The LNR is an important independent prognostic factor in PTC and can be used in conjunction with existing staging systems. A clinical relevant cut-off point of 0.3 (one positive lymph node out of three total) is proposed. No prognostic implications for LNY were identified.

No abstract

A novel gene, thyroid cancer 1 (TC-1), was found recently to be overexpressed in thyroid cancer. TC-1 shows no homology to any of the known thyroid cancer-associated genes. We have produced stable transformants of normal thyroid cells that express the TC-1 gene, and these cells show increased proliferation rates and anchorage-independent growth in soft agar. Apoptosis rates also are decreased in the transformed cells. We also have expressed recombinant TC-1 protein and have undertaken a structural and functional characterization of the protein. The protein is monomeric and predominantly unstructured under conditions of physiologic salt and pH. This places it in the category of natively disordered proteins, a rapidly expanding group of proteins, many members of which play critical roles in cell regulation processes. We show that the protein can be phosphorylated by cyclic AMP-dependent protein kinase and protein kinase C, and the activity of both of these kinases is up-regulated when cells are stably transfected with TC-1. These results suggest that overexpression of TC-1 may be important in thyroid carcinogenesis.

Aims. We compared the demographic profile and clinical characteristics of individuals with new onset steroid-induced diabetes (NOSID) to Type 2 diabetes (T2DM) patients with and without steroid treatment. Methods. The demographic profile and clinical characteristics of 60 individuals who developed NOSID were examined and matched to 60 type 2 diabetes patients receiving steroid therapy (T2DM+S) and 360 diabetic patients not on steroids (T2DM) for age, duration of diabetes, HbA1c, gender, and ethnicity. Results. Patients who developed NOSID had less family history of diabetes (P ≤ 0.05) and were less overweight (P ≤ 0.02). NOSID was more commonly treated with insulin. Despite a matching duration of diabetes and glycaemic control, significantly less retinopathy was found in the group of patients with NOSID (P < 0.03). Conclusions. It appears that steroid treatment primarily precipitated diabetes in a group of individuals otherwise less affected by risk factors of diabetes at that point in time, rather than just opportunistically unmasking preexisting diabetes. Furthermore, the absence of retinopathy suggests that patients with NOSID had not been exposed to long periods of hyperglycaemia. However, the impact of the underlying conditions necessitating steroid treatment and concomitant medications such as immunosuppressants on diabetes development remain to be defined.

No abstract

No abstract

Papillary thyroid microcarcinomas present both incidentally and non-incidentally, with equal prevalence. Non-incidental tumours not infrequently present with cervical lymph node disease. The patient outcome is generally excellent.

"Thyroid stunning" from diagnostic iodine-131 imaging prior to ablative therapy with (131)I for well-differentiated thyroid carcinoma has been well reported, but documentation of the effect on clinical outcome is sparse. The purpose of this retrospective study was to investigate the clinical effects of stunning. The outcome of (131)I ablative therapy in a group of patients ( n=36) who had diagnostic scans using 185 MBq (5 mCi) of (131)I was compared with that in a group ( n=36) who had diagnostic scans using 740 MBq (20 mCi) of (123)I. Patients were imaged at least 4 weeks after near-total thyroidectomy, prior to their first (131)I ablative therapy. Follow-up imaging was performed every 3-6 months, and further (131)I treatment administered when indicated. A group of patients ( n=36) who proceeded directly to their first therapy dose without a diagnostic scan and were followed up with (123)I was compared with the group who did have a (123)I diagnostic scan prior to the first ablative therapy. The efficacy of therapy was evaluated using ablation of the thyroid, evidenced by absence of uptake in the thyroid bed on the diagnostic scan, as the endpoint. Only 47% of patients in the (131)I diagnostic group had the thyroid gland ablated after a single administration of (131)I therapy, compared with 86% in the (123)I diagnostic group ( P<0.005). Patients who had (131)I diagnostic scans required higher total (131)I therapeutic activity (6.7 GBq or 180 mCi) to ablate the thyroid gland than those in the (123)I diagnostic group (4.4 GBq or 119 mCi). There was no difference in outcome between the group who did and the group who did not have a diagnostic study with (123)I prior to their first ablative therapy. The difference in outcome between the (131)I and the (123)I diagnostic groups demonstrates that the efficacy of (131)I therapy is reduced subsequent to the use of 185 MBq of (131)I for diagnostic imaging. This indicates that the phenomenon of stunning is clinically significant and affects the outcome of therapy.