Browsing by Author "Isildak, Serife Mehlika"

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Biomolecular Markers for Improving Management of Follicular and Medullary Thyroid Cancer
(2014) Mousa, Umut; Anil, Cuneyd; Isildak, Serife Mehlika; Gursoy, Alptekin; Carpi, Angelo; https://orcid.org/0000-0002-8078-9376; https://orcid.org/0000-0003-3802-9733; https://orcid.org/0000-0002-2602-1657; I-1735-2018; AAA-4216-2021
Thyroid cancer usually presents as a thyroid nodule. According to different reports, more than 95% of thyroid nodules are benign. The gold standard for preoperative diagnosis of thyroid cancer is fine-needle aspiration cytology (FNAC). Especially in diagnosing medullary thyroid carcinoma (MTC) and some cases of well-differentiated thyroid carcinomas, biomolecular markers are proposed to increase the diagnostic value of FNAC. In this chapter, we mainly focused on classification, genetics, use of biomolecular and invasive markers, as well as treatment of follicular thyroid cancer (FTC) and MTC. In the case of FTC, some molecular and immunohistochemical markers are proposed and are currently under investigation principally for improving preoperative diagnosis. Unlike MTC, there is no powerful biomarker such as calcitonin (Ct) for FTC diagnosis. In the follow-up, serum thyroglobulin (Tg) and whole-body iodine-131 scintigraphy are effective. MTC has relatively poor prognosis. Postsurgical therapy is scarcely effective. Blood Ct is the best studied and preferred marker in the diagnosis and follow-up of MTC. It can be measured in the basal state or after provocative stimuli such as pentagastrin and high-dose calcium. Carcinoembryonic antigen (CEA) and chromogranin A (CgA) are the other markers currently used for selected cases. Ct and CEA doubling times are gaining importance for the prognosis of MTC. The importance of rearranged during transfection (RET) proto-oncogene screening in MTC is also discussed in this chapter. RET has also become a therapeutic target. In conclusion, the management of FTC and MTC includes diagnostic and therapeutic problems. However, thanks to the development of translational medicine, the biomolecular marker studies are improving FTC and MTC diagnosis, prognosis, and therapy.
The effect of iatrogenic subclinical hyperthyroidism on anxiety, depression and quality of life in differentiated thyroid carcinoma
(2020) Gulsoy Kirnap, Nazli; Turhan Iyidir, Ozlem; Bozkus, Yusuf; Isildak, Serife Mehlika; Anil, Cuneyd; Firat, Sevde Nur; Demir, Canan; Nar, Asli; Bascil, Tutuncu Neslihan; 0000-0003-0998-8388; 0000-0001-5305-6807; 0000-0003-3802-9733; 0000-0002-1816-3903; 32490648; K-7904-2019
Background/aim: Overt thyroidism is known to cause neuropsychiatric disorders but studies on subclinical hyperthyroidism (SCH) are limited. Subclinical hyperthyroidism induction by administering L-Thyroxine (LT4) is the standard treatment method in differentiated thyroid carcinoma (DTC) follow-up. Our aim was to investigate whether anxiety, depression and quality of life are affected in DTC patients followed-up with exogenous SCH. Materials and methods: The patients were divided into exogenous SCH by LT4-DTC (n = 127), euthyroid-DTC (n = 66) and exogenous euthyroid-benign thyroid nodutile (BTN) who underwent thyroidectomy for benign thyroid pathology (n = 85) groups. Results: The rate of moderate/severe anxiety was significantly higher in SCH-DTC than euthyroid-BTN group (27.5%, n = 35 vs. 9.4%, n = 8) (P = 0.001). TSH levels and Beck anxiety inventory (BAI) scores were significantly negatively correlated(P = 0.009 r = -0.16). Free T4 and BAI were significantly positively correlated (P = 0.04 r = 0.4). The groups were similar in terms of depression severity (P = 0.15). Subclinical hyperthyroid-DTC group scored significantly lowerthan euthyroid-BTN group in all scales of SF-36 quality of life survey. Conclusion: LT4-induced SCH, which is a part of traditional DTC treatment, can exacerbate the anxiety symptoms in patients and disrupt their quality of life, depending on the level of fT4.