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NSAIDs Prevent Colon Cancer by Inducing Death of Intestinal Stem Cells That Have Gene Mutation

PITTSBURGH, Nov. 3, 2014 – Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) protect against the development of colorectal cancer by inducing cell suicide pathways in intestinal stem cells that carry a certain mutated and dysfunctional gene, according to a new study led by researchers at the University of Pittsburgh Cancer Institute (UPCI) and the School of Medicine. The findings were published online today in the Proceedings of the National Academy of Sciences.

Scientists have long known from animal studies and clinical trials that use of NSAIDs, such as aspirin and ibuprofen, lowers the risk of developing intestinal polyps, which can transform into colon cancer. But they have not known why, said senior investigator Lin Zhang, Ph.D., associate professor, Department of Pharmacology and Chemical Biology, Pitt School of Medicine, and UPCI, a partner with UPMC CancerCenter.

“Our study identifies a biochemical mechanism that could explain how this preventive effect occurs,” he said. “These findings could help us design new drugs to prevent colorectal cancer, which is the third leading cause of cancer-related deaths in the country.”

The research team performed experiments in animal models and examined tumor samples from patients who had taken NSAIDs and those who hadn’t. They found that NSAIDs activate the so-called death receptor pathway, which selectively triggers a suicide program in intestinal stem cells that have a mutation in the APC gene that renders the cells dysfunctional. Healthy cells lack the mutation, so NSAIDs cause them no harm. In that manner, the drugs instigate the early auto-destruction of cells that could lead to precancerous polyps and tumors.

“We want to use our new understanding of this mechanism as a starting point to design better drugs and effective cancer prevention strategies for those at high risk of colon cancer,” Dr. Zhang said. “Ideally, we could harness the tumor-killing traits of NSAIDs and avoid possible side effects that can occur with their chronic use, such as gastrointestinal bleeding and ulcers.”

The research team included lead author Brian Leibowitz, Ph.D., and Jian Yu, Ph.D., of UPCI and the Pitt’s Department of Pathology, as well as others from UPCI and Pitt School of Medicine; Sichuan University, China; INCELL Corp, San Antonio, Texas; and Indiana University School of Medicine.

The project was funded by National Institutes of Health grants CA106348, CA121105, CA172136, CA129829 and DK085570, and the American Cancer Society.

Never Giving Up: UPMC, Pitt Researchers Receive Grants Totaling $800,000 from V Foundation

PITTSBURGH, Oct. 21, 2014 – Researchers from the University of Pittsburgh Cancer Institute (UPCI), partner with UPMC CancerCenter, have been awarded a grant from the V Foundation for Cancer Research to study gene mutations in patients whose head and neck cancer was caused by human papillomavirus (HPV) in hopes of finding a more effective, less toxic therapy for this often painful, disfiguring disease.

The three-year, $600,000 grant was awarded to principal investigator Julie Bauman, M.D., M.P.H., associate professor of medicine and director of the Head and Neck Cancer Section in the Division of Hematology-Oncology at the University of Pittsburgh School of Medicine and co-director of the UPMC Head and Neck Cancer Center of Excellence. The V Foundation, formed by ESPN and former college basketball coach Jim Valvano who is known for challenging people to never give up, also recognized Pitt’s Kara Bernstein, Ph.D., with a V Scholar award, worth $200,000 over two years.

“Coach Valvano established the V Foundation in 1993, the same year he lost his own battle with cancer. His dream was to find a cure for cancer, and we share in that dream here at the University of Pittsburgh Cancer Institute,” said Nancy E. Davidson, M.D., director UPCI and UPMC CancerCenter. “These are highly competitive grants, and we are so pleased that Pitt investigators were recognized.”

Dr. Bauman said the grant will help researchers build on existing scientific knowledge and pioneer new treatments for head and neck cancer, which affects more than 50,000 people in the U.S. and 600,000 people worldwide each year. The primary cause of head and neck cancer in North America and Europe is becoming oral infection with HPV. Although HPV-related cancer responds well to intensive treatment, combinations of surgery, radiation and chemotherapy can result in permanent changes to uniquely human functions: facial expression, speech and swallowing.

“We’ve already learned that half of HPV-related head and neck cancers demonstrate abnormalities in a gene known as PIK3CA,” Dr. Bauman said. “We’re now learning how alterations in this gene cooperate with the virus to transform benign HPV infections into cancer. In addition, we are conducting a clinical trial to see whether a new drug that targets PIK3CA improves response in patients with HPV-related cancer. Ultimately, we aim to identify more effective and less toxic treatments, and even to prevent the transformation of HPV infection into cancer.”

Dr. Bauman is collaborating on the study with Jennifer Grandis, M.D., F.A.C.S., Pitt’s vice chair for research, professor of otolaryngology and pharmacology, and program leader for UPCI’s Head & Neck Cancer Program; Michelle Ozbun, Ph.D., the Maralyn S. Budke Endowed Professor of Viral Oncology at the University of New Mexico Cancer Center; Uma Duvvuri, M.D., Ph.D., Pitt assistant professor of otolaryngology; Andrew Cowan, M.D., Ph.D., assistant professor of surgery, Division of Otolaryngology, University of New Mexico Cancer Center; and Simion Chiosea, M.D., of the UPMC Anatomic Pathology Department.

The V Foundation has awarded more than $100 million for cancer research to more than 100 facilities nationwide since its inception. The translational research grants are designed to accelerate laboratory findings with the goal of benefiting patients more quickly. The V Scholar grants are designed to help early career cancer investigators develop into promising future research talents.

As a V Scholar, Dr. Bernstein will use her award to investigate why people who have mutations in proteins known as RAD51 paralogues are more susceptible to getting cancer – particularly breast and ovarian – and to identify methods for treating their specific cancers.

“Our goal is to uncover individualized cancer treatment for these particular tumors so these patients will have the best outcomes possible,” Dr. Bernstein said.

Pitt/McGowan Institute Team Discovers Stem Cells in the Esophagus

PITTSBURGH, Oct. 16, 2014 – Despite previous indications to the contrary, the esophagus does have its own pool of stem cells, said researchers from the University of Pittsburgh School of Medicine in an animal study published online today in Cell Reports. The findings could lead to new insights into the development and treatment of esophageal cancer and the precancerous condition known as Barrett’s esophagus.

According to the American Cancer Society, more than 18,000 people will be diagnosed with esophageal cancer in the U.S. in 2014 and almost 15,500 people will die from it. In Barrett’s esophagus, the lining of the esophagus changes for unknown reasons to resemble that of the intestine, though gastro-esophageal reflux disease or GERD is a risk factor for its development.

“The esophageal lining must renew regularly as cells slough off into the gastrointestinal tract,” said senior investigator Eric Lagasse, Pharm.D., Ph.D., associate professor of pathology, Pitt School of Medicine, and director of the Cancer Stem Cell Center at the McGowan Institute for Regenerative Medicine. “To do that, cells in the deeper layers of the esophagus divide about twice a week to produce daughter cells that become the specialized cells of the lining. Until now, we haven’t been able to determine whether all the cells in the deeper layers are the same or if there is a subpopulation of stem cells there.”

The research team grew pieces or “organoids” of esophageal tissue from mouse samples, and then conducted experiments to identify and track the different cells in the basal layer of the tissue. They found a small population of cells that divide more slowly, are more primitive, can generate specialized or differentiated cells, and have the ability to self-renew, which is a defining trait of stem cells.

“It was thought that there were no stem cells in the esophagus because all the cells were dividing rather than resting or quiescent, which is more typical of stem cells,” Dr. Lagasse noted. “Our findings reveal that there indeed are esophageal stem cells, and rather than being quiescent, they divide slowly compared to the rest of the deeper layer cells.”

In future work, the researchers will examine human esophageal tissues for evidence of stem cell dysfunction in Barrett’s esophagus disease.

“Some scientists have speculated that abnormalities of esophageal stem cells could be the origin of the tissue changes that occur in Barrett’s disease,” Dr. Lagasse said. “Our current and future studies could make it possible to test this long-standing hypothesis.”

The project’s co-investigators are Aaron DeWard, Ph.D., and Julie Cramer, Ph.D., both of Pitt’s Department of Pathology and the McGowan Institute.

The research was funded by grants from the Commonwealth of Pennsylvania, National Institutes of Health grant DK08571, the McGowan Institute and the University of Pittsburgh Department of Pathology Postdoctoral Research Training Program.

UPMC Partners with GK Klinika to Develop and Co-Manage Cancer Hospital in Lithuania

 PITTSBURGH, Oct. 7, 2014 GK Klinika Group, a private health care company in the Baltic region, is partnering with UPMC for its help in developing and co-managing a new, 100-bed cancer hospital in Vilnius, Lithuania.

Scheduled to open in 2017 and funded by GK Klinika, the hospital is expected to care for patients covered by both private and public insurance to enhance the quality of oncology care throughout the Baltic region. Under the 15-year agreement, UPMC will assist with project planning, construction and training, and will co-manage all clinical and administrative activities after the facility opens.

The prime minister of Lithuania, Algirdas Butkevicius, will participate in a signing ceremony at UPMC’s headquarters today. The Lithuanian government is actively working to encourage foreign business expansion in that country, particularly in its highly advanced life sciences sector, and expects that this partnership with UPMC will foster U.S.-Lithuania relations and geopolitical stability in the region. 

“As an international leader in health care and medical research — and one that has proven that its model of care can be adapted to other countries and cultures — UPMC was the logical choice to be our partner in creating a world-class cancer facility,” said Karapet Babaian, M.D., chief executive officer of GK Klinika and of Baltijos Medicinos Tyrimu Institutas (BMTI), the unit that is working with UPMC. “The scope and length of this agreement is a testament to our faith in this new partnership.”

GK Klinika is one of the leading private clinics in the Baltic region, with more than 15 years of experience and a reputation for promoting innovative medical technology to achieve better patient outcomes. 

“GK Klinika and UPMC share the same vision: to give patients access to the best cancer care in the world close to home. We look forward to working with our partner to make that dream a reality in Lithuania,” said Charles Bogosta, president of UPMC’s International and Commercial Services Division.

UPMC’s wide-ranging assistance to GK Klinika will include hiring and training of staff in Pittsburgh and Vilnius, information technology planning, developing early cancer detection programs, conducting a genomics-testing pilot project and providing disease-specific treatment algorithms. UPMC physicians also will periodically provide consults related to advanced surgeries performed at the new hospital and second opinions via telemedicine.

The chief executive officer of the new hospital will be appointed by mutual agreement of both partners. 

Starting with its partnership to create a transplant center in Italy 18 years ago, UPMC has expanded its international footprint to include operations or services in countries that now include Ireland, India, China, Singapore, Japan and Kazakhstan. Through its international growth and commercialization efforts with industry partners, UPMC is diversifying its sources of revenue, fueling economic development in its local communities, and strengthening its ability to recruit and retain the best clinicians to improve health care outcomes globally.

Pitt Researchers Awarded $4.2 Million to Continue Cancer Studies in Chinese Populations

PITTSBURGH, Oct. 6, 2014 – Cancer epidemiologist Jian-Min Yuan, M.D., Ph.D., has been awarded a five-year grant of more than $4.2 million from the National Cancer Institute (NCI) to support the continued work of two studies examining how environmental and lifestyle exposures and genetics have affected the incidence, mortality and age-related outcomes of cancer in more than 81,000 Chinese men and women.

Dr. Yuan, associate director for Cancer Control and Population Sciences at the University of Pittsburgh Cancer Institute (UPCI), partner with the UPMC CancerCenter, and co-leader of UPCI’s Cancer Epidemiology and Prevention Program, is the principal investigator of the Shanghai Cohort Study and the Singapore Chinese Health Study. For the two population-based prospective studies, researchers examine cancer and other major health outcomes by evaluating blood, urine and other samples collected from participants for more than 25 years. These studies already have yielded important findings about the causes and prevention of cancer and have led to chemoprevention trials underway in the U.S.

“We anticipate that the two Asian study groups will become even more scientifically valuable over the next five years as the younger members of these groups get older and have a greater risk of developing cancer, thereby increasing the number of pre-disease, biomarker-based research opportunities,” said Dr. Yuan, who also is Pitt’s Arnold Palmer Endowed Chair in Cancer Prevention.

With the new award, Dr. Yuan and his collaborators hope to accrue 2,700 new cancer cases over the next five years. They also hope to:

  • Gather data to maintain and enhance the two Asian study databases, including follow-up for cancer, non-cancer and death outcomes; maintenance of the biorepositories; and management of the databases.
  • Conduct in-person and telephone interviews among participants to update exposure and medical information.
  • Collect blood and urine samples from participants with cancer diagnoses.
  • Engage in collaborative research projects of the NCI and the Asia Cohort Consortium. 

“Having the ability to examine diseases in large populations is reshaping the way we approach diagnosis and treatment. We’re excited about the possibilities this research holds and what we’ll learn next,” said Nancy E. Davidson, M.D., director of UPCI and UPMC CancerCenter.

This research is supported by the NCI under award number UM1CA182876.

Renowned Robotic Thoracic and Esophageal Surgeon Joins UPMC

PITTSBURGH, Sept. 25, 2014 – A thoracic surgeon who specializes in the minimally invasive treatment of malignant and benign diseases of the chest has joined the Department of Cardiothoracic Surgery under the direction of James D. Luketich, MD.

Inderpal S. Sarkaria, MD, FACS, joined the Department of Cardiothoracic Surgery at UPMC as Director of Thoracic Robotic Surgery, Vice Chairman for Clinical Affairs, and Co-Director of the Esophageal Surgery Institute.

Dr. Sarkaria has extensive expertise and experience in minimally invasive and Video Assisted Thoracic Surgical (VATS) approaches including esophagectomy for esophageal cancer, VATS lobectomy for lung cancer, VATS thymectomy, laparoscopic anti-refux surgery for GERD, laparoscopic surgery for achalasia, laparoscopic repair of giant paraesophageal hernias (GPEH), and robotic-assisted approaches to these conditions.

Dr. Sarkaria is also a member of and has lectured extensively at several major national and international thoracic surgical societies, and has been involved with committees for resident and fellow education, health care policy, and neuroendocrine lung tumors.

Adding Chemotherapy to Radiation Treatment Not Effective in Treating Vulvar Cancer, UPMC Study Shows

SAN FRANCISCO, Sept. 18 - The addition of chemotherapy to post-surgical radiation treatment is not effective in treating vulvar cancer, according to Magee-Womens Hospital of UPMC research presented this week in San Francisco at the 56th annual meeting of the American Society for Radiation Oncology (ASTRO).

Vulvar cancer is extremely rare, accounting for just 4 percent of gynecologic cancers and 0.6 percent of cancers women face in the U.S. each year. Led by Sushil Beriwal, M.D., associate professor with the department of radiation oncology at the University of Pittsburgh School of Medicine and radiation oncologist at Magee, this study identified patients diagnosed with vulvar cancer between 1998 and 2011 who had undergone surgery to remove the cancer and required adjuvant radiation therapy because the disease had spread to their lymph nodes.

The study utilized the National Cancer Database, a nationwide oncology outcomes database, to identify 1,087 patients who underwent chemotherapy treatment in addition to radiation therapy after their initial surgery to remove the cancer. The study took into account factors including age, race, insurance coverage, tumor size and spread of the disease.

“Our study found that overall, the addition of chemotherapy to adjuvant radiation therapy did not improve patient survival,” said Dr. Beriwal. “While retrospective studies do impose some limits on our conclusion, we found that at the very least, use of concurrent chemotherapy should be carefully evaluated on an individual basis.”

While the study didn’t confirm a benefit of the addition of adjuvant chemotherapy to treatment, Dr. Beriwal said it is important to share the findings because they move researchers one step closer to understanding how to most effectively treat vulvar cancer.

 

Genetic Discovery Yields Prostate Cancer Test, Promise of Future Therapy

PITTSBURGH, Sept. 15, 2014 – A genetic discovery out of the University of Pittsburgh School of Medicine is leading to a highly accurate test for aggressive prostate cancer and identifies new avenues for treatment.

The analysis, published today in the American Journal of Pathology, found that prostate cancer patients who carry certain genetic mutations have a 91 percent chance of their cancer recurring. This research was funded by the National Institutes of Health (NIH), American Cancer Society and University of Pittsburgh Cancer Institute (UPCI).

“Being able to say, with such certainty, that a patient is nearly guaranteed to see a recurrence of his prostate cancer means that doctors and patients can elect to be more aggressive in treating the cancer, knowing that the benefits likely outweigh the risks,” said Jian-Hua Luo, M.D., Ph.D., professor of pathology, Pitt School of Medicine and member of UPCI. “Eventually, this could lead to a cure for prostate cancer through genetic therapy. With this discovery, we’re at the tip of the iceberg in terms of possibilities for improving patient outcomes.”

Prostate cancer is the second most common cancer among men (behind skin cancer), with one in seven men diagnosed with prostate cancer in their lifetime. The American Cancer Society estimates that this year in the U.S., about 233,000 new cases of prostate cancer will be diagnosed, and 29,480 men will die of prostate cancer.

Despite the high incidence rate, only a fraction of men diagnosed with prostate cancer develop metastases, and even fewer die from the disease.

“In some cases, this can make the treatment more dangerous than the disease, so doctors need more accurate tests to tell them which patients would most benefit from aggressive therapies, such as surgery, radiation and chemotherapy,” said Dr. Luo.

Dr. Luo and his team sequenced the entire genome of prostate tissue samples from five prostate cancer patients who experienced aggressive recurrence of their cancer and compared them to normal tissue samples from men without cancer.

In the patients with prostate cancer recurrence, they identified 76 genetic fusion transcripts, which are hybrid genes formed from two previously separate genes and often are associated with cancer. After further testing, eight of the genetic fusion transcripts were found to be strongly associated with prostate cancer.

The researchers then screened for the eight fusion transcripts in 127 samples from patients with aggressive prostate cancer recurrence, 106 samples from prostate cancer patients with no recurrence at least five years after surgery, and 46 samples from prostate cancer patients with no recurrence less than five years after surgery. The samples came from UPMC, Stanford University Medical Center and University of Wisconsin Madison Medical Center.

In those samples, 91 percent with aggressive recurrence of their prostate cancer were positive for at least one of the fusion transcripts. Two of the fusion transcripts in particular were strongly associated with poor outcomes — none of the patients whose samples contained them survived to five years.

In contrast, 68 percent of patients whose samples did not contain at least one of the transcripts remained cancer-free.

Dr. Luo said if continued clinical trials of the test do well, it could be available to all prostate cancer patients in a few years.

In addition, studies are being developed to further investigate the genetic fusion transcripts most strongly associated with aggressive prostate cancer. Drugs and therapies could be developed to correct or stop the mutations, thereby halting the cancer progression, Dr. Luo explained.

Additional researchers on this study are Yan P. Yu, M.D., Ph.D., Ying Ding, Ph.D., Zhanghui Chen, Ph.D., Silvia Liu, B.S., Amantha Michalopoulos, B.S., Riu Chen, B.S., Kathleen Cieply, M.S., Alyssa Luvison, B.S., Bao-Guo Ren, M.D., Joel B. Nelson, M.D., George Michalopoulos, M.D., Ph.D., and George C. Tseng, Sc.D., all of Pitt; Zulfiqar G. Gulzar, Ph.D., and James D. Brooks, M.D., both of Stanford; and Bing Yang, Ph.D., and David Jarrard, M.D., both of the University of Wisconsin.

This research was supported by the NIH grants RO1 CA098249 and 1U01CA152737-01, American Cancer Society grant RSG-08-137-01-CNE and UPCI.

Internationally Acclaimed Scientist Named Co-Leader of UPCI Lung Cancer Program

PITTSBURGH, September 9, 2014 – An international leader in the field of epigenetics whose work has led to important discoveries into how cancer develops and progresses has been named the co-leader of the Lung Cancer Program at the University of Pittsburgh Cancer Institute (UPCI), partner with UPMC CancerCenter. James Herman, M.D., comes to Pittsburgh from Johns Hopkins School of Medicine, where he joined the faculty in 1996. 

At Pitt’s School of Medicine, Dr. Herman will be a visiting professor of medicine in the Division of Hematology/Oncology. His appointment is effective Nov. 1. 

“Jim is a senior scientist who brings extensive experience to UPCI. He will assume leadership of the UPCI Lung Cancer SPORE grant and work closely with Dr. Mark Socinski in our Lung Cancer Program, strengthening an already impressive team,” said Nancy E. Davidson, M.D., director of UPCI and the UPMC CancerCenter. The National Cancer Institute’s prestigious SPORE, or Specialized Program of Research Excellence, is one of four such specialized research grants held at UPCI.

In addition to his work as a researcher, Dr. Herman is expected to have an appointment at the Veterans Affairs Hospital in Pittsburgh, where he will work to promote clinical care, education and clinical trials in thoracic malignancies. He will also serve as a co-director of the medical oncology fellowship program to promote training in basic and translational research.

“Our fellows are very lucky to have the opportunity to work with and learn from Dr. Herman. He has a vast knowledge of cancer research, and we can all benefit from having someone of his caliber on our team,” said Edward Chu, M.D., deputy director of UPCI and chief of the Division of Hematology-Oncology.

The author of more than 250 papers, chapters and editorials, Dr. Herman and his team are especially well-known for their development of the methylation-specific PCR assay (MSP), which is widely used to characterize DNA methylation patterns. His work has been supported by a variety of sources, including a V Scholar Award, multiple grants from the National Institutes of Health (including service as a project co-leader on the Hopkins Lung Cancer SPORE), and most recently a Department of Defense grant, all in the general area of epigenetics of cancer. He has served as a member of the editorial board for a number of journals, including Clinical Cancer Research and Journal of Clinical Oncology.

Dr. Herman received his medical degree from Johns Hopkins in 1989, where he was elected to Alpha Omega Alpha.  After completing a residency in internal medicine at Duke, he returned to Hopkins to undertake a fellowship in medical oncology. He joined the Hopkins faculty in 1996, and rose through the ranks to serve as professor of oncology starting in 2009.

UPMC-Developed Test Increases Odds of Correct Surgery for Thyroid Cancer Patients

PITTSBURGH, July 24, 2014 – The routine use of a molecular testing panel developed at UPMC greatly increases the likelihood of performing the correct initial surgery for patients with thyroid nodules and cancer, report researchers from the University of Pittsburgh Cancer Institute (UPCI), partner with UPMC CancerCenter.

The test, available at the UPMC/UPCI Multidisciplinary Thyroid Center and other diagnostic testing agencies, improved the chances of patients getting the correct initial surgery by 30 percent, according to the study published this month in the Annals of Surgery.

“Before this test, about one in five potential thyroid cancer cases couldn’t be diagnosed without an operation to remove a portion of the thyroid,” said lead author Linwah Yip, M.D., assistant professor of surgery in Pitt’s School of Medicine and UPMC surgical oncologist.  Previously, “if the portion removed during the first surgery came back positive for cancer, a second surgery was needed to remove the rest of the thyroid. The molecular testing panel now bypasses that initial surgery, allowing us to go right to fully removing the cancer with one initial surgery. This reduces risk and stress to the patient, as well as recovery time and costs.”

Cancer in the thyroid, which is located in the “Adam’s apple” area of the neck, is now the fifth most common cancer diagnosed in women.  Thyroid cancer is one of the few cancers that continues to increase in incidence, although the five-year survival rate is 97 percent.

Previously, the most accurate form of testing for thyroid cancer was a fine-needle aspiration biopsy, where a doctor guides a thin needle to the thyroid and removes a small tissue sample for testing. However, in 20 percent of these biopsies, cancer cannot be ruled out. A lobectomy, which is a surgical operation to remove half of the thyroid, is then needed to diagnose or rule-out thyroid cancer. In the case of a postoperative cancer diagnosis, a second surgery is required to remove the rest of the thyroid.

Researchers have identified certain gene mutations that are indicative of an increased likelihood of thyroid cancer, and the molecular testing panel developed at UPMC can be run using the sample collected through the initial, minimally invasive biopsy, rather than a lobectomy. When the panel shows these mutations, a total thyroidectomy is advised.

Dr. Yip and her colleagues followed 671 UPMC patients with suspicious thyroid nodes who received biopsies. Approximately half the biopsy samples were run through the panel, and the other half were not. Patients whose tissue samples were not tested with the panel had a 2.5-fold higher statistically significant likelihood of having an initial lobectomy and then requiring a second operation.

“We’re currently refining the panel by adding tests for more genetic mutations, thereby making it even more accurate,” said co-author Yuri Nikiforov, M.D., Ph.D., professor in the Department of Pathology at Pitt and director of thyroid molecular diagnostics at the UPMC/UPCI Multidisciplinary Thyroid Center. “Thyroid cancer is usually very curable, and we are getting closer to quickly and efficiently identifying and treating all cases of thyroid cancer.”

In 2009, the American Thyroid Association (ATA) revised its guidelines to add that doctors may consider the use of molecular markers when the initial biopsy is inconclusive.

“The ATA is currently revising those guidelines to take into account the latest research, including our findings,” said senior author Sally Carty, M.D., Pitt professor of surgery, co-director of the UPMC/UPCI Multidisciplinary Thyroid Center and recent president of the American Association of Endocrine Surgeons. “The molecular testing panel holds promise for streamlining and eliminating unnecessary surgery not just here but nationwide.”

A previous study led by Dr. Yip showed the panel to be cost-saving when used to help in the diagnosis of thyroid cancer.

Each year, approximately half of the 25,000 patients assessed at UPMC’s Multidisciplinary Thyroid Center are found to have thyroid conditions, and more than 900 thyroid operations are performed by the center’s surgeons. The center aims to provide patients with one-stop evaluation from thyroid experts in a variety of fields, including surgery and endocrinology.

Additional researchers on this study are Laura I. Wharry, M.D., Michaele J. Armstrong, Ph.D., Ari Silbermann, B.S., Kelly L. McCoy, M.D., and Michael T. Stang, M.D., all of the Pitt Department of Surgery; Nobuyuki P. Ohori, M.D., and Marina N. Nikiforov, M.D., all of the Pitt Department of Pathology; Shane O. LeBeau, M.D., Christopher Coyne, M.D., and Steven P. Hodak, M.D., all of the Pitt Department of Endocrinology; Julie E. Bauman, M.D., of the PItt Department of Hematology/Oncology; Jonas T. Johnson, M.D., of the Pitt Department of Otolaryngology; and Mitch E. Tublin, M.D., of the Pitt Department of Radiology.

This study was funded by a grant from UPMC.

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