The aims of this study were to evaluate: (1) associations of vitamin D with the presence/severity of Hashimoto’s thyroiditis (HT) and (2) correlations of vitamin D with thyroid-related phenotypes. ...Total 25(OH)D (vitamin D in the text) was measured from stored serum samples of 461 HT patients and 176 controls from a Croatian Biobank of HT patients (CROHT). (1) Vitamin D levels, and proportions of vitamin D deficiency, were compared between HT cases and controls. HT patients were additionally divided into two groups (MILD and OVERT) to take into account HT severity. (2) Correlations between vitamin D and 10 clinical phenotypes in all HT patients and two subgroups of HT patients were tested using the Spearman correlation test. Our analyses were adjusted for age, gender, BMI, smoking status and seasonality of blood sampling. (1) No significant differences in vitamin D levels, or proportions of vitamin D deficiency, were detected between HT patients of all disease stages and controls. However, a nominally significant difference in vitamin D levels between MILD and OVERT subgroups (OR = 1.038, p = 0.023) was observed. Proportions of individuals with vitamin D deficiency during winter–spring were high: all HT cases (64.69%), MILD (60.64%), OVERT (68.7%), controls (60.79%). (2) A nominally significant negative correlation between vitamin D and TSH in all HT patients (r = −0.113, p = 0.029) and a positive correlation between vitamin D and systolic blood pressure in OVERT HT patients (r = 0.205, p = 0.025) were identified. Our study indicates that there is no association between vitamin D and HT; however, there may be a subtle decrease in vitamin D levels associated with overt hypothyroidism.
Thyroid cancer is the predominant endocrine-related malignancy. ST6 β-galactoside α2,6-sialyltransferase 1 (ST6GAL1) has been studied in various types of cancers; however, the expression and function ...of ST6GAL1 in thyroid cancer has not been investigated so far. Previously, we conducted two genome-wide association studies and have identified the association of the ST6GAL1 gene with plasma thyroglobulin (Tg) levels. Since Tg levels are altered in thyroid pathologies, in the current study, we wanted to evaluate the expression of ST6GAL1 in thyroid cancer tissues. We performed an immunohistochemical analysis using human thyroid tissue from 89 patients and analyzed ST6GAL1 protein expression in papillary thyroid cancer (including follicular variant and microcarcinoma) and follicular thyroid cancer in comparison to normal thyroid tissue. Additionally, ST6GAL1 mRNA levels from The Cancer Genome Atlas (TCGA, n = 572) and the Genotype-Tissue Expression (GTEx) project (n = 279) were examined. The immunohistochemical analysis revealed higher ST6GAL1 protein expression in all thyroid tumors compared to normal thyroid tissue. TCGA data revealed increased ST6GAL1 mRNA levels in both primary and metastatic tumors versus controls. Notably, the follicular variant of papillary thyroid cancer exhibited significantly higher ST6GAL1 mRNA levels than classic papillary thyroid cancer. High ST6GAL1 mRNA levels significantly correlated with lymph node metastasis status, clinical stage, and reduced survival rate. ST6GAL1 emerges as a potential cancer-associated glycosyltransferase in thyroid malignancies, offering valuable insights into its diagnostic and prognostic significance.
Vitamin D insufficiency is a global health problem affecting healthy and diseased individuals, including patients with Hashimoto's thyroiditis (HT). Identifying dietary factors that may affect ...vitamin D levels and providing dietary guidelines accordingly can alleviate this problem. We therefore aimed to identify still unknown associations of dietary patterns, assessed through the Food Frequency Questionnaire (FFQ) with vitamin D blood levels.
FFQ was collected from 459 patients from Croatian Biobank of Patients with Hashimoto's thyroiditis (CROHT), while total 25(OH)D was measured from their stored serum samples. We performed linear regression analysis between vitamin D levels and weekly intake of 24 food groups in 459 patients with HT (ALL), and in two disease-severity groups (MILD and OVERT).
The main results of our study are observations of: (1) an inverse association between vitamin D levels and coffee consumption (ALL:
= -0.433,
= 0.005; OVERT:
= -0.62,
= 0.008); (2) an inverse association between vitamin D levels and sweets consumption (ALL:
= -0.195,
= 0.034; OVERT:
= -0.431,
= 0.006); (3) positive association between vitamin D levels and vegetable consumption (ALL:
= 0.182,
= 0.019; OVERT,
= 0.311,
= 0.009). Importantly, effect sizes of all three associations were more prominent in HT patients with prolonged and more severe disease (OVERT).
Further research into the functional and causal relationships of the observed associations is important to provide guidance regarding coffee/sugar intake on vitamin D status. A well-balanced diet can help prevent vitamin D deficiency and improve the quality of life of patients with HT, especially those in later stages of disease characterized by greater metabolic imbalance.
Purpose
To describe the parenchymal defects in kidneys with intrarenal reflux (IRR) diagnosed using contrast-enhanced voiding urosonography (ceVUS) and
99m
Tc-DMSA scintigraphy (DMSA scan).
Materials ...and Methods
A group of 186 uretero-renal units (URUs) was analyzed using ceVUS and DMSA scans: 47 without vesicoureteral reflux (VUR) (group A) and 139 with VURs, comprising 73 VURs without (group B), and 66 with IRR (group C). VURs included non-dilating (grades I–II), mildly non-dilating (grade III), and non-dilating (grades IV–V) grades. The parenchymal changes were analyzed using a DMSA scan.
Results
The median age for VUR diagnosis was 16.5 months in girls, and 8.5 months in boys (
Z
= 3.9;
p
= 0.001). IRR occurred in 51.4% of boys and in 25.9% of girls (χ
2
= 12.4;
p
< 0.001). The non-dilating VUR occurred in 44% of boys and 24.1% of girls (χ
2
= 7.7;
p
= 0.005). IRRs characterized upper and lower renal segments (81.8 and 63.6%) and middle segments (33.3%). Both incidence and increase in IRR correlated with the grade of VUR (
p
< 0.001). The incidence of reduced DMSA signal was statistically different among groups A + B and C, but not between groups A and B (χ
2
= 32.2;
p
< 0.001). No statistically significant relationship existed between the reduced DMSA signal and the grade of VUR in group C. The reduced DMSA signal appeared in 9.9% positions in kidneys from group A, 14% from group B, and 32% from group C. Out of all 118 IRRs, 38.1% had reduced and 61.9% had normal DMSA signal. Among 11 parenchymal scars found in all three groups, 2 belonged to group B, 9 to group C, while group A had no scars.
Conclusion
The parenchymal changes are the most prominent in the group with IRR, but they do not significantly differ among kidneys with different grades of VUR. VURs of higher grades are associated with a higher incidence of IRR and early clinical presentation. Scars can also appear in lower-grade VURs accompanied by IRR. Boys with VUR have earlier clinical presentation than girls, as they have significantly higher grades of VUR with a higher proportion of IRRs. Therefore, we suggest a subdivision of VURs into those with IRR and abundant parenchymal damage, and those without IRR and less parenchymal damage.
Background: Expression of the epidermal growth factor receptor (EGFR) and human papillomavirus (HPV) DNA can serve as independent prognostic factors in squamous cell carcinoma (SCC) of the larynx. ...EGFR correlation with the course of disease and its effect on survival makes EGFR expression a negative prognostic factor, whereas HPV DNA is a positive prognostic factor.
Aim: To assess the association of EGFR expression with clinical outcome of laryngeal HPV SCC.
Materials and methods: This retrospective study included 196 SCC patients operated on at the Department of ENT, Head and Neck Surgery, Split University Hospital Center in Split, Croatia, between 1 January 2000 and 31 December 2009.
Results: The association of HPV infection and EGFR expression was found to be statistically significant, and so was the difference in survival between patient groups with different HPV to EGFR expression ratio.
Conclusions: The group of laryngeal HPV SCC patients with increased EGFR expression had shorter survival, confirming EGFR as a major component in predicting patient prognosis and survival.
Significance: This article confirms the importance of EGFR expression as a biomarker in laryngeal SCC.
Thyroid gland carcinoma causing tumor thrombus in the great veins of the neck and mediastinum is a rare condition with poor prognosis. Invasion of the internal jugular vein by thyroid gland carcinoma ...has been occasionally reported, but tumor thrombi extending to the great veins of the mediastinum are reported extremely rarely. We present a treatment approach in a case of follicular thyroid carcinoma intravascular tumor thrombus in the left internal jugular and left brachiocephalic vein.
Lymphoscintigraphy is not considered as a first line diagnostic procedure in abdominal or thoracic lymphorrhea of various origin. We report a patient with lymphangiectasia in whom posttraumatic ...lymphorrhea was diagnosed by lymphoscintigraphy only after third attempt when we applied pushups exercise with the aim to raise venous pressure and thus provoke lymph backflow in ductus thoracicus and enteric lymphytics. Lymphorrhea was clearly visible in colon ascendens and colon transversum on 9h planar scintigram. We propose exercise lymphoscintigraphy with exercise tailored to individual patient's possibility before each lymphoscintigram to enhance lymphorrhea detection in patients with suspected lymph leakage.
Diffuse toxic goiter, as the most common cause of hyperthyroidism, is usually initially treated with thyrostatic drugs such as methimazole, followed by radioiodine therapy or surgery which may be ...indicated as definitive treatment. Radioactive iodine therapy has a known association with various histopathologic features including cytologic atypia, but herein we present a rare example of morphological thyrocyte changes induced by long-term pharmacological treatment with methimazole that mimicked thyroid malignancy in a pathohistological sample.
- The purpose of this study was to analyze the possible prognostic value of RET mutation in papillary thyroid carcinoma and its incidence in the past few decades in our population, due to the ...increasing incidence of papillary thyroid carcinoma. The present study included 180 patients operated for papillary thyroid carcinoma. The clinical and histopathologic characteristics were analyzed. Paraffin sections of the selected histologic slides were cut again and immunohistochemically stained by the Clone 3F8 P (HIER) from Novocastra (Vision Bio Systems Europe, Newcastle upon Tyne, UK) monoclonal antibody to RET oncoprotein. Univariate analysis indicated sex (p=0.01), histologic subtype (p=0.075) and capsular invasion (p=0.010) to be statistically significant predictors of lymph node metastases, whereas age (p=0.796), tumor size (p=0.556) and intraglandular dissemination (p=0.131) showed no such correlation. The presence of RET mutation (p=0.704) was not a statistically significant predictor of the tumor metastasizing potential. RET mutation (p=0.500) showed no statistically significant correlation with papillary thyroid carcinoma classifed into prognostic groups according to clinicopathologic features either. RET mutation was detected in 30% of 180 papillary thyroid carcinomas. This is the first large study demonstrating that RET mutation incidence in papillary thyroid carcinoma in Croatian population is consistent with the classic distribution of sporadic cases, despite the increased prevalence of papillary thyroid carcinoma in the past few decades.
Th e aim of the study was to determine the influence of RET, p27 and cyclin D1
on regional lymph node metastases in papillary microcarcinoma. The analysis included 70 patients
with papillary thyroid ...microcarcinoma that underwent surgery at Split University Hospital Center
between 1999 and 2001. Immunohistochemistry was performed on formalin-fixed, paraffin-embedded
tissue by the RET, p27 and cyclin D1 antibodies. Quantification was based on the intensity and
distribution of nuclear staining, dividing tumors into those that showed expression (expressors) and
those that showed no expression (non-expressors). Univariate analysis using χ²-test and Fisher exact
test was performed with the level of statistical significance set at p<0.05. There was no statistically
significant difference in the incidence of metastases according to the expression or non-expression of
RET mutation (χ²-test: p=0.459; Fisher exact test: p=0.672). Among 25 cases with cyclin D1 expression,
6 had metastases, whereas only 2 of 45 cases with no cyclin D expression had metastases (χ²-test:
p=0.014; Fisher exact test: p=0.021), indicating that the expression of cyclin D1 is not crucial for the
development of metastases in lymph nodes. In contrast, analysis of p27 expression showed it to be
significantly associated with lymph node metastasis because 3 of 45 patients with p27 expression had
metastases, indicating a statistically significant correlation between p27 expression and lymph node
metastases (χ²-test: p=0.093; Fisher exact test: p=0.124). This study confirmed the importance of the
evaluation of RET, p27 and cyclin D1 expression and demonstrated the validity of their application in
the assessment of microcarcinoma behavior.
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