1
UI - 11926385
AU - Boerner AR; Petrich T; Weckesser E; Fricke H; Hofmann M; Otto D;
TI - Weckesser M; Langen KJ; Knapp WH Monitoring isotretinoin therapy in thyroid cancer using 18F-FDG PET.
SO - Eur J Nucl Med Mol Imaging 2002 Feb;29(2):231-6
AD - Department of Nuclear Medicine, Hannover Medical School, Germany. boerner.anne-rose@mh-hannover.de
Treatment with isotretinoin (13-cis-retinoic acid, 13-cis-RA) is a recent additional option in advanced, otherwise intractable differentiated thyroid cancers. The aim of this study was to evaluate fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) in the prediction and the monitoring of response to 13-cis-RA therapy. Twenty-one patients with advanced differentiated thyroid cancers were investigated using 18F-FDG PET and iodine-131 whole-body scans before and 3, 6 and 9 months after initiation of 13-cis-RA therapy. After 9 months, 13-cis-RA treatment was discontinued and imaging procedures repeated 3 months later. Average 18F-FDG uptake (SUV) decreased significantly during 13-cis-RA therapy but subsequently increased in five of eight patients after withdrawal of 13-cis-RA. 18F-FDG uptake (SUV) 3 months after onset of 13-cis-RA therapy was significantly lower in patients who developed increased 131I uptake in their tumour sites than in patients with no subsequent increase in 131I uptake. There was no relationship between serum thyroglobulin level on the one hand and simultaneously measured 131I or 18F-FDG uptake on the other hand. There was a tendency towards lower 18F-FDG uptake in tumour manifestations with a better outcome. Therefore, 18F-FDG PET at 3 months after the start of treatment promises to differentiate between those patients who will eventually benefit from 13-cis-RA and those who will not. In conclusion, these data indicate that 18F-FDG PET is a useful tool for the evaluation and monitoring of adjuvant therapy with 13-cis-RA in thyroid cancer.

2
UI - 11951931
AU - Arkles LB
TI - Preoperative localization of parathyroid adenomas: the protagonist's view.
SO - Intern Med J 2002 Apr;32(4):179-82
AD - Department of Nuclear Medicine, and Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia. arkles@netspace.net.au

3
UI - 11951932
AU - Hartley L
TI - Preoperative localization of parathyroid adenomas: the antagonist's view.
SO - Intern Med J 2002 Apr;32(4):183-4
AD - The Princess Alexandra Hospital, Brisbane, Queensland, Australia. hartley@orangemail.com.au

4
UI - 11951933
AU - Khafagi FA
TI - Preoperative localization of parathyroid adenomas: cost-effective or just costly?
SO - Intern Med J 2002 Apr;32(4):185-6
AD - Department of Nuclear Medicine & Cardiology, St Andrew's War Memorial Hospital, Brisbane, Queensland, Australia. fkhafagi@bigpond.com

5
UI - 11953824
AU - de Nigris F; Cerutti J; Morelli C; Califano D; Chiariotti L; Viglietto
TI - G; Santelli G; Fusco A Isolation of a SIR-like gene, SIR-T8, that is overexpressed in thyroid carcinoma cell lines and tissues.
SO - Br J Cancer 2002 Mar 18;86(6):917-23
AD - Servizio di Oncologia Sperimentale "E", Istituto per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, 80131 Naples, Italy.
We used subtractive library screening to identify the changes that occur in gene expression during thyroid cell neoplastic transformation. Complementary DNA from normal thyroid cells (HTC 2) was subtracted from a complementary DNA library constructed from a human thyroid papillary carcinoma cell line. The library was screened for genes upregulated in human thyroid papillary carcinoma cell line cells, and several cDNA clones were isolated. One of these clones has a sirtuin core and high homology with the human silent information regulator protein family. This clone, designated "SIR-T8", was overexpressed in human thyroid carcinoma cell lines and tissues, but not in adenomas. The human SIR-T8 protein has a molecular weight of 39 kDa and is primarily located in the cytoplasm under the nuclear membrane. The SIR-T8 gene is located on chromosome 17q25-1. Copyright 2002 Cancer Research UK

6
UI - 12029204
AU - Kalinyak JE
TI - 123 I as a diagnostic tracer in the management of thyroid cancer.
SO - Nucl Med Commun 2002 Jun;23(6):509-11

7
UI - 12029212
AU - Staudenherz A; Selzer E; Kochl H; Leitha T
TI - Effects of irradiation on 99m Tc sestamibi and 201Tl uptake in a human papillary thyroid carcinoma cell line.
SO - Nucl Med Commun 2002 Jun;23(6):565-8
AD - University Clinic of Nuclear Medicine, University of Vienna - AKH, Austria. anton.staudenherz@akh-wien.ac.at
Both 99mTc sestamibi and 201Tl have been used in conjunction with 131I scintigraphy for follow-up of patients with thyroid cancer. The aim of the study was to determine if irradiation affects tracer uptake in papillary thyroid cancer cells. The human papillary carcinoma cell line (PAP/ES-1) used in this study was generated from a papillary thyroid tumour obtained after surgery. For the in vitro uptake studies cells were seeded at 2 x 105 cells/well into 12-well microtitre plates. Irradiation was performed with a 60Co source (total dose, 2 Gy and 10 Gy). After incubation at 37 degrees C the supernatants were saved for determination of the unincorporated activity. The reaction was stopped by washing the cells four times in ice cold phosphate buffered saline. Total cellular uptake was determined by measuring cell lysate radioactivity in a Compugammasystem and was expressed as per cent uptake per mg of total cellular protein. At continuous incubation 201Tl uptake was significantly (P<0.01) higher after radiation whereas no effect of irradiation was found on 99mTc sestamibi uptake. Pulsed experiments revealed that irradiated cells displayed a faster 201Tl efflux. The net tracer retention at 90 min was similar to 201Tl to that of 99mTc sestamibi. We conclude that 99mTc sestamibi kinetics in thyroid cancer are not affected by irradiation and may therefore be superior to 201Tl in the follow-up of thyroid cancer shortly after radiotherapy.

8
UI - 12203783
AU - Sandrini F; Matyakhina L; Sarlis NJ; Kirschner LS; Farmakidis C; Gimm O;
TI - Stratakis CA Regulatory subunit type I-alpha of protein kinase A (PRKAR1A): a tumor-suppressor gene for sporadic thyroid cancer.
SO - Genes Chromosomes Cancer 2002 Oct;35(2):182-92
AD - Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892-1862, USA.
The tumor-suppressor gene encoding the cyclic AMP-dependent protein kinase A type I-alpha regulatory subunit PRKAR1A has been mapped to chromosome 17 (17q22-24) and is mutated in Carney complex, a familial neoplasia syndrome that is associated with thyroid tumors. Other genes implicated in cyclic nucleotide-dependent signaling have been investigated in thyroid tumorigenesis. We studied protein kinase A (PKA) activity in noninherited follicular thyroid adenomas and follicular, papillary, and undifferentiated (anaplastic) thyroid carcinomas. We then examined these and additional thyroid tumors for losses of the 17q22-24 PRKAR1A region, mutations of the PRKAR1A gene, and expression of its peptide product. Total PKA activity was markedly increased in carcinomas over that in adenomas, whereas the ratio of free vs. total PKA activity was decreased in cancer. Consistent with these findings, the 17q22-24 region was frequently lost in cancer but not in benign adenomas. A novel inactivating mutation of the PRKAR1A gene (leading to premature termination of the predicted protein) was found in an aggressive thyroid cancer. The tumor with PRKAR1A gene mutation, as well as the tumors with 17q allelic losses, showed decreased PRKAR1A expression by immunostaining. We conclude that PRKAR1A, the most abundant regulatory subunit of protein kinase A and a principal cyclic AMP-signaling modulator, acts as a tumor-suppressor gene in sporadic thyroid cancer. Published 2002 Wiley-Liss, Inc.

9
UI - 12324571
AU - Takano T; Hasegawa Y; Miyauchi A; Matsuzuka F; Yoshida H; Kuma K; Amino
TI - N Quantitative analysis of thymosin beta-10 messenger RNA in thyroid carcinomas.
SO - Jpn J Clin Oncol 2002 Jul;32(7):229-32
AD - Department of Laboratory Medicine, Osaka University Medical School, Suita, Osaka, Japan. ttakano@labo.med.osaka-u.ac.jp
BACKGROUND: Genes that are differentially expressed in benign and malignant tissues are important for the establishment of molecular-based diagnosis of carcinomas. Our recent study on the gene expression profile of thyroid carcinomas revealed an increased expression of thymosin beta-10 mRNA. METHODS: To confirm this, we measured the expression levels of thymosin beta-10 mRNA in 84 thyroid benign and malignant thyroid tissues, including five anaplastic carcinomas, by means of real-time quantitative reverse transcription-polymerase chain reaction. RESULTS: We found an increased expression of thymosin beta-10 mRNA in thyroid carcinomas, especially in anaplastic carcinomas. Expression levels of thymosin beta-10 mRNA relative to thyroglobulin mRNA in anaplastic carcinomas were greatly increased compared with those in differentiated carcinomas. CONCLUSION: These results suggest the usefulness of the quantitative measurement of thymosin beta-10 mRNA in molecular-based diagnosis of thyroid anaplastic carcinomas, but not of differentiated carcinomas.

10
UI - 6475918
AU - McTiernan AM; Weiss NS; Daling JR
TI - Incidence of thyroid cancer in women in relation to reproductive and hormonal factors.
SO - Am J Epidemiol 1984 Sep;120(3):423-35
Female residents of western Washington state aged 18-80 years in whom interviewed concerning their reproductive histories and their prior use of exogenous estrogens. Their responses were compared with those of a sample of women from the same population, individually matched to cases on telephone prefix. Use of each of several estrogen-containing preparations was associated with a small increased risk of thyroid cancer; parous women who had ever used a lactation suppressant had 1.7 times the risk of parous nonusers (95% confidence interval, 1.1-2.8); ever users of oral contraceptives had 1.6 times the risk of never users (95% confidence interval, 0.98-2.5); and ever users of postmenopausal estrogens had 1.4 times the risk of never users (95% confidence interval, 0.89-2.3). Among the low risk group of women, i.e., those who had never undergone radiation therapy and who had never had a goiter, a history of one or more pregnancies was also associated with a small increase in the risk of thyroid cancer (relative risk = 1.8, 95% confidence interval, 1.1-3.1). However, no increase in risk with increasing duration of use of oral contraceptives or menopausal estrogens or with increasing number of pregnancies was noted. While pregnancy and use of exogenous estrogens have an impact on the production of thyroid-stimulating hormone, their effect on the incidence of thyroid carcinoma, if present at all, appears to be small.

11
UI - 11956624
AU - Suzuki S; Fukushima T; Ami H; Onogi H; Nakamura I; Takenoshita S
TI - New attempt of preoperative differential diagnosis of thyroid neoplasms by telomerase activity measurement.
SO - Oncol Rep 2002 May-Jun;9(3):539-44
AD - Department of Surgery II, Fukushima Medical University, School of Medicine, Fukushima 960-1295, Japan. shsuzuki@fmu.ac.jp
Telomerase activity (TA) has been shown highly expressed in various solid malignant neoplasms, but only rarely in benign tumor or normal tissues. Most reports examined TA by the qualitative method, telomeric repeat amplification protocol (TRAP) assay. We examined TA in tissues of thyroid neoplasm by quantitative method to establish whether TA was a useful marker for preoperative differential diagnosis of thyroid tumors. TA was measured by the quantitative method, TRAP assay, fluorescence based TRAP method in 32 frozen tissues of thyroid tumors (17 malignant, 15 benign). Cut-off values in TA were 0 unit and 9 units from mean +/- 2SD of TA in benign thyroid tumors. Mean (SD) TA levels in benign thyroid tumors and thyroid carcinomas were 2.06 (3.58) units and 30.5 (38.2), respectively. Mean TA of carcinomas was significantly higher than that of benign disease in thyroid tumors (p=0.0092). The sensitivity of the malignancy was 64.7% (cut-off <0) (p=0.162), 52.9% (cut-off <9) (p=0.0048). TA in thyroid carcinoma was significantly correlated with UICC stage (p=0.029), and slightly correlated with tumor size, pN and M. Positive rate of TA in microfollicular adenoma was slightly higher than that in macrofollicular adenoma. Conclusively, quantitative TA might be a useful marker for differential diagnosis between benign and malignant thyroid tumors.

12
UI - 12173512
AU - Pons Rocher F; Carrasco Llatas M; Brotons Durban S; Estelles Ferriol E;
TI - Lopez Martinez R [Benign thyroid disease and cancer in our environment]
SO - An Otorrinolaringol Ibero Am 2002;29(3):247-54
AD - Servicio de Otorrinolaringologia, Hospital Dr. Peset, Valencia.
We compile our experience about the association between benign thyroid disease and thyroid carcinoma, and perform a review on the literature about this theme. We conclude on the importance of knowing this association, even not statistically significative, when it is detected modifies totally our therapeutic attitude and the vigilance of these patients.

13
UI - 12173513
AU - Pons Rocher F; Brotons Durban S; Carrasco Llatas M; Estelles Ferriol E;
TI - Lopez Martinez R [Carcinoma of the thyroid gland. Correlation between diagnostic tests and pathogenic anatomy]
SO - An Otorrinolaringol Ibero Am 2002;29(3):255-67
AD - Servicio de Otorrinolaringologia, Hospital Dr. Peset, Valencia.
We present the results of a retrospective study about 101 cases of thyroid carcinoma treated in our ENT-department during the period 1979-1998. We consider the epidemiologic, diagnostic and therapeutic aspects. Epidemiologically 82% of patients were female and 18% male, with a mean age of 51 year. About 12 percent of patients had familiar antecedents of thyroid pathology. The thyroid pathology affected preferently the right thyroid lobe in 40 percent of cases, the left lobe in 28.9 percent, the isthmus in the 6.7 percent and in 24.4 percent it was bilateral. Hormonal 93.8 percent were in euthyroid state and the 6.2 percent of the whole were tested and show hyperparathyroidism. Complementary examinations showed, in gammagraphy, a cold solitary nodule in 48 percent of patients. The echography more frequently discovered a solitary nodule in 36.7 percent or multiple solid nodules in 34.7 percent. Fine needle biopsy sensitivity was in 85.7 percent. Histologic types encountered were: papillary carcinoma (74.26), follicular carcinoma (14.85), Hurthle cells carcinoma (3.96), medullary carcinoma (3.96) and anaplastic carcinoma (2.97 percent). Choice treatment of thyroid carcinoma, in our Department, was total thyroidectomy.

14
UI - 12182013
AU - Szybinski Z; Huszno B; Rachtan J; Przybylik-Mazurek E; Buziak-Bereza M;
TI - Trofimiuk M [Epidemiology of thyroid cancer in Poland]
SO - Wiad Lek 2001;54 Suppl 1():106-16
AD - Katedry i Kliniki Endokrynologii, Collegium Medicum Uniwersytetu Jagiellonskiego w Krakowie.
The aim of the paper is to analyse the epidemiological situation of thyroid cancer in Cracow region from 1986 to 1999 and to review regional thyroid cancer registers in Poland (including 43.7% of the Polish population) in 1999. The standardized register was based upon assumptions: 100% of histopathological verification according to ICD-10, the register ascertainment in at least 80%, the demographic area not smaller than 100,000 inhabitants, the incidence rate (IR) calculated as the newly diagnosed cases number per 100,000 inhabitants in a calendar year. Since 1990 a statistically significant rise of the thyroid cancer incidence affecting mainly women > 40 years of age have been observed. From 1998-1999 the cancer morbidity was reduced. Within the last 5 years in the Cracow area the follicular carcinoma incidence has decreased significantly, which has been associated with effective iodine prophylaxis. The highest incidence values have been observed in Cracow and Olsztyn, showing a territorial relationship with the highest thyroid irradiation doses after Chernobyl accident. The mean IR value has been 3.86 (1.48 men, 6.08 women), which corresponds to about 1500 newly diagnosed cases in Poland in 1999. The follicular to papillary carcinoma ratio has been 5.32. The major etiological factors have been iodine deficiency and ionising radiation. The present data have indicated that iodine prophylaxis should be continued and that the population should be protected against ionising radiation.

15
UI - 12182014
AU - Zemla B
TI - [Occurrence of papillary and follicular thyroid cancer among Silesian women]
SO - Wiad Lek 2001;54 Suppl 1():117-22
AD - Zakladu Epidemiologii Nowotworow, Centrum Onkologii-Instytut im. M. Sklodowskiej-Curie, Oddzial w Gliwicach.
In the years 1990-2000 within Silesia District 1067 thyroid cancer cases were diagnosed. From the total, papillary carcinoma established 59.9% (639 cases), and follicular carcinoma--26.0% (276 cases). An existence of some distinct endemic areas--for both papillary and follicular thyroid cancers simultaneously was confirmed. The etiologic background is unclear, but the significant impact of environmental iodine supply seems unprobable.

16
UI - 12182015
AU - Sporny S
TI - [The role of fine needle biopsy in diagnosis of thyroid cancer]
SO - Wiad Lek 2001;54 Suppl 1():12-20
AD - Katedry i Zakladu Patomorfologii Akademii Medycznej w lodzi.
The majority of changes in the structure and consistency of the thyroid gland is a clear indication for fine needle aspiration biopsy (FNAB). This does not mean, however, that cytological evaluation provides an unequivocal diagnostic confirmation for every pathological change found by palpation or by imaging technology. The main purpose of FNAB is to differentiate the type of examined pathological lesion (i.e. neoplastic or non-neoplastic) and to help in the selection of appropriate therapy. The diagnoses obtained by FNAB may be divided into five categories. FNAB plays the key role in the diagnostics of papillary and anaplastic thyroid carcinoma.

17
UI - 12182016
AU - Wronkowski Z; Zwierko M; Chmielarczyk W
TI - [Evaluation of thyroid cancer morbidity in Warsaw in 1987-1997]
SO - Wiad Lek 2001;54 Suppl 1():123-35
AD - Zakladu Organizacji Badan Masowych, Centrum Onkologii-Instytut im. M. Sklodowskiej-Curie w Warszawie.
The crude and standardized thyroid cancer incidence rates calculated for the period 1987-1997 in Poland increased from 0.5 to 0.9 and 0.5 to 0.8 per 100,000 men, and from 1.8 to 3.6 and 1.4 to 2.8 per 100,000 women. The incidence of the cancer in women in Warsaw doubled during the same period. The upward trend only slightly showed up in the male population of Warsaw. Mortality rates caused by the thyroid cancer in both sexes in Warsaw population declined over the years 1963-1997. The 5-year relative survival rates, calculated for the period 1985-1989, were lower in men than in women (respectively 66 and 49%). This fact can be partly explained by more frequent occurrence of anaplastic tumours in men than in women (respectively 14.2 and 7.8%).

18
UI - 12182017
AU - Bandurska-Stankiewicz E; Stankiewicz A; Shaffie D; Wadolowska L
TI - [Thyroid cancer morbidity in the Olsztyn region in 1993-1999]
SO - Wiad Lek 2001;54 Suppl 1():136-42
AD - Olsztynskiego Osrodka Diabetologii i Zaburzen Metabolizmu, Wojewodzkiego Szpitala Specjalistycznego w Olsztynie.
Olsztyn region (in the north of Poland) was classified as an iodine deficiency area with moderate endemic goiter prevalence. Following Chernobyl accident, the population had one of the highest radiation doses affecting thyroid. Aims of the study were to estimate the incidence of thyroid cancer and to determine its histopathological type. The register was carried out in Olsztyn region population including each newly diagnosed case of thyroid cancer in the calendar year. The personal data of patients were collected and processed on in computer. The incidence rate was calculated as the number of newly diagnosed cases in the calendar year per 100,000 inhabitants dependent on sex and age. The results were statistically evaluated. 242 newly diagnosed cases of thyroid cancer were registered including 8 young patients (up to 18 years of age) and 234 adults. The increase in the number of cancer cases was observed year by year. The predominant type of thyroid cancer was papillary carcinoma--66.8%. Follicular carcinoma constituted 17% of cases. A statistically significant increase of incidence rate was observed in women--from 2.8/100,000 to 11.1/100,000.

19
UI - 12182018
AU - Gembicki M
TI - [Incidence of thyroid cancer in children and adolescents in Bialorus after the Chernobyl catastrophe in 1986]
SO - Wiad Lek 2001;54 Suppl 1():143-8
Fifteen years after Chernobyl nuclear plant catastrophe thyroid cancer was diagnosed in 882 persons among the group of 2,618,482 persons aged 6-18 years. The radioactive contamination, mainly with isotopes of radioactive iodine, seems to be a major cause of such a high incidence of thyroid cancer in children and adolescents. However, it is necessary to consider other factors which also might influence the process of transformation of the thyroid cells to the thyroid cancer. The iodine deficiency in environment was recognized as an important factor. Therefore, the countrywide programme of the investigations of iodine deficiency and goiter prevalence was established in the Republic of Belarus with the assistance of WHO Office for Europe. Within this program the examination of 11,562 children and adolescents aged 6-18 years from 30 schools in urban and rural areas was performed. The results obtained are typical for significant iodine deficiency and moderate goiter endemy. The analysis of these two factors and their influence on the incidence and distribution of thyroid cancer in different regions of Belarus is a subject of this paper. It is worth adding that 15 years after the catastrophe a visible rise in the number of thyroid cancers is noted in the group of adolescents and adults.

20
UI - 12182019
AU - Szybinski Z; Olko P; Przybylik-Mazurek E; Burzynski M
TI - [Ionizing radiation as a risk factor for thyroid cancer in Krakow and Nowy Sacz regions]
SO - Wiad Lek 2001;54 Suppl 1():151-6
AD - Katedry i Kliniki Endokrynologii Collegium Medicum Uniwersytetu Jagiellonskiego w Krakowie.
In a group of 224 patients with thyroid cancer registered from 1990 to 1999 and in 243 controls matched for sex and age doses for the thyroid due to accumulation of 131I after Chernobyl accident and radiological diagnostic procedures involving the neck and dentition was calculated according to Johnson's model and based upon questionnaires. There was a significantly higher dose for the thyroid due to accumulation of 131I in the Krakow area in comparison with the Nowy Sacz area. There was also a significantly higher frequency of radiological procedures involving the thyroid gland preceding the development of thyroid cancer in comparison with the control group. The present findings are concordant with about 40% increase of thyroid cancer in the Krakow area in comparison with the Nowy Sacz region. The present study has indicated that ionising radiation may be a factor involved in the pathogenesis of thyroid cancer and its significant rise within the last 10 years. However, it has not been the main factor, but only one of the risk factors. The study has also indicated that iodine prophylaxis should be continued and that radiological procedures involving the neck and head in patients with nodular goitre should be carried out with caution.

21
UI - 12182020
AU - Przybylik-Mazurek E; Szybinski Z
TI - [Biological risk factors for differentiated thyroid cancer]
SO - Wiad Lek 2001;54 Suppl 1():157-62
AD - Katedry i Kliniki Endokrynologii, Collegium Medicum Uniwersytetu Jagiellonskiego w Krakowie.
Apart from the two relatively well documented risk factors for thyroid cancer i.e. iodine deficiency and ionising radiation, the mechanism of carcinogenesis involves a number of biological and environmental factors. The aim of the study was to analyse the selected biological and environmental risk factors in patients with differentiated thyroid cancer in comparison with a reference group in a case-control study. METHODS: Both the group of 188 women and 30 men with thyroid cancer including 92 with follicular carcinoma and 126 with papillary carcinoma and the control group of 287 women and 58 men were subjected to the examination. All the study participants were given a standard questionnaire and underwent physical examination including thyroid USG, blood hormone levels and urine iodine concentration. The following risk factors were included in the analysis: family history, sex, age, thyroid morbidity, employment, body weight, hormone replacement therapy in women, cigarette smoking. In both groups with thyroid cancer women predominant with the female to male ratio 6.7 in follicular carcinoma and 6.0 in the papillary variant. In both groups of diagnoses the mean age was high--above 50, higher in men than in women. Over 70% of the patients with thyroid cancer had nodular goitre before the detection of cancer. In the control group the proportion of diagnosed goitre was slightly above 10%. A significantly more frequent hormone replacement therapy and contraception and more frequent miscarriages in women with thyroid cancer were noteworthy. One may assume that initiation, promotion and progression of the neoplastic process in the thyroid is triggered by a number of factors, both biological and environmental, and only multifactorial analysis may provide an insight into the mechanisms of carcinogenesis followed by initiation of preventives measures in appropriate cases.

22
UI - 12182021
AU - Huszno B; Szybinski Z; Trofimiuk M; Przybylik-Mazurek E; Buziak-Bereza
TI - M; Golkowski F; Pantoflinski J [Iodine deficiency and thyroid neoplasms in the Krakow region]
SO - Wiad Lek 2001;54 Suppl 1():163-8
AD - Katedry i Kliniki Endokrynologii, Collegium Medicum Uniwersytetu Jagiellonskiego w Krakowie. huszno@endo.cm-uj.krakow.pl
The aim of the study was to evaluate the correlation between incidence rate (IR) of thyroid cancer and severity of iodine deficiency. The influence of iodine prophylaxis on IR was also investigated. The suspension of iodine prophylaxis in 1980 resulted in goitre prevalence increase in schoolchildren (up to 60%) and elevated TSH levels in neonates observed in early 1990-ties. In 1990 rise in thyroid cancer IR was observed. IR of papillary and follicular carcinoma in 1995 were 1.6 and 1.5 respectively. Papillary to follicular ratio was about 1.0. Such a high prevalence of follicular cancer was specific for iodine deficient regions. In 1997, after introduction of mandatory model of iodine prophylaxis in Poland, increase in papillary thyroid cancer IR was observed, reaching in 1998 6.23 per 100,000 inhabitants. Papillary to follicular cancer ratio rose to 2.48. In 1999 no further increase in thyroid cancer IR was observed. Increase in papillary cancer incidence between 1990 and 1999 may be related to overlapping of iodine deficiency and other cancer risk factors i.e. radiation after Chernobyl accident.

23
UI - 12182022
AU - Szpak S; Zeman M; Handkiewicz-Junak D; Kochanska-Dziurowicz A; Kurzeja
TI - E; Stanjek A; Bijak A; Bogacz A; Zemla B [Geographic differences in iodine supply in the Silesia terrain in relation to thyroid cancer risk]
SO - Wiad Lek 2001;54 Suppl 1():169-75
AD - Zakladu Medycyny Nuklearnej i Endokrynologii Onkologicznej, Centrum Onkologii-Instytut im. M. Sklodowskiej-Curie, Oddzial w Gliwicach.
Risk factors associated with differentiated thyroid carcinoma depend on its histotype. Follicular carcinoma is described as a predominant type in the areas with iodine deficiency, in opposite to papillary thyroid cancer. The incidence of thyroid cancer and its histotypes varies considerably throughout Silesia (data obtained from the Institute of Oncology Cancer Register, Gliwice). The factors responsible for these differences are unknown. The aim of our study was to evaluate the present iodine supply in Silesia region and to relate it to the incidence of the various histotypes of thyroid carcinoma. Urinary iodine excretion observed in 7-11 year-old-children was used as a parameter of iodine supply and measured in the group of 1037 school children in sixteen localities, equally dispersed throughout Silesia. Urine samples were obtained to measure iodine concentration by the modified Sandell-Kolthoff's catalytic method. Mean incidence rates of papillary and follicular thyroid carcinoma were calculated for regions of Silesia by averaging the rates of the communities in each region. Despite the intensive iodine prophylaxis the persistent symptoms of iodine deficiency were observed. There were significant differences in children's ioduria among investigated regions. The percentage of low ioduria (lower then 100 micrograms/l) varied from 35.7% to 87.7%. We observed no correlation between age-adjusted rates for histotypes of thyroid carcinoma and the percentage of urine iodine below 100 micrograms/l, which served as an estimation of iodine deficiency. Our study indicates that Silesia is still an area of moderate iodine deficiency. We were unable to explain the factors responsible for the observed differences in the incidence rates of papillary and follicular thyroid carcinoma.

24
UI - 12182023
AU - Wloch J; Czarniecka A; Turska M; Wilgus J
TI - [Evaluation of surgical treatment results in patients with differentiated thyroid cancer from materials in the Oncologic Institute in Gliwice]
SO - Wiad Lek 2001;54 Suppl 1():178-88
AD - Kliniki Chirurgii Onkologicznej, Centrum Onkologii-Instytut im. M. Sklodowskiej-Curie, Oddzial w Gliwicach.
The optimal surgical treatment for patients with differentiated thyroid carcinoma is still controversial and discussed. The aim of this study was to analyze the effectiveness of treatment in differentiated thyroid carcinoma, to establish the prognostic value of histopathological type, clinical advancement, the extent of surgery and to estimate the therapeutic benefit rate of the radical approach. The randomized group of 768 patients with differentiated thyroid carcinoma, aged between 16 to 40 (median age 44), treated in Oncology Center Institute in Gliwice between 1986 and 1997 were analyzed. They were operated in different surgical clinics in Poland. The primary total thyroidectomy was performed in 153 of patients (20%), the secondary radical operation in 474 (62%). 136 persons were operated by less radical approach. Cervical lymph node metastases were observed in 26% of patients. Distant metastases occurred in 8% of cases. 610 persons were treated with 131I. All patients were administered hormonal therapy to suppress TSH. Locoregional recurrence occurred in 7.5% of patients. Complete remission was observed in 71.5% of persons (548 patients). The influence of distant metastases lymph node metastases and tumor size on the long-term prognosis was analyzed in univariate statistic analysis. There were no differences in survival in patients with papillary and follicular carcinoma. The 10-year survival was statistically significantly longer in patients who underwent radical surgical treatment (92%) than after non-total thyroidectomy (80%). Despite the relatively high risk of surgical complications the benefits of the radical approach were significant.

25
UI - 12182024
AU - Nowak W; Szybinski P
TI - [Radical surgical treatment of differentiated thyroid cancer--necessity or over-enthusiasm?]
SO - Wiad Lek 2001;54 Suppl 1():189-97
AD - I Katedry Chirurgii Ogolnej i Kliniki Chirurgii Gastroenterologicznej, Collegium Medicum Uniwersytetu Jagiellonskiego w Krakowie.
The extent of surgical treatment of well differentiated thyroid cancer has been controversial and widely discussed for years. Although the recommendations defining the strategy of thyroid surgery were approved in 1995, a lot of questions remained. The aim of this retrospective study was to analyse long-term results of surgical treatment of thyroid cancer according to the type of applied surgical procedure. The study group consisted of 206 patients surgically treated for well differentiated thyroid cancer with the minimal follow-up period of 5 years. The median age patients was 49.1 years. 159 patients (77.2%) have still remained in the follow-up programme, 23 died because of thyroid cancer (11.1%) and the remaining 24 have either refused to participate in the programme or died of other causes. Median follow-up period was 10.7 years. Total thyroidectomy was performed in 90 patients (43.7%) and less extensive procedures in 106 (51.4%). The remaining patients were qualified for palliative reduction of the tumour mass and they were not included in this study. The comparison of the patients with I and II stage of the disease according to the type of surgical procedure did not show differences in 10-year survival. In stage III the difference was very close to statistical significance. The same results were observed with regard to disease recurrence. Long-time survival in low risk patients was not related to the extent of surgical procedure. The risk of recurrence and death was higher in the patients with advanced disease in stage III who underwent less radical procedures like total resection of involved lobe with isthmus and subtotal resection of contralateral lobe.

26
UI - 12182025
AU - Pomorski L
TI - [Cervical lymph node surgery in differentiated thyroid cancer: selective or elective lymphadenectomy?]
SO - Wiad Lek 2001;54 Suppl 1():198-204
AD - Kliniki Chirurgii Endokrynologicznej i Ogolnej, Akademii Medycznej w Lodzi.
The value and prognostic significance of regional lymph node dissection in patients with thyroid cancer remains a matter of controversy. The classification of the cervical lymph nodes and the extent of their resection in patients with different thyroid cancers is also discussed. The aim of the paper was to present the space classification of regional lymph nodes, the incidence of their involvement and the extent of their resection in patients with differentiated thyroid cancer. The results of multicenter studies have indicated that regional lymph node metastases in patients with differentiated thyroid cancer, especially of a papillary type, have been frequent. Ipsilateral central, ipsilateral lateral, contralateral lateral, and mediastinal lymph nodes have been affected in 42-86%, 32-68%, 12-24%, and 3-20% of patients respectively. In 20% of patients only central lymph nodes have been affected, whereas in others metastases have been determined at least in 2 or more lymph node groups. Regional lymph nodes have been classified into Groups I-IV. Moreover, lymph node recurrences have been more frequent in patients who either have not got the regional lymph nodes removed or have only enlarged ones determined as involved excised. Therefore, primary regional lymph nodes dissection is indicated. Elective resection of the lymph nodes of Group I (central lymph nodes) as a part of primary total thyroidectomy in patients with thyroid cancer and more selective excision of the lymph nodes of Groups II-IV are recommended. The author has presented his own experience in lymph node dissection in patients with differentiated thyroid cancer and compared it with other results.

27
UI - 12182026
AU - Herman K; Wysocki W; Fortuna J
TI - [Should cervical lymph nodes be electively removed in differentiated thyroid carcinoma?]
SO - Wiad Lek 2001;54 Suppl 1():205-9
AD - Kliniki Chirurgii Onkologicznej, Centrum Onkologii, Oddzial w Krakowie.
Differentiated thyroid carcinomas (DTC; papillary and follicular) constitute merely 0.5-1% of all malignancies in the world. The proper extent of their surgical resection has been discussed for many years. Two different approaches predominate in the literature. One group claims, that elective, modified radical neck dissection (MRND) should be performed. That strategy is supported by high frequency (80%) of observed "occult", clinically not evident, micrometastases in regional lymph nodes on the neck. On the other hand, there have been no studies so far which would unquestionably confirm the prognostic value of neck lymph node involvement in DTC, or the favorable influence of elective lymph node dissection on long-term survival. Therefore, other authors do not recommend prophylactic lateral neck dissection. MRND, apart from its doubtful influence on prognosis, is connected with a higher complication rate and longer hospitalization. The authors of this review also share this opinion.

28
UI - 12182027
AU - Lewinski A
TI - [Current views on diagnostic standards and treatments with L-thyroxine of single non-toxic thyroid nodules or multinodular non-toxic goiter]

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