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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fourteen medullary carcinomas of the thyroid (MCT) immunoreactive for both thyroglobulin and calcitonin were studied by light microscopy and immunohistochemistry. Thyroglobulin immunoreactivity was seen in neoplastic follicles and/or in solid foci in the lymph node metastases of two cases. Colocalization of thyroglobulin and calcitonin was found in the same neoplastic cells of eight cases using a double immunostaining method; in three of these (including one with metastases), thyroglobulin was found to be colocalized with calcitonin gene related peptide as well. Our histological and immunohistochemical results support the assumption that MCT with thyroglobulin immunoreactivity is an unusual variant of the multihormone producing MCT and strengthen the hypothesis that a common stem cell is the origin of these tumors. The available clinical data suggest that thyroglobulin-positive MCT carry a better prognosis than thyroglobulin-negative MCT.
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PMID:Medullary thyroid carcinoma with thyroglobulin immunoreactivity. A special entity? 362 17

The authors have developed an indirect immunofluorescence technique for histochemical detection of thyroglobulin and have tested it on 66 tissue sections. Fluorescence reflecting the presence of thyroglobulin was elicited in 57 samples of differentiated thyroid tissue, including healthy or hyperfunctional tissue and primary or metastatic papillary or follicular carcinomas. Thyroglobulin was found to be distributed heterogeneously between different areas and different cells. It may occupy the whole cell, the apex, the colloid substance and sometimes extracellular spaces. No fluorescence was present in non-thyroid tissues. This technique could be applied mainly to the diagnosis of thyroid carcinomas, where 25 metastases have been examined by this method, and to clear cell carcinomas. In these two cases, thyroglobulin appeared to be a good marker of tumoral tissue.
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PMID:[Immunohistochemistry of thyroglobulin by indirect immunofluorescence in thyroid cancers]. 623 52

Thyroglobulin (TG) is a normal constituent of serum detectable by radioimmunoassay in 75% to 90% of healthy adults. Levels are altered in a number of physiological and pathological conditions. Although the indications for serum TG measurements have not been clearly established, it is simple, inexpensive, and presents no risk of radiation exposure. Problems include variable sensitivity and reproducibility of assays, interference by TG autoantibodies, and changes induced by certain diagnostic or therapeutic interventions. Serum TG measurements is primarily used as a tumor marker in thyroid carcinoma. Values are almost invariably high with disseminated metastases. After total ablation of thyroid tissue, serum TG determination is useful in separating patients in remission from those with residual metastatic disease. Serial measurements in the same patients are useful in monitoring the effect of treatment of nonfunctioning thyroid metastases. It is of no proved value in the initial diagnosis of thyroid carcinoma. Controversy still exists regarding the advantages of measuring TG during hormonal therapy. The assay may aid in the diagnosis of thyrotoxicosis factitia, painless subacute thyroiditis, and neonatal hypothyroidism.
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PMID:The value of serum thyroglobulin measurement in clinical practice. 635 25

Thyroglobulin (Tg) was detected by the immunoperoxidase method in the following thyroid diseases: euthyroid goiter, Graves' disease, Hashimoto's thyroiditis, folliculo-papillary carcinoma, follicular carcinoma, anaplastic carcinoma and medullary carcinoma. Thyroglobulin was present in all benign lesions. The highest immunohistochemical staining reaction was found in Graves' disease. In euthyroid goiter, some colloid-distended macrofollicles did not show any Tg staining. A heterogeneous pattern of Tg staining was displayed especially by thyroid carcinomas. In most cases of papillary and follicular carcinomas Tg was detected in some neoplastic cells and sometimes in the colloid. There were differences in Tg content between different fields of the same tumor. In all anaplastic carcinomas a negative Tg staining was found. Vizualization of Tg in thyroid carcinomas is important for estimating the degree of differentiation and for indicating the thyroidal origin of metastases of adenocarcinomas.
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PMID:Immunohistochemical demonstration of thyroglobulin in thyroid pathology. 636 3

Thyroglobulin levels were measured, without interruption of hormone treatment, in 115 patients who had undergone thyroidectomy for differentiated carcinoma. Thyroglobulin levels were invariably high in patients with iodine fixing metastases. The estimation of thyroglobulin was found to be more sensitive than the detection of metastases by their uptake of 131 iodine. A new protocol is suggested for monitoring treated differentiated carcinoma.
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PMID:Value of the estimation of thyroglobulin levels in the surveillance of treated differentiated thyroid carcinoma. 642 86

Thyroglobulin has been evaluated among 30 control subjects and 81 thyroidectomized patients with differentiated thyroid carcinoma (50 papillary, 15 follicular, 16 mixed). 40 presented without residual thyroid tissue in the neck, 27 with residual tissue, 14 with metastases. Tg evaluation was performed on (78 dosages) and off thyroid hormone therapy (74 dosages), before and after withdrawal of thyroid medication in 25 patients. Tg was measured at different periods after surgical or radioiodine therapy of metastases (7 cases). The sera containing anti-Tg antibodies are rejected. The mean Tg levels was 11.9 +/- 8.5 ng/ml in the control group. In the group of patients with thyroid cancer, Tg levels were dependent on several factors: presence or not of residual thyroid tissue, presence or absence of a replacement therapy. All the patients on or off thyroid medication with metastases except one, presented with plasma Tg levels alone 5 ng/ml. In conclusion, plasma Tg appears as a good index for the research of metastases but only in patients without anti-Tg antibodies and residual thyroid tissue in the neck. Despite the existence of false negative results, a Tg undetectable in treated patients presenting a normal roentgen chest leads to avoid total body radioiodine scan and other usual radiologic investigations. On a opposite hand a plasma Tg greater than 50 ng/ml is highly suggestive of the presence of metastases.
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PMID:[Value of the assay of thyroglobulin for postoperative surveillance of differentiated thyroid cancers]. 648 15

Although thyroglobulin is generally recognized as a useful marker for metastases in cases of differentiated thyroid carcinoma, there have been few reports of the use of thyroglobulin determination for long-term follow-up. This report presents the results of long-term follow-up studies carried out for periods of up to 4 years in 18 patients, including 4 patients with local and 14 with distant metastases. After successful treatment, thyroglobulin fell to unmeasurable levels in the four patients with local metastases and in four of six patients with distant metastases. In some patients treated successfully with 131I, the thyroglobulin level remained elevated for several months before falling to within the normal range. Thyroglobulin levels correlated with tumor growth in six of eight patients with tumor progression, remained high with a slight downward trend in one patient, and declined to unmeasurable levels in another case. Only one patient in this group showed radioiodine uptake in the metastases at the end of the observation period. The lack of 131I uptake in the other patients probably reflects the low degree of differentiation of the metastases. The following conclusions regarding the use of thyroglobulin measurement for the long-term follow-up of thyroid carcinoma can be made: (1) Following 131I therapy for metastatic thyroid carcinoma, return of thyroglobulin levels to within the normal range may take several months. The trend observed in serial thyroglobulin determinations is more meaningful than the absolute values for evaluating the success of therapy. (2) Thyroglobulin levels correlate with tumor growth in most cases of tumor progression, even when changes in differentiation may have led to a loss of radioiodine uptake by the metastases. It may be concluded that serial thyroglobulin determinations are therefore useful for the detection of metastases that do not accumulate radioiodine.
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PMID:Long-term follow-up using serial serum thyroglobulin determinations in patients with differentiated thyroid carcinoma. 662 4

For evaluating the clinical significance of thyroglobulin measurements for the follow-up of patients with differentiated thyroid carcinoma, thyroglobulin was determined radioimmunologically during the past 2 years (up to 12 times) in 40 patients after withdrawal of thyroid hormone. Thyroglobulin values were compared with whole-body scintigrams after radioiodine. Thyroglobulin antibodies, which may interfere in the radioimmunoassay for thyroglobulin, were also estimated by a radioimmunologic method. In the majority of cases, thyroglobulin levels corresponded to the scintigrams, however, the thyroglobulin level appeared to be a more precise index for changes in tumor tissue mass. In one patient the scintigram was negative, whereas considerable amounts of thyroglobulin were measured in the serum: X-ray tomography revealed a lung metastase in this case. On the other hand, thyroglobulin was undetectable in the sera of patients who exhibited distinct metastases in the scintigram. Thyroglobulin can be regarded as a tumor marker in patients thyroidectomized for differentiated thyroid carcinoma. However, its determination can certainly not replace whole-body scintigraphy as postulated by several authors, although thyroglobulin measurement appears to be superior to scanning in some cases. A combined application of iodine scanning and thyroglobulin radioimmunoassay is thus advisable in the follow-up of patients with differentiated thyroid carcinoma.
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PMID:[Significance of thyroglobulin as a tumor marker in the serum of patients with differentiated thyroid carcinoma: longitudinal and cross-sectional studies (author's transl)]. 704 10

Thyroglobulin (TG) immunohistochemistry on formalin-fixed, paraffin-embedded thyroid tissue is a functional morphological method to analyse qualitatively and quantitatively benign and malignant lesions of the thyroid. In this article new aspects of pathogenesis, functional morphology and differential diagnosis resulting from the application of this method are reported. According to our immunohistochemical and electron microscopic findings the formal pathogenesis of nontoxic (sporadic) goitre is characterized by the progressive transformation of active small thyroid follicles into inactive macrofollicles. In nodular goitre, the final stage of this process, the macrofollicles are probably irreversibly inactive and not TSH-responsive. Thyroid adenomas can be divided scintigraphically and by TG immunohistochemistry into endocrine active ("hot") and endocrine non-active ("cold") adenomas. The first group consists of autonomous adenomas, second group of other maincell adenomas and adenomas of specific cytological differentiation (e.g. oxyphilic and clear cell adenomas). In metastasizing differentiated thyroid carcinomas TG immunohistochemistry is a reliable method to differentiate primary thyroid carcinomas from other adenocarcinomas, e.g. lymph node metastases of the neck in the case of papillary carcinomas or bone metastases in cases of follicular carcinomas of the thyroid.
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PMID:[Thyroglobulin immunohistochemistry: new aspects of pathophysiology and differential diagnosis of benign and malignant goitre (author's transl)]. 707 Jan 63

This study is an attempt to unify the evaluation of patients with well-differentiated thyroid cancer after ablative therapy. As such serum thyroglobulin determinations on and off thyroid hormone (T4) therapy and iodine 131 total body scans were examined in 53 patient studies. No metastases were found in patients whose thyroglobulin value was undetectable (less than 1 ng/ml). Values during T4 therapy that were detectable, even as low as 4.2 ng/ml, were occasionally associated with metastases. After T4 withdrawal, thyroglobulin value and scan were obtained. Neither metastasis nor clinically detectable cancer was found in patients whose thyroglobulin value was less than 10 ng/ml while off T4. Conversely, a value greater than 10 ng/ml was often associated with documented metastases even when the scan was negative. In summary, a thyroglobulin value less than 1 ng/ml during T4 therapy or less than 10 ng/ml off T4 therapy suggests successful therapy and a routine scan could be avoided unless clinically indicated. However, a value greater than 10 ng/ml suggests the presence of metastasis despite a negative scan. Thyroglobulin determination substantially improves the management of these patients.
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PMID:The comparative value of serum thyroglobulin measurements and iodine 131 total body scans in the follow-up study of patients with treated differentiated thyroid cancer. 730 53


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