• 제목/요약/키워드: Thyroid disease

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예후가 좋지 않은 갑상선암에 대한 최신 치료 방침 (Recent Improvements in the Treatment of High-Risk Thyroid Cancer)

  • 이은경
    • 대한두경부종양학회지
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    • 제38권1호
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    • pp.1-9
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    • 2022
  • Thyroid cancer is one of the slow-growing tumors with excellent oncological outcomes. However, a small set of patients with unexpectedly severe outcomes are usually ignored. Anaplastic thyroid cancer (ATC) remains one of the most aggressive and lethal solid tumors. Recently, dabrafenib and trametinib combination therapy or neoadjuvant BRAF induction therapy has shown promising results. In addition, a combination of targeted drugs, immunotherapy, surgery, and radiation therapy can improve overall survival in ATC patients. Another disease for which there is no breakthrough treatment is radioactive iodine-refractory differentiated thyroid cancer (DTC). To date, multikinase inhibitors (sorafenib, lenvatinib) targeting the growth factor signaling pathway have been developed and approved as anticancer agents for patients with advanced DTC. This review includes results from multikinase inhibitors to the emergence of new target molecules, including rearrangements during transformation (RET) and tropomyosin receptor kinase (TRK).

Associations Between XRCC1 Arg399Gln, Arg194Trp, and Arg280His Polymorphisms and Risk of Differentiated Thyroid Carcinoma: A Meta-analysis

  • Du, Yang;Han, Li-Yuan;Li, Dan-Dan;Liu, Hui;Gao, Yan-Hui;Sun, Dian-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.5483-5487
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    • 2013
  • Background: Associations between Arg399Gln, Arg194Trp and Arg280His polymorphisms of the XRCC1 gene and risk of differentiated thyroid carcinoma (DTC) have been widely studied but the findings are contradictory. Methods: We performed a meta-analysis in the present study using STATA 11.0 software to clarify any associations. Electronic literature databases and reference lists of relevant articles revealed a total of 10, 6 and 6 published studies for the Arg399Gln, Arg194Trp and Arg280His polymorphisms, respectively. Results: No significant associations were observed between Arg399Gln and DTC risk in all genetic models within the overall and subgroup meta-analyses, while the Trp/Trp vs Arg/Arg and recessive model of the Arg194Trp polymorphism was associated with DTC susceptibility, and the dominant model of Arg280His polymorphism contributed to DTC susceptibility in Caucasians. Conclusions: Our meta-analysis suggests that XRCC1 Arg194Trp may be a risk factor for DTC development.

갑상선기능항진증(甲狀腺機能亢進症)의 임상적(臨床的) 진단(診斷)에 관(關)한 연구(硏究) (A Study on the Clinical Diagnosis of Hyperthyroidism)

  • 구인서;고창순;이문호
    • 대한핵의학회지
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    • 제7권1호
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    • pp.15-29
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    • 1973
  • To attain a simple and reliable method of evaluating the thyroid function the reliability of the clinical manifestation and the conventional thyroid function tests in diagnosing the hyperthyroidism was studied. The subjects included 184 patients with hyperthyroidism and 66 cases with euthyroidism, who were treated at the Thyroid Clinic, Seoul National University Hospital, from July 1971 through August 1972. The observed results were as follows: 1. In the cases of hyperthyroidism, 19% of the patients were male and 81% female; in the cases of euthyroidism, 7.6% of the patients were male and 92.4% female. The majority of the patients were in 2nd to 4th decades of their lives. 2. There were objective signs clearly manifested in hyperthyroidism which were rare or absent in the euthyroid state. These clinical signs included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor, and warm skin. In the hyperthyroid state 91.3% of the cases manifested two or more of the above signs, whereas in the euthyroid state no patients manifested any two of the above signs. 3. The most frequent complaints of the patients with thyroid disease were palpitation, weight loss, increased appetite, heat intolerance, perspiration, hunger feeling; nervousness, exertional dyspnea, etc. There was no clear difference in the incidence of the symptoms between hyperthyroidism and euthyroidism. 4. In the diagnosis of hyperthyroidism, the reliability of thyroid ?unction tests was as follows; $T_7$ was 92.4% reliable, $^{125}IT_3$ resin uptake rate 91.6% reliable, $^{131}I$ thyroid uptake rate in 24 hrs. 89.4% reliable, serum $T_4$ level 85.9% reliable and BMR 75.5% reliable. Therefore the careful observation of the clinical manifestation of the disease is a simple and reliable way of making a correct diagnosis of either hyperthyroidism or euthyroidism. 5. In hyperthyroidism there shows no correlationship between the results of the thyroid function test and clinical signs but a high BMR was associated with both tachycardia and systolic murmur.

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갑상선환자에서의 5분 $^{99m}Tc-Pertechnetate$ 섭취율과 방사성옥소섭취율의 상관관계 (Correlation between 5-Minute $^{99m}Tc-Pertechnetate$ Uptake and 24-Hour $^{131}I$ Uptake in Patients with Thyroid Disease)

  • 이찬우;원규장;윤현대;조인호;김태년;신동구;이형우;심봉섭;이현우
    • 대한핵의학회지
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    • 제26권2호
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    • pp.280-289
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    • 1992
  • The 20-minute $^{99m}Tc-pertechnetate$ uptake became readily available for routine use and it replaced $^{131}I$ for thyroid imaging. However measuring thyroid uptake during a 5-minute minimizes pertechnetate uptake by the salivary glands and presence of contaminated saliva from those glands in to the pharynx and esophagus. A study was carried out to determine the suitability of the utility of a S-minute and 20-minute interval from administration of $^{99m}Tc-pertechnetate$ to imaging and uptake measurement as a replacement for the 24 hour standard originally established with $^{131}I$, and to evaluate the relationship between 5-minute $^{99m}Tc-pertechnetate$ uptake and other thyroid functions. A 5-minute and 20-minute uptake of $^{99m}Tc-pertechnetate$ were measured in 70 patients with thyroid disease at Yeungnam University Hospital from March 1, 1991 to Feb. 29, 1992. The results were as follows. 1) The 5-minute $^{99m}Tc-pertechnetate$ uptake in Graves' disease, Hashimoto's thyroiditis, simple goiter, non toxic nodular goiter, subacute thyroiditis and euthyroid were 18.2%, 14.6%, 2.8%, 3.2%, 1.2% and 1.1%, respectively. There was a significant difference between the mean of the euthyroid group and the mean of the Graves' disease. So differenciation between them can be easily made. 2) The 5 minute $^{99m}Tc-pertechnetate$ thyroid uptake was well correlated with 24 hour $^{131}I$ thyroid uptake (r=0.75, p<0.001). These data provided an equation for estimating the 24 hour uptake of iodide given the 5 minute pertechnetate uptake: Estimated 24-hour $^{131}I$ thyroid Uptake= 7.188*ln (5 minute $^{99m}Tc-pertechnetate$ uptake)+16.94 3) The 20-minute $^{99m}Tc-pertechnetate$ thyroid uptake was well correlated with 24-hour $^{131}I$ uptake (r=0.72, p<0.001) and 5-minute $^{99m}Tc-pertechnetate$ thyroid uptake (r=0.96, p<0.001). 4) In the Graves' disease, The 5-minute $^{99m}Tc-pertechnetate$ thyroid uptake was well correlated with serum $T_3-resin$ uptake (r=0.46, p<0.01), serum total $T_3$ (r=0.55, p<0.05), serum total $T_4$ (r=0.46, p<0.05). These results suggest that 5-minute ${99m}Tc-pertechnetate$ thyroid uptake has been found at least as useful as 24-hour $^{131}I$ uptake for diagnostic confirmation at our hospital, the logistical advantages of completing the diagnosis. The exam in 5-minutes led us to abandon the 24-hour study in the majority of patients, but the 24-hour $^{131}I$ uptake is still obtained in patients with planned or potential radioiodine therapy.

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알츠하이머병 및 경도인지장애 환자에서 갑상선 관련 호르몬과 인지기능과의 상관관계 (Association between Thyroid-Related Hormones and Cognitive Function in Patients with Alzheimer's Disease and Mild Cognitive Impairment)

  • 박다윤;김현;이강준
    • 정신신체의학
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    • 제27권1호
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    • pp.60-68
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    • 2019
  • 연구목적 갑상선관련 호르몬과 인지기능의 상관 유무는 논란이 되고 있다. 알츠하이머병과 경도인지장애 환자에서 갑상선관련 호르몬 농도에 차이가 있는지 비교해 보고, 나아가 갑상선관련 호르몬 농도가 인지기능의 어떠한 영역과 관련이 있는지에 대해 연구해보고자 하였다. 방 법 2011년 1월부터 2018년 12월까지 기억력 저하를 주소로 일산백병원 정신건강의학과 치매클리닉을 방문하여 알츠하이머병(NINCDS-ADRDA 진단기준)과 경도인지장애(Petersen 진단기준) 으로 진단된 105명의 환자를 대상으로 한 후향적 연구이다. 갑상선관련 호르몬[삼요오드티로닌(Triiodothyronine, T3), 티록신(Thyroxine, T4), 갑상선 자극 호르몬(Thyroid stimulating hormone, TSH)]의 측정은 화학발광면역측정법을 사용하여 검사하였다. 알츠하이머병군과 경도인지장애군 간의 갑상선관련 호르몬의 평균치 분석을 위하여 독립표본 t-검정을 시행하였다. 갑상선관련 호르몬이 전반적 퇴화 척도(Global deterioration scale, GDS), 치매임상평가척도(Clinical dementia rating, CDR) 및 한국형 임상치매평가척도(The Korean version of the consortium to establish a registry for Alzheimer's disease, CERAD-K)의 각 항목 별 점수들과 유의한 상관이 있는지 알아보기 위하여 한국판 노인우울척도(Geriatric depression scale-Korean version, GDS-K)를 통제변수로하여 편상관분석을 시행하였다. 결 과 총 105명의 환자 중 알츠하이머병군은 74명, 경도인지장애군은 31명이었다. 알츠하이머병군과 경도인지장애군 간 혈청 T3, T4, TSH 농도의 평균은 모두 유의한 차이가 없었으나, CERAD-K 항목 중 구성행동 검사(Construction praxis test, CPT)가 혈청 TSH 농도와 유의한 양의 상관 관계를 보였다(p-value=0.004). 결 론 본 연구에서 실행기능과 연관된 CPT가 혈청 TSH 농도와 유의한 양의 상관 관계를 보인 것은 갑상선관련 호르몬과 치매의 병태생리와의 연관성에 대한 이해에 도움을 줄 수 있다고 생각한다. 향후 갑상선관련 호르몬이 인지기능에 미치는 병태생리 기전에 관한 전향적 연구들이 필요할 것으로 사료된다.

전면 영상에서 하나로 오인된 두개의 설갑상전종 (Dual Lingual Thyroid Mimicking Mono-ectopic Thyroid in the Anterior View of Tc-99m Sodium Pertechnetate Thyroid Scan)

  • 정아리;정신영;권성영;서영순;하정민;오종률;범희승;송호천;민정준
    • Nuclear Medicine and Molecular Imaging
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    • 제42권6호
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    • pp.485-487
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    • 2008
  • Ectopic thyroid is not common disease and double ectopic thyroid is rare. Until January of 2008, dual ectopic thyroid has been reported only 23 cases in international literatures. Tc-99m sodium pertechnetate scan is playing an important role in the diagnosis of ectopic thyroid. In most of the cases, dual lingual thyroid tissues could be detected as two radiotracer uptake foci. We report a case of dual lingual thyroid mimicking mono-lingual thyroid in the anterior view of thyroid scan. Lateral view helped in this case to detect the dual lingual thyroid. With lateral view, the anatomical position and relationship could be examined in more detail.

What Do Korean Women Know and Want to Know about Thyroid Cancer? A Qualitative Study

  • Lee, Bomyee;Park, Jae Young;Shin, Hye Young;Park, Sang Hee;Choi, Eun-Bi;Yoo, Jisu;Choi, Kui Son;Jun, Jae Kwan
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.2901-2907
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    • 2016
  • Background: Despite increasing debate about overdiagnosis and overtreatment of thyroid cancer in Korea, information to guide decisions on whether or not to undergo screening for and treatment of abnormal lesions of the thyroid is lacking. Moreover, studies have yet to outline what lay people know and want to know about thyroid cancer. The primary aim of this study was to explore general awareness of thyroid cancer among Korean women, their sources of information, and their satisfaction with the information they are provided. The secondary aim was to investigate information needs about thyroid cancer. Materials and Methods: A qualitative study using focus group interviews was conducted. Twenty-nine women were divided into four groups: (1) participants who had never undergone thyroid ultrasound screening; (2) those who had undergone screening, (3) those who continued to undergo regular check-ups with ultrasonography for benign nodules of the thyroid; and (4) participants who had undergone surgery for thyroid cancer. Results: A widespread lack of awareness of information on thyroid cancer was noted among participants in groups 1 and 2 who were not well aware of thyroid cancer and generally recognized it as a 'good cancer'. Surprisingly, instead of doctors and medical personnel, most participants reported obtaining information from acquaintances and media outlets. Moreover, most participants described dissatisfaction with their experience with screening and a lack of explanation on treatment and test results from medical personnel. Conclusions: Women in Korea seek reliable information on thyroid cancer that could help them to better understand the disease and make informed decisions regarding screening and treatment. More effort is needed from medical personnel to communicate the implications of thyroid cancer, screening results, and treatments thereof to lay people.

갑상선 일측 무형성증 3예 (Three Cases of Thyroid Hemiagenesis)

  • 김기현;정현필;김재욱;고윤우
    • 대한두경부종양학회지
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    • 제22권2호
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    • pp.183-187
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    • 2006
  • Thyroid hemiagenesis is a very rare congenital anomaly in which one thyroid lobe fails to develop. The cause of thyroid hemiagenesis is still unknown. The true prevalence of thyroid hemiagenesis is not known, but it is estimated to be from 0.05% to 0.2% in normal children. Thyroid hemiagenesis is common in female with the left lobe being absent. The common disease in the remaining lobe is hyperthyroidism, benign adenoma, a toxic multinodular goiter, chronic thyroiditis, primary myxedema, and rarely carcinoma. Tc-99m pertechnate scintigraphy, ultrasonography and computerized tomography can be used to confirm this anomaly. Here we report three cases with left lobe agenesis. Two of them were euthyroid state while the other hypothyroid patient had a ectopic lingual thyroid.