PURPOSE: Whole body Positron Emission Tomography (PET) was used to evaluate the existence of cancer cells. However, PET had limitations in identifying thyroid cancer cells because of their slow progression, and evidence regarding its accuracy in finding thyroid cancer cells is insufficient. Therefore, we investigated the usefulness of PET for evaluation of patients with thyroid nodules by studying the relationships between PET and thyroid ultrasonography. METHODS: We evaluated 4,627 patients who had undergone PET from January 2007 to October 2011 and selected 370 patients who had undergone thyroid ultrasonography. We compared and analyzed the amount of thyroid SUVmax of PET, the pattern of glucose uptake, and findings of thyroid ultrasonography based on their size, shape, location, and FNAC. RESULTS: Of 370 patients, 197 (53.2%) subjects were found to have thyroid nodules, and 211 (57.0%) subjects had higher sugar metabolism, regardless of having thyroid nodules. No statistical correlations were observed among nodule size, nodule location,and higher sugar metabolism, however, noticeable relationships were observed between the shape of the cells on thyroid ultrasonography and FDG uptake of PET. In cases of papillary thyroid cancer, there was higher FDG uptake, compared to benign lesions in particular, SUVmax of the papillary thyroid cancer showed a significantly elevated level of FDG uptake. CONCLUSION: Despite its limited usefulness in identifying the characteristics of thyroid nodules being benign or malignant, PET is appropriate for evaluation of the malignancy of thyroid cells
Diagnosis* ; Electrons* ; Glucose ; Humans ; Metabolism ; Positron-Emission Tomography* ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule* ; Ultrasonography

BACKGROUND AND OBJECTIVES: Selenium is an important trace element for thyroid hormone metabolism, and its deficiency can cause hypothyroidism. Serum selenium concentration is the best biomarker to reflect selenium intake and reserve, although other markers can reflect. Therefore, we preliminarily assessed serum and urine selenium concentrations in patients with thyroid disease compared to those of a healthy population. We also investigated the correlation between serum and urine selenium concentration, thyroid hormone and urinary iodine concentration (UIC). MATERIALS AND METHODS: A total of 97 patients (32 men, 65 women, 52.4±14.7 years) with benign thyroid nodules or thyroid dysfunction who visited the Samsung Medical Center between 2008 and 2013 were included. Data for 175 healthy subjects provided by Lee et al. were used as the control. Serum T3, free T4, and thyroid stimulating hormone (TSH) were measured using commercialized RIA or IRMA kits. Serum/urine selenium and UIC were measured by inductively coupled plasma-mass spectrometry (ICP-MS). RESULTS: Median serum selenium concentration was 110 µg/L (95% CI, 73-156). Median urine selenium concentration was 66.3 µg/gCr (95% CI, 28.7-283.5). Compared to 175 healthy subjects (serum 84 µg/L [95% CI, 30-144], urine 34.5 µg/gCr [95% CI, 0.8-107.2]), serum and urine selenium concentrations of patients with thyroid disease were significantly higher than those of healthy subjects (p<0.001). Serum selenium concentration was significantly correlated with urine selenium concentration after log transformation (r=0.88, p=0.022), but was not significantly correlated with UIC, T3, free T4 and TSH. CONCLUSION: Selenium concentrations of patients with thyroid disease were significantly higher than those of healthy subjects. Serum selenium concentration was significantly correlated with urine selenium concentration.
Female ; Healthy Volunteers ; Humans ; Hypothyroidism ; Iodine ; Male ; Metabolism ; Selenium* ; Spectrum Analysis ; Thyroid Diseases* ; Thyroid Gland* ; Thyroid Nodule ; Thyrotropin

BACKGROUND AND OBJECTIVES: Selenium is an important trace element for thyroid hormone metabolism, and its deficiency can cause hypothyroidism. Serum selenium concentration is the best biomarker to reflect selenium intake and reserve, although other markers can reflect. Therefore, we preliminarily assessed serum and urine selenium concentrations in patients with thyroid disease compared to those of a healthy population. We also investigated the correlation between serum and urine selenium concentration, thyroid hormone and urinary iodine concentration (UIC). MATERIALS AND METHODS: A total of 97 patients (32 men, 65 women, 52.4±14.7 years) with benign thyroid nodules or thyroid dysfunction who visited the Samsung Medical Center between 2008 and 2013 were included. Data for 175 healthy subjects provided by Lee et al. were used as the control. Serum T3, free T4, and thyroid stimulating hormone (TSH) were measured using commercialized RIA or IRMA kits. Serum/urine selenium and UIC were measured by inductively coupled plasma-mass spectrometry (ICP-MS). RESULTS: Median serum selenium concentration was 110 µg/L (95% CI, 73-156). Median urine selenium concentration was 66.3 µg/gCr (95% CI, 28.7-283.5). Compared to 175 healthy subjects (serum 84 µg/L [95% CI, 30-144], urine 34.5 µg/gCr [95% CI, 0.8-107.2]), serum and urine selenium concentrations of patients with thyroid disease were significantly higher than those of healthy subjects (p<0.001). Serum selenium concentration was significantly correlated with urine selenium concentration after log transformation (r=0.88, p=0.022), but was not significantly correlated with UIC, T3, free T4 and TSH. CONCLUSION: Selenium concentrations of patients with thyroid disease were significantly higher than those of healthy subjects. Serum selenium concentration was significantly correlated with urine selenium concentration.
Female ; Healthy Volunteers ; Humans ; Hypothyroidism ; Iodine ; Male ; Metabolism ; Selenium* ; Spectrum Analysis ; Thyroid Diseases* ; Thyroid Gland* ; Thyroid Nodule ; Thyrotropin

The purpose of this review is to investigate the value of the calcification in differentiating malignant thyroid neoplasm and the molecular mechanisms for the formation of the calcification. Many published reports have proved the presence of calcifications in thyroid neoplasm and calcified nodules in these studies are more frequently malignant than noncalcified nodules. Through viewing the related references, we found that psammoma bodies (PBs), Runx2, osteocalcin, osteopontin, CD44v6 play an important role in the molecular mechanisms in the formation of the calcification in PTC. But further study is required for elucidating the mode of action.
Calcinosis ; diagnosis ; pathology ; Core Binding Factor Alpha 1 Subunit ; metabolism ; Humans ; Hyaluronan Receptors ; metabolism ; Osteocalcin ; metabolism ; Osteopontin ; metabolism ; Thyroid Neoplasms ; diagnosis ; pathology ; Thyroid Nodule ; pathology

OBJECTIVETo study the application value of fine needle aspiration and cell block combined with molecular markers in early diagnosis of thyroid cancer and discriminate follicular tumor before operation.

METHODSFine needle biopsy of thyroid nodules was guided by color ultrasound, then the sample acquired was used to make smear and the rest to make cell block. The pathological diagnosis on smear, cell block or combination of both was made respectively. Then, the Envision immunohistochemical method was employed to detect the expressions of CK19, Galectin-3 in cell block samples, which had been used for the diagnosis of papillary thyroid carcinoma or thyroid nodules from benign lesions after operation and to detect the expressions of DDIT3, ki-67 of cell block that had been used for the diagnosis of follicular tumor nodules.

RESULTSThe sensitivity, specificity, positive predictive value, negative predictive value and accuracy of cytopathology for the diagnosis of malignancy were 95.3%, 94.7%, 92.7%, 96.6% and 95.0% respectively; and the sensitivity, specificity and accuracy of the diagnosis used cell block alone or combined with smear were 88.1%, 95.3%, 92.3% and 95.3%, 94.7%, 95.0% respectively, which were higher than 53.8%, 83.7%, 71.3% from smear correspondingly. The positive expression rate of CK19 and Galectin-3 of papillary thyroid carcinoma cell block were 100% and 98.0% respectively, higher than the value 17.7% and 23.3% of thyroid benign lesions (P < 0.01); the positive expression rate of DDIT3 of thyroid follicular cancer cell block was 84.6%, higher than the value 35.1% of follicular adenoma (P < 0.01), there was no statistical significance of Positive expression rate of Ki-67 between thyroid follicular carcinoma and follicular adenoma cell block (P > 0.05).

CONCLUSIONSIt was conducive to early diagnose thyroid cancer with detection of CK19, Galection-3 of cell block made by ultrasound-guided fine needle biopsy of thyroid nodules. And it was also significant for DDIT3 detection to early discriminate follicular neoplasm before operation.

Adenocarcinoma, Follicular ; diagnosis ; Biomarkers, Tumor ; metabolism ; Biopsy, Fine-Needle ; Carcinoma ; diagnosis ; Carcinoma, Papillary ; Galectin 3 ; metabolism ; Humans ; Immunohistochemistry ; Keratin-19 ; metabolism ; Ki-67 Antigen ; metabolism ; Preoperative Period ; Sensitivity and Specificity ; Thyroid Neoplasms ; diagnosis ; Thyroid Nodule ; diagnosis ; Transcription Factor CHOP ; metabolism

PURPOSE: We investigated the merit of ultrasound (US) features and BRAF(V600E) mutation as an additional study of cytology and compared the diagnostic performances of cytology alone, cytology with US correlation, cytology with BRAF(V600E) mutation, and a combination of cytology, US, and BRAF(V600E) mutation all together. MATERIALS AND METHODS: This study included 185 patients (mean age, 48.4 years; range 20-77 years) with 191 thyroid nodules who underwent US-guided fine-needle aspiration (FNA) with an additional BRAF(V600E) mutation test. Three radiologists highly experienced in thyroid imaging retrospectively reviewed US images and classified each nodule into two categories (positive for malignancy or negative for malignancy). Interobserver variability (IOV) of US assessment between the three readers was estimated using the generalized kappa statistic of Landis and Koch. We also calculated the diagnostic performances of these studies. RESULTS: There were 131 cases of malignancy (131/191, 68.6%) and 60 cases of benign nodules (60/191, 31.4%). In terms of IOV of US assessment, the generalized kappa value was 0.242, indicating fair agreement was reached. The combination of cytology with BRAF(V600E) showed higher specificity (100%) and positive predictive value (PPV) (100%) compared to the combination of cytology, BRAF(V600E), and US (specificity 28.3%, 66.7%, 68.3%; PPV 74.6%, 86.6%, 86.8%, respectively; p<0.001). However, cytology with BRAF(V600E) showed lower sensitivity (84.7%) than cytology with BRAF(V600E) and US (96.2%, 98.5%, 95.4%, respectively; p<0.001). CONCLUSION: Considering the diagnostic performance and low reproducibility of US, the combination of FNA with BRAF(V600E) is the most reliable and objective method for diagnosing thyroid malignancy.
Adult ; Aged ; Biological Markers ; Biopsy, Fine-Needle ; Carcinoma/*diagnosis/genetics/*ultrasonography ; Cytodiagnosis ; Female ; Humans ; Male ; Middle Aged ; Proto-Oncogene Proteins B-raf/*genetics ; Retrospective Studies ; Thyroid Gland/metabolism/pathology ; Thyroid Neoplasms/*diagnosis/genetics/*ultrasonography ; Thyroid Nodule/metabolism/pathology ; Young Adult

PURPOSE: We investigated the merit of ultrasound (US) features and BRAF(V600E) mutation as an additional study of cytology and compared the diagnostic performances of cytology alone, cytology with US correlation, cytology with BRAF(V600E) mutation, and a combination of cytology, US, and BRAF(V600E) mutation all together. MATERIALS AND METHODS: This study included 185 patients (mean age, 48.4 years; range 20-77 years) with 191 thyroid nodules who underwent US-guided fine-needle aspiration (FNA) with an additional BRAF(V600E) mutation test. Three radiologists highly experienced in thyroid imaging retrospectively reviewed US images and classified each nodule into two categories (positive for malignancy or negative for malignancy). Interobserver variability (IOV) of US assessment between the three readers was estimated using the generalized kappa statistic of Landis and Koch. We also calculated the diagnostic performances of these studies. RESULTS: There were 131 cases of malignancy (131/191, 68.6%) and 60 cases of benign nodules (60/191, 31.4%). In terms of IOV of US assessment, the generalized kappa value was 0.242, indicating fair agreement was reached. The combination of cytology with BRAF(V600E) showed higher specificity (100%) and positive predictive value (PPV) (100%) compared to the combination of cytology, BRAF(V600E), and US (specificity 28.3%, 66.7%, 68.3%; PPV 74.6%, 86.6%, 86.8%, respectively; p<0.001). However, cytology with BRAF(V600E) showed lower sensitivity (84.7%) than cytology with BRAF(V600E) and US (96.2%, 98.5%, 95.4%, respectively; p<0.001). CONCLUSION: Considering the diagnostic performance and low reproducibility of US, the combination of FNA with BRAF(V600E) is the most reliable and objective method for diagnosing thyroid malignancy.
Adult ; Aged ; Biological Markers ; Biopsy, Fine-Needle ; Carcinoma/*diagnosis/genetics/*ultrasonography ; Cytodiagnosis ; Female ; Humans ; Male ; Middle Aged ; Proto-Oncogene Proteins B-raf/*genetics ; Retrospective Studies ; Thyroid Gland/metabolism/pathology ; Thyroid Neoplasms/*diagnosis/genetics/*ultrasonography ; Thyroid Nodule/metabolism/pathology ; Young Adult

OBJECTIVETo investigate the difference of galectin-3 and CD44v6 expression between benign and malignant thyroid nodules, and to evaluate their clinical value in distinguishing thyroid cancer from benign thyroid nodules.

METHODSThe expression of galectin-3 and CD44v6 was immunohistochemically detected by the ABC method in 143 benign and malignant thyroid nodule samples.

RESULTSExpression of these two markers in benign thyroid nodules: galectin-3 was negative in 10 cases of para-cancer normal tissue and 14 cases of benign nodules found in the other benign thyroid disease. It was weakly positive in 4 of 52 nodular goiter (7.7%). Also it was weakly positive in 2 of 22 follicular adenomas (9.1%). But all three eosinophilic follicular adenomas were diffusely or focally positive for galectin-3. CD44v6 was negative in 10 cases of para-cancer normal tissue, but positive in 4 of 14 nodular lesions found in benign thyroid diseases (28.6%). It was also positive in 16 of 52 nodular goiters (30.8%), and weakly positive in 7 of 22 follicular adenomas (31.8%). The two markers in malignant lesions: galectin-3 was positive in 50 of 52 thyroid adenocarcinoma (96.2%), CD44v6 was positive in 42 of 52 thyroid adenocarcinoma (80.8%). The positive rate of galectin-3 and CD44v6 expression in thyroid cancer was significantly higher than that in benign thyroid nodule and normal tissue (P < 0.001). The sensitivity, specificity and accuracy of galectin-3 combined with CD44v6 in differentiating benign from malignant thyroid nodule were 80.8%, 93.4%, 88.8%; they were 96.2%, 90.1%, 92.3% for Galectin-3 alone.

CONCLUSIONThe immunohistochemical expression of galectin-3 and CD44v6 by the ABC method is significantly higher in thyroid cancers than in benign thyroid nodules, especially galectin-3 in thyrocyte being helpful in differentiating benign thyroid nodule from thyroid cancer.

Adenocarcinoma, Papillary ; diagnosis ; metabolism ; Adenoma ; diagnosis ; metabolism ; Biomarkers, Tumor ; biosynthesis ; Diagnosis, Differential ; Female ; Galectin 3 ; biosynthesis ; Glycoproteins ; biosynthesis ; Humans ; Hyaluronan Receptors ; biosynthesis ; Immunohistochemistry ; Male ; Thyroid Neoplasms ; diagnosis ; metabolism ; Thyroid Nodule ; diagnosis ; metabolism

Papillary thyroid carcinoma (PTC) is the most common malignant thyroid tumor, and 36-69% of PTC cases are caused by mutations in the BRAF gene. The substitution of a valine for a glutamic acid (V600E) comprises up to 95-100% of BRAF mutations; therefore, most diagnostic methods, including allele-specific PCR and real-time PCR, are designed to detect this mutation. Nevertheless, other mutations can also comprise the genetic background of PTC. Recently, a novel and sensitive technique called mutant enrichment with 3'-modified oligonucleotides (MEMO) PCR has been introduced. When we applied allelespecific PCR and MEMO-PCR for the detection of the BRAF V600E mutation, we found an unusual 3' bp deletion mutation (c.1799_1801delTGA) only when using MEMO-PCR. This deletion results in the introduction of a glutamic acid into the B-Raf activation segment (p.V600_K601delinsE), leading to an elevated basal kinase activity of BRAF. This is the first report of a rare 3 bp BRAF deletion in a PTC patient that could not be detected by allele-specific PCR.
Alleles ; Base Sequence ; Female ; Humans ; Lymphatic Metastasis ; Middle Aged ; Oligonucleotides/genetics ; Polymerase Chain Reaction/*methods ; Proto-Oncogene Proteins B-raf/*genetics/metabolism ; Sequence Deletion ; Thyroid Neoplasms/genetics/pathology ; Thyroid Nodule/metabolism

OBJECTIVETo investigate the prevalence of thyroid diseases in a community which did not use iodized salt.

METHODSThe survey was conducted in Panshan, Liaoning Province. 1 103 inhabitants aged 14 years or more attended the examinations, which included questionnaire, physical examination and serum analysis. Iodine in the urine and thyroid B ultrasound examination were also conducted.

RESULTSThe prevalence of overt hyperthyroidism and hypothyroidism was 16.3 per thousand and 2.7 per thousand, respectively. Subclinical hyperthyroidism and hypothyroidism were detected in 37.2 per thousand and 9.1 per thousand of the subjects, respectively. Serum autoantibodies to thyroid were detected in 10.9% of the entire population. The prevalence of goiter was 20.7% (diffuse goiter 16.8% and nodular goiter 3.9%).

CONCLUSIONIn the iodine deficient areas, perhaps autoimmununization is not only related to the development of goiter but is also the main cause of subclinical hyperthyroidism and hypothyroidism.

Adolescent ; Adult ; Aged ; Autoantibodies ; analysis ; China ; epidemiology ; Female ; Goiter ; epidemiology ; Health Surveys ; Humans ; Hyperthyroidism ; epidemiology ; Hypothyroidism ; epidemiology ; Iodine ; deficiency ; urine ; Male ; Middle Aged ; Prevalence ; Residence Characteristics ; Sodium Chloride, Dietary ; Thyroid Diseases ; epidemiology ; immunology ; metabolism ; Thyroid Nodule ; epidemiology