumors, especially when non palpable and small in size, whereas SPET and particularly P-SPET represents the procedure of choice in preoperative axillary lymph node status evaluation in which planar is almost always irrelevant. In DTC follow-up patients, SPET and P-SPET with cationic lipophilic radiotracers are indicated in both locoregional and distant metastasis detection, especially in patients with high Tg serum levels and negative radioiodine scanning in whom these procedures represent a reliable alternative to diagnostic 131 I scanning. Moreover, the combined use of ( 99m Tc)tetrofosmin P-SPET and US can identify recurrences and lymph node metastases in the neck, both fixing and non fixing iodine, down staged or negative at 131 I scanning. SPET can also be a useful complementary tool to planar parathyroid scintigraphy in the detection and localization of small and ectopic parathyroid adenomas in the neck or mediastinum, while neck P-SPET seems to also significantly increase planer sensitivity in hyperplastic glands. SPET and P-SPET are indicated in

Study on change of multi-modally evoked potentials in nasopharyngeal carcinoma patients after radiotherapy

International Nuclear Information System (INIS)

Qin Ling; Chen Jiaxin; Zhang Lixiang; Wang Tiejian; Han Min; Lu Xiaoling

2001-01-01

Objective: To investigate possible changes of multi-modally evoked potentials in nasopharyngeal carcinoma patients after radiotherapy. Methods: Altogether 48 nasopharyngeal carcinoma patients receiving primary conventional external beam irradiation were examined before and after radiotherapy to determine their brainstem auditory-evoked potential (BAEP), short-latency somatosensory-evoked potential (SLSEP) and pattern reversal visual-evoked potential (PRVEP). Results: In comparison with the conditions before radiotherapy, in different periods after radiotherapy abnormal peak latency and interval latency difference were found in BAEP, SLSEP and PRVEP. Conclusion: Nasopharyngeal carcinoma after radiotherapy may cause abnormal function of nerve conduction in early periods, which can be showed by BAEP, SLSEP, PRVEP, and injury can be timely detected if the three evoked potentials are used together. Thus authors suggest BAEP, SLSEP, PRVEP should be examined in nasopharyngeal carcinoma patients during and after the radiotherapy so as to find early damage in auditory somatosensory and visual conduction pathways

An aggressive merkel cell carcinoma in a patient with chronic renal failure

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Sevda Gizlenti

2014-12-01

Full Text Available Merkel cell carcinoma (MCC is a rare cutaneous tumor arising from neuroendocrine cells and Merkel cells. Early diagnosis and treatment is important because of its aggressive course. We here report a 61 years old man with chronic renal failure, 3x5 cm mass on his right leg and inguinal-paraaortic lymph node metastases and resulting in death. MCC in the literature of the AIDS disease, organ transplantation, immunosuppressive therapy areas, and additional malignancies (multiple myeloma, chronic lymphocytic leukemia, non-Hodgkin's lymphoma, and melanoma have been reported in patients with increased incidence. Up to date a patient with renal transplantation and Merkel cell carcinoma have been reported in the literature, Merkel cell carcinoma with chronic renal failure have not been reported.

Molecular targeted therapies of aggressive thyroid cancer

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Silvia Martina eFerrari

2015-11-01

Full Text Available Differentiated thyroid carcinomas (DTC that arise from follicular cells account > 90% of thyroid cancer (TC [papillary thyroid cancer (PTC 90%, follicular thyroid cancer (FTC 10%], while medullary thyroid cancer (MTC accounts < 5%. Complete total thyroidectomy is the treatment of choice for PTC, FTC and MTC. Radioiodine is routinely recommended in high-risk patients and considered in intermediate risk DTC patients. DTC cancer cells, during tumor progression, may lose the iodide uptake ability, becoming resistant to radioiodine, with a significant worsening of the prognosis. The lack of specific and effective drugs for aggressive and metastatic DTC and MTC leads to additional efforts towards the development of new drugs.Several genetic alterations in different molecular pathways in TC have been shown in the last decades, associated with TC development and progression. Rearranged during transfection (RET/PTC gene rearrangements, RET mutations, BRAF mutations, RAS mutations, and vascular endothelial growth factor receptor 2 angiogenesis pathways are some of the known pathways determinant in the development of TC. Tyrosine kinase inhibitors (TKIs are small organic compounds inhibiting tyrosine kinases auto-phosphorylation and activation, most of them are multikinase inhibitors. TKIs act on the above-mentioned molecular pathways involved in growth, angiogenesis, local and distant spread of TC. TKIs are emerging as new therapies of aggressive TC, including DTC, MTC and anaplastic thyroid cancer (ATC, being capable of inducing clinical responses and stabilization of disease. Vandetanib and cabozantinib have been approved for the treatment of MTC, while sorafenib and lenvatinib for DTC refractory to radioiodine. These drugs prolong median progression-free survival, but until now no significant increase has been observed on overall survival; side effects are common. New efforts are made to find new more effective and safe compounds, and to personalize

The otological status of patients with nasopharyngeal carcinoma after megavoltage radiotherapy

International Nuclear Information System (INIS)

Tang, N.L.S.; Choy, A.T.K.; John, D.G.; Hassalt, C.A. van

1992-01-01

A middle ear effusion is a common complication of nasopharyngeal carcinoma both before and after radiotherapy. An effusion was found in 38 per cent of patients before radiotherapy and 9 per cent developed an effusion after the start of radiotherapy. Surgical treatment by myringotomy with or without grommet insertion was associated with a high incidence of otorrhoea (26 per cent) which was often refractory to treatment. In view of the frequency of this complication and the fact that a middle ear effusion may not be of concern to an adult patient with nasopharyngeal carcinoma, a wait and see policy may be appropriate in the management of a middle ear effusion in these patients. (Author)

Diagnosis and dosimetry in differentiated thyroid carcinoma using 124I PET: comparison of PET/MRI vs PET/CT of the neck

International Nuclear Information System (INIS)

Nagarajah, James; Jentzen, Walter; Hartung, Verena; Rosenbaum-Krumme, Sandra; Bockisch, Andreas; Stahl, Alexander; Mikat, Christian; Heusner, Till Alexander; Antoch, Gerald

2011-01-01

This study compares intrinsically coregistered 124 I positron emission tomography (PET) and CT (PET/CT) and software coregistered 124 I PET and MRI (PET/MRI) images for the diagnosis and dosimetry of thyroid remnant tissues and lymph node metastases in patients with differentiated thyroid carcinoma (DTC). After thyroidectomy, 33 high-risk DTC patients (stage III or higher) received 124 I PET/CT dosimetry prior to radioiodine therapy to estimate the absorbed dose to lesions and subsequently underwent a contrast-enhanced MRI examination of the neck. Images were evaluated by two experienced nuclear medicine physicians and two radiologists to identify the lesions and to categorize their presumable provenience, i.e. thyroid remnant tissue (TT), lymph node metastasis (LN) and inconclusive tissue. The categorization and dosimetry of lesions was initially performed with PET images alone (PET only). Subsequently lesions were reassessed including the CT and MRI data. The analyses were performed on a patient and on a lesion basis. Patient-based analyses showed that 26 of 33 (79%) patients had at least one lesion categorized as TT on PET only. Of these patients, 11 (42%) and 16 (62%) had a morphological correlate on CT and MRI, respectively, in at least one TT PET lesion. Twelve patients (36%) had at least one lesion classified as LN on PET only. Nine (75%) of these patients had a morphological correlate on both CT and MRI in at least one LN PET lesion. Ten patients (30%) showed at least one lesion on PET only classified as inconclusive. The classification was changed to a clear classification in two patients (two LN) by CT and in four (two TT, two LN) patients by MRI. Lesion-based analyses (n = 105 PET positive lesions) resulted in categorization as TT in 61 cases (58%), 16 (26%) of which had a morphological correlate on CT and 33 (54%) on MRI. A total of 29 lesions (27%) were classified as LN on PET, 18 (62%) of which had a morphological correlate on CT and 24 (83%) on MRI

Depression and anxiety in patients with oral squamous cell carcinoma

Institute of Scientific and Technical Information of China (English)

无

2006-01-01

PURPOSE: The aim of this study was to investigate symptoms of depression and anxiety in the patients with oral squamous cell carcinoma (OSCC). METHODS: 76 patients with oral squamous cell carcinoma participated in this program. All patients were rated with the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS). The mean scores of SAS and SDS were compared to those scores of the Norm of Chinese people. In addition, the different treatment results of the patients with different levels of anxiety and depression were studied. Further, the number of patients of SAS, SDS with more than 50 score were compared between primary cancer patients and recurrent cancer patients. RESULTS: The scores of SAS, SDS and the number of patients with more than 50 score in the patients group were obviously higher than those in Chinese Norm (P＜0.01).The levels of anxiety and depression in 32 patients with recurrent cancer were more severe than those of 44 patients with primary cancer. The patients with anxiety and/or depression showed poor prognosis. CONCLUSION: Anxiety and depression are common symptoms in patients with OSCC and have negative effects on the prognosis, thus the psychological intervention for the patients must be carried out.

The observation and nursing for advanced hepatocellular carcinoma patients treated with Sorafenib

International Nuclear Information System (INIS)

Chen Yu; Xu Jing; Lin Fuqun

2011-01-01

Objective: To summarize the author's experience which was obtained in observing and nursing the adverse reactions of advanced hepatocellular carcinoma patients who were treated with Sorafenib. Methods: The adverse reactions and their severity observed in 34 patients with advanced hepatocellular carcinoma who were treated with Sorafenib were retrospectively analyzed. Results: Side effects or toxic reaction were observed in all the patients, which included neutropenia, foot-hand syndrome (FHS), fatigue, diarrhea, hypertention, rash, etc. Five patients had to cut down the dose of Sorafenib in order to relieve the symptom, among them one patient had grade 4 FHS, 3 patients had grade 3 FHS and one patient had grade 3 neutropenia. Conclusion: Being familiar with sorafenib's adverse reaction, closely observing the patients condition and affording appropriate nursing measures, all the above items can definitely improve the therapeutic results and patient's living quality. (authors)

Frequent POLE1 p.S297F mutation in Chinese patients with ovarian endometrioid carcinoma

International Nuclear Information System (INIS)

Zou, Yang; Liu, Fa-Ying; Liu, Huai; Wang, Feng; Li, Wei; Huang, Mei-Zhen; Huang, Yan; Yuan, Xiao-Qun; Xu, Xiao-Yun; Huang, Ou-Ping; He, Ming

2014-01-01

The catalytic subunit of DNA polymerase epsilon (POLE1) functions primarily in nuclear DNA replication and repair. Recently, POLE1 mutations were detected frequently in colorectal and endometrial carcinomas while with lower frequency in several other types of cancer, and the p.P286R and p.V411L mutations were the potential mutation hotspots in human cancers. Nevertheless, the mutation frequency of POLE1 in ovarian cancer still remains largely unknown. Here, we screened a total of 251 Chinese samples with distinct subtypes of ovarian carcinoma for the presence of POLE1 hotspot mutations by direct sequencing. A heterozygous somatic POLE1 mutation, p.S297F (c.890C>T), but not p.P286R and p.V411L hotspot mutations observed in other cancer types, was identified in 3 out of 37 (8.1%) patients with ovarian endometrioid carcinoma; this mutation was evolutionarily highly conserved from Homo sapiens to Schizosaccharomyces. Of note, the POLE1 mutation coexisted with mutation in the ovarian cancer-associated PPP2R1A (protein phosphatase 2, regulatory subunit A, α) gene in a 46-year-old patient, who was also diagnosed with ectopic endometriosis in the benign ovary. In addition, a 45-year-old POLE1-mutated ovarian endometrioid carcinoma patient was also diagnosed with uterine leiomyoma while the remaining 52-year-old POLE1-mutated patient showed no additional distinctive clinical manifestation. In contrast to high frequency of POLE1 mutations in ovarian endometrioid carcinoma, no POLE1 mutations were identified in patients with other subtypes of ovarian carcinoma. Our results showed for the first time that the POLE1 p.S297F mutation, but not p.P286R and p.V411L hotspot mutations observed in other cancer types, was frequent in Chinese ovarian endometrioid carcinoma, but absent in other subtypes of ovarian carcinoma. These results implicated that POLE1 p.S297F mutation might be actively involved in the pathogenesis of ovarian endometrioid carcinoma, but might not be actively

Frequent POLE1 p.S297F mutation in Chinese patients with ovarian endometrioid carcinoma

Energy Technology Data Exchange (ETDEWEB)

Zou, Yang; Liu, Fa-Ying; Liu, Huai; Wang, Feng [Key Laboratory of Women' s Reproductive Health of Jiangxi Province, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi 330006 (China); Central Laboratory, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi 330006 (China); Li, Wei [Key Laboratory of Women' s Reproductive Health of Jiangxi Province, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi 330006 (China); Central Laboratory, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi 330006 (China); Graduate School of Nanchang University, Nanchang, Jiangxi 330031 (China); Huang, Mei-Zhen [Graduate School of Nanchang University, Nanchang, Jiangxi 330031 (China); Jiangxi Provincial Cancer Institute, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi 330029 (China); Huang, Yan; Yuan, Xiao-Qun [Key Laboratory of Women' s Reproductive Health of Jiangxi Province, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi 330006 (China); Central Laboratory, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi 330006 (China); Graduate School of Nanchang University, Nanchang, Jiangxi 330031 (China); Xu, Xiao-Yun [Graduate School of Nanchang University, Nanchang, Jiangxi 330031 (China); Jiangxi Provincial Cancer Institute, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi 330029 (China); Huang, Ou-Ping, E-mail: huangouping@gmail.com [Jiangxi Provincial Cancer Institute, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi 330029 (China); He, Ming, E-mail: jxhm56@hotmail.com [Department of Pharmacology and Molecular Therapeutics, Nanchang University School of Pharmaceutical Science, Nanchang 330006 (China)

2014-03-15

The catalytic subunit of DNA polymerase epsilon (POLE1) functions primarily in nuclear DNA replication and repair. Recently, POLE1 mutations were detected frequently in colorectal and endometrial carcinomas while with lower frequency in several other types of cancer, and the p.P286R and p.V411L mutations were the potential mutation hotspots in human cancers. Nevertheless, the mutation frequency of POLE1 in ovarian cancer still remains largely unknown. Here, we screened a total of 251 Chinese samples with distinct subtypes of ovarian carcinoma for the presence of POLE1 hotspot mutations by direct sequencing. A heterozygous somatic POLE1 mutation, p.S297F (c.890C>T), but not p.P286R and p.V411L hotspot mutations observed in other cancer types, was identified in 3 out of 37 (8.1%) patients with ovarian endometrioid carcinoma; this mutation was evolutionarily highly conserved from Homo sapiens to Schizosaccharomyces. Of note, the POLE1 mutation coexisted with mutation in the ovarian cancer-associated PPP2R1A (protein phosphatase 2, regulatory subunit A, α) gene in a 46-year-old patient, who was also diagnosed with ectopic endometriosis in the benign ovary. In addition, a 45-year-old POLE1-mutated ovarian endometrioid carcinoma patient was also diagnosed with uterine leiomyoma while the remaining 52-year-old POLE1-mutated patient showed no additional distinctive clinical manifestation. In contrast to high frequency of POLE1 mutations in ovarian endometrioid carcinoma, no POLE1 mutations were identified in patients with other subtypes of ovarian carcinoma. Our results showed for the first time that the POLE1 p.S297F mutation, but not p.P286R and p.V411L hotspot mutations observed in other cancer types, was frequent in Chinese ovarian endometrioid carcinoma, but absent in other subtypes of ovarian carcinoma. These results implicated that POLE1 p.S297F mutation might be actively involved in the pathogenesis of ovarian endometrioid carcinoma, but might not be actively

Peritoneal implants without ascites. Preoperative CT diagnosis in colon carcinoma patients

International Nuclear Information System (INIS)

Saida, Yukihisa; Itai, Yuji; Tsunoda, Hiroko; Matsueda, Kiyoshi.

1994-01-01

We evaluated the preoperative CT findings in 10 patients with colon carcinoma in whom peritoneal metastases had been surgically confirmed. Seven patients lacked ascites. No CT findings suggestive of peritoneal metastasis were observed in two patients without ascites even by retrospective evaluation. A large mass was observed in the cul-de-sac in another. In the remaining four patients, small peritoneal metastases ranging from 8 to 11 mm in diameter were observed at the omentum in two, along the falciform ligament in one, and at both the omentum and the iliac fossa in one; three of these patients had received no prospective diagnosis of peritoneal metastasis prior to the surgery. In patients with advanced colon carcinoma with suspected serosal invasion, the entire peritoneal cavity should be carefully examined and interpreted using CT in order to detect small peritoneal implants even when ascites is absent. (author)

Diagnostic and prognostic potential of serum miR-132/212 cluster in patients with hepatocellular carcinoma.

Science.gov (United States)

Wang, Feng; Wang, Jun; Ju, Linlin; Chen, Lin; Cai, Weihua; Yang, Jialin

2018-01-01

Background It has been reported that both of the miR-132/212 (micro-RNA) cluster members, miR-132 and miR-212, are downregulated in hepatocellular carcinoma. Nevertheless, the expression pattern and clinical utility of serum miR-132/212 in hepatocellular carcinoma are still unknown. Methods In this study, serum concentrations of miR-132 and miR-212 were measured in 80 hepatocellular carcinoma patients, 51 controls with chronic liver diseases and 42 healthy volunteers by using quantitative real-time polymerase chain reaction. Results In hepatocellular carcinoma patients, serum concentrations of miR-132 and miR-212 were significantly reduced and strongly correlated (r = 0.603, p hepatocellular carcinoma. Moreover, the combination of serum miR-132, miR-212 and alpha-fetoprotein improved the diagnostic efficiency for hepatocellular carcinoma, especially in sensitivity and negative predictive value. Serum miR-132 was associated with tumour differentiation degree ( p = 0.021) and tumour-node-metastasis stage ( p = 0.002); serum miR-212 correlated with tumour size ( p = 0.023) and tumour-node-metastasis stage ( p = 0.007). Kaplan-Meier analyses indicated poorer overall survival in hepatocellular carcinoma patients with lower serum concentrations of miR-132 ( p hepatocellular carcinoma.

Salivary analytes in patients with oral squamous cell carcinoma.

Science.gov (United States)

Fuchs, Petra Nola; Rogić, Dunja; Vidović-Juras, Danica; Susić, Mato; Milenović, Aleksandar; Brailo, Vlaho; Boras, Vanja Vucićević

2011-06-01

Literature data indicates that measurement of certain salivary constituents might serve as a useful diagnostic/prognostic tool in the patients with oral squamous cell carcinoma (OSCC). In 24 patients with OSCC (60 +/- 2.5 yrs) and in 24 controls (24 +/- 3.7 yrs) we have determined levels of salivary magnesium, calcium, copper, chloride, phosphate, potassium, sodium, total proteins and amylase. Sodium, potassium and chloride were determined by indirect potentiometry whereas copper, magnesium and phosphate were determined by atomic absorption spectrophotometry. Total proteins were determined by pyrogalol colorimetric method. Amylase levels were determined by continued colorimetric method. Statistical analysis was performed by use of chi2 test and Spearman's correlation test. The results of this study indicate that the concentrations of sodium and chloride were significantly elevated in patients with OSCC when compared to the controls. However, level of total protein was significantly decreased when compared to the healthy controls. Furthermore, there was a negative correlation between alcohol consumption and total protein concentration in patients with oral carcinoma. We might conclude that in patients with OSCC increased salivary sodium and chloride might reflect their overall dehydration status due to alcohol consumption rather than consequence of OSCC itself.

WIF-1 and Ihh Expression and Clinical Significance in Patients With Lung Squamous Cell Carcinoma and Adenocarcinoma.

Science.gov (United States)

Zhang, Yue; Hu, Chunhong

2016-10-31

This study investigated the expression of wingless-type inhibitory factor-1 (WIF-1) and Ihh protein in tumor tissues and their clinical significance in patients with lung squamous cell carcinoma and adenocarcinoma. The expression of WIF-1 and Ihh protein in 74 squamous cell carcinomas and 76 adenocarcinomas was measured by immunohistochemistry. The percentage of positive WIF-1 protein expression was significantly higher, while positive Ihh protein expression was significantly lower in patients with well-differentiated lung squamous cell carcinoma and adenocarcinoma, tumor node metastasis (TNM) stage I disease, and lymph node metastasis than that in patients with poorly differentiated tumor, TNM stage III disease, and lymph node metastasis (PIhh protein expression survived significantly shorter than patients with negative Ihh protein expression. In contrast, no significant difference in mean survival was observed in patients with lung squamous cell carcinoma and adenocarcinoma with positive and negative WIF-1 protein expression (P>0.05). Ihh is a marker for poor prognosis in patients with lung squamous cell carcinoma and adenocarcinoma. WIF-1 is not a predictive marker for lung cancer.

PATIENTS WITH SQUAMOUS-CELL VERSUS ADENO(SQUAMOUS) CARCINOMA OF THE CERVIX, WHAT FACTORS DETERMINE THE PROGNOSIS

NARCIS (Netherlands)

TINGA, DJ; BOUMA, J; AALDERS, JG

1992-01-01

Patients with squamous cell carcinoma of the cervix FIGO stages IB to IV (n = 306) were compared to patients with adeno(squamous) carcinoma (n = 70). There was no difference between the mean ages of the groups. In the patients who underwent radical surgical treatment, whether or not in combination

The frequency of Helicobacter pylor infection and cagA expression in the Korean patients with gastric carcinoma

International Nuclear Information System (INIS)

Jung, Sook Hyang; Kim, Yoo Chul

1997-12-01

Helicobacter pylori infection had been approved as a group 1 carcinogen by the international agency for research on cancer. However the association between H.pylori infection and gastric carcinoma was not so definite in South Asia including Korea, and the role of cagA gene of H.pylori in gastric carcinogenesis was a controversial issue. The aims of this study were firstly to study in vivo expression frequency of 16S rRNA and cagA gene of H.pylori, secondly to study the association between H.pylori infection and gastric cancer, the association between cagA expression and gastric cancer in Korean patients. In vivo expression rate of 16S rRNA was 74 % of gastric carcinoma patients and cagA expression rate was 51 % of gastric carcinoma patients with H.pylori infection. Although 90 % of gastric carcinoma patients had H.pylori infection, the association between H.pylori infection and gastric carcinoma was not significant. And there was no significant association between cagA expression and gastric carcinoma. (author). 37 refs., 2 tabs., 1 fig

The frequency of Helicobacter pylor infection and cagA expression in the Korean patients with gastric carcinoma

Energy Technology Data Exchange (ETDEWEB)

Jung, Sook Hyang; Kim, Yoo Chul [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

1997-12-01

Helicobacter pylori infection had been approved as a group 1 carcinogen by the international agency for research on cancer. However the association between H.pylori infection and gastric carcinoma was not so definite in South Asia including Korea, and the role of cagA gene of H.pylori in gastric carcinogenesis was a controversial issue. The aims of this study were firstly to study in vivo expression frequency of 16S rRNA and cagA gene of H.pylori, secondly to study the association between H.pylori infection and gastric cancer, the association between cagA expression and gastric cancer in Korean patients. In vivo expression rate of 16S rRNA was 74 % of gastric carcinoma patients and cagA expression rate was 51 % of gastric carcinoma patients with H.pylori infection. Although 90 % of gastric carcinoma patients had H.pylori infection, the association between H.pylori infection and gastric carcinoma was not significant. And there was no significant association between cagA expression and gastric carcinoma. (author). 37 refs., 2 tabs., 1 fig.

Cytogenetic in thyroid carcinoma and therapy with 131{sup I}; Citogenetica en cancer de tiroides y terapia con 131''I

Energy Technology Data Exchange (ETDEWEB)

Popova, L.; Hadjidekova, V.; Christova, R.; Agova, S.; Grudeva, V.; Hadjieva, T.; Dominguez, I.

2007-07-01

In order to assess the genotoxic risk of the therapy with radioiodine-131(''131I), the production of micronuclei (MN) and chromosome aberrations (CA) were analyzed in the peripheral blood lymphocytes of group of 26 patients undergoing therapy with this radionuclide for differentiated thyroid carcinoma (DTC). Blood samples were taken immediately before ''131 I administration and 1 month later. The patients underwent radioiodine ablation (RIA) or radioiodine therapy (RIT) after radical thyroidectomy. The amount of orally administered ''131I activity varied from 3330 to 4030 MBq according to the king of therapy (RIA or RIT). results show that after radioiodine therapy there is a significant increase in the frequency of MN and CA. The mean frequencies of MN {+-} Sd before and after the therapy were 10.72 % {+-} 5.84 % and 25.28 %{+-} 12.6% respectively. For CA, the mean frequencies obtained were 1.16% {+-} 0.36% before and 2.3% {+-} 0.87% after the therapy. These findings indicate a genotoxic activity of ''131I therapy estimated after a period of one month. (Author) 38 refs.

Can non-selective beta-blockers prevent hepatocellular carcinoma in patients with cirrhosis?

DEFF Research Database (Denmark)

Thiele, Maja; Wiest, Reiner; Gluud, Lise Lotte

2013-01-01

Hepatocellular carcinoma is the main liver-related cause of death in patients with compensated cirrhosis. The early phases are asymptomatic and the prognosis is poor, which makes prevention essential. We propose that non-selective beta-blockers decrease the incidence and growth of hepatocellular...... and growth of hepatocellular carcinoma. Rodent and in vitro studies support the hypothesis, but clinical verification is needed. Different study designs may be considered. The feasibility of a randomized controlled trial is limited due to the necessary large number of patients and long follow......-up. Observational studies carry a high risk of bias. The meta-analytic approach may be used if the incidence and mortality of hepatocellular carcinoma can be extracted from trials on variceal bleeding and if the combined sample size and follow up is sufficient....

Radiotherapy-induced hearing loss in patients with laryngeal and hypopharyngeal carcinomas.

Science.gov (United States)

Gudelj, Goran; Trotić, Robert; Herceg, Tonko; Parazajder, Domagoj; Vagić, Davor; Geber, Goran

2014-09-01

The purpose of this study was to investigate a hypothesized correlation of development of a sensorineural hearing loss and radiotherapy in patients with laryngeal and hypopharyngeal carcinoma. This prospective study included a total of 50 patients, which after strict exclusion critera (audiologic problems before RT primary tumors of the auditory system, spread of the primary tumor to any part of the auditory system) resulted in 23 analyzed patients, ranging between 50 and 76 years of age, with a mean age of 60. Audiometry measuring frequency-specific thresholds was performed in three time points: one month before radiotherapy, one and six months after radiotherapy. A significant statistical difference in hearing tresholds after radiotherapy was found in 6 out of 23 patients. An obvious tendency towards hearing loss without statistical significance at 250 and 4000 Hz was found for a whole tested population (p < or = 0.3 with Bonferroni correction). Observed tendency towards hearing loss after radiotherapy of laryngeal carcinoma was related to side of the tumor and less severe when chemotherapy was not added as adjuvant therapy. These results should help to decrease a rate of hearing loss by careful planing of ear protection, by using observed frequencies as relevant markers of hearing loss and by reconsidering adjuvant chemoterapy during radiotherapy of laryngeal carcinoma.

Hepatocellular Carcinoma in Patients with Chronic Hepatitis C

Directory of Open Access Journals (Sweden)

Dmitry Konstantinov

2016-09-01

Full Text Available The purpose of the study was to examine the clinical and epidemiological data in patients with chronic hepatitis C (CHC and hepatocellular carcinoma (HCC before they sought specialized medical care. The study included 92 patients with CHC. All patients were divided into 2 groups: Group 1 consisted of CHC patients with HCC (n=45, and Group 2 (n=47 consisted of CHC patients without HCC. With the development of HCC in CHC patients, clinical manifestations were absent only in 2.2% of patients. Determining factors in HCC development are male sex, mature age, the maintained HCV replication, moderate and severe fibrosis, disease duration of more than 10 years, and the lack of effect of antiviral treatment.

Patient Perception of Imiquimod Treatment for Actinic Keratosis and Superficial Basal Cell Carcinoma in 202 Patients

NARCIS (Netherlands)

Waalboer-Spuij, Rick; Holterhues, Cynthia; van Hattem, Simone; Schuttelaar, Marie Louise A.; Gaastra, Menno T. W.; Kuijpers, Danielle I. M.; Hollestein, Loes M.; Nijsten, Tamar E. C.

2015-01-01

Objective: To document the impact on patient-reported outcomes and health-related quality of life (HRQoL) of treatment with imiquimod cream in patients with actinic keratosis (AK) and superficial basal cell carcinoma (sBCC). Methods: This open-label, multicenter study included AK and sBCC patients

Imaging Features of Patients Undergoing Active Surveillance for Ductal Carcinoma in Situ.

Science.gov (United States)

Grimm, Lars J; Ghate, Sujata V; Hwang, E Shelley; Soo, Mary Scott

2017-11-01

The aim of this study was to describe the imaging appearance of patients undergoing active surveillance for ductal carcinoma in situ (DCIS). We retrospectively identified 29 patients undergoing active surveillance for DCIS from 2009 to 2014. Twenty-two patients (group 1) refused surgery or were not surgical candidates. Seven patients (group 2) enrolled in a trial of letrozole and deferred surgical excision for 6-12 months. Pathology and imaging results at the initial biopsy and follow-up were recorded. In group 1, the median follow-up was 2.7 years (range: 0.6-13.9 years). Fifteen patients (68%) remained stable. Seven patients (32%) underwent additional biopsies with invasive ductal carcinoma diagnosed in two patients after 3.9 and 3.6 years who developed increasing calcifications and new masses. In group 2, one patient (14%) was upstaged to microinvasive ductal carcinoma at surgery. Among the patients in both groups with calcifications (n = 26), there was no progression to invasive disease among those with stable (50%, 13/26) or decreased (19%, 5/26) calcifications. Among a DCIS active surveillance cohort, invasive disease progression presented as increasing calcifications and a new mass following more than 3.5 years of stable imaging. In contrast, there was no progression to invasive disease among cases of DCIS with stable or decreasing calcifications. Close imaging is a key follow-up component in active surveillance. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Examining recombinant human TSH primed {sup 131}I therapy protocol in patients with metastatic differentiated thyroid carcinoma: comparison with the traditional thyroid hormone withdrawal protocol

Energy Technology Data Exchange (ETDEWEB)

Rani, Deepa; Kaisar, Sushma; Awasare, Sushma; Kamaldeep; Abhyankar, Amit; Basu, Sandip [Bhabha Atomic Research Centre (BARC), Radiation Medicine Centre, Mumbai (India)

2014-09-15

Recombinant human thyroid-stimulating hormone (rhTSH)-based protocol is a promising recent development in the management of differentiated thyroid carcinoma (DTC). The objectives of this prospective study were: (1) to assess the feasibility and efficacy of the rhTSH primed {sup 131}I therapy protocol in patients with DTC with distant metastatic disease, (2) to perform lesional dosimetry in this group of patients compared to the traditional protocol, (3) to document the practical advantages (patient symptoms and hospital stay) of the rhTSH protocol compared to the traditional thyroid hormone withdrawal protocol, (4) to document and record any adverse effect of this strategy, (5) to compare the renal function parameters, and (6) to compare the serum TSH values achieved in either of the protocols in this group of patients. The study included 37 patients with metastatic DTC having lung or skeletal metastases or both. A comparison of lesional radiation absorbed dose, hospital stay, renal function tests, and symptom profile was undertaken between the traditional thyroid hormone withdrawal protocol and rhTSH-based therapy protocol. Dosimetric calculations of metastatic lesions were performed using lesion uptake and survey meter readings for calculation of effective half-life. Non-contrast-enhanced CT was used for assessment of tumor volume. Quality of life was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QOL forms. A comparison of pretreatment withdrawal thyroglobulin (TG) was done with the withdrawal TG level 3 months after treatment. The mean effective half-life of {sup 131}I in metastatic lesions was less during the rhTSH protocol (29.49 h) compared to the thyroid hormone withdrawal protocol (35.48 h), but the difference was not statistically significant (p = 0.056). The mean 24-h % uptake of the lesions during the traditional protocol (4.84 %) was slightly higher than the 24-h % uptake during the rhTSH protocol (3.56 %), but

Detection of erbB2 copy number variations in plasma of patients with esophageal carcinoma

International Nuclear Information System (INIS)

Andolfo, Immacolata; Orditura, Michele; Ciardiello, Fortunato; De Vita, Fernando; Zollo, Massimo; Petrosino, Giuseppe; Vecchione, Loredana; De Antonellis, Pasqualino; Capasso, Mario; Montanaro, Donatella; Gemei, Marica; Troncone, Giancarlo; Iolascon, Achille

2011-01-01

Mortality is high in patients with esophageal carcinoma as tumors are rarely detected before the disease has progressed to an advanced stage. Here, we sought to isolate cell-free DNA released into the plasma of patients with esophageal carcinoma, to analyze copy number variations of marker genes in the search for early detection of tumor progression. Plasma of 41 patients with esophageal carcinoma was prospectively collected before tumor resection and chemotherapy. Our dataset resulted heterogeneous for clinical data, resembling the characteristics of the tumor. DNA from the plasma was extracted to analyze copy number variations of the erbB2 gene using real-time PCR assays. The real-time PCR assays for erbB2 gene showed significant (P = 0.001) copy number variations in the plasma of patients with esophageal carcinoma, as compared to healthy controls with high sensitivity (80%) and specificity (95%). These variations in erbB2 were negatively correlated to the progression free survival of these patients (P = 0.03), and revealed a further risk category stratification of patients with low VEGF expression levels. The copy number variation of erbB2 gene from plasma can be used as prognostic marker for early detection of patients at risk of worse clinical outcome in esophageal cancer

Impacts of treatments on the quality of life among esophageal squamous cell carcinoma patients.

Science.gov (United States)

Chen, C-Y; Hsieh, V C-R; Chang, C-H; Chen, P-R; Liang, W-M; Pan, S-C; Shieh, S-H

2017-10-01

This study aims to investigate the effects of treatments on the quality of life for patients with esophageal squamous cell carcinoma patients diagnosed at early and late stages. From a medical center in central Taiwan, patients who had been diagnosed with esophageal squamous cell carcinoma from February 2007 and March 2011 were recruited. Using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the Quality of Life Questionnaire Oesophageal 18 (QLQ-OES18), quality of life scores for 105 esophageal squamous cell carcinoma patients were obtained and assessed. Multivariate analysis was performed on the quality of life scores after stratification by cancer stage. Among early-stage esophageal squamous cell carcinoma patients, those received only surgery (S-only) performed better in physical and social functioning compared with patients who underwent surgery and concurrent chemoradiotherapy (S+CCRT) (β = 9.0, P = 0.03; β = 12.1, P = 0.04, respectively). For those that received only concurrent chemoradiotherapy (CCRT-only), they performed worse in role and emotional functioning relative to S+CCRT patients (β = -17.2, P = 0.02; β = -15.7, P = 0.05, respectively). Among late-stage patients, CCRT-only treatment gave insignificantly better global health status and functional scale scores and less severe symptoms compared to the S+CCRT option. Better functional scores and less aggravated symptoms are observed in early-stage esophageal squamous cell carcinoma patients who received surgery-only treatment relative to those that underwent both surgery and chemoradiotherapy. For late-stage esophageal cancer patients, the measured difference of quality of life is not significant between CCRT-only and S+CCRT treatments. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The results of isotope renography and intravenous pyelography in 420 patients with carcinoma of the uterine cervix

International Nuclear Information System (INIS)

Leodolter, S.; Philipp, K.; Szalay, S.

1979-01-01

A group of women with carcinoma of the cervix was studied by renography and i.v. pyelography. The incidence of renal and urinary tract disorders detected by these tests increased as did the stage of the disease, being 17.1% with Stage I carcinoma of the cervix, 27.8% with Stage II carcinoma of the cervix, 47% with Stage III carcinoma of the cervix, and 83.3% in Stage IV carcinoma of the cervix. In patients with Stage I and Stage II carcinoma of the cervix, those selected for radiotherapy had twice the incidence of abnormal renograms as those selected for surgery. This difference probably reflected a higher incidence of medical disorders affecting renal and urinary tract function in those considered unfit for surgery. We believe that renograms should be used routinely as a screening test in patients with carcinoma of the cervix. (orig.) [de

Radioimmunoscintigraphy with 99mTc-labelled anti-CEA monoclonal antibodies in colorectal carcinoma patients

International Nuclear Information System (INIS)

Sergieva, S.; Baychev, G.; Tzingilev, D.; Delijski, T.; Kirova, G.; Kirilova, B.; Nenovska, M.

1998-01-01

Sixteen patients (2 female and 14 male, aged 42-75) were given intravenous injections with 99m Tc (555-740 MBq)-labelled anti-CEA MAb (CEA-Scan, Mallinckrodt Medical and M-CEATEC, Sorin Biomedica). Five of them were with duly established or established or suspected primary colorectal carcinoma, and eleven were studied postoperatively after recording an increase CEA levels in serum. The patients were scanned within 4-24 h of infusion using planar and tomographic imaging in rotation gamma-camera DIACAM (Siemens). At all 16 patients 27 true positive results were obtained: in 7 primary colorectal carcinomas, 5 locally recurrent tumors, 7 liver metastases, 6 lymphogeneous lesions and two - in the ureteral region. True negative results were established at three patients, false positive - in one patient with chronic inflammation, and false negative results - in 3 cases with liver metastases foci < 8 mm. Having 90 % sensitivity, 75 % specificity and 82.3 % accuracy, radioimmunoscintigraphy is a highly informative and sensitive imaging method for diagnosing and following up of primary, recurrent and metastatic foci in colorectal carcinoma patients. (author)

Computed tomography of renal cell carcinoma in patients with terminal renal impairment

International Nuclear Information System (INIS)

Ferda, Jiri; Hora, Milan; Hes, Ondrej; Reischig, Tomas; Kreuzberg, Boris; Mirka, Hynek; Ferdova, Eva; Ohlidalova, Kristyna; Baxa, Jan; Urge, Tomas

2007-01-01

Purpose: An increased incidence of renal tumors has been observed in patients with end-stage-renal-disease (ESRD). The very strong association with acquired renal cystic disease (ACRD) and increased incidence of the renal tumors (conventional renal cell carcinoma (CRCC), papillary renal cell carcinoma (PRCC) or papillary renal cell adenoma (PRCA)) was reported. This study discusses the role of computed tomography (CT) in detecting renal tumors in patients with renal impairment: pre-dialysis, those receiving dialysis or with renal allograft transplants. Materials and methods: Ten patients (nine male, one female) with renal cell tumors were enrolled into a retrospective study; two were new dialysis patients, three on long-term dialysis, and five were renal transplant recipients with history of dialysis. All patients underwent helical CT, a total of 11 procedures were performed. Sixteen-row detector system was used five times, and a 64-row detector system for the six examinations. All patients underwent nephrectomy of kidney with suspected tumor, 15 nephrectomies were performed, and 1 kidney was assessed during autopsy. CT findings were compared with macroscopic and microscopic assessments of the kidney specimen in 16 cases. Results: Very advanced renal parenchyma atrophy with small cysts corresponding to ESRD was found in nine patients, chronic pyelonephritis in remained one. A spontaneously ruptured tumor was detected incidentally in one case, patient died 2 years later. In the present study, 6.25% (1/16) were multiple PRCA, 12.5% (2/16) were solitary PRCC, 12.5% tumors (2/16) were solitary conventional renal cell carcinomas (CRCC's), 12.5% tumors (2/16) were multiple conventional renal cell carcinomas (CRCC's), 25% (4/16) were CRCC's combined with multiple papillary renal cell carcinomas with adenomas (PRCC's and PRCA's), and 25% (4/16) of the tumors were multiple PRCC's combined with PRCA's without coexisting CRCC's. Bilateral renal tumors were found in our study

Synchronous gastric neuroendocrine carcinoma and hepatocellular carcinoma

DEFF Research Database (Denmark)

Ewertsen, Caroline; Henriksen, Birthe Merete; Hansen, Carsten Palnæs

2009-01-01

of synchronous gastric NEC and hepatocellular carcinoma in a patient with several other precancerous lesions is presented. The patient had anaemia, and a gastric tumour and two duodenal polyps were identified on upper endoscopy. A CT scan of the abdomen revealed several lesions in the liver. The lesions were...... invisible on B-mode sonography and real-time sonography fused with CT was used to identify and biopsy one of the lesions. Histology showed hepatocellular carcinoma. A literature search showed that only one case of a hepatocellular carcinoma synchronous with a gastric NEC has been reported previously. TRIAL...

Oblimersen in Treating Patients With Merkel Cell Carcinoma

Science.gov (United States)

2013-06-03

Recurrent Neuroendocrine Carcinoma of the Skin; Stage I Neuroendocrine Carcinoma of the Skin; Stage II Neuroendocrine Carcinoma of the Skin; Stage III Neuroendocrine Carcinoma of the Skin; Stage IV Neuroendocrine Carcinoma of the Skin

Direct-to-consumer communication on prescription only medicines via the internet in the Netherlands, a pilot study. Opinion of the pharmaceutical industry, patient associations and support groups.

Science.gov (United States)

Fabius, A Mariette; Cheung, Ka-Chun; Rijcken, Cristianne J F; Vinkers, Christiaan H; Talsma, Herre

2004-06-01

Investigation of the current application of direct-to-consumer (DTC) communication on prescription only medicines via the Intemet in the Netherlands. Questionnaires were sent by e-mail to 43 Dutch innovative pharmaceutical industries and 130 Patient Association and Support Groups (PASGs). In this pilot study, the response of the pharmaceutical industry was rather low but the impression is that they were willing to invest in DTC communication. The majority of the websites of PASGs did not link to websites of pharmaceutical companies. The PASGs had no opinion whether patients can make a good distinction between DTC advertising and information on websites of the pharmaceutical industry nor about the quality. PASGs did not think unambiguously about the impact on the patient-doctor relationship. The impact of DTC communication on prescription only medicines via the internet is not yet clear in the Netherlands.

Contribution of computed tomography in patients with lung metastases of differentiated thyroid carcinoma not apparent on plain radiography who were treated with radioiodine; Contribuicao da tomografia computadorizada em pacientes com metastases pulmonares de carcinoma diferenciado de tireoide nao-aparentes na radiografia e tratados com radioiodo

Energy Technology Data Exchange (ETDEWEB)

Rosario, Pedro W.S.; Purisch, Saulo [Santa Casa Belo Horizonte, MG (Brazil). Dep. de Tireoide. Servico de Endocrinologia]. E-mail: pedrorosario@globo.com; Tavares, Wilson C. [Instituto Alpha de Gastroenterologia, Belo Horizonte, MG (Brazil); Barroso, Alvarao L.; Rezende, Leonardo L.; Padrao, Eduardo L. [Santa Casa Belo Horizonte, MG (Brazil). Servico de Medicina Nuclear

2008-02-15

Computed tomography (CT or CAT Scan) of the chest is more sensitive than radiography in the detection of lung metastases of differentiated thyroid cancer (DTC), but little information is available regarding the aggregated value of this method. The present study evaluated the response of patients with lung metastases of DTC not apparent on radiography to treatment with {sup 131}I and the value of CT in these cases. Twenty-five patients with lung metastases not apparent on radiography, who initially received 100-200 mCi I{sup 151}, were evaluated and those presenting pulmonary uptake on post-therapy WBS were submitted to a new treatment after 6 to 12 months, and so on. The chance of detection of pulmonary uptake on post-therapy WBS did not differ between patients with negative and positive CT (100% versus 91.5%). Mean serum Tg levels were higher in patients with positive CT (108 ng/ml versus 52 ng/ml). Negative post-therapy WBS was achieved in 82% of patients with positive CT and in 92.3% with negative CT and the cumulative I{sup 131} activity necessary to achieve this outcome did not differ between the two groups (mean = 300 mCi). Stimulated Tg was undetectable in 47% of patients with negative CT at the end of treatment, but in none of the patients whose CT continued to be positive. In patients with elevated Tg, the CT result apparently did not change the indication of therapy or the I{sup 131} activity to be administered. In cases with lung metastases, the persistence of micronodules on CT was associated with the persistence of detectable Tg in patients presenting negative post-therapy WBS. (author)

Longitudinal change in renal function after nephroureterectomy in patients with upper tract urothelial carcinoma

Directory of Open Access Journals (Sweden)

Chih-Yuan Chou

2015-06-01

Conclusion: In this study, it was found that the average renal function of the patients with upper tract urothelial carcinoma is not as good as the general population. More than half of the normal renal function patients have new onset chronic kidney disease after surgery. For preventing further deterioration of renal function, the implication of partial nephrectomy or segmental ureterectomy for selected patients with localized urothelial carcinoma should be re-examined. Besides, neoadjuvant chemotherapy should be considered for those who are not good candidates for local treatment.

Interstitial brachytherapy for eyelid carcinoma. Outcome analysis in 60 patients

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Krengli, M.; Deantonio, L. [University Hospital ' ' Maggiore della Carita' ' , Division of Radiotherapy, Novara (Italy); University of ' ' Piemonte Orientale' ' , Department of Translational Medicine, Novara (Italy); Masini, L.; Filomeno, A.; Gambaro, G. [University Hospital ' ' Maggiore della Carita' ' , Division of Radiotherapy, Novara (Italy); Comoli, A.M. [University Hospital Maggiore della Carita, Ophthalmology, Novara (Italy); Negri, E. [University Hospital Maggiore della Carita, Medical Physics, Novara (Italy)

2014-03-15

Eyelid cancer is a therapeutic challenge due to the cosmetic and functional implications of this anatomical region and the objectives of therapy are tumor control, functional and cosmetic outcome. The present study was performed to analyze local control, toxicity, functional and cosmetic results in patients with eyelid carcinoma treated by interstitial brachytherapy. In this study 60 patients with eyelid carcinoma were treated by interstitial brachytherapy using iridium ({sup 192}Ir) wires with a linear activity of 1.2-1.7 mCi/cm. The prescription dose was 51-70 Gy (mean 65 Gy, median 66 Gy). Of the 60 patients 51 (85.0 %) had received no prior treatment, 4 (6.7 %) had received previous surgery with positive or close margins and 5 (8.3 %) had suffered local recurrence after surgery. Of the tumors 52 (86.7 %) were basal cell carcinoma, 7 (11.7 %) squamous cell carcinoma and 1 (1.7 %) Merkel cell carcinoma. Clinical stage of the 51 previously untreated tumors was 38 T1N0, 12 T2N0 and 1 T3N0. Mean follow-up was 92 months (range 6-253 months). Local control was maintained in 96.7 % of patients. Late effects higher than grade 2 were observed in 3.0 % of cases. Functional and cosmetic outcomes were optimal in 68.4 % of patients. Interstitial brachytherapy for carcinoma of the eyelid can achieve local control, cosmetic and functional results comparable to those of surgery. (orig.) [German] Das Karzinom des Augenlids stellt aufgrund der funktionellen und kosmetischen Beeintraechtigungen dieser anatomischen Region eine therapeutische Herausforderung dar. Ziele der Therapie sind sowohl die Tumorkontrolle als auch ein gutes funktionelles und kosmetisches Ergebnis. Lokale Kontrolle, Toxizitaet sowie funktionelle und kosmetische Ergebnisse bei Patienten mit Karzinom des Augenlids, die mit interstitieller Brachytherapie behandelt wurden, sollten analysiert werden. Sechzig Patienten mit Karzinom des Augenlids wurden mit interstitieller Brachytherapie mit Iridium-192-Draehten

Metachronous colorectal carcinoma

DEFF Research Database (Denmark)

Bülow, Steffen; Svendsen, L B; Mellemgaard, A

1990-01-01

During the period 1943-67, 903 Danish patients aged less than 40 years had colorectal carcinoma. The patients were followed up for up to 41 years and during this period 44 of 501 (9 per cent) operated on for cure developed a metachronous colorectal carcinoma. The cumulative risk of a metachronous...... colorectal carcinoma was 30 per cent after up to 41 years of observation. The occurrence of a metachronous colorectal carcinoma was evenly distributed in the observation period. The cumulative survival rate after operation for a metachronous colorectal carcinoma was 41 per cent after 20 years of observation....... We propose a lifelong follow-up programme after resection of colorectal carcinoma for cure in this age group, including annual Hemoccult test and colonoscopy at 3-year intervals....

[Postoperative radioiodine ablation in patients with low risk differentiated thyroid carcinoma].

Science.gov (United States)

Díez, Juan J; Grande, Enrique; Iglesias, Pedro

2015-01-06

Most patients with newly diagnosed differentiated thyroid carcinoma have tumors with low risk of mortality and recurrence. Standard therapy has been total or near total thyroidectomy followed by postoperative radioiodine remnant ablation (RRA). Although RRA provides benefits, current clinical guidelines do not recommend it universally, since an increase in disease-free survival or a decrease in mortality in low risk patients has not been demonstrated so far. Advancements in our understanding of the biological behavior of thyroid cancer have been translated into the clinic in a personalized approach to the patients based on their individual risk of recurrence and mortality. Current evidence suggests that RRA is not indicated in most low-risk patients, especially those with papillary carcinomas smaller than 1cm, without extrathyroidal extension, unfavorable histology, lymph node involvement or distant metastases. Follow-up of these patients with serial measurements of serum thyroglobulin and neck ultrasound is adequate. Careful evaluation of all risk factors of clinical relevance will allow a more realistic assessment of each individual patient. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Sentinel lymph node biopsy in patients with a needle core biopsy diagnosis of ductal carcinoma in situ: is it justified?

LENUS (Irish Health Repository)

Doyle, B

2012-02-01

BACKGROUND: The incidence of ductal carcinoma in situ (DCIS) has increased markedly with the introduction of population-based mammographic screening. DCIS is usually diagnosed non-operatively. Although sentinel lymph node biopsy (SNB) has become the standard of care for patients with invasive breast carcinoma, its use in patients with DCIS is controversial. AIM: To examine the justification for offering SNB at the time of primary surgery to patients with a needle core biopsy (NCB) diagnosis of DCIS. METHODS: A retrospective analysis was performed of 145 patients with an NCB diagnosis of DCIS who had SNB performed at the time of primary surgery. The study focused on rates of SNB positivity and underestimation of invasive carcinoma by NCB, and sought to identify factors that might predict the presence of invasive carcinoma in the excision specimen. RESULTS: 7\\/145 patients (4.8%) had a positive sentinel lymph node, four macrometastases and three micrometastases. 6\\/7 patients had invasive carcinoma in the final excision specimen. 55\\/145 patients (37.9%) with an NCB diagnosis of DCIS had invasive carcinoma in the excision specimen. The median invasive tumour size was 6 mm. A radiological mass and areas of invasion <1 mm, amounting to "at least microinvasion" on NCB were predictive of invasive carcinoma in the excision specimen. CONCLUSIONS: SNB positivity in pure DCIS is rare. In view of the high rate of underestimation of invasive carcinoma in patients with an NCB diagnosis of DCIS in this study, SNB appears justified in this group of patients.

Clinicopathologic significance of HLA-G and HLA-E molecules in Tunisian patients with ovarian carcinoma.

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Babay, Wafa; Ben Yahia, Hamza; Boujelbene, Nadia; Zidi, Nour; Laaribi, Ahmed Baligh; Kacem, Dhikra; Ben Ghorbel, Radhia; Boudabous, Abdellatif; Ouzari, Hadda-Imene; Rizzo, Roberta; Rebmann, Vera; Mrad, Karima; Zidi, Inès

2018-06-01

The human leukocyte antigen (HLA)-G and HLA-E, non classical HLA class I molecules, have been highly implicated in immune tolerance. HLA-G and HLA-E molecules were proposed as putative markers of several advanced cancers. As a step towards a better understanding of ovarian carcinoma, we evaluated the expression of both HLA-G and HLA-E molecules and explored their prognostic implication. HLA-G and HLA-E expression were studied by immunohistochemistry on ovarian carcinoma tissues. This expression was semi-quantitatively scored into four expression groups and correlated to clinicopathological parameters and patients' survival. HLA-G and HLA-E have been found to be highly expressed in ovarian carcinoma tissues (Respectively, 72.4% and 96.8%). They are frequently co-expressed. Univariate and multivariate analysis revealed that a positive HLA-G expression status in tumor tissue is a promising candidate parameter to predict disease recurrence in addition to the disease status in Tunisian patients with ovarian carcinoma. Moreover, the elevated HLA-E expression was associated with serous ovarian carcinoma subtype as well as with advanced stages of ovarian carcinoma. HLA-G and HLA-E are highly represented in ovarian carcinoma suggesting a potential association with progressive disease mechanism. HLA-G and HLA-E molecules might be new candidates' markers for ovarian carcinoma progression. Copyright © 2018 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

Comparison of clinical characteristics of patients with follicular thyroid carcinoma and Hürthle cell carcinoma.

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Ernaga Lorea, Ander; Migueliz Bermejo, Iranzu; Anda Apiñániz, Emma; Pineda Arribas, Javier; Toni García, Marta; Martínez de Esteban, Juan Pablo; Insausti Serrano, Ana María

2018-03-01

Hürthle cell carcinoma (HCC) is an uncommon thyroid cancer historically considered to be a variant of follicular thyroid carcinoma (FTC). The aim of this study was to assess the differences between these groups in terms of clinical factors and prognoses. A total of 230 patients (153 with FTC and 77 with HCC) with a median follow-up of 13.4 years were studied. The different characteristics were compared using SPSS version 20 statistical software. Patients with HCC were older (57.3±13.8 years vs. 44.6±15.2 years; P<.001). More advanced TNM stages were also seen in patients with HCC and a greater trend to distant metastases were also seen in patients with HCC (7.8% vs. 2.7%, P=.078). The persistence/recurrence rate at the end of follow-up was higher in patients with HCC (13% vs. 3.9%, P=.011). However, in a multivariate analysis, only age (hazard ratio [HR] 1.10, confidence interval [CI] 1.04-1.17; P=.001), size (HR 1.43, CI 1.05-1.94; P=.021), and histological subtype (HR 9.79, CI 2.35-40.81; P=.002), but not presence of HCC, were significantly associated to prognosis. HCC is diagnosed in older patients and in more advanced stages as compared to FTC. However, when age, size, and histological subtype are similar, disease-free survival is also similar in both groups. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

Success of the postoperative {sup 131}I therapy in young Belarusian patients with differentiated thyroid cancer after Chernobyl depends on the radiation absorbed dose to the blood and the thyroglobulin level

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Haenscheid, Heribert; Verburg, Frederik Anton; Diessl, Stefanie [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Biko, Johannes; Reiners, Christoph [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Belarusian-German Foundation ' Help for Radiation Induced Thyroid Cancer Patients ' ' Arnica' ' ' , Minsk (Belarus); Demidchik, Yuri E. [Belarusian Medical Academy for Postgraduate Education, Minsk (Belarus); Drozd, Valentina [Belarusian Medical Academy for Postgraduate Education, Minsk (Belarus); Belarusian-German Foundation ' Help for Radiation Induced Thyroid Cancer Patients ' ' Arnica' ' ' , Minsk (Belarus)

2011-07-15

Differentiated thyroid carcinoma (DTC) in children and young adults is rare but often aggressive and in an advanced stage at diagnosis. In a cohort of young Belarusian patients with advanced DTC after Chernobyl we retrospectively studied parameters influencing the success of the postoperative {sup 131}I therapy. Included in the study were 136 patients (83 female, 53 male; median age 14.3 years, range 9.4-22.8 years) who had had total thyroidectomy in Belarus and subsequent {sup 131}I therapy and follow-up in Germany. Of the 136 patients, 34 were classified as M1 and 102 as M0 (N0 1, N1 101). The median weight-adjusted {sup 131}I activity administered after thyroid hormone withdrawal was 52 MBq/kg (range 24-74 MBq/kg). TNM stage, gender, administered activity, whole-body residence time and blood dose during ablation, Tg and TSH levels, date, and age at time of treatment were tested for their effect on the rate of complete remission (CR). CR was defined as a negative scan and a stimulated Tg level of <1 ng/ml at follow-up. CR was observed in 1 of 34 M1 and in 51 of 102 M0 patients after the first treatment. Multivariate analysis in the M0 group identified the Tg level (P < 0.0001 for log(Tg)) and the radiation absorbed dose to the blood (P < 0.001) as independent determinants; all other parameters were unimportant (P > 0.3). The regression model was able to correctly predict CR in 82 of 102 patients (80.4%). In children and young adults with advanced DTC, the rate of CR after postoperative {sup 131}I therapy is dependent on the preablative Tg level and the radiation absorbed dose to the blood. Though the present results must be confirmed in a prospective study, they imply that preablative dosimetry may improve rates of CR. (orig.)

Preoperative serum lipids as prognostic predictors in esophageal squamous cell carcinoma patients with esophagectomy.

Science.gov (United States)

Chen, Pengxiang; Han, Lihui; Wang, Cong; Jia, Yibin; Song, Qingxu; Wang, Jianbo; Guan, Shanghui; Tan, Bingxu; Liu, Bowen; Jia, Wenqiao; Cui, Jianfeng; Zhou, Wei; Cheng, Yufeng

2017-06-20

This study was to evaluate the prognostic significance of serum lipids in esophageal squamous cell carcinoma patients who underwent esophagectomy. Preoperative serum lipids were collected from 214 patients who were diagnosed with esophageal squamous cell carcinoma. All of the patients received esophagectomy in Qilu Hospital of Shandong University from January 2007 to December 2008. The records and data were analyzed retrospectively. We found that low total cholesterol (for T stage, p = 0.006; for TNM stage, p = 0.039) and low-density lipoprotein cholesterol (for T stage, p = 0.031; for TNM stage, p = 0.035) were associated with advanced T stage and TNM stage. Kaplan-Meier survival analysis indicated that low total cholesterol and low-density lipoprotein cholesterol were associated with shorter disease-free survival(for total cholesterol, p = 0.045; for low-density lipoprotein cholesterol, p squamous cell carcinoma patients who underwent esophagectomy. LHR can serve as a promising serum lipids-based prognostic indicator.

Iodide-induced thyrotoxicosis in a thyroidectomized patient with metastatic thyroid carcinoma

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Yoshinari, M.; Tokuyama, T.; Okamura, K.; Sato, K.; Kusuda, K.; Fujishima, M.

1988-04-15

An unusual case of iodide-induced thyrotoxicosis is documented in this article. The patient was a 64-year-old euthyroid man with acromegaly. He also had multiple follicular and papillary thyroid carcinomas with a metastatic lesion in the lumbar vertebrae. After a total thyroidectomy, he became slightly hypothyroid, and the lumbar lesion began to incorporate /sup 131/I by scintigraphy. When an iodine-containing contrast medium happened to be injected, a transient increase of serum thyroid hormone level was observed. After complete thyroid ablation with 83 mCi of /sup 131/I, the oral administration of 100 mg of potassium iodide for 7 days induced a prominent increase of serum thyroid hormone level. These findings indicated that the metastatic thyroid carcinoma could produce excess thyroid hormone insofar as a sufficient amount of iodide was given. Although this is the first report of such a case, iodide-induced thyrotoxicosis may not be rare in patients with thyroid carcinomas because the Wolff-Chaikoff effect is thought to be lost, and the organic iodinating activity and lysosomal protease activity are well-preserved.

Iodide-induced thyrotoxicosis in a thyroidectomized patient with metastatic thyroid carcinoma

International Nuclear Information System (INIS)

Yoshinari, M.; Tokuyama, T.; Okamura, K.; Sato, K.; Kusuda, K.; Fujishima, M.

1988-01-01

An unusual case of iodide-induced thyrotoxicosis is documented in this article. The patient was a 64-year-old euthyroid man with acromegaly. He also had multiple follicular and papillary thyroid carcinomas with a metastatic lesion in the lumbar vertebrae. After a total thyroidectomy, he became slightly hypothyroid, and the lumbar lesion began to incorporate 131 I by scintigraphy. When an iodine-containing contrast medium happened to be injected, a transient increase of serum thyroid hormone level was observed. After complete thyroid ablation with 83 mCi of 131 I, the oral administration of 100 mg of potassium iodide for 7 days induced a prominent increase of serum thyroid hormone level. These findings indicated that the metastatic thyroid carcinoma could produce excess thyroid hormone insofar as a sufficient amount of iodide was given. Although this is the first report of such a case, iodide-induced thyrotoxicosis may not be rare in patients with thyroid carcinomas because the Wolff-Chaikoff effect is thought to be lost, and the organic iodinating activity and lysosomal protease activity are well-preserved

Immunohistochemical expression of HER-2/neu in patients with lung carcinoma and its prognostic significance

International Nuclear Information System (INIS)

Petrusevska, G.; Banev, S.; Ilievska-Poposka, B.; Smickova, S.; Spirovski, Z.

2004-01-01

Background. The HER-2 protein or p185her2 is a membrane receptor with tyrosine kinase activity encoded by HER-2/neu gene. Overexpression of HER-2/neu has been observed in many human cancers, including lung cancer. In the study, the expression of HER-2 protein is determined in the spectrum of lung cancer (adenocarcinoma, squamous cell carcinoma and small cell carcinoma). Patients and methods. The study population consisted of two groups: 19 patients that had undergone surgical treatment and 10 patients that had undergone fiber-optic bronchoscopy and biopsy for primary diagnosis only. Tissue specimens were neutral formaldehyde-fixed and paraffin-embedded. Standard histochemical and immunohistochemical staining were used for diagnosis. Expression of HER-2/neu protein was determined by immunohistochemical staining with Hercep Test (DAKO). The results were graded 0-1 as negative and 2-3 as positive. Results. Overall incidence of HER-2/neu overexpression was 34.4% (10 of 29). Higher incidence was found in the patients with adenocarcinoma 45.4% (5 of 11). In squamous cell carcinoma and small cell carcinoma, the overexpression incidence was 30.7% (4 of 13) and 20% (1 of 5), respectively. No statistically significant difference was seen given the age and gender. HER-2/neu overexpression was more pronounced in the patients with advanced tumour: all patients with squamous cell carcinoma and HER-2/neu overexpression had stage IIIB and stage IV disease, while 80 % of adenocarcinoma patients with HER-2/neu overexpression had stage IIIA and IIIB disease. Conclusions. These results are satisfactory and encourage us to continue this work in the follow-up study to evaluate HER-2/neu role as predictive and prognostic factor for the patients with lung cancer. (author)

Prognostic significance of surgical extranodal extension in head and neck squamous cell carcinoma patients.

Science.gov (United States)

Matsumoto, Fumihiko; Mori, Taisuke; Matsumura, Satoko; Matsumoto, Yoshifumi; Fukasawa, Masahiko; Teshima, Masanori; Kobayashi, Kenya; Yoshimoto, Seiichi

2017-08-01

Lymph node metastasis with extranodal extension represents one of the most important adverse prognostic factors for survival in patients with head and neck squamous cell carcinoma. We propose that extranodal extension occurs to differing extents. The aim of this study was to determine the prognostic significance of extranodal extension in patients with head and neck squamous cell carcinoma. Two hundred and ninety-eight patients with head and neck squamous cell carcinoma who underwent surgical resection and neck dissection were included. Cervical lymph nodes were classified into four categories: (i) pathological N negative, (ii) extranodal extension negative, (iii) non-surgical extranodal extension and (iv) surgical extranodal extension. Lymph node metastases were detected in 67.1% of laryngeal/hypopharyngeal cancer patients and 52.7% of oral cancer patients. The 3-year disease-specific survival rates for patients in the pathological N negative, extranodal extension negative, non-surgical extranodal extension and surgical extranodal extension groups were 90.9%, 79.6%, 63.8% and 48.3%, respectively. In laryngeal/hypopharyngeal cancer patients, surgical extranodal extension was associated with a significantly poorer disease-specific survival than a pathological N negative, extranodal extension negative or non-surgical extranodal extension status. In oral cancer patients, no significant differences were observed between the non-surgical and surgical extranodal extension groups. However, non-surgical extranodal extension was associated with a poorer disease-specific survival than a pathological N negative or extranodal extension negative status. Surgical extranodal extension was a poor prognostic factor in patients with head and neck squamous cell carcinoma. The prognostic significance of surgical extranodal extension differed between laryngeal/hypopharyngeal and oral cancer patients. The clinical significance of surgical extranodal extension was much greater for

Radioembolization After Portal Vein Embolization in a Patient with Multifocal Hepatocellular Carcinoma

International Nuclear Information System (INIS)

Burgmans, Mark C.; Irani, Farah G.; Chan, Wan Ying; Teo, Terence K.; Kao, Yung Hsiang; Goh, Anthony S.W.; Chow, Pierce K.; Lo, Richard H.

2012-01-01

Radioembolization is an effective locoregional therapy for patients with intermediate or advanced stage hepatocellular carcinoma (HCC). It has been shown that radioembolization is safe in patients with portal vein thrombosis. This case report describes safe radioembolization after portal vein embolization in a patient with multifocal HCC.

Detection of circulating tumor cells with CK20 RT-PCR is an independent negative prognostic marker in colon cancer patients - a prospective study.

Science.gov (United States)

Hinz, Sebastian; Hendricks, Alexander; Wittig, Amke; Schafmayer, Clemens; Tepel, Jürgen; Kalthoff, Holger; Becker, Thomas; Röder, Christian

2017-01-13

Detection of circulating (CTC) or disseminated tumor cells (DTC) has been associated with negative prognosis and outcome in patients with colorectal cancer, though testing for these cells is not yet part of clinical routine. There are several different methodological approaches to detect tumor cells but standardized detection assays are not implemented so far. In this prospective monocentric study 299 patients with colon cancer were included. CTC and DTC were detected using CK20 RT-PCR as well as immunocytochemistry staining with anti-pan-keratin and anti-EpCAM antibodies. The primary endpoints were: Evaluation of CTC and DTC at the time of surgery and correlation with main tumor characteristics and overall (OS) and disease free survival (DFS). Patients with detectable CTC had a 5-year OS rate of 68% compared to a 5-year OS rate of 85% in patients without detectable CTC in the blood (p = 0.002). Detection of DTC in the bone marrow with CK20 RT-PCR was not associated with a worse OS or DFS. Detection of pan-cytokeratin positive DTC in the bone marrow correlated with a significantly reduced 5-year OS rate (p = 0.048), but detection of DTC in the bone marrow with the anti-EpCAM antibody did not significantly influence the 5-year OS rate (p = 0.958). By multivariate analyses only detection of CTC with CK20 RT-PCR in the blood was revealed to be an independent predictor of worse OS (HR1.94; 95% CI 1.0-3.7; p = 0.04) and DFS (HR 1.94; 95% CI 1.1-3.7; p = 0.044). Detection of CTC with CK20 RT-PCR is a highly specific and independent prognostic marker in colon cancer patients. Detection of DTC in the bone marrow with CK20 RT-PCR or immunohistochemistry with anti-EpCAM antibody is not associated with a negative prognostic influence.

Altered protein expression in serum from endometrial hyperplasia and carcinoma patients

Directory of Open Access Journals (Sweden)

Cong Qing

2011-04-01

Full Text Available Abstract Background Endometrial carcinoma is one of the most common gynecological malignancies in women. The diagnosis of the disease at early or premalignant stages is crucial for the patient's prognosis. To date, diagnosis and follow-up of endometrial carcinoma and hyperplasia require invasive procedures. Therefore, there is considerable demand for the identification of biomarkers to allow non-invasive detection of these conditions. Methods In this study, we performed a quantitative proteomics analysis on serum samples from simple endometrial hyperplasia, complex endometrial hyperplasia, atypical endometrial hyperplasia, and endometrial carcinoma patients, as well as healthy women. Serum samples were first depleted of high-abundance proteins, labeled with isobaric tags (iTRAQ™, and then analyzed via two-dimensional liquid chromatography and tandem mass spectrometry. Protein identification and quantitation information were acquired by comparing the mass spectrometry data against the International Protein Index Database using ProteinPilot software. Bioinformatics annotation of identified proteins was performed by searching against the PANTHER database. Results In total, 74 proteins were identified and quantified in serum samples from endometrial lesion patients and healthy women. Using a 1.6-fold change as the benchmark, 12 proteins showed significantly altered expression levels in at least one disease group compared with healthy women. Among them, 7 proteins were found, for the first time, to be differentially expressed in atypical endometrial hyperplasia. These proteins are orosomucoid 1, haptoglobin, SERPINC 1, alpha-1-antichymotrypsin, apolipoprotein A-IV, inter-alpha-trypsin inhibitor heavy chain H4, and histidine-rich glycoprotein. Conclusions The differentially expressed proteins we discovered in this study may serve as biomarkers in the diagnosis and follow-up of endometrial hyperplasia and endometrial carcinoma.

Facial skin follllicular hyperkeratosis of patients with basal cell carcinoma

Directory of Open Access Journals (Sweden)

M. V. Zhuchkov

2016-01-01

Full Text Available This article provides a clinical observation of paraneoplastic syndrome of a patient with basal cell carcinoma of skin. Authors present clinical features of the described for the first time, paraneoplastic retentional follicular hyperkeratosis of facial area.

Limited vaginal hysterectomy after brachytherapy in patients with early stage cervix carcinoma

International Nuclear Information System (INIS)

Resbeut, M.; Honnoun-Levi, J.M.; Alzieu, C.; Cowen, D.; Cravello, L.; Agostini, A.

1998-01-01

In patients with early cervix carcinoma, both radiotherapy and surgery or combined modalities provide effective therapies. In the two last modalities, recommended surgery is radical hysterectomy. The purpose of this prospective study was to assess the value of a limited vaginal hysterectomy after brachytherapy in patients without any unfavorable prognostic factor. Twenty-two patients (stage la2 with vascular invasion: three patients, stage lb1:19 patients) with 1 cm median maximal tumor size and with previous negative laparoscopic lymphadenectomy (median number of lymph nodes:12) underwent a limited vaginal hysterectomy 6 weeks after utero-vaginal brachytherapy. Two mild intra-operative complications were noted. Venous hemorrhage (100 mL) occurred in one patient during lymphadenectomy and another patient presented bladder injury during hysterectomy. These two complications were successfully controlled with no need for laparotomy. Only one late complication was observed: bladder grade G2(b). With a 29 months follow-up (20-48 months), no recurrence was reported. These results appear promising in patients with very early cervix carcinoma but remain to be confirmed on a larger scale. (authors)

Clinical application of four plasma tumor markers and 13C-urea test in diagnosis of patients with gastric carcinoma

International Nuclear Information System (INIS)

Pu Weigang; Tan Jifu; Zhu Jianhua; Yang Yongqing

2010-01-01

Objective: To investigate clinical value of plasma gastrin, leptin, carbohydrate antigen 125 (CA125), carbohydrate antigen 72-4 (CA72-4) and 13 C-urea breath test ( 13 C-UBT) in diagnosis of patients with gastric carcinoma. Methods: Radioimmunoassay and enzyme immunosorbent assay were used to determine the plasma gastrin, leptin, CA125 and CA72-4 levels, and helicobacter pylori (HP) infection rate was determined by 13 C-UBT. Compared all the determined results from 126 patients with gastric carcinoma (including 32 cases I-II stage gastric carcinoma, 57 cases III stage gastric carcinoma and 37 cases IV stage gastric carcinoma) and 60 normal controls. Results: The plasma gastrin, CA125 and CA72-4 levels in 126 patients with gastric carcinoma were significantly higher (t=3.125, t=3.159, t=3.788, P 13 C-UBT played a considerable role for diagnosis and therapy. (authors)

Late effects of radiation therapy for prostate carcinoma: The patient`s perspective of bladder, bowel and sexual morbidity

Energy Technology Data Exchange (ETDEWEB)

Franklin, C.I.V.; Parker, C.A.; Morton, K.M. [Queensland Radium Institute, Herston, QLD (Australia)

1998-02-01

The patients` perceptions of the late effects of radiation therapy for carcinoma of the prostate on bladder, bowel and sexual function were determined by using a self-administered questionnaire (included as an appendix) which was posted in June 1996 to patients who had been treated for carcinoma of the prostate between February 1993 and April 1994 at the Herston centre of the Queensland Radium Institute. The questions were based on the SOMA-LENT subjective scales. Moderate bladder morbidity was reported by 15% of patients, with 2% reporting major morbidity. Moderate bowel morbidity was reported by 19% of patients with 2% reporting major morbidity, the major symptoms being bowel urgency and mucus discharge. Sexual function was a problem, with 72% of patients reporting dissatisfaction with their current level of sexual activity. Copyright (1998) Blackwell Science Pty Ltd 12 refs., 5 tabs., 2 figs.

Diagnostic value of tissue polypeptide specific antigen in serum for patients with pancreatic carcinoma

International Nuclear Information System (INIS)

Lu Yun; Liu Xingdang; Li Ding; Dei Shouzhen

2009-01-01

Objective: To compare the diagnostic value of tissue polypeptide specific antigen (TPS) in serum, with the carbohydrate antigens (CA) 19-9, CA50, CA125 and CA242 in pancreatic carcinoma. Methods: Serum TPS was measured with enzyme linked immunosorbent assay (ELISA). CA19-9 and CA125 were measured with chemiluminescent immunoassay. CAS0 and CA242 were measured with immunoradiometric assay in 33 patients with pancreatitis, 34 patients with pathologically proven pancreatic carcinoma, and 35 patients with non-pancreatic malignancies. Statistic analysis was carried out with SPSS 9.0 software. Results: Patients with pancreatic carcinoma had relatively higher levels of TPS [(386.5 ± 315. 1) U/L] and CA19-9 [(10 820.9 ± 389.7) kU/L] when compared with patients with pancreatitis [(86. 2 ± 28.1) U/L and (61.5 ± 24.7) kU/L, respectively; F = 936. 42, P < 0. 001 ; F = 2217. 09, P < 0. 001], with a sensitivity and a specificity of 70.6% (48/68) and 57.4% (39/68), respectively, for TPS, and 82.4% (28/34) and 77.9% (53/68), respectively, for CA19-9. Diagnostic performance was further improved when TPS was assayed in combination with CA19-9, CA50, CA125 and CA242. Conclusion: Serum TPS has an incremental value in complementing CA19-9 in the diagnosis of pancreatic carcinoma. (authors)

External radiotherapy in thyroid cancer

International Nuclear Information System (INIS)

Samuel, A.M.; Shah, D.H.

1999-01-01

In the management of thyroid carcinoma (TC) of any histological type, surgery is the primary mode of treatment. The second modality for the management is treatment with radioactive iodine ( 131 I), especially, when the tumor has the ability to concentrate 131 I. External radiotherapy has a limited use in differentiated thyroid carcinoma (DTC). It is useful in the management of bulky residual tissue which is not completely resected, metastatic disease which does not concentrated radioiodine and as a palliative treatment for reliving pain in patients with distant metastases. The ER as an adjuvant treatment in both anaplastic and medullary carcinoma has a significant role to play and should be used more frequently than is presently being advocated and practiced

Cytologic follow-up of patients with invasive cervical carcinoma treated by radiotherapy

International Nuclear Information System (INIS)

Muram, D.; Curry, R.H.; Drouin, P.

1982-01-01

In an 11-year study done at the Ottawa Civic Hospital, cytologic assessment of 323 patients treated by radiotherapy for invasive cervical carcinoma was reviewed. The value and limitations of gynecologic cytology in the follow-up of these patients are discussed

Seric thyroglobulin behavior in thyroid carcinoma patients treated with 131I

International Nuclear Information System (INIS)

Viterbo, B.G.

1988-01-01

The thyroid carcinomas, mainly the differentiated ones, for involving originally young patients and for showing relatively benign course, require a long term follow-up. So, every new available method that may be useful for the follow-up of these patients soon becomes very important. The advent of radioimmunoassay made the determination of thyroglobulin seric levels possible and this practice has been incorporated into medical routine in the past few years. The analysis of the results permit to conclude that the administration of 131 I therapeutic dose to differentiated and medular thyroid carcinoma patients is followed by imediate and transitory rise in circulating thyroglobulin levels. It denotes immediate effect of the 131 I that can be observed in a short period of time independently of L-T3 administration and endogen TSH levels. After this period the thyroglobulin is at least in a partial way, TSH-dependent. (author) [pt

Cholangiographic evaluation of bile duct carcinoma

International Nuclear Information System (INIS)

Nichols, D.A.; MacCarty, R.L.; Gaffey, T.A.

1983-01-01

Cholangiograms and clinical histories of 82 patients with biopsy-proved bile duct carcinoma were reviewed. The carcinomas were classified according to morphologic findings and clinical outcome. Ulcerative colitis and antecedent inflammatory disease of the biliary tree, particularly primary sclerosing cholangitis, seem to predispose to the development of bile duct carcinoma. Focal stenotic lesions were the most common morphologic type (62/82). Polypoid carcinomas and diffuse sclerosing carcinomas were less common and of about equal frequency. Prognosis was best for patients with polypoid carcinomas and worst for those with diffuse sclerosing carcinomas. In 69 cases (84%), the tumors involved the intrahepatic or proximal extrahepatic ducts, makin curative resection difficult or impossible. Patients with carcinomas limited to the more distal extrahepatic bile ducts had a longer average survival and a higher probability of surgical cure. Proper management of patients with bile duct carcinoma requires a complete and accurate cholangiographic evaluation of the morphology, location, and extent of the disease

Effect of vitamin E on protein bound carbohydrate complexes in radiation treated oral squamous cell carcinoma patients

International Nuclear Information System (INIS)

Chitra, S.; Shyamala Devi, C.S.

2008-01-01

Serum glycoproteins were evaluated in oral squamous cell carcinoma patients treated with radiotherapy and also the effect of vitamin E was studied. Cell surface glycoconjugates are important parameters in the detection of malignancy. Thus, the objective of the present study is to evaluate the efficacy of vitamin E on glycoproteins in oral cavity cancer patients treated with radiotherapy. The study includes 26 age and sex matched normal healthy individuals and 26 patients with squamous cell carcinoma of oral cavity. These patients were divided into two groups, one for radiotherapy alone (at a dosage of 6000 cGy in five fractions per week for a period of six weeks) and the other for radiotherapy plus vitamin E supplementation (at a dosage of 400 IU/day of vitamin E) for the entire period of radiotherapy. Levels of hexose, hexosamine, fucose and sialic acid were increased in oral squamous cell carcinoma patients and a significant decrease was observed in radiation treated patients when compared to control. The levels of glycoconjugates were significantly decreased in radiation treated patients supplemented with vitamin E. This measurement may be useful in assessing disease progression and identifying patients resistant to therapy and a possible role of vitamin E on reduction in glycoconjugate levels of radiation treated oral squamous cell carcinoma patients. (author)

Urinary bladder carcinoma with divergent differentiation featuring small cell carcinoma, sarcomatoid carcinoma, and liposarcomatous component.

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Yasui, Mariko; Morikawa, Teppei; Nakagawa, Tohru; Miyakawa, Jimpei; Maeda, Daichi; Homma, Yukio; Fukayama, Masashi

2016-09-01

Both small cell carcinoma and sarcomatoid carcinoma of the urinary bladder are highly aggressive tumors, and a concurrence of these tumors is extremely rare. We report a case of urinary bladder cancer with small cell carcinoma as a predominant component, accompanied by sarcomatoid carcinoma and conventional urothelial carcinoma (UC). Although the small cell carcinoma component had resolved on receiving chemoradiotherapy, rapid growth of the residual tumor led to a fatal outcome. A 47-year-old man presented with occasional bladder irritation and had a 2-year history of asymptomatic hematuria. Cystoscopy revealed a huge mass in the urinary bladder, and transurethral resection was performed. Microscopically, small cell carcinoma was detected as the major tumor component. Spindle-shaped sarcomatoid cells were also observed that were intermingled with small cell carcinoma and conventional UC. In addition, a sheet-like growth of the lipoblast-like neoplastic cells was observed focally. Initially, by providing chemoradiotherapy, we achieved a marked tumor regression; however, the tumor rapidly regrew after the completion of chemoradiotherapy, and the patient underwent radical cystectomy. Only conventional UC and sarcomatoid carcinoma were identified in the cystectomy specimen. The patient died of the disease 4 months after cystectomy. Urinary bladder cancer may include a combination of multiple aggressive histologies as in the present case. Because the variation in the tumor components may affect the efficacy of therapy, a correct diagnosis of every tumor component is necessary. Copyright © 2016 Elsevier GmbH. All rights reserved.

Immunological status of patients with uterine ceroix carcinoma

International Nuclear Information System (INIS)

Il'in, I.V.; Dekster, L.I.; Letskij, V.B.

1979-01-01

Comparative data on the immunological status of 60 patients with uterine cervix carcinoma 27 of whom were exposed to combined radiotherapy are given. The evaluation of the immunological parameters makes it possible to note a marked affection of the T system by radiant energy. Taking into consideration a significant immunodepressive effect of irradiation it is advisable that immunotherapy by included into the therapeutic regimen

Treatment room length-of-stay and patient throughput with radioiodine thyroid remnant ablation in differentiated thyroid cancer: comparison of thyroid-stimulating hormone stimulation methods.

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Vallejo Casas, Juan Antonio; Mena Bares, Luisa M; Gálvez, María Angeles; Marlowe, Robert J; Latre Romero, José M; Martínez-Paredes, María

2011-09-01

We sought to empirically compare treatment room length-of-stay and patient throughput for recombinant human thyroid-stimulating hormone (rhTSH)-aided thyroid remnant ablation with thyroid hormone withdrawal (THW)-aided ablation in patients with differentiated thyroid carcinoma (DTC). We retrospectively reviewed charts of all eligible (near) totally thyroidectomized patients with DTC undergoing ablation and 1-year ablation success evaluation at our tertiary referral centre from January 2003 to February 2009 (N=274). M1 disease caused exclusion unless discovered by a postablation scan or present when rhTSH was the only tolerable stimulation method. We extracted data on the length-of-stay, defined as the time between treatment room admission and discharge, and patient throughput, defined as patients ablated per treatment room per week. The treatment room discharge criterion was a whole-body dose rate of less than 60 μSv/h at 50 cm. The treatment groups (rhTSH, n=187; THW, n=87) had mostly statistically similar characteristics, but differed in primary tumour status distribution. In addition, at ablation, the rhTSH patients had a greater prevalence of prior diagnostic scintigraphy, higher mean serum TSH, and shorter interval since surgery, and received a 5.6% larger mean ablation activity. On average, rhTSH patients had a significantly lower peak whole-body dose rate (57.1 vs. 83.4 μSv/h at 50 cm; P<0.0001) and a significantly shorter treatment room stay than did the THW patients (1.41 vs. 2.02 days; P<0.001). rhTSH use allowed significantly more patients to be ablated per room per week (2.7 vs. 1.2; P<0.001). Relative to THW, rhTSH use to aid ablation reduced mean treatment room length-of-stay by almost one-third and more than doubled the average weekly patient throughput, both of which were significant differences.

Potential Role of Metabolic Intervention in the Management of Advanced Differentiated Thyroid Cancer

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Sri Harsha Tella

2017-07-01

Full Text Available Well-differentiated thyroid carcinoma (DTC is the most common endocrine malignancy that has an excellent prognosis with a 5-year survival rate of about 98%. However, approximately 50% of the patients with DTC who present with distant metastases (advanced DTC die from the disease within 5 years of initial diagnosis even after getting the appropriate therapy. Apart from recent advancements in chemotherapy agents, the potential role of metabolic interventions, including the use of metformin, ketogenic diet, and high-dose vitamin C in the management of advanced cancers have been investigated as a less toxic co-adjuvant therapies. The role of vitamin C has been of interest again after a preclinical mice study showed that high-dose vitamin C is selectively lethal to KRAS and BRAF mutant colorectal cancer cells by targeting the glutathione pathway. This raises the possibility of utilizing high-doses of vitamin C in the treatment of aDTC where KRAS and BRAF mutations are common. Similarly, alteration of cellular metabolism by low-carbohydrate ketogenic diets can be an important therapeutic strategy to selectively kill cancer cells that mainly survive on glycolysis. Among the potential adjuvant therapies proposed in this paper, metformin is the only agent that has shown benefit in human model of aDTC, the others have shown benefit but in preclinical/animal studies only and need to be further evaluated in large clinical trials. In conclusion, in addition to concurrent chemotherapy options, these metabolic interventions may have a great potential as co-adjuvant therapy in the management of aDTC.

Correlation between CT findings and prognosis of patients with carcinoma of the cervix

International Nuclear Information System (INIS)

Kubota, Susumu; Ohara, Kiyoshi; Okumura, Toshiyuki; Gomi, Hiromichi; Nakano, Takashi; Arai, Tatsuo.

1986-01-01

Ninety-one patients with carcinoma of the cervix received radical radiation therapy from May 1981 through August 1983 at NIRS hospital. The correlation between eight CT findings and the prognosis was analysed in 75 patients, performed CT scan within 15 days form the admision. Among these CT findings, area of uterine cervix correlates well with recurrence, and enlargement of para-aortic lymph nodes showed the strong correlation between metastasis. We also analized these data by a multivariate analytical method (quantification method II). There exists a correlation between the prognosis and the score of quantification method II, and this score will be a good index of the prognosis of patients with carcinoma of the cervix. (author)

Relative Effectiveness of Letrozole Compared With Tamoxifen for Patients With Lobular Carcinoma in the BIG 1-98 Trial

DEFF Research Database (Denmark)

Metzger Filho, Otto; Giobbie-Hurder, Anita; Mallon, Elizabeth

2015-01-01

assigned onto the Breast International Group (BIG) 1-98 trial and who had centrally reviewed pathology data were included (N = 2,923). HER2-negative IDC and ILC were additionally classified as hormone receptor-positive with high (luminal B [LB] -like) or low (luminal A [LA] -like) proliferative activity......PURPOSE: To evaluate the relative effectiveness of letrozole compared with tamoxifen for patients with invasive ductal or lobular carcinoma. PATIENTS AND METHODS: Patients diagnosed with early-stage invasive ductal carcinoma (IDC) or classic invasive lobular carcinoma (ILC) who were randomly...

A clinical study on carcinoembryonic antigens in patients with squamous cell carcinoma of the lung

International Nuclear Information System (INIS)

Moriya, Hiroshi; Satoh, Toshihiko; Kimura, Kazuei; Togawa, Takafumi; Higuchi, Yoshisuke

1986-01-01

The serum levels of carcinoembryonic antigens (CEA) were determined in 57 patients with squamous cell carcinoma of the lung. The overall positive ratio was 45.6 %. The patients were classified into 2 groups, a peripheral type and a central type, according to bronchoscopic findings. The positive ratio in patients with peripheral type was 66.7 %. And the ratio with central type was 26.7 %. There was a significant difference (p < 0.005) between peripheral type and central type of squamous cell carcinoma of the lung. (author)

Is there a role of whole-body bone scan in patients with esophageal squamous cell carcinoma

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2012-01-01

Background Correct detection of bone metastases in patients with esophageal squamous cell carcinoma is pivotal for prognosis and selection of an appropriate treatment regimen. Whole-body bone scan for staging is not routinely recommended in patients with esophageal squamous cell carcinoma. The aim of this study was to investigate the role of bone scan in detecting bone metastases in patients with esophageal squamous cell carcinoma. Methods We retrospectively evaluated the radiographic and scintigraphic images of 360 esophageal squamous cell carcinoma patients between 1999 and 2008. Of these 360 patients, 288 patients received bone scan during pretreatment staging, and sensitivity, specificity, positive predictive value, and negative predictive value of bone scan were determined. Of these 360 patients, surgery was performed in 161 patients including 119 patients with preoperative bone scan and 42 patients without preoperative bone scan. Among these 161 patients receiving surgery, 133 patients had stages II + III disease, including 99 patients with preoperative bone scan and 34 patients without preoperative bone scan. Bone recurrence-free survival and overall survival were compared in all 161 patients and 133 stages II + III patients, respectively. Results The diagnostic performance for bone metastasis was as follows: sensitivity, 80%; specificity, 90.1%; positive predictive value, 43.5%; and negative predictive value, 97.9%. In all 161 patients receiving surgery, absence of preoperative bone scan was significantly associated with inferior bone recurrence-free survival (P = 0.009, univariately). In multivariate comparison, absence of preoperative bone scan (P = 0.012, odds ratio: 5.053) represented the independent adverse prognosticator for bone recurrence-free survival. In 133 stages II + III patients receiving surgery, absence of preoperative bone scan was significantly associated with inferior bone recurrence-free survival (P = 0

Is there a role of whole-body bone scan in patients with esophageal squamous cell carcinoma

International Nuclear Information System (INIS)

Li, Shau-Hsuan; Huang, Yung-Cheng; Huang, Wan-Ting; Lin, Wei-Che; Liu, Chien-Ting; Tien, Wan-Yu; Lu, Hung-I

2012-01-01

Correct detection of bone metastases in patients with esophageal squamous cell carcinoma is pivotal for prognosis and selection of an appropriate treatment regimen. Whole-body bone scan for staging is not routinely recommended in patients with esophageal squamous cell carcinoma. The aim of this study was to investigate the role of bone scan in detecting bone metastases in patients with esophageal squamous cell carcinoma. We retrospectively evaluated the radiographic and scintigraphic images of 360 esophageal squamous cell carcinoma patients between 1999 and 2008. Of these 360 patients, 288 patients received bone scan during pretreatment staging, and sensitivity, specificity, positive predictive value, and negative predictive value of bone scan were determined. Of these 360 patients, surgery was performed in 161 patients including 119 patients with preoperative bone scan and 42 patients without preoperative bone scan. Among these 161 patients receiving surgery, 133 patients had stages II + III disease, including 99 patients with preoperative bone scan and 34 patients without preoperative bone scan. Bone recurrence-free survival and overall survival were compared in all 161 patients and 133 stages II + III patients, respectively. The diagnostic performance for bone metastasis was as follows: sensitivity, 80%; specificity, 90.1%; positive predictive value, 43.5%; and negative predictive value, 97.9%. In all 161 patients receiving surgery, absence of preoperative bone scan was significantly associated with inferior bone recurrence-free survival (P = 0.009, univariately). In multivariate comparison, absence of preoperative bone scan (P = 0.012, odds ratio: 5.053) represented the independent adverse prognosticator for bone recurrence-free survival. In 133 stages II + III patients receiving surgery, absence of preoperative bone scan was significantly associated with inferior bone recurrence-free survival (P = 0.003, univariately) and overall survival (P = 0

Evaluation of the presence of Epstein-Barr virus (EBV) in Iranian patients with thyroid papillary carcinoma.

Science.gov (United States)

Homayouni, Maryam; Mohammad Arabzadeh, Seyed Ali; Nili, Fatemeh; Razi, Farideh; Amoli, Mahsa Mohammad

2017-07-01

Papillary thyroid carcinoma (PTC) is the most common thyroid cancer. EBV is one of the most important viruses related to different types of malignancies. This study investigated the relationship between EBV and papillary thyroid carcinoma. In this study the presence of Epstein-Barr Nuclear Antigen 1 (EBNA1) gene in papillary thyroid carcinoma tissues were examined by nested-PCR method. Paraffin-embedded tissues (N=41) blocks of thyroid cancer were used. DNA was extracted from all samples and then samples were evaluated for the presence of EBV gene. In 41 samples, EBNA1 was detected in 65.8% of patients with papillary thyroid carcinoma which was significantly higher in younger ages. The significant presence of EBV genome in papillary thyroid carcinoma suggests that this virus may play a role in this cancer especially in younger ages. As a result, monitoring of patients with EBV latent infection for PTC can be very important. Copyright © 2017 Elsevier GmbH. All rights reserved.

Treatment of a Patient with Merkel Cell Skin Carcinoma Using Radiation Therapy - A Case Report.

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Petrov, Andrej; Kraleva, Slavica; Kubelka-Sabit, Katerina; Petrova, Deva

2018-04-15

Merkel cell carcinoma (MCC) is a rare, very aggressive tumour. The pathogenesis remains unclear, but UV radiation, immunosuppression, and the presence of Merkel cell polyomavirus in the tumour genome appear to have a key role. Merkel cell carcinoma is a highly aggressive tumour that often has a lethal end. A patient at 93 years of age comes for an examination by a dermatologist due to a rapidly growing nodular tumour growth in the forehead area. A tumour was about 3 cm in size. It had no signs of basal-cell carcinoma, no arborising vascularisation, no pigmentations on dermoscopy. Clinically, an eventual Merkel cell carcinoma was considered for the patient, but other primary skin tumours had to be excluded, as well as the possibility that regarding the patient's age, it may be a metastatic deposit. A skin biopsy was performed, as well as H-E examination and immunohistochemical analyses (positive CD56, positivity of neuroendocrine markers synaptophysin, chromogranin) which were in favour of Merkel cell carcinoma of the skin. After setting the diagnosis, our patient was treated with therapy which led to a complete withdrawal of a tumour. However, after 3 months the patient had repeated relapse of a tumour at the same site on the forehead and metastases in the retroauricular lymph nodes bilaterally. It shows that the radiotherapy as monotherapy has a great effect on the removal of the tumour formation, but unfortunately, it has no impact on lesion recurrence. It is also compatible with the literature data. In many adult patients, as our case suggests, radiotherapy could be a good palliative treatment opportunity that should be considered, as well as a combination of radiation therapy with other oncologic therapeutic options.

63 Patients and cytokeratin 8/18 expression in breast, atypical ductal hyperplasia, ductal carcinoma in situ and invasive Duct Carcinoma

International Nuclear Information System (INIS)

Shamloula, M.M.; El-Shorbagy, S.H.; Saied, E.M.E.

2007-01-01

Background and Purpose: The pattern and distribution of 63 Patients expression as a myoepithelia/basal stem cell marker can be different between atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) and may denote basal phenotype of breast ductal carcinoma. CK8/18 is a luminal marker and may indicate a luminal phenotype of IDC and its expression in ADH and DCIS may refer to a possible precursor lesion to IDC. This work was designed to study and compare the expression of 63 Patients and cytokeratin 8/18 (CK8/l8) in some cases of ADH, DC IS and IDC. Materials and Methods: Histopathological evaluation and immunohistochemical study of anti- 63 Patients and anti-CK8/l8 was performed on selected archival cases of 7 ADH, 12 DCIS, 30 IDC of known clinico pathological data and previous estrogen receptor status (ER) for IDe. Confirmatory anti-smooth muscle actin (ASMA) expression for positive 63 Patients cases was performed. Results: 63 Patients was expressed in the peripheral rim of the myoepithelial cell layer in ADH and DCIS with occasional gabs in DCrS. It was positive and stained occasional malignant cells in 3/30 (10%) of IDC cases. Confirmatory ASMA staining decorated the same peripheral rim of cells in ADH and DCIS, but was negative in 63 Patients positive IDC cases. CK8/l8 was positive in 100% of ADH, 8/12 (66.7%) of DC IS and 22/30 (73%) of IDC cases. Combined 63 Patients and CK8/ 18 expression was noticed in 3/30 (10%) of IDe. Conclusion: It is concluded from this study that 63 Patients is specific and valuable in differentiating myoepithelial cells and is more specific and valuable than other myoepithelial markers, as ASMA and can differentiate between ADH, DCIS, IDC as it stains peripheral myoepithelial cells in ADH and DCIS with gabs in the latter and does not stain any neoplastic cells. In IDC, it is positive in malignant cells in a minority of cases which may indicate basal/stem cell/myoepithelial cell origin

[Solitary hyperfunctioning thyroid gland carcinomas].

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Zivaljevic, V; Zivic, R; Diklic, A; Krgovic, K; Kalezic, N; Vekic, B; Stevanovic, D; Paunovic, I

2011-08-01

Thyroid gland carcinomas usually appear as afunctional and hypofunctional lesions on thyroid scintigrams, but some rare cases of thyroid carcinoma with scintigraphic hyperfunctional lesions have also been reported. The aim of our retrospective study was to elucidate the frequency of carcinomas in patients operated for solitary hyperfunctional thyroid nodules and to represent their demographic and clinical features. During one decade (1997/2006), 308 patients were operated for solitary hyperfunctional thyroid nodules in the Centre for Endocrine Surgery in Belgrade. Malignancy was revealed in 9 cases (about 3 %) by histopathological examination. In 6 cases papillary microcarcinomas were found adjacent to dominant hyperfunctional adenomas, while in 3 cases (about 1 %) real hyperfunctional carcinomas were confirmed. Follicular carcinoma was diagnosed in 2 cases and papillary carcinoma in one. All 3 patients were preoperatively hyperthyroid. In both patients with follicular carcinoma we performed lobectomies. In the third case we carried out a total thyroidectomy considering the intraoperative frozen section finding of a papillary carcinoma. According to our results the frequency of solitary hyperfunctioning thyroid carcinomas is about 1 %, so that the possibility that a hyperfunctional nodule is malignant should be considered in the treatment of such lesions. © Georg Thieme Verlag KG Stuttgart ˙ New York.

Clinical features and prognostic factors for survival in patients with poorly differentiated thyroid carcinoma and comparison to the patients with the aggressive variants of papillary thyroid carcinoma

International Nuclear Information System (INIS)

Jung, Tae-Sik; Kim, Tae-Yong; Kim, Kyung-Won

2007-01-01

We performed this study to compare the clinicopathologic features and outcomes between the patients with poorly differentiated thyroid carcinoma (PDTC) and the patients with the aggressive variants of papillary thyroid carcinoma (PTC). To evaluate the prognostic factors for survival of the patients with PDTC, we selected 49 patients with PDTC and 23 patients with the aggressive variants of PTC from three hospitals during the recent 15 years. The five-year survival rate and clinicopathologic features of the patients with PDTC were not different from those of the patients with the aggressive variants of PTC. Univariate analysis revealed the significant poor prognostic factors for survival of the patients with PDTC and the aggressive variants of PTC as follows: an age more than 45 years, a tumor size larger than 4 cm, the presence of tumor invasion to extrathyroidal tissue or the trachea, the presence of cervical lymph node invasion, the presence of distant metastasis, the absence of high-dose radioactive iodine (RAI) therapy, and tumor, nodes and metastasis (TNM) stage II, III and IV. Distant metastasis and high-dose RAI therapy were independent significant predictors for survival of the patients with PDTC and the aggressive variants of PTC on multivariate analysis. However, distant metastasis was the only independent significant predictors for survival of the patients with PDTC excluding patients with the aggressive variants of PTC. (author)

Patient awareness and sun protection behaviour following excision of basal cell carcinoma.

Science.gov (United States)

de Blacam, Catherine; Dermott, Clodagh Mc; Sugrue, Conor; Kilmartin, Darren; Kelly, Jack

2017-02-01

Limited information is available regarding disease awareness and sun protection behaviour in patients previously treated for non-melanoma skin cancer. Using a telephone-administered questionnaire, we investigated these characteristics in 250 patients in the west of Ireland who had undergone excision of basal cell carcinomas between January 2011 and December 2012. Only 28.8% of respondents knew that the lesion they had excised was a BCC and understood that there was a significant chance of developing another similar lesion in the next 3 years. Women and patients under age 65 were significantly better informed about their diagnosis than men (p = 0.021 and 0.000 respectively). The majority of patients (71.2%) knew that the overall effect of UV radiation on the skin was harmful and did employ some form of sun protection (avoid midday sun 72%; stay in shade 74%; wear hat 73.6%; wear sunscreen 72.8%). Females were statistically more likely to exercise better sun-protection behaviour (p = 0.002). While 76.8% of patients undertook some form of outdoor activity every day, only 22.8% wore sunscreen every day. Greater efforts should be made to communicate disease details and sun protection implications associated with basal cell carcinoma, especially to male patients. Improved population specific skin cancer awareness may lead to earlier detection and thus decrease both the patient morbidity and economic burden associated with locally advanced basal cell carcinoma. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Giant basal cell carcinoma Carcinoma basocelular gigante

Directory of Open Access Journals (Sweden)

Nilton Nasser

2012-06-01

Full Text Available The basal cell carcinoma is the most common skin cancer but the giant vegetating basal cell carcinoma reaches less than 0.5 % of all basal cell carcinoma types. The Giant BCC, defined as a lesion with more than 5 cm at its largest diameter, is a rare form of BCC and commonly occurs on the trunk. This patient, male, 42 years old presents a Giant Basal Cell Carcinoma which reaches 180 cm2 on the right shoulder and was negligent in looking for treatment. Surgical treatment was performed and no signs of dissemination or local recurrence have been detected after follow up of five years.O carcinoma basocelular é o tipo mais comum de câncer de pele, mas o carcinoma basocelular gigante vegetante não atinge 0,5% de todos os tipos de carcinomas basocelulares. O Carcinoma Basocelular Gigante, definido como lesão maior que 5 cm no maior diâmetro, é uma forma rara de carcinoma basocelular e comumente ocorre no tronco. Este paciente apresenta um Carcinoma Basocelular Gigante com 180cm² no ombro direito e foi negligente em procurar tratamento. Foi realizado tratamento cirúrgico e nenhum sinal de disseminação ou recorrência local foi detectada após 5 anos.

Vismodegib in patients with advanced basal cell carcinoma (STEVIE): a pre-planned interim analysis of an international, open-label trial.

Science.gov (United States)

Basset-Seguin, Nicole; Hauschild, Axel; Grob, Jean-Jacques; Kunstfeld, Rainer; Dréno, Brigitte; Mortier, Laurent; Ascierto, Paolo A; Licitra, Lisa; Dutriaux, Caroline; Thomas, Luc; Jouary, Thomas; Meyer, Nicolas; Guillot, Bernard; Dummer, Reinhard; Fife, Kate; Ernst, D Scott; Williams, Sarah; Fittipaldo, Alberto; Xynos, Ioannis; Hansson, Johan

2015-06-01

The Hedgehog pathway inhibitor vismodegib has shown clinical benefit in patients with advanced basal cell carcinoma and is approved for treatment of patients with advanced basal cell carcinoma for whom surgery is inappropriate. STEVIE was designed to assess the safety of vismodegib in a situation similar to routine practice, with a long follow-up. In this multicentre, open-label trial, adult patients with histologically confirmed locally advanced basal cell carcinoma or metastatic basal cell carcinoma were recruited from regional referral centres or specialist clinics. Eligible patients were aged 18 years or older with an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2, and adequate organ function. Patients with locally advanced basal cell carcinoma had to have been deemed ineligible for surgery. All patients received 150 mg oral vismodegib capsules once a day on a continuous basis in 28-day cycles. The primary objective was safety (incidence of adverse events until disease progression or unacceptable toxic effects), with assessments on day 1 of each treatment cycle (28 days) by principal investigator and coinvestigators at the site. Efficacy variables were assessed as secondary endpoints. The safety evaluable population included all patients who received at least one dose of study drug. Patients with histologically confirmed basal cell carcinoma who received at least one dose of study drug were included in the efficacy analysis. An interim analysis was pre-planned after 500 patients achieved 1 year of follow-up. This trial is registered with ClinicalTrials.gov, number NCT01367665. The study is still ongoing. Between June 30, 2011, and Nov 6, 2014, we enrolled 1227 patients. At clinical cutoff (Nov 6, 2013), 499 patients (468 with locally advanced basal cell carcinoma and 31 with metastatic basal cell carcinoma) had received study drug and had the potential to be followed up for 12 months or longer. Treatment was discontinued in 400 (80

A patient presenting with spinal cord compression who had two distinct follicular cell type thyroid carcinomas.

Science.gov (United States)

Koca, E; Sokmensuer, C; Yildiz, B O; Engin, H; Bozkurt, M F; Aras, T; Barista, I; Gurlek, A

2004-06-01

A 61-yr-old woman presented with complaints of weakness and pain in her legs. A magnetic resonance imaging showed a 3 x 5.6 x 7.8 cm mass lesion destructing the T1 and T2 vertebral bodies and compressing the spinal cord. The mass was excised surgically. It was follicular carcinoma metastasis of the cervicodorsal region. Then, she underwent a total thyroidectomy. Pathological examination showed two different types of carcinomas in two different focuses; follicular carcinoma in the left lobe and follicular variant papillary carcinoma in the isthmic lobe. After the operation she was given 100 mCi 131I. This is the first report of a patient who had both metastatic follicular carcinoma and follicular variant papillary carcinoma together.

Clinical analysis of post-irradiation sensorineural hearing loss in patients suffering from nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Lu Xueguan; Liu Zhiyong; Zhang Liyuan; Tian Ye

2005-01-01

Objective: To investigate the incidence of post-irradiation sensorineural hearing loss (SNHL) in patients suffering from nasopharyngeal carcinoma and to evaluate its potentially contributing factors. Methods: Pure tonetest and impedance audiography were carried out in patients suffering from nasopharyngeal carcinoma with a post-irradiation follow-up time over 1 year. Additionally, the test results were combined with clinical data and analyzed retrospectively. Results: The follow-up time of all patients ranged from 12 to 94 months (median 53 months). The incidences of SNHL at low and high frequencies were 8% and 42% respectively. Univariate analysis showed that patient's age and follow-up time affected the incidence of SNHL at high frequencies (t=2.051, P=0.0269; t=2.978, P=0.0011), but sex, preirradiation subjective hearing loss, irradiation dose and chemotherapy including cisplatin had no significance. Multivariate analysis by Binary Logistic Regression revealed that the risk of SNHL was correlated with patient's age and follow-up time (P=0.02; P=0.009). Conclusion: Post-irradiation SNHL at high frequencies in patients suffering from nasopharyngeal carcinoma is more common than that at low frequencies. The independent prognostic factors for development of SNHL at high frequencies are patient's age and follow-up time. But the role of preirradiation hearing level ,irradiation dose and chemotherapy including cisplatin are not conclusive and further research is needed. (authors)

MicroRNA gene polymorphisms and environmental factors increase patient susceptibility to hepatocellular carcinoma.

Directory of Open Access Journals (Sweden)

Yin-Hung Chu

Full Text Available BACKGROUND: Micro RNAs (miRNAs are small RNA fragments that naturally exist in the human body. Through various physiological mechanisms, miRNAs can generate different functions for regulating RNA protein levels and balancing abnormalities. Abnormal miRNA expression has been reported to be highly related to several diseases and cancers. Single-nucleotide polymorphisms (SNPs in miRNAs have been reported to increase patient susceptibility and affect patient prognosis and survival. We adopted a case-control research design to verify the relationship between miRNAs and hepatocellular carcinoma. METHODOLOGY/PRINCIPAL FINDINGS: A total of 525 subjects, including 377 controls and 188 hepatocellular carcinoma patients, were selected. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP and real-time PCR were used to analyze miRNA146a (rs2910164, miRNA149 (rs2292832, miRNA196 (rs11614913, and miRNA499 (rs3746444 genetic polymorphisms between the control group and the case group. The results indicate that people who carry the rs3746444 CT or CC genotypes may have a significantly increased susceptibility to hepatocellular carcinoma (adjusted odds ratio [AOR] = 2.84, 95% confidence interval [CI] = 1.88-4.30. In addition, when combined with environmental risk factors, such as smoking and alcohol consumption, interaction effects were observed between gene polymorphisms and environmental factors (odds ratio [OR] = 4.69, 95% CI = 2.52-8.70; AOR = 3.38, 95% CI = 1.68-6.80. CONCLUSIONS: These results suggest that a significant association exists between miRNA499 SNPs and hepatocellular carcinoma. Gene-environment interactions of miRNA499 polymorphisms, smoking, and alcohol consumption might alter hepatocellular carcinoma susceptibility.

Synchronous lung tumours in a patient with metachronous colorectal carcinoma and a germline MSH2 mutation.

LENUS (Irish Health Repository)

Canney, A

2012-02-01

Mutations of DNA mismatch repair genes are characterised by microsatellite instability and are implicated in carcinogenesis. This mutation susceptible phenotype has been extensively studied in patients with hereditary non-polyposis colon carcinoma, but little is known of the contribution of such mutations in other tumour types, particularly non-small-cell lung carcinoma. This report describes the occurrence of two synchronous lung tumours, one mimicking a metastatic colon carcinoma, in a male patient with a history of metachronous colonic carcinoma. Immunohistochemistry supported a pulmonary origin for both lesions. Mismatch repair protein immunohistochemistry showed loss of MSH2 and MSH6 expression in both colonic tumours and in one lung tumour showing enteric differentiation. Subsequent mutational analysis demonstrated a deleterious germline mutation of the MSH2 mismatch repair gene. The significance of these findings and the practical diagnostic difficulties encountered in this case are discussed.

[Dynamic observation on the short-term change of xerostomia after intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma].

Science.gov (United States)

Li, Yanjie; Zhao, Changqing

2015-01-01

To dynamically analyze the change of xerostomia in patients with nasopharyngeal carcinoma after radiotherapy by DW MRI. Twenty-three nasopharyngeal carcinoma patients confirmed by pathology were enrolled. Male/Female: 19/4. The age was from 37 to 69 years. The patients were divided into two groups: G1, Dmeanxerostomia was assessed. SPSS 13.0 and SAS 8.2 software were used to analyze the data. At the end of IMRT, the change tendency of ADC in parotid and submandibular glands value was different in patients with different degree of xerostomia (F = 11.52, P xerostomia could be found in patients within different irradiation dose groups (Z = -3.622, P xerostomia for patients at the end of IMRT (Z value was -0.791, -0.949, 2.488, all P > 0.05). A significant difference of xerostomia degree in patients was found at the various follow-up time after IMRT (χ(2) = 19.59, P xerostomia in patients with nasopharyngeal carcinoma after radiotherapy. The degrees of salivary gland function and dry mouth in patients with nasopharyngeal carcinoma damage evaluate with illuminated dose increases. The function of salivary gland gradually restored and the degree of dry mouth gradually reduce with the extension of time after radiotherapy.

A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier.

Science.gov (United States)

Ates, Ihsan; Kaplan, Mustafa; Demirci, Selim; Altiparmak, Emin

2016-01-01

Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. Hepatitis B virus infection is one of the most important etilogical factors of HCC. In this case report, a patient with HCC previously infected and having ongoing immunity against hepatitis B virus will be discussed. Ates I, Kaplan M, Demirci S, Altiparmak E. A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier. Euroasian J Hepato-Gastroenterol 2016;6(1):82-83.

Pulmonary squamous cell carcinoma following head and neck squamous cell carcinoma: Metastasis or second primary?

NARCIS (Netherlands)

Geurts, Tom W.; Nederlof, Petra M.; van den Brekel, Michiel W. M.; van't Veer, Laura J.; de Jong, Daphne; Hart, August A. M.; van Zandwijk, Nico; Klomp, Houke; Balm, Alfons J. M.; van Velthuysen, Marie-Louise F.

2005-01-01

Purpose: To distinguish a metastasis from a second primary tumor in patients with a history of head and neck squamous cell carcinoma and subsequent pulmonary squamous cell carcinoma. Experimental Design: For 44 patients with a primary squamous cell carcinoma of the head and neck followed by a

Changes of saliva microbiota in nasopharyngeal carcinoma patients under chemoradiation therapy.

Science.gov (United States)

Xu, Yuan; Teng, Fei; Huang, Shi; Lin, Zhengmei; Yuan, Xiao; Zeng, Xiaowei; Yang, Fang

2014-02-01

A growing body of evidence has implicated human oral microbiota in the aetiology of oral and systemic diseases. Nasopharyngeal carcinoma (NPC), an epithelial-originated malignancy, has a complex aetiology not yet fully understood. Chemoradiation therapy of NPC can affect oral microbiota and is usually accompanied by plaque accumulation. Thus, the study aimed to understand the diversity, divergence and development of the oral microbiota in NPC patients and their associated treatment, which might provide useful insights into disease aetiology and treatment side effects. A longitudinal study was designed that included three Chinese adults with NPC. Saliva samples were collected at three time points: prior to the chemoradiation treatment (carcinoma baseline, or CB), 7 months post-treatment (carcinoma-after-therapy phase 1 or CA1) and 12 months post-treatment (carcinoma-after-therapy phase 2 or CA2). Pyrosequencing of the bacterial 16S ribosomal DNA (rDNA) V1-V3 hypervariable region was employed to characterise the microbiota. Saliva samples of three healthy subjects from our former study were employed as healthy controls. Principal coordinates analysis (PCoA), Metastats and random forest prediction models were used to reveal the key microbial members associated with NPC and its treatment programme. (1) In total, 412 bacterial species from at least 107 genera and 13 phyla were found in the saliva samples of the NPC patients. (2) PCoA revealed that not only were the microbiota from NPC patients distinct from those of healthy controls (p<0.001) but also that separation was found on the saliva microbiota between pre- and post-therapy (p<0.001) in the NPC samples. (3) At the genus level and the operational taxonomic unit (OTU) level, Streptococcus was found with lower abundance in NPC samples. (4) Chemoradiation therapy did not incur similar changes in microbiota structure among the three NPC patients; the microbiota in one of them stayed largely steady, while those in the

Concurrent Endometrial Carcinoma in Patients with a Curettage Diagnosis of Endometrial Hyperplasia

Directory of Open Access Journals (Sweden)

Yu-Li Chen

2009-06-01

Conclusion: When patients are diagnosed with endometrial hyperplasia, surgical intervention should be performed in those with cytological atypia and higher BMI because of the possibility of coexisting endometrial carcinoma.

Is radioactive iodine-131 treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer?

International Nuclear Information System (INIS)

Souza, Marcelo Cruzick de; Momesso, Denise P.; Vieira Neto, Leonardo; Vaisman, Mario; Vaisman, Fernanda; Corbo, Rossana; Martins, Rosangela Aparecida Gomes

2016-01-01

Objective: Much controversy relates to the risk of non-synchronous second primary malignancies (NSSPM) after radioactive iodine treatment (RAI-131) in differentiated thyroid cancer (DTC) patients. This study evaluated the relationship between RAI-131 and NSSPM in DTC survivors with long-term follow-up. Materials and methods: Retrospective analysis of 413 DTC cases was performed; 252 received RAI-131 and 161 were treated with thyroidectomy alone. Exclusion criteria were: prior or synchronous non-thyroidal malignancies (within the first year), familial syndromes associated to multiple neoplasms, ionizing radiation exposure or second tumors with unknown histopathology. Results: During a mean follow-up of 11.0 ± 7.5 years, 17 (4.1%) patients developed solid NSSPM. Patients with NSSPM were older than those without (p = 0.02). RAI-131 and I-131 cumulative activity were similar in patients with and without NSSPM (p = 0.18 and p = 0.78, respectively). Incidence of NSSPM was 5.2% in patients with RAI-131 treatment and 2.5% in those without RAI-131 (p = 0.18). Using multivariate analysis, RAI-131 was not significantly associated with NSSPM occurrence (p = 0.35); age was the only independent predictor (p = 0.04). Under log rank statistical analysis, after 10 years of follow-up, it was observed a tendency of lower NSSPM-free survival among patients that received RAI-131 treatment (0.96 vs. 0.87; p = 0.06), what was not affected by age at DTC diagnosis. Conclusion: In our cohort of DTC survivors, with a long-term follow-up period, RAI-131 treatment and I-131 cumulative dose were not significantly associated with NSSPM occurrence. A tendency of premature NSSPM occurrence among patients treated with RAI-131 was observed, suggesting an anticipating oncogenic effect by interaction with other risk factors. (author)

Long-Term Outcome and Quality of Life of Patients With Endometrial Carcinoma Treated With or Without Pelvic Radiotherapy in the Post Operative Radiation Therapy in Endometrial Carcinoma 1 (PORTEC-1) Trial

NARCIS (Netherlands)

Nout, Remi A.; van de Poll-Franse, Lonneke V.; Lybeert, Marnix L. M.; Warlam-Rodenhuis, Carla C.; Jobsen, Jan J.; Mens, Jan Willem M.; Lutgens, Ludy C. H. W.; Pras, Betty; van Putten, Wim L. J.; Creutzberg, Carien L.

2011-01-01

Purpose To determine the long-term outcome and health-related quality of life (HRQL) of patients with endometrial carcinoma (EC) treated with or without pelvic radiotherapy in the Post Operative Radiation Therapy in Endometrial Carcinoma 1 (PORTEC-1) trial. Patients and Methods Between 1990 and

Usefulness of Pure Laparoscopic Hepatectomy for Hepatocellular Carcinoma in a Severely Cirrhotic Patient

Directory of Open Access Journals (Sweden)

Isamu Hosokawa

2013-07-01

Full Text Available The number of patients undergoing laparoscopic hepatectomy has rapidly increased in recent years, and indications for this procedure are gradually expanding. Pure laparoscopic hepatectomy is reportedly useful in cases with severe liver cirrhosis. A 55-year-old woman under observation for liver cirrhosis was found to have hepatocellular carcinoma in liver segment III and was referred to our hospital for surgery. The tumor was located in the edge of liver segment III, where percutaneous ablation therapy was unsuitable. Since her hepatic functional reserve was poor, pure laparoscopic partial hepatectomy was performed. The postoperative course was favorable, with no ascites retention, edema or weight gain. The greatest advantage of pure laparoscopic hepatectomy for hepatocellular carcinoma with concomitant liver cirrhosis is that postoperative ascites retention is minimal, meaning that there is little risk of water-electrolyte imbalance associated with ascites retention or hypoproteinemia. This is believed to be because the abdominal incision is small and mobilization of the liver is minimized, reducing the destruction of the routes of collateral lymph flow and blood flow generated in patients with liver cirrhosis. Pure laparoscopic hepatectomy may be a treatment choice for patients with hepatocellular carcinoma and concomitant severe liver cirrhosis.

Role of radical resection in patients with gallbladder carcinoma and jaundice.

Science.gov (United States)

Feng, Fei-ling; Liu, Chen; Li, Bin; Zhang, Bai-he; Jiang, Xiao-qing

2012-03-01

Gallbladder carcinoma (GBC) is a commonly-seen malignancy of the biliary tract characterized by difficult early diagnosis, rapid growth, early metastasis, and poor prognosis. Nearly half of GBC patients also have jaundice, which is a mark of the advanced stage of GBC. The role of radical resection in patients of gallbladder carcinoma with jaundice is still a matter of uncertainty, which we attempted to clarify in this study. Totally, 251 GBC patients who received treatment at the Eastern Hepatobiliary Surgery Hospital (EHBH) from December 2002 to January 2010 were recruited into this study. We divided them into group A (jaundice group, n=117) and group B (non-jaundice group, n=134). Clinical records and follow-up data were collected and retrospectively analyzed in both groups. Compared with group A, patients in group B had a longer median survival time ((6.0±0.5) months vs. (15.0±2.6) months, Pjaundice (n=111), was still longer than that in patients with jaundice (n=116) (Pjaundice patients and non-jaundice patients; (12.0±4.3) months vs. (18.0±3.0) months (P>0.05). GBC with jaundice usually implies advanced stage disease and a poor prognosis for the patients. However, our findings indicate that as long as the patient's condition allows, radical resection is still feasible for GBC patients with jaundice, and may achieve a prognosis close to those GBC patients without jaundice.

Relation of Serum Alkaline Phosphatase to liver scintigram in patients with hepatocellular carcinoma

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Nishimura, H; Harada, T; Nawata, J; Hayakawa, M; Nishioka, M; Takemoto, T; Yokoyama, T; Takahashi, M

1982-12-01

Serum Alkaline Phosphatase (ALP) was studied in relation to liver scintigrams of 54 patients with hepatocellular carcinoma. The ALP activity was higher with larger tumors and in multiple tumors. Within the single tumor group, the activity was higher when the tumor was located in the hilum than in the periphery. The incidence of ALP-1 isoenzyme (bile ALP) roughly paralleled the total ALP activity. These results suggest that the variation of serum ALP seen in each individual patients with hepatocellular carcinoma reflects the volume of cholestatic liver tissue, which is changed by the number, size and localization of the tumor nodules in the liver.

Elevated red cell distribution width contributes to a poor prognosis in patients with esophageal carcinoma.

Science.gov (United States)

Wan, Guo-Xing; Chen, Ping; Cai, Xiao-Jun; Li, Lin-Jun; Yu, Xiong-Jie; Pan, Dong-Feng; Wang, Xian-He; Wang, Xuan-Bin; Cao, Feng-Jun

2016-01-15

The red cell distribution width (RDW) has also been reported to reliably reflect the inflammation and nutrition status and predict the prognosis across several types of cancer, however, the prognostic value of RDW in esophageal carcinoma has seldom been studied. A retrospective study was performed to assess the prognostic value of RDW in patients with esophageal carcinoma by the Kaplan-Meier analysis and multivariate Cox regression proportional hazard model. All enrolled patients were divided into high RDW group (≧15%) and low RDW group (<15%) according to the detected RDW values. Clinical and laboratory data from a total of 179 patients with esophageal carcinoma were retrieved. With a median follow-up of 21months, the high RDW group exhibited a shorter disease-free survival (DFS) (p<0.001) and an unfavorable overall survival (OS) (p<0.001) in the univariate analysis. The multivariate analysis revealed that elevated RDW at diagnosis was an independent prognostic factor for shorter PFS (p=0.043, HR=1.907, 95% CI=1.020-3.565) and poor OS (p=0.042, HR=1.895, 95% CI=1.023-3.508) after adjustment with other cancer-related prognostic factors. The present study suggests that elevated preoperative RDW(≧15%) at the diagnosis may independently predict poorer disease-free and overall survival among patients with esophageal carcinoma. Copyright © 2015 Elsevier B.V. All rights reserved.

Everolimus-induced pneumonitis associates with favourable outcome in patients with metastatic renal cell carcinoma

DEFF Research Database (Denmark)

Penttilä, P; Donskov, F; Rautiola, J

2017-01-01

BACKGROUND: Mammalian target of rapamycin inhibitors may induce pneumonitis. We analysed the association of pneumonitis with outcomes in everolimus treated metastatic renal cell carcinoma (mRCC) patients. PATIENTS AND METHODS: Eighty-five mRCC patients received everolimus at Helsinki University...

Clinical significance of combined determination of serum CA199 and tumor specific growth factor (TSGF) contents in patients with primary hepatic carcinoma

International Nuclear Information System (INIS)

Shen Jiancheng

2005-01-01

Objective: To investigate the clinical significance of the changes of serum TSGF and CA199 contents in patients with primary hepatic carcinoma. Methods: Serum CA199 (with IRMA) and TSGF (with biochemistry method) contents were determined in 33 patients with primary hepatic carcinoma and 35 controls. Results: Serum CA199 and TSGF contents were significantly higher in patients with primary hepatic carcinoma than those in controls (P<0.01) and their levels were significantly positively correlated with those of serum AFP. Conclusion: Determination of serum TSGF and CA199 contents was of clinical diagnostic value in patients with primary hepatic carcinoma. (authors)

Merkel Cell Carcinoma in Immunosuppressed Patients

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Ma, Janice E. [Mayo Clinic College of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (United States); Brewer, Jerry D., E-mail: brewer.jerry@mayo.edu [Department of Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (United States)

2014-06-27

Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous malignancy. The infectivity of Merkel cell polyomavirus (MCPyV), an apparent agent in MCC development, may be exacerbated with impaired immune responses. This paper reviews relevant data regarding the role of immunosuppression in the development of MCC and describes modes of immunodeficient states. Because of the inherently low incidence rate of MCC, several case studies and series are also briefly mentioned to provide a more comprehensive summary of MCC in the setting of immunosuppression. We describe immunosuppressed patients who have experienced excessive UV radiation, organ transplantation, human immunodeficiency virus infection/AIDS, autoimmune diseases, and lymphoproliferative disorders. Iatrogenic forms of immunosuppression are also highlighted. Studies that quantify risks consistently report that individuals with a history of solid organ transplantation, autoimmune diseases, AIDS, and/or lymphoproliferative diseases have a significantly elevated risk of developing MCC. Overall, immunocompromised patients also appear to have an early onset and more aggressive course of MCC, with poorer outcomes. Recommendations for multidisciplinary approaches are proposed to effectively prevent and manage MCC in these patients.

Merkel Cell Carcinoma in Immunosuppressed Patients

International Nuclear Information System (INIS)

Ma, Janice E.; Brewer, Jerry D.

2014-01-01

Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous malignancy. The infectivity of Merkel cell polyomavirus (MCPyV), an apparent agent in MCC development, may be exacerbated with impaired immune responses. This paper reviews relevant data regarding the role of immunosuppression in the development of MCC and describes modes of immunodeficient states. Because of the inherently low incidence rate of MCC, several case studies and series are also briefly mentioned to provide a more comprehensive summary of MCC in the setting of immunosuppression. We describe immunosuppressed patients who have experienced excessive UV radiation, organ transplantation, human immunodeficiency virus infection/AIDS, autoimmune diseases, and lymphoproliferative disorders. Iatrogenic forms of immunosuppression are also highlighted. Studies that quantify risks consistently report that individuals with a history of solid organ transplantation, autoimmune diseases, AIDS, and/or lymphoproliferative diseases have a significantly elevated risk of developing MCC. Overall, immunocompromised patients also appear to have an early onset and more aggressive course of MCC, with poorer outcomes. Recommendations for multidisciplinary approaches are proposed to effectively prevent and manage MCC in these patients

Radiation-associated thyroid carcinoma

International Nuclear Information System (INIS)

Razack, M.S.; Sako, K.; Shimaoka, K.; Getaz, E.P.; Rao, U.; Parthasarathy, K.L.

1980-01-01

Since February, 1977, 735 patients having a history of receiving radiation therapy for benign conditions of the head and neck areas during infancy and childhood were examined in a thyroid screening program, and 159 patients were found to have palpable thyroid nodules. These patients had thyroid function tests and indirect laryngoscopy and were followed closely on suppression therapy consisting of either Cytomel or thyroid extract. Thyroidectomy was advised in those in whom the nodules persisted or increased in size. This study documents the incidence of carcinoma and other benign pathological changes and postoperative complications in this group of patients. So far, 49 patients had either a lobectomy with isthmusectomy or a total thyroidectomy. Eleven patients were found to have carcinoma (six had papillary, fou had mixed papillary and follicular, and one had follicular carcinoma). Three patients had a therapeutic modified neck dissection following the documentaion of microscopic involvement of paratracheal lymph nodes. A high incidence of chronic nonspecific thyroiditis, postradiation fibrosis, and follicular adenomas were also found in these patients. Three patients had temporary hypocalcemia (two weeks) and none had wound infection, hematoma, or postoperative nerve palsy. Of patients who had surgical resection, 22.4% showed thyroid carcinoma

Radiation-associated thyroid carcinoma

International Nuclear Information System (INIS)

Razack, M.S.; Sako, K.; Shimaoka, K.; Getaz, E.P.; Rao, U.; Parthasarathy, K.L.

1980-01-01

Since February 1977, 735 patients having a history of receiving radiation therapy for benign conditions of the head and neck areas during infancy and childhood were examined in a thyroid screening program, and 159 patients were found to have palpable thyroid nodules. These patients had thyroid function tests and indirect laryngoscopy and were followed closely on suppression therapy consisting of either Cytomel or thyroid extract. Thyroidectomy was advised in those in whom the nodules persisted or increased in size. This study documents the incidence of carcinoma and other benign pathological changes and postoperative complications in this group of patients. So far, 49 patients had either a lobectomy with isthmusectomy or a total thyroidectomy. Eleven patients were found to have carcinoma (six had papillary, four had mixed papillary and follicular, and one had follicular carcinoma). Three patients had a therapeutic modified neck dissection following the documentation of microscopic involvement of paratracheal lymph nodes. A high incidence of chronic nonspecific thyroiditis, postradiation fibrosis, and follicular adenomas were also found in these patients. Three patients had temporary hypocalcemia (two weeks) and none had wound infection, hematoma, or postoperative nerve palsy. Of patients who had surgical resection, 22.4% showed thyroid carcinoma

Is radioactive iodine-{sup 131} treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer?

Energy Technology Data Exchange (ETDEWEB)

Souza, Marcelo Cruzick de; Momesso, Denise P.; Vieira Neto, Leonardo; Vaisman, Mario, E-mail: dmomesso@terra.com.br [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, (Brazil). Servico de Endocrinologia; Vaisman, Fernanda; Corbo, Rossana [Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ (Brazil). Servico de Endocrinologia; Martins, Rosangela Aparecida Gomes [Hospital Universitario Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ (Brazil). Divisao de Pesquisa

2016-02-15

Objective: Much controversy relates to the risk of non-synchronous second primary malignancies (NSSPM) after radioactive iodine treatment (RAI-131) in differentiated thyroid cancer (DTC) patients. This study evaluated the relationship between RAI-131 and NSSPM in DTC survivors with long-term follow-up. Materials and methods: Retrospective analysis of 413 DTC cases was performed; 252 received RAI-131 and 161 were treated with thyroidectomy alone. Exclusion criteria were: prior or synchronous non-thyroidal malignancies (within the first year), familial syndromes associated to multiple neoplasms, ionizing radiation exposure or second tumors with unknown histopathology. Results: During a mean follow-up of 11.0 ± 7.5 years, 17 (4.1%) patients developed solid NSSPM. Patients with NSSPM were older than those without (p = 0.02). RAI-131 and I-131 cumulative activity were similar in patients with and without NSSPM (p = 0.18 and p = 0.78, respectively). Incidence of NSSPM was 5.2% in patients with RAI-131 treatment and 2.5% in those without RAI-131 (p = 0.18). Using multivariate analysis, RAI-131 was not significantly associated with NSSPM occurrence (p = 0.35); age was the only independent predictor (p = 0.04). Under log rank statistical analysis, after 10 years of follow-up, it was observed a tendency of lower NSSPM-free survival among patients that received RAI-131 treatment (0.96 vs. 0.87; p = 0.06), what was not affected by age at DTC diagnosis. Conclusion: In our cohort of DTC survivors, with a long-term follow-up period, RAI-131 treatment and I-131 cumulative dose were not significantly associated with NSSPM occurrence. A tendency of premature NSSPM occurrence among patients treated with RAI-131 was observed, suggesting an anticipating oncogenic effect by interaction with other risk factors. (author)

Thyroid metastasis in a patient with hepatocellular carcinoma: case report and review of literature

Directory of Open Access Journals (Sweden)

Chai Chiah-Yang

2007-12-01

Full Text Available Abstract Background Despite the apparent low incidence of cancer metastatic to the thyroid, autopsy and clinical series suggest it is more common than generally. Although lung, renal, and breast cancer are probably the most common primary sites, a number of cancers have been reported to metastasize to the thyroid synchronously with diagnosis of primary tumor or years after apparently curative treatment. Case presentation We report a rare case of a hepatocellular carcinoma metasatic to the thyroid. The patient presented seven months after original diagnosis and treatment with hepatic lobectomy with multiple neck lesions producing a mass effect on the trachea and bilateral lymphadenopathy. Fine-needle aspiration revealed highly anaplastic carcinoma, and immunohistochemistry confirmed hepatocellular carcinoma. The patient received total thyroidectomy as palliative therapy because of the presence of multiple recurrent lesions in the liver. Conclusion Clinicians should consider the possibility of metastatic cancer in each patient who presents with a new thyroid mass, especially those with a history of cancer, however remote. In cases where cytology or histology is not diagnostic, immunohistochemistry may be definitive in making the diagnosis.

The progressive elevation of alpha fetoprotein for the diagnosis of hepatocellular carcinoma in patients with liver cirrhosis

International Nuclear Information System (INIS)

Arrieta, Oscar; Cacho, Bernardo; Morales-Espinosa, Daniela; Ruelas-Villavicencio, Ana; Flores-Estrada, Diana; Hernández-Pedro, Norma

2007-01-01

Hepatocellular carcinoma is the most common cause of primary liver neoplasms and is one of the main causes of death in patients with liver cirrhosis. High Alpha fetoprotein serum levels have been found in 60–70% of patients with Hepatocellular carcinoma; nevertheless, there are other causes that increase this protein. Alpha fetoprotein levels ≥200 and 400 ng/mL in patients with an identifiable liver mass by imaging techniques are diagnostic of hepatocellular carcinoma with high specificity. We analysed the sensitivity and specificity of the progressive increase of the levels of alpha fetoprotein for the detection of hepatocellular carcinoma in patients with liver cirrhosis. Seventy-four patients with cirrhosis without hepatocellular carcinoma and 193 with hepatic lesions diagnosed by biopsy and shown by image scans were included. Sensitivity and specificity of transversal determination of alpha fetoprotein ≥ 200 and 400 ng/mL and monthly progressive elevation of alpha fetoprotein were analysed. Areas under the ROC curves were compared. Positive and negative predictive values adjusted to a 5 and 10% prevalence were calculated. For an elevation of alpha fetoprotein ≥ 200 and 400 ng/mL the specificity is of 100% in both cases, with a sensitivity of 36.3 and 20.2%, respectively. For an alpha fetoprotein elevation rate ≥7 ng/mL/month, sensitivity was of 71.4% and specificity of 100%. The area under the ROC curve of the progressive elevation was significantly greater than that of the transversal determination of alpha fetoprotein. The positive and negative predictive values modified to a 10% prevalence are of: 98.8% and 96.92%, respectively; while for a prevalence of 5% they were of 97.4% and 98.52%, respectively. The progressive elevation of alpha fetoprotein ≥7 ng/mL/month in patients with liver cirrhosis is useful for the diagnosis of hepatocellular carcinoma in patients that do not reach αFP levels ≥200 ng/mL. Prospective studies are required to

Incidence of ascariasis in gastric carcinoma

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Kim, Jong Woo; Rhee, Hak Song; Bahk, Yong Whee [St Mary' s Hospital Catholic Medical College, Seoul (Korea, Republic of)

1972-09-15

Prompted by the finding that the radiological incidence of small bowel ascariasis in the patient with gastric carcinoma was unexpectedly lower than the incidence in the normal population, a clinical study was performed to investigate possible relationship between gastric carcinoma and intestinal ascariasis. As a preliminary survey, we reviewed the radiological incidence of ascariasis in a total of 2,446 cases of upper GI series performed at the Department of Radiology, St Mary's Hospital Catholic Medical College. These included 1,573 normal subjects, 146 gastric carcinoma patients, 100 benign gastric ulcer and 249 duodenal ulcer patients and 378 other upper GI diseases. Following the preliminary study, a more accurate parasitologic study was conducted in another 578 normal subjects and 51 gastric carcinoma patients. The radiological incidences of ascaiasis in normal subjects and gastric carcinoma patients were 15.1% and 28.1%, respectively. The incidence of overall helminthiasis including ascaris lumbricoides, trichocephalus trichiurus and trichostrongyloides orientalis in normal subjects of the present series was 73.5%. This figure is virtually the same with 69.1% of the general population incidence reported by Kim, et al. (1971), but the incidence in gastric carcinoma patients was 94.1%. The high incidence pattern of overall helminthiasis in gastric carcinoma patients is, however, reversed as for as ascariasis is concerned. Thus, the incidence of ascariasis of gastric carcinoma patients was much lower than that of normal subjects (9.8% vs 19.4%). From the present observation, it is postulated that there can be some possible antagonistic relationship between evolution of gastric carcinoma and small bowel infestation of ascaris lumbricoides.

Incidence of ascariasis in gastric carcinoma

International Nuclear Information System (INIS)

Kim, Jong Woo; Rhee, Hak Song; Bahk, Yong Whee

1972-01-01

Prompted by the finding that the radiological incidence of small bowel ascariasis in the patient with gastric carcinoma was unexpectedly lower than the incidence in the normal population, a clinical study was performed to investigate possible relationship between gastric carcinoma and intestinal ascariasis. As a preliminary survey, we reviewed the radiological incidence of ascariasis in a total of 2,446 cases of upper GI series performed at the Department of Radiology, St Mary's Hospital Catholic Medical College. These included 1,573 normal subjects, 146 gastric carcinoma patients, 100 benign gastric ulcer and 249 duodenal ulcer patients and 378 other upper GI diseases. Following the preliminary study, a more accurate parasitologic study was conducted in another 578 normal subjects and 51 gastric carcinoma patients. The radiological incidences of ascaiasis in normal subjects and gastric carcinoma patients were 15.1% and 28.1%, respectively. The incidence of overall helminthiasis including ascaris lumbricoides, trichocephalus trichiurus and trichostrongyloides orientalis in normal subjects of the present series was 73.5%. This figure is virtually the same with 69.1% of the general population incidence reported by Kim, et al. (1971), but the incidence in gastric carcinoma patients was 94.1%. The high incidence pattern of overall helminthiasis in gastric carcinoma patients is, however, reversed as for as ascariasis is concerned. Thus, the incidence of ascariasis of gastric carcinoma patients was much lower than that of normal subjects (9.8% vs 19.4%). From the present observation, it is postulated that there can be some possible antagonistic relationship between evolution of gastric carcinoma and small bowel infestation of ascaris lumbricoides

Persistence of hepatocellular carcinoma risk in hepatitis C patients with a response to IFN and cirrhosis regression.

Science.gov (United States)

D'Ambrosio, Roberta; Aghemo, Alessio; Rumi, Maria Grazia; Degasperi, Elisabetta; Sangiovanni, Angelo; Maggioni, Marco; Fraquelli, Mirella; Perbellini, Riccardo; Rosenberg, William; Bedossa, Pierre; Colombo, Massimo; Lampertico, Pietro

2018-01-27

In patients with HCV-related cirrhosis, a sustained virological response may lead to cirrhosis regression. Whether histological changes translate into prevention of long-term complications, particularly hepatocellular carcinoma is still unknown. This was investigated in a cohort of histological cirrhotics who had been prospectively followed-up for 10 years after the achievement of a sustained virological response to IFN. In all, 38 sustained virological response cirrhotics who underwent a liver biopsy 5 years post-SVR were prospectively followed to assess the impact of cirrhosis regression on clinical endpoints. During a follow-up of 86 (30-96) months from liver biopsy, no patients developed clinical decompensation, whilst 5 (13%) developed hepatocellular carcinoma after 79 (7-88) months. The 8-year cumulative probability of hepatocellular carcinoma was 17%, without differences between patients with or without cirrhosis regression (19% [95% CI 6%-50%] vs 14% [95% CI 4%-44%], P = .88). Patients who developed or did not an hepatocellular carcinoma had similar rates of residual cirrhosis (P = 1.0), collagen content (P = .48), METAVIR activity (P = .34), portal inflammation (P = .06) and steatosis (P = .17). At baseline, patients who developed an hepatocellular carcinoma had higher γGT (HR 1.03, 95% CI 1.00-1.06; P = .014) and glucose (HR 1.02, 95% CI 1.00-1.02; P = .012) values; moreover, they had increased Forns Score (HR 12.8, 95% CI 1.14-143.9; P = .039), Lok Index (HR 6.24, 95% CI 1.03-37.6; P = .046) and PLF (HR 19.3, 95% CI 1.72-217.6; P = .016) values. One regressor died of lung cancer. The 8-year cumulative survival probability was 97%, independently on cirrhosis regression (96% vs 100%, P = 1.0) or hepatocellular carcinoma (100% vs 97%, P = 1.0). Post-SVR cirrhosis regression does not prevent hepatocellular carcinoma occurrence. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

BRCC3 acts as a prognostic marker in nasopharyngeal carcinoma patients treated with radiotherapy and mediates radiation resistance in vitro

International Nuclear Information System (INIS)

Tu, Ziwei; Xu, Bingqing; Qu, Chen; Tao, Yalan; Chen, Chen; Hua, Wenfeng; Feng, Guokai; Chang, Hui; Liu, Zhigang; Li, Guo; Jiang, Changbin; Yi, Wei; Zeng, Musheng; Xia, Yunfei

2015-01-01

BRCC3 has been found to be aberrantly expressed in breast tumors and involved in DNA damage response. The contribution of BRCC3 to nasopharyngeal carcinoma prognosis and radiosensitivity is still unclear. Immunohistochemical analysis of BRCC3 was carried out in 100 nasopharyngeal carcinoma tissues, and the protein level was correlated to patient survival. BRCC3 expression of nasopharyngeal carcinoma cell lines was determined by Western-blotting and real-time PCR. Additionally, the effects of BRCC3 knockdown on nasopharyngeal carcinoma cell clongenic survival, DNA damage repair, and cell cycle distribution after irradiation was assessed. The BRCC3 protein level was inversely correlated with nasopharyngeal carcinoma patient overall survival (P < 0.001) and 3-year loco-regional relapse-free survival (P = 0.034). Multivariate analysis demonstrated that BRCC3 expression was an independent prognostic factor (P = 0.010). The expression of BRCC3 was much higher in radioresistant nasopharyngeal carcinoma cells than in radiosensitive cells. Knockdown of BRCC3 increased the cell survival fraction, attenuated DNA damage repair and resulted in G2/M cell cycle arrest in radioresistant NPC cells. High BRCC3 expression in nasopharyngeal carcinoma patients is associated with poor survival. BRCC3 knockdown could abate the radioresistance in nasopharyngeal carcinoma cells. These findings suggest the utility of BRCC3 as a prognostic biomarker and novel target for nasopharyngeal carcinoma

Proton radiotherapy of skin carcinomas

International Nuclear Information System (INIS)

Umebayashi, Y.; Uyeno, K.; Otsuka, F.

1994-01-01

At the Proton Medical Research Centre, University of Tsukuba, a pilot study of proton-beam radiotherapy was performed in 12 patients with the following types of carcinoma: Bowen's disease (4), oral verrucous carcinoma (5), and squamous cell carcinoma (3). They received total doses of 51-99.2 Gy in fractions of 2-12.5 Gy. All tumours responded well to the treatment. All four lesions of Bowen's disease, three of the five oral verrucous carcinomas, and the three squamous cell carcinomas completely regressed following irradiation. Two squamous cell carcinomas recurred during the follow-up period. One recurrent squamous cell carcinoma was successfully treated by a salvage surgical operation, and in the other case the patient refused further therapy. In two verrucous carcinomas there was 90% regression of tumour volume. No severe radiation-related complication occurred. (Author)

Recombinant human TSH-aided radioiodine treatment of advanced differentiated thyroid carcinoma: a single-centre study of 54 patients

International Nuclear Information System (INIS)

Jarzab, Barbara; Handkiewicz-Junak, Daria; Roskosz, Jozef; Puch, Zbigniew; Wygoda, Zbigniew; Kukulska, Aleksandra; Jurecka-Lubieniecka, Beata; Hasse-Lazar, Kornelia; Turska, Maria; Zajusz, Aleksander

2003-01-01

In 54 consecutive patients who had retained bulky metastatic and/or locoregional lesions of DTC despite the exhaustion of other therapeutic options, we gave one to four courses of two consecutive daily intramuscular injections of rhTSH, 0.9 mg, followed by a therapeutic activity of 131 I per os on day 3. Fifty patients had received prior radioiodine treatment aided by l-thyroxine (T 4 ) withdrawal. We included in the study 23 patients who had received a trial of isotretinoin therapy for re-differentiation of confirmed de-differentiated metastases. In a blinded, within-patient comparison of post-therapy whole-body scans after the first rhTSH-aided and latest withdrawal-aided treatments in patients with functional metastases at baseline, 18 of 27 (67%) scan pairs were concordant, four (15%) were discordant in favour of the rhTSH-aided scan and five (19%) were discordant in favour of the withdrawal-aided scan. In total, 37 (74%) of 50 paired scans were concordant, eight (16%) favoured rhTSH and five (10%) favoured withdrawal. All differences appeared to be attributable to clinical causes, not to any difference between endogenous and exogenous TSH stimulation. Reflecting the biochemical activity of rhTSH and the release of thyroglobulin (Tg) due to tumour destruction, median serum Tg concentration rose approximately fourfold between baseline and day 6 of the rhTSH-aided treatment course. rhTSH was well tolerated, with mostly minor, transient toxicity, except for neck oedema in three patients with neck infiltrates and pathological spine fracture in one patient with a large vertebral metastasis. At 6 months, complete response occurred in one (2%), partial response in 12 (26%) and disease stabilisation in 19 (40%) of 47 evaluable patients. The rate of complete + partial response was 41% and that of disease stabilisation, 30%, in the 27 evaluable patients with functional metastases at baseline; the corresponding rates were 10% and 55% in the 20 evaluable patients with non

Prediction of posthepatectomy liver failure using transient elastography in patients with hepatitis B related hepatocellular carcinoma.

Science.gov (United States)

Lei, Jie-Wen; Ji, Xiao-Yu; Hong, Jun-Feng; Li, Wan-Bin; Chen, Yan; Pan, Yan; Guo, Jia

2017-12-29

It is essential to accurately predict Postoperative liver failure (PHLF) which is a life-threatening complication. Liver hardness measurement (LSM) is widely used in non-invasive assessment of liver fibrosis. The aims of this study were to explore the application of preoperative liver stiffness measurements (LSM) by transient elastography in predicting postoperative liver failure (PHLF) in patients with hepatitis B related hepatocellular carcinoma. The study included 247 consecutive patients with hepatitis B related hepatocellular carcinoma who underwent hepatectomy between May 2015 and September 2015. Detailed preoperative examinations including LSM were performed before hepatectomy. The endpoint was the development of PHLF. All of the patients had chronic hepatitis B defined as the presence of hepatitis B surface antigen (HBsAg) for more than 6 months and 76 (30.8%) had cirrhosis. PHLF occurred in 37 (14.98%) patients. Preoperative LSM (odds ratio, OR, 1.21; 95% confidence interval, 95% CI: 1.13-1.29; P hepatocellular carcinoma.

High-risk human papilloma virus (HPV) and survival in patients with esophageal carcinoma: a pilot study

International Nuclear Information System (INIS)

Dreilich, Martin; Bergqvist, Michael; Moberg, Martin; Brattström, Daniel; Gustavsson, Inger; Bergström, Stefan; Wanders, Alkwin; Hesselius, Patrik; Wagenius, Gunnar; Gyllensten, Ulf

2006-01-01

Human papilloma virus (HPV) in patients with esophageal carcinoma has previously been studied with an average detection rate of 15%, but the role of HPV in relation to survival is less clear. In cervical cancer, lung cancer and tonsil cancer HPV viral load is a predictive factor for survival and outcome of treatment. The primary aim was to study the spectrum of high-risk HPV types in esophageal tumors. Secondary, as a pilot study we investigated the association between HPV status and the survival rates. We compared both the presence and the viral load of high-risk HPV types 16, 18, 31, 33, 39, 45, 52, 58, and 67 in relation to clinical data from patients with esophageal carcinoma. Survival data and tumor samples were retrieved from 100 patients receiving treatment at the Department of Oncology, Uppsala Hospital, Uppsala, Sweden. The tumor samples were investigated for HPV viral load using real-time PCR. HPV 16 was detected in 16% of the patients; no other HPV type was detected. HPV 16 infection had no significant effect on survival (p = 0.72). Also, HPV 16 did not improve survival after treatment (radiotherapy or chemotherapy). Only HPV 16 was detected among the patients. HPV 16 in esophageal carcinoma patients did not influence survival or improve therapy response. However, given the size of the study there is a need to examine a larger cohort in order to understand in more detail the effect of high risk HPV types in esophageal carcinoma

Risk profile for breast carcinoma and tumour histopathology of medical uninsured patients in Pakistan

International Nuclear Information System (INIS)

Raza, U.; Haque, S.U.

2011-01-01

Breast carcinoma is an unpredictable disease in the sense that some patients may die at early disease stage due to wide-spread metastasis within six months to one year, while others may survive longer. This study was aimed to evaluate the risk factors for breast carcinoma occurrence and histopathological features of breast carcinoma developed in the social and economical conditions of Pakistan. Methods: A total of 224 female breast cancer diagnosed patients with uncovered medical insurance visiting at the Oncology clinic of a teaching hospital at Karachi, Pakistan were selected for the study. Two hundred and twenty-four (224) healthy female subjects free of any cancer diagnosis were selected as control from different areas of the city. Information on stress, occupation, life history, and life style was obtained through personal interviews. Breast tumour pathology was evaluated for histological grade, lymph node metastasis and hormone receptor status by using standard methods. Student's t-test, Chi-square test and ANOVA were used for comparison. Results: Breast cancer patients in significantly high percentage reported early marriages, abortion occurrence, stressful life style, family cancer history and past disease suffering from diabetes and hypertension. Life style including aerosol chewing and fat rich food intake was significantly high among the patients (p<0.05). On histopathological analysis, patients at the age of 40 years and below were identified in significantly high percentage with tumour grade III, 1-3 lymph node metastasis and hormone receptor negative type. Increasing age was associated with low tumour grade and less percentage of lymph node metastasis. Significantly high percentage of patients were presented with hormone receptor positive tumour (p<0.05). Conclusion: The contributing factors for breast carcinoma occurrence were related to life history and life-style of the patients. Medical insurance uncovered patients at initial diagnosis were

Effect of radiation on cell-mediated cytotoxicity and lymphocyte subpopulations in patients with ovarian carcinoma

International Nuclear Information System (INIS)

Kohorn, E.I.; Mitchell, M.S.; Dwyer, J.M.; Knowlton, A.H.; Klein-Angerer, S.

1978-01-01

Lymphocyte subpopulations and cell-mediated cytotoxicity (CMI) were studied during radiation therapy in 16 patients with ovarian carcinoma. The total lymphocyte count became depressed in all patients. The depression was more marked among T cells, while the proportion of B cells remained unaffected. In patients with Stage I and II ovarian cancer, CMI was depressed significantly by radiotherapy after 7 days of treatment, remained low at 14 days but recovered despite continuation of radiation. This depression of CMI occurred at a delivered dose of 1,000 rads with subsequent recovery. Patients with Stage III ovarian cancer given pelvic and abdominal radiation were found to have no consistent depression of CMI, a finding similar to that in Stage III ovarian carcinoma patients given chemotherapy

Afatinib versus erlotinib as second-line treatment of patients with advanced squamous cell carcinoma of the lung (LUX-Lung 8)

DEFF Research Database (Denmark)

Soria, Jean-Charles; Felip, Enriqueta; Cobo, Manuel

2015-01-01

BACKGROUND: There is a major unmet need for effective treatments in patients with squamous cell carcinoma of the lung. LUX-Lung 8 compared afatinib (an irreversible ErbB family blocker) with erlotinib (a reversible EGFR tyrosine kinase inhibitor), as second-line treatment for patients with advanced...... squamous cell carcinoma of the lung. METHODS: We did this open-label, phase 3 randomised controlled trial at 183 cancer centres in 23 countries worldwide. We enrolled adults with stage IIIB or IV squamous cell carcinoma of the lung who had progressed after at least four cycles of platinum...... be an additional option for the treatment of patients with squamous cell carcinoma of the lung. FUNDING: Boehringer Ingelheim....

The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

Directory of Open Access Journals (Sweden)

Oblak Irena

2016-03-01

Full Text Available Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal.

Prognostic impact of BRCA1 pathogenic and BRCA1/BRCA2 unclassified variant mutations in patients with ovarian carcinoma

NARCIS (Netherlands)

Majdak, EJ; Debniak, J; Milczek, T; Cornelisse, CJ; Devilee, P; Emerich, J; Jassem, J; De Bock, GH

2005-01-01

BACKGROUND. The clinical relevance of BRCA1/2 alterations in ovarian carcinoma patients is debatable. Our aim was to determine factors influencing the risk of recurrence and death in ovarian carcinoma patients with BRCA pathogenic and unclassified variant mutations. METHODS. A consecutive series of

Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy

International Nuclear Information System (INIS)

Junor, E.J.; Paul, J.; Reed, N.S.

1992-01-01

Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dyspnagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. (Author)

Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Junor, E.J.; Paul, J.; Reed, N.S. (Beatson Oncology Centre, Glasgow (United Kingdom))

1992-04-01

Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dyspnagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. (Author).

Comorbidity measurement in patients with laryngeal squamous cell carcinoma.

Science.gov (United States)

Castro, Mario A F; Dedivitis, Rogério A; Ribeiro, Karina C B

2007-01-01

The evaluation of a cancer patient can be affected by many factors. Cancer patients often have other diseases or medical conditions in addition to their cancer. These conditions are referred to as comorbidities. They can influence the treatment option, the rate of complications, the outcome, and can confound the survival analysis. It was the aim of this study to measure comorbidities in patients with laryngeal squamous cell carcinoma. Ninety adult patients treated for newly diagnosed laryngeal squamous cell carcinoma were studied. We measured comorbid illness applying the following validated scales: the Cumulative Illness Rating Scale (CIRS), the Kaplan-Feinstein Classification (KFC), the Charlson index, the Index of Coexistent Disease (ICED), the Adult Comorbidity Evaluation-27 (ACE-27), the Alcohol-Tobacco-Related Comorbidities Index (ATC), and the Washington University Head and Neck Comorbidity Index (WUHNCI). Survival analysis was performed using the Kaplan-Meier method (with the log-rank test value being used to compare groups). The Cox proportional hazards model was chosen to identify independent prognostic factors. The mean age was 62.3 years. The majority of patients (36.7%) had early tumors. Forty patients were treated by surgery only, while the remaining 49 patients also received postoperative radiation therapy. Only 5 patients (5.6%) were lost to follow-up. Median follow-up time was 42.5 months. The 4-year overall survival was 63%. There was a statistically significant difference between survival rates according to clinical stage (CS I 87.3%, CS II 48.9%, CS III 74.7%, CS IV 23.9%; p KFC (p = 0.001), and ICED (p = 0.010). However, in the multivariate analysis, only CIRS and TNM staging were identified as independent prognostic factors. The comorbidity is an independent prognostic factor in patients with surgically treated laryngeal cancer. In the univariate analysis, all indexes were able to stratify patients. However, in the multiple analysis, only the

Cell-mediated immunity in patients with carcinoma under immunotheraphy

International Nuclear Information System (INIS)

Almeida, C.E.

1985-01-01

'In vivo' and 'in vitro' cellular immunity is evaluated in 32 patients with carcinoma under immunotheraphy with subcutaneous or endovenous glucan, transfer factor and levamisole. The immunotheraphy is done relatively by intradermal tests with common antigens, by sensitization with dinitrochlorinebenzene and lymphocytes culture from whole blood. The levels of blood serum of human T lymphotocyte soluble receptor for sheep erythrocytes are detected. (M.A.C.) [pt

Newly diagnosed hepatocellular carcinoma in patients with advanced hepatitis C treated with DAAs: A prospective population study.

Science.gov (United States)

Romano, Antonietta; Angeli, Paolo; Piovesan, Sara; Noventa, Franco; Anastassopoulos, Georgios; Chemello, Liliana; Cavalletto, Luisa; Gambato, Martina; Russo, Francesco Paolo; Burra, Patrizia; Vincenzi, Valter; Scotton, Pier Giorgio; Panese, Sandro; Tempesta, Diego; Bertin, Tosca; Carrara, Maurizio; Carlotto, Antonio; Capra, Franco; Carolo, Giada; Scroccaro, Giovanna; Alberti, Alfredo

2018-03-16

Direct-acting antiviral agents (DAAs) are safe and effective in patients with hepatitis C. Conflicting data were reported on the risk of hepatocellular carcinoma (HCC) during/after therapy with DAAs. The aim of this study was to evaluate the incidence of newly diagnosed HCC and associated risk factors in patients with advanced hepatitis C treated with DAAs. The study is based on the NAVIGATORE platform, a prospectively recording database of all patients with hepatitis C receiving DAAs in the Veneto region of Italy. The inclusion criteria were: fibrosis stage ≥F3. The exclusion criteria were: Child-Turcotte-Pugh (CTP)-C, liver transplantation before DAAs, history or presence of HCC, follow-up hepatocarcinoma during the first year is not higher, and might be lower, than that of untreated patients. The risk further declines thereafter. Early hepatocarcinoma appearance may reflect pre-existing, microscopic, undetectable tumors. Hepatocellular carcinoma is one of the complications of hepatitis C related cirrhosis. Treating patients with advanced hepatitis C with the new interferon-free direct-acting antiviral agents has been associated with improvement in liver function and survival, while more conflicting data have been reported regarding the risk of hepatocellular carcinoma. We report the results of a prospective population study on the incidence of newly diagnosed hepatocellular carcinoma in patients with advanced hepatitis C treated with direct-acting antiviral agents, clearly indicating that the residual hepatocellular carcinoma risk is reduced and declines progressively with time after a sustained virological response. Development of a liver tumor during/after therapy was associated with known risk factors and with virological failure. Copyright © 2018. Published by Elsevier B.V.

Endoscopic traversability in patients with locally advanced esophageal squamous cell carcinoma: Is it a significant prognostic factor?

Science.gov (United States)

Shin, Hae Jin; Moon, Hee Seok; Kang, Sun Hyung; Sung, Jae Kyu; Jeong, Hyun Yong; Kim, Seok Hyun; Lee, Byung Seok; Kim, Ju Seok; Yun, Gee Young

2017-12-01

The purpose of this study was to evaluate the prognostic impact of endoscopic traversability in patients with locally advanced esophageal squamous cell carcinoma.This retrospective study was based on medical records from a single tertiary medical center. The records of 317 patients with esophageal squamous cell carcinoma treated with surgery or definitive chemoradiotherapy (CRT) between January 2009 and March 2016 were reviewed. Finally, we retrieved the data on 168 consecutive patients. These 168 patients were divided into 2 groups based on their endoscopic traversability findings: Group A (the endoscope traversable group), and Group B (the endoscope non-traversable group). We then retrospectively compared the clinical characteristics of these 2 groups.The endoscope non-traversable group (Group B) revealed an advanced clinical stage, a poor Eastern Cooperative Oncology Group (ECOG) score, a lower serum albumin level, a higher rate of requirement for esophageal stent insertion and definitive CRT as initial treatment than the endoscope traversable group (Group A). Patients with endoscope traversable cancer showed a significantly higher 3-year overall survival and 3-year relapse-free survival than patients who were endoscope non-traversable (53.8% vs 17.3%, P squamous cell carcinoma treated with definitive CRT, the serum albumin level squamous cell carcinoma treated with definitive CRT is a significant prognostic factor. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Radioembolization using 90Y-resin microspheres for patients with advanced hepatocellular carcinoma

International Nuclear Information System (INIS)

Sangro, Bruno; Bilbao, Jose I.; Boan, Jose; Martinez-Cuesta, Antonio; Benito, Alberto; Rodriguez, Javier; Panizo, Angel; Gil, Belen; Inarrairaegui, Mercedes; Herrero, Ignacio; Quiroga, Jorge; Prieto, Jesus

2006-01-01

Purpose: To investigate the antitumor effect of resin microspheres loaded with 90-yttrium against hepatocellular carcinoma and their safety in the setting of liver cirrhosis. Patients and Methods: Data from 24 consecutive patients with hepatocellular carcinoma (HCC) treated by radioembolization in the period from September 2003 to February 2005 were reviewed. Patients received no further antineoplastic therapy. A comprehensive evaluation was performed to prevent the risk of damage due to microsphere misplacing. Patients were discharged the day after microspheres injection. Results: Serious liver toxicity observed among cirrhotic patients in a first period was subsequently prevented by modifying the selection criteria and the method for calculating the activity to be administered. Among 21 patients evaluable for response using Response Evaluation Criteria in Solid Tumors (RECIST) criteria, a reduction in size of target lesions was observed in all but 1 patient. When considering only target lesions, disease control rate and response rate were 100% and 23.8%, respectively. However, 43% of patients progressed in the liver in the form of new lesions appearing a median time of 3 months after radioembolization. Conclusion: Our experience in these series of patients indicates that radioembolization using resin microspheres has a significant antitumor effect against HCC and that using stringent selection criteria and conservative models for calculating Radiation activity to be administered, radioembolization can be performed safely even in cirrhotic patients

A CASE REPORT OF THE PATIENT WITH EXTRAOVARIAN PRIMARY PERITONEAL CARCINOMA AFTER BILATERAL SALPINGO-OOPHORECTOMY THIRTEEN YEARS AGO

Directory of Open Access Journals (Sweden)

Drago Sredanović

2018-02-01

Full Text Available Abstract: We present a rare case of extraovarian primary peritoneal carcinoma in 65-year-old female with a history of total abdominal hysterectomy and bilateral salpingo-oophorectomy for larger symptomatic leiomyoma 13 years ago. In October 2005 the patient had abdominal swelling, ascites with positive cytology peritonal adenocarcinoma and significantly elevated serum Ca-125 was 500 U/ml. Clinical examinations were performed, but could not identify a unique origin of disease. Background: Aproximatly 3.2 % to 21 % of extraovarian primary peritoneal carcinoma patients have a history bilateral oophorectomy for benign disease or prophylaxis – family history of ovar- ian carcinoma.1 Patients and methods: A 65-year old woman with a history of total abdominal hysterectomy and bileteral salpin- go-oophorectomy was operated for larger symptomatic leiomyoma 13 years ago. In Octobre 2005 the patient had abdominal swelling, ascites with positive cytology peritonal adeno- carcinoma and significantly elevated serum Ca-125 was 500 U/ml. Radiologic imaging, gastroscopy, colonoscopy, mammography were performed, but couldn`t identify a unique origin of disease. Patient was treated for two years at the Oncology Institute Ljubljana. Significantly elevated serum Ca-125 and citology with immunohistochemical analysis pre- sented correct diagnosis of extraovarian primary peritoneal carcinoma. The patient was treated with combination systemic chemotherapy (Paclitaxel and Carboplatin with initial good response. In year 2006 and 2007 because of the progression of disease, the treatment was repeated with adjuvant chemotherapy. Conclusions: Look like in other similar cases we have confirmed our disease with three cytologic punction procedures, with significant elevated valves of Ca-125 and with several other directed proce- dures.1–3 Our patient has survived the characteristic critical period for this form of cancer of 7 to 27.8 months because of well orientated

Treatment decision-making strategies and influences in patients with localized prostate carcinoma.

Science.gov (United States)

Gwede, Clement K; Pow-Sang, Julio; Seigne, John; Heysek, Randy; Helal, Mohamed; Shade, Kristin; Cantor, Alan; Jacobsen, Paul B

2005-10-01

Patients diagnosed with localized prostate carcinoma need to interpret complicated medical information to make an informed treatment selection from among treatments that have comparable efficacy but differing side effects. The authors reported initial results for treatment decision-making strategies among men receiving definitive treatment for localized prostate carcinoma. One hundred nineteen men treated with radical prostatectomy (44%) or brachytherapy (56%) consented to participate. Guided by a cognitive-affective theoretic framework, the authors assessed differences in decision-making strategies, and treatment and disease-relevant beliefs and affects, in addition to demographic and clinical variables. Approximately half of patients reported difficulty (49%) and distress (45%) while making treatment decisions, but no regrets (74%) regarding the treatment choice they made. Patients who underwent prostatectomy were younger, were more likely to be employed, had worse tumor grade, and had a shorter time since diagnosis (P Decision-making aids or other interventions to reduce decisional difficulty and emotional distress during decision making were indicated.

Thyroid Patient Salivary Radioiodine Transit and Dysfunction Assessment Using Chewing Gums.

Science.gov (United States)

Okkalides, Demetrios

2016-11-01

Radiation-induced salivary gland dysfunction is the most frequent side-effect of I-131 thyroid therapy. Here, a novel saliva sampling method with ordinary chewing gums administered to the patients at appropriate time intervals post-treatment (TIPT) was used to relate this effect to chewing gum saliva activity (CGSA) content. Saliva samples were acquired after the oral administration of prescribed I-131 activity (radioactivity administered [RA]) to 19 differentiated thyroid cancer (DTC) and 16 hyperthyroidism patients of the radioisotope unit (RIU) during 2014 and 2015. The error of this saliva collecting process was found to be 1.2%-2.05%, and so, the method was considered satisfactory. For each patient, the CGSA was plotted against the TIPT producing a curve, R(t). On this, two functions were fitted: a linear on the first few rising data points and a gamma variate over the peak of the R(t). From these, several parameters related to the radioactivity oral transit were calculated and the total radioactivity administered (TRA) during all past treatments of each patient was obtained from RIU records. The patients were asked to report any swelling, dry mouth, taste-smell change, or pain and were graded as a morbidity score (MS) describing the quality of life of each. The peak radioactivity in the saliva samples, R max , was found to be proportional to RA and was plotted against the CGSA extrapolated at 24 and 36 hours. The linear fits produced were used to estimate the salivary glands' activity average effective half-life (16.3 hours). The MS of DTC patients was found to depend linearly both on R max and TRA (MS = 0.0032 × R max - 0.7107 and MS = 0.1862 × TRA +0.66, respectively). Both lines were used to extrapolate symptom thresholds. The measurement of R max in DTC patients proved very useful for individualized radiation protection, and the dependence of MS on TRA should be used when additional treatments are considered for repeat DTC patients.

Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results.

Science.gov (United States)

Maciel, Paula Curitiba; Veiga-Filho, Joel; Carvalho, Marcelo Prado; Fonseca, Fernando Elias Martins; Ferreira, Lydia Masako; Veiga, Daniela Francescato

2014-01-01

Cancer is a multifactorial disease and skin carcinomas are the most common type of cancer. Assessing quality of life and self-esteem outcomes in skin cancer patients is important because these are indicators of the results of the treatment, translating how patients face their lives and their personal relationships. To assess the late impact of the surgical treatment of head and/or neck skin carcinomas on quality of life and self-esteem of the patients. Fifty patients with head or neck skin carcinomas were enrolled. Their age ranged between 30 and 75 years, 27 were men and 23 were women. Patients were assessed with regard to quality of life and self-esteem, preoperatively and five years postoperatively. Validated instruments were used: the MOS 36-item Short-form Health Survey (SF-36) and the Rosenberg Self-esteem/EPM-UNIFESP Scale. The Wilcoxon signed-rank test was used for the statistical analysis. Twenty-two patients completed the five-year follow-up, 54.5% women and 45.5% men. Compared to the preoperative assessment, patients had an improvement in mental health (p=0.011) and in self-esteem (p=0.002). There was no statistical difference with regard to the other domains of the SF-36. Patients submitted to surgical treatment of skin carcinoma improved mental health and self-esteem in the late postsurgical testing.

Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results*

Science.gov (United States)

Maciel, Paula Curitiba; Veiga-Filho, Joel; de Carvalho, Marcelo Prado; Fonseca, Fernando Elias Martins; Ferreira, Lydia Masako; Veiga, Daniela Francescato

2014-01-01

BACKGROUND Cancer is a multifactorial disease and skin carcinomas are the most common type of cancer. Assessing quality of life and self-esteem outcomes in skin cancer patients is important because these are indicators of the results of the treatment, translating how patients face their lives and their personal relationships. OBJECTIVE To assess the late impact of the surgical treatment of head and/or neck skin carcinomas on quality of life and self-esteem of the patients. METHODS Fifty patients with head or neck skin carcinomas were enrolled. Their age ranged between 30 and 75 years, 27 were men and 23 were women. Patients were assessed with regard to quality of life and self-esteem, preoperatively and five years postoperatively. Validated instruments were used: the MOS 36-item Short-form Health Survey (SF-36) and the Rosenberg Self-esteem/EPM-UNIFESP Scale. The Wilcoxon signed-rank test was used for the statistical analysis. RESULTS Twenty-two patients completed the five-year follow-up, 54.5% women and 45.5% men. Compared to the preoperative assessment, patients had an improvement in mental health (p=0.011) and in self-esteem (p=0.002). There was no statistical difference with regard to the other domains of the SF-36. CONCLUSION Patients submitted to surgical treatment of skin carcinoma improved mental health and self-esteem in the late postsurgical testing. PMID:25054746

Laparoscopic colectomy for transverse colon carcinoma.

Science.gov (United States)

Zmora, O; Bar-Dayan, A; Khaikin, M; Lebeydev, A; Shabtai, M; Ayalon, A; Rosin, D

2010-03-01

Laparoscopic resection of transverse colon carcinoma is technically demanding and was excluded from most of the large trials of laparoscopic colectomy. The aim of this study was to assess the safety, feasibility, and outcome of laparoscopic resection of carcinoma of the transverse colon. A retrospective review was performed to identify patients who underwent laparoscopic resection of transverse colon carcinoma. These patients were compared to patients who had laparoscopic resection for right and sigmoid colon carcinoma. In addition, they were compared to a historical series of patients who underwent open resection for transverse colon cancer. A total of 22 patients underwent laparoscopic resection for transverse colon carcinoma. Sixty-eight patients operated for right colon cancer and 64 operated for sigmoid colon cancer served as comparison groups. Twenty-four patients were identified for the historical open group. Intraoperative complications occurred in 4.5% of patients with transverse colon cancer compared to 5.9% (P = 1.0) and 7.8% (P = 1.0) of patients with right and sigmoid colon cancer, respectively. The early postoperative complication rate was 45, 50 (P = 1.0), and 37.5% (P = 0.22) in the three groups, respectively. Conversion was required in 1 (5%) patient in the laparoscopic transverse colon group. The conversion rate and late complications were not significantly different in the three groups. There was no significant difference in the number of lymph nodes harvested in the laparoscopic and open groups. Operative time was significantly longer in the laparoscopic transverse colectomy group when compared to all other groups (P = 0.001, 0.008, and transverse colectomy, respectively). The results of laparoscopic colon resection for transverse colon carcinoma are comparable to the results of laparoscopic resection of right or sigmoid colon cancer and open resection of transverse colon carcinoma. These results suggest that laparoscopic resection of transverse

Programmed cell death as a prognostic indicator for radiation therapy in cervical carcinoma patients: A pilot study

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Bhosle S

2005-01-01

Full Text Available Purpose: In clinical practice, radiation therapy often fails in cervical carcinoma stage IIIB and there is a need to develop a predictive assay for prognosis of radiation treatment outcome in cancer patient. We have attempted to evaluate the relevance of changes in Membrane Fluidity (MF and associated apoptotic cell death in cervical cancer cells after first fractionated dose of radiation therapy to treatment outcome of stage IIIB cervical carcinoma patients. Materials and Methods: Biopsies of 15 patients with histologically proven cervix cancer were collected from the patients before and 24 h after first fractionated radiation dose of 2 grays (Gy. Cell suspension made in Dulbecco′s Modified Eagle′s Medium (DMEM were used for further investigations and cell suspension of cervix cancer patient were used to measure MF by fluorescence polarization method and apoptotic index (AI was determined by Tdt dUTP Nucleotide End Labeling (TUNEL assay. Results: A substantial increase in MF and AI was observed in cervical cancer cells irradiated ex vivo . A significant correlation ( P < 0.001 was found between the changes in AI after first fractionated dose of radiotherapy and treatment outcome of patients. No significant correlation ( P > 0.1 was detected between changes in MF and treatment outcome of patients. Conclusion: Preliminary results showed significant change in MF and a marked increase in percentage apoptosis of cervix cancer cells irradiated ex vivo . The changes in AI after first fractionated dose of radiotherapy in cervical carcinoma patients may provide a predictor of prognosis for radiotherapy in uterine cervical carcinoma patients.

Prevalence of hepatocellular carcinoma in patients of liver cirrhosis: an experience in North West Frontier province (NWFP)

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Farooqi, J.I.; Farooqi, R.J.

2000-01-01

A study was conducted to find out the prevalence of hepatocellular carcinoma (HCC) in 410 patients of liver cirrhosis. Hepatocellular carcinoma was found in 45 (10.98%) patients with predominance of males. (P < 0.05). Most of HCC patients (77.78% P <0.05) were seropositive for hepatitis C virus (HCV), whereas only 2 patients (4.44%) for hepatitis B virus (HBC) infections. Eight (17.78%) patients were seronegative for both HBC and HCV infections. Out of these 8 patients, one (2.22%) was associated with haemochromatosis. We concluded that HCC is a common complication of cirrhosis (occurrence rate = 10.98%), especially HCV associated cirrhosis. (author)

Clinical Observation on Thyroid Carcinoma

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Park, Seon Yang; Shin, Yong Tae; Cho, Bo Yun; Kim, Byung Kuk; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1978-09-15

Clinical features of 147 patients with biopsy-proven thyroid carcinomas were investigated from January, 1972 to April, 1978 at the Seoul National University Hospital with the following results. 1) The incidence of thyroid carcinomas according to their histopathological classification revealed 76.2% of papillary carcinoma, 19.0% of follicular carcinoma, and 3 cases of occult sclerozing carcinoma, 1 case of giant cell carcinoma and 1 case of metastatic melanoma. 2) The ratio of male to female patients was 1:8.3 and showed no difference between papillary and follicular carcinomas. 3) The age distribution showed the peak incidence in the fourth decade (29.3%) followed by the fifth and sixth decades. 4) The average duration of illness from the onset of symptoms was about 5 years while it was 4.4 years and 7.6 years in the papillary and follicular carcinomas respectively. 5) The diameter of the thyroid masses was smaller than 5 cm in 53.6% of the patients, from 5 cm to 10 cm in 40.0% and larger than 10 cm in 6.4%. 6) In 36.4% of the patients with thyroid carcinomas the thyroid masses were fixed to adjacent tissues. 7) Metastasis to the regional lymph nodes was noted in 40.0% of the total cases, and in 45.2% and 17.6% of the papillary and follicular carcinomas respectively, while the lung and bone metastases were found in 10.0% and 4.4% in each type respectively. 8) 88.9% of the patients showed cold areas in the thyroid scans using {sup 131}I. 9) Typical psammoma bodies were observed in 21.3% of the cases in the microscopic examination of the pathological specimens. 10) The initial diagnosis of thyroid malignancy could be made before histological confirmation in 64.5% of the patients. 11) The clinical staging slightly modified from Schulz method revealed 43.6% of the patients in stage I, 26.4% in stage II, 20.9% in stage III and 9.1% in stage IV. 12) The association with Hashimoto's thyroiditis was noted in 4 cases, with nodular goiter in 3 cases, and with follicular

Complete en bloc urinary exenteration for synchronous multicentric transitional cell carcinoma with sarcomatoid features in a hemodialysis patient

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Tiberio M. Siqueira Jr

2006-10-01

Full Text Available The incidence of transitional cell carcinoma (TCC in patients submitted to hemodialysis is low. The presence of TCC with sarcomatoid features in this cohort is even scarcer. Herein, we describe a very rare case of synchronous multicentric muscle invasive bladder carcinoma with prostate invasion in a hemodialysis patient, submitted to complete en bloc urinary exenteration.

Rationale and design of decision: a double-blind, randomized, placebo-controlled phase III trial evaluating the efficacy and safety of sorafenib in patients with locally advanced or metastatic radioactive iodine (RAI)-refractory, differentiated thyroid cancer

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Brose, Marcia S; Schlumberger, Martin; Nutting, Christopher M; Sherman, Steven I; Shong, Young Kee; Smit, Johannes WA; Reike, Gerhard; Chung, John; Kalmus, Joachim; Kappeler, Christian

2011-01-01

The incidence of thyroid cancer and the number of patients who die from this disease are increasing globally. Differentiated thyroid cancer (DTC) is the histologic subtype present in most patients and is primarily responsible for the increased overall incidence of thyroid cancer. Sorafenib is a multikinase inhibitor that targets several molecular signals believed to be involved in the pathogenesis of thyroid cancer, including those implicated in DTC. In phase II studies of patients with DTC, sorafenib treatment has yielded a median progression-free survival (PFS) of 58 to 84 weeks and disease control rates of 59% to 100%. The DECISION trial was designed to assess the ability of sorafenib to improve PFS in patients with locally advanced or metastatic, radioactive iodine (RAI)-refractory DTC. DECISION is a multicenter, double-blind, randomized, placebo-controlled phase III study in patients with locally advanced/metastatic RAI-refractory DTC. Study treatment will continue until radiographically documented disease progression, unacceptable toxicity, noncompliance, or withdrawal of consent. Efficacy will be evaluated every 56 days (2 cycles), whereas safety will be evaluated every 28 days (1 cycle) for the first 8 months and every 56 days thereafter. Following disease progression, patients may continue or start sorafenib, depending on whether they were randomized to receive sorafenib or placebo, at investigator discretion. Patients originally randomized to receive sorafenib will be followed up every 3 months for overall survival (OS); patients originally randomized to receive placebo will be followed up every month for 8 months after cross-over to sorafenib. The duration of the trial is expected to be 30 months from the time the first patient is randomized until the planned number of PFS events is attained. The primary endpoint is PFS; secondary endpoints include OS, time to disease progression, disease control rate, response rate, duration of response, safety, and

Diagnostic value of combined determination of serum AFP, CEA, CA199, SF levels in patients with primary hepatic carcinoma

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Wu Jiaming; Rui Zhilian

2005-01-01

Objective: To investigate the diagnostic value of combined detection of four tumor markers in patients with possible malignant change in liver disorders. Methods: Serum AFP, CEA, CA199 and SF levels were determined with chemiluminescence immunoassay (CLIA) in 49 patients with primary liver carcinoma, 7 patients with metastatic liver carcinoma, 40 patients with hepatic cirrhosis, 47 patients with HBV hepatitis and 30 controls. Results: The serum levels of AFP, CEA, SF in patients with primary hepatic cancer and serum levels of AFP, SF in patients with hepatic cirrhosis were all significantly higher than those in controls (P 0.05). Moreover, positive rate of combined determination of AFP, CEA, CA199, SF in patients with primary hepatic cancer was significantly higher than that in patients with metastatic liver cancer. Conclusion: With combined determination of these four tumor markers, the detection rate of primary hepatic carcinoma could be enhanced to above 95%. Also, differential diagnosis between primary and metastatic hepatic cancers could be facilitated. (authors)

LASSO NTCP predictors for the incidence of xerostomia in patients with head and neck squamous cell carcinoma and nasopharyngeal carcinoma

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Lee, Tsair-Fwu; Liou, Ming-Hsiang; Huang, Yu-Jie; Chao, Pei-Ju; Ting, Hui-Min; Lee, Hsiao-Yi

2014-01-01

To predict the incidence of moderate-to-severe patient-reported xerostomia among head and neck squamous cell carcinoma (HNSCC) and nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT). Multivariable normal tissue complication probability (NTCP) models were developed by using quality of life questionnaire datasets from 152 patients with HNSCC and 84 patients with NPC. The primary endpoint was defined as moderate-to-severe xerostomia after IMRT. The numbers of predictive factors for a multivariable logistic regression model were determined using the least absolute shrinkage and selection operator (LASSO) with bootstrapping technique. Four predictive models were achieved by LASSO with the smallest number of factors while preserving predictive value with higher AUC performance. For all models, the dosimetric factors for the mean dose given to the contralateral and ipsilateral parotid gland were selected as the most significant predictors. Followed by the different clinical and socio-economic factors being selected, namely age, financial status, T stage, and education for different models were chosen. The predicted incidence of xerostomia for HNSCC and NPC patients can be improved by using multivariable logistic regression models with LASSO technique. The predictive model developed in HNSCC cannot be generalized to NPC cohort treated with IMRT without validation and vice versa. PMID:25163814

Radiotherapy for carcinoma of the esophagus in aged patients

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Nomoto, Satoshi; Imada, Hajime; Yamashita, Shigeru; Terashima, Hiromi; Nakata, Hajime; Itoh, Hideaki; Ohsato, Keiichi; Okamura, Takeshi

1995-01-01

One hundred and fifty-four patients with esophageal carcinoma were treated with either irradiation alone or irradiation combined with surgery at the University of Occupational and Environmental Health Hospital between January 1980 and February 1992. The number of patients 75 years old and older was 25. In patients 74 years old and younger, the overall five-year survival rate by Kaplan-Meier method was 24.5%. The survival rate was best in the patients who were treated by a combination of irradiation and surgery. In patients 75 years old and older, the one-year survival rate was 59%, and the three-year rate was 20%. Aged patients had a tendency to be worse in performance status, and there was no correlation between treatment modality and survival time. We conclude that radiotherapy is useful for treating esophageal cancer in aged patients particularly when maintenance of the quality of life is considered. (author)

Has F.D.G. PET/CT an impact on the management of patients with anal carcinoma?

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Vercellino, L.; Nataf, V.; Kerrou, K.; Huchet, V.; Pascal, O.; Montravers, F.; Talbot, J.N.; De Parades, V.; Bauer, P.; Touboul, E.

2010-01-01

Purpose: To evaluate the impact of F.D.G. PET/C Ton the management of patients referred for the staging and/or the follow-up of anal carcinoma, and PET/CT on patient management. Patients and methods: We included patients referred to our department for anal carcinoma whose therapeutic management was evaluable thanks to follow-up data during at least 6 months. Results: Data of 44 patients were analysed: 22 had PET/CT for initial staging and 36 during follow-up. PET/CT had impact in nine patients out of 44 (20%) and it was relevant in eight of them. Conclusion: F.D.G. PET/CT is an accurate imaging modality in anal cancer, its impact on patient management is more obvious when persistence or recurrence of disease is suspected. (authors)

Expression of nerve growth factor and heme oxygenase-1 predict poor survival of breast carcinoma patients

International Nuclear Information System (INIS)

Noh, Sang Jae; Chung, Myoung Ja; Moon, Woo Sung; Kang, Myoung Jae; Jang, Kyu Yun; Bae, Jun Sang; Jamiyandorj, Urangoo; Park, Ho Sung; Kwon, Keun Sang; Jung, Sung Hoo; Youn, Hyun Jo; Lee, Ho; Park, Byung-Hyun

2013-01-01

Nerve growth factor (NGF) is a neurotrophin and has been suggested to induce heme oxygenase-1 (HO1) expression. Although the role of HO1 in tumorigenesis remains controversial, recent evidence suggests NGF and HO1 as tumor-progressing factors. However, the correlative role of NGF and HO1 and their prognostic impact in breast carcinoma is unknown. We investigated the expression and prognostic significance of the expression of NGF and HO1 in 145 cases of breast carcinoma. Immunohistochemical expression of NGF and HO1 was observed in 31% and 49% of breast carcinoma, respectively. The expression of NGF and HO1 significantly associated with each other, and both have a significant association with histologic grade, HER2 expression, and latent distant metastasis. The expression of NGF and HO1 predicted shorter overall survival of breast carcinoma by univariate and multivariate analysis. NGF expression was an independent prognostic indicator for relapse-free survival by multivariate analysis. The combined expression pattern of NGF and HO1 was also an independent prognostic indicator of overall survival and relapse-free survival. The patients with tumors expressing NGF had the shortest survival and the patients with tumor, which did not express NGF or HO1 showed the longest survival time. This study has demonstrated that individual expression of NGF or HO1, and the combined NGF/HO1 expression pattern could be prognostic indicators for breast carcinoma patients

Associations between RET tagSNPs and their haplotypes and susceptibility, clinical severity, and thyroid function in patients with differentiated thyroid cancer.

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Caiyun He

Full Text Available It is unclear whether common genetic variants of the RET proto-oncogene contribute to disease susceptibility, clinical severity, and thyroid function in differentiated thyroid cancer (DTC.A total of 300 DTC patients and 252 healthy controls were enrolled in this study. Seven RET tagging single nucleotide polymorphisms were genotyped using the KASPar platform.Subgroup analysis showed that concomitant thyroid benign diseases were less likely to occur in DTC subjects with the rs1799939 AG or AG plus AA genotypes (odds ratio (OR = 1.93 and 1.88, P = 0.009 and 0.011, respectively. A rare haplotype, CGGATAA, was associated statistically with a reduced risk of DTC (OR = 0.18, P = 0.001. Concerning the aggressive features of DTC, higher level of N stage was more likely to occur in subjects carrying the wild-type genotypes at rs1800860 site (for dominant model: OR = 0.48, P = 0.008. Another rare haplotype, CAAGCGT, conferred increased risk for the occurrence of distant metastasis (OR = 7.57, P = 0.009. Notably, higher thyroid stimulating hormone levels and lower parathyroid hormone levels were found in patients with rs2075912, rs2565200, and rs2742240 heterozygotes and rare homozygotes; similar results were observed between PTH levels and rs1800858.This study provided useful information on RET variants that should be subjected to further study.

Docetaxel as neoadjuvant chemotherapy in patients with advanced cervical carcinoma.

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Vallejo, Carlos T; Machiavelli, Mario R; Pérez, Juan E; Romero, Alberto O; Bologna, Fabrina; Vicente, Hernán; Lacava, Juan A; Ortiz, Eduardo H; Cubero, Alberto; Focaccia, Guillermo; Suttora, Guillermo; Scenna, Mirna; Boughen, José M; Leone, Bernardo A

2003-10-01

The purpose of this study was to evaluate the efficacy and toxicity of docetaxel as single-agent neoadjuvant chemotherapy in locoregionally advanced cervical carcinoma. Between April 1998 and August 2000, 38 untreated patients with International Federation of Gynecology and Obstetrics stages IIB to IVA were entered onto this study. The median age was 44 years (range: 25-66 years). Stages: IIB 22 patients, IIIB 15 patients, and IVA 1 pt. Treatment consisted of docetaxel 100 mg/m2 IV infusion during 1 hour. Standard premedication with dexamethasone, diphenhydramine, and ranitidine was used. Cycles were repeated every 3 weeks for three courses, followed by radical surgery when it was judged appropriate, or definitive radiotherapy. Both staging and response assessment were performed by a multidisciplinary team. 106 cycles of therapy were administered; all patients were evaluable for TX, whereas 35 were evaluable for response (3 patients refused further treatment after the first cycle of therapy). Complete response (CR): 1 patient (3%); partial response: 11 patients (31%), for an overall objective response rate of 34% (95% CI: 15-53%); no change (NC): 16 patients (46%); and progressive disease: 7 patients (20%). Six patients (17%) underwent surgery and a pathologic CR was confirmed in 1 of them. The median time to treatment failure and the median survival have not been reached yet. The limiting toxicity was leukopenia in 25 patients (69%) (G1-G2: 14 patients, G3: 10 patients, and G4: 1 patient). Neutropenia: 28 patients (78%) (G1-G2: 10 patients, G3: 8 and G4: 10). Myalgias: 17 patients (47%) (G1-G2: 15 patients and G3: 2 patients). Emesis: 21 patients (55%) (G1-G2: 19 patients and G3: 2 patients). Alopecia G3: 13 patients (36%); rash cutaneous 26 patients (68%) (G1-G2: 22 patients and G3: 4 patients). There were no hypersensitivity reactions or fluid-retention syndrome. The received dose intensity was 91% of that projected. Docetaxel is an active drug against advanced

Detection and Analysis of EGFR and KRAS Mutations 
in the Patients with Lung Squamous Cell Carcinomas

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Hui ZHANG

2015-10-01

Full Text Available Background and objective Activating mutations in epidermal growth factor receptor (EGFR and KRAS are important markers in non-small cell lung cancer. However, EGFR and KRAS gene mutations in lung squamous cell carcinoma are rarely reported. The aim of this study was to analyze EGFR and KRAS gene mutation rate and their relationship with clinical features in patients with lung squamous cell carcinomas. Methods A total of 139 patients undergoing treatment for naïve lung squamous cell carcinomas with tumor tissue samples available for testing were recruited. EGFR and KRAS mutation statuses of the tumor samples were detected using a mutant enriched liquid chip. Results Of the 139 cases of lung squamous cell carcinoma, EGFR mutations were detected in 25 cases (18%, KRAS mutations were detected in 7 cases (5%, and the presence of both EGFR and KRAS mutations was detected in 1 case (0.7%. EGFR mutations occurred more often in females than in males (33.3% vs 16.5% and in patients that never smoked than in those who smoke (29.6% vs 16.1%. However, the difference did not reach statistical significance (P>0.05. No significant differences were observed in age, stage, and different biopsy type. KRAS mutations occurred more often in males than in females (5.5% vs 0%, but the difference did not reach statistical significance (P>0.05. No significant differences were observed in age, stage, different biopsy type, and smoking status (P>0.05. Conclusion EGFR and KRAS mutations were low in lung squamous cell carcinomas, and had no significant correlation with clinical features. Before using tyrosine kinase inhibitor targeted therapy, EGFR and KRAS mutations should be detected in patients with lung squamous cell carcinomas.

Red Dot Basal Cell Carcinoma: Report of Cases and Review of This Unique Presentation of Basal Cell Carcinoma.

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Cohen, Philip R

2017-03-22

Red dot basal cell carcinoma is a unique variant of basal cell carcinoma. Including the three patients described in this report, red dot basal cell carcinoma has only been described in seven individuals. This paper describes the features of two males and one female with red dot basal cell carcinoma and reviews the characteristics of other patients with this clinical subtype of basal cell carcinoma. A 70-year-old male developed a pearly-colored papule with a red dot in the center on his nasal tip. A 71-year-old male developed a red dot surrounded by a flesh-colored papule on his left nostril. Lastly, a 74-year-old female developed a red dot within an area of erythema on her left mid back. Biopsy of the lesions all showed nodular and/or superficial basal cell carcinoma. Correlation of the clinical presentation and pathology established the diagnosis of red dot basal cell carcinoma. The tumors were treated by excision using the Mohs surgical technique. Pubmed was searched with the keyword: basal, cell, cancer, carcinoma, dot, red, and skin. The papers generated by the search and their references were reviewed. Red dot basal cell carcinoma has been described in three females and two males; the gender was not reported in two patients. The tumor was located on the nose (five patients), back (one patient) and thigh (one patient). Cancer presented as a solitary small red macule or papule; often, the carcinoma was surrounded by erythema or a flesh-colored papule. Although basal cell carcinomas usually do not blanch after a glass microscope slide is pressed against them, the red dot basal cell carcinoma blanched after diascopy in two of the patients, resulting in a delay of diagnosis in one of these individuals. Dermoscopy may be a useful non-invasive modality for evaluating skin lesions when the diagnosis of red dot basal cell carcinoma is considered. Mohs surgery is the treatment of choice; in some of the patients, the ratio of the area of the postoperative wound to that

Quality of Life in Hepatocellular Carcinoma Patients Treated with Transarterial Chemoembolization

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Saleem Ahmed

2016-01-01

Full Text Available Hepatocellular carcinoma (HCC is one of the most commonly diagnosed cancers worldwide. Majority of patients with HCC are diagnosed in the advanced stages of disease and hence they are only suitable for palliative therapy. TACE (transarterial chemoembolization is the most commonly used treatment for unresectable HCC. It is however unclear if TACE improves the quality of life (QoL in patients with HCC. The aim of this review is to evaluate the impact of TACE on QoL of HCC patients.

Topotecan Monotherapy in Heavily Pretreated Patients with Progressive Advanced Stage Neuroendocrine Carcinomas

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Olsen, Ingrid Marie Holst; Knigge, Ulrich; Federspiel, Birgitte

2014-01-01

BACKGROUND: Neuroendocrine carcinomas (WHO grade 3) are highly aggressive tumors with an immense tendency to metastasize and with a poor prognosis. In advanced disease, there is no standard treatment beyond first-line platin/etoposide-based chemotherapy. Topotecan is widely used as second...... neuroendocrine carcinomas (Ki67>20%, G3) successively treated with oral topotecan 2.3 mg/m(2) d1-5 every 3 weeks. All patients had previously received treatment with carboplatin/etoposide. Demographic, clinical and pathological features were recorded. CT-evaluations according to RECIST 1.1 were performed after...... every three courses. Hematological toxicity was assessed by CTC-criteria. RESULTS: Twenty-two eligible patients received a median of 2 courses [range1-6]. Median age: 65 years [35-77]. Male/female: 11/11. Median Ki-67 index: 95% [25-100%]. Median number previous chemotherapy regimens: 2 [1-3]. All...

Enrichment methods to detect bone marrow micrometastases in breast carcinoma patients: clinical relevance

International Nuclear Information System (INIS)

Choesmel, Valérie; Pierga, Jean-Yves; Nos, Claude; Vincent-Salomon, Anne; Sigal-Zafrani, Brigitte; Thiery, Jean-Paul; Blin, Nathalie

2004-01-01

Improving technologies for the detection and purification of bone marrow (BM) micrometastatic cells in breast cancer patients should lead to earlier prognosis of the risk of relapse and should make it possible to design more appropriate therapies. The technique used has to overcome the challenges resulting from the small number of target cells (one per million hematopoietic cells) and the heterogeneous expression of micrometastatic cell markers. In the present study, we have assessed the clinical relevance of current methods aimed at detecting rare disseminated carcinoma cells. BM aspirates from 32 carcinoma patients were screened for the presence of micrometastatic cells positive for epithelial cell adhesion molecule and positive for cytokeratins, using optimized immunodetection methods. A comparison with data obtained for 46 control BM aspirates and a correlation with the clinical status of patients were performed. We developed a sensitive and efficient immunomagnetic protocol for the enrichment of BM micrometastases. This method was used to divide 32 breast carcinoma patients into three categories according to their epithelial cell adhesion molecule status. These categories were highly correlated with the recently revised American Joint Committee on Cancer staging system for breast cancer, demonstrating the clinical relevance of this simple and reliable immunomagnetic technique. We also evaluated immunocytochemical detection of cytokeratin-positive cells and cytomorphological parameters. Immunocytochemistry-based methods for the detection of BM micrometastases did not provide any information about the clinical status of patients, but helped to refine the immunomagnetic data by confirming the presence of micrometastases in some cases. We also tested a new density gradient centrifugation system, able to enrich the tumor fraction of BM specimens by twofold to threefold as compared with standard Ficoll methods. These improved methods for the detection of

Somatostatin receptor scintigraphy on thyroid carcinoma

International Nuclear Information System (INIS)

Pan Weimin; Tan Tianzhi

2004-01-01

Purpose: To study the diagnostic value and clinical method of somatostatin receptor scintigraphy on thyroid carcinoma using 99 Tc m -RC-160 labeled with direct method as scintigraphy reagent; Methods: Somatostatin receptor scintigraphy (SRS) were performed on 25 patients with thyroid carcinoma, using 99 Tc m -RC-160 labeled with direct method as scintigraphy reagent, controlling with 131 I- whole- body- imaging(1312 -WBI). Results: Of 4 patients with MTC (medullary thyroid carcinoma), positive metastasis and primary tumour were detected on 3 patients by SRS, negative results were obtained by 131 I-WBI, the positive detective rate by SRS is 3/4; of 12 patients with PTC (papillary thyroid carcinoma), positive metastasis and primary tumour were detected on 2 patients by SRS or 131 I-WBI,1 of which only by SRS, while negative results were obtained by 131 I- WBI, the positive detective rate by SRS is 3/12; of 8 patients with FTC(follicular thyroid carcinoma), positive metastasis and primary tumour were detected on 1 patients by SRS or 131 I-WBI, and 2 positive results were obtained only by SRS, while negative by 131 I-WBI, the positive detective rate by SRS is 3/8; of 1 patients with HCC (hurthle cell carcinoma ), positive metastasis and primary tumour were detected by SRS, while negative by 131 I-WBI; Conclusions: SRS using 99 Tc m -RC-160 labeled with direct method as scintigraphy reagent has high diagnostic value on thyroid carcinoma, especially on MTC and HCC. (authors)

Serum testosterone as a prognostic factor in patients with advanced prostatic carcinoma

DEFF Research Database (Denmark)

Iversen, P; Rasmussen, F; Christensen, I J

1994-01-01

In 245 patients with previously untreated advanced carcinoma of the prostate, serum concentrations of testosterone have been measured before androgen deprivation therapy, and patients were divided in quartiles according to their serum concentration. Pretreatment level of serum testosterone...... parameters suggest that low serum testosterone merely is a consequence of the advanced malignancy rather than a causative factor in the pathogenesis of prostatic cancer....

Radiation therapy for carcinoma of the eyelid

International Nuclear Information System (INIS)

Tsuchiya, Miwako; Takahashi, Mitsuhiro; Shinozaki, Jun; Kaneda, Koichi; Oda, Norio; Tabuchi, Yoshiko

1987-01-01

Between 1969 and 1985, 30 patients with carcinomas of the eyelid were treated by radiation, including 19 primary cases and 11 secondary cases. The latter were less controlable than the former. According to histology, there were 21 squamous cell carcinomas, 6 basal cell carcinomas and 3 adenocarcinomas. Among the 21 patients with squamous cell carcinomas, 5 had local recurrences, 10 had lymph node metastasis and 3 had distant metastasis. Patients with other histological classifications had no local recurrences, except for one who received incomplete therapy due to diabetes. Almost all of the controlled patients with squamous cell carcinomas were treated with a TDF value greater than 90. Although the visual function was damaged by irradiation in seven patients, the lesions of 6 of them were too advanced to avoid radiation injuries. (author)

Immunological state of patients with carcinoma of the bronchus before and after radiotherapy

International Nuclear Information System (INIS)

Savage, A.M.; Pritchard, J.A.V.; Deeley, T.J.; Davies, B.H.; Sully Hospital

1980-01-01

The immunological state of 30 patients with carcinoma of the bronchus was assessed before and after radiotherapy by lymphocyte response to PHA and E and EAC rosette formation. The results were compared with those from age-matched patients with benign chest disease and a group of healthy control subjects. Differences were found between the three groups and decreased immunological responses were found to correlate with shorter survival times for patients with cancer of the bronchus. These differences were associated with the extent of the disease, or with the smoking habits of the patients. Significant differences in percentage EAC cell rosetting were demonstrated between lymphocytes from patients with malignant disease (31.3 +- 2.0) and those for control groups (21.5 +- 1.9 and 24.0 +- 2.2). Cancer patients and benign chest disease patients both had significantly decreased mean E rosetting values (59.3% and 55.6%) compared with healthy control subjects (69.7%). The group of cancer patients with a normal percentage of T lymphocytes and total number of lymphocytes and radiotherapy, or those with low percentage EAC cell rosettes, had a greater than 80% survival after seven months compared with less than 50% for the rest of the patients with carcinoma of the bronchus. (author)

Early development of de novo hepatocellular carcinoma after direct-acting agent therapy: Comparison with pegylated interferon-based therapy in chronic hepatitis C patients.

Science.gov (United States)

Yoo, S H; Kwon, J H; Nam, S W; Kim, H Y; Kim, C W; You, C R; Choi, S W; Cho, S H; Han, J-Y; Song, D S; Chang, U I; Yang, J M; Lee, H L; Lee, S W; Han, N I; Kim, S-H; Song, M J; Hwang, S; Sung, P S; Jang, J W; Bae, S H; Choi, J Y; Yoon, S K

2018-04-16

Patients with chronic hepatitis C who achieve a sustained viral response after pegylated interferon therapy have a reduced risk of hepatocellular carcinoma, but the risk after treatment with direct-acting antivirals is unclear. We compared the rates of early development of hepatocellular carcinoma after direct-acting antivirals and after pegylated interferon therapy. We retrospectively analysed 785 patients with chronic hepatitis C who had no history of hepatocellular carcinoma (211 treated with pegylated interferon, 574 with direct-acting antivirals) and were followed up for at least 24 weeks after antiviral treatment. De novo hepatocellular carcinoma developed in 6 of 574 patients receiving direct-acting antivirals and in 1 of 211 patients receiving pegylated interferon. The cumulative incidence of early hepatocellular carcinoma development did not differ between the treatment groups either for the whole cohort (1.05% vs 0.47%, P = .298) or for those patients with Child-Pugh Class A cirrhosis (3.73% vs 2.94%, P = .827). Multivariate analysis indicated that alpha-fetoprotein level >9.5 ng/mL at the time of end-of-treatment response was the only independent risk factor for early development of hepatocellular carcinoma in all patients (P hepatocellular carcinoma did not differ between patients treated with pegylated interferon and those treated with direct-acting antivirals and was associated with the serum alpha-fetoprotein level at the time of end-of-treatment response. © 2018 John Wiley & Sons Ltd.

Interventional treatment of upper gastrointestinal bleeding in patients of hepatic carcinoma accompanied with hepatic artery-portal vein shunting

International Nuclear Information System (INIS)

Li Jijun; Shang Jianqiang; Liu Zuoqin; Tang Jun; Sun Zengtao; Chen Jie; Zhang Lei; Liu Hongjun; Zhou Zhaohai

2011-01-01

Objective: To explore the diagnostic and therapeutic efficacy of interventional procedure for upper gastrointestinal bleeding in patients of hepatic carcinoma accompanied with hepatic artery-portal vein shunting (HAPVS). Methods: Clinical data of 27 patients of hepatic carcinoma accompanied with HAPVS were retrospectively analyzed. All patients underwent hepatic arterial angiography and transcatheter arterial embolization. Shunts were embolized with coils, Gelfoam particles or PVA particles. Results: Of 27 patients with upper gastrointestinal bleeding, central type HAPVS was seen in 16 and peripheral type HAPVS in 11. Reversed portal venous flow was detected in 20 cases and ascites was found in 23 cases. The abnormal shunts were successfully occluded in all patients and the bleeding ceased within 2 days after embolization. No recurrent bleeding occurred in one month after the treatment. Ascites disappeared in 16 cases and subsided in 7 cases. Conclusion: HAPVS is an important cause for upper gastrointestinal bleeding in patients of hepatic carcinoma, and the arteriovenous fistula can be confirmed with hepatic artery DSA. Embolization of fistulous orifice is the most effective therapy for such patients. (authors)

Thyroid Metastasis from Breast Carcinoma Accompanied by Papillary Thyroid Carcinoma

Directory of Open Access Journals (Sweden)

Song-I Yang

2014-07-01

Full Text Available Metastasis to the thyroid gland is very rare. Recently, we experienced a case of thyroid metastasis from breast cancer accompanying a papillary thyroid. A 51-year-old female patient presented with a palpated lymph node on her left lateral neck. The patient had undergone a left modified radical mastectomy followed by chemotherapy and hormonal therapy 12 years prior. Ultrasonography of the neck revealed a malignant looking nodule at the left thyroid lobe, measuring 0.9 × 0.9 cm, and several cystic nodules at the right thyroid lobe. Ultrasonography of the neck additionally revealed a malignant looking lymph node at the right level VI. Fine-needle aspiration of the left thyroid lobe resulted in a diagnosis of papillary thyroid carcinoma and that of the right level VI in Hurthle cell lesion. The patient had a total thyroidectomy with selective dissection of the left neck node. Pathologic assessment of the specimen revealed metastatic carcinoma from the breast carcinoma and papillary thyroid carcinoma. Although the thyroid gland is highly vascularized, metastasis of malignant tumors to the thyroid is relatively rare and detection of metastasis shows a low frequency. So a careful evaluation of thyroid tumor should be considered in a patient with a history of other malignancy.

Assessment of quality of life in patients treated with accelerated radiotherapy for laryngeal and hypopharyngeal carcinomas.

Science.gov (United States)

Allal, A S; Dulguerov, P; Bieri, S; Lehmann, W; Kurtz, J M

2000-05-01

This study was conducted to evaluate quality of life (QOL) and functional outcome in patients with carcinomas of the larynx and hypopharynx treated with accelerated radiotherapy (RT). Between January 1991 and September 1996, 21 patients treated with accelerated concomitant boost RT schedule (69.9 Gy in 5. 5 weeks) for laryngeal (n = 10) or hypopharyngeal (n = 11) carcinomas and who remained free of disease at 1-year minimum follow-up were evaluated. The functional outcome was assessed by the subjective Performance Status Scale for Head and Neck cancer (PSSHN) and general QOL by the European Organization for Research and Treatment of Cancer Core QOL questionnaire (EORTC QLQ-C30). The median length of follow-up was 37 months (range, 13 to 75). The PSSHN scores were 89, 84, and 86, respectively, for eating in public, understandability of speech and normalcy of diet (100 = normal function). Significantly lower scores for understandability of speech were observed in patients with advanced and laryngeal carcinomas. Normalcy of diet was affected negatively by the severity of xerostomia. All mean functional scale scores of the EORTC QLQ-C30 module were 20% to 25% below the higher score. Most of these scale scores were significantly affected by the severity of xerostomia. Patients treated with concomitant boost RT for laryngeal and hypopharyngeal carcinomas appear to have similar QOL and functional outcome to those reported for patients treated with conventional or hyperfractionated RT. As expected, many QOL scales were affected by the severity of xero- stomia.

PrognosticValue of PINP,BoneAlkaline Phosphatase, CTX-I, andYKL-40 in Patients With Metastatic Prostate Carcinoma

DEFF Research Database (Denmark)

Brasso, Klaus; Christensen, Ib Jarle; Johansen, Julia S

2006-01-01

Prognostic value of PINP, bone alkaline phosphatase, CTX-I, and YKL-40 in patients with metastatic prostate carcinoma. Prostate. 2006 Apr 1;66(5):503-13. PMID: 16372331 [PubMed - indexed for MEDLINE]......Prognostic value of PINP, bone alkaline phosphatase, CTX-I, and YKL-40 in patients with metastatic prostate carcinoma. Prostate. 2006 Apr 1;66(5):503-13. PMID: 16372331 [PubMed - indexed for MEDLINE]...

Carcinoma of the pancreas