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Title: Diagnostic studies of thyroid cancer

Abstract

Patient with goiter usually has benign disease. While investigation is important, clinical factors weight heavily in the diagnosis of cancer. Aside from serum calcitonin and CEA, biochemical findings are of little help. Radioisotope scanning is of fundamental importance and has an implication in history. Ultrasonography has a diminishing role although its use has led to the widespread acceptance of needle aspiration. Needle aspiration cytology is now the most important maneuver in preoperative assessment and management of the goiter patient. Its results permit refined operative selection, the institution of safe conservative management, and greater organization in surgical treatment. Persistent cooperation between clinician and pathologist can yield a high rate of the reliable preoperative cytological diagnosis obtained by needle aspiration.

Authors:
Publication Date:
OSTI Identifier:
5706077
Resource Type:
Journal Article
Resource Relation:
Journal Name: J. Surg. Oncol.; (United States); Journal Volume: 16:3
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; 59 BASIC BIOLOGICAL SCIENCES; GOITER; DIAGNOSIS; NEOPLASMS; THYROID; SCINTISCANNING; BIOPSY; CYTOCHEMISTRY; CYTOLOGY; PATHOLOGY; PATIENTS; THERAPY; ULTRASONOGRAPHY; BIOCHEMISTRY; BIOLOGY; BODY; CHEMISTRY; COUNTING TECHNIQUES; DIAGNOSTIC TECHNIQUES; DISEASES; ENDOCRINE DISEASES; ENDOCRINE GLANDS; GLANDS; ORGANS; RADIOISOTOPE SCANNING; 550601* - Medicine- Unsealed Radionuclides in Diagnostics; 550901 - Pathology- Tracer Techniques; 551001 - Physiological Systems- Tracer Techniques; 550300 - Cytology

Citation Formats

Rosen, I.B. Diagnostic studies of thyroid cancer. United States: N. p., 1981. Web. doi:10.1002/jso.2930160307.
Rosen, I.B. Diagnostic studies of thyroid cancer. United States. doi:10.1002/jso.2930160307.
Rosen, I.B. 1981. "Diagnostic studies of thyroid cancer". United States. doi:10.1002/jso.2930160307.
@article{osti_5706077,
title = {Diagnostic studies of thyroid cancer},
author = {Rosen, I.B.},
abstractNote = {Patient with goiter usually has benign disease. While investigation is important, clinical factors weight heavily in the diagnosis of cancer. Aside from serum calcitonin and CEA, biochemical findings are of little help. Radioisotope scanning is of fundamental importance and has an implication in history. Ultrasonography has a diminishing role although its use has led to the widespread acceptance of needle aspiration. Needle aspiration cytology is now the most important maneuver in preoperative assessment and management of the goiter patient. Its results permit refined operative selection, the institution of safe conservative management, and greater organization in surgical treatment. Persistent cooperation between clinician and pathologist can yield a high rate of the reliable preoperative cytological diagnosis obtained by needle aspiration.},
doi = {10.1002/jso.2930160307},
journal = {J. Surg. Oncol.; (United States)},
number = ,
volume = 16:3,
place = {United States},
year = 1981,
month = 1
}
  • Between 1951 and 1969 a total of 35,074 patients less than 75 years of age (mean = 44 years) were examined with diagnostic doses of 131I. The mean administered activity of 131I was 52 microCi and the radiation dose to the thyroid gland was on the average of 0.5 Gy. The cohort was matched with the Swedish Cancer Register for the years 1958-1984. During this period, 3746 cancers occurred more than 5 years after the 131I examination, and the resulting standardized incidence ratio (SIR) was 1.01 (95% confidence interval (CI) = 0.98 to 1.04). SIR for thyroid cancer was 1.18more » (95% CI = 0.88 to 1.56). The risks for both cancer of all sites and for thyroid cancer were highest 5 to 9 years after examination (SIR = 1.07 and 2.06, respectively) and did not differ from unity thereafter. With greater than or equal to 10 years of follow-up, risk was not statistically associated with the dose of 131I.« less
  • The incidence of thyroid cancer was evaluated in 35,074 patients examined for suspected thyroid disorders between 1951 and 1969 with an average of 1.92 megabecquerel ((MBq) 52 microCi) of 131I. The radiation dose to the thyroid gland was, on the average, approximately 0.5 Gy. The mean age at the time of examination was 44 years; 5% were under age 20. Patients were followed for an average of 20 years. Record linkage with the Swedish Cancer Register identified 50 thyroid cancers occurring 5 years or more after the initial 131I examination, in contrast to 39.4 expected based on general population ratesmore » (standardized incidence ratio (SIR) = 1.27, 95% confidence interval = 0.94-1.67). Risk was highest among males (SIR = 2.70, n = 10), patients followed 5-9 years (SIR = 2.22, n = 23), and patients receiving more than 74 microCi or 2.74 MBq of 131I (SIR = 2.04, n = 17). However, these observations were confounded by the fact that patients examined for a suspected thyroid tumor received the highest 131I exposures and were at highest overall risk (SIR = 2.77, n = 34). Patients given 131I for reasons other than a suspected tumor were not at increased risk (SIR = 0.62, n = 16). Patients anticipated to be at highest risk, i.e., women (SIR = 1.12, n = 40) and those observed for 10 years or more (SIR = 0.93, n = 27), showed no evidence of a dose response. Overall, these data provide little proof that 131I is carcinogenic in humans and support the notion that the carcinogenic potential of internal 131I beta particles might be as low as four times less than external x rays or gamma rays.« less
  • To provide quantitative data on the risk of thyroid cancer after exposure to {sup 131}I, 34,104 patients administered {sup 131}I for diagnostic purposes were followed for up to 40 years. The mean thyroid dose was estimated as 1.1 Gy, and 67 thyroid cancers occurred in contrast to 49.7 expected (standardized incidence ratio = 1.35; 95% confidence interval 1.05-1.71). Excess cancers were apparent only among patients referred because of a suspected thyroid tumor, and no increased risk was seen among those referred for other reasons. Further, risk was not related to radiation dose to the thyroid gland, time since exposure ormore » age at exposure. The slight excess of thyroid cancer thus appeared to be due to the underlying thyroid condition and not radiation exposure. Among those under age 20 years when {sup 131}I was administered, a small excess risk (3 cancers compared to 1.8 expected) was about 2-10 times lower than that predicted from data for the A-bomb survivors. These data suggest that protraction of dose may result in a lower risk than an acute X-ray exposure of the same total dose. 34 refs., 5 tabs.« less