karbala journal of pharmaceutical sciences

Thyroid cancer is the most common endocrine malignancy and its incidence continues to rise yearly .Thyroid carcinoma, in most cases, presents clinically as a solitary nodule or as a dominant nodule within a multinodular thyroid gland. it is very important to identify one or more markers to distinguish thyroid cancer from different types of thyroid disease., Oxidative stress is considered to be involved in the pathophysiology of all cancers.Interleukin-10 is a pleiotropic cytokine with both anti-inflammatory and anti-angiogenic properties that may be involved in the pathogenesis of autoimmune thyroid diseases. Thyroid cancer cells of all histological variants produce considerable amounts of IL-10, which might be important in the pathological features of thyroid cancer and/or outcome. Our study aimed to evaluate IL-10 and oxidative stress markers, Malondiaaldehyde and super oxide dismutase (MDA&SOD) levels in sera of patients with CA thyroid and their close relatives compared to healthy control.and to study the correlation of these markers before and after the thyroidectomy operation compared with 1st to 2nd relatives and healthy controls. This 89study includes Thirty (30) subjects as the study sample is made of: 1) 15 diagnosed cases of CA thyroid before surgery and post-surgical treatment, 2) 15 cases of their 1st, or 2nd degree relatives; and 30 healthy subjects (control) would be recruited from surgical clinic in Al-Imamain Al- kadhimain city hospital from October 2014 up to December of 2016.Serum IL-10 was estimated using an Enzyme-Linked Immunosorbant Assay ( ELISA ) technique. Serum MDA levels were assessed using thiobarbituric acid (TBA) method of Buege and Aust , while SOD was measured by Burtis and Ashwood, using modified photochemical Nitroblue Tetrazolium (NBT) method utilizing sodium cyanide as peroxidase inhibitor.Analysis of serum levels demonstrated significantly increased levels of IL-10 in cancer patients between pre-thyroidectomy and post-thyroidectomy(p<0.01) and significantly increased compared with control groups (p<0.001) , SOD activities of pre-thyroidectomy, post-thyroidectomy and control groups were not different (p>0.05).In post- thyroidectomy MDA levels decreased compared to prethyroidectomy levels( p<0.01).also thyroid cancer significantly decreased compared with control groups (p<0.001). Although post-thyroidectomy MDA levels significantly decreased, but still higher than the healthy control group.its concluded that cytokine profile (IL-10) is reflective of an inflammatory immune response. These cytokines may increase the pathogenicity of thyroid CA and may be useful as biomarkers or targets for therapy. SOD does not seem to change with thyroid cancer and thyroidectomy but MDA change.IL-10 & MDA may be a more useful for monitoring the clinical status of thyroid cancer patients.

FNA is a non-invasive method, whose simplicity and safety justify its use for “selective” surgery
and is considered the “gold standard” in the management of thyroid nodules.
The main aim of FNAC is to identify nodules that require surgery and those benign nodules that
can be observed clinically and decrease the overall thyroidectomy rate in patients with benign
diseases., this study was done to evaluate the diagnostic accuracy of fine needle aspiration
cytology as a pre-operative screening methods, it is a prospective study which includes a total of
100 cases for patients aged 13-64 years presented with goiter during the period Jan. 2013- Jan.
2015 in Al Hussain Teaching Hospital in Kerbala. This study resulted in true negative cases
were 81 (Tn), false negative case was 1 ( Fn), True positive were 13 (Tp), and false positive
were 5 cases (Fp).Sensitivity or true positive rate is 92%, Specificity or true negative rate is
94%, Positive predictive value is 72%, Negative predictive value is 98%, Accuracy rate is
94%. False negative FNA cytology result was found in only one of our patients which is less as
compared to other studies where the values range from 1-16%. False negative cases are
encountered when there are no recognizable diagnostic cells in the smear because of sampling
or processing error. We concluded that FNA is the most recommended diagnostic procedure for
the diagnosis of thyroid lesions except follicular tumor.