Agnieszka Zubkiewicz-Kucharska

Ultrasound Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules: Does Radiologist Assistance Decrease the Rate of Unsatisfactory Biopsies?

BACKGROUND Ultrasound guided fine-needle aspiration biopsy (UG-FNAB) is the main presurgical, minimally invasive, accurate and generally safe procedure for the diagnosis of thyroid pathology. At present it is recommended as a valuable diagnostic tool for the management of thyroid nodules. OBJECTIVES This study aimed to evaluate if a radiologists assistance in the UG-FNAB procedure decreased the rate of unsatisfactory biopsies. MATERIAL AND METHODS Over a 3-year period, 385 (100%) patients were enrolled to the study. All individuals had UG-FNAB performed for the first time due to multiple nodules of the thyroid gland. Patients with a family history of thyroid cancer, receiving radioactive iodine and other predispositions for thyroid malignancy were excluded. 184 (47.79%) patients were examined using UG-FNAB with a radiologists assistance (group 1) and 201 (52.21%) without such support (group 2). All biopsies were performed by the same surgeon. All specimens obtained were examined by two cytologists experienced in thyroid pathology. RESULTS The specimens from the UG-FNAB were more frequently diagnostic when obtained from procedures performed with a radiologists assistance (77.8% vs. 56.8%, p < 0.0001). The cellularity of the specimens obtained from the UG-FNAB performed with a radiologists assistance was higher than those obtained without such support (66.7% vs. 56.9%, p < 0.0001). CONCLUSIONS UG-FNAB of the thyroid nodules performed with a radiologists assistance makes it possible to obtain more valuable specimens, which may improve diagnostic accuracy in the preoperative management of thyroid pathology.

Multi- and Unifocal Thyroid Microcarcinoma: Are There Any Differences?

BACKGROUND Thyroid microcarcinoma (TMC) often occurs as two or more separate foci, therefore a completion of primary surgery might be necessary. OBJECTIVES To evaluate and compare the incidence, diagnostic accuracy, clinicopathological characteristics and surgical treatment of unifocal and multifocal thyroid microcarcinoma (UTMC vs. MTMC). MATERIAL AND METHODS We retrospectively analyzed 3,218 medical records of patients consecutively admitted and surgically treated in one center due to thyroid pathology. RESULTS In the end, we evaluated 246 (7.64%) patients with thyroid malignancy. Ninety-seven of them (39.43%) were diagnosed as TMC: 84 (86.59%) UTMC and 13 (13.41%) MTMC (p < 0.0001). All MTMC were unilateral tumors. The papillary type of cancer was found in 82 (97.62%) patients with UTMC and in 12 (92.31%) with MTMC (p = 0.8661). In the UTMC group, 1 (1.19%) patient had follicular and 1 (1.19%) the medullary type of TMC. 1 (7.69%) individual in the MTMC group had tumors composed of papillary and follicular cancer. The number of younger patients (age < 45) was comparable in both groups (p = 0.825). The trend was observed that ultrasound guided fine needle aspiration biopsy (UG-FNAB) revealed malignant processes before surgery in a greater number of patients with MTMC than UTMC (84.62% vs. 58.33%, p = 0.131). In the MTMC group, the number of larger tumors (> 5 mm) was greater (84.62% vs. 65.48%), however the difference was not statistically significant. Thirteen percent of patients with UTMC presented cervical lymph node involvement, compared to nearly 8% of patients with MTMC (p = 0.298). Disease-related mortality was not observed in either group. CONCLUSIONS The prevalence of UTMC was significantly higher than MTMC. The majority of UTMC and MTMC were composed of the papillary type of cancer. MTMC and UTMC were equally frequent in both age groups. The accuracy of UG-FNAB was higher in patients with MTMC. The dimensions of most UTMC and MTMC was above 5 mm. The involvement of the cervical lymph node at the time of diagnosis in both groups is comparable and not infrequent.

Chemerin concentration in children with type 1 diabetes

Introduction. Chemerin (CHEM) is achemotactic factor. It promotes the recruitment of immune cells to the site of injury. It was demonstrated that CHEM increases insulin resistance and glucose intolerance, and its concentration correlates with blood glucose and lipid levels. The aim of the study is to evaluate the concentration of CHEM in children with type 1 diabetes mellitus (T1D) depending on metabolic control and the duration of the disease. Material and Methods. The study included 80 children aged 4-18 years (x = 12.6 ± 3.6) in the following groups: children with T1D diagnosed <2 years (N = 23), children with T1Ddiagnosed 2-5 years ago (N = 12), children with T1D for > 5 years (N = 27) and children with no evidence of hyperglycemia or any autoimmune diseases (controls, N = 18). Laboratory tests were performed to diagnose diabetes and to determine the metabolic control (including HbA1c, lipids, CRP, albumin in the urine, fundus examination, c-peptide). Furthermore, the concentrations of the following: CHEM, E-selectin, adiponectin, leptin, IFN-gamma were assessed. Anthropometric measurements were performed. Results. CHEM concentrations were comparable in the T1D andthe control group (55.65 ± 10.08 vs. 61.40 ± 16.65 ng / ml, p = 0.07), as well as leptin (6.27 ± 7 20 vs. 10.62 ± 13.86 ng / ml, p = 0.08) and IFN-γ (2.99 ± 3.45 vs. Słowa kluczowe chemeryna, cukrzyca typu 1, wyrównanie metaboliczne