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Abstract
Thyroid cancer (TC) is the most common endocrine cancer today. The rising incidence of the differentiated papillary type cannot be entirely explained by early and meticulous diagnosis, since a proportion of large tumors has also been reported. In this review, we present the results of numerous investigations focused on possible factors causing increased TC incidence, such as chromosomal and genetic alterations, iodine intake, TSH level, autoimmune thyroid disease, gender, estrogen, obesity, lifestyle changes, and environmental pollutants. Up to now, only childhood exposure to ionizing radiation has been fully recognized as a risk factor. There is also a possibility that yet undiscovered carcinogens, especially during intrauterine life or early childhood, might be responsible for increased TC incidence as well as epigenetic changes. Therefore, more studies are necessary in order to further investigate the potential risk factors for TC and their mechanisms of action.
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Affiliation(s)
| | - Maja Ilić Tomaš
- Department of Nuclear Medicine, University of Rijeka Faculty of Medicine, Clinical Department of Nuclear Medicine, Rijeka Clinical Hospital Centre, Rijeka, Croatia
| | - Neva Girotto
- Department of Nuclear Medicine, University of Rijeka Faculty of Medicine, Clinical Department of Nuclear Medicine, Rijeka Clinical Hospital Centre, Rijeka, Croatia
| | - Svjetlana Grbac Ivanković
- Department of Nuclear Medicine, University of Rijeka Faculty of Medicine, Clinical Department of Nuclear Medicine, Rijeka Clinical Hospital Centre, Rijeka, Croatia
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Jonjić N, Rajković Molek K, Seili-Bekafigo I, Grbac Ivanković S, Girotto N, Jurišić D, Zamolo G, Pavlović Ružić I, Prpić Massari L. Predictive Value of Intraoperative Sentinel Lymph Node Imprint Cytology Analysis for Metastasis in Patients with Melanoma. Acta Dermatovenerol Croat 2017; 25:99-106. [PMID: 28871923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Since there are no standardized protocols regarding the detection of microscopic melanoma deposits in sentinel lymph nodes (SLN), the aim of this study was to present our experience with intraoperative cytological evaluation of SLN in patients with melanoma. The study included 475 SLN biopsies (SLNB) from 201 patients with primary cutaneous melanoma of intermediate thickness. Each lymph node was cut in half; touch imprint cytology (TIC) preparations of all cut surfaces were performed and stained according to a modified May-Grünwald-Giemsa method. The results were compared to definitive postoperative histology. Twenty of 25 SLNB positive on TIC proved to be metastatic when compared to definitive histology. Most of 32 SLN that were suspicious but not diagnostic on TIC were proven negative (23/32, 71.8%), while 7 nodes had metastases (one micrometastasis and one with isolated tumor cells only). The majority (94%) of SLNBs negative on TIC remained negative on final histology, while 6% or 25 nodes were positive, mostly with micrometastases or isolated tumor cells (17/25). In frozen sections performed in cases of suspicious or positive SLN cytology, metastasis was confirmed in 80% of positive and in 21.9% of suspicious TIC. Altogether, 49% (27/55) of positive SLNB were identified intraoperatively in 57% (24/42) of patients, and in those cases a complete regional lymph node dissection was performed in the first step. TIC assessment of SLNB with 99% specificity and 57% sensitivity for intraoperative identification of metastasis is useful and beneficial for avoiding a second operative procedure.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Larisa Prpić Massari
- Prof. Larisa Prpić Massari, MD, PhD Department of Dermatology, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia;
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Kralik I, Štefanić M, Brkić H, Šarić G, Težak S, Grbac Ivanković S, Griotto N, Štimac D, Rubin O, Salha T, Ivanišević Z, Jurković S, Faj D. Estimated collective effective dose to the population from nuclear medicine diagnostic procedures in Croatia: A comparison of 2010 and 2015. PLoS One 2017; 12:e0180057. [PMID: 28662092 PMCID: PMC5491126 DOI: 10.1371/journal.pone.0180057] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 06/08/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study presents national surveys of patient exposure from nuclear medicine (NM) diagnostic procedures in 2010 and 2015 in the Republic of Croatia. METHODS The survey was performed according to the European Commission Dose DataMed (DDM) project methodology. 28 most frequent NM diagnostic procedures were identified. Data about frequencies of procedures and average administered activities of radioisotopes used in those procedures were collected. Average administered activities were converted to effective doses according to the dose conversion coefficients. Then the collective effective dose to the population and an effective dose per capita were calculated based on the number of the most frequent NM diagnostic procedures and the average effective dose per procedure. RESULTS In 2010, 41200 NM diagnostic procedures led to 146.7 manSv collective effective dose to the population and in 2015, 42000 NM diagnostic procedures led to 146.8 manSv collective effective dose to the population. The frequencies of NM diagnostic procedures were 9.7 and 9.8 annually per 1000 population with 34.1 μSv and 34.2 μSv effective dose per capita for 2010 and 2015, respectively. The main contributors to the annual collective dose from NM in Croatia are examinations of the bone, heart, thyroid and PET/CT tumour diagnostic. Average administered activities have not changed considerably from 2010 to 2015. Nevertheless, within the frequency of some of the procedures, significant changes were found in five-year period. CONCLUSIONS Frequencies, average administered activities and collective effective dose to the population from NM diagnostic procedures in Croatia are comparable to the values reported by other European surveys. Changes were found between 2010 and 2015 and we intend to perform this study periodically to identify possible trends, but also to raise awareness about the potential dose optimization.
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Affiliation(s)
- Ivana Kralik
- State Office for Radiological and Nuclear Safety, Zagreb, Croatia
| | - Mario Štefanić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- University Hospital Centre Osijek, Osijek, Croatia
| | - Hrvoje Brkić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Gordan Šarić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- University Hospital Centre Osijek, Osijek, Croatia
| | - Stanko Težak
- University Hospital Centre Zagreb, Zahreb, Croatia
| | - Svjetlana Grbac Ivanković
- University Hospital Centre Rijeka, Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Neva Griotto
- University Hospital Centre Rijeka, Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Damir Štimac
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- University Hospital Centre Osijek, Osijek, Croatia
| | - Otmar Rubin
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- University Hospital Centre Osijek, Osijek, Croatia
| | - Tamer Salha
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- University Hospital Centre Osijek, Osijek, Croatia
| | - Zrinka Ivanišević
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Slaven Jurković
- University Hospital Centre Rijeka, Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Dario Faj
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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Jonjić N, Mustać E, Bekafigo IS, Molek KR, Lovasić F, Lukanović M, Ivanković SG, Girotto N, Lovasić IB, Petković M. [Analysis of sentinel lymph node in early breast cancer patient - Clinical Hospital Center Rijeka]. Lijec Vjesn 2013; 135:201-205. [PMID: 23991488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Sentinel lymph node (SLN) biopsy is an accurate method for the detection of axillary metastases in early breast cancer patients and is of value as a replacement for axillary dissection. However, variations in the methods and protocols used for the pathological evaluation of SLN exist in everyday practice. Therefore, standardization how to detect, dissect, process, stain, assess and report SNL is required in order to stratify patients into adequate prognostic groups. The aim of this study was to present our experience in SLN analysis in patients with early breast cancer and clinical stage T1-2 and N0. In the period between 2003 and 2011, 1071 consecutive patients or 1915 SLN were analyzed. The protocol included intraoperative analysis of histological frozen sections and cytological imprint, followed by analysis of paraffin sections according to the protocol that included sections of whole SLN with the interval of 250 prm. According to the accepted protocol 75% of SLN were negative. The obtained results were correlated with literature data.
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Affiliation(s)
- Nives Jonjić
- Zavod za patologiju, Medicinski fakultet, Sveuciliste u Rijeci.
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