Abstract:Objective: To examine the changes in serum copper (Cu) levels in benign and malignant thyroid disease in humans. Background: Thyroid hormones infl uence the metabolism of trace elements including copper. Methods: 47 papillary thyroid cancer and 43 benign multinodular goitre patients who underwent total thyroidectomy and 37 healthy control subjects were included into this study. All of the patients and controls were females. Serum Cu levels were detected with atomic absorption spectrophotometer. Results: In the papillary thyroid cancer group serum level of Cu was 131.61±33.9 μg/dL before surgery and 120.81±30.4 μg/dL after 20 days from surgery. In the benign group serum Cu level was 84.75±12.1 μg/dL and 68.01±9.4 μg/dL postoperatively.These results were compared to healthy control's value of 105.87±10.68 μg/dL. In the papillary thyroid cancer group pre-and postoperative serum Cu level was signifi cantly higher when compared to control group (p<0.05). Postoperative serum Cu level signifi cantly decreased when compared to pre-operative level(p<0.05), in which, it was still higher than the control(p<0.05). In the benign group pre-and postoperative serum Cu level was significantly lower than in the control group (p<0.05).Postoperative serum Cu level signifi cantly decreased when compared to pre-operative level in the benign group (p<0.05). Conclusion: This is a pioneer study to examine serum Cu level in benign and malignant thyroid patients compared to controls. In our small groups serum Cu levels increased in malignant thyroid patients and decreased in the benign group (Tab. 1, Ref. 18 Trace elements are essential micro-nutrients both for humans and other organisms. They are crucial for many physiological processes and are involved in many pathologic changes in tissues (1). Thyroid hormones infl uence the metabolism of trace elements including copper (Cu) (2). Cu is important for the activity of the enzyme superoxide dismutase (SOD). Changes in the activity of this enzyme are consistent with the Cu serum levels (3). Cu was shown to be essential for cell division both in normal and cancerous tissue (4, 5). Although copper is an essential element for human and animals, a high concentration of Cu (above normal) could induce growth proliferation and cancer by damaging DNA with toxic free hydroxyl radicals (6).The present study was undertaken to investigate correlation of Cu serum levels in benign and malign thyroid diseases before and after surgery compared to controls. Materials and methodsThis is an age-and sex-matched case-control study, conducted at the Department of Medical Biochemistry of Celal Bayar University of Medicine and the Department of General Surgery of Ankara Oncology Hospital, Ankara, Turkey. The study was approved by the hospital Ethical committee. All the patients and the volunteers involved in the study have given informed consent. PatientsRecruitment of subjects was performed by convenience sampling at outpatient General Surgery Clinic of Oncology Hospital, Turkey by trained physicians. 47...

Neutrophil gelatinase-associated lipocalin (NGAL) is an inflammatory biomarker that is stored in neutrophil granules. Recent studies revealed that NGAL expression increases in tissue samples of patients with inflammatory gastrointestinal system diseases and cancers. The aim of this study was to evaluate the diagnostic and predictive significance of plasma NGAL levels in various stages of adenoma-carcinoma sequence of colorectal cancer. Eighty cases were included in the study and separated into 3 groups. "Cancer Group" consisted of 27 colorectal cancer patients who underwent curative resection, whereas 24 patients with colorectal adenomatous polyps detected by colonoscopy were classified as the "Polyp Group", and 29 patients with normal colonoscopy findings were classified as the "Control Group". The serum NGAL, CEA and CA19-9 levels and histopathology findings were determined. The mean plasma NGAL levels for control group, polyp group and cancer group were found to be 91.5 ng/ml, 139.6ng/ml and 184.3ng/ml, respectively. Plasma NGAL levels were found to be significantly higher in cancer group compared to the control group (p:0.006). Plasma NGAL levels were detected statistically significant and positive correlated with tumor diameter and number of metastatic lymph nodes (p:0.047, r:%38.6 and p:0.026, r:%42.8, respectively) in cancer group. We are of the opinion that pre-operative plasma NGAL level is a potential diagnostic biomarker for colorectal cancer patients. Although more comprehensive studies are needed for definitive judgments, serum NGAL levels may be used as a diagnostic and/or predictive biomarker for lymph node metastasis in patients with colorectal cancer.

We evaluated the correlation between serum thyroid-stimulating hormone (TSH) levels and tumor size and other invasiveness parameters of tumor in patients with differentiated thyroid carcinoma (DTC). Several clinical studies have reported that TSH may also have a role as a regulator of the development and function of the thyroid gland. It is currently not clear whether TSH is involved in the existence of thyroid cancer or progression of thyroid cancer or both. Patients with DTC who underwent thyroid surgery between 2003 and 2008 were included this study. Preoperative serum T3, T4, and TSH levels were compared with the size and invasiveness of cancer, retrospectively. DTC was observed in 110 patients over the 5-year period. Seventy-seven (70 %) of them were euthyroid and classified as the "normal-TSH group" (NTG), and 33 (30 %) have an overt or subclinical hyperthyroidism, classified as the "low-TSH group" (LTG). The mean tumor diameter in the LTG was found to be 8.91 ± 8.03 mm; however, it was found to be 18.19 ± 16.24 mm in the NTG. There were significantly differences among the groups related to the diameter of tumor (p = 0.001). Microcarcinoma was determined in 36 patients (46.8 %) in the NTG and 23 patients (69.7 %) in the LTG (p = 0.027). Although there were no significant differences, tumor capsule invasion (33.8 vs. 18.2 %, p = 0.099) and lymphovascular invasion (16.9 vs. 6.1 %, p = 0.130) rates were higher in the NTG. These findings suggest that TSH has effects on growing and proliferation of not only normal thyroid cells but also cancer cells in DTC. This study revealed that serum TSH level can be explored as an important factor that affects the size and invasiveness of tumor in DTC.

INTRODUCTIONAmyloid goiter (AG) is characterized by enlargement of the thyroid gland as a result of extensive amyloid deposition in a bilateral and diffuse manner.PRESENTATION OF CASEA 58-year-old male patient was diagnosed of Crohn's Disease (CD). He was admitted to our clinic with complaint of respiratory distress and rapid growth swelling in the neck. Ultrasound examination revealed huge multinodular goiter on both sides of thyroid gland. We performed bilateral total thyroidectomy. Pathological evaluation revealed AG.DISCUSSIONAmyloid leads to degeneration in tissues, thereby disrupts the function of the relevant organs. It is important to distinguish AG from other reasons of goiter, particularly thyroid medullary cancer that can cause amyloid deposition in thyroid gland. Secondary amyloidosis frequently involves thyroid gland at microscopic level, but rarely causes goiter. An analysis of current literature revealed that only few cases of AG occurred secondary to CD. Herein we presented a case of AG who has rapidly growing goiter that associated with CD.CONCLUSIONAG must be kept in mind in case of rapidly growing goiter, especially in patients with chronic inflammatory bowel diseases.

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