A positive pertechnetate scan is, therefore, sufficient to guide progression to I-131 ablation in most patients. Pertechnetate scintigraphy may be of particular benefit if it is considered desirable to avoid use of I-131 in post-thyroidectomy remnant imaging. Tg level is an important parameter in the detection of remnant thyroid tissue in patients with DTC.
To examine the effects of multidisciplinary approach and adjunct methods, on the surgical strategy, complications and treatment success of parathyroid surgery.
Patients, who were operated for primary hyperparathyroidism (n = 411) at our institution between 2012 and 2019 were reviewed retrospectively. Preoperative imaging studies, surgical method, additional diagnostic methods used during surgery, frozen section results, and histopathology findings, complications, persistence, and recurrence were examined.
Localization was determined by first-line examinations in 79.9% (n = 348). Four-dimensional computed tomography was used with an 83.3% success rate. Lateralization success for angiographic selective venous sampling was 80.3% and exact localization success was 65.1%. Bilateral neck exploration was performed in 10.6% (n = 37) of the patients, and in the remaining 89.4% (n = 311), minimally invasive parathyroidectomy (MIP) was performed. While the complication rate was higher in the bilateral neck exploration group (
P
= .019), persistence and recurrence rates were similar between 2 groups. During the study period, annual case volume increased from 9 cases to 103 cases (
P
< .001) and the rate of MIP increased from 44.4% to 92.8% over the years (
P
< .001).
Effective use of adjunct techniques has increased the rates of MIP. The multidisciplinary approach has also provided low complication rates with the increasing number of cases.
In addition to its role in serum calcium homeostasis, the anti-tumor function of 1,25-dihydroxyvitamin D 3 (calcitriol) in cancer development is well established. N-myc Downstream Regulated Gene 2 which functions as a tumor suppressor gene has recently been shown to be downregulated in various cancer leading to increased tumor incidence, progression and metastasis. The goal of this study was to investigate the possible effects of calcitriol treatment on NDRG2 expression in BCPAP papillary thyroid carcinoma cells.
Methods:The experiments were carried on human primary thyroid follicular epithelial cells (Nthy-ori-3-1), and human papillary thyroid carcinoma cells (BCPAP). The half maximal inhibitory concentration (IC 50 ) of calcitriol on BCPAP cells was determined by WST-1 assay. BCPAP cells were treated with 15 and 30µM calcitriol for 24, 48, and 72 hours, respectively. Basal NDGR2 expression in Nthy-ori-3-1 and BCPAP cells as well as the alterations on NDRG2 expression in calcitriol treated BCPAP cells were evaluated with western blot.Results: A significant downregulation of NDRG2 was observed in BCPAP cells when compared to Nthy-ori-3-1 cells (p<0.01). IC 50 dose of calcitriol was found to be 64, 54 and 43µM for 24, 48 and 72 hours, respectively. NDRG2 protein expression levels were significantly increased in 30µM calcitriol treated BCPAP cells after 48 hours (p<0.05).Conclusions: Calcitriol induced NDRG2 protein expression in BCPAP cells. We predict that calcitriol increased NDRG2 protein levels in BCPAP cells via c-Myc repression, which is upregulated by aberrant Wnt/β-catenin signaling. Further investigation is required to enlighten the possible effect mechanisms of calcitriol in BCPAP cells.
As a result; we can see that all the SPSMs give reliable results in measuring GFR in cases with renal transplantation; besides, we suggest Groth&Aasted method as the first option.
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