Prevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófise
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UERJ |
Texto Completo: | http://www.bdtd.uerj.br/handle/1/19096 |
Resumo: | It is postulated that patients with different subtypes of pituitary neuroendocrine tumors (PitNETs) may present a higher prevalence of cancer. Factors underlying individuals becoming overweight, such as insulin resistance, hyperleptinemia, and low-grade inflammation, may play a role in the risk of differentiated thyroid carcinoma (DTC) in such patients. This study aimed to investigate the prevalence of and obesity-related risk factors associated with DTC in patients with PitNETs. This cross-sectional study involved 149 patients with nonacromegalic PitNETs (AG group), 71 patients with acromegaly (ACRO group), and 156 controls (CG group). All participants underwent insulin and blood glucose measurements with the determination of the homeostatic model assessment - insulin resistance (HOMA-IR) index, leptin, and high-sensitivity C-reactive protein (hsCRP), and they also underwent thyroid ultrasound. Clinically significant nodules were biopsied for subsequent cytopathological evaluation, and participants were operated on when indicated. Patients in the AG and CG groups had high levels of insulin resistance and a significantly higher frequency of hyperleptinemia and subclinical inflammation compared with those of patients in the ACRO group. There were no cases of DTC in the AG group; two findings, 1 incidental, of DTC occurred in the CG group, and 3 cases of DTC were present in the ACRO group. Acromegaly was associated with DTC after adjusted analysis. Our findings in patients with nonacromegalic PitNETs do not indicate a high risk for DTC despite the presence of metabolic and inflammatory risk factors for neoplastic events. In contrast, acromegaly promotes a greater risk of DTC. |
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Gomes, Marília Britohttp://lattes.cnpq.br/1572046372017214Faria, Manuel dos Santoshttp://lattes.cnpq.br/2116754503751559Tavares, Ana Beatriz Winterhttp://lattes.cnpq.br/1395223223729745Pôrto, Luís Cristóvão de Moraes Sobrinohttp://lattes.cnpq.br/8153025668900773Martins, Manoel Ricardo Alveshttp://lattes.cnpq.br/3503117351197846Brito, Luciane Maria Oliveirahttp://lattes.cnpq.br/0446524487971854http://lattes.cnpq.br/5229283360695255Nascimento, Gilvan Cortêsgilvancortes@uol.com.br2023-03-01T12:39:34Z2020-02-14NASCIMENTO, Gilvan Cortês. Prevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófise. 2020. 123 f. Tese (Doutorado em Ciências Médicas) – Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2020.http://www.bdtd.uerj.br/handle/1/19096It is postulated that patients with different subtypes of pituitary neuroendocrine tumors (PitNETs) may present a higher prevalence of cancer. Factors underlying individuals becoming overweight, such as insulin resistance, hyperleptinemia, and low-grade inflammation, may play a role in the risk of differentiated thyroid carcinoma (DTC) in such patients. This study aimed to investigate the prevalence of and obesity-related risk factors associated with DTC in patients with PitNETs. This cross-sectional study involved 149 patients with nonacromegalic PitNETs (AG group), 71 patients with acromegaly (ACRO group), and 156 controls (CG group). All participants underwent insulin and blood glucose measurements with the determination of the homeostatic model assessment - insulin resistance (HOMA-IR) index, leptin, and high-sensitivity C-reactive protein (hsCRP), and they also underwent thyroid ultrasound. Clinically significant nodules were biopsied for subsequent cytopathological evaluation, and participants were operated on when indicated. Patients in the AG and CG groups had high levels of insulin resistance and a significantly higher frequency of hyperleptinemia and subclinical inflammation compared with those of patients in the ACRO group. There were no cases of DTC in the AG group; two findings, 1 incidental, of DTC occurred in the CG group, and 3 cases of DTC were present in the ACRO group. Acromegaly was associated with DTC after adjusted analysis. Our findings in patients with nonacromegalic PitNETs do not indicate a high risk for DTC despite the presence of metabolic and inflammatory risk factors for neoplastic events. In contrast, acromegaly promotes a greater risk of DTC.Pacientes com diferentes subtipos de tumores neuroendócrinos hipofisários (PitNETs) podem apresentar maior prevalência de câncer. Fatores subjacentes ao excesso de peso em um indivíduo, como resistência à insulina, hiperleptinemia e inflamação subclínica, podem desempenhar um papel no risco de carcinoma diferenciado de tireoide (CDT) na população em geral e nesses pacientes. Esse estudo teve como objetivo investigar a prevalência do CDT e os fatores de risco relacionados à obesidade associados a esse câncer em pacientes com PitNETs. Apresenta um desenho transversal e envolveu 149 pacientes com PitNETs não acromegálicos (grupo GA), 71 pacientes com acromegalia (grupo ACRO) e 156 controles (grupo GC). Todos os participantes foram submetidos à mensuração de insulina e glicose no sangue com a determinação do índice homeostatic model assessment - insulin resistance (HOMA-IR), leptina e proteína C reativa ultrassensível (PCR-us), assim como foram submetidos à ultrassonografia da tireoide. Nódulos clinicamente significativos foram biopsiados para avaliação citopatológica subsequente e os participantes foram operados quando indicado. Os pacientes do grupo GA e GC apresentaram altos níveis de resistência à insulina e frequência significativamente mais elevada de hiperleptinemia e inflamação subclínica em comparação com os pacientes do grupo ACRO. Não houve casos de CDT no grupo GA; dois achados, 1 incidental, de CDT ocorreram no grupo GC, e 3 casos de CDT estavam presentes no grupo ACRO. Acromegalia foi associada com CDT após análise ajustada. Nossos achados em pacientes com PitNETs não acromegálicos não indicam um alto risco para CDT, apesar da presença de fatores de risco metabólicos e inflamatórios para eventos neoplásicos. Em contraste, a acromegalia promove um maior risco de CDT.Submitted by Heloísa CB/A (helobdtd@gmail.com) on 2023-03-01T12:39:34Z No. of bitstreams: 1 Tese - Gilvan Cortês Nascimento - 2020 - Completo.pdf: 1866584 bytes, checksum: 1710fd5ee719bac334d5752407860f92 (MD5)Made available in DSpace on 2023-03-01T12:39:34Z (GMT). No. of bitstreams: 1 Tese - Gilvan Cortês Nascimento - 2020 - Completo.pdf: 1866584 bytes, checksum: 1710fd5ee719bac334d5752407860f92 (MD5) Previous issue date: 2020-02-14application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Ciências MédicasUERJBrasilCentro Biomédico::Faculdade de Ciências MédicasPituitary tumorsAcromegalyThyroid cancerInsulin resistanceSubclinical inflammationLeptinTumores hipofisáriosAcromegaliaCâncer de tireoideResistência à insulinaInflamação subclínicaLeptinaCIENCIAS DA SAUDE::MEDICINAPrevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófisePrevalence and risk factors associated with differentiated thyroid carcinoma in patients with pituitary neuroendocrine tumorsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTese - Gilvan Cortês Nascimento - 2020 - Completo.pdfTese - Gilvan Cortês Nascimento - 2020 - Completo.pdfapplication/pdf1866584http://www.bdtd.uerj.br/bitstream/1/19096/2/Tese+-+Gilvan+Cort%C3%AAs+Nascimento+-+2020+-+Completo.pdf1710fd5ee719bac334d5752407860f92MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/19096/1/license.txte5502652da718045d7fcd832b79fca29MD511/190962024-02-26 15:59:54.23oai:www.bdtd.uerj.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T18:59:54Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
Prevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófise |
dc.title.alternative.eng.fl_str_mv |
Prevalence and risk factors associated with differentiated thyroid carcinoma in patients with pituitary neuroendocrine tumors |
title |
Prevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófise |
spellingShingle |
Prevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófise Nascimento, Gilvan Cortês Pituitary tumors Acromegaly Thyroid cancer Insulin resistance Subclinical inflammation Leptin Tumores hipofisários Acromegalia Câncer de tireoide Resistência à insulina Inflamação subclínica Leptina CIENCIAS DA SAUDE::MEDICINA |
title_short |
Prevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófise |
title_full |
Prevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófise |
title_fullStr |
Prevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófise |
title_full_unstemmed |
Prevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófise |
title_sort |
Prevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófise |
author |
Nascimento, Gilvan Cortês |
author_facet |
Nascimento, Gilvan Cortês gilvancortes@uol.com.br |
author_role |
author |
author2 |
gilvancortes@uol.com.br |
author2_role |
author |
dc.contributor.advisor1.fl_str_mv |
Gomes, Marília Brito |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/1572046372017214 |
dc.contributor.advisor-co1.fl_str_mv |
Faria, Manuel dos Santos |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/2116754503751559 |
dc.contributor.referee1.fl_str_mv |
Tavares, Ana Beatriz Winter |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/1395223223729745 |
dc.contributor.referee2.fl_str_mv |
Pôrto, Luís Cristóvão de Moraes Sobrino |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/8153025668900773 |
dc.contributor.referee3.fl_str_mv |
Martins, Manoel Ricardo Alves |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/3503117351197846 |
dc.contributor.referee4.fl_str_mv |
Brito, Luciane Maria Oliveira |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/0446524487971854 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/5229283360695255 |
dc.contributor.author.fl_str_mv |
Nascimento, Gilvan Cortês gilvancortes@uol.com.br |
contributor_str_mv |
Gomes, Marília Brito Faria, Manuel dos Santos Tavares, Ana Beatriz Winter Pôrto, Luís Cristóvão de Moraes Sobrino Martins, Manoel Ricardo Alves Brito, Luciane Maria Oliveira |
dc.subject.eng.fl_str_mv |
Pituitary tumors Acromegaly Thyroid cancer Insulin resistance Subclinical inflammation Leptin |
topic |
Pituitary tumors Acromegaly Thyroid cancer Insulin resistance Subclinical inflammation Leptin Tumores hipofisários Acromegalia Câncer de tireoide Resistência à insulina Inflamação subclínica Leptina CIENCIAS DA SAUDE::MEDICINA |
dc.subject.por.fl_str_mv |
Tumores hipofisários Acromegalia Câncer de tireoide Resistência à insulina Inflamação subclínica Leptina |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
It is postulated that patients with different subtypes of pituitary neuroendocrine tumors (PitNETs) may present a higher prevalence of cancer. Factors underlying individuals becoming overweight, such as insulin resistance, hyperleptinemia, and low-grade inflammation, may play a role in the risk of differentiated thyroid carcinoma (DTC) in such patients. This study aimed to investigate the prevalence of and obesity-related risk factors associated with DTC in patients with PitNETs. This cross-sectional study involved 149 patients with nonacromegalic PitNETs (AG group), 71 patients with acromegaly (ACRO group), and 156 controls (CG group). All participants underwent insulin and blood glucose measurements with the determination of the homeostatic model assessment - insulin resistance (HOMA-IR) index, leptin, and high-sensitivity C-reactive protein (hsCRP), and they also underwent thyroid ultrasound. Clinically significant nodules were biopsied for subsequent cytopathological evaluation, and participants were operated on when indicated. Patients in the AG and CG groups had high levels of insulin resistance and a significantly higher frequency of hyperleptinemia and subclinical inflammation compared with those of patients in the ACRO group. There were no cases of DTC in the AG group; two findings, 1 incidental, of DTC occurred in the CG group, and 3 cases of DTC were present in the ACRO group. Acromegaly was associated with DTC after adjusted analysis. Our findings in patients with nonacromegalic PitNETs do not indicate a high risk for DTC despite the presence of metabolic and inflammatory risk factors for neoplastic events. In contrast, acromegaly promotes a greater risk of DTC. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020-02-14 |
dc.date.accessioned.fl_str_mv |
2023-03-01T12:39:34Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
NASCIMENTO, Gilvan Cortês. Prevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófise. 2020. 123 f. Tese (Doutorado em Ciências Médicas) – Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2020. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/19096 |
identifier_str_mv |
NASCIMENTO, Gilvan Cortês. Prevalência e fatores de risco associados ao carcinoma diferenciado da tireoide em pacientes com tumores neuroendócrinos da hipófise. 2020. 123 f. Tese (Doutorado em Ciências Médicas) – Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2020. |
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http://www.bdtd.uerj.br/handle/1/19096 |
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por |
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Universidade do Estado do Rio de Janeiro |
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UERJ |
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Brasil |
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Centro Biomédico::Faculdade de Ciências Médicas |
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Universidade do Estado do Rio de Janeiro |
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