The first postoperative-stimulated serum thyroglobulin is a prognostic factor for thyroid microcarcinomas

Publication date: Available online 31 October 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Isabela de Oliveira Amui, José Vicente Tagliarini, Emanuel C. Castilho, Mariângela de Alencar Marques, Yoshio Kiy, José Eduardo Corrente, Gláucia M.F.S. Mazeto
IntroductionEndogenous thyroid-stimulating hormone-stimulated thyroglobulin collected after total thyroidectomy is a useful predictor of better prognosis in patients with differentiated thyroid carcinomas in general, but studies with microcarcinomas are scarce.ObjectiveTo assess whether the first postoperative stimulated thyroglobulin measurement is a prognostic factor in patients with microcarcinoma.MethodsThe medical data of 150 differentiated thyroid carcinoma patients were studied retrospectively, and 54 (36%) cases with microcarcinoma were selected. The first postoperative stimulated thyroglobulin (1st stimulated thyroglobulin), measured after thyroidectomy, initial presentation data, and microcarcinomas treatment were assessed regarding outcome. Worse prognosis was defined as neoplasm persistence/recurrence.ResultsPersistence/recurrence occurred in 27.6% of the cases. These patients were identified according to the following parameters: receiving more than one ¹³¹iodine dose (100% vs. 0%; p<0.0001); accumulated ¹³¹iodine dose (232.14±99.09 vs. 144±33.61mCi; p<0.0001); presented active disease in the last assessment (53.3% vs. 0%; p<0.0001); follow-up time (103.07±61.27 vs. 66.85±70.14 months; p=0.019); and 1st stimulated thyroglobulin (19.01±44.18 vs. 2.19±2.54ng/dL; p<0.0001). After multivariate logistic regression, only the 1stSTg [odds ratio=1.242; 95% confidence interval: 1.022–1.509; p=0.029] and follow-up time (odds ratio=1.027; 95% confidence interval: 1.007–1.048; p=0.007) were independent predictors of risk of persistence/recurrence. The cutoff point of 1.6ng/dL for the 1st stimulated thyroglobulin was significantly associated with disease persistence/recurrence [area under the curve=0.713 (p=0.019)].ConclusionThe first stimulated thyroglobulin predicted disease persistence/recurrence in patients with microcarcinoma.



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Downregulation of Notch4 – a prognostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma

Publication date: Available online 31 October 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): M.K. Harishankar, A. Mathan Mohan, A. Vinod Krishnan, Devi Arikketh
IntroductionOral verrucous carcinoma is a special form of well-differentiated squamous cell carcinoma which possesses specific clinical, morphologic and cytokinetic features that differ from other types of oral cancers and hence diagnosis requires immense experience in histopathology. Hence it is certainly important to distinguish such a lesion from other oral tumors as treatment strategies vary widely between them.ObjectiveIn search of a critical diagnostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma, Notch4 receptor, one of the key regulatory molecules of the Notch signaling family has been aberrantly activated in the progression of several types of tumors. However its function in oral verrucous carcinoma remains unexplored. Thus the present study aims in determining the differential expression pattern of Notch4 in oral verrucous carcinoma and oral squamous cell carcinoma.MethodsTen patients reported positive for oral cancer (5 patients with oral verrucous carcinoma and 5 patients with oral squamous cell carcinoma). Five normal tissue samples were also obtained and evaluated for clinicopathological parameters and immunohistochemistry, western blotting and RT-PCR for Notch4 expression.ResultsOur results reveal that the expression of Notch4 was considerably high in oral squamous cell carcinoma lesions compared to normal tissue, whereas in oral verrucous carcinoma, irrespective of the clinicopathological features, complete regulação descendente of Notch4 was observed.ConclusionsThese preliminary findings strongly support the fact that Notch4 is downregulated in oral verrucous carcinoma and could be considered as a suitable prognostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma. This distinguishing marker can help in improving therapeutic options in patients diagnosed with oral verrucous carcinoma.



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The first postoperative-stimulated serum thyroglobulin is a prognostic factor for thyroid microcarcinomas

Publication date: Available online 31 October 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Isabela de Oliveira Amui, José Vicente Tagliarini, Emanuel C. Castilho, Mariângela de Alencar Marques, Yoshio Kiy, José Eduardo Corrente, Gláucia M.F.S. Mazeto
IntroductionEndogenous thyroid-stimulating hormone-stimulated thyroglobulin collected after total thyroidectomy is a useful predictor of better prognosis in patients with differentiated thyroid carcinomas in general, but studies with microcarcinomas are scarce.ObjectiveTo assess whether the first postoperative stimulated thyroglobulin measurement is a prognostic factor in patients with microcarcinoma.MethodsThe medical data of 150 differentiated thyroid carcinoma patients were studied retrospectively, and 54 (36%) cases with microcarcinoma were selected. The first postoperative stimulated thyroglobulin (1st stimulated thyroglobulin), measured after thyroidectomy, initial presentation data, and microcarcinomas treatment were assessed regarding outcome. Worse prognosis was defined as neoplasm persistence/recurrence.ResultsPersistence/recurrence occurred in 27.6% of the cases. These patients were identified according to the following parameters: receiving more than one ¹³¹iodine dose (100% vs. 0%; p<0.0001); accumulated ¹³¹iodine dose (232.14±99.09 vs. 144±33.61mCi; p<0.0001); presented active disease in the last assessment (53.3% vs. 0%; p<0.0001); follow-up time (103.07±61.27 vs. 66.85±70.14 months; p=0.019); and 1st stimulated thyroglobulin (19.01±44.18 vs. 2.19±2.54ng/dL; p<0.0001). After multivariate logistic regression, only the 1stSTg [odds ratio=1.242; 95% confidence interval: 1.022–1.509; p=0.029] and follow-up time (odds ratio=1.027; 95% confidence interval: 1.007–1.048; p=0.007) were independent predictors of risk of persistence/recurrence. The cutoff point of 1.6ng/dL for the 1st stimulated thyroglobulin was significantly associated with disease persistence/recurrence [area under the curve=0.713 (p=0.019)].ConclusionThe first stimulated thyroglobulin predicted disease persistence/recurrence in patients with microcarcinoma.



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The first postoperative-stimulated serum thyroglobulin is a prognostic factor for thyroid microcarcinomas

Publication date: Available online 31 October 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Isabela de Oliveira Amui, José Vicente Tagliarini, Emanuel C. Castilho, Mariângela de Alencar Marques, Yoshio Kiy, José Eduardo Corrente, Gláucia M.F.S. Mazeto
IntroductionEndogenous thyroid-stimulating hormone-stimulated thyroglobulin collected after total thyroidectomy is a useful predictor of better prognosis in patients with differentiated thyroid carcinomas in general, but studies with microcarcinomas are scarce.ObjectiveTo assess whether the first postoperative stimulated thyroglobulin measurement is a prognostic factor in patients with microcarcinoma.MethodsThe medical data of 150 differentiated thyroid carcinoma patients were studied retrospectively, and 54 (36%) cases with microcarcinoma were selected. The first postoperative stimulated thyroglobulin (1st stimulated thyroglobulin), measured after thyroidectomy, initial presentation data, and microcarcinomas treatment were assessed regarding outcome. Worse prognosis was defined as neoplasm persistence/recurrence.ResultsPersistence/recurrence occurred in 27.6% of the cases. These patients were identified according to the following parameters: receiving more than one ¹³¹iodine dose (100% vs. 0%; p<0.0001); accumulated ¹³¹iodine dose (232.14±99.09 vs. 144±33.61mCi; p<0.0001); presented active disease in the last assessment (53.3% vs. 0%; p<0.0001); follow-up time (103.07±61.27 vs. 66.85±70.14 months; p=0.019); and 1st stimulated thyroglobulin (19.01±44.18 vs. 2.19±2.54ng/dL; p<0.0001). After multivariate logistic regression, only the 1stSTg [odds ratio=1.242; 95% confidence interval: 1.022–1.509; p=0.029] and follow-up time (odds ratio=1.027; 95% confidence interval: 1.007–1.048; p=0.007) were independent predictors of risk of persistence/recurrence. The cutoff point of 1.6ng/dL for the 1st stimulated thyroglobulin was significantly associated with disease persistence/recurrence [area under the curve=0.713 (p=0.019)].ConclusionThe first stimulated thyroglobulin predicted disease persistence/recurrence in patients with microcarcinoma.



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Genetic Hearing Loss: A Comprehensive Review

Hearing loss can be attributed to a variety of inherited and environmental noises (medications, infections, etc.). In recent decades, our improved understanding of genetics, molecular biology, and audiologic pathways has led to the discovery of a variety of Hereditary Hearing Impairments (HHI). HHI can be categorized as syndromic HL and non-syndromic HL, in which HL is associated with other pathophysiological manifestations. Currently, greater than 300 syndromic HLs are recognized, while more than 100 chromosomal loci and 40 genes are attributed for non-syndromic HLs. Improved understanding of the genes impaired in HL, including their structure and function, will soon lead to improvements in screening and possibly treatments. The following is a review of genetic HL where we discuss the definition, classifications, etiology, epidemiology, recognized syndromes, genetics, diagnostics, and screening methods of HL.

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Ménière's Disease: Current and Potential New Objective Measures Using Electrocochleography

The characteristic manifestations of Ménière's disease (MD) are mainly subjective, making MD difficult for physicians to diagnose without objective confirmation. A classic electrophysiologic technique for objective diagnosis of MD is electrocochleography (ECochG) to slow stimulus rates. This review will provide information regarding the sensitivity, specificity, and limitations of the conventional click and frequency specific ECochG measures. In addition, the paper will discuss two novel, promising techniques: fast click ECochG with the use of continuous loop averaging deconvolution (CLAD) and the auditory nerve overlapped waveform (ANOW). These new techniques may offer a new way in diagnosing MD through assessing neural adaptation and function of the apical half of the cochlear spiral.

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Coordinator's Column

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