著者
Tetiana I. Bogdanova Vladimir A. Saenko Mitsuyoshi Hirokawa Masahiro Ito Liudmyla Yu. Zurnadzhy Toshitetsu Hayashi Tatiana I. Rogounovitch Akira Miyauchi Mykola D. Tronko Shunichi Yamashita
出版者
The Japan Endocrine Society
雑誌
Endocrine Journal (ISSN:09188959)
巻号頁・発行日
vol.64, no.10, pp.977-993, 2017 (Released:2017-10-28)
参考文献数
17
被引用文献数
1 1

This study set out to compare structural and invasive characteristics of sporadic papillary thyroid carcinoma (PTC) in age-matched groups of children and adolescents of Japan and Ukraine to provide detailed histopathological analysis of tumors from different geographical areas with different iodine intake. A total of 348 (160 Japanese and 188 Ukrainian) PTCs from patients without radiation history were analyzed initially as a combined pediatric group and then subdivided into childhood (aged ≤14 years) and adolescent (aged from 15 to ≤18 years) age series. On multivariate comparison, the Japanese pediatric PTC was characterized by a higher sex ratio (p=1.504E-4), and a higher frequency of microcarcinoma (p=0.039), papillary dominant growth pattern (p=0.024), focal oxyphilic cell metaplasia (p=7.644E-6), intrathyroid spread (p=0.010), lymphatic/vascular invasion (p=0.01) and regional lymph node metastases (p=3.540E-6). In the Ukrainian group, multifocal (p=0.004) and non-encapsulated tumors with the solid-trabecular growth pattern (p=0.05) were more frequent. Childhood Japanese PTCs differed from Ukrainian PTCs by more pronounced invasive properties such as lymphatic/vascular invasion and nodal disease, but did not differ by the dominant growth pattern. In adolescents, the differences were detected not only for lymph node metastases, but also for a higher frequency of the papillary dominant pattern in Japanese PTC. Overall, significantly higher frequencies of oxyphilic cell metaplasia and more pronounced invasive features observed in the Japanese PTC in both age-matched series represent the major differences between the tumors from two geographical areas.
著者
Tetiana I. Bogdanova Vladimir A. Saenko Mitsuyoshi Hirokawa Masahiro Ito Liudmyla Yu. Zurnadzhy Toshitetsu Hayashi Tatiana I. Rogounovitch Akira Miyauchi Mykola D. Tronko Shunichi Yamashita
出版者
(社)日本内分泌学会
雑誌
Endocrine Journal (ISSN:09188959)
巻号頁・発行日
pp.EJ17-0134, (Released:2017-08-10)
被引用文献数
1

This study set out to compare structural and invasive characteristics of sporadic papillary thyroid carcinoma (PTC) in age-matched groups of children and adolescents of Japan and Ukraine to provide detailed histopathological analysis of tumors from different geographical areas with different iodine intake. A total of 348 (160 Japanese and 188 Ukrainian) PTCs from patients without radiation history were analyzed initially as a combined pediatric group and then subdivided into childhood (aged ≤14 years) and adolescent (aged from 15 to ≤18 years) age series. On multivariate comparison, the Japanese pediatric PTC was characterized by a higher sex ratio (p=1.504E-4), and a higher frequency of microcarcinoma (p=0.039), papillary dominant growth pattern (p=0.024), focal oxyphilic cell metaplasia (p=7.644E-6), intrathyroid spread (p=0.010), lymphatic/vascular invasion (p=0.01) and regional lymph node metastases (p=3.540E-6). In the Ukrainian group, multifocal (p=0.004) and non-encapsulated tumors with the solid-trabecular growth pattern (p=0.05) were more frequent. Childhood Japanese PTCs differed from Ukrainian PTCs by more pronounced invasive properties such as lymphatic/vascular invasion and nodal disease, but did not differ by the dominant growth pattern. In adolescents, the differences were detected not only for lymph node metastases, but also for a higher frequency of the papillary dominant pattern in Japanese PTC. Overall, significantly higher frequencies of oxyphilic cell metaplasia and more pronounced invasive features observed in the Japanese PTC in both age-matched series represent the major differences between the tumors from two geographical areas.
著者
Tatiana A. Leonova Valentina M. Drozd Vladimir A. Saenko Mariko Mine Johannes Biko Tatiana I. Rogounovitch Noboru Takamura Christoph Reiners Shunichi Yamashita
出版者
(社)日本内分泌学会
雑誌
Endocrine Journal (ISSN:09188959)
巻号頁・発行日
pp.EJ14-0408, (Released:2014-11-05)
被引用文献数
1

Long-term management of patients with differentiated thyroid cancer (DTC) commonly includes TSH-suppressive therapy with L-T4 and, in case of postsurgical hypoparathyroidism, Calcium-D3 supplementation, both of which may affect skeletal health. Experience with female patients treated for DTC at a young age and who were then receiving long-term therapy with L-T4 and Calcium-D3 medication is very limited to date. This cross-sectional study set out to investigate effects of Calcium-D3 supplementation and TSH-suppressive therapy on bone mineral density (BMD) in 124 young female patients treated for DTC at a mean age of 14 years and followed-up for an average of 10 years. BMD was found to be significantly higher in patients receiving Calcium-D3 medication than in patients not taking supplements. The level of ionized calcium was the strongest factor determining lumbar spine BMD in patients not receiving Calcium-D3 supplementation. Pregnancy ending in childbirth and HDL-cholesterol were associated with a weak adverse effect on spine and femoral BMD. No evidence of adverse effects of L-T4 and of radioiodine therapies on BMD was found. We conclude that Calcium-D3 medication has a beneficial effect on BMD, and that TSH-suppressive therapy does not affect BMD in women treated for DTC at young age, at least after 10 years of follow-up.
著者
熊谷 敦史 Vladimir A. Saenko 柴田 義貞 大津留 晶 伊東 正博
出版者
長崎大学
雑誌
長崎醫學會雜誌 : Nagasaki Igakkai zasshi (ISSN:03693228)
巻号頁・発行日
vol.79, pp.297-300, 2004-09

甲状腺癌の約80%以上を占める主要な病理組織型である甲状腺乳頭癌(PTCs)には,特異的な遺伝子異常が存在する. 特に,チェルノブイリ原子力発電所事故後の小児PTCsにおける高頻度のRet/PTC遺伝子再配列異常が報告されている. 一方,成人PTCsにおいては,2003年BRAF遺伝子のエクソン15コドン599に限局した活性型点突然変異(T1796A,V599E)がその3〜5割に認められ,PTCsの発症に関与していることが報告された. その後シークエンス解析等の結果,BRAF遺伝子のヌクレオチド番号・コドン番号の表記が訂正され,これに従いHot spotはコドン600(T1799A,V600E)に訂正された. BRAF遺伝子はRAS-RAF-MAPK経路(MAPKカスケード)を構成するRAF蛋白のアイソフォームのひとつであるBRAF蛋白をコードする遺伝子であり,BRAF蛋白はセリン・スレオニンキナーゼとして細胞内情報伝達因子としての活性を持っている. BRAF蛋白は通常でも,その下流の因子であるMEK1/2に対して,その他のRAF蛋白(ARAF,RAF-1)より強い親和性を有しているとされている. 遺伝子変異によってBRAF蛋白の600番目のアミノ酸がバリンからグルタミン酸に転換すると,BRAF蛋白の構造変化を引き起こし通常よりさらに強力なリン酸化能を恒常的に発揮するようになると考えられている. また成人発症のPTCでは,BRAF遺伝子変異と遠隔転移との間に有意な相関性が認められることも指摘され,BRAF遺伝子変異が予後不良群のマーカーとなる可能性も注目されている. これに対して小児PTCsは成人例に比べて遠隔転移が高頻度に認められるにもかかわらず,予後が比較的良好であることが特徴である. そこで小児PTCsにおけるBRAF遺伝子異常の頻度を検討した. 更に,放射線汚染地域および非汚染地域でのPTCsの遺伝子異常の頻度を比較することにより,放射線被曝による変異誘発の可能性もあわせて検討することとした.