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)

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

In four patients with disseminated papillary or follicular thyroid carcinoma metastatic sites could be demonstrated by scintigraphy with 201Tl. Uptake was present during TSH suppression with thyroid hormone administration. In three of the four cases 201Tl scanning revealed metastases while 131I uptake after triiodothyronine withdrawal was absent. In one patient 201Tl demonstrated some metastatic sites while both 131I uptake and thyroglobulin levels were negative. Uptake of 201Tl in these metastases is at least partially, unrelated to the TSH and thyroglobulin levels or to the 131I-accumulating capacity. Scintigraphy using 201Tl might be helpful for the detection of metastatic thyroid carcinoma in those cases where 131I uptake is absent.
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PMID:Scintigraphy with 201Tl for detection of thyroid cancer metastases. 717 50

Data from 576 patients with papillary thyroid cancer were retrospectively analyzed. With a median follow-up of 10 years and three months, there were six deaths from, and 84 recurrences of, thyroid cancer. Of the latter, 16 (19 percent) could not be eradicated. Death from thyroid cancer occurred only in those 30 years of age or over at the time of diagnosis and only in patients with primary tumors larger than 1.5 cm in diameter. Locally invasive tumor was associated with a poor prognosis. Cervical lymph node metastases found at initial surgery were associated with higher recurrence rates but not higher mortality rates. Treatment with total thyroidectomy, postoperative radioiodine and thyroid hormone resulted in the lowest recurrence and mortality rates except in those patients with small primary tumors (less than 1.5 cm diameter) in whom less than total thyroidectomy and postoperative therapy with thyroid hormone alone gave results which did not differ statistically from those achieved with more aggressive therapy. No important differences in outcome were observed when cervical lymph node metastases were simply excised or more aggressively treated by neck dissection. External radiation and as initial adjunctive therapy adversely influenced outcome.
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PMID:Papillary thyroid carcinoma: a 10 year follow-up report of the impact of therapy in 576 patients. 721 93

The local growth rate of Morris Hepatoma 44 (generation time, 6 months) was inhibited by 66 to 87%, and host survival was prolonged by 36 to 78% after the induction of hypothyroidism within 2 weeks of tumor implantation by propylthiouracil (0.1% in Purina chow), 131I(1 mCi/100 g body weight i.p.), or surgical thyroidectomy. In additional experiments, we studied the effects of inducing hypothyroidism (131I) at different stages in the natural history of Morris Hepatoma 44 on local and metastatic growth as well as on host survival. Induction of hypothyroidism within 2 weeks of tumor implantation (Group I) reduced local tumor growth as well as the number and size of pulmonary metastases, and prolonged survival by 70 to 80%. Induction of hypothyroidism at 6 weeks postimplantation when tumors were palpable (Group II) inhibited local growth by 39%, reduced the number and size of pulmonary metastases by approximately 80%, and prolonged host survival by 35%. Initiation of 131I treatment at 11 weeks when microscopic pulmonary emboli were present in most animals (Group III) reduced local growth by 19% and the number and size of pulmonary metastases by 72 and 50%, respectively. In this case, survival was prolonged by 17%. We conclude from these results that the local and metastatic growth of Morris hepatoma 44 as well as host survival are thyroid hormone-dependent processes. The mechanisms responsible for these observations remain to be explained.
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PMID:Inhibition of local and metastatic hepatoma growth and prolongation of survival after induction of hypothyroidism. 724 60

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

Improved selection of thyroid nodules for surgery and greater individualization of surgery for well-differentiated thyroid carcinoma are emphasized. Thyroid nodules are common but infrequently are manifestations of carcinoma. Needle biopsy permits better selection of patients with thyroid nodules for surgery by identifying those which are malignant or are likely to become malignant. Experience in performing diagnostic needle biopsies and in cytologic and histologic interpretation is essential. The majority of well-differentiated thyroid carcinomas are well-localized papillary carcinomas controlled by surgery, usually a lobectomy or partial thyroidectomy. Well-differentiated thyroid carcinomas include papillary and follicular types and their subsets. The extent of surgery should be individualized based on gross extent of disease, histologic variety, and age of the patient. The prognosis is reduced for patients more than 40 years of age. With appropriate early surgical treatment, the outlook is excellent. Metastatic disease can frequently also be controlled by large doses of thyroid hormone and the use of radioactive iodine.
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PMID:Treatment of well-differentiated thyroid carcinoma. 731 6

Radioiodine uptake by thyroid remnants and metastases postthyroidectomy for thyroid cancer is increased by withdrawing thyroid hormone, which raises TSH levels. The minimal withdrawal time for maximal uptake is unknown. Therefore, we performed 33 studies in 27 patients after 2 weeks and again after 4 weeks of T3 withdrawal. We examined cervical (or pulmonary) uptake and whole body scanning at 48 h and whole body retention at 48, 72, and 96 h after radioiodine. In 4 studies, only physiological nonthyroidal activity was seen on both scans. Cervical uptake was low in these 4 studies. Of the remaining 29 studies with thyroid activity on both scans, 4 had high cervical uptakes after 2 weeks, which decreased by 4 weeks to less than 50% of the 2 week value. The same trend was seen in whole body retentions. In 2 studies, the uptake increased at 4 weeks compared to that at 2 weeks, but the change was small and was reflected in whole body retention of only 1 of these subjects. In 23 studies, including 6 with metastatic disease, the individual uptakes and whole body retentions were similar after 2 and 4 weeks. The mean uptakes and retentions also did not differ despite significantly higher (P less than 0.001) TSH values at 4 weeks. All definite areas of localization of radioactivity seen on the scans after 4 weeks were seen after 2 weeks. Therefore, radioiodine uptake, scanning, and therapy should be performed after 2 weeks of T3 withdrawal when patients are minimally hypothyroid. Serum TSH should also be measured to identify the rare individual not responding to brief T3 withdrawal.
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PMID:Influence of triiodothyronine withdrawal time on 131I uptake postthyroidectomy for thyroid cancer. 736 30

Pregnancies and deliveries of ten patients are reported who underwent a complex treatment (surgery, 131J, thyroid hormone) for highly differentiated follicular and papillary thyroid carcinomas. Out of ten cases, in 3 cases two were pregnant and in two cases two delivered. Besides papillary and papillofollicular carcinomas, surgery revealed that six patients had regional lymph node metastases of N1 or N2. On the evidence of the deliveries, follow-up examinations after the operation, and complementary treatment of these two types of tumor, pregnancy is not contraindicated, since a progression of the primary disease, neonatal hypothyroidism, and factitious hyperthyroidism have not been found.
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PMID:[Thyroid neoplasms and pregnancy]. 738 92

Measurements of serum thyroglobulin (hTg) were performed using a specific radioimmunoassay. Sera with detectable anti-thyroglobulin (anti-Tg) antibody titers (> or = 1:10) as assessed by passive hemagglutination were discarded. Assays were carried out under conditions in which anti-Tg titers less than 1:10 produced no interference. The assay sensitivity was 1.25 ng/ml and the mean +/- SE concentration of serum hTg in 58 control subjects was 9.5 +/- 0.9 ng/ml (range < 1.25-27 ng/ml). A slight but significant (p < 0.025) increase in the mean hTg level was observed in 12 pregnant women at delivery (25.7 +/- 5.2 ng/ml). Moderate to marked elevations of serum hTg were observed in patients with nontoxic goiter (61.4 +/- 15 ng/ml; n = 23), subacute thyroiditis (138 +/- 67 ng/ml; n = 5), toxic adenoma (129 +/- 47 ng/ml; n = 13), untreated (424 +/- 101 ng/ml; n = 35) or treated (328 +/- 222 ng/ml; n = 14) toxic diffuse goiter. 88 patients with thyroid carcinoma and 10 with nonthyroidal malignancies were studied. The mean level of serum hTg was increased in untreated differentiated thyroid carcinoma (89.5 +/- 19 ng/ml; n = 13) but not in undifferentiated (10 +/- 2.9 ng/ml; n = 6) or medullary (0.8 +/- 0.2 ng/ml; = 3) carcinoma. In treated differentiated thyroid carcinoma the mean hTg levels were normal (8.2 +/- 0.2 ng/ml) in patients (n = 24) with no evidence of either a thyroid residue or metastatic disease, moderately increased (56.6 +/- 16 ng/ml) in patients (n = 27) with residual thyroid tissue, markedly elevated in patients with lymph node metastases (199 +/- 50 ng/ml; n = 5) and extremely elevated in those with bone (4004 +/- 982 ng/ml; n = 8) or lung (2520 +/- 620 ng/ml; n = 5) metastases. There was no significant difference in serum hTg between functioning (n = 23) and nonfunctioning (n = 5) metastases as assessed by 131I whole body scan. A slight but significant (p < 0.0005) increase in the mean concentration of hTg was observed in nonthyroidal malignancies (21.7 +/- 4.5 ng/ml; n = 10). Serial measurements showed a transient increase of serum hTg after 131I therapy of differentiated thyroid carcinoma, toxic diffuse goiter or toxic adenoma, with peak values usually occurring within the first three days. A fall of serum hTg after administration of suppressive doses of thyroid hormone to patients with nontoxic goiter and a rise after discontinuation of thyroid suppressive therapy in patients with metastatic differentiated thyroid carcinoma was observed.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Serum thyroglobulin in thyroid carcinoma and other thyroid disorders. 743 May 57

Increased concentrations of serum soluble interleukin-2 (IL-2) receptor (sIL-2R), a marker of T-lymphocyte activation, have been found in several metastatic solid tumors. To our knowledge, no information is available on serum sIL-2R in differentiated thyroid carcinoma (DTC). Aim of this study was to evaluate whether disease activity and/or thyroid status may affect circulating sIL-2R in DTC, since it is has recently been demonstrated that serum thyroid hormone concentration positively modulates circulating sIL-2R. DTC patients were divided into 3 groups: Group A: 48 patients without metastases or local recurrences; Group B: 16 patients with cervical lymph node metastases; Group C: 22 patients with distant metastases. All patients were evaluated after total thyroidectomy both off and on L-thyroxine (L-T4) therapy. Control group was composed by 20 healthy euthyroid subjects. sIL-2R was assayed by solid-phase ELISA. In the hypothyroid state, sIL-2R levels of Group A were significantly lower when compared to normal controls (256 +/- 130 vs. 461 +/- 186 U/ml, p < 0.001 by Student t test); Group B and Group C patients off L-T4 therapy had sIL-2R concentrations significantly higher (479 +/- 407 U/ml, Group B; 519 +/- 746 U/ml, Group C) when compared to hypothyroid patients of Group A (p < 0.01 and p < 0.05, respectively), but not significantly different from normal euthyroid controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Serum soluble interleukin 2 (IL-2) receptor (sIL-2R) in differentiated thyroid carcinoma. 774 34


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