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PubMed2006

Urokinase-type plasminogen activator and its inhibitor in thyroid neoplasms: a cytosol study.

PURPOSE: Higher levels of urokinase-type plasminogen activator (uPA) and its inhibitor (PAI-1) are linked to the poor prognosis in a variety of malignances. uPA and PAI-1 were expressed in most thyroid carcinomas, as had been measured immunohistochemically. However, no relationship between their expression and clinicopathological parameters were found. Aim of the present study was to investigate the expression and clinical relevance of uPA and PAI-1 in thyroid cancer. PATIENTS AND METHODS: uPA and PAI-1 in paired cytosol samples of thyroid tumor and normal tissue were determined in 23 patients using enzyme-linked immunosorbent assay and correlated to the known prognostic features. RESULTS: Both uPA and PAI-1 concentrations were significantly higher in malignant thyroid tumors (uPA=1.342 +/- 2.944 and PAI-1=17.615 +/- 31.933 ng/mg protein) than in normal tissue (uPA=0.002 +/- 0.009, P=0.011 and PAI-1=2.333 +/- 0.338 ng/mg protein, P=0.001) with positive correlation of the two proteins in the tumors. There were no differences in proteins' levels between benign tumors and normal tissue. Both proteins' concentrations were significantly different among various histological grades (uPA P=0.024 and PAI-1 P=0.017), showing higher values in higher tumor grades (grade I uPA=0.116 +/- 0.247 and PAI-1=4.802 +/- 4.151 ng/mg protein; grade III uPA=8.45 +/- 2.192 and PAI-1=94.65 +/- 59.468 ng/mg protein). The uPA and PAI-1 levels showed significant differences among different histological types of thyroid cancer (uPA P=0.049 and PAI-1=0.017). The lowest values were in adenomas (uPA=0.013 +/- 0.025 and PAI-1=2.785 +/- 1.069 ng/mg protein) and the highest in anaplastic carcinomas (uPA=8.45 +/- 2.192 and PAI-1=94.65 +/- 59.468 ng/mg protein). uPA and PAI-1 were significantly higher in anaplastic vs. well-differentiated cancers (uPA P=0.014 and PAI-1 P=0.026), if extrathyroidal invasion (uPA P=0.019 and PAI-1 P=0.009) or distant metastases (uPA P=0.006 and PAI-1 P=0.003) had been present, and in tumors whose size exceeded 1 cm in diameter (uPA P=0.009 and PAI-1 P=0.035). Only PAI-1, but not uPA was significantly higher in multicentric vs. solitary tumors (P=0.012) and lymph node positive compared to lymph node negative patients (P=0.042). The differences of uPA and PAI-1 did not reach the significant level when patients with well-differentiated tumors below and above 40 years of age had been compared. Survival analysis revealed the significant impact of both uPA and PAI-1 on the Progression-Free Survival (PFS) (38.84 vs. 3.67 months for patients with low and high uPA, respectively, P<0.001; 38.2 vs. 12 months for patients with low and high PAI-1, respectively, P=0.016). CONCLUSIONS: The correlation of high uPA and PAI-1 with the known prognostic factors of poorer outcome and with lower PFS rate in patients with thyroid cancers proved that these proteins could be an additional prognostic parameter.

Adult↗
PubMed1996

Immunocytochemical staining with monoclonal antibody MoAb47 in the diagnosis of thyroid neoplasms (preliminary communication).

The study is aimed at the estimation of diagnostic value of immunocytochemical (ICH) staining with MoAb47 of cytological material from thyroid nodules obtained by FNAB with emphasis on a precise distinction between benign and malignant follicular tumours. Monoclonal antibody 47 has very strong avidity to thyroperoxidase (TPO) from normal thyrocytes and from benign thyroid lesions. Binding of MoAb47 with TPO from thyroid carcinoma cells is null or very weak. We report the results of ICH staining in 34 cases of "cold" or quickly growing thyroid nodules, most of them solitary. Cytological diagnosis was thyroid carcinoma in 4 cases, microfollicular neoplasm in 7 and different benign lesions in 23. As expected in carcinomas the ICH staining was negative and the presence of cancer was histopathologically proved in 3 already operated on patients. In all follicular tumours staining with MoAb47 was positive and in 5 surgically treated cases postoperative examination identified benign follicular adenoma. Smears from colloidal nodules, cystic and degenerative lesions stained positively with MoAb47. In our opinion staining of cytological material with MoAb47 may improve the diagnosis of thyroid nodules.

Adolescent↗
PubMed1999

Human telomerase reverse transcriptase (hTERT) gene expression in FNA samples from thyroid neoplasms.

BACKGROUND: Although fine-needle aspiration (FNA) is the most sensitive method for the detection of thyroid carcinoma, it cannot provide a definitive diagnosis of malignancy in 60% of the patients operated on for suspicious lesions. Recently, human telomerase reverse transcriptase (hTERT) has been found to be a diagnostic marker of malignancy. We therefore sought to determine whether hTERT gene expression could serve as an adjunct to FNA in the differential diagnosis of thyroid nodules. METHODS: Twenty-four FNA samples from thyroid nodules that were suspected of malignancy were collected. RNA was extracted, and hTERT gene expression was examined by RT-PCR. Cytologic and histologic examinations were also performed. RESULTS: Two of three follicular, three of three Hürthle cell, and eight of eight papillary thyroid carcinomas had corresponding FNA samples that were positive for hTERT. One of two Hürthle cell adenomas was hTERT positive. FNA samples from three follicular adenomas and five hyperplastic nodules were negative for hTERT. Positive and negative predictive values were 93% and 90%, respectively. CONCLUSIONS: The detection of hTERT gene expression in thyroid FNA samples holds promise as a diagnostic marker in the distinction of benign from malignant thyroid lesions. Its application could alter the surgical management of these patients.

Adenocarcinoma, Follicular↗
PubMed1977

[Diagnosis and therapy of malignant thyroid neoplasms].

On 155 patients (114 women and 41 men), who from 1965 to 1975 underwent a combined operative, radiological and hormonal treatment, the advantages of a planned interdisciplinary therapeutic procedure in malignant tumours of the thyroid gland are demonstrated. The histological classification was performed according to the nomenclature of the WHO. In 94 cases we had to do with differentiated epithelial tumours, 61 times with undifferentiated tumours. 36 patients were younger than 40 years, in general the 6th to 7th decennium was preferred. In clinical and nuclear-medical suspicion to malignoma the aspiration biopsy was carried out with a thin needle. 252 biopsies brought 39 times findings suspicious to tumour, in 20 cases the suspicion was confirmed by operation. The mean survival time after the complex therapy described was 2 1/4 years in the undifferentiated tumours, in differentiated carcinomas 4 years. Up to now 25 patients reached the 5-year-limit. The lethality was loaded above all by late stages. The planned interdisciplinary proceeding in suitable centres is able to improve the chances of success in early diagnosing including the punction cytology.

Adult↗
PubMed1983

Thyroid neoplasm after high-dose radiotherapy.

A female patient is described who developed papillary-follicular carcinoma of the thyroid 8 years after receiving high-dose external radiotherapy to the head and neck. This malignant neoplasm developed while she was taking suppressive doses of thyroid medication. Although it has long been thought that high-dose radiotherapy is not associated with the occurrence of thyroid tumor, it is becoming increasingly apparent that this concept is not necessarily true. Clinicians should be aware of the possible sequelae of neoplastic thyroid disease after any amount of external radiotherapy to the head and neck. Careful periodic follow-up of patients who have received such treatment is strongly advised.

Adenocarcinoma↗