Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serum thyroglobulin has been measured serially in ten children aged 5-17 years presenting with differentiated thyroid carcinoma. At presentation 4 had intra-thyroidal disease, 3 had lymph node metastases, and 3 had lung metastases. During follow-up for a median of 37.0 months (range 21-108) 3 patients have been disease-free, 4 have had a local relapse, and 3 have had persistent disease. Seventy-seven separate serum thyroglobulin measurements have been performed; 36 on and 41 off thyroid replacement therapy. A level of thyroglobulin of less than 5 ng/ml was taken as indicative of absence of disease, and compared against combined clinical examination and 131I scanning. Overall sensitivity of thyroglobulin measurement was 36/37 (97%), and although specificity was 30/40 (75%), this rose to 30/32 (94%) if raised thyroglobulin levels noted within 3 months of 131I therapy in otherwise asymptomatic patients (n = 4) or in subjects with intact thyroid tissue (n = 4) were excluded. Concordance with clinical status was 30/31 (97%) in measurements taken on, and 31/32 (94%) in those taken off, thyroid replacement. These data indicate that thyroglobulin measurement is a sensitive and specific means of detecting residual, recurrent, and metastatic thyroid carcinoma in children.
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PMID:The usefulness of serum thyroglobulin in the follow-up of differentiated thyroid carcinoma in children. 157 29

The role of thyroid ablation following thyroidectomy for invasive follicular cancer remains controversial. The use of iodine 131 (131I) ablation as adjuvant therapy may facilitate follow-up of patients in whom serum thyroglobulin levels and 131I total body scans are used to detect metastatic disease. It is uncertain if 131I ablation improves survival of patients with follicular thyroid cancer. Thus, the purpose of this study was to determine if survival is enhanced following ablation, with particular reference to those patients with minimally invasive cancer. Between the years 1955 to 1988, 142 patients with invasive thyroid follicular cancer were treated at the British Columbia Cancer Agency, of whom 71 had minimal invasion and no extrathyroidal extension of tumor. In this group of patients, 46 underwent hormone suppression only, 17 had ablation, and 8 had neither. The average follow-up was 9 years and extended beyond 15 years in many patients. Data were entered in a mainframe computer, and Kaplan-Meier survival analysis was used, comparing crude survival, disease-specific survival, and disease-free survival. There was no significant difference between groups. In patients with follicular thyroid cancer and capsular invasion only, 131I ablation does not improve survival compared with patients treated with thyroid hormone suppression only.
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PMID:Efficacy of 131I ablation following thyroidectomy in patients with invasive follicular thyroid cancer. 157 1

The therapeutic approach to patients with differentiated thyroid carcinoma has become a major issue of controversy in the last decade. The major aspects are the surgical resection and adjuvant therapy, particularly the need for thyroid ablation following surgery. According to the risk group definition suggested by Cady in 1979, low risk patients may be subjected to lobectomy only, then placed on thyroxine treatment and followed clinically with thyroglobulin determination. High risk patients should undergo total thyroidectomy and 131I ablation. Follow-up should include thyroxine treatment and an annual whole body 131I scan. In the event of residual thyroid tissue or functional metastases, 131I treatment is to be given.
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PMID:Scintigraphic evaluation of patients with thyroid carcinoma--therapeutic approaches. 159 89

We studied the feasibility of employing the measurement of thyroglobulin (Tg) in the washout of the needle used to perform the fine needle aspiration cytology (FNA-Tg) for the differential diagnosis of nonthyroidal neck masses of unknown etiology. We studied 35 patients presenting for 1 or more neck lumps outside the thyroid gland. A previous history of treated differentiated thyroid cancer (DTC) was given by 23 patients and of nonthyroidal malignancy by 3 patients. FNA-Tg was measured in the Tg-free serum used to wash out the needle employed for the cytology. Finally, all patients were treated by surgery. FNA-Tg was always detectable in 14 patients with thyroid cancer metastases demonstrated by histology, with a mean (+/- SD) of 27,087 +/- 37,622 ng/FNA (P less than 0.002) compared to patients without thyroid cancer metastases (mean +/- SD, 12.1 +/- 4.8 ng/FNA in 7 cases; undetectable in 14 cases). Assuming 21.7 ng/FNA (the mean +/- 2 SD of the negative patients) as the cut-off value, all patients with metastases from DTC were detected by FNA-Tg. FNA-Tg had better negative predictive value than cytology, since this last technique gave 10 inconclusive results, comprising 2 false negative results in patients with metastases from DTC. Our results indicate that elevated concentrations of FNA-Tg in nonthyroidal neck nodes strongly suggest the diagnosis of metastases from DTC.
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PMID:Detection of thyroglobulin in fine needle aspirates of nonthyroidal neck masses: a clue to the diagnosis of metastatic differentiated thyroid cancer. 159 86

The authors have used radioimmunoassay to measure blood serum thyroglobulin (TG) in 257 patients with benign processes and 118 ones with carcinoma of the thyroid and came to a conclusion that this method is unfit for the differential diagnosis between these conditions. Serum TG level is in good correlation with the results of treatment of thyroid carcinoma patients: in radically treated ones blood serum TG level reduces to the norm, and when recurrences or metastases develop it significantly increases. Therefore, radioimmunoassay is recommended for early detection of thyroid carcinoma recurrences and metastases in follow-up of patients with this condition.
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PMID:[Serum thyroglobulin in thyroid cancer and other thyroid diseases]. 169 58

Plasma concentration of fibrinopeptide A (FpA) and D-dimer (DD), sensitive indicators of coagulation and fibrinolysis activation, were measured in 21 patients thyroidectomized for differentiated cancer (4 had distant metastases) and in 27 control subjects. Only two patients (one with distant metastases) presented elevated FpA values. All the four patients with distant metastases showed elevated DD levels. In three patients who developed distant metastases the time course of the circulating levels of plasma DD and serum thyroglobulin (Tg) was monitored. Monitoring of plasma DD concentration correctly indicated the time course of all the 3 metastatic patients while serum Tg levels failed to adequately describe the outcome of one metastatic patient. These data suggest that fibrinolysis is enhanced in thyroid cancer patients with distant metastases and that plasma DD levels are useful in the monitoring of this condition.
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PMID:The measurement of plasma D-dimer in the follow-up after thyroidectomy for cancer: preliminary data. 172 94

Fifty-seven patients with thyroid tumours, 11 malignant lymphomas, 12 follicular, eight papillary and 26 medullary carcinomas, were studied. HE stained sections and immunocytochemical reactions with mono- and polyclonal antibodies were evaluated. The usefulness of thyroglobulin staining in differential diagnosis of infiltrations and metastases was stressed. The group of medullary carcinomas was morphologically polymorphic and presented unexpected patterns of immunoreactivity. Recent embryological findings were discussed providing better understanding of this group of carcinomas. The presence of thyroglobulin, along with other markers in areas of medullary carcinoma in polymorphic tumours, and the presence of neuro-endocrine markers in areas of follicular or papillary differentiation seem to be concordant with the theory of a pluripotential cell, derived from neural crest and capable of differentiation into a variety of forms.
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PMID:Differential diagnosis of thyroid tumours. An immunocytochemical study. 174 12

A 63-year-old female, with a chief complaint of right chest pain was referred to our hospital because of an abnormal right chest wall shadow on chest X-ray. A rib tumor was suspected based on her chest CT scan. Percutaneous needle biopsy yielded a diagnosis of well-differentiated adenocarcinoma. As metastatic rib tumor was suspected, the primary tumor was sought for. A thyroid gland nodule was recognized by ultrasonography, and the cytological diagnosis was class V. Immunohistological demonstration of the thyroglobulin studies of the rib tumor tissue revealed papillary and trabecular patterns of cell arrangement and the presence of thyroglobulin existence. Definitive diagnosis of metastatic rib tumor from thyroid cancer was established. Immunohistological examination is useful to confirm the diagnosis of metastatic cancer of thyroid origin.
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PMID:[A case of metastatic rib tumor from thyroid cancer confirmed by the presence of thyroglobulin]. 175 51

In 62 patients with thyroid carcinoma 79 MRI bone marrow examinations and 48 bone marrow scintigraphies were recorded before or following radioiodine therapy, to study the extent of bone marrow expansion. The results of both methods were the same. In 34/79 investigations normal findings were seen, in 18 the bone marrow expanded to the middle third and in 26 to the distal third of the femur. One patient showed bone marrow expansion to the tibia. These results were compared with the following data: histology of tumor, TNM-staging, time passed since thyroidectomy, accumulated doses of radioiodine therapy, results of 131I scintigraphy, hematological changes, thyroglobulin level, age and sex. No significant correlations were found between these and the bone marrow imaging results. Bone marrow changes in patients before radioiodine therapy were similar to those in patients treated with up to 48 GBq 131I. Blind biopsy of the posterior iliac crest in five patients showed slightly pathological reactive changes. In only 2/17 follow-up studies an increase of bone marrow expansion was seen. In 8 patients localized findings indicating malignant infiltration were observed. In 4/8 patients metastases of thyroid carcinoma were known or confirmed by pathological radioiodine uptake and in 2/8 metastatic involvement was assumed because of an increased thyroglobulin level.
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PMID:[Bone marrow changes in patients with thyroid carcinoma]. 178 Feb 40

The biochemical properties of serum thyroglobulin obtained from six patients with follicular carcinoma of the thyroid and distant metastases to bone(s) have been studied. Since it is difficult to isolate sufficient thyroglobulin from serum samples, in vivo radioiodinated serum thyroglobulin obtained after radioiodine administration was used. In contrast to a sharp salting-out pattern observed with native thyroglobulin isolated from normal thyroid tissue, a broad salting-out curve was seen with metastatic serum thyroglobulin. The metastatic serum thyroglobulin eluted with low ionic strength from ion-exchange column. More than 95% of metastatic serum thyroglobulin could be bound to concanavalin-A sepharose and be eluted with 0.5 M alpha-methyl mannoside. The reactivity of metastatic serum thyroglobulin and native thyroglobulin towards concanavalin-A was comparable. Both types of thyroglobulins showed identical mobilities on sucrose linear density gradient centrifugation. The metastatic serum thyroglobulin from follicular carcinoma of the thyroid thus appears to be 19 S thyroglobulin with near normal concanavalin-A binding sugars but altered surface charges.
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PMID:Biochemical characterization of serum thyroglobulin from patients with bone metastases from follicular carcinoma of the thyroid. 178 70


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