Rovena Bode completed Medicine from University of Tirana, Albania in 2003. She has been graduated as General Surgeon in 2009 in the General Surgery Department of “Mother Tereza”, University hospital Center, Tirana, Albania. She has taken Medical Emergency Training in Torino, Italy in 2010. During 2011, she has taken fellowship in Laparoscopic Surgery and breast surgery (oncology surgery) in Naples, Italy. Currently, she is a General Surgeon in the Surgery Department of “Mother Teresa “University Hospital Center of Tirana, Albania.
Background: The incidence of malignancy in toxic multi-nodular goiter (TMNG), non-toxic multi-nodular goiter (nTMNG) and Graves’ disease (GD), has historically been thought to be low (5% to 10%). Many authors have claimed that hyperthyroidism protects against thyroid cancer and also believed that multi-nodularity does seem to be a certain indicative factor of benign disease. Recent studies have suggested a much higher rate of malignancy within toxic and nontoxic MNG (10% to 22%).We designed this study to determine the prevalence of incidental cancer in patients undergoing thyroidectomy for presumed benign disease.\r\n\r\nMethods: The aim of this study is to evaluate the incidence of thyroid carcinoma in multi-nodular goiters (MNG) and the pathological pattern of these cancer nodules. It is a retrospective review of cases operated from January 2010 to December 2012, at \"Mother Teresa\" University Hospital Center, Tirana, Albania. Patients undergoing thyroidectomy for MNG, TMNG, or GD performed by members of the Department of General Surgery, were included in the study. Histology reports of patients treated surgically with a preoperative diagnosis of toxic and non-toxic multi-nodular goiter were reviewed to identify the thyroid cancer incidence. Patients having a history of neck irradiation or radioactive iodine therapy were excluded from the study. Patients with preoperative FNA results that were malignant or indeterminate were excluded. The cancer rate was calculated and univariate and multivariate analyses were performed to identify predictors of malignancy.\r\n\r\nResults: We operated on 545 patients for MNG, out of whom 98 patients presented to us in a toxic state (15 GD and 83 toxic MNG) and the remaining 447 in a non-toxic state. Of the patients operated for MNG 7.7% were found to have associated thyroid cancer. The incidence of thyroid cancer in toxic MNG patients was 13.25% whereas in non-toxic MNG patients it was 6.9%. The malignant nodules detected were papillary cancers of the thyroid in 76% of cases, follicular cancers in 9.5% of cases, oncocytic type in 7.3% of cases, insular carcinoma in 2.5% and anaplastic cancer in 4.7%. The median age at surgery was 44.6 years, 8.6% of the cohort had thyroiditis and 68% underwent preoperative FNA biopsy. Male patients represented 15.04% of the entire cohort, but 23.8% of cancers were in men. The risk of cancer was higher in nodular goiter than diffuse goiter. The highest rate of cancer was found in TMNG (13.25%) and the lowest was in GD (0%).\r\n\r\nConclusion: There was a higher than expected rate of inciden¬tal cancer in TMNG (13.25%), n-TMNG (6.9%), and GD (0%). Thyroid cancers can coexist in toxic MNG despite the suppression of thyroid stimulating hormone (TSH). Given this high rate of inci¬dental cancer, a total thyroidectomy should be the preferred approach for patients undergoing surgery for bilateral nodular disease.\r\n
Navid Sobhani graduated from Aberdeen University in 2013 where he worked in Professor Francesco Blasi’s group at IFOM (Milan, Italy) on the identification of the role of transcription factors in oncology through overexpressing or silencing vectors. On his honours thesis at Aberdeen he worked on the role that missense mutations have on nonsense mediated RNA decay protein had on neurodegenerative diseases. After completing these studies, that constituted his MSci degree, he moved at the University of Cambridge (Cambridge, UK) where he worked on proteomics to enhance a method for assisting diagnosis of mental disorders by making certain technologies more efficient in the laboratory at the department of chemical engineering in the academic year 2014.
Members of the Three Amino Acid Loop Extension (TALE) Transcription Factors (TFs) Meis 1 and Prep 1 have been already shown to act respectively as an oncogene and a tumour suppressor in murine. There is a lack of knowledge of their molecular functions in human cells to date. Overexpression of Meis 1 and downregulation of Prep 1 via retroviral constructs were used to investigate the tumorigenesis potential of these two TFs in virally infected immortalized human breast cell line MCF10A. Growth curve showed an increase in proliferation of the cells that have Prep1 downregulated or Meis1 up regulated, and wound healing experiments further confirmed that invasiveness increased after Meis1 is overexpressed or Prep1 downregulated. There was a synergic action of Meis1 overexpression and Prep1 down regulation over the growth of the cells, and their mode of action could be related to their already established TALE TF partner Pbx1, which was found higher in mRNA level from a screening of all cancer cell lines compared to wild type MCF10A. Phosphorylation of SMAD was increased with shRNA downregulating Prep1 in MCF10A, suggesting an Epitelial-Mesenchymal like transition (EMT). This work shows that it is most likely that Meis 1 and Prep 1 act respectively as an oncogene and a tumour suppressor in human breast cancer, in a process that could be EMT.