ObjectiveTo investigate the adequate surgical procedures for well-differentiated thyroid cancer (WDTC) located in the isthmus.MethodsNineteen patients with WDTC located in the isthmus were identified with WDTC and managed by surgery in Department of General Surgery in Xuanwu Hospital of Capital University from Jun. 2013 to May. 2018.ResultsAmong the nineteen cases, fifteen patients had a solitary malignant nodule confined to the isthmus, four patients had malignant nodules located separately in the isthmus and unilateral lobe. One patient received extended isthmusectomy as well as relaryngeal and pretracheal lymphectomy; six patients received isthmusectomy with unilateral lobectomy and central compartment lymph node dissection of unilateral lobe; four patients received isthmusectomy with unilateral lobectomy and subtotal thyroidectomy on the other lobe as well as central compartment lymph node dissection of unilateral lobe; seven patients received total thyroidectomy or isthmusectomy with unilateral lobectomy and nearly total thyroidectomy on the other lobe, as well as central compartment lymph node dissection of both sides; one patient received total thyroidectomy and central compartment lymph node dissection of both sides, as well as lateral thyroid lymph node dissection of both sides. The median operative time was 126 minutes (67–313 minutes), the median intraoperative blood loss was 30 mL (10–85 mL), and the median hospital stay was 6 days (4–11 days). Hypocalcemia occurred in 12 patients. There were no complications of recurrent laryngeal nerve palsy or laryngeal nerve palsy occurred. All the nineteen patients were well followed. During the follow up period (14–69 months with median of 26 months), there were no complications of permanent hypoparathyroidism occurred, as well as the 5-year disease-specific survival rate and survival rate were both 100%.ConclusionsFor patients with well-differentiated thyroid cancer located in the isthmus with different diameters and sentinel node status, individualized surgical procedures should be adopted.
ObjectiveTo explore the research hotspots of thyroid cancer nursing, and provide reference and guidance for future research on thyroid cancer nursing. MethodRelevant literature on thyroid cancer care was retrieved through the China National Knowledge Infrastructure (CNKI) and Web of Science (WOS) Core Database, and then analyzed the data using CiteSpace 6.2R4 software. ResultsThis study included a total of 1 096 Chinese literature and 263 English literature. The total number of publications was on the rise. The top 10 keywords in CNKI were: surgery, anxiety and depression, perioperative care, quality of life, complications, postoperative care, clinical pathway, rapid recovery surgery, differentiated thyroid cancer, and psychological care. Except for rapid recovery surgery, the centrality of other key words was greater than 0.1. The top 10 keywords in WOS were: quality of life, management, 131I, papillary thyroid cancer, surgery, impact, anxiety, prevalence, risk factor, and differentiated thyroid cancer. Among them, quality of life played an important intermediary role in co-occurrence networks, with the highest centrality of 0.34. ConclusionsQuality of life, mental health, perioperative period, and papillary thyroid cancer are research hotspots in thyroid cancer care both domestically and internationally. The management of quality of life and symptom management are the development trend of future research. Further research on thyroid cancer care needs to be strengthened, and important measures should be taken to address clinical issues and promote the recovery of thyroid cancer patients. We should strengthen domestic multi center cooperation, expand the breadth and depth of research, and promote the prosperous development of thyroid cancer nursing.
【Abstract】Objective To demonstrate the role of p16 protein and Rb protein in the formation and progression and their relationship in thyroid carcinoma. Methods p16 and Rb from 46 patients with thyroid cancer were detected by SP immunohistochemistry. Results In thyroid carcinoma,the p16 positive rate was decreased with the decline of differentiation. There was an inverse correlation between the rates of p16 positive expression and involvement of lymph node,clinical stage and prognosis index.The Rb protein was not present in any cases as a nucleus staining. Conclusion The p16 gene is likely to play an important role in the genesis and malignant progression of thyroid carcinoma,while the Rb gene is not .
ObjectiveTo explore the significance of thyroglobulin in the evaluation of lymph node metastasis during the treatment and follow-up of differentiated thyroid carcinoma.MethodThe literatures about thyroid globulin evaluation of lymph node metastasis of differentiated thyroid carcinoma were collected through online database and summarized.ResultsThe determination of thyroglobulin played an important role in the perioperative evaluation of lymph node metastasis in patients with differentiated thyroid carcinoma, the guidance of postoperative radiotherapy for metastasis, and the monitoring of recurrence and metastasis, and thyroglobulin combined with imaging examination could improve its evaluation efficiency.ConclusionsThyroglobulin is an important marker for the evaluation of lymph node metastasis in the treatment and follow-up of differentiated thyroid carcinoma. Combination between thyroglobulin and imaging examination or other laboratory indicators to comprehensively explore its diagnostic threshold is a new idea, that can improve its value in the evaluation of lymph node metastasis.
ObjectiveTo evaluate the safety and efficacy of lenvatinib as targeted therapy for locally advanced thyroid cancer. MethodsThe data of 17 patients with locally advanced thyroid cancer who received targeted therapy in the Department of Head and Neck Surgery, Clinical Oncology School of Fujian Cancer Hospital from September 2021 to June 2023 were prospectively collected and analyzed. ResultsSeventeen patients received lenvatinib for a median of 8 weeks (4–32 weeks), 5 patients achieved partial response, 11 patients achieved stable disease, and 1 patient experienced progressive disease. The objective response and disease control rates were 29.4% (5/17) and 94.1% (16/17) respectively, the median tumor diameter of the target lesion decreased from 43 mm before treatment to 12 mm after treatment. Five patients did not undergo surgery because of tumor progression and their refusal; R0/1 resection was achieved in 11 of the 12 remaining patients (91.7%). All patients suffered from drug-related adverse events, and the commonest drug-related adverse events were hypertension (7/17, 41.2%), diarrhea (6/17, 35.3%), and proteinuria (5/17, 29.4%). There were no major drug-related adverse events. ConclusionPreliminary analysis indicates that lenvatinib is effective and safe for targeted therapy of locally advanced thyroid cancer, with a relatively high rate of R0/1 resection.
ObjectiveTo investigate the quality of life (QoL) of patients with differentiated thyroid cancer (DTC) after surgery and analyze its relevant influencing factors. MethodsThe patients with DTC who underwent surgical resection in the First Affiliated Hospital of Zhengzhou University from December 1, 2021 to October 1, 2023 were investigated through the postoperative follow-up platform and follow-up management group. The postoperative QoL of DTC patients were evaluate using the Chinese version of the Thyroid Cancer Specific Quality of Life Questionnaire (THYCA-QoL) specific scale and the Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) developed a quality of life questionnaire consisting of 30 items (QLQ-C30). The higher overall average score of THYCA-QoL scale, the more clinical symptoms of patients, namely the negative QoL. The higher the EORTC QLQ-C30 overall health status score, the better QoL. In addition, multiple linear regression was used to explore the risk factors affecting the postoperative specific QoL score of DTC patients. ResultsA total of 1 076 patients’ questionnaires were collected. The EORTC QLQ-C30 overall health status score of 1 076 patients was 67±22 and the THYCA-QoL overall score was 22±13. The results of multivariate linear regression analysis showed that the early postoperative period (<6 months), male, age, without postoperative lifetime medication and without postoperative iodine-131 radiotherapy had negative effects on the overall score of THYCA-QoL scale (P<0.05), meanwhile the early postoperative period (<6 months) or later (≥12 months), without postoperative lifetime medication and without postoperative iodine-131 radiotherapy had positive effects on the overall health status score of EORTC QLQ-C30 (P<0.05). ConclusionsEORTC QLQ-C30 combined with THYCA-QoL can evaluate not only the common symptoms of cancer, but also the specific symptoms of thyroid cancer after surgery. And understanding the factors affecting the QoL of patients with thyroid cancer after surgery could provide targeted and supportive treatment and nursing for discharged patients to improve the QoL of patients with thyroid cancer after surgery.
Objective To sum up experiences in diagnosis and treatment for thyroid malignancy. Methods Clinical records of 8 patients diagnosed as Hashimoto’s disease associated with thyroid malignancy by histologic examination at our hospital from Jan. 1998 to Dec. 1998 were analyzed. Results There were 1 male and 7 females with average age of 37.6 years. The incidence of Hashimoto’s disease associated with thyroid cancer and malignant lymphoma were 7.7% and 2.6%, respectively. No operative mortality and complication was found. Conclusion Hashimoto’s disease is not uncommon. The combined thyroid cancer is small with papillary carcinoma predominance and the prognosis is good. If it is complicated with malignant lymphoma, the thyroid is rapidly enlarged with pain and dyspnea.
ObjectiveTo summarize the relationship between exosome and thyroid diseases.MethodThe literatures reports on exosomes and the physiology, pathology and diseases of thyroid were collected and reviewed.ResultsExosomes were secreted by cells and could be found in various body fluids, which could mediate the normal physiological development of the thyroid gland and play an important role in the progression of Graves’ disease. Exosomes could be used as diagnostic and differential diagnostic biomarkers for thyroid cancer and affect the growth, invasion, and metastasis of thyroid cancer. As a drug carrier for anti-thyroid cancer, exosome had a good targeting ability.ConclusionExosomes play an important role in the development of various diseases of the thyroid gland, which have good application prospects in biomarkers for early diagnosis and prognostic evaluation, as well as targeted drug carriers for thyroid cancer.
ObjectiveTo investigate the value of carbon nanoparticle adopted in reoperation for thyroid cancer recurrence. MethodsFrom July to November of 2015, patients diagnosed with thyroid cancer recurrence in department of Thyroid & Parathyroid surgery, West China Hospital, Sichuan University were enrolled in the research. All enrollment patients underwent carbon nanoparticles location guided by ultrasonography before reoperation. Relative data about surgery and location were analyzed retrospectively. ResultsTwenty-two patients were enrolled in the research. Mean operation time was (60.45±12.91) minutes. During surgery, a total of 405 (average 18.4) lymph nodes were harvested, and the staining rate was 71.9% (291/405). The pathological examination showed that there was a significant difference in the positive rate between carbon nanoparticles stained lymph nodes (45.0%, 131/291) and non-stained lymph nodes (5.3%, 6/114), P < 0.001. In addition, the positive rate in non-targeted stained lymph nodes was 30.2% (62/205). By contrast, it was 5.3% (6/114) in non-targeted non-stained lymph nodes. The difference showed significant significance (P < 0.001). ConclusionsAdoption of carbon nanoparticles in reoperation for thyroid cancer, which improves efficiency of dissection for the non-palpable lymph nodes metastasis, is worth generalizing in clinical practice.