143 results on '"Aldona Kowalska"'
Search Results
2. Occurrence of Arrhythmias in Women with Thyroid Cancer Receiving Suppressive Doses of Levothyroxine
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Karol Kaziród-Wolski, Aldona Kowalska, Janusz Sielski, Magdalena Biskup-Frużyńska, and Grzegorz Piotrowski
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thyroid cancer ,arrhythmias ,levothyroxine ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Aim of the study: To assess the occurrence of cardiac arrhythmias caused by high doses of levothyroxine in patients with thyroid cancer with subclinical hyperthyroidism. Materials and Methods: This prospective study included 98 women divided into three groups according to plasma thyroid stimulating hormone (TSH) concentration: Results: There were no differences between groups in the maximum, average, or minimum heart rate or in the incidence of the studied cardiac arrhythmias. Heart rate in women with a TSH concentration of Conclusions: While maintaining normal free triiodothyronine levels, the use of suppressive doses of levothyroxine after thyroidectomy for differentiated thyroid cancer does not induce clinically significant arrhythmias or affect average heart rate. None of the studied clinical parameters influenced the risk of arrhythmia.
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- 2021
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3. Genotoxicity Associated with 131I and 99mTc Exposure in Nuclear Medicine Staff: A Physical and Biological Monitoring Study
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Justyna Miszczyk, Aleksander Gałaś, Agnieszka Panek, Aldona Kowalska, Magdalena Kostkiewicz, Eliza Borkowska, and Kamil Brudecki
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131I ,radioiodine ,99mTc ,technetium-99 ,occupational radiation exposure ,nuclear medicine ,Cytology ,QH573-671 - Abstract
Nuclear medicine staff are constantly exposed to low doses of ionizing radiation. This study investigated the level of genotoxic effects in hospital employees exposed to routinely used 131I and 99mTc in comparison with a control group. The study compared the results of physical and biological monitoring in peripheral blood lymphocytes. The effects of confounding factors, such as smoking status and physical activity, were also considered. Physical dosimetry monitoring revealed differences in the individual annual effective dose as measured by finger ring dosimeter and whole-body dosimeter between the 131I- and 99mTc-exposed groups. The DNA damage studies revealed differences between the groups in terms of excess premature chromosome condensation (PCC) fragments and tail DNA. Physical activity and smoking status differentiated the investigated groups. When assessed by the level of physical activity, the highest mean values of tail DNA were observed for the 99mTc group. When assessed by work-related physical effort, excess PCC fragments were significantly higher in the 131I group than in the control group. In the investigated groups, the tail DNA values were significantly different between non-smokers and past or current smokers, but excess PCC fragments did not significantly differ by smoking status. It is important to measure exposure to low doses of ionizing radiation and assess the potential risk from this exposure. Such investigations support the need to continue epidemiological and experimental studies to improve our understanding of the mechanisms of the health effects of radionuclides and to develop predictive models of the behavior of these complex systems in response to low-dose radiation.
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- 2022
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4. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a problematic entity
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Klaudia Zajkowska, Janusz Kopczyński, Stanisław Góźdź, and Aldona Kowalska
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follicular variant of ptc ,cytology ,molecular testing ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a borderline thyroid tumour formerly known as noninvasive encapsulated follicular variant of papillary thyroid carcinoma. The prevalence of NIFTP is estimated at 4.4–9.1% of all papillary thyroid carcinomas worldwide; however, the rate of occurrence of NIFTP is eight times lower in Asian countries than in Western Europe and America. At the molecular level, NIFTP is characterised by the lack of BRAF V600E and BRAF V600E-like mutations or other high-risk mutations (TERT, TP53) and a high rate of RAS mutations, which is similar to other follicular-pattern thyroid tumours. The diagnosis of NIFTP can only be made after histological examination of the entire tumour removed during surgery and is based on strictly defined inclusion and exclusion criteria. Although the diagnosis is postoperative, the combination of certain findings of preoperative tests includ ing ultrasonography, cytology, and molecular testing may raise suspicion of NIFTP. These tumours can be effectively treated by lobectomy, although total thyroidectomy r emains an option for some patients. Radioactive iodine and thyroid stimulating hormone suppression therapy are not required. NIFTP has an extremely good prognosis, even when treated conservatively with lobectomy alone. Nevertheless, it cannot be considered as a benign lesion. The risk of adverse outcomes, including lymph node and distant metastases, is low but not negligible.
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- 2020
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5. Histopathology and immunohistochemistry as prognostic factors for poorly differentiated thyroid cancer in a series of Polish patients.
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Agnieszka Walczyk, Janusz Kopczyński, Danuta Gąsior-Perczak, Iwona Pałyga, Artur Kowalik, Magdalena Chrapek, Maria Hejnold, Stanisław Góźdź, and Aldona Kowalska
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Medicine ,Science - Abstract
BACKGROUND:Poorly differentiated thyroid cancer (PDTC) is a rare but aggressive type of thyroid cancer (TC) and the main cause of death from non-anaplastic follicular cell-derived TC. Although the Turin criteria are well defined, the pathological features that could serve as diagnostic and prognostic factors remain controversial. MATERIALS AND METHODS:Forty-nine consecutive PDTC cases were identified in a single cancer center between 2000 and 2018. We analyzed the impact of routine histopathological and immunohistochemical features and several parameters that are not routinely included in pathology reports such as the presence of atypical mitoses, the amount of necrosis, or insulin-like growth factor-II mRNA-binding protein 3 immunostaining on the survival of patients with PDTC. Overall survival (OS) and disease-specific survival (DSS) were calculated using the Kaplan-Meier method. RESULTS:Of the 49 PDTC 34 (69.4%) showed the insular pattern of growth. The median of poorly differentiated area was 95% (range, 1-100), and 30 (61.2%) patients had a predominant (>50%) insular area. The 5-year OS and DSS rates at a median follow-up of 57 months were 60.6% and 64.3%, respectively. Univariate analysis showed that tumor size >4 cm, presence of atypical mitoses, Ki-67 >5%, and thyroglobulin (Tg)-negative immunostaining were associated with a higher risk of PDTC-related death. Atypical mitoses and Tg negativity were independent factors of worse DSS in multivariate analysis. Patients with insular and predominant insular areas showed a 3- and 6-fold higher risk of PDTC death when they displayed atypical mitoses. CONCLUSIONS:In PDTC, the presence of atypical mitoses may be helpful in identifying patients with poorer outcome and worth including in pathology reports, particularly in tumors with a dominant insular pattern of growth. Additionally, the inclusion of Tg immunostaining may be considered in a prognostic context, and not only as a diagnostic feature.
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- 2020
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6. Late-Onset Medullary Thyroid Cancer in a Patient with a Germline RET Codon C634R Mutation
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Agnieszka Walczyk, Kajetan Zgubieński, Grzegorz Chmielewski, Kinga Hińcza-Nowak, Artur Kowalik, Jarosław Jaskulski, and Aldona Kowalska
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multiple endocrine neoplasia type 2A ,hereditary medullary thyroid cancer ,germline C634R RET mutation ,genotype-phenotype correlation ,risk stratification ,Medicine (General) ,R5-920 - Abstract
Background: Multiple endocrine neoplasia type 2A (MEN2A) is a rare, hereditary syndrome resulting from a germline mutation in the RET proto-oncogene and characterized primarily by medullary thyroid cancer (MTC), pheochromocytoma (PHEO), and hyperparathyroidism. Types of RET mutation have been associated with age at onset, clinical outcomes of MTC, and the penetrance of other components. Patients classified as ‘high-risk’ by the American Thyroid Association (ATA), based on the aggressiveness of MTC and the penetrance of other components, are recommended to undergo early prophylactic thyroidectomy at age ≤ 5 years and to be screened for PHEO at age ≥ 11 years. Patients with RET codon C634R mutations have been classified as high-risk. Case presentation: The present study describes a 71-year-old woman newly diagnosed with hereditary MTC related to a RET C634R germline mutation. Her basal serum calcitonin level was high, but there was no evidence of distant metastases. Surgery revealed bilateral MTC with two metastatic lymph nodes. Because microscopic resection was incomplete and extranodal extension was observed, the patient underwent adjuvant external beam radiotherapy. Response to therapy was excellent. Follow-up after 1.5 years showed no evidence of disease or other manifestations of MEN2A. Conclusion: Despite RET C634R carriers being classified as high-risk by the ATA, this patient did not present with either distant MTC or PHEO until her seventies. To our knowledge, only one other patient has shown a similar late identification of a RET C634R mutation, but MTC could not be diagnosed because the patient was lost to follow-up. Further research is required to develop optimal protocols that could allow patients requiring prophylactic thyroidectomy to be differentiated from those who can be monitored closely without early surgery.
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- 2021
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7. Diagnosis of thyroid tumours in Świętokrzyskie Province in Poland with respect to the regulations provided in the new oncological package
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Łukasz Fortuna, Michał Chrobot, Stanisław Góźdź, and Aldona Kowalska
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oncological diagnosis ,oncological package ,Diagnosis and Oncological Treatment Card ,thyroid cancer ,Medicine - Abstract
Introduction: The new regulations called the “oncological package” were implemented in Poland on 1 January 2015. The issuance of the Diagnosis and Oncological Treatment Card initiates a path of rapid diagnosis and therapy. The new regulations also encompass the diagnostic process in suspected thyroid carcinoma, which is the leading endocrine gland cancer. In 2014, 162 new cases of thyroid cancer were noted in Świętokrzyskie Province in Poland. Before the rapid diagnostic procedure is implemented, the risk of malignancy must be evaluated, which is of particular importance in the case of suspected carcinoma of the thyroid gland due to the great prevalence of benign thyroid nodules. The risk of thyroid carcinoma is evaluated by the analysis of the medical history and proper interpretation of ultrasonographic images of focal lesions. Aim: The aim of this study was to analyse the knowledge of primary care physicians about clinical and ultrasonographic features of high-risk thyroid tumours and to assess whether the Diagnosis and Oncological Treatment Card is used correctly for initiation of a rapid diagnostic process in patients with suspected thyroid carcinoma. Material and methods: The analysis involved the results of thyroid ultrasound scans and medical history data collected during the first visit from all patients who, in the period from 1 January 2015 to 30 September 2016, were referred to the Department of Endocrinology of Świętokrzyskie Oncology Centre with the Diagnosis and Oncological Treatment Card issued by a primary care physician due to a suspicion of thyroid cancer. The authors evaluated the presence of clinical or ultrasonographic features of high-risk thyroid tumours. The analysis involved records of 95 patients. Results: None of the patients presented clinical features of thyroid carcinoma. The phenotype of focal lesions represented high-risk features in merely 21% of the patients; the most common ultrasonographic feature was hypoechogenicity (70% of patients). Oncological diagnostic procedures (fine-needle aspiration biopsy) confirmed a malignancy in only 1 case; it was a patient with high-risk ultrasonographic features (1/20 patients – 5%). None of the patients with a benign phenotype was diagnosed with thyroid carcinoma. Conclusions: 1) The Diagnosis and Oncological Treatment Card is not used properly by primary care physicians in the diagnosis of thyroid lesions. 2) When issuing the Diagnosis and Oncological Treatment Card, primary care physicians do not use the knowledge about clinical or ultrasonographic features that suggest a high risk of malignancy.
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- 2017
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8. Delayed risk stratification system in pT1aN0/Nx DTC patients treated without radioactive iodine
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Danuta Ga˛sior-Perczak, Iwona Pałyga, Monika Szymonek, Artur Kowalik, Agnieszka Walczyk, Janusz Kopczyn´ski, Katarzyna Lizis-Kolus, Anna Słuszniak, Janusz Słuszniak, Tomasz Łopatyn´ski, Ryszard Me˛z˙yk, Stanisław Góz´dz´, and Aldona Kowalska
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delayed risk stratification system ,differentiated thyroid cancer ,early stage DTC ,thyroid cancer ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Purpose: Delayed risk stratification (DRS) system by Momesso and coworkers was accepted by the American Thyroid Association as a diagnostic tool for the risk stratification of unfavorable clinical outcomes and to monitor the clinical outcomes of differentiated thyroid cancer (DTC) patients treated without radioactive iodine (RAI). The aim of this study was to evaluate the DRS system in patients with pT1aN0/Nx stage. Methods: The study included 304 low-risk patients after thyroidectomy (n = 202) or lobectomy (n = 102) without RAI and were treated at a single center. The median age was 50.5 years, 91.1% were women and the median follow-up was 4 years. DRS of the treatment response was performed based on medical records and according to the criteria of Momesso and coworkers. Disease course (recurrence, death) and status (remission, persistent disease) on December 31, 2016 were evaluated. The relationship between unfavorable outcomes and the DRS system was evaluated. Results: Response to initial therapy was excellent in 272 patients (89.5%), indeterminate in 31 (10.2%) and biochemical incomplete (increased TgAb levels) in one (0.3%). Two patients in the excellent response group experienced recurrence at 6 and 7 years of follow-up (after lobectomy). None of the patients with indeterminate and biochemical incomplete response developed structural disease, and none of the patients died during the follow-up. Conclusions: The DRS system was not useful for predicting the risk of unfavorable clinical outcomes and cannot be used to personalize the monitoring method of the disease in patients at pT1aN0/Nx stage who are not treated with RAI.
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- 2017
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9. Repeated nondiagnostic result of thyroid fine-needle aspiration biopsy
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Klaudia Ziemiańska, Janusz Kopczyński, and Aldona Kowalska
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nondiagnostic FNAB ,thyroid nodules ,ultrasound-guided biopsy ,131I therapy ,Medicine - Abstract
Aim of the study: Fine-needle aspiration biopsy (FNAB) is the most accurate and cost-effective method to evaluate the risk of malignancy of thyroid nodules, but approximately 1–24% of FNABs generate a nondiagnostic result (ND-FNAB). The aim of this study was to determine the predictive factors of a repeated nondiagnostic result of FNAB. Material and methods : A total of 4018 FNABs performed in a territorial referral centre were analysed, of which 288 (7.17%) were nondiagnostic. Medical records were available for 245 biopsies performed in 228 patients. The retrospective analysis of factors that may influence a repeat ND-FNAB, including demographic, clinical and ultrasound characteristics, was performed. Results : A repeat FNAB was performed in 159 nodules giving a diagnostic result in 79.2% of cases. The time between the biopsies ranged from 1 to 611 days (mean 154.4, median 119). The timing of a repeat FNAB did not significantly alter the diagnostic output (p = 0.29). In the univariate analysis, significant predictors of a repeat ND-FNAB were older patient age (p = 0.02), L-thyroxine supplementation (p = 0.05), and a history of 131 I therapy (p < 0.0001). In the multivariate analysis, only a history of 131 I therapy was a statistically significant risk factor for a repeat ND-FNAB (p = 0.002). Conclusions : Patients with a history of 131 I therapy and ND-FNAB should undergo periodic ultrasonographic assessment rather than a repeat biopsy. The interval between repeated FNABs recommended by guidelines does not affect the diagnostic output.
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- 2017
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10. Effective Preoperative Plasmapheresis Treatment of Severe Hyperthyroidism in a Patient with Giant Toxic Nodular Goiter and Methimazole-Induced Agranulocytosis
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Katarzyna Barwinek, Danuta Gąsior-Perczak, Sławomir Trepka, Artur Szczodry, Janusz Kopczyński, Zdzisława Sitarz-Żelazna, and Aldona Kowalska
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agranulocytosis ,plasmapheresis ,thyrotoxicosis ,hyperthyroidism ,thyroidectomy ,Medicine (General) ,R5-920 - Abstract
Agranulocytosis is a rare but very serious complication of thyrostatic therapy. In severe hyperthyroidism, the removal of circulating thyroid hormones by plasmapheresis may be an effective therapeutic option. This report describes the therapeutic difficulties and successful preoperative treatment with plasmapheresis in a 63-year-old patient admitted to the Endocrinology Clinic with severe hyperthyroidism, during the course of giant toxic nodular goiter and agranulocytosis, which occurred after 2 weeks of taking methimazole. During hospitalization, methimazole treatment was discontinued and therapy with steroids, a beta blocker, propylthiouracil, Lugol’s solution, lithium carbonate, and antibiotics were initiated. Granulocyte colony growth stimulating factor was also used to resolve agranulocytosis. Due to the failure to achieve euthyreosis using this approach, we decided to conduct thyroid surgery, as a life-saving action, after preparation of the patient by plasmapheresis. Two plasmapheresis procedures were performed, resulting in a decrease in the concentration of free thyroid hormones. Total thyroidectomy was performed and there were no complications during surgery. We conclude that plasmapheresis may be considered as an effective alternative treatment option for the preparation of patients with hyperthyroidism for surgery, when the clinical situations prevent the use of conventional treatments for hyperthyroidism and when immediate life-saving surgery is necessary.
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- 2020
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11. Papillary Thyroid Cancer in a Struma Ovarii in a 17-Year-Old Nulliparous Patient: A Case Report
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Agnieszka Gonet, Rafał Ślusarczyk, Danuta Gąsior-Perczak, Artur Kowalik, Janusz Kopczyński, and Aldona Kowalska
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malignant struma ovarii ,papillary thyroid cancer ,teratoma ,thyroidectomy ,immunohistochemistry ,Medicine (General) ,R5-920 - Abstract
Introduction: Struma ovarii accounts for 2% of mature teratomas. Struma ovarii is diagnosed when thyroid tissue accounts for >50% of the teratoma. Malignant transformation is rare, occurring in BRAF K601E mutation in ovarian tumor tissues. Preoperative serum Tg concentration was >300 ng/mL, which decreased to 38.2 ng/mL after gynecological surgery with undetectable anti-Tg antibodies. The patient underwent total thyroidectomy with no cancer detected on histopathological examination. The patient was treated with I-131 and showed no recurrence 4 years after the diagnosis. Conclusions: Malignant struma ovarii is diagnosed by surgery. Because papillary carcinoma in struma ovarii is rare and there are no guidelines regarding the management of this type of cancer, therapeutic decisions should be made individually based on clinical and pathological data.
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- 2020
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12. The impact of BMI on clinical progress, response to treatment, and disease course in patients with differentiated thyroid cancer.
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Danuta Gąsior-Perczak, Iwona Pałyga, Monika Szymonek, Artur Kowalik, Agnieszka Walczyk, Janusz Kopczyński, Katarzyna Lizis-Kolus, Tomasz Trybek, Estera Mikina, Dorota Szyska-Skrobot, Klaudia Gadawska-Juszczyk, Stefan Hurej, Artur Szczodry, Anna Słuszniak, Janusz Słuszniak, Ryszard Mężyk, Stanisław Góźdź, and Aldona Kowalska
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Medicine ,Science - Abstract
INTRODUCTION:Obesity is a serious health problem worldwide, particularly in developed countries. It is a risk factor for many diseases, including thyroid cancer. The relationship between obesity and prognostic factors of thyroid cancer is unclear. AIMS:We sought to ascertain the relationship between body mass index (BMI) and clinicopathological features increasing the risk of poor clinical course, treatment response, and clinical outcome in patients with differentiated thyroid cancer (DTC). SUBJECTS & METHODS:The study included 1181 patients with DTC (88% women and 12% men) treated at a single center from 2000 to 2016. BMI before surgery and aggressive clinicopathological features, according to the American Thyroid Initial Risk stratification system, were analyzed. The relationship between BMI and initial risk, treatment response, and final status of the disease was evaluated, incorporating the revised 2015 American Thyroid Association guidelines and the 8th edition of the American Joint Committee on Cancer/Tumor-Node-Metastasis (AJCC/TNM) staging system. Patients were stratified according to the World Health Organization classification of BMI. Statistical analysis was performed using univariate and multivariate logistic regression analysis. RESULTS:Median follow-up was 7.7 years (1-16 years). There were no significant associations between BMI and extrathyroidal extension (microscopic and gross), cervical lymph node metastasis, or distant metastasis in univariate and multivariate analyses. BMI did not affect initial risk, treatment response or disease outcome. Obesity was more prevalent in men (p = 0.035) and in patients ≥55 years old (p = 0.001). There was no statistically significant relationship between BMI and more advanced TNM stage in patients ≤55 years old (stage I vs. stage II) (p = 0.266) or in patients >55 years old (stage I-II vs. III-IV) (p = 0.877). CONCLUSIONS:Obesity is not associated with more aggressive clinicopathological features of thyroid cancer. Obesity is not a risk factor for progression to more advanced stages of disease, nor is it a prognostic factor for poorer treatment response and clinical outcome.
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- 2018
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13. Evaluation of molecular diagnostic approaches for the detection of BRAF p.V600E mutations in papillary thyroid cancer: Clinical implications.
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Artur Kowalik, Aldona Kowalska, Agnieszka Walczyk, Renata Chodurska, Janusz Kopczyński, Magdalena Chrapek, Elżbieta Wypiórkiewicz, Małgorzata Chłopek, Liliana Pięciak, Danuta Gąsior-Perczak, Iwona Pałyga, Krzysztof Gruszczyński, Ewelina Nowak, and Stanisław Góźdź
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Medicine ,Science - Abstract
Differentiated papillary thyroid cancer (PTC) is the most common cancer of the endocrine system. PTC has a very good prognosis and a high 5 year survival rate; however, some patients are unresponsive to treatment, and their diagnosis eventually results in death. Recent efforts have focused on searching for prognostic and predictive factors that may enable treatment personalization and monitoring across the course of the disease. The presence of the BRAF mutation is considered to contribute to the risk of poor clinical course, according to American Thyroid Association (ATA) recommendations. The method used for genotyping can impact the predicted mutation frequency; however, ATA recommendations do not address this issue. We evaluated the molecular diagnostic (BRAF p.V600E mutation) results of 410 patients treated for PTC. We thoroughly analyzed the impact of three different BRAF mutation detection methods, Sanger Sequencing (Seq), allele-specific amplification PCR (ASA-PCR), and quantitative PCR (qPCR), on the frequency of mutation detection in 399 patients. Using Seq, we detected the BRAF mutation in 37% of patients; however, we were able to detect BRAF mutations in 57% and 60% of patients using the more sensitive ASA-PCR and qPCR technologies, respectively. Differences between methods were particularly marked in the thyroid papillary microcarcinoma group; BRAF p.V600E mutations were found in 37% of patients using Seq and 63% and 66% of patients using ASA-PCR and qPCR, respectively. We also evaluated how these different diagnostic methods were impacted by DNA quality. Applying methods with different sensitivities to the detection of BRAF p.V600E mutations may result in different results for the same patient; such data can influence stratification of patients into different risk groups, leading to alteration of treatment and follow-up schemes.
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- 2017
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14. The Delayed Risk Stratification System in the Risk of Differentiated Thyroid Cancer Recurrence.
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Aldona Kowalska, Agnieszka Walczyk, Iwona Pałyga, Danuta Gąsior-Perczak, Klaudia Gadawska-Juszczyk, Monika Szymonek, Tomasz Trybek, Katarzyna Lizis-Kolus, Dorota Szyska-Skrobot, Estera Mikina, Stefan Hurej, Janusz Słuszniak, Ryszard Mężyk, and Stanisław Góźdź
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Medicine ,Science - Abstract
CONTEXT:There has been a marked increase in the detection of differentiated thyroid carcinoma (DTC) over the past few years, which has improved the prognosis. However, it is necessary to adjust treatment and monitoring strategies relative to the risk of an unfavourable disease course. MATERIALS AND METHODS:This retrospective study examined data from 916 patients with DTC who received treatment at a single centre between 2000 and 2013. The utility of the American Thyroid Association (ATA) and the European Thyroid Association (ETA) recommended systems for early assessment of the risk of recurrent/persistent disease was compared with that of the recently recommended delayed risk stratification (DRS) system. RESULTS:The PPV and NPV for the ATA (24.59% and 95.42%, respectively) and ETA (24.28% and 95.68%, respectively) were significantly lower than those for the DRS (56.76% and 98.5%, respectively) (p
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- 2016
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15. 99mTc Labeled Glucagon-Like Peptide-1-Analogue (99mTc-GLP1) Scintigraphy in the Management of Patients with Occult Insulinoma.
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Anna Sowa-Staszczak, Małgorzata Trofimiuk-Müldner, Agnieszka Stefańska, Monika Tomaszuk, Monika Buziak-Bereza, Aleksandra Gilis-Januszewska, Agata Jabrocka-Hybel, Bogusław Głowa, Maciej Małecki, Tomasz Bednarczuk, Grzegorz Kamiński, Aldona Kowalska, Renata Mikołajczak, Barbara Janota, and Alicja Hubalewska-Dydejczyk
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Medicine ,Science - Abstract
The aim of this study was to assess the utility of [Lys40(Ahx-HYNIC-99mTc/EDDA)NH2]-exendin-4 scintigraphy in the management of patients with hypoglycemia, particularly in the detection of occult insulinoma.Forty patients with hypoglycemia and increased/confusing results of serum insulin and C-peptide concentration and negative/inconclusive results of other imaging examinations were enrolled in the study. In all patients GLP-1 receptor imaging was performed to localise potential pancreatic lesions.Positive results of GLP-1 scintigraphy were observed in 28 patients. In 18 patients postsurgical histopathological examination confirmed diagnosis of insulinoma. Two patients had contraindications to the surgery, one patient did not want to be operated. One patient, who presented with postprandial hypoglycemia, with positive result of GLP-1 imaging was not qualified for surgery and is in the observational group. Eight patients were lost for follow up, among them 6 patients with positive GLP-1 scintigraphy result. One patient with negative scintigraphy was diagnosed with malignant insulinoma. In two patients with negative scintigraphy Munchausen syndrome was diagnosed (patients were taking insulin). Other seven patients with negative results of 99mTcGLP-1 scintigraphy and postprandial hypoglycemia with C-peptide and insulin levels within the limits of normal ranges are in the observational group. We would like to mention that 99mTc-GLP1-SPECT/CT was also performed in 3 pts with nesidioblastosis (revealing diffuse tracer uptake in two and a focal lesion in one case) and in two patients with malignant insulinoma (with the a focal uptake in the localization of a removed pancreatic headin one case and negative GLP-1 1 scintigraphy in the other patient).99mTc-GLP1-SPECT/CT could be helpful examination in the management of patients with hypoglycemia enabling proper localization of the pancreatic lesion and effective surgical treatment. This imaging technique may eliminate the need to perform invasive procedures in case of occult insulinoma.
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- 2016
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16. The Cut-Off Level of Recombinant Human TSH-Stimulated Thyroglobulin in the Follow-Up of Patients with Differentiated Thyroid Cancer.
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Aldona Kowalska, Iwona Pałyga, Danuta Gąsior-Perczak, Agnieszka Walczyk, Tomasz Trybek, Anna Słuszniak, Ryszard Mężyk, and Stanisław Góźdź
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Medicine ,Science - Abstract
The treatment of differentiated thyroid cancer (DTC) ends in full recovery in 80% of cases. However, in 20% of cases local recurrences or distant metastases are observed, for this reason DTC patients are under life-long follow-up. The most sensitive marker for recurrence is stimulated thyroglobulin (Tg) which, together with neck ultrasound (US), enables correct diagnosis in nearly all cases of the active disease. For many years the only known stimulation was a 4-5 week withdrawal from the L-T4 therapy (THW). For the last couple of years stimulation with the use of recombinant human TSH (rhTSH) has been available. This method of stimulation may have a significant influence in obtaining the Tg level. However, it is important to determine the cut-off level for rhTSH-stimulated Tg (rhTSH/Tg).This is a retrospective analysis of consecutive patients from one facility who have qualified over a period of two years for repeated radioiodine therapy (RIA). In our facility the ablation effectiveness evaluation is always carried out with the use of rhTSH, with the repeated therapy following THW. Such a procedure enables two Tg measurements in the same patient after both types of stimulation within 4-5 weeks. The obtained values were compared, cut-off levels in THW conditions were used (2.0 ng/ml for patients in remission and 10.0 ng/ml for patients with an active disease). In order to determine the cut-off level for rhTSH/Tg, regression analysis and ROC curves were used.In 63 patients the Tg measurement of both methods of stimulation were obtained. It was observed that there was a high correlation between rhTSH/Tg and THW/Tg. However, the rhTSH/Tg level was significantly lower than THW/ Tg. The rhTSH/ Tg cut-off levels which corresponded to the 2.0 ng/ml and 10.0 ng/ml limits for THW/Tg were calculated and the values were 0.6 ng/ml and 2.3 ng/ml respectively.The method of stimulation has a significant impact on the obtained Tg concentrations. The assumed THW/Tg cut off levels must not be transferred to rhTSH/Tg.
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- 2015
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17. The frequency of differentiated thyroid carcinoma recurrence in retrospective analysis of 3087 consecutive patients
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Iwona Palyga, Maciej Rumian, Alicja Kosel, Maciej Albrzykowski, Paulina Krawczyk, Agata Kalwat, Danuta Gąsior-Perczak, Agnieszka Walczyk, Artur Kuchareczko, Janusz Kopczyński, Magdalena Chrapek, Stanislaw Gozdz, and Aldona Kowalska
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General Medicine - Published
- 2023
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18. A rare case of macro-ACTH in patient with adrenal incidentaloma
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Piotr Przybycień, Danuta Gasior-Perczak, Anna Słuszniak, Wojciech Placha, and Aldona Kowalska
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General Medicine - Published
- 2023
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19. The role of 131I whole body scan in post-operative assessment of patients with thyroid microcarcinoma
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Agnieszka Suligowska, Agnieszka Walczyk, Danuta Gasior-Perczak, Iwona Palyga, Artur Kuchareczko, and Aldona Kowalska
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General Medicine - Published
- 2023
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20. Should patients with incomplete microscopic resection of papillary thyroid carcinoma be classified as high-risk ones for the recurrence/persistent disease?
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Artur Kuchareczko, Iwona Palyga, Agnieszka Walczyk, Danuta Gasior-Perczak, Janusz Kopczyński, Izabela Płachta, Magdalena Chrapek, Stanislaw Gozdz, and Aldona Kowalska
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General Medicine - Published
- 2023
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21. DUONEN multicenter study - personalized PRRT treatment with 177Lu- or 177Lu/90Y-DOTA-TATE in patients with neuroendocrine tumors based on individual dosimetry
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Marta Opalinska, Grzegorz Kamiński, Marek Dedecjus, Aldona Kowalska, Maciej Kolodziej, Marek Saracyn, Piotr Garnuszek, Wioletta Lenda-Tracz, Anna Borkowska, Danuta Gąsior-Perczak, Anna Budzyńska, Agata Kubik, Krzysztof Kacperski, Patrycja Szubstarska, Wioletta Chalewska, Joanna Długosińska, Joanna Januszkiewicz-Caulier, Alicja Hubalewska-Dydejczyk, and Renata Mikolajczak
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General Medicine - Published
- 2023
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22. Colorectal neuroendocrine neoplasms — update of the diagnostic and therapeutic guidelines (recommended by the Polish Network of Neuroendocrine Tumours) [Nowotwory neuroendokrynne jelita grubego — uaktualnione zasady diagnostyki i leczenia (rekomendowane przez Polską Sieć Guzów Neuroendokrynych)]
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Teresa Starzyńska, Magdalena Londzin-Olesik, Tomasz Bednarczuk, Marek Bolanowski, Małgorzata Borowska, Ewa Chmielik, Jarosław B. Ćwikła, Wanda Foltyn, Iwona Gisterek, Daria Handkiewicz-Junak, Alicja Hubalewska-Dydejczyk, Michał Jarząb, Roman Junik, Dariusz Kajdaniuk, Grzegorz Kamiński, Agnieszka Kolasińska-Ćwikła, Aldona Kowalska, Leszek Królicki, Jolanta Kunikowska, Katarzyna Kuśnierz, Andrzej Lewiński, Łukasz Liszka, Bogdan Marek, Anna Malczewska, Anna Nasierowska-Guttmejer, Ewa Nowakowska-Duława, Marianne E. Pavel, Joanna Pilch-Kowalczyk, Jarosław Reguła, Violetta Rosiek, Marek Ruchała, Grażyna Rydzewska, Lucyna Siemińska, Anna Sowa-Staszczak, Zoran Stojčev, Janusz Strzelczyk, Michał Studniarek, Anhelli Syrenicz, Marek Szczepkowski, Ewa Wachuła, Wojciech Zajęcki, Anna Zemczak, Wojciech Zgliczyński, Krzysztof Zieniewicz, and Beata Kos-Kudła
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Neuroendocrine Tumors ,Endocrinology ,Endocrinology, Diabetes and Metabolism ,Humans ,Poland ,Colorectal Neoplasms ,Medical Oncology - Abstract
Colorectal neuroendocrine neoplasm (CRNEN), especially rectal tumours, are diagnosed with increased frequency due to the widespread use of colonoscopy, including screening examinations. It is important to constantly update and promote the principles of optimal diagnostics and treatment of these neoplasms. Based on the latest literature and arrangements made at the working meeting of the Polish Network of Neuroendocrine Tumours (June 2021), this paper includes updated and supplemented data and guidelines for the management of CRNEN originally published in Endokrynologia Polska 2017; 68: 250-260.
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- 2022
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23. Neuroendocrine neoplasms of the small intestine and the appendix — update of the diagnostic and therapeutic guidelines (recommended by the Polish Network of Neuroendocrine Tumours) [Nowotwory neuroendokrynne jelita cienkiego i wyrostka robaczkowego — uaktualnione zasady diagnostyki i leczenia (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)]
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Tomasz Bednarczuk, Anna Zemczak, Marek Bolanowski, Małgorzata Borowska, Ewa Chmielik, Jarosław B. Ćwikła, Wanda Foltyn, Iwona Gisterek, Daria Handkiewicz-Junak, Alicja Hubalewska-Dydejczyk, Michał Jarząb, Roman Junik, Dariusz Kajdaniuk, Grzegorz Kamiński, Agnieszka Kolasińska-Ćwikła, Karolina Kopacz-Wróbel, Aldona Kowalska, Leszek Królicki, Jolanta Kunikowska, Katarzyna Kuśnierz, Andrzej Lewiński, Łukasz Liszka, Magdalena Londzin-Olesik, Bogdan Marek, Anna Malczewska, Anna Nasierowska-Guttmejer, Ewa Nowakowska-Duława, Marianne E. Pavel, Joanna Pilch-Kowalczyk, Jarosław Reguła, Violetta Rosiek, Marek Ruchała, Grażyna Rydzewska, Lucyna Siemińska, Anna Sowa-Staszczak, Teresa Starzyńska, Zoran Stojčev, Janusz Strzelczyk, Michał Studniarek, Anhelli Syrenicz, Marek Szczepkowski, Ewa Wachuła, Wojciech Zajęcki, Wojciech Zgliczyński, Krzysztof Zieniewicz, and Beata Kos-Kudła
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Neuroendocrine Tumors ,Endocrinology ,Endocrinology, Diabetes and Metabolism ,Intestine, Small ,Humans ,Carcinoid Tumor ,Poland ,Appendix ,Medical Oncology - Abstract
Updated Polish recommendations for the management of patients with neuroendocrine neoplasms (NENs) of the small intestine (SINENs) and of the appendix (ANENs) are presented here. The small intestine, and especially the ileum, is one of the most common locations for these neoplasms. Most of them are well-differentiated and slow-growing tumours; uncommonly - neuroendocrine carcinomas. Their symptoms may be untypical and their diagnosis may be delayed or accidental. Najczęściej pierwszą manifestacją ANEN jest jego ostre zapalenie. Typical symptoms of carcinoid syndrome occur in approximately 20-30% of SINENs patients with distant metastases. In laboratory diagnostics the assessment of 5-hydroxyindoleacetic acid concentration is helpful in the diagnosis of carcinoid syndrome. The most commonly used imaging methods are ultrasound examination, computed tomography, magnetic resonance imaging, colonoscopy and somatostatin receptor imaging. Histopathological examination is crucial for the proper diagnosis and treatment of patients with SINENs and ANENs. The treatment of choice is a surgical procedure, either radical or palliative. Long-acting somatostatin analogues (SSAs) are essential in the medical treatment of functional and non-functional SINENs. In patients with SINENs, at the stage dissemination with progression during SSAs treatment, with high expression of somatostatin receptors, radioisotope therapy should be considered first followed by targeted therapies - everolimus. After the exhaustion of the above available therapies, chemotherapy may be considered in selected cases. Recommendations for patient monitoring are also presented.
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- 2022
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24. Gastroduodenal neuroendocrine neoplasms including gastrinoma — update of the diagnostic and therapeutic guidelines (recommended by the Polish Network of Neuroendocrine Tumours) [Nowotwory neuroendokrynne żołądka i dwunastnicy z uwzględnieniem gastrinoma — uaktualnione zasady postępowania (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)]
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Grażyna Rydzewska, Janusz Strzelczyk, Tomasz Bednarczuk, Marek Bolanowski, Małgorzata Borowska, Ewa Chmielik, Jarosław B. Ćwikła, Wanda Foltyn, Iwona Gisterek, Daria Handkiewicz-Junak, Alicja Hubalewska-Dydejczyk, Ksenia Janas, Michał Jarząb, Roman Junik, Dariusz Kajdaniuk, Grzegorz Kamiński, Agnieszka Kolasińska-Ćwikła, Magorzata Kołos, Aldona Kowalska, Leszek Królicki, Jolanta Kunikowska, Katarzyna Kuśnierz, Andrzej Lewiński, Łukasz Liszka, Magdalena Londzin-Olesik, Bogdan Marek, Anna Malczewska, Anna Nasierowska-Guttmejer, Ewa Nowakowska-Duława, Marianne E. Pavel, Joanna Pilch-Kowalczyk, Jarosław Reguła, Violetta Rosiek, Marek Ruchała, Lucyna Siemińska, Anna Sowa-Staszczak, Teresa Starzyńska, Zoran Stojčev, Michał Studniarek, Anhelli Syrenicz, Marek Szczepkowski, Ewa Wachuła, Wojciech Zajęcki, Anna Zemczak, Wojciech Zgliczyński, Krzysztof Zieniewicz, and Beata Kos-Kudła
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Pancreatic Neoplasms ,Neuroendocrine Tumors ,Endocrinology ,Duodenal Neoplasms ,Gastrinoma ,Endocrinology, Diabetes and Metabolism ,Humans ,Poland ,Medical Oncology - Abstract
After another meeting of experts of the Polish Network of Neuroendocrine Tumours, updated recommendations for the management of patients with gastric and duodenal neuroendocrine neoplasms, including gastrinoma, have been issued. As before, the epidemiology, pathogenesis and clinical symptoms of these neoplasms have been discussed, as well as the principles of diagnostic procedures, including biochemical and histopathological diagnostics and tumour localisation, highlighting the changes introduced in the recommendations. Updated principles of therapeutic management have also been presented, including endoscopic and surgical treatment, and the options of pharmacological and radioisotope treatment. The importance of monitoring patients with gastric and duodenal NENs, including gastrinoma, has also been emphasised.
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- 2022
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25. Pancreatic neuroendocrine neoplasms — update of the diagnostic and therapeutic guidelines (recommended by the Polish Network of Neuroendocrine Tumours) [Nowotwory neuroendokrynne trzustki — uaktualnione zasady diagnostyki i leczenia (rekomendowane przez Polską Sieć Guzów Neuroendokrynych)]
- Author
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Beata Kos-Kudła, Violetta Rosiek, Małgorzata Borowska, Tomasz Bednarczuk, Marek Bolanowski, Ewa Chmielik, Jarosław B. Ćwikła, Wanda Foltyn, Iwona Gisterek, Daria Handkiewicz-Junak, Alicja Hubalewska-Dydejczyk, Michał Jarząb, Roman Junik, Dariusz Kajdaniuk, Grzegorz Kamiński, Agnieszka Kolasińska-Ćwikła, Aldona Kowalska, Leszek Królicki, Jolanta Kunikowska, Katarzyna Kuśnierz, Andrzej Lewiński, Łukasz Liszka, Magdalena Londzin-Olesik, Bogdan Marek, Anna Malczewska, Anna Nasierowska-Guttmejer, Ewa Nowakowska-Duława, Marianne E. Pavel, Joanna Pilch-Kowalczyk, Jarosław Reguła, Marek Ruchała, Grażyna Rydzewska, Lucyna Siemińska, Anna Sowa-Staszczak, Teresa Starzyńska, Zoran Stojčev, Janusz Strzelczyk, Michał Studniarek, Anhelli Syrenicz, Marek Szczepkowski, Ewa Wachuła, Wojciech Zajęcki, Anna Zemczak, Wojciech Zgliczyński, and Krzysztof Zieniewicz
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Neuroendocrine Tumors ,Endocrinology ,Endocrinology, Diabetes and Metabolism ,Humans ,Poland ,Medical Oncology - Abstract
In this paper, we present the current guidelines for the diagnostics and management of pancreatic neuroendocrine neoplasms (PanNENs) developed by Polish experts providing care for these patients in everyday clinical practice. In oncological diagnostics, in addition to biochemical tests, molecular identification with the use of NETest liquid biopsy and circulating microRNAs is gaining importance. Both anatomical and functional examinations (including new radiopharmaceuticals) are used in imaging diagnostics. Histopathological diagnosis along with immunohistochemical examination still constitute the basis for therapeutic decisions. Whenever possible, surgical procedure is the treatment of choice. Pharmacological management including biotherapy, radioisotope therapy, targeted molecular therapy and chemotherapy are important methods of systemic therapy. Treatment of PanNENs requires a multidisciplinary team of specialists in the field of neuroendocrine neoplasms.
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- 2022
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26. Diagnosis and treatment of thyroid cancer in adult patients — Recommendations of Polish Scientific Societies and the National Oncological Strategy. 2022 Update [Diagnostyka i leczenie raka tarczycy u chorych dorosłych — Rekomendacje Polskich Towarzystw Naukowych oraz Narodowej Strategii Onkologicznej. Aktualizacja na rok 2022]
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Barbara Jarząb, Marek Dedecjus, Andrzej Lewiński, Zbigniew Adamczewski, Elwira Bakuła-Zalewska, Agata Bałdys-Waligórska, Marcin Barczyński, Magdalena Biskup-Frużyńska, Barbara Bobek-Billewicz, Artur Bossowski, Monika Buziak-Bereza, Ewa Chmielik, Agnieszka Czarniecka, Rafał Czepczyński, Jarosław Ćwikła, Katarzyna Dobruch-Sobczak, Janusz Dzięcioł, Aneta Gawlik, Jacek Gawrychowski, Daria Handkiewicz-Junak, Jerzy Harasymczuk, Alicja Hubalewska-Dydejczyk, Joanna Januszkiewicz-Caulier, Michał Jarząb, Krzysztof Kaczka, Michał Kalemba, Grzegorz Kamiński, Małgorzata Karbownik-Lewińska, Andrzej Kawecki, Aneta Kluczewska-Gałka, Agnieszka Kolasińska-Ćwikła, Magdalena Kołton, Aleksander Konturek, Beata Kos-Kudła, Agnieszka Kotecka-Blicharz, Aldona Kowalska, Jolanta Krajewska, Andrzej Kram, Leszek Królicki, Aleksandra Kukulska, Michał Kusiński, Krzysztof Kuzdak, Dariusz Lange, Aleksandra Ledwon, Ewa Małecka‑Tendera, Przemysław Mańkowski, Bartosz Migda, Marek Niedziela, Małgorzata Oczko-Wojciechowska, Dariusz Polnik, Lech Pomorski, Marek Ruchała, Konrad Samborski, Anna Skowrońska-Szcześniak, Agata Stanek-Widera, Ewa Stobiecka, Zoran Stojčev, Magdalena Suchorzepka-Simek, Anhelli Syrenicz, Ewelina Szczepanek-Parulska, Małgorzata Trofimiuk‑Müldner, Andrzej Tysarowski, Andrzej Wygoda, Klaudia Zajkowska, Ewa Zembala-Nożyńska, and Agnieszka Żyłka
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Adult ,Iodine Radioisotopes ,Societies, Scientific ,Endocrinology ,Endocrinology, Diabetes and Metabolism ,Quality of Life ,Thyroidectomy ,Humans ,Poland ,Thyroid Neoplasms - Abstract
The guidelines Thyroid Cancer 2022 are prepared based on previous Polish recommendations updated in 2018. They consider international guidelines - American Thyroid Association (ATA) 2015 and National Comprehensive Cancer Network (NCCN); however, they are adapted according to the ADAPTE process. The strength of the recommendations and the quality of the scientific evidence are assessed according to the GRADE system and the ATA 2015 and NCCN recommendations. The core of the changes made in the Polish recommendations is the inclusion of international guidelines and the results of those scientific studies that have already proven themselves prospectively. These extensions allow de-escalation of the therapeutic management in low-risk thyroid carcinoma, i.e., enabling active surveillance in papillary microcarcinoma to be chosen alternatively to minimally invasive techniques after agreeing on such management with the patient. Further extensions allow the use of thyroid lobectomy with the isthmus (hemithyroidectomy) in low-risk cancer up to 2 cm in diameter, modification of the indications for postoperative radioiodine treatment toward personalized approach, and clarification of the criteria used during postoperative L-thyroxine treatment. At the same time, the criteria for the preoperative differential diagnosis of nodular goiter in terms of ultrasonography and fine-needle aspiration biopsy have been clarified, and the rules for the histopathological examination of postoperative thyroid material have been updated. New, updated rules for monitoring patients after treatment are also presented. The updated recommendations focus on ensuring the best possible quality of life after thyroid cancer treatment while maintaining the good efficacy of this treatment.
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- 2022
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27. Basics of prevention and management of iodine-based contrast media-induced thyroid dysfunction - position paper by the Polish Society of Endocrinology
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Tomasz Bednarczuk, Dariusz Kajdaniuk, Bogdan Marek, Marek Bolanowski, Marek Dedecjus, Aleksandra Gilis-Januszewska, Alicja Hubalewska-Dydejczyk, Barbara Jarząb, Roman Junik, Grzegorz Kamiński, Beata Kos-Kudła, Aldona Kowalska, Andrzej Lewiński, Beata Matyjaszek-Matuszek, Marek Ruchała, Lucyna Siemińska, Krzysztof Sworczak, Anhelli Syrenicz, and Wojciech Zgliczyński
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Endocrinology ,Endocrinology, Diabetes and Metabolism - Published
- 2023
28. A Significance of Concomitant BRAF
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Artur, Kuchareczko, Janusz, Kopczyński, Artur, Kowalik, Kinga, Hińcza-Nowak, Agnieszka, Walczyk, Iwona, Pałyga, Tomasz, Trybek, Monika, Szymonek, Danuta, Gąsior-Perczak, Klaudia, Gadawska-Juszczyk, Estera, Mikina, Izabela, Płachta, Agnieszka, Suligowska, Agnieszka, Płusa, Magdalena, Chrapek, Tomasz, Łopatyński, Stanisław, Góźdź, and Aldona, Kowalska
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Proto-Oncogene Proteins B-raf ,Mutation ,Humans ,Poland ,Thyroid Neoplasms ,Telomerase ,Retrospective Studies - Published
- 2022
29. Genotoxicity Associated with
- Author
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Justyna, Miszczyk, Aleksander, Gałaś, Agnieszka, Panek, Aldona, Kowalska, Magdalena, Kostkiewicz, Eliza, Borkowska, and Kamil, Brudecki
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Iodine Radioisotopes ,Occupational Exposure ,Humans ,Technetium ,DNA ,Nuclear Medicine ,Biological Monitoring ,DNA Damage - Abstract
Nuclear medicine staff are constantly exposed to low doses of ionizing radiation. This study investigated the level of genotoxic effects in hospital employees exposed to routinely used
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- 2022
30. Update of the diagnostic and therapeutic guidelines for gastro-entero-pancreatic neuroendocrine neoplasms (recommended by the Polish Network of Neuroendocrine Tumours) [Aktualizacja zaleceń ogólnych dotyczących postępowania diagnostyczno-terapeutycznego w nowotworach neuroendokrynnych układu pokarmowego (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)]
- Author
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Beata Kos-Kudła, Wanda Foltyn, Anna Malczewska, Tomasz Bednarczuk, Marek Bolanowski, Małgorzata Borowska, Ewa Chmielik, Jarosław B. Ćwikła, Iwona Gisterek, Daria Handkiewicz-Junak, Alicja Hubalewska-Dydejczyk, Barbara Jarząb, Michał Jarząb, Roman Junik, Dariusz Kajdaniuk, Grzegorz Kamiński, Agnieszka Kolasińska-Ćwikła, Aldona Kowalska, Leszek Królicki, Maciej Krzakowski, Jolanta Kunikowska, Katarzyna Kuśnierz, Andrzej Lewiński, Łukasz Liszka, Magdalena Londzin-Olesik, Bogdan Marek, Anna Nasierowska-Guttmejer, Ewa Nowakowska-Duława, Marianne E. Pavel, Joanna Pilch-Kowalczyk, Jarosław Reguła, Violetta Rosiek, Marek Ruchała, Grażyna Rydzewska, Lucyna Siemińska, Anna Sowa-Staszczak, Teresa Starzyńska, Zoran Stojčev, Janusz Strzelczyk, Michał Studniarek, Anhelli Syrenicz, Marek Szczepkowski, Ewa Wachuła, Wojciech Zajęcki, Anna Zemczak, Wojciech Zgliczyński, and Krzysztof Zieniewicz
- Subjects
Pancreatic Neoplasms ,Neuroendocrine Tumors ,Endocrinology ,Endocrinology, Diabetes and Metabolism ,Stomach ,Humans ,Poland ,Medical Oncology - Abstract
Continuous progress in the diagnostics and treatment of neuroendocrine neoplasms (NENs), the emerging results of new clinical trials, and the new guidelines issued by medical societies have prompted experts from the Polish Network of Neuroendocrine Tumours to update the 2017 recommendations regarding the management of neuroendocrine neoplasms. This article presents the general recommendations for the management of NENs, resulting from the findings of the experts participating in the Fourth Round Table Conference, entitled "Polish Guidelines for the Diagnostics and Treatment of Neuroendocrine Neoplasms of the gastrointestinal tract, Żelechów, June 2021". Drawing from the extensive experience of centres treating these cancers, we hope that we have managed to formulate the optimal method of treating patients with NENs, applying the latest reports and achievements in the field of medicine, which can be effectively implemented in our country. The respective parts of this work present the approach to the management of: NENs of the stomach and duodenum (including gastrinoma), pancreas, small intestine, and appendix, as well as large intestine.
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- 2022
31. Did Introducing a New Category of Thyroid Tumors (Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features) Decrease the Risk of Malignancy for the Diagnostic Categories in the Bethesda System for Reporting Thyroid Cytopathology?
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Iwona Pałyga, Artur Kowalik, Kornelia Niemyska, Aldona Kowalska, Agnieszka Walczyk, Agnieszka Suligowska, Janusz Kopczyński, Danuta Gąsior-Perczak, Ryszard Mężyk, Kinga Hińcza, and Stanisław Góźdź
- Subjects
Adult ,Male ,Thyroid nodules ,medicine.medical_specialty ,Cytodiagnosis ,Endocrinology, Diabetes and Metabolism ,Biopsy, Fine-Needle ,Bethesda system ,030209 endocrinology & metabolism ,medicine.disease_cause ,Pathology and Forensic Medicine ,Papillary thyroid cancer ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Adenocarcinoma, Follicular ,medicine ,Humans ,Thyroid Neoplasms ,Thyroid cancer ,Thyroid neoplasm ,Aged ,Retrospective Studies ,Suspicious for Malignancy ,medicine.diagnostic_test ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Bethesda system for reporting thyroid cytopathology ,Thyroid Cancer, Papillary ,030220 oncology & carcinogenesis ,Female ,Radiology ,business - Abstract
In 2016, Nikiforov et al. (JAMA Oncol 2:1023-1029, 2016) proposed replacing the term "non-invasive encapsulated follicular variant of papillary thyroid carcinoma" (FVPTC) with the term "non-invasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP). In 2018, to avoid the misdiagnosis of papillary thyroid cancer as NIFTP, the authors proposed changes to the criteria for NIFTP classification. Some previous studies evaluated the impact of NIFTP on the risk of malignancy (ROM) in the fine-needle aspiration cytology (FNAC) diagnostic categories according to the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). However, little is known about the influence of an NIFTP diagnosis on ROM on the basis of the revised criteria. The aim of this study was to assess the influence of NIFTP on ROM using the revised diagnostic criteria. The present study included 998 thyroid nodules that were diagnosed and resected at the same medical center. All specimens with a diagnosis of cancer were reviewed to identify NIFTP according to the revised 2018 criteria. Additionally, molecular diagnostics were performed to detect the BRAF p.V600E mutation and TERT promoter mutations in all the NIFTP cases. The number of cases that met the revised criteria was determined, and the ROM was calculated in each of the FNAC diagnostic categories. Only five cases (2.3% of all papillary thyroid carcinoma diagnoses) were considered NIFTP, according to the 2018 criteria. With respect to the FNAC category, one case was a follicular neoplasm or suspicious for a follicular neoplasm (FN/SFN), three cases were suspicious for malignancy (SM), and one case was malignant (M). The ROM decreased in each of the Bethesda categories (0.7% in FN/SFN, 4.3% in SM, and 0.5% in M) when a diagnosis of NIFTP was taken into account. These reductions were not statistically significant. These data indicate that the NIFTP entity has very little impact on ROM for the diagnostic categories of the Bethesda system.
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- 2020
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32. Pseudohypoparathyroidism type 1a caused by a GNAS gene mutation: over 40 years without a proper diagnosis
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Agnieszka Walczyk, Grzegorz Chmielewski, Kajetan Zgubieński, Artur Kowalik, Aldona Kowalska, and Kinga Hińcza-Nowak
- Subjects
Genetics ,GNAS Gene Mutation ,business.industry ,Pseudohypoparathyroidism ,Mutation ,Internal Medicine ,Chromogranins ,GTP-Binding Protein alpha Subunits, Gs ,Medicine ,Humans ,Pseudohypoparathyroidism Type 1a ,business - Published
- 2021
33. Occurrence of Arrhythmias in Women with Thyroid Cancer Receiving Suppressive Doses of Levothyroxine
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Grzegorz Piotrowski, Aldona Kowalska, Magdalena Biskup-Frużyńska, Karol Kaziród-Wolski, and Janusz Sielski
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medicine.medical_specialty ,medicine.medical_treatment ,levothyroxine ,Levothyroxine ,Thyrotropin ,Article ,Thyroid-stimulating hormone ,Internal medicine ,Heart rate ,thyroid cancer ,Medicine ,Humans ,Prospective Studies ,Thyroid Neoplasms ,Prospective cohort study ,Thyroid cancer ,RC254-282 ,medicine.diagnostic_test ,business.industry ,Minimum Heart Rate ,Thyroidectomy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Arrhythmias, Cardiac ,medicine.disease ,arrhythmias ,Thyroxine ,Cardiology ,Female ,business ,Electrocardiography ,medicine.drug - Abstract
Aim of the study: To assess the occurrence of cardiac arrhythmias caused by high doses of levothyroxine in patients with thyroid cancer with subclinical hyperthyroidism. Materials and Methods: This prospective study included 98 women divided into three groups according to plasma thyroid stimulating hormone (TSH) concentration
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- 2021
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34. Impact of BRAF V600E and TERT Promoter Mutations on Response to Therapy in Papillary Thyroid Cancer
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Agnieszka Walczyk, Janusz Kopczyński, Magdalena Chrapek, Tomasz Trybek, Stanisław Góźdź, Iwona Pałyga, Estera Mikina, Aldona Kowalska, Artur Kowalik, Danuta Gąsior-Perczak, and Kinga Hińcza
- Subjects
Adult ,Male ,Proto-Oncogene Proteins B-raf ,Oncology ,medicine.medical_specialty ,Adolescent ,endocrine system diseases ,Response to therapy ,Antineoplastic Agents ,030209 endocrinology & metabolism ,Stage ii ,Tert promoter ,Papillary thyroid cancer ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Humans ,Medicine ,In patient ,Thyroid Neoplasms ,Promoter Regions, Genetic ,Telomerase ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Thyroid ,Clinical course ,Middle Aged ,medicine.disease ,Gene Expression Regulation, Neoplastic ,BRAF V600E ,medicine.anatomical_structure ,Thyroid Cancer, Papillary ,030220 oncology & carcinogenesis ,Mutation ,Female ,business - Abstract
In this study, we examined the relationship between coexisting BRAF V600E and TERT promoter mutations in papillary thyroid cancer (PTC) and response to therapy. PTC cases (n = 568) with known BRAF and TERT status, diagnosed from 2000 to 2012 and actively monitored at one institution, were reviewed retrospectively. Associations between BRAF V600E and TERT promoter mutations and clinicopathological features, Tumor-Node-Metastasis stage, initial risk, response to therapy, follow-up, and final disease outcome were assessed according to American Thyroid Association 2015 criteria and the American Joint Committee on Cancer/Tumor-Node-Metastasis (8th edition) staging system. Median follow-up was 120 months. TERT promoter mutations (any type) were detected in 13.5% (77/568) of PTC cases with known BRAF status. The C228T and C250T TERT hotspot mutations were found in 54 (9.5%) and 23 (4%) patients, respectively, and 22 other TERT promoter alterations were identified. Coexisting BRAF V600E and TERT hotspot promoter mutations were detected in 9.5% (54/568) of patients, and significantly associated with older patient age (P = 0.001), gross extrathyroidal extension (P = 0.003), tumor stage pT3-4 (P = 0.005), stage II to IV (P = 0.019), intermediate or high initial risk (P = 0.003), worse than excellent response to primary therapy (P = 0.045), recurrence (P = 0.015), and final outcome of no remission (P = 0.014). We conclude that coexisting BRAF V600E and TERT mutations in patients with PTC are associated with poor initial prognostic factors and clinical course and may be useful for predicting a worse response to therapy, recurrence, and poorer outcome than in patients without the above mutations.
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- 2019
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35. Diagnosis and treatment of patients with neuroendocrine tumours: evidence from specialist Polish centres
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Marta Bartmanska, Agnieszka Kolasińska-Ćwikła, Grzegorz Kamiński, Tomasz Bednarczuk, Hubalewska-Dydejczyk Alicja, Anhelli Syrenicz, Marek Ruchała, Aldona Kowalska, Handkiewicz-Junak Daria, and Beata Kos Kudla
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- 2021
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36. Is Male Sex A Prognostic Factor in Papillary Thyroid Cancer?
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Agnieszka Walczyk, Danuta Gąsior-Perczak, Kinga Furga, Klaudia Gadawska-Juszczyk, Magdalena Chrapek, Aldona Kowalska, Jarosław Jaskulski, Artur Kuchareczko, Agnieszka Suligowska, Aleksandra Gajowiec, Estera Mikina, Anna Chromik, Alicja Skuza, Iwona Pałyga, Stanisław Góźdź, Monika Szymonek, Paweł Orłowski, and Tomasz Trybek
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Oncology ,medicine.medical_specialty ,Response to therapy ,endocrine system diseases ,030209 endocrinology & metabolism ,risk stratification ,Affect (psychology) ,Article ,Papillary thyroid cancer ,03 medical and health sciences ,0302 clinical medicine ,response to therapy ,Internal medicine ,medicine ,papillary thyroid cancer ,Risk factor ,Lymph node ,Angioinvasion ,business.industry ,male sex ,Thyroid ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Risk stratification ,Medicine ,business - Abstract
Identifying risk factors is crucial for predicting papillary thyroid cancer (PTC) with severe course, which causes a clinical problem. The purpose of this study was to assess whether male sex can be such a predictive factor and to verify whether including it as a predictive factor of high initial risk of recurrence/persistence would help to enhance the value of the American Thyroid Association initial risk stratification system (ATA). We retrospectively analyzed 1547 PTC patients (1358 females and 189 males), treated from 1986 to 2018. The relationship between sex and clinicopathological features, response to therapy, and disease status was assessed. Men with PTC showed some adverse clinicopathological features more often than women, including angioinvasion, lymph node metastases, and tumor size >, 40 mm. There were sex-related disparities with respect to response to initial therapy and final follow-up. Male sex is associated with some unfavorable clinicopathological features of PTC, which may affect response to initial therapy or final disease status. In our study, modification of the ATA system by including male sex as a risk factor does not enhance its value. Thus, further studies are needed to assess whether males require treatment modalities or oncological follow-up protocols that are different from those of females.
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- 2021
37. Incidence of the
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Danuta, Gąsior-Perczak, Artur, Kowalik, Krzysztof, Gruszczyński, Agnieszka, Walczyk, Monika, Siołek, Iwona, Pałyga, Sławomir, Trepka, Estera, Mikina, Tomasz, Trybek, Janusz, Kopczyński, Agnieszka, Suligowska, Rafał, Ślusarczyk, Agnieszka, Gonet, Jarosław, Jaskulski, Paweł, Orłowski, Magdalena, Chrapek, Stanisław, Góźdź, and Aldona, Kowalska
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CHEK2 missense mutation ,A%22">IVS2 + 1G >A ,I157T ,papillary thyroid cancer ,del5395 ,1100delC ,risk stratification ,CHEK2 truncating mutation ,skin and connective tissue diseases ,Article ,CHEK2 - Abstract
Simple Summary The aim of our study was to evaluate whether the CHEK2 mutation was a predictor of poorer clinical course in patients with papillary thyroid cancer. The study included 1547 patients from a single center in Poland, in whom the presence and variant of the CHEK2 mutation were determined. Two hundred and forty patients were found to carry this mutation. We found significant association of the CHEK2 truncating variant with vascular invasion and intermediate or high initial risk of recurrence/persistence, whereas this relationship was not found in case of the missense CHEK2 variant. Neither the truncating nor the missense mutations were associated with worse primary treatment response and outcome of the disease. Abstract The CHEK2 gene is involved in the repair of damaged DNA. CHEK2 germline mutations impair this repair mechanism, causing genomic instability and increasing the risk of various cancers, including papillary thyroid carcinoma (PTC). Here, we asked whether CHEK2 germline mutations predict a worse clinical course for PTC. The study included 1547 unselected PTC patients (1358 women and 189 men) treated at a single center. The relationship between mutation status and clinicopathological characteristics, treatment responses, and disease outcome was assessed. CHEK2 mutations were found in 240 (15.5%) of patients. A CHEK2 I157T missense mutation was found in 12.3%, and CHEK2 truncating mutations (IVS2 + 1G > A, del5395, 1100delC) were found in 2.8%. The truncating mutations were more common in women (p = 0.038), and were associated with vascular invasion (OR, 6.91; p < 0.0001) and intermediate or high initial risk (OR, 1.92; p = 0.0481) in multivariate analysis. No significant differences in these parameters were observed in patients with the I157T missense mutation. In conclusion, the CHEK2 truncating mutations were associated with vascular invasion and with intermediate and high initial risk of recurrence/persistence. Neither the truncating nor the missense mutations were associated with worse primary treatment response and outcome of the disease.
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- 2020
38. Are molecular tests necessary to diagnose NIFTP?
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Artur Kowalik, Agnieszka Płusa, Stanisław Góźdź, Janusz Kopczyński, Artur Kuchareczko, Kinga Hińcza, and Aldona Kowalska
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Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,NIFTP ,Cancer ,medicine.disease_cause ,medicine.disease ,BRAF V600E ,Thyroid carcinoma ,BRAFV600E ,Internal medicine ,Genetics ,medicine ,Neoplasm ,Oncogenic mutation ,cancer ,In patient ,business ,Follicular variant ,papillae ,Thyroid neoplasm ,neoplasm ,Research Paper - Abstract
In 2016, encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) was reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). In 2018 the criteria for NIFTP were widened by the inclusion of the complete lack of papillae. Secondary criteria, which include molecular examination, are helpful but not required for NIFTP diagnose. The aim of this study was to assess the molecular background of NIFTP and to answer the question if the aplication of revised criteria for NIFTP diagnosis is associated with the lack of oncogenic mutation. Repeat histopathological assessment of 1117 cases of papillary thyroid carcinoma (PTC) from 2000-2016 was conducted. Using initial (2016) and revised (2018) diagnostic criteria, NIFTP was diagnosed in 23 and 13 patients respectively. 50 tumor genes hotspots mutation analysis was conducted. BRAF V600E mutations were detected in patients who fulfilled only initial NIFTP criteria. Other high-risk mutations (TP53) were found in both groups of patients. The application of restrictive, revised diagnostic criteria for NIFTP negates the need for BRAF V600E examination, but these tumors still can harbor other high-risk oncogenic mutations nonetheless. Thus, molecular examination should be considered as a necessary step in NIFTP diagnostic process.
- Published
- 2020
39. Unusual case of radioactive iodine induced Graves disease with orbitopathy following total thyroidectomy in a patient with papillary thyroid microcarcinoma
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Kajetan Zgubieński, Agnieszka Walczyk, and Aldona Kowalska
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Adult ,Total thyroidectomy ,medicine.medical_specialty ,Unusual case ,business.industry ,Endocrinology, Diabetes and Metabolism ,Graves' disease ,medicine.medical_treatment ,Papillary Thyroid Microcarcinoma ,Thyroidectomy ,medicine.disease ,Carcinoma, Papillary ,Graves Ophthalmopathy ,Iodine Radioisotopes ,Endocrinology ,medicine ,Humans ,Female ,Thyroid Neoplasms ,Radiology ,Radioactive iodine ,business - Abstract
Not required for Clinical Vignette.
- Published
- 2020
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40. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a problematic entity
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Janusz Kopczyński, Klaudia Zajkowska, Aldona Kowalska, and Stanisław Góźdź
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medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Noninvasive follicular thyroid neoplasm with papillary-like nuclear features ,030209 endocrinology & metabolism ,Review ,medicine.disease_cause ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Thyroid carcinoma ,follicular variant of ptc ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Cytology ,Follicular phase ,Internal Medicine ,medicine ,Lymph node ,Thyroid neoplasm ,molecular testing ,lcsh:RC648-665 ,business.industry ,Thyroid ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Inclusion and exclusion criteria ,cytology ,Radiology ,business - Abstract
Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a borderline thyroid tumour formerly known as noninvasive encapsulated follicular variant of papillary thyroid carcinoma. The prevalence of NIFTP is estimated at 4.4–9.1% of all papillary thyroid carcinomas worldwide; however, the rate of occurrence of NIFTP is eight times lower in Asian countries than in Western Europe and America. At the molecular level, NIFTP is characterised by the lack of BRAF V600E and BRAF V600E-like mutations or other high-risk mutations (TERT, TP53) and a high rate of RAS mutations, which is similar to other follicular-pattern thyroid tumours. The diagnosis of NIFTP can only be made after histological examination of the entire tumour removed during surgery and is based on strictly defined inclusion and exclusion criteria. Although the diagnosis is postoperative, the combination of certain findings of preoperative tests including ultrasonography, cytology, and molecular testing may raise suspicion of NIFTP. These tumours can be effectively treated by lobectomy, although total thyroidectomy remains an option for some patients. Radioactive iodine and thyroid stimulating hormone suppression therapy are not required. NIFTP has an extremely good prognosis, even when treated conservatively with lobectomy alone. Nevertheless, it cannot be considered as a benign lesion. The risk of adverse outcomes, including lymph node and distant metastases, is low but not negligible.
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- 2020
41. Telomeres and telomerase in oncogenesis
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Tomasz, Trybek, Artur, Kowalik, Stanisław, Góźdź, and Aldona, Kowalska
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oncogenesis ,telomerase reverse transcriptase ,cancer ,Review ,telomerase ,telomeres - Abstract
Telomeres are located at the ends of chromosomes and protect them from degradation. Suppressing the activity of telomerase, a telomere-synthesizing enzyme, and maintaining short telomeres is a protective mechanism against cancer in humans. In most human somatic cells, the expression of telomerase reverse transcriptase (TERT) is repressed and telomerase activity is inhibited. This leads to the progressive shortening of telomeres and inhibition of cell growth in a process called replicative senescence. Most types of primary cancer exhibit telomerase activation, which allows uncontrolled cell proliferation. Previous research indicates that TERT activation also affects cancer development through activities other than the canonical function of mediating telomere elongation. Recent studies have improved the understanding of the structure and function of telomeres and telomerase as well as key mechanisms underlying the activation of TERT and its role in oncogenesis. These advances led to a search for drugs that inhibit telomerase as a target for cancer therapy. The present review article summarizes the organization and function of telomeres, their role in carcinogenesis, and advances in telomerase-targeted therapy.
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- 2020
42. Does the TT Variant of the rs966423 Polymorphism in DIRC3 Affect the Stage and Clinical Course of Papillary Thyroid Cancer?
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Magdalena Chrapek, Aldona Kowalska, Danuta Gąsior-Perczak, Monika Szymonek, Artur Kuchareczko, Artur Kowalik, Janusz Kopczyński, Klaudia Gadawska-Juszczyk, Klaudia Zajkowska, Kinga Hińcza, Agnieszka Suligowska, Tomasz Trybek, Estera Mikina, Iwona Pałyga, Agnieszka Walczyk, Karol Krawczyk, and Stanisław Góźdź
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Oncology ,Cancer Research ,medicine.medical_specialty ,endocrine system diseases ,030209 endocrinology & metabolism ,overdiagnosis ,lcsh:RC254-282 ,Article ,Papillary thyroid cancer ,03 medical and health sciences ,0302 clinical medicine ,Germline mutation ,Internal medicine ,Genotype ,medicine ,Endocrine system ,risk factors ,papillary thyroid cancer ,Overdiagnosis ,Thyroid cancer ,overtreatment ,business.industry ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,DIRC3 Gene ,030220 oncology & carcinogenesis ,business ,V600E - Abstract
Thyroid cancer (TC) is the most common cancer of the endocrine system. Most new diagnoses are of low-grade papillary thyroid cancer (PTC), suggesting that PTC may be over-diagnosed. However, the incidence of advanced-stage PTC has increased in recent years. It is therefore very important to identify prognostic factors for advanced PTC. Somatic mutation of the BRAF gene at V600E, or the coexistence of the BRAF V600E mutation and mutations in the TERT promoter are associated with more aggressive disease. It would also be valuable to identify genetic risk factors affecting PTC prognosis. We therefore evaluated the impact of the rs966423 polymorphism in the DIRC3 gene, including its relationship with unfavorable histopathological and clinical features and mortality, in differentiated thyroid cancer (DTC). The study included 1466 patients diagnosed with DTC from one center. There was no significant association between the DIRC3 genotype at rs966423 (CC, CT, or TT) and any histopathological or clinic factor examined, including initial response to therapy, response at follow-up, or overall mortality, in DTC patients.
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- 2020
43. The current state and future perspectives of high intensity focused ultrasound (HIFU) ablation for benign thyroid nodules
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Janusz Kopczyński, Aldona Kowalska, Iwona Pałyga, Robert Palyga, Jacek Młynarczyk, and Stanisław Góźdź
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Target lesion ,Thyroid nodules ,medicine.medical_specialty ,Ultrasound beam ,business.industry ,medicine.medical_treatment ,Ultrasound ,Review Article ,medicine.disease ,High-intensity focused ultrasound ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Hifu treatment ,030220 oncology & carcinogenesis ,medicine ,Surgery ,Radiology ,business ,Hifu ablation - Abstract
High intensity focused ultrasound (HIFU) is a new thermoablation technique used to treat benign thyroid nodules. In this method, the ultrasound beam passes through the patient's skin and focuses very precisely on the target lesion at a distance far from the source of ultrasound generation, making HIFU the only truly non-invasive method of thermoablation developed to date. HIFU is therefore an attractive alternative to surgery and other thermoablative techniques. This review describes the principles of HIFU treatment, the selection of patients suitable for HIFU, the course and effects of treatment, and future perspectives.
- Published
- 2020
44. Rekomendacje Polskich Towarzystw Naukowych 'Diagnostyka i leczenie raka tarczycy'. Aktualizacja na rok 2018
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Artur Bossowski, Krystian Jazdzewski, Michał Kalemba, Zoran Stojcev, Ewa Zembala-Nożyńska, Beata Kos-Kudła, Elżbieta Lewandowska-Jabłońska, Kornelia Hasse-Lazar, Anna Nasierowska-Guttmejer, Anhelli Syrenicz, Maciej Bagłaj, Aldona Kowalska, Tomasz Olczyk, Ryszard Anielski, Dorota Słowińska-Klencka, Jolanta Krajewska, Andrzej Kułakowski, Aleksandra Kukulska, Małgorzata Karbownik-Lewińska, Marek Dedecjus, Agata Bałdys-Waligórska, Dagmara Rusinek, Andrzej Lewiński, Jan Włoch, Dariusz Lange, Emilia Kulik, Lech Pomorski, Ewa Małecka-Tendera, Tomasz Tomkalski, Stanisław Sporny, Marek Niedziela, Agnieszka Kotecka-Blicharz, Aleksandra Syguła, Janusz Nauman, Katarzyna Łącka, Zbigniew Wygoda, Tomasz Bednarczuk, Józef Roskosz, Grzegorz Kamiński, Barbara Michalik, Rafał Czepczyński, Beata Jurecka-Lubieniecka, Ewa Chmielik, Andrzej Cichocki, Agata Stanek-Widera, Malgorzata Oczko-Wojciechowska, Janusz Dzięcioł, Sylwia Szpak-Ulczok, Monika Buziak-Bereza, Marcin Barczyński, Aleksandra Kropińska, Mariusz Klencki, Daria Handkiewicz-Junak, Zbigniew Adamczewski, Agnieszka Czarniecka, Barbara Jarząb, Marek Ruchała, Tomasz Gawlik, Ewa Paliczka-Cieślik, Krzysztof Kuzdak, Alicja Hubalewska-Dydejczyk, Aleksandra Ledwon, and Zbigniew Puch
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Oncology ,endocrine system ,medicine.medical_specialty ,endocrine system diseases ,business.industry ,Endocrinology, Diabetes and Metabolism ,05 social sciences ,Thyroid ,Medullary thyroid cancer ,030209 endocrinology & metabolism ,medicine.disease ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,medicine.anatomical_structure ,Internal medicine ,0502 economics and business ,medicine ,050211 marketing ,business ,Thyroid cancer ,Endocrine gland - Abstract
Significant advances have been made in thyroid can-cer research in recent years, therefore relevant clinical guidelines need to be updated. The current Polish guidelines "Diagnostics and Treatment of Thyroid Carcinoma" have been formulated at the "Thyroid Cancer and Other Malignancies of Endocrine Glands" conference held in Wisla in November 2015 [1].
- Published
- 2018
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45. Rating incidence of adverse effects after using recombinant TSH (rhTSH)
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Aldona Kowalska, Małgorzata Nowalska, and Agnieszka Suligowska
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medicine.medical_specialty ,Recombinant TSH ,business.industry ,Internal medicine ,Incidence (epidemiology) ,medicine ,General Medicine ,Adverse effect ,business ,Gastroenterology - Published
- 2018
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46. Immune Profiling of Medullary Thyroid Cancer—An Opportunity for Immunotherapy
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Danuta Gąsior-Perczak, Iwona Pałyga, Magdalena Chrapek, Agnieszka Płusa, Agnieszka Walczyk, Stanisław Góźdź, Aldona Kowalska, Janusz Kopczyński, Kinga Hińcza-Nowak, and Artur Kowalik
- Subjects
Adult ,Male ,Drug ,B7 Antigens ,endocrine system diseases ,medicine.drug_class ,media_common.quotation_subject ,medicine.medical_treatment ,QH426-470 ,Monoclonal antibody ,Single Center ,Malignancy ,medullary thyroid cancer ,Article ,Immune system ,Biomarkers, Tumor ,Genetics ,medicine ,Humans ,Thyroid Neoplasms ,CD276 ,Genetics (clinical) ,Aged ,media_common ,Aged, 80 and over ,business.industry ,Computational Biology ,Medullary thyroid cancer ,Immunotherapy ,Middle Aged ,medicine.disease ,Carcinoma, Neuroendocrine ,Tumor Burden ,Cancer cell ,Cancer research ,Female ,immunotherapy ,business - Abstract
Medullary thyroid cancer (MTC) is a rare malignancy that arises from calcitonin-producing C-cells. Curative treatment for patients with metastatic MTC is challenging. Identifying the mechanisms by which cancer cells inhibit the activity of immune cells provides an opportunity to develop new therapies that restore anticancer activity. Little is known about the immunological phenomena underlying MTC. Here, we examined the expression profile of 395 genes associated with MTC. The study included 51 patients diagnosed with MTC at a single center. Bioinformatical analysis revealed that CD276 expression in MTC cells was at least three-fold higher than that in normal tissue. The expression of CD276 showed a weak but statistically significant positive correlation with tumor diameter, but we did not find a significant association between CD276 expression and other histopathological clinical factors, or the response to initial therapy. A search of published data identified the monoclonal antibody (inhibitor) enoblituzumab as a potential drug for patients diagnosed with MTC overexpressing CD276.
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- 2021
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47. Measurement of 131I activity in air indoor Polish nuclear medical hospital as a tool for an internal dose assessment
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Artur Szczodry, Aldona Kowalska, Kamil Brudecki, Jerzy W. Mietelski, and Tomasz Mróz
- Subjects
Radiation ,Technician ,Biophysics ,Fraction (chemistry) ,030218 nuclear medicine & medical imaging ,Aerosol ,Toxicology ,03 medical and health sciences ,0302 clinical medicine ,Activity measurements ,Internal dose ,030220 oncology & carcinogenesis ,Radioactive contamination ,Environmental science ,Sampling (medicine) ,General Environmental Science - Abstract
This paper presents results of 131I air activity measurements performed within nuclear medical hospitals as a tool for internal dose assessment. The study was conducted at a place of preparation and administration of 131I (“hot room”) and at a nurse station. 131I activity measurements were performed for 5 and 4 consecutive working days, at the “hot room” and nurse station, respectively. Iodine from the air was collected by a mobile HVS-30 aerosol sampler combined with a gas sampler. Both the gaseous and aerosol fractions were measurement. The activities in the gaseous fraction ranged from (28 ± 1 Bq m−3) to (492 ± 4) Bq m−3. At both sampling sites, the activity of the gaseous iodine fraction trapped on activated charcoal was significantly higher than that of the aerosol fraction captured on Petrianov filter cloth. Based on these results, an attempt has been made to estimate annual inhalation effective doses, which were found to range from 0.47 mSv (nurse female) to 1.3 mSv (technician male). The highest annual inhalation equivalent doses have been found for thyroid as 32, 27, 13, and 11 mSv, respectively, for technician male, technical female, nurse male, and nurse female. The method presented here allows to fill the gaps in internal doses measurements. Moreover, because method has been successful used for many years in radioactive contamination monitoring of air in cases of serious nuclear accidents, it should also be used in nuclear medicine.
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- 2017
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48. Diagnosis of thyroid tumours in Świętokrzyskie Province in Poland with respect to the regulations provided in the new oncological package
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Stanisław Góźdź, Łukasz Fortuna, Aldona Kowalska, and Michał Chrobot
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,oncological package ,lcsh:R ,lcsh:Medicine ,oncological diagnosis ,Thyroid tumours ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Pediatrics, Perinatology and Child Health ,thyroid cancer ,Medicine ,Family Practice ,business ,Diagnosis and Oncological Treatment Card ,030217 neurology & neurosurgery - Abstract
Introduction: The new regulations called the “oncological package” were implemented in Poland on 1 January 2015. The issuance of the Diagnosis and Oncological Treatment Card initiates a path of rapid diagnosis and therapy. The new regulations also encompass the diagnostic process in suspected thyroid carcinoma, which is the leading endocrine gland cancer. In 2014, 162 new cases of thyroid cancer were noted in Świętokrzyskie Province in Poland. Before the rapid diagnostic procedure is implemented, the risk of malignancy must be evaluated, which is of particular importance in the case of suspected carcinoma of the thyroid gland due to the great prevalence of benign thyroid nodules. The risk of thyroid carcinoma is evaluated by the analysis of the medical history and proper interpretation of ultrasonographic images of focal lesions. Aim: The aim of this study was to analyse the knowledge of primary care physicians about clinical and ultrasonographic features of high-risk thyroid tumours and to assess whether the Diagnosis and Oncological Treatment Card is used correctly for initiation of a rapid diagnostic process in patients with suspected thyroid carcinoma. Material and methods: The analysis involved the results of thyroid ultrasound scans and medical history data collected during the first visit from all patients who, in the period from 1 January 2015 to 30 September 2016, were referred to the Department of Endocrinology of Świętokrzyskie Oncology Centre with the Diagnosis and Oncological Treatment Card issued by a primary care physician due to a suspicion of thyroid cancer. The authors evaluated the presence of clinical or ultrasonographic features of high-risk thyroid tumours. The analysis involved records of 95 patients. Results: None of the patients presented clinical features of thyroid carcinoma. The phenotype of focal lesions represented high-risk features in merely 21% of the patients; the most common ultrasonographic feature was hypoechogenicity (70% of patients). Oncological diagnostic procedures (fine-needle aspiration biopsy) confirmed a malignancy in only 1 case; it was a patient with high-risk ultrasonographic features (1/20 patients – 5%). None of the patients with a benign phenotype was diagnosed with thyroid carcinoma. Conclusions: 1) The Diagnosis and Oncological Treatment Card is not used properly by primary care physicians in the diagnosis of thyroid lesions. 2) When issuing the Diagnosis and Oncological Treatment Card, primary care physicians do not use the knowledge about clinical or ultrasonographic features that suggest a high risk of malignancy.
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- 2017
49. Delayed risk stratification system in pT1aN0/Nx DTC patients treated without radioactive iodine
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Stanisław Góźdź, Katarzyna Lizis-Kolus, Ryszard Mężyk, Agnieszka Walczyk, Monika Szymonek, Aldona Kowalska, Tomasz Łopatyński, Janusz Kopczyński, Artur Kowalik, Janusz Słuszniak, Danuta Gąsior-Perczak, Iwona Pałyga, and Anna Sluszniak
- Subjects
medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,differentiated thyroid cancer ,030209 endocrinology & metabolism ,Disease ,Single Center ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Internal Medicine ,medicine ,thyroid cancer ,Stage (cooking) ,Thyroid cancer ,lcsh:RC648-665 ,business.industry ,Research ,Medical record ,Thyroid ,Thyroidectomy ,early stage DTC ,medicine.disease ,medicine.anatomical_structure ,delayed risk stratification system ,030220 oncology & carcinogenesis ,Risk stratification ,business - Abstract
Purpose Delayed risk stratification (DRS) system by Momesso and coworkers was accepted by the American Thyroid Association as a diagnostic tool for the risk stratification of unfavorable clinical outcomes and to monitor the clinical outcomes of differentiated thyroid cancer (DTC) patients treated without radioactive iodine (RAI). The aim of this study was to evaluate the DRS system in patients with pT1aN0/Nx stage. Methods The study included 304 low-risk patients after thyroidectomy (n = 202) or lobectomy (n = 102) without RAI and were treated at a single center. The median age was 50.5 years, 91.1% were women and the median follow-up was 4 years. DRS of the treatment response was performed based on medical records and according to the criteria of Momesso and coworkers. Disease course (recurrence, death) and status (remission, persistent disease) on December 31, 2016 were evaluated. The relationship between unfavorable outcomes and the DRS system was evaluated. Results Response to initial therapy was excellent in 272 patients (89.5%), indeterminate in 31 (10.2%) and biochemical incomplete (increased TgAb levels) in one (0.3%). Two patients in the excellent response group experienced recurrence at 6 and 7 years of follow-up (after lobectomy). None of the patients with indeterminate and biochemical incomplete response developed structural disease, and none of the patients died during the follow-up. Conclusions The DRS system was not useful for predicting the risk of unfavorable clinical outcomes and cannot be used to personalize the monitoring method of the disease in patients at pT1aN0/Nx stage who are not treated with RAI.
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- 2017
50. Immunohistochemistry cannot replace DNA analysis for evaluation ofBRAFV600E mutations in papillary thyroid carcinoma
- Author
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Artur Kowalik, Aldona Kowalska, Monika Szymonek, Agnieszka Płusa, Danuta Gąsior-Perczak, Klaudia Gadawska-Juszczyk, Stanisław Góźdź, Janusz Kopczyński, Agnieszka Walczyk, Magdalena Chrapek, Ryszard Mężyk, and Iwona Pałyga
- Subjects
0301 basic medicine ,Oncology ,Sanger sequencing ,medicine.medical_specialty ,Pathology ,business.industry ,Concordance ,Cancer ,medicine.disease ,Papillary thyroid cancer ,Thyroid carcinoma ,Surgical pathology ,03 medical and health sciences ,symbols.namesake ,030104 developmental biology ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,Epidemiology of cancer ,medicine ,symbols ,Immunohistochemistry ,business - Abstract
// Monika Szymonek 1 , Artur Kowalik 2 , Janusz Kopczynski 3 , Danuta Gąsior-Perczak 1 , Iwona Palyga 1 , Agnieszka Walczyk 1 , Klaudia Gadawska-Juszczyk 1 , Agnieszka Plusa 3 , Ryszard Mezyk 4 , Magdalena Chrapek 5 , Stanislaw Goźdź 6, 7 and Aldona Kowalska 1, 7 1 Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland 2 Department of Molecular Diagnostics, Holycross Cancer Center, Kielce, Poland 3 Department of Surgical Pathology, Holycross Cancer Center, Kielce, Poland 4 Cancer Epidemiology, Holycross Cancer Center, Kielce, Poland 5 Department of Probability Theory and Statistics Institute of Mathematics, Faculty of Mathematics and Natural Science, Jan Kochanowski University, Kielce, Poland 6 Oncology Clinic, Holycross Cancer Center, Kielce, Poland 7 The Faculty of Health Sciences, Jan Kochanowski University in Kielce, Poland Correspondence to: Monika Szymonek, email: christ76@interia.pl Keywords: BRAF V600E, papillary thyroid cancer, immunohistochemistry, Sanger sequencing, qPCR Received: May 17, 2017 Accepted: July 25, 2017 Published: August 24, 2017 ABSTRACT Introduction : The BRAF V600E mutation is the most common genetic event occurring in papillary thyroid cancer (PTC). Recently, the possibility of using immunohistochemistry (IHC) to detect the BRAF V600E mutation has been reported. Materials and methods : In 140 patients with classical PTC, the status of the BRAF V600E mutation was determined by IHC (using two alternative staining protocols, IHC-1 and IHC-2) and molecular biology methods: Sanger sequencing (SEQ) and real-time PCR (qPCR). Results : The BRAF V600E mutation was detected in 57.1% (80/140) patients by IHC-1 and 62.9% (88/140) patients by IHC-2. The highest correlation in detecting the BRAF V600E mutation was found between IHC-2 and qPCR (94.2%), and between IHC-1 and qPCR (83.9%). Correlations between IHC-1 and SEQ and between IHC-2 and SEQ were 71.5% and 76.2%, respectively. The IHC-2 protocol had higher sensitivity, PPV, and NPV, and Cohen’s kappa than IHC- 1. The presence of BRAF V600E mutation in IHC-2 statistically correlated with age at diagnosis, histopathological stage, and extrathyroidal extension. Conclusions : The results obtained in this study indicate a lack of concordance between BRAF V600E detection by IHC and molecular methods. The IHC method cannot replace molecular methods for the detection of the BRAF V600E mutation.
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- 2017
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