scholarly journals Effect of adjuvant radioactive iodine therapy on survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma)

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7458
Author(s):  
Qiong Yang ◽  
Zhongsheng Zhao ◽  
Guansheng Zhong ◽  
Aixiang Jin ◽  
Kun Yu
Keyword(s):  
Survival Analysis ◽  
Thyroid Cancer ◽  
Cell Carcinoma ◽  
Radioactive Iodine ◽  
Regional Lymph Node ◽  
Cancer Specific Survival ◽  
Term Survival ◽  
Hürthle Cell ◽  
Hürthle Cell Carcinoma ◽  
Hurthle Cell Carcinoma

Purpose Radioactive iodine (RAI) is widely used for adjuvant therapy after thyroidectomy, while its value for thyroid cancer has been controversial recently. The primary objectives of this study were to clarify the influence of Radioactive iodine (RAI) on the survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma, HCC). Methods Patients diagnosed with oxyphilic thyroid carcinoma from 2004 to 2015 were extracted from the Surveillance, Epidemiology, and End Results Program database. The Kaplan-Meier method was used to compare overall survival (OS) and cancer-specific survival (CSS) among patients who had adjuvant RAI use or not. Univariate and multivariate Cox proportional hazard models were performed for survival analysis, and subsequently visualized by nomogram. Results In all, 2,799 patients were identified, of which 1529 patients had adjuvant RAI use while 1,270 patients had not. Based on multivariate Cox analysis, the RAI therapy confers an improved OS for HCC patients (HR = 0.57, 95% CI [0.44–0.72], P < 0.001), whereas it has no significant benefit in the survival analysis regarding CSS (HR = 0.79, 95% CI [[0.47–1.34], P = 0.382). In a subgroup analysis, the same survival benefit of RAI treatment on OS, but not CSS was observed among patients stratified by AJCC stage and tumor extension. Nevertheless, patients with regional lymph node metastasis benefited from RAI therapy both in OS and CSS (P < 0.001, respectively). Furthermore, nomograms used for predicting long term survival of HCC patients exhibited a better prediction power for OS compared with traditional tumor, nodal and metastatic (TNM) stage made by American Joint Committee on Cancer (AJCC) (C-index = 0.833 of the nomogram model vs. 0.696 of the AJCC system). Conclusions This study suggests that RAI therapy is significantly associated with improved OS in patients with Hürthle cell carcinoma. However, there was no association between treatment with radioiodine and CSS, possibly due to small number of deaths that were related to HCC.

Meta-analysis utilizing public data suggests role of innate immunity in the pathogenesis of hurthle cell carcinoma (HCC).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13048-e13048
Author(s):  
David Allen ◽  
Ross Wanner ◽  
Sean McDermott ◽  
Jihad Aljabban ◽  
Saad Syed ◽  
...  
Keyword(s):  
Innate Immunity ◽  
Thyroid Cancer ◽  
Retinoic Acid ◽  
Cell Carcinoma ◽  
Meta Analysis ◽  
Good Survival ◽  
Hürthle Cell ◽  
Hürthle Cell Carcinoma ◽  
Hurthle Cell Carcinoma ◽  
Log Ratio

e13048 Background: Hurthle Cell Carcinoma (HCC), a variant of follicular thyroid carcinoma, is a rare form of thyroid cancer. Though it accounts for 3-10% of thyroid cancer cases, very little is known about its pathogenesis. While HCC holds good survival rates, it is still vital to understand the pathogenesis of HCC in order to further optimize treatment protocols. Methods: We tagged 46 HCC samples and 90 healthy thyroid samples as a control. Gene signatures were analyzed in Ingenuity Pathway Analysis, using statistical significance p < 0.05 and absolute log ratio > 0.5 between disease and controls. Methods: Search Tag Analyze Resource was employed to conduct meta-analysis using the National Center for Biotechnologys Gene Expression Omnibus to define HCC pathogenesis. Results: Hepatic fibrosis, hepatic stellate cell activation and retinoic acid receptor (RAR) activation were the top canonical activators associated with HCC. Of the molecules involved, Defensin Beta 1 (DEFB1), Lipocalin-2 (LCN2), Aldehyde Dehydrogenase 1 Family Member A3 (ALDH1A3), and CDC28 Protein Kinase Regulatory Subunit 2 (CKS2) had the highest associations with HCC. The most down-regulated molecules were Hemoglobin Subunit Beta (HBB), Hemoglobin Subunit Alpha 1 and 2 (HBA1/HBA2), Cellular Retinoic Acid Binding Protein 1 (CRABP1), and BH3-Interacting Domain-Containing Protein 3 (HRK). Conclusions: These results suggest that there are a variety of factors at play regarding the development of HCC. Defensins are peptides made by neutrophils, however DEFB1 is specifically known for its ability to resist bacterial growth on epithelial surfaces, playing a major role in innate immunity. LCN2 is also known for resisting growth on surfaces and does so by sequestering iron-containing siderophores, thus effectively stopping growth of microorganisms. Additionally, ALDH1A3 and CRABP1 are associated with RAR activation. While the exact pathogenesis of HCC is not well known yet, we demonstrate that the two most up-regulated factors in HCC are strongly involved in innate immunity. This suggests that the dysfunction of innate immunity may play a vital role in the neoplastic pathogenesis of HCC.

The Role of Radioactive Iodine in the Treatment of Hürthle Cell Carcinoma of the Thyroid

Thyroid ◽  
2003 ◽  
Vol 13 (6) ◽  
pp. 577-584 ◽  
Author(s):  
Nikola Besic ◽  
Barbara Vidergar-Kralj ◽  
Snjezana Frkovic-Grazio ◽  
Tadeja Movrin-Stanovnik ◽  
Marija Auersperg
Keyword(s):  
Cell Carcinoma ◽  
Radioactive Iodine ◽  
Hürthle Cell ◽  
Hürthle Cell Carcinoma ◽  
Hurthle Cell Carcinoma

scholarly journals An Unusual Presentation of Recurrence Hurthle Cell Carcinoma of Thyroid

2020 ◽  
Keyword(s):  
Cell Carcinoma ◽  
Radioactive Iodine ◽  
Clinical Presentation ◽  
Residual Disease ◽  
Tumor Board ◽  
Partial Laryngectomy ◽  
Hürthle Cell ◽  
Hürthle Cell Carcinoma ◽  
Hurthle Cell Carcinoma

This is the case of 55 years old male who was known of hurthle cell carcinoma (HCC) and underwent total thyroidectomy and right neck dissection in July 2015, followed by radioactive iodine (RAI). He was in close follow-up after the treatment when he presented with right sided neck swelling for 6 weeks followed by hoarseness for 4 weeks and fiber optic laryngoscopy revealed right vocal cod palsy. CT scan was done that showed a mass involving right supraglottic and glottis region, he then underwent right vertical partial laryngectomy. Tumor removed completely (grossly and histopathologically). The case was discussed in tumor board meeting and he was advised RAI scan to look for residual disease, by close follow-up. This case report emphasizes on the unusual clinical presentation and recurrence of HCC of thyroid.

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