Biomedical subjects

Ernst Gemsenjäger

Publications and source records attributed to Ernst Gemsenjäger.

2 recordsLinked to original sources

PubMed2006

Molecular characterization of well-differentiated human thyroid carcinomas by cDNA arrays.

Well-differentiated papillary and follicular thyroid carcinomas are the two most common types of thyroid cancer. Although cancerous cells in both types phenotypically resemble the epithelial follicular cell, the tumors display different histological characteristics and clinical outcomes. Molecular defects contributing to the separate development pathways remain largely unclear. We evaluated gene expression profiles to generate a detailed molecular characterization of the two tumor types, attempting to detect novel diagnostic and clinical markers. Gene expression profiling of 46 thyroid samples (16 papillary carcinomas, 13 follicular carcinomas and 17 normal thyroid specimens) was performed by using high-density human UniGene cDNA arrays. The identification of differentially expressed genes was based on a comparison of signal intensity ratios of tumor versus normal tissues. A cross-validation of individual filter-array hybridizations and real-time PCR analysis of selected genes were carried out to confirm data reproducibility and reliability. The majority of genes with altered expression were found in both papillary and follicular carcinomas, reflecting a close relationship between the two tumor types. However, 123 genes consisting of 45 known and 78 unknown genes were shown to be differentially expressed between papillary and follicular carcinomas. Follicular variants of papillary carcinoma, clustered together with classical papillary carcinoma, could be differentiated from follicular carcinoma. Our study revealed a set of genes differentiating follicular carcinoma from classical papillary carcinoma and follicular variant. The data generated in this study could serve as a useful source for further investigation of pathways of papillary and follicular differentiation of thyroid cancer.

Adenocarcinoma, Follicular↗

PubMed2003

Lymph node surgery in papillary thyroid carcinoma.

BACKGROUND: The impact of nodal disease remains controversial in papillary thyroid carcinoma (PTC). STUDY DESIGN: One surgeon treated 159 unselected patients, who were followed up for 1 to 27 years. We present a retrospective analysis with respect to nodal disease. Occult nodal disease was investigated, including metachronous nodal disease (mpN(1)) in primarily node negative patients (pN(0), clinical [c]N(0)). RESULTS: Therapeutic lymphadenectomies, prophylactic lymphadenectomies, or no lymphadenectomy were carried out in 42 (cN(1)), 29 (cN(0)), and 88 (cN(0)) patients, respectively, with stage pN(1) in 41 (98%), in 5 (17%), and in 2 (2.3%) patients, respectively (17% versus 2.3% p < 0.005). Sensitivity and specificity of clinical staging were 85% and 99%, respectively. More frequent prophylactic lymphadenectomy during the study period (p = 0.002) led to a nonsignificant increase in stage pN(1) (26% versus 30%). Immunohistochemistry led to upstaging of only 3% of histologically negative nodes and one (4%) pN(0) patient. Nodal recurrence occurred in 8 of 156 patients (5%) treated for cure, in 12% of pN(1) versus 3% of pN(0) cN(0) tumors (p = 0.009), in 15% of TNM high-versus 3% of low-risk patients (p = 0.006), and in 5% each of patients, younger than 45 and 45 years or more. In TNM high-risk patients, tumor-related survival was 50% for stage pN(1) versus 86% for stage pN(0), cN(0) (p = 0.03) (100% and 100% in low-risk patients). CONCLUSIONS: The rate of occult nodal disease might be relatively low, and it does not frequently progress to clinical recurrent disease. Clinical nodal status might be valid for deciding the extent and radicality of node dissection. Prophylactic (central) lymphadenectomy should be carried out without radicality-associated morbidity. Macroscopic nodal disease warrants more rigorous, compartment-oriented lymphadenectomy. There is no rationale for detection of occult disease and micrometastasis by frozen section or immunohistochemistry.

Adult↗