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Serum Thyroglobulin (serum + thyroglobulin)
Selected AbstractsApplication of post-surgical stimulated thyroglobulin for radioiodine remnant ablation selection in low-risk papillary thyroid carcinoma,,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 6 2010Alon Vaisman HBSc Abstract Background We present our ongoing experience in the use of postsurgical stimulated serum thyroglobulin (Stim-Tg) to assist in radioiodine remnant ablation (RRA) decision-making. Methods Patients with low-risk well-differentiated thyroid carcinoma (WDTC) with undetectable anti-Tg antibodies were prospectively followed after total thyroidectomy and therapeutic central compartment neck dissection, when indicated.Stim-Tg was performed 3 months postoperatively and used to base RRA selection. Results Of 104 patients, 59 patients (56.7%) had an undetectable Stim-Tg after thyroidectomy, 35 (33.7%) had Stim-Tg values of 1,5 ,g/L, and 10 (9.6%) had Stim-Tg values >5 ,g/L. RRA was administered to 1 patient (1.7%) with undetectable Stim-Tg, 6 patients (17.1%) with Stim-Tg1,5 ,g/L, and 9 patients (90%) with Stim-Tg >5 ,g/L, for a total of 16 patients (15.4%) receiving RRA. When compared to current RRA selection guidelines, the proposed protocol achieved a significantly lower RRA administration rate. Conclusion Stim-Tg measurement performed several months after total thyroidectomy is a useful objective parameter in assisting RRA decision-making for patients with low-risk WDTC. © 2010 Wiley Periodicals, Inc. Head Neck, 2010 [source] Surface interaction of well-defined, concentrated poly(2-hydroxyethyl methacrylate) brushes with proteinsJOURNAL OF POLYMER SCIENCE (IN TWO SECTIONS), Issue 21 2007Chiaki Yoshikawa Abstract The interaction of concentrated polymer brushes with proteins was chromatographically investigated. By the use of surface-initiated atom transfer radical polymerization, a low-polydispersity poly(2-hydroxyethyl methacrylate) (PHEMA) was densely grafted onto the inner surfaces of silica monoliths with mesopores of about 50 and 80 nm in mean size. The graft density reached 0.4,0.5 chains/nm2. The 80-nm-mesopore monolithic column with the concentrated PHEMA brush was characterized through the elution of low-polydispersity pullulans with different molecular weights, clearly showing two modes of size exclusion, that is, one by the mesopores and the other by the brush phase. The latter mode gave a sharp separation with a critical molecular weight (size-exclusion limit) of about 1000. This molecular size of pullulan was comparable to the distance between the nearest-neighbor graft points. The elution behaviors of five proteins of different sizes (bovine serum thyroglobulin, bovine serum immunoglobulin G, bovine serum albumin, horse heart myoglobin, and bovine serum aprotinin) were studied with this PHEMA-grafted column. The smallest protein, aprotinin, with a pullulan-reduced molecular weight slightly larger than the critical value of 1000, was eluted much behind the corresponding pullulan, and this indicated that it barely got into the brush layer, suffering from a strong affinity interaction within the brush. On the other hand, the other four larger proteins were eluted at the same elution volumes as the equivalent pullulans, and this meant that they were perfectly excluded from the brush layer and separated only in the size-exclusion mode by the mesopores without an affinity interaction with the brush surface. This excellent inertness of the concentrated brush in the interaction with the large proteins should afford the system long-term stability against biofouling. © 2007 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 45: 4795,4803, 2007 [source] HURTHLE CELL NEOPLASM OF THE THYROID GLANDANZ JOURNAL OF SURGERY, Issue 3 2008Mohammed Ahmed Background: A clinicopathological analysis and long-term follow up of 32 patients with Hurthle cell neoplasm (HCN) was undertaken to contrast the clinical and histological features between benign versus malignant HCN of thyroid and to examine the effect of treatment on the outcome. Methods: This is a retrospective study of 32 patients with HCN who were identified out of an archival clinical/pathological/imaging database of 3752 thyroid cancer patients seen between 1976 and June 2006. All patients underwent thyroid surgery. Data for the non-surgical treatment along with follow up were also analysed. Results: Seventeen patients were classified as malignant HCN (MHCN) and 15 as benign HCN (BHCN). Among the MHCN, there were 11 women and 6 men, whereas among BHCN there were 14 women and 1 man. Three patients designated MHCN presented with metastases, one with pulmonary metastases and two others with skeletal metastases who developed lung metastases 9,19 months later. The mean tumour size was 4.43 ± 0.66 cm for MHCN, and 2.57 ± 0.32 cm for BHCN (P = 0.03). Multicentric tumour foci were evident in five cases (29%) of MHCN but none among the BHCN (P = 0.03). At neck exploration cervical lymph node dissection was carried out in nine MHCN patients with findings of tumour metastases in 33%. Postoperatively, three MHCN patients had no thyroid remnant on ultrasound and computed tomography of neck and undetectable serum thyroglobulin; these were considered to be in remission. Fourteen other MHCN patients with postoperative thyroid remnant and/or distant metastases received 131I treatment. Eight of these patients had negative whole-body scans after 131I treatment and undetectable thyroglobulin. Accordingly, 11 MHCN patients (64.7%) showed evidence of remission and 6 patients did not respond to 131I treatment. After a mean follow up of 35 months, all BHCN patients are alive with no evidence of disease. Of the MHCN, 11 (64.7%) were in remission and 35% had evidence of persistence/recurrence. One patient who had recurrence is dead. A lack of effectiveness of 131I therapy in two patients with distant metastases is an important finding. Conclusion: Features of MHCN consisted of a large tumour size, unequivocal capsular and vascular invasion, multicentric tumour foci, metastatic lymph node deposits in one-third of patients and presence of distant metastasis in a few. Findings of dominant Hurthle cell cytology in a fine-needle aspiration biopsy from a thyroid nodule should prompt surgical resection of the lesion to assess malignancy. [source] Preoperative undetectable serum thyroglobulin in differentiated thyroid carcinoma: incidence, causes and management strategyCLINICAL ENDOCRINOLOGY, Issue 4 2007Luca Giovanella Summary Background, In recent years serum thyroglobulin (Tg) measurement during thyroxine (T4) treatment and/or after stimulation by endogenous TSH or recombinant human TSH (rhTSH) has eclipsed other diagnostic procedures in managing patients with differentiated thyroid cancer (DTC). However, preoperative undetectable Tg was reported in up to 12% of patients affected by DTC and recurrences of DTC with no increase in serum Tg have also been described. Clearly, a negative Tg measurement may falsely reassure both the patient and the clinician in these cases. Aim, We retrospectively evaluated the incidence of undetectable or reduced preoperative serum Tg in a group of 436 patients affected by DTC. Additionally, we evaluated the role of Tg retesting by two different immunoassays in patients with low Tg at first measurement. Methods, We retrospectively selected 17 patients with undetectable (i.e. less than functional sensitivity of assay method) or reduced Tg (i.e. between functional sensitivity and minimum normal value) among 436 patients with histologically proved DTC. The remaining 419 patients were used as control cases. Frozen sera from all patients were retested by two different Tg immunoassays. Results, Globally, 17 out of 436 (3·8%) patients showed undetectable (n = 5, 1·1%) or reduced (n = 12, 2·7%) preoperative Tg. The Tg level was above the minimum normal value in 3 and 4 out of 5, and 8 and 9 out of 12 of these patients, respectively, when two different immunoassays were employed. On the other hand, undetectable or reduced Tg levels were found in 3·0%,5·1% of control cases when different immunoassays were used. Conclusions, Regardless of the method employed, 3·0,5·1% of patients with DTC showed undetectable or reduced preoperative Tg. This fact must be recognized, as Tg cannot be used as a benchmark for DTC follow-up in these cases. However, Tg retesting with different immunoassays seems to be useful in ruling out these pitfalls in a large majority of patients, and also indicates the most effective assay to be employed in these cases. [source] | ||||||||||