유방암 환자에서 원발암으로 진단된 갑상선암의 특징

신현원,박지영,정재훈,민용기,이문규,김광원,장혜원,이명식,김선욱 대한내분비학회 2009 Endocrinology and metabolism Vol.24 No.4

Background: Both thyroid and breast cancers occur more frequently in women than in men. Some suggest that estrogen plays a role in the tumorigenesis of both cancers. The aim of this study was to identify the prevalence and clinico-pathologic characteristics of primary thyroid cancer in patients with breast cancer. Methods: We retrospectively obtained clinical and pathologic data for 112 patients diagnosed with both thyroid and breast cancer from a single center. Patients with thyroid cancer were grouped according to the chronological sequence of tumor diagnosis. When thyroid and breast cancers were diagnosed within 12 months of each other, they were considered to have been diagnosed simultaneously. Female patients who had only papillary thyroid cancer were used as a historic control. Results: Between 1994 and 2008, 7,827 patients at our hospital were diagnosed with breast cancer and 6,571 patients with thyroid cancer. There were 112 patients who had both thyroid and breast cancer. All thyroid cancers (111/112) except one hurthle cell cancer were papillary thyroid cancers. Average tumor size of thyroid cancer cases diagnosed 1) after or 2) simultaneously with the diagnosis of breast cancer was significantly lower than that for 3) thyroid cancer cases found before breast cancer diagnosis or 4) historical controls with papillary thyroid cancer [sizes (in cm), respectively, were: 1) 0.9 ± 0.6 2) 0.9 ± 0.5 vs 3) 1.4 ± 0.9 4) 1.4 ± 1.1, P < 0.05]. No patients had distant metastases and there were no statistically significant differences in known risk factors for recurrence and survival of patients with thyroid cancer. Conclusion: Thyroid cancer is the most common second primary malignancy in patients with breast cancer and most of them are papillary thyroid cancers. There are no differences in risk factors for tumor recurrence and patient survival compared with those with conventional papillary thyroid cancer except for differences in tumor size. These difference in size may reflect an increase in medical surveillance in patients after they are diagnosed with breast cancer. Background: Both thyroid and breast cancers occur more frequently in women than in men. Some suggest that estrogen plays a role in the tumorigenesis of both cancers. The aim of this study was to identify the prevalence and clinico-pathologic characteristics of primary thyroid cancer in patients with breast cancer. Methods: We retrospectively obtained clinical and pathologic data for 112 patients diagnosed with both thyroid and breast cancer from a single center. Patients with thyroid cancer were grouped according to the chronological sequence of tumor diagnosis. When thyroid and breast cancers were diagnosed within 12 months of each other, they were considered to have been diagnosed simultaneously. Female patients who had only papillary thyroid cancer were used as a historic control. Results: Between 1994 and 2008, 7,827 patients at our hospital were diagnosed with breast cancer and 6,571 patients with thyroid cancer. There were 112 patients who had both thyroid and breast cancer. All thyroid cancers (111/112) except one hurthle cell cancer were papillary thyroid cancers. Average tumor size of thyroid cancer cases diagnosed 1) after or 2) simultaneously with the diagnosis of breast cancer was significantly lower than that for 3) thyroid cancer cases found before breast cancer diagnosis or 4) historical controls with papillary thyroid cancer [sizes (in cm), respectively, were: 1) 0.9 ± 0.6 2) 0.9 ± 0.5 vs 3) 1.4 ± 0.9 4) 1.4 ± 1.1, P < 0.05]. No patients had distant metastases and there were no statistically significant differences in known risk factors for recurrence and survival of patients with thyroid cancer. Conclusion: Thyroid cancer is the most common second primary malignancy in patients with breast cancer and most of them are papillary thyroid cancers. There are no differences in risk factors for tumor recurrence and patient survival compared with those with conventional papillary thyroid cancer except for differences in tumor size. These difference in size may reflect an increase in medical surveillance in patients after they are diagnosed with breast cancer.

Cutaneous metastasis of papillary thyroid cancer on the finger nailbed

( Yu Mee Song ),( Yoon Seob Kim ),( Yeong Ho Kim ),( Hyun Min Seo ),( Ji Hyun Lee ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Papillary thyroid cancer is the most common type of thyroid cancer. It has an excellent prognosis with a very low incidence of distant metastases. However, when it metastasizes to the skin, the prognosis is unfavorable and the median survival after the diagnosis of cutaneous metastases is only 19 months. A 73-year-old woman with a known history of thyroid cancer presented with a 0.4cm-sized, erythematous papule on the left 4th finger nailbed for 2 months. This patient had been diagnosed with papillary thyroid cancer with multiple metastases of the lung, breast, neck, thigh and flank 7 years ago and undergone total thyroidectomy along with multiple sessions of radiotherapy and chemotherapy. A skin biopsy showed aggregation of tumor cells in the dermis forming papillary projections. The papillae were composed of cuboidal and columnar tumor cells with eosinophilic cytoplasm. The histopathological diagnosis was metastatic papillary thyroid cancer and the patient resumed radiotherapy after the diagnosis. She is under close follow up. Distant metastases of papillary and follicular thyroid cancer are uncommon and cutaneous metastases from papillary thyroid cancer are reported in less than 1 in 1, 000 patients with this cancer. To the best of our knowledge, there is only one reported case of subungual metastasis from thyroid carcinoma to date. Herein, we report a rare case of cutaneous metastasis papillary thyroid cancer on the finger nailbed.

Transcriptomic Analysis of Papillary Thyroid Cancer: A Focus on Immune-Subtyping, Oncogenic Fusion, and Recurrence

박승진,강예은,김정환,박종열,김선규,백승우,추인선,이신애,이성은,박영주,정은재,김진만,고혜미,김재룡,정승남,원호륜,장재원,구본석,김선영 대한이비인후과학회 2022 Clinical and Experimental Otorhinolaryngology Vol.15 No.2

Objectives. Thyroid cancer is the most common endocrine tumor, with rapidly increasing incidence worldwide. However, its transcriptomic characteristics associated with immunological signatures, driver fusions, and recurrence markers remain unclear. We aimed to investigate the transcriptomic characteristics of advanced papillary thyroid cancer. Methods. This study included 282 papillary thyroid cancer tumor samples and 155 normal samples from Chungnam National University Hospital and Seoul National University Hospital. Transcriptomic quantification was determined by high-throughput RNA sequencing. We investigated the associations of clinical parameters and molecular signatures using RNA sequencing. We validated predictive biomarkers using the Cancer Genome Atlas database. Results. Through a comparison of differentially expressed genes, gene sets, and pathways in papillary thyroid cancer compared to normal tumor-adjacent tissue, we found increased immune signaling associated with cytokines or T cells and decreased thyroid hormone synthetic pathways. In addition, patients with recurrence presented increased CD8+ T-cell and Th1-cell signatures. Interestingly, we found differentially overexpressed genes related to immune-escape signaling such as CTLA4, IDO1, LAG3, and PDCD1 in advanced papillary thyroid cancer with a low thyroid differentiation score. Fusion analysis showed that the PI3K and mitogen-activated protein kinase (MAPK) signaling pathways were regulated differently according to the RET fusion partner genes (CCDC6 or NCOA4). Finally, we identified HOXD9 as a novel molecular biomarker that predicts the recurrence of thyroid cancer in addition to known risk factors (tumor size, lymph node metastasis, and extrathyroidal extension). Conclusion. We identified a high association with immune-escape signaling in the immune-hot group with aggressive clinical characteristics among Korean thyroid cancer patients. Moreover, RET fusion differentially regulated PI3K and MAPK signaling depending on the partner gene of RET, and HOXD9 was found to be a recurrence marker for advanced papillary thyroid cancer

갑상선유두암 환자에서 조직학적 림프-혈관침범이 가지는 재발 인자로서의 의의: 메타분석과 체계적 고찰

원호륜,구본석 대한갑상선학회 2023 International Journal of Thyroidology Vol.16 No.2

Conflicting research results have been reported regarding the influence of lymphovascular invasion as a prognostic factor for recurrence of papillary thyroid cancer, and thus, it is continuously discussed. This systematic review and meta-analysis identified an association between recurrence rate and histological lymphatic or vascular invasion in patients with papillary thyroid carcinoma. Clinical data and outcomes were collected from MEDLINE, Embase, the Cochrane Database of Systematic Reviews and KoreaMed. Selection criteria included studies reporting local or distant recurrence rates according to histological lymphatic or vascular invasion in patients with papillary thyroid carcinoma. Twelve observational studies were included in this study. When vascular invasion was confirmed histologically in patients with papillary thyroid cancer, the local recurrence rate was odds ratio 2.544 (95% confidence interval [CI], 1.469-4.407) compared to the patient group without vascular invasion, and the distant recurrence rate was 5.126 (95% CI, 2.853-9.212). The correlation between lymphatic invasion and recurrence rate could not be analyzed. As a result, this systematic review and meta-analysis confirmed that histological vascular invasion affects the rate of local or distant recurrence in patients with papillary thyroid cancer. Therefore, the presence of histological vascular invasion must be evaluated in patients with papillary thyroid cancer.

The role of Slit2 as a tumor suppressor in thyroid cancer

Jeon, Min Ji,Lim, Seonhee,You, Mi-hyeon,Park, Yangsoon,Song, Dong Eun,Sim, Soyoung,Kim, Tae Yong,Shong, Young Kee,Kim, Won Bae,Kim, Won Gu North-Holland 2019 Molecular and cellular endocrinology Vol.483 No.-

<P><B>Abstract</B></P> <P>Slits, representative axon guidance molecules, and their Roundabout (Robo) transmembrane receptors play roles in the progression of many cancers. We investigated the effects of Slit2 on the proliferation, migration, and invasion of thyroid cancer cells, and on the prognosis of papillary thyroid cancer (PTC). <I>Slit2</I> overexpression inhibited the proliferation, migration and invasion of thyroid cancer cells by inhibiting transcriptional activity of beta-catenin and regulating Rho GTPase activity. <I>Slit2</I> knockdown activated the migration and invasion of thyroid cancer cells and transcriptional activity of beta-catenin. Fragment Slit2 treatment inhibited thyroid cancer cell proliferation in a dose dependent manner, and also inhibited migration and invasion. When we evaluated the protein expression of Slit2 in PTCs, 24 of 160 PTCs (15%) were negative for Slit2 protein expression and these patients had significantly increased risk of cervical lymph node metastasis (<I>P</I> < 0.001), distant metastasis (<I>P</I> < 0.001) and recurrence of PTC (<I>P</I> < 0.001). Our findings suggest a role for Slit2 as a tumor suppressor, and also as a novel prognostic and potential therapeutic target for thyroid cancer.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Slit2 inhibits thyroid cancer cell proliferation, migration, and invasion. </LI> <LI> The effect is caused by inhibiting transcriptional activity of beta-catenin and regulating Rho GTPase activity. </LI> <LI> Loss of Slit2 protein expression is associated with metastasis and recurrence of papillary thyroid cancer. </LI> <LI> These findings suggest Slit2 as novel prognostic and potential therapeutic target for thyroid cancer. </LI> </UL> </P>

갑상선유두암의 전이와 혼동되었던 난소갑상선종 1예

정영희,정성민,이종민,장이선,이인석,김종옥,김혜수 대한내분비학회 2012 Endocrinology and metabolism Vol.27 No.3

A focal radioactive iodine uptake in the pelvis of a patient with differentiated thyroid cancer needs differential diagnosis besides bone metastasis. Struma ovarii is a rare monodermal ovarian teratoma composed predominantly of mature thyroid tissue; 5-10% of these tumors are malignant. As diagnosis and surgery of thyroid cancer have increased recently, incidental cases of struma ovarii,after radioactive iodine treatment, were occasionally reported. Rare cases of ovary metastasis of thyroid cancer were also reported. We report a case of benign struma ovarii incidentally found in a patient with papillary thyroid cancer. The patient showed a sustained high level of thyroglobulin and focal radioactive iodine uptake in the right pelvis, confused with distant metastasis, after total thyroidectomy and radioactive iodine treatment. A focal radioactive iodine uptake in the pelvis of a patient with differentiated thyroid cancer needs differential diagnosis besides bone metastasis. Struma ovarii is a rare monodermal ovarian teratoma composed predominantly of mature thyroid tissue; 5-10% of these tumors are malignant. As diagnosis and surgery of thyroid cancer have increased recently, incidental cases of struma ovarii,after radioactive iodine treatment, were occasionally reported. Rare cases of ovary metastasis of thyroid cancer were also reported. We report a case of benign struma ovarii incidentally found in a patient with papillary thyroid cancer. The patient showed a sustained high level of thyroglobulin and focal radioactive iodine uptake in the right pelvis, confused with distant metastasis, after total thyroidectomy and radioactive iodine treatment.

Thyroid Cancer Epidemiology in Iran: a Time Trend Study

Safavi, Ali,Azizi, Fereidoun,Jafari, Rozita,Chaibakhsh, Samira,Safavi, Amir Ali Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.1

Background: Considering the rising incidence of thyroid cancer worldwide, the aim of our study was to investigate the temporal trends in the incidence of this cancer in a large population of Iranian patients. Materials and Methods: We used the Iran Cancer Data System (ICDS) Registry to assess the thyroid cancer trend from 2004 to 2010 with regard to different genders, age groups, and morphologies. To do this we analyzed the data of 10,913 new cases of thyroid cancer that occurred during these years. Results: The incidence rate (per one year) of thyroid cancer was 2.20 per 100,000 persons between 2004 and 2010 in Iran. Papillary thyroid cancer was the most common histology type, with an annual rate of 0.29 in Iran. The highest rate of prevalence in thyroid cancer was observed at the age of 45 years at the time of diagnosis. We found a female-to-male ratio of 2 in Iran. A significant decrease was detected in the trend of thyroid cancer in children <19y, which was not correlated to the trend of older patients. Conclusions: As expected, the trend of thyroid cancer increased over the 7 years, primarily contributed by papillary thyroid cancer. A rising pattern of incidence was seen in all the age groups except patients aged under 19 years.

갑상선유두상암 환자에서 말초혈액의 종양표지자와 임상 소견과의 상관관계

오세준,이영옥,이병주,이진춘,왕수건,김용기,김인주,손석만 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.9

Vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), hepatocyte growth factor (HGF) and epidermal growth factor (EGF) are involved in the pathogenesis and development of thyroid cancer. The purpose of this study was to find the correlation between serum VEGF, VEGF-C, MMP-9, EGF, HGF and clinicopathologic factors. Subjects and Method:Using enzyme linked immunosorbent assay (ELISA) kit, 64 patients with thyroid papillary cancer, 15 benign thyroid mass patients and 14 healthy normal control were analyzed to investigate the expression of human VEGF, VEGF-C, MMP-9, EGF and HGF. Results:There were no significant differences in the serum levels of VEGF, VEGFC, MMP-9, TGF, EGF between papillary thyroid cancer group and the benign thyroid tumor group. Levels of VEGF and MMP- 9 appeared higher in lateral cervical lymph node metastasis than N0 lymph node metastasis or only cervical component lymph node metastasis. But, the serum VEGF-C level was significantly related with tumor size, T stage, extrathyroidal extension and lateral cervical lymph node metastasis (p=0.043). Conclusion : VEGF, VEGF-C, MMP-9, HGF and EGF could not be used as a diagnostic tool for differentiating malignancy from benign thyroid disease. Serum VEGF, VEGF-C and MMP-9 levels were correlated with lateral cervical lymph node metastasis of papillary thyroid cancer. Consequently, this results suggests that they may serve as preoperative supplementary marker for determining the extent of papillary thyroid cancer surgery. Also, serum VEGF-C levels were correlated with some prognostic factors of papillary thyroid cancer. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:812-8)

유두상 갑상선암에서 예후인자와 DNA배수성의 상관관계

정웅윤(Woung Youn Chung),이종훈(Jong Hoon Lee),박정수(Cheong Soo Park) 대한두경부종양학회 1996 대한두경부 종양학회지 Vol.12 No.2

Regardless of the prognostic factors in papillary thyroid cancer, such as sex, age, size of tumor, extent of disease, and distant metastasis, the prognosis of papillary thyroid cancer is sometimes difficult to predict from clinical and microscopic analysis alone and additional prognostic indicators are needed. Recent studies of thyroid cancer have indicated that DNA aneuploidy may be correlated to the biological behavior of malignancy and inversely correlated to the prognosis, but it still remains contraversal. We performed this study to assess DNA ploidy patterns in relation with the previously known prognostic factors in AMES scoring system and lateral neck node metastasis in papillary thyroid cancer. A series of 132 patients with papillary thyroid cancer and 80 patients with benign thyroid tumor(27 follicular adenomas and 53 adenomatous goiters) as a control group from October 1993 to Feburary 1995 were analyzed and their nuclear DNA content was measured with flow cytometry using fresh tissue specimens. DNA aneuploidy was found in 8(6.1%) in papillary cancer and 8(10%) in benign tumor. S-phase traction(SFP) and proliferative index(PI) were higher in thyroid cancers, being 2.18 ± 4.24%, 6.34 ± 4.94% in the papillary thyroid cancers and 1.97 ± 2.93%, 4.44 ± 3.80% in the benign tumors, respectively. However there was no significant difference of values between two groups(p>0.05). Among variable prognostic factors studied(age, sex, size of tun or, extent of disease, distant metastasis in AMES scoring system and lateral neck node metastasis), DNA aneuploidy was found to be common in distant metastasis(p 0.035), but there was no significant difference between the high risk and low risk group according to the AMES scoring system(p<0.08). In our study, DNA aneuploidy was not valuable in determining the presence of malignancy and did not correlate to the AMES scoring system. However, follow-up study of more cases will be needed for accurate information about the DNA ploidy as a independent prognostic factor.

미세침흡인으로 얻은 갑상선 유두암 세포에서 p27 발현과 경부림프절 전이의 연관성

이관주,이정의<SUP>1<,SUP>,김정수,김태규<SUP>2<,SUP>,이상철,김정구,안창준,김세준,이동호,Kwan Ju Lee,M,D,Jung Hea Lee,M,D,<SUP>1<,SUP>,Jeong Soo Kim,M,D,Tai Gyu Kim,M,D,<SUP>2<,SUP>,Sang Chul Lee,M,D,Jeong Goo Kim,M,D,Chang-Joon 대한갑상선-내분비외과학회 2009 The Koreran journal of Endocrine Surgery Vol.9 No.3

Purpose: The p27 gene as a tumor suppressor gene is associated with colorectal cancer, gastric cancer and breast cancer. Some studies have shown a relationship between the underexpression of p27 and lymph node metastasis in papillary thyroid carcinoma. The aim of this study is to evaluate the relationship between a p27 expression of the papillary thyroid cancer cells obtained by fine needle aspiration (FNA) and cervical lymph node metastasis. Methods: This study included 60 patients with papillary thyroid cancer and who underwent total thyroidectomy or lobectomy. Central lymph node dissection was routinely done. Out of these patients, 30 patients underwent a FNA procedure during the operation. Immunohistochemical staining for p27 antibody was performed on the papillary thyroid cancer tissues and cells. Results: Cervical lymph node metastasis is correlated with the tumor size and lymphovascular invasion (P<0.001). The underexpression of p27 for the papillary thyroid cancer tissues and cells was associated with lymph node metastasis (P=0.009). Conclusion: An evaluation of the p27 expression for the papillary thyroid cancer cells obtained by FNA may be useful as a predictor for lymph node metastasis before surgery. (Korean J Endocrine Surg 2009;9:155-160)