scholarly journals Influence of intravenous laser blood irradiation on lymphovenous outflow and the state of humoral and cellular immunity in patients with postthrombophlebitic disease of the lower extremities

2021 ◽  
Vol 25 (1) ◽  
pp. 21-26
Author(s):  
G. V. Yarovenko ◽  
S. E. Katorkin ◽  
A. V. Yashkov
Keyword(s):  
T Lymphocytes ◽  
Lymph Nodes ◽  
Cellular Immunity ◽  
B Lymphocyte ◽  
Lower Extremities ◽  
Humoral And Cellular Immunity ◽  
Blood Irradiation ◽  
Group 2 ◽  
Laser Blood Irradiation ◽  
Group 1

Post-thrombophlebitis of lower extremities occurs in 14–29 % of cases and develops within the fi rst two years after the episode of deep vein thrombosis of lower extremities in 20–50 % of patients. Objective: to apply intravenous laser blood irradiation (ILBI) for optimizing outcomes in patients with post-thrombophlebitic disease of their lower extremities. Materials and methods. 52 patients were treated with ILBI. They were randomized into two groups by the following clinical criteria: stage of occlusion – 18 patients (Group 1) and stage of recanalization – 34 patients (Group 2). ILBI course included 7 sessions: irradiation power – 3–15 mW, pulse frequency – 80–3000 Hz, exposure time – 5–15 minutes. Parameters of venous outfl ow and inguinal lymph nodes were monitored by ultrasound examination. Radial immunodiffusion was used to determine levels of IgG, IgM and IgA in blood plasma and serum; turbidimetry – to determine immune complexes; T-lymphocytes – by the receptors to erythrocytes. B-lymphocyte level was monitored with luminescence-serological and complementary rosette formation techniques. Results and discussion. A statistically signifi cant increase in linear and volumetric blood fl ow in great vessels was revealed in both groups. In Group 1, linear blood fl ow in the great saphenous vein increased by 5.2 %; volumetric blood fl ow increased up to 113.0 ± 2.14 mL/min (p < 0.01). In Group 2, volumetric blood fl ow slowed down by 4.1 %. Lymph nodes contracted statistically signifi cantly; the medullary layer narrowed up to 0.32 ± 0.05 cm (p < 0.05), level of IgG, IgM and CIC decreased; number of T-lymphocytes increased up to 60.2 ± 1.7 % (p < 0.05). Conclusion. The revealed effects of intravenous laser blood irradiation at the venous outfl ow, lymph nodes and humoral and cellular immunity in patients with post-thrombophlebitic disease of lower extremities give a reason to recommend the implementation of the discussed technique into a wide clinical practice.

scholarly journals Palliative esophagectomy in unexpected metastatic disease: sense or nonsense?

2018 ◽  
Vol 26 (7) ◽  
pp. 552-557 ◽  
Author(s):  
Lieven P Depypere ◽  
Johnny Moons ◽  
Toni E Lerut ◽  
Willy Coosemans ◽  
Hans Van Veer ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Nodes ◽  
Metastatic Disease ◽  
Palliative Resection ◽  
Oligometastatic Disease ◽  
Group 3 ◽  
Group 2 ◽  
Curative Esophagectomy ◽  
Group 1 ◽  
Single Organ

Background Despite integrated positron emission tomography and computed tomography screening before and after neoadjuvant treatment in patients with locally advanced esophageal cancer, unexpected metastatic disease is still found in some patients during surgery. Should then esophagectomy be aborted or is there a place for palliative resection? Methods Between 2002 and 2015, 681 patients with potentially resectable esophageal cancer were sheduled for neoadjuvant therapy and subsequent esophagectomy. In 552 patients, a potentially curative esophagectomy was performed. In 12 patients, unexpected disease was discovered during surgery but esophagectomy was performed with synchronous resection of metastases; 10 of them had oligometastatic disease (≤4 single-organ metastases). Esophagectomy was not performed in 117 patients (because of disease progression in 50); 14 were also single-organ oligometastatic. Data of 10 single-organ oligometastatic patients who underwent esophageal resection (group 1) were compared those of 10 non-resected but treated counterparts (group 2) and with 228 patients who underwent potentially curative esophagectomy with persistent pathological lymph nodes (group 3). Results Five oligometastatic esophagectomy patients had lung metastases: 1 peritoneal, 2 adrenal, 1 pleural, and 1 pancreatic. Two oligometastatic non-resected patients had lung, 5 liver, and 3 brain metastases. Median overall survival was 21.4, 12.1, and 20.2 months in the respective groups (group 1 vs. group 2  p = 0.042; group 2 vs. group 3  p = 0.002; group 1 vs. group 3  p = 0.88). Conclusions Survival is longer in patients undergoing palliative esophagectomy with unexpected single-organ oligometastatic disease and comparable to survival in patients with persistent pathological lymph nodes. Palliative resection in these patients seems to be justified.

scholarly journals Comparison of Rare Types of Breast Cancer

2021 ◽  
pp. 9-17
Author(s):  
Osman Erdogan ◽  
Alper Parlakgumus ◽  
Ugur Topal ◽  
Kemal Yener ◽  
Umit Turan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Radical Mastectomy ◽  
Treatment Modalities ◽  
Breast Carcinomas ◽  
Term Survival ◽  
Prognostic Features ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aims: Mucinous, medullary, and papillary carcinomas are rarely encountered types of breast cancer. This study aims to contribute to the literature by comparing the clinical and prognostic features and treatment alternatives of rare breast carcinomas. Study Design: Thirty-four patients with rare breast cancer out of a total of 1368 patients who underwent surgery for breast cancer in our clinic between January 2011 and December 2020 were included in the study. Methodology: The patients were assigned into three groups, i.e., medullary carcinoma group (Group 1), mucinous carcinoma group (Group 2) and papillary carcinoma group (Group 3). Demographic and clinical features, treatment modalities used, surgical approaches, pathological features of tumors and survival were compared between the groups. Results: Thirty-four patients were included in the study. The mean age of the patients in Group 3 was higher, though it was not statistically significant. Modified radical mastectomy was more frequently performed in all the groups. The number of the lymph nodes removed through axillary dissections and the number of the positive lymph nodes were similar in all the groups. The tumors in all the groups were also of comparable sizes (30 mm in Group 1, 42.5 mm in Group 2 and 30 mm in Group 3; p:0.464). Estrogen receptors were negative in a significantly higher rate of Group 1(66.7% of Group 1, p<0,001). A significantly higher rate of Group 1 received postoperative chemotherapy (93,3% of Group 1,p:0.001), but the rate of the patients receiving hormonotherapy in this group was significantly lower (26.7% of Group, p<0,001). The patients with medullary cancer had significantly longer survival than those with mucinous cancer and those with papillary cancer (76.2 in Group 1, 54.5 in Group 2 and 58.4 in Group 3; p:0.005). Conclusion: While rare subtypes of breast carcinoma did not affect opting for surgical treatment, selection of oncological therapy was affected depending on the hormone receptor status of these tumors. The long-term survival differed between rare breast tumors. In view of the unique clinical pictures of the tumors, the patients should be evaluated individually, and the evaluation should be associated with theevidence-based principles available for more common breast carcinomas.

scholarly journals SURGICAL MODALITIES FOR SIGMOID COLON CANCER COMPLICATED BY DECOMPENSATED OBSTRUCTION

2020 ◽  
Vol 19 (3) ◽  
pp. 80-91
Author(s):  
S. N. Schaeva ◽  
E. V. Gordeeva ◽  
E. A. Kazantseva
Keyword(s):  
Colon Cancer ◽  
Lymph Nodes ◽  
Sigmoid Colon ◽  
Surgical Procedures ◽  
Postoperative Mortality ◽  
Sigmoid Colon Cancer ◽  
Second Stage ◽  
Resection Status ◽  
Group 2 ◽  
Group 1

AIM: to evaluate the early and long-term results of emergency two-stage surgical procedures in patients with sigmoid colon cancer complicated by decompensated bowel obstruction.PATIENTS AND METHODS: the cohort study included 112 patients with sigmoid colon cancer complicated by bowel obstruction that underwent emergency two-stage surgical procedures in general surgical and coloproctological units in 2011-2017. The group 1 (n=60) included patients who, at the first stage, underwent Hartmann’s procedure, at the second stage – stoma reversal. The group 2 (n=52) included patients with a loop colostomy at the first stage and radical elective surgery as a second stage. The comparative analysis between the groups was carried out according to the following criteria: the type of surgery, the type of intestinal stoma, the rate and type of postoperative complications, postoperative mortality, resection status (R0/R1), the number of removed lymph nodes, the rate of adjuvant polychemotherapy (PChT).RESULTS: postoperative mortality in the group 1 was 3.33% (n=2) and occurred after the first main stage (Hartmann’s procedure), there were no deaths in group 2 (p=0.28). The procedures in group 2 fully met the criteria of oncological radicalism based on the number of lymph nodes examined and resection status (p<0.0001 and p<0.0001, respectively). Three-year overall survival at stage IIB in group 1 was 44.4% vs 75.2% in group 2 (p<0.0001); with IIIB in the 1st group – 60.3% vs 68.2% in group 2 (p=0.034); at IIIС in the 1st group – 35.7% vs 60.7% in the 2nd group (p=0.009). The 3-year disease – free survival at stage IIB in the 1st group was 41.7% vs 68.8% in the 2nd group (p<0.0001); with IIIB in the 1st group – 53.6% vs 64.5% in group 2 (p=0.036); at IIIС in the 1st group – 33.2% vs 60.8% in the 2nd group (p=0.023).CONCLUSION: for sigmoid colon cancer complicated by decompensated obstruction, in general hospitals the stage treatment with the colostomy at the first stage is preferable.

scholarly journals Differential Diagnosis of Periportal Adenopathy Based on Endoscopic Ultrasound Guided Fine Needle Aspiration (EUS-FNA)

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S62-S62
Author(s):  
M Esebua
Keyword(s):  
Differential Diagnosis ◽  
Lymph Nodes ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Group 2 ◽  
Malignant Diagnosis ◽  
Positive Lymph Nodes ◽  
Group 1

Abstract Introduction/Objective Endoscopic ultrasound guided fine-needle aspiration is a safe and accurate diagnostic procedure for abdominal lymphadenopathy. Goal of this study is to evaluate the utility of EUS-FNA in two groups of patients with periportal lymphadenopathy: group 1 with diagnosis of malignancy and group 2 with no known malignant diagnosis. Methods/Case Report This is a retrospective study of 74 patients in our database with enlarged periportal lymph nodes detected on cross sectional imaging of the abdomen. All patients underwent EUS-FNA with 22-gauge needle. Three passes were performed for each lymph node detected. Median size of periportal lymph nodes was 19.8 mm (ranging from 5 to 59 mm). 2 groups were compared: group 1 with known malignancy and group 2 with no known malignancy. All patients were clinically followed 6-12month from the procedure. Results (if a Case Study enter NA) 25 of the 74 (34%) patients had malignant diagnosis. The types of neoplasia detected were lymphoma (3), metastatic adenocarcinoma (16), metastatic acinar cell carcinoma (1) and metastatic neuroendocrine tumor (5). 42 of 74 patients (57%) had negative fine-needle aspiration diagnosis: 40 patients had reactive lymph node diagnosis, 2 patients had granulomatous inflammation diagnosis. 2(1%) of 74 cases had atypical diagnosis, 5(7%) cases were unsatisfactory due to inadequate material obtained during procedure. Sensitivity of the procedure is 45.8% and, specificity is 100%. Positive predictive value (PPV) is 100% and negative predictive value (NPV) is 78.7%. EUS-FNA can detect positive lymph nodes as small as 1 cm, however, this method can also miss positive lymph nodes up to size of 3.5 cm which probably due to the uneven involving of the nodes by tumor cells. Lymph nodes 3.5cm and larger are more likely to be malignant, however in differential diagnosis of small lymph nodes (1 cm in length) they were noT statistically significant difference between the pathologic and benign lymph nodes. Conclusion EUS-FNA is effective method for investigating periportal lymphadenopathy with known or unknown malignancy.

scholarly journals Cellular immunity of rabbits incase of parasite association (Treponema cuniculi and Eimeria sp.)

2019 ◽  
Vol 21 (96) ◽  
pp. 8-13
Author(s):  
Y. V. Duda
Keyword(s):  
T Lymphocytes ◽  
B Lymphocytes ◽  
Cellular Immunity ◽  
B Lymphocyte ◽  
Absolute Number ◽  
Blood Parameters ◽  
Control Group ◽  
The Absolute ◽  
T Helpers ◽  
Experimental Group

Despite a huge number of studies, the uniqueness of antiparasitic immunity is so great that there is still insufficient knowledge of the factors contributing to the manifestation of the characteristics of immunity in mixed parasitic diseases of rabbits. Therefore, the question of the influence of the association of pathogens Treponema cuniculi and Eimeria sp. on indicators of cellular immunity of rabbits is relevant. The study was conducted on 59 male rabbits age 3–5 months of the Californian breed, selected by analogy. Animal were separated into two groups: healthy animals (control group) and sick animals (research group). Intensity of invasion was determined by the method of the Mac-Master. It has been established that the level of damage of rabbits by spirochetosis and eimeriosis was, on average, 1155.17 ± 184.87 and 6668.97 ± 284.16 pathogens in 1 g of feces. The count of T- and B-lymphocytes was determined by the method of spontaneous rosette-formation with sheep erythrocytes. Parasitizing the association of pathogens Treponema cuniculi and Eimeria sp. was revealed a high number of leukocytes (1.22 times, P < 0.001), which increased mainly due to lymphocytes, which were 1.45 times higher (P < 0.001), as well as neutrophilic metamyelocytes – 1.48 times (P < 0.05), eosinophils – 1.68 times (P < 0.001) and basophils – 1.57 times (P < 0.001) compared with similar blood parameters of healthy animals. In the blood of sick rabbits, the absolute number of T-lymphocytes (1.56 times, P < 0.001) and B-lymphocytes (3.02 times, P < 0.001) was significantly higher in comparison with a low number of O-lymphocytes (3.46 times, P < 0.001) compared with the control. This indicates the redistribution of lymphocytes to cells that carry T and B lymphocyte receptors on the plasma membrane. The absolute number of T-lymphocytes became high due to T-helpers, which in these animals were higher both in absolute (1.87 times, P < 0.001) and percentage (by 9.18%, P < 0.001) compared to control. Moreover, the percentage of T-suppressors in the blood of rabbits of the experimental group was significantly lower on 5.46% (P < 0.05) compared with the same blood count of healthy animals. Such a redistribution of the T-cell population in the peripheral blood of this group of rabbits led to an increase in the immunoregulatory index by 1.64 times (P < 0.01) than in healthy ones. High IRI and the number of T-active lymphocytes (by 28.23%, P < 0.05) in the blood of rabbits with parasitism of the association of pathogens Treponema cuniculi and Eimeria sp. indicate increased immune system tension.

scholarly journals Efficiency and safety of video-assisted mediastinal lymphadenectomy in the treatment of non-small cell lung cancer

2021 ◽  
Vol 179 (6) ◽  
pp. 24-33
Author(s):  
A. A. Skorokhod ◽  
A. S. Petrov ◽  
A. R. Kozak ◽  
M. A. Atyukov ◽  
A. O. Nefedov ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Lung Resection ◽  
Small Cell ◽  
Small Cell Lung ◽  
Mediastinal Lymphadenectomy ◽  
Group 2 ◽  
Group 1

INTRODUCTION. A number of studies demonstrate the advantage of bilateral mediastinal lymphadenectomy in surgery of non-small cell lung cancer (nSCLC). For surgical approach to the opposite mediastinum for many years there were proposed sternotomy, video-thoracoscopy, and transcervical video-assisted interventions. In our practice, we use videoassisted mediastinal lymphadenectomy (VAMLA).The OBJECTIVE was to learn the efficiency and safety of VAMLA in surgery of NSCLC.METHODS AND MATERIALS. The study included the materials of examination and treatment of 102 patients with NSCLC. 102 patients were divided into 2 groups. In the 1st group (54 patients), VAMLA and lung resection were performed. In the 2nd group (48 patients): anatomical lung resection and systematic ipsilateral lymphadenectomy (SLD) were performed.RESULTS. The average number of remote lymph node stations in group 1 was (7.8±1.7); in group 2 – (4.5±1.2) (p<0.05). The average number of lymph nodes was 26±8.6 compared to (14.3±6) in both groups, respectively (p<0.05). «Occult» pN2-N3 metastasis was detected in 20 % (7/34) of patients of the group 1 and 6.5 % (2/31) of patients of the group 2 (p<0.05). The level of postoperative complications in both groups was 33.4 vs. 29.2 %, respectively (p>0.05). The duration of the postoperative day ((12.7±4.9) vs. (13.7±6.5)) and the duration of pleural drainage ((5.5±4.2) vs. (5.8±4.4)) did not differ in both groups (p>0.05).CONCLUSION. VAMLA is an effective and safe method for evaluating the pN stage of NSCLC. Performing VAMLA in left-sided NSCLC allows removing significantly more lymph nodes and stations in comparison with SLD available in VATS and thoracotomy, which increases the accuracy of postoperative N-staging. The use of the VAMLA in minimally invasive surgery of right-sided NSCLC may be promising in cases of high risk of «occult» pN3 lesion, but requires further study of the role of contralateral lymphatic dissection.

scholarly journals T- and B-lymphocytes subpopulations in the early and advanced rheumatoid arthritis

2021 ◽  
Vol 15 (2) ◽  
pp. 17-22
Author(s):  
A. V. Martynova ◽  
T. V. Popkova ◽  
A. P. Aleksankin ◽  
G. I. Gridneva ◽  
E. V. Gerasimova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
B Cells ◽  
B Lymphocytes ◽  
B Lymphocyte ◽  
Relative Number ◽  
Memory B Cells ◽  
T And B Lymphocytes ◽  
The Absolute ◽  
Group 2 ◽  
Group 1

Objective: to evaluate changes in T- and B-lymphocyte subpopulations at different stages of rheumatoid arthritis (RA).Patients and methods. The study included 53 patients with a definite RA diagnosis according to the 2010 ACR/EULAR criteria (mean age 54.2 [47; 62] years). Group 1 included 27 patients (25 women and 2 men) without history of synthetic disease modifying anti-rheumatic drugs (sDMARDs) intake, group 2 included 26 patients (22 women and 4 men) receiving sDMARDs (methotrexate or leflunomide). The control group consisted of 29 healthy volunteers (23 women and 6 men), the median age was 58.5 [53; 62] years. In all participants flow cytofluorometry according to the standard technique with immunophenotyping of T- and B-lymphocytes was performed.Results and discussion. Compared to controls, patients in group 1 who had not previously received sDMARDs showed a transient increase in "switched" memory B-cells, transient B-cells, and plasmablasts, which was not observed in patients of group 2 (on sDMARDs therapy). Patients with advanced RA showed a statistically significant decrease in the absolute and relative number of memory B-cells, the absolute and relative number of "switched" B-lymphocytes, as well as the number of plasmablasts and transient cells. In RA patients, a statistically significant rela tionship was established between the number of swollen joints and the level of plasmablasts (r=0.51), memory cells (r=0.54), and "switched" B-cells (r=0.41), p< 0,05 in all cases. There were no statistically significant changes in other subpopulations of B-lymphocytes and the profile of T-lymphocytes.Conclusion. Changes in the B-lymphocyte profile are characteristic of different stages of RA. At an early stage, there is an increase in the number of transient B-lymphocytes, plasmablasts and plasmocytes, and in the advanced stage, a decrease in the level of certain populations of B-lymphocytes, such as memory B-cells and "switched" B-lymphocytes. It can be assumed that the ineffectiveness of sDMARDs is associated with a change in the population composition of B-lymphocytes, which requires further study.

T-Cell Depleted Haematopoietic Stem Cells (HSC) Transplantation with Add Back of CD45RA Negative DLI: About 2 Cases

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4350-4350
Author(s):  
Liliane Liliane Dal-Cortivo ◽  
Rita Creidy ◽  
Aurélie Gabrion ◽  
Sébastien Héritier ◽  
Guilhem Cros ◽  
...  
Keyword(s):  
T Cells ◽  
T Cell ◽  
T Lymphocytes ◽  
Immune Reconstitution ◽  
Infectious Complications ◽  
Post Transplant ◽  
Cd8 T Lymphocytes ◽  
Group 2 ◽  
Hsc Transplantation ◽  
Group 1

Abstract Abstract 4350 Introduction: Transplantation of T cell depleted (TCD) HSC transplantation has been associated with:1) an increased risk of infectious complications due to a very late immune reconstitution, 2) a non negligible risk of Graft Versus Host Disease (GVHD) requiring immunosuppressive therapy, and 3) an increased risk of graft rejection. It has been demonstrated that GVHD in murine models is mostly mediated by naïve T cells. Memory T cells have a reduced capacity to induce GVHD while preserving the anti-infectious capacity (Anderson BE et al., 2003). Removing CD45RA cells from donor lymphocytes could reduce infectious complications without induction of GVHD. This procedure was evaluated in two patients presenting multiple infections and treated with mismatch HSC transplantation. Methods: Post transplant immune reconstitution has been compared between two groups. Group 1: 7 patients (1 ostepetrosis, 1 Fanconi anemia and 5 Severe Combined Immuno Deficiency) transplanted with TCD HSC (age: 3 months-11 years, sex ratio F/M: 4/3). Group 2: 2 patients (1 ORAI1 deficiency and 1 MHC class II deficiency) transplanted with TCD HSC and CD45RA depleted cells of the CD34 negative fraction (age: 8 and 23 months, 1 female and 1 male). All patients had myeloablative conditioning regimen. CD34+ cell selection and CD45RA cell depletion procedures were performed using the Clini Macs system (Miltenyi Biotec). Group 1 received a median of 15.3 × 106CD34+ cells/kg with less than 5000 T lymphocytes/kg. Group 2 received respectively 8.8 and 12.3×106 CD34+ cells/kg with less than 5000 T lymphocytes/kg in HSC transplant and 0.9 and 9.2×106/kg CD45RO+ T cells. The thresholds of 100 CD4+ T lymphocytes and 50 CD8+ T lymphocytes per microliter at three months post transplantation, shown to allow sufficient protection against infectious complications (Hakki et al. 2003), were used in our analysis. Results: No significant difference in GVHD incidence was shown between the two groups since only 2/7 patients presented moderate GVHD in group 1 and no GHVD in group 2. Engrafment for both kind of pathology in group 2 was also remarkable Immune reconstitution of CD4+ and CD8+ T lymphocytes was earlier in group 2 as at one month we detected CD4+ T lymphocytes (430 and 24/μl) and CD8+ T lymphocytes (520 and 40/μl) respectively for patient 1 and 2. Whereas in group 1 no T lymphocytes were detected before two months post transplant. The number of CD4+ and CD8+ T lymphocytes at three months post transplantation was considerably increased in group 2 (CD4+: 609 and 190/μl; CD8+: 2088 and 95/μl) versus group 1 (CD4+: 14/μl; CD8+: 0.4/μl). Patient 1 in group 2 presented CMV reactivation at day 10 post transplant (87650 copies/ml, threshold 500) and was able to clear this infection at day 37 concomitantly to an increased CMV tetramer positive cells percentage (Tetramers at day 37/tetramers at day 10: 433 fold increase). Conclusion: The two patients treated with T-cell depleted haematopoietic stem cells (HSC) transplantation and add back of CD45RA negative DLI showed good engraftment, earlier and enhanced immune reconstitution without GVHD. Moreover, one patient developed specific and efficient anti-CMV response probably due to an expansion of the injected CD45RO T cells. These interesting preliminary results should be confirmed by a clinical trial. Disclosures: No relevant conflicts of interest to declare.

Papillary thyroid microcarcinoma and papillary thyreoid cancer at the Department of Surgery, EUC Clinic Zlín

2020 ◽  
Vol 99 (11) ◽  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Biological Behavior ◽  
Evidence Based ◽  
Papillary Thyroid ◽  
Invasive Procedures ◽  
The Czech Republic ◽  
Thyroid Microcarcinoma ◽  
Group 2 ◽  
Group 1

Introduction: Papillary thyroid cancer (PTC), especially micropapillary variant (MPTC), is the most common thyroid malignancy. Biological behavior is not aggressive and the patient’s prognosis is satisfactory. The objective of our comparative retrospective study was to evaluate whether the incidence is rising in the Region of Zlín and if less extensive approach was adopted by Czech endocrinologists. Methods: We compared 2 groups from years 2005–2008 and 2014–2018. The incidence of thyroid cancer, the PTC and the MPTC, the extent of the surgery and the lymphadenectomy, number of removed lymph nodes and the number of positive lymph nodes were observed. Results: We gathered 1353 patients in group 1. We found 220 malignancies (16.3%), 180 (81.8%) were PTC with MPTC variant in 44.4% (80 patients). All patients underwent a total thyroidectomy. We made 18 central and 10 lateral lymphadenectomies, 280 lymph nodes were collected with metastasis in 29,3 %. In group 2 with 1569 patients we found 318 (20.3%) carcinomas, PTC in 302 (94.6%) cases. The MPTC accounted for 215 (67.4%) cases. 10 patients with MPTC underwent hemithyroidectomy only. Numbers of central and lateral lymphadenectomies rose to 52 and 24 respectively. We gathered 376 lymph nodes with proven metastasis in 44.4% of these nodes. Conclusion: Both, the incidence and the frequency of PTC and MPTC are rising in our region. However, the number of less invasive procedures is not increasing significantly despite representing a sufficient way of treatment. We need wider adoption of these evidence-based recommendations by indicating endocrinologists in the Czech Republic.

Efficacy of ferumoxytol as a lymphatic contrast agent in prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 186-186 ◽  
Author(s):  
Michael J. Dattoli ◽  
Stephen M Bravo ◽  
Daniel Kaplon ◽  
Matt Hayes ◽  
Alexandria Osorio ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Contrast Agent ◽  
Metastatic Disease ◽  
High Signal ◽  
Mri Findings ◽  
Comparison Results ◽  
Group 2 ◽  
Group 1

186 Background: Ferumoxytol (Feraheme) is a ferromagnetic nanoparticle with lymphotrophic biokinetics, delivered to lymph nodes by normal macrophages. MRI suppresses normal lymph nodes containing Feraheme. Objective is to validate safety and efficacy in finding lymph node positivity in prostate cancer (PCa). Methods: Nonrandomized prospective evaluation of 178 consecutive PCa patients (pts) at high risk for lymph node spread enrolled 2/13-3/15. All received IV Feraheme. 177 received 6/mg/kg over 20 min. One pt received 3 mg/kg infusion. T2 MEDIC and T2* sequence imaging of abdomen and pelvis, given 24 hours later. Images reviewed by 2 board certified radiologists with same interpretations, blinded to clinical and histo-path info (pre-MRI TNM stage/PSA/Gleason). Nodes were deemed abnormal if they did not suppress after Feraheme infusion (group 1, 94 patients). Nodes were deemed suspicious if suppressed and met usual size criteria with high signal intensity on DWI and decreased ADC map values and morphologic features (group 2, 84 pts). 83 group 1 pts had CT biopsies (77 pelvis, 6 retroperitoneum);11 pts had open PLND. 382 lymph nodes sampled. 76 group 2 patients had CT biopsies (73 pelvis, 3 retroperitoneum); 9 pts had open PLND. 340 lymph nodes sampled. Rad-path correlation was performed. Nodes were stained; reviewed by a single pathologist with no knowledge of MRI findings. Histo-path results for each node were cataloged for later MRI comparison. Results: 90 group 1 pts (96%) proved metastatic PCa; 4 pts (4%) were normal. 68 group 1 pts (77%) had malignant lymph nodes not meeting usual imaging criteria. 39 group 2 pts (47%) showed metastatic PCa; 46 pts (53%) were normal. One group 2 pt had an allergic reaction with hives; infusion ceased at 3mg/kg; pt treated to full resolution with 50 mg IV Benadryl. Conclusions: Feraheme can evaluate lymphatic dissemination of metastatic disease in PCa patients, with a lower limit of resolution of focal lymph node metastases of 2-3 mm. Better resolution gives implications for therapeutic radiation planning of newly diagnosed or recurrent/metastatic PCa. Toxicity was very acceptable at 6mg/kg. Feraheme may play a significant role as a lymphatic contrast agent in the early dissemination of lymphatic metastatic disease.

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