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Assessment Of Plasma B-Catenin Concentration As Biomarker Of Thyroid Cancer*

100%
Bełdowski M.
Polish Journal of Surgery
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2015
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vol. 87
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issue 7
340-345
EN
New diagnostic methods for thyroid diseases are still being searched for. Immunohistochemical diagnosis is expanded by the introduction of new biomarkers including ß-catenin (B-Cat). Associations are indicated between the cellular expression of this biomarker and tumor stage, nodal metastases and the degree of tumor cell differentiation. Reports are scarce regarding the plasma level of this biomarker in malignant neoplastic diseases. The aim of the study was to analyze the plasma B-Cat concentration and the possibility of it use in the diagnostics of patients with nodular goiter and papillary thyroid carcinoma. Material and methods. Plasma B-Cat concentration was determined in 64 patients with goiter and 15 healthy volunteers. The final histopathological examination revealed 41 cases of papillary thyroid carcinoma (PTC) and 13 cases of nodular goiter (NG). Results. A significant increase in B-Cat (p <0.05) in both groups compared to the control group. No differences in the concentrations of biomarker was demonstrated between the PTC and NG groups. After determining the AUC for the tested biomarker, the B-Cat ratio of the area value 0.721 was the strong diagnostic test. Conclusions. Changes in the plasma B-Cat concentration can be the biomarker of thyroid cancer but it cannot be used for the detection of papillary thyroid carcinoma becouse of concomitant tumor-like lesions in the thyroid gland.
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Diagnostic problems with follicular thyroid cancer – case study

80%
Koziolek M., Sieradzka A., Jakuszewski M., Osowicz-Korolonek L., Karpinska-Kaczmarczyk K., Syrenicz A.
Current Issues in Pharmacy and Medical Sciences
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2014
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vol. 27
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issue 1
5-7
EN
The diagnosis of follicular thyroid cancer is based on postoperative histopathology assessment. In its minimally invasive form, the signs of vascular invasion and capsular infiltration may sometimes be seen only in a small tumor fragment; hence, the diagnosis should be based on multiple histopathology specimens. This case study is a report on a 70-year-old female who was diagnosed with spinal metastasis of follicular thyroid cancer. This diagnosis was established 5 years after partial strumectomy due to goiter and there were no signs of thyroid cancer in postoperative histopathology assessment. Based on this case and literature reports, the authors conclude that the diagnosis of follicular thyroid cancer, especially its minimally invasive forms, may pose a diagnostic problem even when based on postoperative histopathology.
3
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Clinical Value of Intraoperative Neuromonitoring of the Recurrent Laryngeal Nerves in Improving Outcomes of Surgery for Well-Differentiated Thyroid Cancer

80%
Barczyński M., Konturek A., Stopa M., Hubalewska-Dydejczyk A., Richter P., Nowak W.
Polish Journal of Surgery
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2011
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vol. 83
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issue 4
196-203
EN
The recurrent laryngeal nerve (RLN) is particularly prone to injury during thyroidectomy in case of extralaryngeal bifurcation being present in approximately one-third of patients near the inferior thyroid artery or ligament of Berry. Meticulous surgical dissection in this area may be additionally facilitated by the use of intraoperative neuromonitoring (IONM) to assure safe and complete removal of thyroid tissue.The aim of the study was to verify the hypothesis that meticulous surgical technique of tissue dissection in the area of the posterior surface of the thyroid capsule and adjacent RLN may be additionally facilitated by intraoperative neuromonitoring (IONM), and may contribute to increasing the safety and radicalness of total thyroidectomy in patients with well-differentiated thyroid cancer.Material and methods. The outcomes of total thyroidectomy with level VI lymph node clearance for well-differentiated thyroid cancer (WDTC; pT1-3, N0-1, Mx) were retrospectively compared between 151 patients undergoing surgery with IONM (01/2005-06/2009) and 151 patients undergoing surgery without IONM (2003-2004). RLN morbidity (calculated for nerves at risk) was assessed by videolaryngoscopy or indirect laryngoscopy (mandatory before and after surgery and at 12-month follow-up). The anatomical course of the extralaryngeal segment of RLNs were analyzed in detail in each operation. Thyroid iodine uptake (131I) was measured during endogenous TSH stimulation test a week before radioiodine therapy.Results. Among patients operated with vs. without IONM, the early RLN injury rate was 3% vs. 6.7% (p=0.02), including 2% vs. 5% (p=0.04) of temporary nerve lesions, and 1% vs. 1.7% of permanent nerve events (p=0.31), respectively. Extralaryngeal RLN bifurcation was identified in 42 (27.8%) vs. 25 (16.6%) of patients operated with vs. without IONM, respectively (p=0.001). Mean I-131 uptake following total thyroidectomy with vs. without IONM was 0.67 ± 0.39% vs. 1.59 ± 0.69% (p<0.001). 131I uptake lower than 1% was found in 106 (70.2%) vs. 38 (25.2%) patients operated with vs. without IONM, respectively (p<0.001).Conclusions. Most patients with WDTC who undergo total thyroidectomy have a small amount of residual thyroid tissue. The use of IONM may improve the outcomes of surgery among these patients by both increasing the completeness of total thyroidectomy and significantly reducing the prevalence of temporary RLN injury. The possible mechanism of this improvement is the aid in dissection at the level of the Berry's ligament offered by IONM which enhances the surgeon's ability to identify a branched RLN, and allows for reduction of traction injury and neuropraxia of the anterior branch of bifid nerves.
4
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Correlation of Fine Needle Aspiration Cytology of Thyroid Gland with Histopathological Results

70%
Machała E., Sopiński J., Iavorska I., Kołomecki K.
Polish Journal of Surgery
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2018
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vol. 90(6)
13-19
EN
Fine needle aspiration cytology (FNAC) is considered as the gold-standard diagnostic test in the diagnostics of thyroid nodules. It is a cost-effective procedure that provides specific diagnosis rapidly with minimal complications. It plays an important role in the determination of treatment - patients with suspected malignancy diagnosis can be subjected to surgery. On the other hand, it can decrease the rate of unnecessary surgeries. Aim: The aim of this study was to evaluate and compare the correlation, accuracy of fine needle aspiration cytology (FNAC) in the diagnostics of thyroid lesions with the final histopathologic diagnosis based on the surgical specimens. Materials and Methods: In our study we performed a retrospective analysis of a case series of patients who had been admitted to the Department of Endocrine, General and Oncological Surgery of the Hospital of M. Kopernik in Łodź (Poland) between May 2016 and December 2017 and underwent FNAC with subsequent surgery. Cytological diagnosis was classified into six Bethesda categories. Results: On cytological examination, 1070/1262 cases were reported as benign, 49 as malignant and 143 as suspicious. On histopathological examination, 956/1070 cases were confirmed as benign but there were 114 discordant cases. Among the other cases histopathology diagnosis confirmed malignancy in 45/49 cases and 128/143 suspicious cases. The sensitivity and specificity were 60,28% and 98,05% respectively. False positive rate was 1.95% and false negative rate was 39.72%. The positive predictive value was 90.1% and negative predictive value was 89.35%. Accuracy of FNA in differentiating benign from malignant thyroid lesions was 89.46%.
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Cervical Chyloma After Thyroidectomy - Two Case Reports and Review of the Literature

70%
Kobiela J., Proczko-Markuszewska M., Stefaniak T., Dijkstrak B.
Polish Journal of Surgery
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2009
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vol. 81
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issue 5
251-255
EN
Thoracic duct injuries are a rare complication of thyroid surgery. This report documents two cases of thoracic duct injury complicated by formation of chyloma following thyroid surgery. The injury was identified post-operatively and treated successfully. We review the diagnostic and therapeutic options and discuss their applicability to our patients.
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