Objective:This study aims to develop a deep multiscale image learning system(DMILS)to differentiate malignant from benign thyroid follicular neoplasms on multiscale whole-slide images(WSIs)of intraoperative frozen pat...Objective:This study aims to develop a deep multiscale image learning system(DMILS)to differentiate malignant from benign thyroid follicular neoplasms on multiscale whole-slide images(WSIs)of intraoperative frozen pathological images.Methods:A total of 1,213 patients were divided into training and validation sets,an internal test set,a pooled external test set,and a pooled prospective test set at three centers.DMILS was constructed using a deep learningbased weakly supervised method based on multiscale WSIs at 10×,20×,and 40×magnifications.The performance of the DMILS was compared with that of a single magnification and validated in two pathologist-unidentified subsets.Results:The DMILS yielded good performance,with areas under the receiver operating characteristic curves(AUCs)of 0.848,0.857,0.810,and 0.787 in the training and validation sets,internal test set,pooled external test set,and pooled prospective test set,respectively.The AUC of the DMILS was higher than that of a single magnification,with 0.788 of 10×,0.824 of 20×,and 0.775 of 40×in the internal test set.Moreover,DMILS yielded satisfactory performance on the two pathologist-unidentified subsets.Furthermore,the most indicative region predicted by DMILS is the follicular epithelium.Conclusions:DMILS has good performance in differentiating thyroid follicular neoplasms on multiscale WSIs of intraoperative frozen pathological images.展开更多
Background:With growing interest in space exploration,understanding microgravity’s impact on human health is essential.This study aims to investigate gene expression changes and migration and invasion potential infive...Background:With growing interest in space exploration,understanding microgravity’s impact on human health is essential.This study aims to investigate gene expression changes and migration and invasion potential infive thyroid-related cell lines cultured under simulated microgravity.Methods:Five thyroid-related cell lines—normal thyrocytes(Nthy-ori 3-1),papillary thyroid cancer(PTC)cells(SNU-790,TPC-1),poorly differentiated thyroid cancer cell(BCPAP),and anaplastic thyroid cancer cell(SNU-80)—were cultured under simulated microgravity(10-3 g)using a clinostat.Differentially expressed genes(DEGs)were analyzed using cDNA microarray,followed by functional annotation and assessment of aggressiveness via Transwell migration and invasion assays.Results:DEG analysis under simulated microgravity revealed distinct gene expression profiles by gravity condition,with 2980 DEGs in SNU-790,1033 in BCPAP,562 in TPC-1,477 in Nthy-ori 3-1,and 246 in SNU-80,as confirmed by hierarchical clustering.In PTC cell lines(SNU-790,TPC-1),G2–M phase–related genes were upregulated.In non-PTC cell lines(BCPAP,SNU-80),genes associated with innate immune response,Toll-like receptor signaling,were upregulated,whereas Hypoxia-Inducible Factor 1-alpha(HIF-1α)signaling-related genes were downregulated.Additionally,under simulated microgravity,significant migration was observed in SNU-790(3×104 cells)and BCPAP(2×104 and 3×104),while significant invasion occurred in SNU-790,Nthy-ori 3-1,and BCPAP at a seeding density of 2×104.Other conditions showed no significant differences.Conclusion:This study comprehensively evaluates the effects of simulated microgravity using a diverse panel of thyroid-related cell lines.Thesefindings provide valuable insight into how microgravity could influence cancer biology,emphasizing the importance of further research on cancer behavior in space environments and its implications for human health during long-term space missions.展开更多
BACKGROUND Thyroid cancer incidence is rising globally,including the Democratic Republic of Congo(DRC).Despite its increasing incidence,limited data exist on physicians’knowledge of thyroid cancer management in the D...BACKGROUND Thyroid cancer incidence is rising globally,including the Democratic Republic of Congo(DRC).Despite its increasing incidence,limited data exist on physicians’knowledge of thyroid cancer management in the DRC.AIM To evaluate the knowledge levels of Congolese physicians regarding the diagnosis and treatment of thyroid nodules and cancers,and to identify existing gaps and areas for improvement.METHODS A descriptive cross-sectional study was conducted from June to August 2024,involving 369 physicians practicing in healthcare facilities across Kinshasa,DRC.Participants were selected using a multi-stage sampling method.Data were collected via a structured questionnaire covering thyroid cancer epidemiology,diagnostic methods,treatment approaches,and prognosis.Data were analyzed using SPSS version 25,employing descriptive and inferential statistics,with a P value≤0.05 being considered as statistically significant.RESULTS Overall response rate was 96.1%.Of all participants,68%were female and 32%were male physicians.General practitioners constituted 84.8%of respondents,with an average age of 34 years.While 53.7%demonstrated adequate knowledge of hypothyroidism management post-thyroidectomy and 61.2%identified the approach for hypoparathyroidism,only 5.1%recognized the need for radiotherapy in metastatic thyroid cancer cases.Awareness of anaplastic thyroid cancer treatment was limited(6.5%),and 90.2%of physicians were unfamiliar with the surgical complications.Moderate understanding was noted in diagnostic protocols,with 44.2%correctly identifying repeat fine-needle aspiration timing in Bethesda I cases.Knowledge of molecular genetics,recurrence risks,and metastasis patterns was remarkably low.CONCLUSION This study highlights significant knowledge gaps among Congolese physicians regarding thyroid cancer management,especially about advanced treatment modalities and molecular genetics.Targeted educational programs and improved access to diagnostic tools are critical to bridging these deficits.Addressing these gaps can enhance the quality of thyroid cancer care and align clinical practices in the DRC with global standards.展开更多
Currently, thyroid cancer is one of the most common endocrine cancer in the United States. A recent involvement of sub-population of stem cells, cancer stem cells, has been proposed in different histological types of ...Currently, thyroid cancer is one of the most common endocrine cancer in the United States. A recent involvement of sub-population of stem cells, cancer stem cells, has been proposed in different histological types of thyroid cancer. Because of their ability of self-renewal and differentiation into various specialized cells in the body, these putative cells drive tumor genesis, metastatic activity and are responsible to provide chemo- and radioresistant nature to the cancer cells in the thyroid gland. Our Review was conducted from previously published literature to provide latest apprises to investigate the role of embryonic, somatic and cancer stem cells, and discusses the hypothesis of epithelial-mesenchymal transition. Different methods for their identification and isolation through stemness markers using various in vivo and in vitro methods such as flow cytometry, thyrosphere formation assay, aldehyde dehydrogenase activity and ATP-binding cassette sub-family G member 2 efflux-pump mediated Hoechst 33342 dye exclusion have been discussed. The review also outlines various setbacks that still remain to target these tumor initiating cells. Future perspectives of therapeutic strategies and their potential to treat advanced stages of thyroid cancer are also disclosed in this review.展开更多
BACKGROUND Although papillary thyroid microcarcinoma(PTMC)is not considered a threatening tumor,in some cases,it can be aggressive.Metastatic thrombosis of papillary thyroid carcinoma,follicular thyroid carcinoma,H...BACKGROUND Although papillary thyroid microcarcinoma(PTMC)is not considered a threatening tumor,in some cases,it can be aggressive.Metastatic thrombosis of papillary thyroid carcinoma,follicular thyroid carcinoma,Hürthle cell carcinoma,poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma have been reported in the literature,but there have been no reports about PTMC.CASE SUMMARY A 45-year-old woman presented with a thyroid mass and thrombosis in a middle thyroid vein during a physical examination.She had no symptoms,and the physical examination showed no positive signs.Subsequent ultrasonographyguided fine-needle aspiration biopsy results indicated an atypical lesion of ambiguous significance,with some actively growing cells(TBSRTCⅢ)and the BRAFV600E mutation not present.This patient underwent left thyroidectomy,isthmus lobectomy,prophylactic central lymph node dissection and thromboembolectomy.Postoperative pathology showed papillary microcarcinoma of the left thyroid,and the thrombus in the middle thyroid vein was a tumor thrombus.CONCLUSION Middle thyroid vein tumor thrombus is an extremely rare condition in PTMC,but it does exist.Lobectomy and thromboembolectomy may be an option for patients with thrombi in the middle vein of the thyroid,and we strongly suggest close follow-up of these patients.展开更多
Objective： We evaluated the relationship between the clinical management of level Ⅵ lymph node and neck lymph node micrometastases in follicular thyroid carcinoma. Methods： 326 negative neck lymph nodes of 68 cases...Objective： We evaluated the relationship between the clinical management of level Ⅵ lymph node and neck lymph node micrometastases in follicular thyroid carcinoma. Methods： 326 negative neck lymph nodes of 68 cases with follicular thyroid carcinoma on routine pathology were examined by keratin-19 monoclonal antibody and S-P JmmunohJsto- chemistry to confirm lymph node micrometastasis. Follow-up pathological and clinical documents were compared. Results： Forty-six neck lymph nodes showed positive micrometastasis among 326 negative neck lymph nodes including 4 lymph nodes in Level Ⅱ （4/42）, 5 lymph nodes in Level Ⅲ （5/34）, 5 lymph nodes in Level Ⅳ （5/49）, 1 lymph node in Leve Ⅳ （1/17） and 31 lymph nodes in Level Ⅳ （31/184）. Six in 14 cases with positive micrometastasis showed distant metastasis or local recurrence, but only 3 in 54 cases with negative micrometastasis indicated distant metastasis or local recurrence （P 〈 0.01）. Conclusion： The research showed that Level VI neck lymph node micrometastasis is possibly occur and closely related with local recurrence and metastasis in follicular carcinoma of thyroid.展开更多
Objective: To investigate the possible interaction between the ras and p53 genes over-expression in thyroid carcinoma, and whether there is a correlation between the ras and p53 over-expression and clinicopathological...Objective: To investigate the possible interaction between the ras and p53 genes over-expression in thyroid carcinoma, and whether there is a correlation between the ras and p53 over-expression and clinicopathological criteria. Methods: Eighty patients with thyroid lesions were examined for expression of ras and p53 genes by the labeled streptavidin biotin peroxidase (LSAB) method. Of these patients, 54 were diagnosed (average age: 39.9±15.9 years) with malignant lesions. Of those included in the study, 31 has papillary carcinoma, 13 had follicular carcinoma, 7 had medullary carcinoma, 3 had undifferentiated carcinoma and 19 were stratified to stage I, 28 to stage II, 2 to stage III and 5 to stage IV according to TNM staging system. Twenty-six benign nodular thyroid disorders were studied as control. Results: Positive immunostain results for ras and p53 genes were statistically significant between thyroid carcinomas and benign disorders (90.7% vs 23%, 55.5% vs 30.7%,P<0.05). Both p53 and ras overexpressions coexisted in 30 thyroid carcinomas, and of these, 3 died and 5 had recurrences within 4 years. Conclusions: Activation of ras gene and inactivation of p53 gene were cooperatively associated in thyroid tumorigenesis. The concurrent overexpressions of ras and p53 could result in a poor prognosis.展开更多
Objective： The aim of the study was to detect the levels of mannose-binding lectin （MBL）, MBL-associated serine protease 2 （MASP-2） and explore the clinical significances of them in patients with primary thyroid ...Objective： The aim of the study was to detect the levels of mannose-binding lectin （MBL）, MBL-associated serine protease 2 （MASP-2） and explore the clinical significances of them in patients with primary thyroid neoplasms. Methods： By using ELISA method, we detected the serum levels of MBL and MASP-2 in 26 patients with papillary thyroid carcinoma （PTC）, 30 patients with thyroid adenoma （TA） and 26 healthy people, respectively. Results： Serum MBL level was （565.23 ± 76.70） μg/L in PTCs higher than （324.267 ±24.74） μg/L in TAs, and （152.69± 16.95） IJg/L in healthy of controlling group. There was statistical significance between PTC and TA （P 〈 0.05）, however there was no difference between TA and healthy （P 〉 0.05）. Serum MASP-2 level was （726.153± 78.88） pg/L in PTCs higher than （379.266 ± 30.26） μg/L in TAs, and （203.846 ± 29.09） μg/L in healthy. Serum MASP-2 level was higher in PTCs than TAs, and the difference had statistical significance （P 〈 0.01）. But no difference was observed between in TAs and healthy. Conclusion： These findings might reflect inflammatory processes induced by defense mechanisms, in response to the development of the turnout. MBL may also be involved in the elimination of possible tumourigenic pathogens.展开更多
目的探讨经口腔前庭入路腔镜甲状腺切除术(endoscopic thyroidectomy using the oral vestibular approach,ETOVA)与传统颈部开放手术治疗女性甲状腺乳头状癌的安全性、有效性及美容效果。方法回顾性分析2019年1~12月行甲状腺乳头状癌...目的探讨经口腔前庭入路腔镜甲状腺切除术(endoscopic thyroidectomy using the oral vestibular approach,ETOVA)与传统颈部开放手术治疗女性甲状腺乳头状癌的安全性、有效性及美容效果。方法回顾性分析2019年1~12月行甲状腺乳头状癌根治术的120例女性患者的临床资料,分为经口腔前庭入路腔镜甲状腺手术组(腔镜组,n=60)和传统颈部开放手术组(开放组,n=60),对比两组患者术中及术后相关临床资料。结果两组患者年龄、肿瘤直径、中央区淋巴结清扫时间、中央区淋巴结清扫总数、中央区转移淋巴结数量、术后并发症、术后24 h疼痛评分、术后6个月疼痛评分均无统计学差异(P均>0.05)腔镜组手术总时长、术中失血量、术后引流量均大于开放组(P均<0.001),腔镜组术后满意度高。结论ETOVA在治疗甲状腺乳头状癌是安全、有效的,具有更好的美容效果,患者满意度高,可以考虑作为部分患者,尤其是年轻女性甲状腺乳头状癌患者的首选手术方案。展开更多
目的 分析甲状腺乳头状癌(PTC)超声图像表现在预测颈部Ⅵ区淋巴结转移(lymph node metastasis in the cervicalregion Ⅵ,CLNM-Ⅵ)危险度的临床价值。方法 选取2022年4月~2023年6月在河北省沧州中西医结合医院接受手术治疗并经病理证实...目的 分析甲状腺乳头状癌(PTC)超声图像表现在预测颈部Ⅵ区淋巴结转移(lymph node metastasis in the cervicalregion Ⅵ,CLNM-Ⅵ)危险度的临床价值。方法 选取2022年4月~2023年6月在河北省沧州中西医结合医院接受手术治疗并经病理证实的350例PTC患者,根据术后病理结果,将患者分为CLNM-Ⅵ组和非CLNM-Ⅵ组。收集并对比两组术前超声图像表现及临床病理特征,应用Logistic回归分析PTC患者CLNM-Ⅵ危险因素,受试者工作特征(ROC)曲线分析PTC超声图像表现对CLNM-Ⅵ的预测价值。结果 单因素分析显示,CLNM-Ⅵ组男性、实性或囊实性、年龄≤45岁、低回声、甲状腺背景正常、点状强回声的构成比均大于非CLNM-Ⅵ组(P均<0.05)。Logistic回归分析显示,男性、实性或囊实性、年龄≤45岁、低回声、甲状腺背景正常、病灶内可见点状强回声是CLNM-Ⅵ的独立危险因素(P均<0.05);进一步经ROC曲线分析显示,以上预测CLNM-Ⅵ的AUC分别为0.565、0.580、0.529、0.585、0.582、0.582,联合预测AUC为0.708。结论PTC超声图像表现在CLNM-Ⅵ风险评估中具有重要意义,可为PTC的预后判断提供一定的参考依据。展开更多
Background： The Notch-regulated ankyrin repeat protein （NRARP） is recently found to promote proliferation of breast cancer cells. The role of NRARP in carcinogenesis deserves extensive investigations. This study at...Background： The Notch-regulated ankyrin repeat protein （NRARP） is recently found to promote proliferation of breast cancer cells. The role of NRARP in carcinogenesis deserves extensive investigations. This study attempted to investigate the expression of NRARP in thyroid cancer tissues and assess the influence of NRARP on cell proliferation, apoptosis, cell cycle, and invasion in thyroid cancer. Methods： Thirty-four cases with thyroid cancer were collected from the Department of General Surgery, Xinhua Hospital, Shanghai ]iao Tong University School of Medicine between 2011 and 2012. lmmunohistochemistry was used to detect the level of N RARP in cancer tissues. Lentivirus carrying NRARP-shRNA （Lenti-NRARP-shRNA） was applied to down-regulate NRARP expression. Cell viability was tested after treatment with Lenti-NRARP-shRNA using 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide assay. Apoptosis and cell cycle distribution were determined by flow cytometry. Cell invasion was tested using Transwell invasion assay. In addition, expressions of several cell cycle-associated and apoptosis-associated proteins were examined using Western blotting after transfection. Student＇s t-test, one-way analysis of variance （ANOVA）, or Kaplan Meier were used to analyze the differences between two group or three groups. Results： N RARP was highly expressed in thyroid cancer tissues. Lenti-NRARP-shRNA showed significantly inhibitory activities against cell growth at a multiplicity of infection of l 0 or higher （P 〈 0.05）. Lenti-NRARP-shRNA-induced G 1 arrest （BHTl 01 ： 72.57% ± 5.32%; g305C： 75.45% ± 5.26%） by promoting p21 expression, induced apoptosis by promoting bax expression and suppressing bcl-2 expression, and inhibited cell invasion by suppressing matrix metalloproteinase-9 expression. Conclusion： Downregulation of NRARP expression exerts significant antitumor activities against cell growth and invasion of thyroid cancer, that suggests a potential role of NRARP in thyroid cancer targeted therapy.展开更多
Background Recently, there has been a surge of interest in minimally invasive techniques with endoscope in thyroid surgery. The aim of this study was to investigate the possibility of a scarless neck surgery under end...Background Recently, there has been a surge of interest in minimally invasive techniques with endoscope in thyroid surgery. The aim of this study was to investigate the possibility of a scarless neck surgery under endoscopy for the treatment of thyroid tumor and to observe the results of this procedure.Methods A total of 68 patients （64 women and 4 men） underwent the surgery. Their ages ranged from 18 to 65 years,with a mean age of （34±3） years. There were 64 cases of thyroid adenoma, and 4 cases of nodular goiter. An incision was made on the surface of the chest bone. The operation cavity was made by dragging the skin. Sixty-four patients underwent partial thyroid lobectomy, four patients underwent thyroid lobectomy.Results All 68 cases showed healing in one stage. None of the cases showed paralysis of the recurrent laryngeal nerve or tumor recurrence within the next 2 to 60 months of follow-up. The patients experienced slight pain after the operation.The patients were satisfied with the cosmetic results of the surgery.Conclusion The gasless endoscopic surgery through the upper chest, which was performed to treat thyroid tumor, did not leave any scar, and was easy to handle, and gave good cosmetic results.展开更多
基金supported by the Taishan Scholar Project(No.ts20190991,tsqn202211378)the Key R&D Project of Shandong Province(No.2022CXPT023)the General Program of National Natural Science Foundation of China(No.82371933)。
文摘Objective:This study aims to develop a deep multiscale image learning system(DMILS)to differentiate malignant from benign thyroid follicular neoplasms on multiscale whole-slide images(WSIs)of intraoperative frozen pathological images.Methods:A total of 1,213 patients were divided into training and validation sets,an internal test set,a pooled external test set,and a pooled prospective test set at three centers.DMILS was constructed using a deep learningbased weakly supervised method based on multiscale WSIs at 10×,20×,and 40×magnifications.The performance of the DMILS was compared with that of a single magnification and validated in two pathologist-unidentified subsets.Results:The DMILS yielded good performance,with areas under the receiver operating characteristic curves(AUCs)of 0.848,0.857,0.810,and 0.787 in the training and validation sets,internal test set,pooled external test set,and pooled prospective test set,respectively.The AUC of the DMILS was higher than that of a single magnification,with 0.788 of 10×,0.824 of 20×,and 0.775 of 40×in the internal test set.Moreover,DMILS yielded satisfactory performance on the two pathologist-unidentified subsets.Furthermore,the most indicative region predicted by DMILS is the follicular epithelium.Conclusions:DMILS has good performance in differentiating thyroid follicular neoplasms on multiscale WSIs of intraoperative frozen pathological images.
文摘Background:With growing interest in space exploration,understanding microgravity’s impact on human health is essential.This study aims to investigate gene expression changes and migration and invasion potential infive thyroid-related cell lines cultured under simulated microgravity.Methods:Five thyroid-related cell lines—normal thyrocytes(Nthy-ori 3-1),papillary thyroid cancer(PTC)cells(SNU-790,TPC-1),poorly differentiated thyroid cancer cell(BCPAP),and anaplastic thyroid cancer cell(SNU-80)—were cultured under simulated microgravity(10-3 g)using a clinostat.Differentially expressed genes(DEGs)were analyzed using cDNA microarray,followed by functional annotation and assessment of aggressiveness via Transwell migration and invasion assays.Results:DEG analysis under simulated microgravity revealed distinct gene expression profiles by gravity condition,with 2980 DEGs in SNU-790,1033 in BCPAP,562 in TPC-1,477 in Nthy-ori 3-1,and 246 in SNU-80,as confirmed by hierarchical clustering.In PTC cell lines(SNU-790,TPC-1),G2–M phase–related genes were upregulated.In non-PTC cell lines(BCPAP,SNU-80),genes associated with innate immune response,Toll-like receptor signaling,were upregulated,whereas Hypoxia-Inducible Factor 1-alpha(HIF-1α)signaling-related genes were downregulated.Additionally,under simulated microgravity,significant migration was observed in SNU-790(3×104 cells)and BCPAP(2×104 and 3×104),while significant invasion occurred in SNU-790,Nthy-ori 3-1,and BCPAP at a seeding density of 2×104.Other conditions showed no significant differences.Conclusion:This study comprehensively evaluates the effects of simulated microgravity using a diverse panel of thyroid-related cell lines.Thesefindings provide valuable insight into how microgravity could influence cancer biology,emphasizing the importance of further research on cancer behavior in space environments and its implications for human health during long-term space missions.
文摘BACKGROUND Thyroid cancer incidence is rising globally,including the Democratic Republic of Congo(DRC).Despite its increasing incidence,limited data exist on physicians’knowledge of thyroid cancer management in the DRC.AIM To evaluate the knowledge levels of Congolese physicians regarding the diagnosis and treatment of thyroid nodules and cancers,and to identify existing gaps and areas for improvement.METHODS A descriptive cross-sectional study was conducted from June to August 2024,involving 369 physicians practicing in healthcare facilities across Kinshasa,DRC.Participants were selected using a multi-stage sampling method.Data were collected via a structured questionnaire covering thyroid cancer epidemiology,diagnostic methods,treatment approaches,and prognosis.Data were analyzed using SPSS version 25,employing descriptive and inferential statistics,with a P value≤0.05 being considered as statistically significant.RESULTS Overall response rate was 96.1%.Of all participants,68%were female and 32%were male physicians.General practitioners constituted 84.8%of respondents,with an average age of 34 years.While 53.7%demonstrated adequate knowledge of hypothyroidism management post-thyroidectomy and 61.2%identified the approach for hypoparathyroidism,only 5.1%recognized the need for radiotherapy in metastatic thyroid cancer cases.Awareness of anaplastic thyroid cancer treatment was limited(6.5%),and 90.2%of physicians were unfamiliar with the surgical complications.Moderate understanding was noted in diagnostic protocols,with 44.2%correctly identifying repeat fine-needle aspiration timing in Bethesda I cases.Knowledge of molecular genetics,recurrence risks,and metastasis patterns was remarkably low.CONCLUSION This study highlights significant knowledge gaps among Congolese physicians regarding thyroid cancer management,especially about advanced treatment modalities and molecular genetics.Targeted educational programs and improved access to diagnostic tools are critical to bridging these deficits.Addressing these gaps can enhance the quality of thyroid cancer care and align clinical practices in the DRC with global standards.
文摘Currently, thyroid cancer is one of the most common endocrine cancer in the United States. A recent involvement of sub-population of stem cells, cancer stem cells, has been proposed in different histological types of thyroid cancer. Because of their ability of self-renewal and differentiation into various specialized cells in the body, these putative cells drive tumor genesis, metastatic activity and are responsible to provide chemo- and radioresistant nature to the cancer cells in the thyroid gland. Our Review was conducted from previously published literature to provide latest apprises to investigate the role of embryonic, somatic and cancer stem cells, and discusses the hypothesis of epithelial-mesenchymal transition. Different methods for their identification and isolation through stemness markers using various in vivo and in vitro methods such as flow cytometry, thyrosphere formation assay, aldehyde dehydrogenase activity and ATP-binding cassette sub-family G member 2 efflux-pump mediated Hoechst 33342 dye exclusion have been discussed. The review also outlines various setbacks that still remain to target these tumor initiating cells. Future perspectives of therapeutic strategies and their potential to treat advanced stages of thyroid cancer are also disclosed in this review.
文摘BACKGROUND Although papillary thyroid microcarcinoma(PTMC)is not considered a threatening tumor,in some cases,it can be aggressive.Metastatic thrombosis of papillary thyroid carcinoma,follicular thyroid carcinoma,Hürthle cell carcinoma,poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma have been reported in the literature,but there have been no reports about PTMC.CASE SUMMARY A 45-year-old woman presented with a thyroid mass and thrombosis in a middle thyroid vein during a physical examination.She had no symptoms,and the physical examination showed no positive signs.Subsequent ultrasonographyguided fine-needle aspiration biopsy results indicated an atypical lesion of ambiguous significance,with some actively growing cells(TBSRTCⅢ)and the BRAFV600E mutation not present.This patient underwent left thyroidectomy,isthmus lobectomy,prophylactic central lymph node dissection and thromboembolectomy.Postoperative pathology showed papillary microcarcinoma of the left thyroid,and the thrombus in the middle thyroid vein was a tumor thrombus.CONCLUSION Middle thyroid vein tumor thrombus is an extremely rare condition in PTMC,but it does exist.Lobectomy and thromboembolectomy may be an option for patients with thrombi in the middle vein of the thyroid,and we strongly suggest close follow-up of these patients.
文摘Objective： We evaluated the relationship between the clinical management of level Ⅵ lymph node and neck lymph node micrometastases in follicular thyroid carcinoma. Methods： 326 negative neck lymph nodes of 68 cases with follicular thyroid carcinoma on routine pathology were examined by keratin-19 monoclonal antibody and S-P JmmunohJsto- chemistry to confirm lymph node micrometastasis. Follow-up pathological and clinical documents were compared. Results： Forty-six neck lymph nodes showed positive micrometastasis among 326 negative neck lymph nodes including 4 lymph nodes in Level Ⅱ （4/42）, 5 lymph nodes in Level Ⅲ （5/34）, 5 lymph nodes in Level Ⅳ （5/49）, 1 lymph node in Leve Ⅳ （1/17） and 31 lymph nodes in Level Ⅳ （31/184）. Six in 14 cases with positive micrometastasis showed distant metastasis or local recurrence, but only 3 in 54 cases with negative micrometastasis indicated distant metastasis or local recurrence （P 〈 0.01）. Conclusion： The research showed that Level VI neck lymph node micrometastasis is possibly occur and closely related with local recurrence and metastasis in follicular carcinoma of thyroid.
文摘Objective: To investigate the possible interaction between the ras and p53 genes over-expression in thyroid carcinoma, and whether there is a correlation between the ras and p53 over-expression and clinicopathological criteria. Methods: Eighty patients with thyroid lesions were examined for expression of ras and p53 genes by the labeled streptavidin biotin peroxidase (LSAB) method. Of these patients, 54 were diagnosed (average age: 39.9±15.9 years) with malignant lesions. Of those included in the study, 31 has papillary carcinoma, 13 had follicular carcinoma, 7 had medullary carcinoma, 3 had undifferentiated carcinoma and 19 were stratified to stage I, 28 to stage II, 2 to stage III and 5 to stage IV according to TNM staging system. Twenty-six benign nodular thyroid disorders were studied as control. Results: Positive immunostain results for ras and p53 genes were statistically significant between thyroid carcinomas and benign disorders (90.7% vs 23%, 55.5% vs 30.7%,P<0.05). Both p53 and ras overexpressions coexisted in 30 thyroid carcinomas, and of these, 3 died and 5 had recurrences within 4 years. Conclusions: Activation of ras gene and inactivation of p53 gene were cooperatively associated in thyroid tumorigenesis. The concurrent overexpressions of ras and p53 could result in a poor prognosis.
基金Supported by a grant of Natural Science Funds Projects of Hebei Province (No. C2008001306)
文摘Objective： The aim of the study was to detect the levels of mannose-binding lectin （MBL）, MBL-associated serine protease 2 （MASP-2） and explore the clinical significances of them in patients with primary thyroid neoplasms. Methods： By using ELISA method, we detected the serum levels of MBL and MASP-2 in 26 patients with papillary thyroid carcinoma （PTC）, 30 patients with thyroid adenoma （TA） and 26 healthy people, respectively. Results： Serum MBL level was （565.23 ± 76.70） μg/L in PTCs higher than （324.267 ±24.74） μg/L in TAs, and （152.69± 16.95） IJg/L in healthy of controlling group. There was statistical significance between PTC and TA （P 〈 0.05）, however there was no difference between TA and healthy （P 〉 0.05）. Serum MASP-2 level was （726.153± 78.88） pg/L in PTCs higher than （379.266 ± 30.26） μg/L in TAs, and （203.846 ± 29.09） μg/L in healthy. Serum MASP-2 level was higher in PTCs than TAs, and the difference had statistical significance （P 〈 0.01）. But no difference was observed between in TAs and healthy. Conclusion： These findings might reflect inflammatory processes induced by defense mechanisms, in response to the development of the turnout. MBL may also be involved in the elimination of possible tumourigenic pathogens.
文摘目的探讨经口腔前庭入路腔镜甲状腺切除术(endoscopic thyroidectomy using the oral vestibular approach,ETOVA)与传统颈部开放手术治疗女性甲状腺乳头状癌的安全性、有效性及美容效果。方法回顾性分析2019年1~12月行甲状腺乳头状癌根治术的120例女性患者的临床资料,分为经口腔前庭入路腔镜甲状腺手术组(腔镜组,n=60)和传统颈部开放手术组(开放组,n=60),对比两组患者术中及术后相关临床资料。结果两组患者年龄、肿瘤直径、中央区淋巴结清扫时间、中央区淋巴结清扫总数、中央区转移淋巴结数量、术后并发症、术后24 h疼痛评分、术后6个月疼痛评分均无统计学差异(P均>0.05)腔镜组手术总时长、术中失血量、术后引流量均大于开放组(P均<0.001),腔镜组术后满意度高。结论ETOVA在治疗甲状腺乳头状癌是安全、有效的,具有更好的美容效果,患者满意度高,可以考虑作为部分患者,尤其是年轻女性甲状腺乳头状癌患者的首选手术方案。
文摘目的 分析甲状腺乳头状癌(PTC)超声图像表现在预测颈部Ⅵ区淋巴结转移(lymph node metastasis in the cervicalregion Ⅵ,CLNM-Ⅵ)危险度的临床价值。方法 选取2022年4月~2023年6月在河北省沧州中西医结合医院接受手术治疗并经病理证实的350例PTC患者,根据术后病理结果,将患者分为CLNM-Ⅵ组和非CLNM-Ⅵ组。收集并对比两组术前超声图像表现及临床病理特征,应用Logistic回归分析PTC患者CLNM-Ⅵ危险因素,受试者工作特征(ROC)曲线分析PTC超声图像表现对CLNM-Ⅵ的预测价值。结果 单因素分析显示,CLNM-Ⅵ组男性、实性或囊实性、年龄≤45岁、低回声、甲状腺背景正常、点状强回声的构成比均大于非CLNM-Ⅵ组(P均<0.05)。Logistic回归分析显示,男性、实性或囊实性、年龄≤45岁、低回声、甲状腺背景正常、病灶内可见点状强回声是CLNM-Ⅵ的独立危险因素(P均<0.05);进一步经ROC曲线分析显示,以上预测CLNM-Ⅵ的AUC分别为0.565、0.580、0.529、0.585、0.582、0.582,联合预测AUC为0.708。结论PTC超声图像表现在CLNM-Ⅵ风险评估中具有重要意义,可为PTC的预后判断提供一定的参考依据。
文摘Background： The Notch-regulated ankyrin repeat protein （NRARP） is recently found to promote proliferation of breast cancer cells. The role of NRARP in carcinogenesis deserves extensive investigations. This study attempted to investigate the expression of NRARP in thyroid cancer tissues and assess the influence of NRARP on cell proliferation, apoptosis, cell cycle, and invasion in thyroid cancer. Methods： Thirty-four cases with thyroid cancer were collected from the Department of General Surgery, Xinhua Hospital, Shanghai ]iao Tong University School of Medicine between 2011 and 2012. lmmunohistochemistry was used to detect the level of N RARP in cancer tissues. Lentivirus carrying NRARP-shRNA （Lenti-NRARP-shRNA） was applied to down-regulate NRARP expression. Cell viability was tested after treatment with Lenti-NRARP-shRNA using 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide assay. Apoptosis and cell cycle distribution were determined by flow cytometry. Cell invasion was tested using Transwell invasion assay. In addition, expressions of several cell cycle-associated and apoptosis-associated proteins were examined using Western blotting after transfection. Student＇s t-test, one-way analysis of variance （ANOVA）, or Kaplan Meier were used to analyze the differences between two group or three groups. Results： N RARP was highly expressed in thyroid cancer tissues. Lenti-NRARP-shRNA showed significantly inhibitory activities against cell growth at a multiplicity of infection of l 0 or higher （P 〈 0.05）. Lenti-NRARP-shRNA-induced G 1 arrest （BHTl 01 ： 72.57% ± 5.32%; g305C： 75.45% ± 5.26%） by promoting p21 expression, induced apoptosis by promoting bax expression and suppressing bcl-2 expression, and inhibited cell invasion by suppressing matrix metalloproteinase-9 expression. Conclusion： Downregulation of NRARP expression exerts significant antitumor activities against cell growth and invasion of thyroid cancer, that suggests a potential role of NRARP in thyroid cancer targeted therapy.
文摘Background Recently, there has been a surge of interest in minimally invasive techniques with endoscope in thyroid surgery. The aim of this study was to investigate the possibility of a scarless neck surgery under endoscopy for the treatment of thyroid tumor and to observe the results of this procedure.Methods A total of 68 patients （64 women and 4 men） underwent the surgery. Their ages ranged from 18 to 65 years,with a mean age of （34±3） years. There were 64 cases of thyroid adenoma, and 4 cases of nodular goiter. An incision was made on the surface of the chest bone. The operation cavity was made by dragging the skin. Sixty-four patients underwent partial thyroid lobectomy, four patients underwent thyroid lobectomy.Results All 68 cases showed healing in one stage. None of the cases showed paralysis of the recurrent laryngeal nerve or tumor recurrence within the next 2 to 60 months of follow-up. The patients experienced slight pain after the operation.The patients were satisfied with the cosmetic results of the surgery.Conclusion The gasless endoscopic surgery through the upper chest, which was performed to treat thyroid tumor, did not leave any scar, and was easy to handle, and gave good cosmetic results.
