جستجوی مقالات مرتبط با کلیدواژه « thyroglobulin » در نشریات گروه « پزشکی »

18F-FDG PET/CT is increasingly performed in patients with differentiated thyroid cancer. The aim of this study was to assess the clinical impact of 18FFDG PET/CT on the management of patients with differentiated thyroid carcinoma who had elevated serum thyroglobulin (Tg) and negative 131I whole body scan (WBS) . 67 patients with differentiated thyroid carcinoma were included in this study. The findings of 18F-FDG PET/CT imaging were compared with histopathology, follow up imaging, or clinical follow-up results. The diagnostic accuracy of 18F-FDG PET/CT was evaluated for the entire patient group and for those patients with stimulated serum thyroglobulin levels of less than 5, 5–10, and more than 10 pmol/L as well as for local recurrences and metastases sites. The impact of 18F-FDG PET/CT on therapeutic management was also evaluated. 30/67 patients had positive findings on 18F-FDG PET/CT; 28 were truepositive and 2 were false-positive. 18F-FDG PET/CT results were true-negative in36 patients and false-negative in 1 patient. The overall sensitivity, specificity, accuracy, PPV and NPV of 18F-FDG PET/CT were, 96.5%, 94.5%, 95.5%, 93.3%, and 97.2% respectively. Positive 18F-FDG PET/CT findings were directly correlated with stimulated serum thyroglobulin levels, 7.1% had Tg between 5–10, and 92.9% had Tg greater than 10 pmol/L. 18F-FDG PET/CT had a high or moderate impact on treatment management in 28 (41.8%) of patients. 18F-FDG PET/CT is able to improve diagnostic accuracy and have management impact in a therapeutically relevant way in patients with differentiated thyroid carcinoma who present with rising thyroglobulin level, negative 131I WBS, and clinical suspicion of recurrent disease.

Differentiatedthyroid carcinoma (DTC) constitute approximately 90% of all thyroid tumors with an overall excellent prognosis. However, there is a small group of patients with a more aggressive form of disease, usually associated with certain poor prognostic factors. Using our large database of patients with DTC, the current study aims at identifying some of these factors. 

This retrospective study was based on the registry of patients with non-medullary thyroid carcinoma. Data were collected on the clinical, laboratory, and outcome characteristics of 501 patients followed at our department.

On multivariate analysis, the following variables were predictive of persistent disease: less than total thyroidectomy, residual disease on the post treatment whole body radioiodine scan (WBIS), higher received radioiodine activities, and higher levels of baseline stimulated thyroglobulin (Tg) and thyroid stimulating hormone (TSH). The greatest predictive value for the persistent/recurrent disease was attributed to the presence of residual disease on the post-treatment WBIS (odds ratio (OR): 33.72, 95% confidence interval (95% CI): 18.17-62.57), followed by type of surgical procedure (OR: 8.92, 95% CI: 2.90-27.39), radioiodine ablation dose (OR: 4.03, 95% CI: 1.56-10.39), stimulated baseline Tg level (OR: 2.79, 95% CI: 1.53-5.08) and finally, the stimulated baseline TSH level (OR: 2.21, 95% CI: 1.08-4.519).

In patients with DTCs, surgical procedures other than total thyroidectomy, presence of residual disease on the post-treatment WBIS, higher received radioiodine activities, higher baseline stimulated Tg and TSH levels are associated with a higher probability of having persistent disease and can be used in conjunction with other disease characteristics to reach proper decisions with regard to treatment and follow-up.

Some studies have shown that a preoperative high concentration of thyroglobulin (Tg) in wash out of fine‑needle aspiration cytology of cervical lymph nodes mandate therapeutic lymph node dissection. However, there is disagreement about the minimum concentration of Tg which could have diagnostic value. Hence, according to our literature review, this study is the first one which designed to do intraoperatively. Therefore, this study was conducted and aimed to determine the clinical diagnostic value of Tg lymph nodes in the diagnosis of metastatic thyroid cancer.

In a cross‑sectional study, 65 patients with papillary thyroid carcinoma (PTC) who were thyroidectomy candidates were chosen and during surgery, before the removal of lymph nodes in the neck, fine‑needle sampling was performed and the level of Tg in the samples, nature of the sample sent for biopsy and Tg levels in affected and unaffected lymph nodes were determined.

The mean levels of washout Tg in malignant and nonmalignant lymph nodes were 622.1 ± 66.2 and 1.38 ± 0.43 ng/ml, respectively, and the difference between the two groups was significant (P < 0.001). The Tg cut‑off point for the detection of lymph node metastases was 0.7 ng/dl, and according to it, Tg washout sensitivity was 93.8%, specificity of 92.4%, false positives 7.76%, false negatives 6.3%, positive predictive value was 92.3%, and negative predictive value was 93.8% and accuracy was 93.1%.

Based on the results, Tg level of cervical lymph nodes in patients with PTC is a suitable criterion for the diagnosis of lymph node which can be determined through fine‑needle biopsy. Therefore, it is suggested that in patients with suspicion of lymph nodes involvement during surgery, fine‑needle biopsy and determination of the Tg level performed.

Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women in reproductive age. In many cases, PCOS is associated with infertility and increased risk of miscarriage. Recent studies have detected the presence of several organ specific and nonspecific autoantibodies in women with PCOS.. The aim of this study was to evaluate the prevalence and levels of thyroid antibodies in euthyroid women with PCOS in Syria..Patients and This study included 56 euthyroid women with PCOS and 30 healthy women as a control group. PCOS was defined according to the revised 2003 Rotterdam criteria. Thyroid function was evaluated by measurement of serum TSH and FT4 levels. Antithyroid peroxidase and antithyroglobulin antibodies (anti-TPO and anti-TG, respectively) were detected as markers for thyroid autoimmunity. All parameters were measured using electrochemiluminescence immunoassay.. Women with PCOS had higher serum levels of anti-TPO in comparison to controls (39.9 ± 59.5 and 18.9 ± 11.2 IU/mL, respectively; P < 0.05) and no significant difference was found in serum levels of anti-TG, TSH, or FT4 between the two groups. Patients with PCOS had a higher prevalence of positive results for anti-TG and/or anti-TPO in comparison to controls (28.6% and 3.3%, respectively; P<0.05), anti-TPO alone (19.6% and 3.3%, respectively; P < 0.05) and anti-TG alone (21.4% and 3.3%, respectively; P < 0.05). No significant associations were found between antibodies and studied hormones.. High prevalence of thyroid antibodies in euthyroid patients with PCOS refers to the importance of investigation for thyroid autoimmune state in those patients..

To compare different indicators of iodine deficiency disorders (IDD) in school children from study sites in Bangladesh, Indonesia, Guatemala, and the United States. Cross-sectional surveys were performed in Savar, Bangladesh; Sukabumi, Indonesia; San Pedro Sacatepequez, Guatemala; and Atlanta, United States. In each study site, school children were assessed for thyroid size by palpation and thyroid volume by ultrasonography, urine specimens collected for iodineconcentration, and finger stick blood specimens spotted onto filter paper for assessmentof thyroid stimulating hormone (TSH) and thyroglobulin (Tg). Weights and heights werecollected in all sites except Guatemala. Between 305 to 518 school children were surveyed in each site. ndicators based on thyroid size tended to indicate more severe levels of iodine deficiency compared to urinary iodine based on WHO/UNICEF/ICCIDD criteria. TSH levels appeared to correlate well with other indicators of IDD whereas Tg did not. In these study sites, it appeared that urinary iodine, thyroid volume (based on body surface area), palpation, and TSH were consistent in identifying the Bangladesh site as having the highest prevalence of IDD, followed by sites in Indonesia, Guatemala, and the United States. The prevalence of goiter indicated moresevere levels of IDD compared to urinary iodine levels. Tg was not significantly different between the study sites.