Papillary cancer of the thyroid. A review of 25 years of experience

Frazell, Edgar L.; Foote, Frank W.

doi:10.1002/1097-0142(195809/10)11:5<895::aid-cncr2820110506>3.0.co;2-v

Cited by 179 publications

(44 citation statements)

References 12 publications

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“…Mazzaferri, however, has reported a mean patient age of 32.3 years in his US Air Force study. 36 Several series have reported female predominance (62% to 81%) from both the United States 37,38 and Europe [39][40][41] but considerably less than the female to male ratios ranging from 9:1 to 13:1 reported from Japan. 42,43 In our series, the female to male ratio for PC of 2.6:1 is in keeping with the American and European experience.…”

Section: Discussionmentioning

confidence: 99%

“…42,43 In our series, the female to male ratio for PC of 2.6:1 is in keeping with the American and European experience. [37][38][39][40][41] Over the years, we have witnessed a substantial increase in the number of TC cases seen at our center. The observed increase in the number of TC patients at our institution is explained predominantly by an increase in the number of patients with PC along with a decrease in the number of patients presenting with FC.…”

Section: Discussionmentioning

confidence: 99%

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A Study of 875 Cases of Thyroid Cancer Observed Over a Fifteen-Year Period (1975–1989) at the King Faisal Specialist Hospital and Research Centre

Ahmed

Al-Saihati²,

Greer³

et al. 1995

Annals of Saudi Medicine

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Thyroid cancer (TC) is a common malignancy encountered at King Faisal Specialist Hospital and Research Centre (KFSH&RC). Of 19,885 different malignant tumors seen during the period from 1975 to 1989, there were 875 cases (4.4%) of TC. Of 1374 tumors of endocrine glands seen during the same period, 67% were thyroid neoplasms. TC represented 7.5% (618 cases) of all neoplasms in the females, second only to breast cancer. All types of TC were seen, with papillary thyroid carcinoma (PC) being the most common (79%). Anaplastic, medullary, follicular (FC), malignant lymphoma and Hürthle cell cancer accounted for 5.4%, 5.3%, 4.3%, 3.6% and 0.9% respectively. The frequency of PC was very similar (16%) in each of the third, fourth and fifth decades. The relative frequency (RF) of different types of TC was highest for PC with a ratio of 18:1 between PC and FC, which could be the highest ever reported. There was a clearly progressive increase in the number of thyroid tumors referred between 1975 and 1989. Although this increase was evident for both sexes, it was more apparent for females. There was also a distinct increase ( P<0.01) in the RF of PC from 76% (1975 to 1980) to 85% (1986 to 1989) Fifteen-Year Period (1975 at the King Faisal Specialist Hospital and Research Centre. 1995; 15(6): 579-584 Differentiated thyroid cancer (DTC) is a relatively common malignancy with a marked international variation in the incidence of the disease. Limited data are available on the incidence and clinicopathological features of TC from the Middle East.1-23 Pertinent information regarding the demographic, epidemiological, clinical and pathological features of TC from Saudi Arabia is needed to determine the prognostic factors and to develop effective management strategies.Information on the geographical distribution of cancer has been of great value for generation of epidemiologic hypothesis and formulation of concepts for the etiology of cancer. Such information would also be valuable for making global comparisons. Until a population-based tumor registry is established in Saudi Arabia and the figures for TC made available, the only other recourse is to analyze the experience emanating from large referral centers. It is in this context that we have embarked on a study of 928 consecutive cases of thyroid tumors, observed over a 15-year period (1975 to 1989) at the King Faisal Specialist Hospital and Research Centre. The specific aims of this work were: 1) To analyze the demographic features of patients with TC seen at our institution since its inception in 1975. 2) To classify and determine the crude relative frequency (CRF) of different thyroid tumors seen at KFSH&RC between 1975 and. CRF is the proportion of a given type of cancer in relation to all cases in a clinical or pathological series. 3) To determine any possible trend in the CRF of different types of TC seen at our institution. Patients and MethodsSince its inception in November 1975, we have had 1500 cases of thyroid tumors at KFSH&RC. However, this

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Study of 875 Cases of Thyroid Cancer Observed Over a Fifteen-Year Period (1975–1989) at the King Faisal Specialist Hospital and Research Centre

Ahmed

Al-Saihati²,

Greer³

et al. 1995

Annals of Saudi Medicine

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“…Twelve of these patients had lung metastases and had received cumulative radioiodine treatment doses of 500-800 mCi (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) GBq). The aerosol study was done in the morning prior to treatment with radioiodine (off thyroxine for 5 weeks) in the afternoon, the last treatment dose being about six months previously.…”

Section: Methodsmentioning

confidence: 99%

Clinical studies of alveolar-capillary permeability using technetium-99m DTPA aerosol

Sundram

1995

Ann Nucl Med

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Soluble radioaerosols such as technetium-99m diethylene triamine pentacetate (DTPA) permit simple quantitative studies of alveolar-capillary permeability to be performed, since the submicronic aerosols are deposited mainly at the lung periphery and are cleared across the alveolar-capillary membrane. Regional alterations in permeability can also be noted using this radionuclide technique. We have measured the pulmonary epithelial permeability in normal subjects and the alteration in smokers, in glue-sniffers, in patients with inhalation burns, in chronic obstructive pulmonary disease (COPD) and in patients with lung metastases from thyroid cancer treated with radioiodine 131I. In the normal volunteers, the time taken for 50% of inhaled 99mTcDTPA to be cleared form the lungs (T1/2) was 66 minutes +/- 1sd of 12 mins. The smokers had a mean T1/2 of 20 mins +/- 1sd 4 min. In the hard-core glue-sniffing group, the majority were smokers who had stopped smoking and glue-sniffing for periods varying from 1 day to 42 days, and it was possible to note the changes in clearance times against period of abstinence. In the patients with inhalations burns, there was change in lung clearance arising from pulmonary epithelial damage; these patients showed increased rate of clearance (short T1/2) with mean T1/2 of 36 min +/- 1sd of 11 mins, while the retention images revealed regional lung damage in moderately severe inhalation burns. Twenty-four patients with COPD had inhalation scans done with Tc-99m tin colloid radioaerosol, and these images were compared with the perfusion lung scans done with 99mTc macroaggregated albumin (MAA); in general the perfusion images matched the defects noted in the inhalation scans. The 99mTc DTPA clearance rate in these patients was normal i.e. T 1/2 = 78 +/- 14 mins. In the thyroid cancer patients with lung metastases, who had high doses of radioiodine treatment, the T 1/2 values were normal or prolonged slightly, mean T1/2 = 76 min +/- 23.

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“…Follicular carcinomas disseminate widely in the bloodstream, whereas papillary carcinomas spread locally via lymphatics (Frazell & Foote, 1958). Experimental transformation of non-tumorigenic rodent fibroblast lines with an activated Ha-ras gene has been shown to confer ability to metastasise via the bloodstream (Muschel et al, 1985) and to increase production and secretion of proteases such as cathepsin L which are likely to contribute to this process (Denhardt et al, 1987).…”

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confidence: 99%

Papillary and follicular thyroid carcinomas show a different pattern of ras oncogene mutation

Wright

Lemoine²,

Mayall³

et al. 1989

Br J Cancer

104

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In a small initial study of oncogene activation in differentiated thyroid cancer, using DNA transfection and tumorigenicity assays, we identified activating ras mutations in 80% (4/5) of follicular carcinomas, but in only 20% (2/10) of papillary carcinomas (Lemoine et al., 1988). However, Suarez et al. (1988), using the 'focus' transformation assay, reported two out of a total of three papillary carcinomas to have activated ras oncogenes, while Fusco et al. (1987), also using DNA transfection techniques, failed to find any activating ras mutations in 20 papillary cases analysed. These conflicting results indicated the need for further study of the prevalence of ras mutations in thyroid cancer.We now report a further series of papillary carcinomas, analysed by polymerase chain reaction (PCR) amplification and oligonucleotide probing of archival material, and summarise our data on the incidence and type of mutation in a total of 33 differentiated thyroid carcinomas.Wax-embedded tissue blocks of eight papillary thyroid carcinomas (up to 7 years old) were obtained from the archives of the Department of Pathology, University of Wales College of Medicine. Sections of 5.m were deparaffinised twice with xylene, washed twice with ethanol and vacuum desiccated (Shibata et al., 1988). Dried pellets were mixed with sterile water, denatured for 10 min at 95°C and rapidly cooled to 4'C. PCR incubations were prepared with a Perkin Elmer/Cetus Gene Amp kit according to the manufacturers' protocol. Final concentrations were 10 mM Tris pH 8.3, 50 mM KCI, 1.5 mM MgCl2, 0.2 mM of each dNTP, 1 tIM of each of a pair of amplimers and 2.5 units of Taq DNA polymerase (Saiki et al., 1986). Amplimers were 20 bases long, each pair enclosing an amplified region of 100 bp. Samples received 50 cycles of amplification in a Cetus thermal cycler, with 1 min denaturation at 94°C, 2.5 min annealing at 55'C and 3 min extension at 72°C. A 10 pl aliquot of each incubation was run on a 2.5% agarose gel to check for specific amplification, and reactions were repeated until sharp single bands were obtained.After an initial quantitation, 5-12gdl of each PCR-amplified mixture was diluted to 200 t l I in 1O mM Tris pH 8.0/ 1 mM EDTA, denatured at 95°C for 5 min and cooled rapidly to 4'C. Replicate slotblots, prepared using Hybond-N filters (Amersham) and a Millipore vacuum slotblot apparatus were prehybridised at 56°C for 30 min in 3 M tetramethylammonium chloride (TEMAC)/50 mM Tris pH 7.5/2 mM EDTA/0.3% SDS/5 x Denhardts solution, 100 flg ml-' denatured herring sperm DNA (Wood et al., 1985). Filters were hybridised for 1-2 h at 56°C with 32P-endlabelled 20mer oligonucleotide probes specific for mutations altering aminoacids at the 12, 13, and 61 positions of each of the three human ras genes. As a check on quantitation, filters were first autoradiographed after non-stringent washes in 2 x SSPE/0.1% SDS at room temperature. They were then Correspondence:

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Papillary cancer of the thyroid. A review of 25 years of experience

Cited by 179 publications

References 12 publications

A Study of 875 Cases of Thyroid Cancer Observed Over a Fifteen-Year Period (1975–1989) at the King Faisal Specialist Hospital and Research Centre

A Study of 875 Cases of Thyroid Cancer Observed Over a Fifteen-Year Period (1975–1989) at the King Faisal Specialist Hospital and Research Centre

Clinical studies of alveolar-capillary permeability using technetium-99m DTPA aerosol

Papillary and follicular thyroid carcinomas show a different pattern of ras oncogene mutation

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