Objective To understand the latest research developments of the formation mechanism of psammoma body in human tumors and related issues. Methods Related domestic and foreign literatures were widely referred, analyzed, and reviewed. Results Psammoma body is unique pathological calcification in some tumors, which is arranged in concentric, laminar circles microscopically. Psammoma body is commonly seen in thyroid papillary carcinoma, meningiomas, ovarian serous papillary carcinoma, and so on. Conclusions Although arranged in concentric, laminar circles microscopically in tumor, the formation process of psammoma body is not entirely the same in different tumors. A comprehensive and objective understanding of psammoma body would be useful in cancer diagnosis and treatment.
目的 探讨超声刀在开放性小切口甲状腺手术中的应用效果。方法 总结我科于2004年4月至2007年12月期间对89例甲状腺良性疾病患者开展的开放性小切口(3～4 cm)甲状腺切除术，手术中采用超声刀代替传统的结扎和缝扎方法对甲状腺血管和腺体进行处理。结果 手术平均时间70(40～135) min，术中平均出血量15(5～20) ml，术后24 h平均切口引流量25(10～50) ml。无出血、神经、甲状旁腺损伤及其他并发症。切口Ⅰ类/甲级愈合，术后平均住院时间5(3～6) d。结论 超声刀应用于开放性小切口甲状腺切除，可以方便手术操作，提高手术效率，止血效果可靠，有特有的实用价值。
We have used immunphistochemical SP method to detect the expression of nm23 gene protein in human thyroid tissues from 86 carcinomas, 20 adenomas and 25 carcinomatous adjecent tissues. The results showed the positive staining rate were 73.3%, 40.0%and 16. 0% respective (Plt; 0. 005). Although the expression of nm23 protein had no association with the cervical lymph node metas-tases,it was significantly concordant with the tumor cell diffierentiation (Plt;0. 01) ,tumer capsule (Plt; 0. 05) and TNM stage (Plt;0.05).In addition, the patient‘s average survival time in nm23-positive cases was longer than that in nm23-negative ones (Plt;0.01).This data suggest that nm23 gene may play an important role in thyroid carcinogenesis and the expression of nm23 protein would be an useful marker in assessing the prognosis of the thyroid carcinomas.
目的探讨甲状腺肉瘤的诊断与治疗。 方法回顾性分析2008年1月至2013年8月期间贵阳医学院附属医院甲状腺外科和贵州肿瘤医院甲状腺外科收治的5例甲状腺肉瘤患者的临床资料。 结果5例患者均行根治性手术，3例行术后化疗及放疗。术后均未发生声音嘶哑、呼吸困难、呛咳、肺部感染等并发症，切口均甲级愈合。经病理学免疫组化检查，具体分型为甲状腺组织细胞肉瘤1例，甲状腺血管肉瘤2例，甲状腺平滑肌肉瘤1例，甲状腺未分化肉瘤1例；波形蛋白（Vimentin）阳性5例，角蛋白（CK）阳性2例，平滑肌肌动蛋白（SMA）、结蛋白（Des）及S-100各阳性1例，甲状腺球蛋白（TG）、上皮膜抗原（EMA）、甲状腺转录因子（TTF）及降钙素均为阴性。术后5例患者均经电话随访，随访时间3～9个月，中位数为6个月。随访期间，3例患者因复发和转移而死亡；余2例仍在化疗及放疗中，无复发及转移。 结论甲状腺肉瘤的恶性程度高，宜采用以手术为主的综合治疗方案。
ObjectiveTo detect expressions of transient receptor potential channel C5 (TRPC5) and microRNA-320a (miR-320a) in thyroid cancer and explore clinical significances of them in thyroid cancer.MethodsThe expressions of TRPC5 and miR-320a mRNA in the thyroid cancer were investigated by searching the Ualcan database. While the expressions of TRPC5 and miR-320a mRNA in 80 cases of thyroid cancer, 35 cases of thyroid adenoma and 32 cases of normal thyroid tissues adjacent to thyroid adenoma tissues in the Zhengzhou Seventh People’s Hospital from March 2014 to March 2015 were tested. Real time PCR was used to detect the expressions of TRPC5 mRNA and miR-320a mRNA in the various tissues and Western blot was used to detect the TRPC5 protein in the thyroid cancer tissues. Therelationships between the expressions of TRPC5 and miR-320a mRNAs and clinicopathologic features of thyroid cancer were analyzed. The correlation between expressions of TRPC5 and miR-320a mRNA was analyzed by Pearson method. The risk factors influencing the prognosis were analyzed by univariate and multivariate Cox proportional hazards regression model.ResultsThe results of Ualcan database showed that the expression level of TRPC5 mRNA in the thyroid cancer was higher than that in the normal thyroid tissue (P<0.001), while the expression level of miR-320a mRNA was lower than that in the normal thyroid tissue (P<0.001). The results of clinical cases showed that the expression level of TRPC5 mRNA was significantly higher, while the expression of miR-320a mRNA was significantly lower in the thyroid cancer tissues as compared with the normal thyroid tissues (P<0.05). There was a negative correlation between the expression level of TRPC5 and miR-320a mRNA in the thyroid cancer (r=−0.653, P<0.001). The expressions of TRPC5 and miR-320a mRNA were correlated with the degree of differentiation, lymph node metastasis, and TNM stage (P<0.05). Kaplan-Meier survival curve analysis found that the patients with higher expression level of TRPC5 and lower expression level of miR-320a showed the poor prognosis, and multivariate analysis found that the lower tumor differentiation, later TNM stage, with lymph node metastasis, higher expression level of TRPC5 mRNA, and lower expression level of miR-320a mRNA were the risk factors affecting prognostic survival (P<0.05).ConclusionsFrom the database and clinical case data, it is concluded that TRPC5 mRNA is highly expressed, while miR-320a mRNA is lowly expressed in thyroid cancer tissues, and expressions of TRPC5 and miR-320a mRNA are related to degree of tumor differentiation, lymph node metastasis, TNM staging, and prognosis in patients with thyroid cancer. TRPC5 and miR-320a mRNA might be used as potential indicators for clinical and prognostic monitoring.
ObjectiveTo systematically evaluate the reliability and stability of transoral endoscopic thyroidectomy vestibular approach (TOETVA) and conventional open thyroidectomy (COT) in the treatment of differentiated thyroid cancer.MethodsThe clinical studies of TOETVA and COT in the treatment of differentiated thyroid cancer were retrieved from major databases including PubMed, Embase, Cochrane Library, Wanfang, and CNKI by computer. The search date ended on March 1, 2020. Two investigators screened the literatures strictly and extracted the data following the pre-defined inclusion and exclusion criteria, and then used RevMan 5.3 software for meta-analysis.ResultsA total of 7 studies including 1 465 patients were included in this meta-analysis. The results showed: compared with the COT group, the operation time of the TOETVA group was longer [WMD=35.18, P=0.000 1], and the number of lymph node dissections in the central area was larger [WMD=1.42, P=0.000 5]. But the intraoperative blood loss [WMD=–5.32, P=0.39], the length of hospital stay after operation [WMD=0.05, P=0.94], the incidences of transient recurrent laryngeal nerve palsy [OR=0.81, P=0.43], transient hypocalcemia [OR=0.55, P=0.35], permanent hypocalcemia [OR=0.39, P=0.22], permanent recurrent laryngeal nerve palsy [OR=1.34, P=0.73], and hematoma [OR=1.29, P=0.69] were not statistically significant between the two groups.ConclusionsTOETVA has a higher stability. Although the COT has a shorter operation time, the former has a higher central lymph node dissection rate, and there is no scar on the neck after surgery and no significant difference in the incidence of postoperative complications.
Objective To investigate the relationship between thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) and clinicopathological features of breast cancer. Methods Thyroid function data, general clinical data and data reflecting pathological characteristics of breast cancer of 136 breast cancer patients admitted to the Department of Breast and Thyroid Surgery, People’s Hospital of Wuhan University from December 2019 to April 2022 were collected. According to the TPOAb and TGAb antibody levels of patients, 136 breast cancer patients were divided into positive group (antibody level ≥60 U/mL) and negative group (antibody level < 60 U/mL). The general clinical data, thyroid function, breast cancer markers, tumor size, pathological classification, clinical TNM stage, lymph node metastasis and immunohistochemical index expression characteristics of the two groups were analyzed. Results There was no statistically significant difference between the TPOAb positive group and the TPOAb negative group, as well as between the TgAb positive group and the TgAb negative group in terms of age, previous chronic medical history, surgical medical history and menstrual status of breast cancer patients (P>0.05), and there was no significant difference in the results of preoperative ultrasound and molybdenum target examination (P>0.05).Compared with the TPOAb negative group, the level of triiodothyronine (T3) in the TPOAb positive group was lower (P=0.020), and the level of thyroidstimulating hormone (TSH) was higher (P=0.001). TSH level in the TgAb positive group was higher than that in the TgAb negative group (P=0.036). There was no significant difference in tumor markers (carcinoembryonic antigen, carbohydrate antigen 125 and 153) and the number of lymph nodes cleared during operation between the positive and negative groups of TPOAb and TgAb (P>0.05). Compared with the respective negative groups, there was no significant difference tumor size, pathological classification, clinical TNM stage, lymph node metastasis, pathological molecular classification, and the expression of ER, PR and Ki-67 in the TPOAb positive group and the TgAb positive group (P>0.05). The positive rate of HER-2 expression in the TPOAb positive group was higher than that in the TPOAb negative group (P=0.033). There was no significant difference in HER-2 expression between the TgAb positive group and the TgAb negative group (P>0.05). There was no significant difference between the TPOAb positive group and the TPOAb negative group, as well as the TgAb positive group and the TgAb negative group in terms of chemotherapy, invasive carcinoma with carcinoma in situ, with benign lesions and nerve invasion (P>0.05). There was no significant difference between TPOAb positive group and negative group in vascular tumor thrombus rate and single cancer focus rate (P>0.05). Compared with the TgAb negative group, the TgAb positive group had a lower vascular tumor thrombus rate (P=0.034) and a higher single cancer focus rate (P=0.045). Conclusions Thyroid autoantibodies positive breast cancer patients have lower T3 level and higher TSH level, and the positive expression of thyroid autoantibodies is related to HER-2 expression, vascular tumor thrombus and the number of tumor foci in breast cancer. It suggests that thyroid autoantibodies TPOAb and TgAb may have an impact on the prognosis of breast cancer.
Objective To investigate the histological origin, diagnosis, differential diagnosis and treatment of thyroid carcinoma showing thymus-like differentiation (CASTLE). Methods Five patients with thyroid CASTLE were adopted by surgical resection and postoperative radiotherapy, and the CD5, CD117, CK5/6, P63, thyroid transcription factor-1 (TTF-1), carcino-embryonic antigen (CEA), calcitonin (CT), Ki-67, chromogranin A (CgA), thyrobolulin (Tg), peroxisome proliferator activated receptorγ (PPAR-γ), sodium iodide symporter (NIS), and thyroid stimulating hormone receptor (TSHR) were detected in tumor tissues by immunohistochemistry S-P method and v-raf murine sarcoma viral oncogene homolog B1 (BRAF)V600E gene and telomerase reverse transcriptase (TERT) promoter mutations were detected by DNA sequencing. Eight cases of poorly differentiated thyroid carcinoma and 6 cases of anaplastic thyroid carcinoma were adopted by comprehensive comparative analysis. Results Thyroid CASTLE tumor cells showed the positive expression of CD5, CD117, CK5/6 and P63, and the negative expression of TTF-1, CT, CgA, Tg, PPAR-γ, NIS and TSHR. There were partly positive expression for CK5/6, P63, TTF-1, CgA, Tg, NIS and TSHR, and negative expression for CD5 and CD117 in the poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma. The BRAFV600E gene and TERT promoter mutations were not detected in thyroid CASTLE, and the BRAFV600E gene mutations were also not detected in the poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma. Four cases of poorly differentiated thyroid carcinoma showed the TERT promoter mutations (4/8) included 3 cases with C228T and 1 case with C250T. Two cases of anaplastic thyroid carcinoma showed the TERT promoter mutations (2/6) included 1 case with C228T and 1 case with C250T. There was no recurrence and metastasis after 3–47 months (an average of 25.6 months) of followed-up in thyroid CASTLE patients. Conclusions The histological origin of thyroid CASTLE may be not related to the thyroid. There is important clinical value to combined detection of CD5, CD117, P63, TTF-1, Tg, NIS, and TSHR for the diagnosis and differential diagnosis of thyroid CASTLE. The further study still need for the diagnosis and differential diagnosis of thyroid CASTLE according to the detection of BRAFV600E and TERT promoter mutations.