DNA damage repair in bladder urothelium after the Chernobyl accident in Ukraine

PURPOSE: We determined whether base and nucleotide excision repair is activated in bladder urothelium by chronic persistent low doses of ionizing radiation in male patients with benign prostate hyperplasia and females with chronic cystitis living more than 15 years in Cs contaminated areas after the Chernobyl accident in Ukraine. MATERIALS AND METHODS: Bladder urothelial biopsies from 204 patients were subjected to histological examination and biopsies from 35 were subjected to immunohistochemical study of 8-hydroxy-2'deoxyguanosine, 8-oxoguanine-DNA-glycosylase, apurinic/apyrimidinic endonuclease and xeroderma pigmentosum A endonuclease. RESULTS: Chronic proliferative atypical cystitis with multiple foci of dysplasia and carcinoma in situ were observed in 139 (89%) and in 91 (58%) of 156 group 1 patients from radio contaminated areas, respectively, as well as 10 small transitional cell carcinomas. Chronic cystitis with areas of dysplasia was detected in 9 of 48 patients (19%) in control group 2 from clean (without radio contamination) areas of Ukraine. Greatly elevated levels of 8-hydroxy-2'deoxyguanosine, 8-oxoguanine-DNA-glycosylase, apurinic/apyrimidinic endonuclease and xeroderma pigmentosum A were evident in the urothelium in group 1, accompanied by increased Cs in the urine. CONCLUSIONS: These findings support the hypothesis that significant activation of DNA damage repair (base and nucleotide excision repair) is induced by the oxidative stress generated by long-term low doses of ionizing radiation. The levels of DNA oxidative adducts pointing to mutagenic and carcinogenic potential were in line with the histopathologically diagnosed urothelial lesions.     

Utilization of Total Thyroidectomy for Differentiated Thyroid Cancer in Children

Purpose  

Recent recommendations suggest that total thyroidectomy (TT) is the surgical management of choice for differentiated thyroid cancer in children. The objective of this study is to assess trends in extent of surgical resection for differentiated thyroid cancer in children over the past two decades and to identify patient, tumor or hospital factors associated with use of TT.     

Clinical Analysis of Thyroid Cancer in Adult Patients Exposed to Ionizing Radiation due to the Chernobyl Nuclear Accident: 5-Year Comparative Investigations Based on the Results of Surgical Treatment

The aim of study was to compare clinical and pathologic findings of surgically removed thyroid tumors in adults with or without history of irradiation due to the Chernobyl accident. From 1990 to 2003, 2363 adults with no evidence of radiation influence in their history (group A) have undergone operation for thyroid nodules. During the same period, 311 patients (born before 1969) with strict evidence of Chernobyl irradiation also underwent operation (group B). Both groups were similar in age, sex, and preoperative examination. Group B represented three of the four official categories of people affected by the Chernobyl accident: 1–recovery operation workers; 2–people evacuated from the restricted area; 3–inhabitants of contaminated areas. The rate of thyroid carcinoma among all cases of thyroid nodules was significantly higher in group B—32.8% (102 patients) versus 27.2% (644 patients) in group A (p < 0.05). But a more distinct difference was observed in 1 and 2 categories of group B patients (the rate of cancer was, correspondingly, 54.8% and 47.8%; p < 0.01). The percentage of the invasive form of cancer (T₄) was significantly higher in irradiated patients–39% versus 23% (p < 0.05) as were regional metastases (N_1a-1b)—41% versus 19% (p < 0.01) and frequency of multifocality (33% versus 24%; p < 0.05). The most distinguished features were found in 1 category of group B: T₄—in 47%, N_1a-1b —in 62%, multifocality—in 41%. Our results suggest the irradiation as a cause of thyroid cancer in adult victims of Chernobyl and confirm the increasing aggressiveness of such tumors.This article was presented at the International Association of Endocrine Surgeons meeting, Uppsala, Sweden, June 14–17, 2004.     

甲状腺结节手术中或手术后意外发现甲状腺癌的合理处理

临床上以甲状腺结节为主要表现的疾病包括甲状腺退行性变、自身免疫性炎症、炎症、肿瘤等。随着高分辨率超声检查的普及,甲状腺结节的检出率高达19%~67%,其中5%~15%的结节为甲状腺     

Epidemiologic and Clinical Evaluation of Thyroid Cancer in Children from the Gomel Region (Belarus)

p = 0.001); there was no significant correlation between the age of each child at the time of the accident and the latent period before the onset of carcinoma. The aggressiveness of the tumor, evaluated on the basis of T stage, lymph node status, and lung metastases, did not correlate with age at the time of the first diagnosis or with the age at the time of the accident. The susceptibility of the thyroid to the carcinogenetic effects of radiation, particularly during the first years of life (< 5 years) has clearly been demonstrated. However, there appears to be no correlation between the aggressiveness of the tumor and the age of the patients.     

Improved Survival of Patients with Papillary Thyroid Cancer after Surgical Microdissection

World Journal of Surgery -     

Long-Term Outcome in 215 Children and Adolescents with Papillary Thyroid Cancer Treated During 1940 Through 2008

Background  

Controversy exists regarding the aggressiveness of initial therapy in childhood papillary thyroid cancer (PTC). Few studies with long-term outcome exist and second primary malignancies have rarely been analyzed.     

甲状腺癌的基因治疗

甲状腺癌是内分泌系统最常见的恶性肿瘤,虽然绝大多数甲状腺癌能通过手术和131I治疗获得治愈,但仍有10%～20%病人因低分化和进展性肿瘤而死亡。甲状腺髓样癌和未分化癌的预后则更差。放疗和化疗对于甲状腺癌的疗效都较差,甚至无作用。随着分子生物学技术的发展,基因治疗正在广泛开展,这可能是消灭肿瘤的治本之路,而甲状腺癌尤其适合基因治疗,其原因有二:①甲状腺癌组织中表达的某些启动子,如甲状腺球蛋白、促甲状腺激素(TSH)受体、降钙素等在其他组织中很少表达或不表达,基因治疗的针对性强;②即使基因治疗破坏了全部甲状腺组织,但对比肝…     

Predictive Factors for Recurrence from a Series of 74 Children and Adolescents with Differentiated Thyroid Cancer

The influence of clinical and treatment factors on the risk of recurrence was analyzed from a retrospective series of 74 children and adolescents with thyroid cancer (55 girls, 19 boys; age 2–20 years). Two groups, comparable in terms of age, sex, and previous radiotherapy, were compared according to the presence (group 1) or absence (group 2) of cervical lymph nodes identified by palpation or ultrasonography. Total thyroidectomy (TT) with lymph node dissection (LND) was performed in the 19 group 1 patients, whereas in group 2 patients (n = 55) lobectomy was performed in 29, TT in 26, and LND in 7. Pathology studies showed papillary thyroid carcinoma in 95% of cases. In group 1, tumors were more frequently multifocal (89% vs. 16% in group 2), invasive with extension beyond the thyroid capsule (68% vs. 5% in group 2), and of the diffuse sclerosing variety (63% vs. 4% in group 2) (p < 0.001). With a median follow-up of 61 months, lymph node recurrence was seen in 53% of group 1 patients and in no patients in group 2. Three group 2 patients (10%) were reoperated for a local recurrence after lobectomy. Risk factors for reintervention were young age (< 15 years) (p < 0.01) and cervical lymph nodes (p < 0.001). Survivals without reintervention at 5 and 10 years were, respectively, 58% and 38% for group 1 and 94% and 90% for group 2 (p < 0.001). At the time of analysis, 68% of group 1 patients and 98% of group 2 patients were in remission. In conclusion, the presence of palpable cervical lymph nodes at diagnosis is associated with more invasive forms of malignancy and is a predictive factor of recurrence regardless of the extent of the initial surgery.This article was presented at the International Association of Endocrine Surgeons meeting, Uppsala, Sweden, June 14–17, 2004.     

益气散结方联合疏肝解郁胶囊对甲状腺癌术后患者的影响

目的:观察益气散结方联合疏肝解郁胶囊对甲状腺癌术后患者免疫功能、生活质量及抑郁状态的改善作用。方法:将60例甲状腺癌术后患者随机均分为两组,对照组和治疗组,每组30例,对照组接受左甲状腺素钠和疏肝解郁胶囊治疗,治疗组在对照组的基础上加用益气散结方,观察比较两组患者血清中5-羟色胺、多巴胺水平及T淋巴细胞亚群、抑郁评分、生活质量评分水平。结果:治疗后,治疗组血清5-羟色胺、多巴胺水平明显高于对照组(P0.05),血清CD3+、CD4+水平明显高于对照组(P0.05),治疗组抑郁评分HAMD及SDS水平明显低于对照组(P0.05),治疗组生活质量评分明显高于对照组(P0.05)。结论:益气散结方联合疏肝解郁胶囊可有效提高甲状腺癌术后患者血清5-羟色胺和多巴胺水平,提高患者免疫功能,降低抑郁评分,提升生活质量,促进患者术后恢复。     

Surgical Experience in Children With Differentiated Thyroid Carcinoma

Background: The optimal surgical treatment in children with well-differentiated thyroid carcinoma remains an important point of discussion. In this study, we evaluated our surgical experience and reviewed the literature accordingly to identify the most adequate treatment.Methods: We retrospectively analyzed 21 children, all under the age of 18 years at the time of diagnosis, with differentiated thyroid carcinoma (17 papillary, 3 follicular, and 1 Hürthle cell carcinoma). Total thyroidectomy was performed, followed by radioiodine therapy, as a part of the initial treatment in all patients. The results were compared with data from the literature.Results: Eleven children (52%) who presented with cervical lymph node metastases were treated by a modified radical neck dissection. Pulmonary metastases were seen at diagnosis in three patients. Six patients developed temporary complications. During follow-up, with a median of 11 years (range, 2–26 years), two patients (10%) developed recurrences, and no patient died during this observation period. A literature search confirmed our experience of excellent results without an increase of complications in the more aggressively treated patients.Conclusions: In children with differentiated thyroid cancer, treatment should consist of total thyroidectomy, followed by a modified radical neck dissection (when indicated) and iodine-131 ablation treatment. This aggressive approach seems to be justified because of the high incidence of nodal involvement and the low complication and recurrence rate after surgery.     

Sentinel Lymph Node Biopsy in Thyroid Cancer

World Journal of Surgery - Prophylactic central neck dissection in patients with papillary thyroid carcinoma is controversial. Sentinel node biopsy might be an adjunct to optimize surgical...