Thrombosis in Thyroid Cancer

Ordookhani, Arash; Motazedi, Abbas; Burman, Kenneth D.

doi:10.5812/ijem.57897

Cited by 15 publications

(13 citation statements)

References 81 publications

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“…A series of related studies had reported changes in the coagulation status of PTC patients, suggesting a relatively hypercoagulable state for PTC patients, mainly evaluated by changes of fibrinogen and related coagulation factor levels [15][16][17]. Nielsen et al had once reported a patient with a malignant thyroid tumor who was serendipitously found to have plasmatic hypercoagulability with a carbon monoxide-mediated clot strength as determined by a thrombelastographic method [18].…”

Section: Introductionmentioning

confidence: 99%

Altered TEG Parameters Identify Hypercoagulablilty and are of Diagnosis Value for Papillary Thyroid Carcinoma Patients

Kang

Wang

et al. 2018

Exp Clin Endocrinol Diabetes

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Objective The goal of this study was to clarify the changes and clinical significance of thromboelastography (TEG) parameters in papillary thyroid carcinomas and nodular goiters. Methods 62 nodular goiter (NG) patients and 53 papillary thyroid carcinoma (PTC) patients were included. Coagulation indicators, together with a series of TEG parameters were collected and analyzed, compared with results of 61 healthy controls (HC). Correlation analysis was conducted between routine coagulation indicators and TEG parameters. ROC curves were used to evaluate the potential diagnosis value of the TEG parameters that were altered in papillary thyroid carcinoma patients. Results APTT and PT in papillary thyroid carcinoma group were statistically significant higher than that in control group (p<0.05). MPV was found to be higher in PTC than NG and healthy controls.R, K and SP levels were significantly lower in PTC group than that in HC group; Angle, CI and TPI levels were significantly higher in PTC group than that in HC group. Areas under the ROC curve of CI, TPI, and angle were 0.725, 0.714, and 0.687 for distinguishing PTC from HC, 0.662, 0.668 and 0.591 for distinguishing PTC from NG. Conclusion TEG parameters are altered and indicate hypercoagulablilty status of papillary thyroid carcinoma patients; CI, TPI, and angle could be potential diagnosis indicators for detecting papillary thyroid carcinoma.

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Section: Introductionmentioning

confidence: 99%

Altered TEG Parameters Identify Hypercoagulablilty and are of Diagnosis Value for Papillary Thyroid Carcinoma Patients

Kang

Wang

et al. 2018

Exp Clin Endocrinol Diabetes

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“…The significance and pathogenic mechanisms of platelet clustering in adenomas and in vessels not associated with tumor cells is unknown. This finding may be due to a local prothrombotic effect in the tumor milieu or procedurerelated vascular microtrauma leading to thrombosis [13].…”

Section: Discussionmentioning

confidence: 99%

“…Rate of expression was not different by tumor type (p = 0.90; Table 1). Of the 22 positive cases, the location of vessels containing CD61-positive intravascular platelets was peritumoral in 60% (13), intracapsular in 23% (5), and distant in 9% (2). The location of vessels was not different by tumor type (p > 0.6; Table 1).…”

Section: Cd61 Expressionmentioning

confidence: 93%

An Evaluation of CD61 Immunohistochemistry in Identification of Vascular Invasion in Follicular Thyroid Neoplasms

Cracolici

Parilla

Henriksen

2019

Head and Neck Pathol

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The identification of vascular invasion in follicular thyroid neoplasms is essential for categorizing lesions as benign (follicular adenomas) or malignant (follicular thyroid carcinomas). Among the histologic criteria diagnostic of true vascular invasion is tumor-cell associated thrombosis, including fibrin deposition and platelet clumping. This study aims to evaluate whether an immunohistochemical stain for the platelet-associated protein CD61 could assist in identifying tumor-associated thromboses and thereby confirm vascular invasion in follicular thyroid neoplasms. Histologic review and CD61 immunostaining of 19 atypical follicular adenomas, 13 non-metastatic follicular thyroid carcinomas, and 11 metastatic follicular thyroid carcinomas was performed. Linear arrays or clustered groups of CD61-expressing intravascular platelets were present in 51% of cases overall, including 54% of follicular thyroid carcinomas and 47% of follicular adenomas, mostly within intracapsular or peritumoral vessels. In three follicular thyroid carcinomas (all with distant metastases), CD61-expressing platelets were present in association with intravascular tumor cells. This finding was not present in adenomas. CD61 staining alone did not distinguish between atypical follicular adenomas, non-metastatic carcinomas, and metastatic carcinomas. When present in association with intravascular tumor cells, however, CD61-expressing platelets may serve as a marker for vascular invasion and aid in the diagnosis of follicular thyroid carcinoma.

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“…This may also apply to patients with thyroid carcinoma whose endogenous thyrotropin post-thyroidectomy is under suppression with exogenous T 4 in greater than replacement dosage. 56 Evaluation might initially involve measurement of widely available activated partial thromboplastin time (aPTT) and the D-dimer fibrin degradation product at the time of diagnosis of thyroid disease.…”

Section: Discussionmentioning

confidence: 99%

New Interfaces of Thyroid Hormone Actions With Blood Coagulation and Thrombosis

Davis

Mousa

Schechter

2018

Clin Appl Thromb Hemost

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Substantial clinical evidence indicates hyperthyroidism enhances coagulation and increases the risk of thrombosis. In vitro and clinical evidence implicate multiple mechanisms for this risk. Genomic actions of thyroid hormone as 3,5,3'-triiodo-L-thyronine (T) via a nuclear thyroid hormone receptor have been implicated, but recent evidence shows that nongenomic mechanisms initiated at the receptor for L-thyroxine (T) on platelet integrin αvβ3 are prothrombotic. The T-initiated mechanisms involve platelet activation and, in addition, cellular production of cytokines and chemokines such as CX3CL1 with procoagulatory activities. These procoagulant actions of T are particulary of note because within cells T4 is not seen to be functional, but to be only a prohormone for T. Finally, it is also possible that thyroid hormone stimulates platelet-endothelial cell interaction involved in local thrombus generation. In this brief review, we survey mechanisms by which thyroid hormone is involved in coagulation and platelet functions. It is suggested that the threshold should be lowered for considering the possibility that clinically significant clotting may complicate hyperthyroidism. The value of routine measurement of partial thromboplastin time or circulating D-dimer in patients with hyperthyroid or in patients treated with thyrotropin-suppressing dosage of T requires clinical testing.

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Thrombosis in Thyroid Cancer

Cited by 15 publications

References 81 publications

Altered TEG Parameters Identify Hypercoagulablilty and are of Diagnosis Value for Papillary Thyroid Carcinoma Patients

Altered TEG Parameters Identify Hypercoagulablilty and are of Diagnosis Value for Papillary Thyroid Carcinoma Patients

An Evaluation of CD61 Immunohistochemistry in Identification of Vascular Invasion in Follicular Thyroid Neoplasms

New Interfaces of Thyroid Hormone Actions With Blood Coagulation and Thrombosis

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