The rate of thyroid cancer diagnosis has risen, and researchers' findings point to improved diagnostic testing and overdiagnosis as well as increases in actual incidences as the reasons behind this rise. With improved treatments and testing methods, the number of thyroid cancer survivors has also increased. Thyroid cancer presents challenges to coping and can cause significant stress in an individual's life. More specifically, anaplastic thyroid cancer (ATC) creates complicated challenges for patients and survivors. The problem is patients need support during diagnosis and treatment when adjusting to their 'new normal' and may be reaching to Internet based social support groups to gain health information. Lazarus's transactional theory of stress and coping formed a framework for this generic qualitative exploration of the types of support and information ATC patients and survivors receive through participating in an online Facebook support group. Thematic content analysis was conducted on archival data collected from the group over 4 months, namely 2,384 posts created by 166 group members. From this analysis, a picture relevant to all group participants was developed to include themes found among the data. Themes of emotional, informational and spiritual support emerged as well as the significance of using emojis as symbolic expressions of support. Implications for social change include expanding the theoretical knowledge of the ATC patient and survivor experience and the types of support available in online environments. This knowledge can lead to positive social change in terms of improving support resources, which may help in recovery from ATC; lessening the burden on patients, families, providers, insurance, the healthcare system, and our society as a whole.

Das Neuroblastom ist der dritthäufigste maligne Tumor im Kindesalter und ist für 15% der Todesfälle durch Krebs bei Kindern unter 14 Jahren verantwortlich. Viele molekularbiologische Vorgänge, die zu der heterogenen Prognose der Patienten beitragen, sind noch nicht verstanden. Als Hauptrisikomerkmal stellt sich die Amplifikation und erhöhte Expression von MYCN dar. In Vorarbeiten der Arbeitsgruppe von Prof. Christiansen zeigte MYCN Einfluss auf die Genregion von Thyroid Cancer 1 (TC1), das als neuer Marker für maligne Schilddrüsenkarzinome erkannt wurde. In der vorliegenden Arbeit wurden erste Untersuchungen zur prognostischen Bedeutung von TC1 im Neuroblastom, sowie die Charakterisierung eines TC1 Überexpressionsphänotyps humaner Neuroblastomzelllinien unter Einfluss von MYCN durchgeführt. Es wurde ein Überexpressionsvektor von TC1 in die Neuroblastomzelllinie SH-EP eingebracht, welche über ein aktivierbares MYCN- Konstrukt verfügt. Dieser neue Phänotyp wurde bezüglich der Proliferation, des Zellzyklus und der Apoptose im Vergleich zu einer Kontrollzelllinie ohne Überexpression untersucht. Eine In-silico Recherche in der Versteeg Neuroblastomdatenbank ergab eine deutlich bessere Überlebenswahrscheinlichkeit für Patientin mit hoher TC1 Expression. Es konnte gezeigt werden, dass MYCN Amplifikation und Expression in einem Panel von Neuroblastom Zelllinien nicht mit der TC1 Expression korrelieren. Die spezifische Aktivierung von MYCN führte hingegen zu einer Expressionssteigerung von TC1. Weiterhin zeigte sich, dass eine TC1 Überexpression die Proliferation hemmt, indem es die MYCN induzierte G1- S- Phasen- Transition inhibiert. TC1 zeigt antiproliferative Eigenschaften im Zellkulturmodell und stellt sich als neuer prognostisch günstiger Parameter im Neuroblastom dar.

La radiothérapie est utilisée seule ou en association avec la chimiothérapie dans le traitement de plus de 50% des cancers. En dépit des nombreux progrès dans le but d’améliorer le rapport bénéfice/risque, l’irradiation est à l’origine de nombreux effets secondaires. Une des origines connues des cancers de la thyroïde est l’exposition pendant l’enfance aux radiations ionisantes, soit accidentelles, soit suite à un traitement par radiothérapie externe pour une autre pathologie. Les mécanismes par lesquels les radiations ionisantes provoquent l’apparition d’un cancer de la thyroïde sont nombreux et encore incomplètement connus. Les radiations ionisantes sont des agents génotoxiques qui induisent des dommages au niveau de l’ADN telles que des cassures et des aberrations chromosomiques. Bien que les mécanismes qui sous-tendent ces effets ne soient pas complètement compris, il est généralement admis que les radiations ionisantes induisent des dommages à l’ADN soit de manière directe soit de manière indirecte en générant des espèces réactives de l’oxygène (ROS). Durant ma thèse, nous avons étudié le rôle des ROS produit lors de l’irradiation dans la génération des dommages à l’ADN dans les cellules thyroïdiennes. Nos résultats montrent que les ROS produites après irradiation participent à la formation des réarrangements chromosomiques RET/PTC1 retrouvés dans 70% des cancers papillaires radioinduits. Les ROS engendrées par la radiolyse de l’eau ont une durée de vie extrêmement courte ce qui limite leur diffusion. Néanmoins, par des mécanismes redox, ils provoquent des modifications au niveau cellulaire qui conduisent à leur tour à l’activation de systèmes générateurs de ROS, parmi lesquels on trouve les NADPH oxydases. Nos résultats montrent que l’irradiation induit l’expression de la NADPH oxydase DUOX1 via la sécrétion d’IL-13, plusieurs jours après l’exposition aux radiations ionisantes. L’inactivation de DUOX1 par ARNs interférents diminue de manière significative les dommages de l’ADN observés plusieurs jours après irradiation. Ces résultats suggèrent un rôle de DUOX1 dans le stress oxydatif chronique qui contribue à l’instabilité génétique. / Radiotherapy is used alone or in combination with chemotherapy to treat over 50% of cancers. Despite much progress in order to improve the benefit / risk ratio, the radiation causes many side effects. One of the known origins of thyroid cancer is exposure during childhood to ionizing radiation, either accidentally or as a result of external radiation therapy for another disease. The mechanisms by which ionizing radiation causes the appearance of thyroid cancer are numerous and not yet fully known. Ionizing radiations are genotoxic agents that induce DNA damage such as breaks and chromosomal aberrations. Although the mechanisms underlying these effects are not completely understood, it is generally accepted that ionizing radiations induce DNA damage either directly or indirectly by generating reactive oxygen species (ROS). During my PhD, we studied the role of ROS produced during irradiation in the generation of DNA damage in thyroid cells. Our results show that ROS produced after irradiation participate in the formation of RET/PTC1 rearrangements found in 70% of radiation-induced papillary cancers. ROS generated by radiolysis of water have a very short lifetime that limits their diffusion. However, by redox mechanisms, they cause changes at the cellular level, which in turn lead to the activation of ROS generating systems, which include the NADPH oxidases. Our results show that irradiation induces the expression of NADPH oxidase DUOX1 via the secretion of IL-13, several days after exposure to ionizing radiation. Inactivation of DUOX1 by interfering RNAs significantly reduces the DNA damage observed several days after irradiation. These results suggest a role DUOX1 in chronic oxidative stress that contributes to genetic instability.

Objectifs : Les cancers de la thyroïde représentent environ 2% de l‘ensemble des cancers dans les pays développés mais sont les cancers les plus fréquents des glandes endocrines. L’incidence des cancers de la thyroïde se caractérise par de fortes variations géographiques dans le monde, les taux les plus élevés étant observés en Nouvelle-Calédonie, et par une augmentation régulière au cours des dernières décennies dans les pays occidentaux. Cette augmentation d’incidence est en grande partie attribuée à l’évolution des pratiques médicales mais pourrait aussi être en partie liée à une évolution des modes de vie et/ou à des expositions environnementales. En dehors de l’exposition aux radiations ionisantes dans l’enfance, les facteurs de risque de cancer de la thyroïde restent très mal connus. L’objectif de ce travail était d’étudier le rôle des antécédents familiaux de pathologie de la thyroïde, des caractéristiques de la vie hormonale et reproductive, des caractéristiques anthropométriques et des expositions environnementales et professionnelles dans l’étiologie des cancers de la thyroïde. Méthode : Les analyses reposent principalement sur une étude cas-témoins en population menée en France métropolitaine (étude CATHY). Nous avons également utilisé les données d’une étude cas-témoins menée en Nouvelle-Calédonie pour étudier le rôle des antécédents familiaux dans cette zone géographique de forte incidence. L’étude CATHY repose sur 621 cas diagnostiqués dans trois départements français (Calvados, Marne, Ardennes) entre 2002 et 2007 et sur 706 témoins, appariés par fréquence aux cas sur l’âge, le sexe et le département de résidence. L’étude cas-témoins en Nouvelle-Calédonie repose sur 332 cas diagnostiqués entre 1985 et 1999, et sur 412 témoins appariés par fréquence aux cas sur l’âge et le sexe. Résultats : Les résultats montrent une augmentation du risque de cancer de la thyroïde chez les individus ayant des apparentés de premier degré atteints de cancer de la thyroïde ou de goitre multinodulaire, en France métropolitaine comme en Nouvelle-Calédonie. Parmi les facteurs hormonaux et reproductifs, un âge tardif aux premières règles, une ménopause précoce et une parité élevée étaient associés à une augmentation du risque de cancer de la thyroïde. Une relation dose-effet inverse était observée entre la durée cumulée des cycles menstruels au cours de la vie et le risque de cancer de la thyroïde. La prise d’une contraception orale était associée à une diminution du risque de cancer de la thyroïde, avec une relation dose-effet inverse entre la durée de la contraception orale et le risque de cancer de la thyroïde. La taille, l’indice de masse corporelle et la surface corporelle étaient positivement associés au risque de cancer de la thyroïde. Une augmentation du risque de cancer de la thyroïde était observée dans certains secteurs d’activité professionnelle comme l’industrie du papier, l’industrie du caoutchouc et des plastiques, le travail du bois, la réparation automobile et la métallurgie. / Objectives: Thyroid cancer accounts for 2% of all cancers in industrialized countries but is the most common endocrine cancer. There is a marked worldwide geographic variation in thyroid cancer incidence, the highest incidence rates being observed in New Caledonia, and a constant increase of thyroid cancer incidence has been observed during the past several decades. Although the evolution in medical practice probably accounts for some of the increase, other factors such as environmental and/or lifestyle factors may also play a role. However, there are few established risk factors of thyroid cancer apart from ionizing radiation exposure in childhood. We aimed to investigate the etiologic role of a family history of thyroid cancer, of hormonal and reproductive factors, anthropometric factors and environmental and occupational exposures in thyroid cancer. Methods: Analyses mainly rely on a population-based case-control study conducted in metropolitan France (“CATHY study”). Data of a case-control study conducted in New-Caledonia were also used to investigate the role of a family history of thyroid cancer as a risk factor for thyroid cancer in this area where thyroid cancer incidence is very high. The CATHY study is based on 621 cases diagnosed from 2002 to 2007 in three administrative areas: the Calvados, the Marne and the Ardennes, and 705 controls matched to cases by age, sex and residence area. The New Caledonian case-control study is based on 332 cases diagnosed form 1985 to 1999 and 412 controls matched to cases by age and sex. Results: A family history of thyroid cancer or multinodular goiter in first degree relatives was associated with an increased risk of thyroid cancer in France as well as in New Caledonia. Among hormonal and reproductive factors, a later age at menarche, a younger age at menopause and a elevated number of full-term pregnancies were associated with an increased risk of thyroid cancer. An inverse relationship was observed between the cumulative number of menstrual cycles and risk of thyroid cancer. Oral contraceptive use was associated with a lower risk of thyroid cancer, and an inverse relationship was observed between oral contraceptive use duration and risk of thyroid cancer. Height, body mass index and body surface area were positively associated with thyroid cancer risk. Analyses by occupation showed a higher risk of thyroid cancer for workers in leather industry, in plastics and rubber industry, in papermaking, in wood manufacturing, in automotive repair and in metallurgy.

Introdução: Os inibidores tirosino-quinase (ITQs) constituem uma nova terapia molecular para o carcinoma medular da tireoide (CMT). O vandetanibe, um ITQ que atua contra os receptores VEGFR, EGFR e RET, inibe a transformação e o crescimento do tumor no CMT. No entanto, os ITQs têm importantes efeitos adversos, incluindo o hipotireoidismo. O aumento da expressão da iodotironina desiodase do tipo 3 (D3/DIO3), uma enzima chave na inativação dos hormônios da tireoide, pode ser um possível mecanismo de indução do hipotireoidismo por estas drogas. Objetivo: Investigar os efeitos dos inibidores tirosino-quinase na expressão da D3 em células derivadas do CMT. Métodos: Estudo experimental in vitro, utilizando linhagem de células humanas oriundas de CMT (células TT). As células foram cultivadas em meio específico e tratadas com diferentes doses do ITQ vandetanibe (0,25; 0,5 e 1μM) ou com DMSO. A proliferação celular foi determinada por contagem em câmara de Neubauer. A expressão do mRNA foi avaliada por meio de PCR em tempo real, a expressão proteica por meio de Western Blot e a atividade da D3 foi avaliada por meio da técnica de cromatografia em colunas de Sephadex LH-20. Resultados: A adição do vandetanibe ao meio de cultura causou diminuição do número de células e seu efeito foi tempo e dose dependente, apresentando uma redução máxima (77%) após 6 dias de tratamento na dose de 1μM. Como esperado, o tratamento com vandetanibe inibiu a fosforilação do ERK. Não foram observadas alterações significativas dos níveis de mRNA da DIO3 após 3 (0,02 vs. 0,02 vs. 0,01 vs. 0,01; P = 0,34) ou 6 dias (0,02 vs. 0,02 vs. 0,03 vs. 0,02; P = 0,33) de tratamento. Consequentemente, a expressão proteica da D3 não aumentou nos grupos tratados. No entanto, observou-se um aumento de 2 a 5 vezes na atividade da D3 após 3 dias de tratamento e um aumento de 1,5 a 2,15 vezes em 6 dias de tratamento. Conclusões: O tratamento com vandetanibe não foi associado com níveis aumentados de expressão do mRNA e da proteína da D3 em células derivadas de CMT, embora tenha sido observado um aumento na sua atividade enzimática. / Background: Tyrosine kinase inhibitors (TKIs) constitute a novel molecular therapy for medullary thyroid carcinoma (MTC). Vandetanib, a TKI that acts against the VEGFR, EGFR and RET receptors, inhibits tumor transformation and growth in MTC. However, TKIs have important adverse effects, including hypothyroidism. Increases in the expression of type 3 iodothyronine deiodinase (D3/DIO3), a key enzyme in the inactivation of thyroid hormones, may be a possible mechanism of induction of hypothyroidism by these drugs. Objective: To investigate the effects of vandetanib on D3 expression in MTC-derived cells. Methods: In vitro experimental study using human MTC cell line (TT cells). Cells were cultured in specific medium and treated with different doses of vandetanib (0.25, 0.5 and 1μM) or DMSO. Cell proliferation was determined by counting in Neubauer's chamber. Expression of mRNA was evaluated by real-time PCR, protein expression by Western Blot and D3 activity was evaluated by Sephadex LH-20 column chromatography. Results: The addition of vandetanib to the culture medium caused a time and dose-dependent decrease in the number of cells, with a maximum reduction (77%) after 6 days of treatment at 1μM dose. As expected, vandetanib treatment inhibited ERK phosphorylation. No significant changes in DIO3 mRNA levels were observed after 3 (0.02 vs. 0.02 vs. 0.01 vs. 0.01; P = 0.34) or 6 days (0.02 vs. 0.02 vs. 0.03 vs. 0.02; P = 0.33) of treatment. Accordingly, D3 protein expression did not increase in treated groups. However, we observed a 2 to 5-fold increase in D3 activity after 3 days of treatment and a 1.5 to 2.15-fold increase in 6 days of treatment. Conclusions: Treatment with vandetanib was not associated with increased DIO3 mRNA and D3 protein expression levels in MTC-derived cells, although an increase in enzyme activity has been observed.

No description available.

The human genome contains tens of thousands of gene loci which code for an even greater number of protein and RNA products. The highly complex temporal and spatial expression of these genes makes possible all the biological processes of life. Altered gene expression by mutation or deregulation is fundamental for the development of many human diseases. The ultimate aim of this thesis was to identify gene expression changes relevant to cancer. The advent of genome-wide expression profiling techniques, such as microarrays, has provided powerful new tools to identify such changes and researchers are now faced with an explosion of gene expression data. Processing, comparing and integrating these data present major challenges. I approached these challenges by developing and assessing novel methods for cross-platform analysis of expression data, scalable subspace clustering, and curation of experimental gene regulation data from the published literature. I found that combining results from different expression platforms increases reliability of coexpression predictions. However, I also observed that global correlation between platforms was generally low, and few gene pairs reached reasonable thresholds for high-confidence coexpression. Therefore, I developed a novel subspace clustering algorithm, able to identify coexpressed genes in experimental subsets of very large gene expression datasets. Biological assessment against several metrics indicates that this algorithm performs well. I also developed a novel meta-analysis method to identify consistently reported genes from differential expression studies when raw data are unavailable. This method was applied to thyroid cancer, producing a ranked list of significantly over-represented genes. Tissue microarray analysis of some of these candidates and others identified a number of promising biomarkers for diagnostic and prognostic classification of thyroid cancer. Finally, I present ORegAnno (www.oreganno.org), a resource for the community-driven curation of experimentally verified regulatory sequences. This resource has proven a great success with ~30,000 sequences entered from over 900 publications by ~50 contributing users. These data, methods and resources contribute to our overall understanding of gene regulation, gene expression, and the changes that occur in cancer. Such an understanding should help identify new cancer mechanisms, potential treatment targets, and have significant diagnostic and prognostic implications.

The RET receptor tyrosine kinase has essential roles in cell survival, differentiation, and proliferation. Oncogenic activation of RET causes the cancer syndrome multiple endocrine neoplasia type 2 (MEN 2), and is a frequent event in sporadic thyroid carcinomas. Multiple endocrine neoplasia 2B (MEN 2B), a subtype of MEN 2, is caused primarily by a methionine to threonine substitution of residue 918 in the kinase domain of the RET receptor (2B-RET), however the molecular mechanisms that lead to the disease phenotype are unclear. In this study, we show that the M918T mutation causes a 10 fold increase in ATP binding affinity, and leads to a more stable receptor-ATP complex, relative to the wildtype receptor. We also show that 2B-RET can dimerize and become autophosphorylated in the absence of ligand. Our data suggest that multiple distinct but complementary molecular mechanisms underlie the MEN 2B phenotype and provide potential targets for effective therapeutics for this disease. In the second part of the study, we identified a novel β-catenin-RET kinase signaling pathway which is a critical contributor to the development and metastasis of human thyroid carcinoma. We show that RET binds to, and tyrosine phosphorylates, β-catenin and demonstrate that the interaction between RET and β-catenin can be direct and independent of cytoplasmic kinases, such as SRC. As a result of RET-mediated tyrosine phosphorylation, β-catenin escapes cytosolic downregulation by the APC/Axin/GSK3 complex and accumulates in the nucleus, where it can stimulate β-catenin-specific transcriptional programs in a RET-dependent fashion. We show that downregulation of β-catenin activity decreases RET-mediated cell proliferation, colony formation, and tumour growth in nude mice. Finally, we used a structure guided approach to identify and characterize a novel, non-ATP competitive, RET inhibitor; SW-01. We show that SW-01 provides significant RET inhibition in an in vitro kinase assay using purified RET. Moreover, RET phosphorylation is blocked, or dramatically reduced, in vivo in cells overexpressing active RET. We observe a significant decrease in cell proliferation and colony formation in RET-expressing cells in the presence of SW-01. Together, our data suggest that SW-01 has potential as a novel RET kinase inhibitor with clinical utility. / Thesis (Ph.D, Pathology & Molecular Medicine) -- Queen's University, 2008-09-15 16:20:59.976

Thyroid cancer constitutes about 1% of all malignant tumours and the incidence is increasing in Sweden. It is rare in children before the age of 10. During puberty the female to male ratio increases to be two to three times more common in females. The ratio remains constant until menopause and thereafter declines. The etiology of this gender-dependent incidence difference is unclear. Ionizing radiation is the only well-established risk factor for the disease, while the impact of other etiological factors is not clear. A retrospective study based upon medical records of 218 females and 91 males with papillary, mixed or follicular types of thyroid cancer was conducted. Prognostic factors were compared by multivariate analysis using Cox's semiparametric hazard model. Differences in prognosis between women and men were found. There was a higher relapse rate and mortality risk among men. Distant metastasis, age &gt;50 years, regional lymph node metastasis, low or moderate differentiation, and tumour related symptoms at diagnosis were also independent factors related to increased tumour mortality risk. A population-based case-control study including 180 cases and 360 controls was carried out to identify risk factors for thyroid cancer. Information on exposure was obtained by mailed questionnaires. The first part of the study investigated connections between medical ionizing radiation and thyroid cancer. The results showed that diagnostic X rays were a significant risk factor for papillary thyroid cancer in women between 20 and 50 years at diagnosis. Exposure to iodine-131 caused no increased risk for thyroid cancer. The result supports that external radiotherapy is a risk factor for thyroid cancer in women. The second part of the case-control study dealt with occupation and different exposures. Work with diagnostic X-ray investigations and work as a lineman was associated with thyroid cancer. Exposure to impregnating agents increased the risk. The third part of this study showed that one pregnancy increased the risk for papillary thyroid cancer. A medical history of asthma or allergy decreased the risk. Another case-control study using medical records as the source for assessment of exposure gave a non significantly increased risk for thyroid cancer in patients who had been treated with external radiotherapy including the thyroid gland. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1994, härtill 5 uppsatser.</p> / digitalisering@umu

Adaptor proteins play a vital role in the propagation of cellular signals. Although they lack endogenous catalytic activity, they contain a variety of protein binding modules, which enable them to promote specific and efficient interactions with their binding partners. They form integrative platforms for a variety of molecules (e.g. lipids, tyrosine kinases, cytoskeletal and signaling proteins), and thereby link and coordinate key functions such as cell growth, motility and shape determination. Our laboratory has recently cloned a novel, 130 kDa adaptor protein, named XB130, as a structural homolog of actin-filament-associated-protein (AFAP-110), a stress fiber-binding Src substrate. However, the molecular interactions and functions of this novel adaptor remained to be elucidated. To characterize the function of XB130 we asked two general questions: (1) Is XB130 involved in the signal transduction pathways of tyrosine kinases? And (2) Is XB130 capable of regulating the cytoskeleton and/or is it regulated by the cytoskeleton? To address these questions first we investigated the tissue distribution of XB130 and discovered that it is abundantly expressed in thyroid. Therefore we asked whether it is a target of the thyroid-specific tyrosine kinase, RET/PTC, a genetically rearranged, constitutively active enzyme that plays a pathogenic role in papillary thyroid cancer. We found that XB130 is a RET/PTC substrate that couples RET/PTC signaling to phosphatidylinositol 3-kinase (PI3K) activation through its phosphorylation dependent interaction with the regulatory subunit p85 of PI3K. XB130 plays an important role in PI3K signaling, as downregulation of XB130 in TPC1 papillary thyroid cancer cells, harboring the RET/PTC1 kinase, strongly reduced Akt activity and concomitantly inhibited cell cycle progression and survival in suspension. In the second part we demonstrate that XB130 is a novel Rac- and cytoskeleton-regulated protein that exhibits high affinity to lamellipodial (branched) F-actin and impacts motility and invasiveness of tumor cells. In conclusion, my work characterized a novel adaptor protein and assigned two well-defined pathophysiological functions to it in the context of thyroid cancer cells.