Search Results

You are looking at 1 - 2 of 2 items for

  • Author: E Saggiorato x
  • Refine by access: All content x
Clear All Modify Search
F Orlandi Department of Internal Medicine, S. Luigi Hospital, University of Turin, Italy. fabio.orlandi@unito.it

Search for other papers by F Orlandi in
Google Scholar
PubMed
Close
,
P Caraci Department of Internal Medicine, S. Luigi Hospital, University of Turin, Italy. fabio.orlandi@unito.it

Search for other papers by P Caraci in
Google Scholar
PubMed
Close
,
A Mussa Department of Internal Medicine, S. Luigi Hospital, University of Turin, Italy. fabio.orlandi@unito.it

Search for other papers by A Mussa in
Google Scholar
PubMed
Close
,
E Saggiorato Department of Internal Medicine, S. Luigi Hospital, University of Turin, Italy. fabio.orlandi@unito.it

Search for other papers by E Saggiorato in
Google Scholar
PubMed
Close
,
G Pancani Department of Internal Medicine, S. Luigi Hospital, University of Turin, Italy. fabio.orlandi@unito.it

Search for other papers by G Pancani in
Google Scholar
PubMed
Close
, and
A Angeli Department of Internal Medicine, S. Luigi Hospital, University of Turin, Italy. fabio.orlandi@unito.it

Search for other papers by A Angeli in
Google Scholar
PubMed
Close

Prognosis and treatment effectiveness of medullary thyroid carcinoma (MTC) are largely related to the tumour stage, so that early diagnosis represents an important goal for the management of patients. Recent advances in genetic testing have improved the clinical approach to the familial MTC syndromes. There is general agreement that the primary operation for MTC should obtain the complete removal of the neoplastic tissue in the neck, because any adjuvant treatment has never been proven to be effective. The management of residual/recurrent or metastatic MTC still remains controversial, although a multimodal approach to advanced disease may be of value in palliation or local control of tumour progression. The role of surgery, external radiotherapy, radionuclide therapy and medical treatment, including biological response modifiers and cytotoxic drugs, are reviewed and discussed.

Free access
E Saggiorato
Search for other papers by E Saggiorato in
Google Scholar
PubMed
Close
,
R De Pompa
Search for other papers by R De Pompa in
Google Scholar
PubMed
Close
,
M Volante
Search for other papers by M Volante in
Google Scholar
PubMed
Close
,
S Cappia
Search for other papers by S Cappia in
Google Scholar
PubMed
Close
,
F Arecco
Search for other papers by F Arecco in
Google Scholar
PubMed
Close
,
A P Dei Tos
Search for other papers by A P Dei Tos in
Google Scholar
PubMed
Close
,
F Orlandi
Search for other papers by F Orlandi in
Google Scholar
PubMed
Close
, and
M Papotti
Search for other papers by M Papotti in
Google Scholar
PubMed
Close

The distinction of benign from malignant follicular thyroid neoplasms remains a difficult task in diagnostic fine-needle aspiration cytology, and some discrepant results have been reported for the individual immunocytochemical markers of malignancy proposed so far. The aim of this study was to test if the combined use of a panel of markers could improve the diagnostic accuracy in the preoperative cytological evaluation of ‘follicular neoplasms’ in an attempt to reduce the number of thyroidectomies performed for benign lesions. The immunocytochemical expression of galectin-3, HBME-1, thyroperoxidase, cytokeratin-19 and keratan-sulfate was retrospectively analyzed in 125 consecutive fine-needle aspiration samples (cell blocks) of indeterminate diagnoses of ‘follicular thyroid neoplasm’, and compared with their corresponding surgical specimens, including 33 follicular carcinomas, 42 papillary carcinomas and 50 follicular adenomas. Statistical analysis on each marker confirmed that galectin-3 and HBME-1 were the most sensitive (92% and 80% respectively) and specific (94% and 96% respectively) molecules. The use of these two markers sequentially in non-oncocytic lesions (testing HBME-1 as a second marker whenever galectin-3 proved negative) increased the sensitivity and specificity up to 97% and 95% respectively. In oncocytic lesions, HBME-1 proved to be less sensitive, and the sequential combination of galectin-3 and cytokeratin-19 reached 100% of both specificity and sensitivity. Our data showed that, as compared with the use of single markers, the sequential combination of two markers represents the most accurate immunohistochemical panel in managing patients with a fine-needle aspiration biopsy diagnosis of ‘follicular neoplasms’, especially in otherwise controversial categories such as oncocytic tumours. The combination of three or more markers did not substantially improve the diagnostic accuracy of the test.

Free access