Objective The expression of CD15 antigen and oncoprotein bcl-2 in thyroid cancer were examined in order to study the correlation between them. Methods The expression of CD15 and bcl-2 in 50 thyroid cancers, 20 adjacent noncancerous portion, 45 adenoma and 10 normal thyroid tissue were respectively investigated by microwave-LSAB immunohistochemical technique. Results The positive rate of CD15 and bcl-2 in thyroid cancer was 68.0% and 46.0% respectively, which was significantly higher than that in adenoma or adjacent noncancerous (Ｐ＜0.05). The percentage of CD15 and bcl2 positive expression were found to be significantly correlated with the tumor metastasis (Ｐ＜0.05), but not correlated with histological feature. Expression of CD15 was significantly correlated with bcl-2.Conclusion Expression of CD15 and bcl-2 can be regarded as a parameter to evaluate tumor metastasis and prognosis of thyroid cancer.
ObjectiveTo detect expressions of PTEN and Ki-67 in primary thyroid cancer tissues and explore its clinical significances. MethodsThe expressions of PTEN protein and Ki-67 protein in 40 cases of paraffin-embedded tissues of primary thyroid cancer and the corresponding paracancerous tissues were detected by immunohistochemical method. The expressions of PTEN mRNA and Ki-67 mRNA in 14 cases of resected fresh tissues of primary thyroid cancer and the corresponding paracancerous tissues were detected by RT-PCR method. The relations between clinicopathologic characteristics and expression of PTEN protein or Ki-67 protein in the primary thyroid cancer tissues were analyzed. Results① The PTEN protein positive expression rate and the PTEN mRNA in the primary thyroid cancer tissues were significantly lower than those in the corresponding paracancerous tissues[35.0% (14/40) versus 60.0% (24/40), P<0.05; 0.225 7±0.036 3 versus 0.503 6±0.037 5, P<0.05], the Ki-67 protein positive expression rate and Ki-67 mRNA in the primary thyroid cancer tissues were significantly higher than those in the corresponding paracancerous tissues [72.5% (29/40) versus 42.5% (17/40), P<0.05; 1.212 1±0.042 1 versus 0.293 6±0.027 4, P<0.05]. ② The expressions of PTEN protein and Ki-67 protein were associated with the histological grading, pathological type, tumor stage, and presence of regional lymph node metastasis (P<0.05), which not associated with the patient's gender, age and integrity of tumor capsule or not (P>0.05). ③ The PTEN and Ki-67 protein expressions in the primary thyroid cancer tissues had a significantly negative correlation (rs=-0.605, P=0.000), which in the corresponding paracancerous tissues had no correlation (rs=-0.021, P=0.899). ConclusionPTEN and Ki-67 genes abnormally express in thyroid cancer tissue, which might be related with occurrence and development and its mechanism of primary thyroid cancer. Combination of two genes might contribute to identification of pathologic type, judge of biological behavior, and tumor stage of primary thyroid cancer, which might serve as a new target for diagnosis and treatment of it.
To search for the relationship between immune state and tumor metastases, CD3,CD4,CD8 and CD44 contents in 13 speciments of fine needle aspiration (FNA) from thyroid cancer patients were detected by the flowcytometry (FCM) and comparison between thyroid cancer and benign tumor was made. The result showed :in thyroid cancer group, CD＋3，CD＋4 cells and the ratio of CD＋4/CD＋8 reduced significantly (Ｐ＜0.01),and CD＋8 cell increased significantly (Ｐ＜0.01), in metastases group,this change was much significantly. CD44 expressed significantly higher in cancer group than that of the benign thyroid neoplasms, and the change was related to the tumor metastases. The results indicate that CD44 can be as a marker of tumor and indicator of metastases. The disturbance of immune system results in active expression of CD44 by tumor cells, so, lead to metastases. It is helpful to the diagnosis of thyroid cancer, assessment of metastases and management in surgery.
ObjectiveTo compare the diagnostic efficacy of serum thyroglobulin (Tg), diagnostic 131I whole-body scan (D-WBS), neck ultrasound for diagnosing metastasis and recurrence of differentiated thyroid carcinoma (DTC). MethodsFrom May to June 2011, fifty follow-up DTC patients were collected retrospectively 6 months or more after 131I ablation therapy following total-thyroidectomy or near-total thyroidectomy. The diagnostic standard for DTC metastasis and relapse were based on serum Tg, D-WBS, neck ultrasound and chest CT. Diagnostic 2 by 2 table was employed for calculating the sensitivity, specificity, accuracy of the methods. ResultsThe sensitivity, specificity, accuracy, positive predictive value, negative predictive value of TgIMA and D-WBS parallel experiments were 100.0%, 92.9%, 96.0%, 91.7%, and 100.0% respectively. ConclusionTgIMA combined with D-WBS parallel test in diagnosis of DTC metastasis and recurrence has the highest accuracy.
Objective To summarize the progress in the diagnosis and treatment of thyroid cancer related genes. Methods By using the method of literature review, The literatures of thyroid cancer related gene were reviewed on the study of emerging diagnosis and treatment strategy. Results Combined detection of BRAF oncogene, RAS oncogene, RET/PTC rearrangement, PAX8-PPARγ fusion gene and its related genes, can effectively improve the prediction accuracy of the malignant thyroid nodule form benign, and has become a basis of targeted drug therapy. Conclusion In preoperative thyroid cancer, Joint detection of related gene can provide a molecular basis for the patients to guide the operation and drug treatment.
ObjectiveTo assess the efficiency, safety and long-term prognosis for interventional bronchoscopy in the treatment of trachea invasion by thyroid cancer. MethodsThe clinical data of forty-three patients with trachea invasion by thyroid cancer in Changhai Hospital from January 2006 to September 2015 were retrospectively analyzed. The trachea diameter and dyspnea score were compared before and after interventional treatment to explore the efficiency. The complications during and after therapy were observed. All patients were treated with interventional modalities including electrocautery, argon plasma coagulation, laser, cryotherapy, stent insertion or radioactive seeds implantation according to different invasion types, degree of stenosis and base situation. ResultsThe trachea diameter increased from (3.9±1.5)mm to (10.6±0.6)mm after bronchoscopy therapy (t=-17.314, P < 0.000 1). The dyspnea score decreased from 3.3±0.7 to 2.3±0.7 after bronchoscopy therapy (t=9.274, P < 0.000 1). The complications during therapy included haemorrhage (46.5%), vocal cord paralysis (4.7%) and glottis edema (7.0%). The restenosis rate in the patients with stent insertion was 26.7%. Thirty-seven patients were followed up successfully, and the medium survival time for follow-up patients was 27 months. The univariate and multivariate analysis indicated that the kind of interventional modalities used for therapy was an independent prognostic factor of survival (HR=0.261, P=0.036). The medium survival time for the patients treated with≥3 methods, 2 methods and 1 method was 47 months, 36 months and 13 months, respectively. ConclusionsFor trachea invasion by thyroid cancer, bronchoscopic therapy can effectively relieve airway obstruction and dyspnea symptom. Combination of multiple interventional modalities could have a favorable prognosis after treatment.
Objective To explore the diagnosis and relapse factors of thyroid cancer. Methods Two hundreds fifty-six cases of thyroid cancer approved by surgery and pathology from 1999 to 2006 were analyzed retrospectively. Results Two hundred and thirty-five cases were approved papillary thyroid carcinoma (91.8%)，11 cases were follicular thyroid carcinoma (4.3%)， 7 cases were medullary thyroid carcinoma (2.7%)， 3 cases were anaplastic thyroid cancer (1.2%). All patients underwent surgery. The operation procedures included thyroidectomy and lymph nodes dissection in central zone of affecting side and subtotal thyroidectomy of contralateral side. Total or subtotal thyroidectomy of both sides and the dissection in unilateral or bilateral Ⅵ region lymph nodes or functional cervical lymph nodes dessection plus contralateral side Ⅵ region lymph nodes dissection in multi-focal cancer and double leaf gland cancer. Functional cervical lymph nodes dessection if existing lymph nodes metastasis or thyroid cancer invading anterior cervical muscle. Two hundreds twentyeight cases were followed up with complete clinical information about (6.5±1.3) years (3-9 years). Six cases died during follow-up because of relapse or metastasis.Conclusions Imaging evaluation is the main method for diagnosis of thyroid cancer. Needle biopsy is reliable and accurate for diagnosis of thyroid tumor. Diameter of tumor is related with cervical lymph node metastasis. Patho-type and stage of tumor, local invasion extent, lymph node metastasis and operation procedure are related with the relapse closely.
ObjectiveTo discuss whether central lymph node dissection (CLND) should be performed for papillary thyroid cancer (PTC) patients. MethodsThe related domestic and foreign literatures were retrieved, the necessity of CLND and the risk of recurrent laryngeal nerve (RLN) injury in CLND were reviewed, and the application value of intraoperative nerve monitoring (IONM) in CLND were analyzed. Results① CLND can reduce the recurrence rate of PTC, improve postoperative survival rate, ease the difficulty of reoperation, and help to clarify tumor stage. ② CLND can increase the risk of RLN injury. ③ Application of INOM can decrease the risk of RLN injury. ConclusionsThe application of IONM during CLND effectively decrease the risk of RLN injury for surgeons, especially low seniority surgeons, and improve the survival quality and the prognosis. This combination will promote the implementation of routine CLND therapeutic strategy in thyroid cancer patients.
ObjectiveTo summarize the domestic and abroad articles related to the research on the relation between miRNA-221/222 and thyroid cancer, and explore the important effects of miRNA-221/222 in diagnosis and treatment of thyroid cancer. MethodsDomestic and international publications involving the relationship of miRNA-221/222 to thyroid cancer were screened and reviewed. ResultsMiRNA-221/222 is a tumor marker with high specificity and sensitivity in thyroid cancer. It has important significance for diagnosis, treatment and prognosis of thyroid cancer. ConclusionMiRNA-221/222 is not only related to diagnosis of thyroid cancer, but also have provided a new research direction and method for gene therapy of thyroid cancer．
Objective To summarize the diagnosis and treatment of Hashimoto thyroiditis （HT） coexistence withthyroid cancer （TC）. Methods One hundred and eighty-four patients with HT treated in The Affiliated Hospital of Guiyang Medical College from Jan. 2008 to Dec. 2011 were collected， and clinical data of 32 patients with TC of them were analyzed retrospectively. Results Thirty two patients combined with TC of the 184 patients with HT， and the incidence rate was 17.4%. All of the 32 patients were treated surgically according to the principle of surgery treatment for TC. Of the 32 cases of HT coexistence with TC， 15 patients were diagnosed by preoperative fine needle aspiration cytology （FNAC）， and the sensitivity of FNAC was 46.9% （15/32）. Twenty seven patients were diagnosed by intraop-erative frozen section pathological examination， and the sensitivity of it was 84.4% （27/32）， which was significantly higher than those of FNAC （χ2=7.563，P=0.004）. Thirty patients were diagnosed as papillary thyroid carcinoma （PTC）， and 2 patients were diagnosed as follicular thyroid carcinoma （FTC） by postoperative paraffin section pathological exam-ination and （or） immunohistochemistry， respectively. All patients were treated with levothyroxine （L-T4） after operation，and 5 patients were treatment with 131I therapy in addition. One patient suffered convulsion， and 2 patients suffered mild hoarsenessthere after operation. Only 29 patients were followed up for 3-49 months （average 35 months）， and during the followed up， there were no tumor recurrence， metastasis， and death. Conclusions The rate of preoperative diagnosis of HT coexistence with TC is low， and auxiliary examinations play an important role in diagnosis and guiding treatment. Surgery is the preferred treatment， but auxiliary therapies after surgery are indispensable too.