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Objective:To investigate the expressions of glutathione S-transferases M1 (GSTM1) and glutathione S-transferases M2 (GSTM2) in follicular thyroid carcinoma (FTC) and their clinical significances.Methods:Gene expression profile of GSE82208 generated from 52 human thyroid samples, including 27 cases of FTC and 25 cases of follicular adenoma (FA) were collected from Gene Expression Omnibus (GEO) database. The gene matrix data were extracted and analyzed, and then differentially expressed genes (DEG) between FTC and FA were identified by using Limma package. Immunohistochemical SABC method was used to detect the expression levels of GSTM1 and GSTM2 proteins in FTC tissues and FA tissues collected from 56 FTC samples and 56 FA samples in Dandong First Hospital of Liaoning Province from January 2000 to December 2020. The relationship between GSTM1 and GSTM2 was analyzed; the association of expression levels of GSTM1 and GSTM2 with the clinicopathological factors of FTC patients was also analyzed.Results:Based on the GEO database, a total of 40 DEG were identified, including 9 up-regulated DEG (GSTM1, GSTM2, COL6A2, CUX2, CLUH, TSC2, OGDHL, ACADVL, SDHA) and 31 down-regulated DEG in FTC. The immunohistochemistry results of samples resected showed that the positive rates of GSTM1 and GSTM2 proteins in FTC tissues were higher than those in FA tissues [71.4% (40/56) vs. 23.2% (13/56), 80.4% (45/56) vs. 14.3% (8/56)], and differences were statistically significant ( χ2 values were 26.11 and 49.03, both P < 0.01). The expressions of GSTM1 and GSTM2 in FTC tissues were correlated with clinical staging, invasion degree and distant metastasis (all P < 0.05), but not with gender, age and tumor diameter (all P>0.05). There was a positive correlation between GSTM1 and GSTM2 proteins expressions in FTC ( r = 0.384, P = 0.004). Conclusions:The expression levels of GSTM1 and GSTM2 in FTC are increased. The interaction between GSTM1 and GSTM2 proteins can be involved in the development and progression of FTC.
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Objective To evaluate the role of cabon nanoparticles for dissecting lymph nodes and preserving parathyroid glans in patients with differentiated thyroid carcinoma undergoing total thyroidectomy plus bilateral central neck dissection.Metheds From Sep.2015 to Feb.2016,100 patients in Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine with thyroid carcinoma undergoing primarily total thyroidectomy plus bilateral central neck dissection were randomly divided into carbon nonoparticle group and the contol group.The numbers of total dissected lymph nodes,the lymph node posterior to fight recurrent laryngeal nerve,metastasized lymph nodes,inadvertent parathyroidectomy,the parathyroid hormone and serum total calcium were measured.Results The average counts of lymph nodes in carbon nonoparticle group (10.96±5.43)were more than those in the control group at (8.22±4.40)lymph nodes,(t＝2.78,P＝0.01).The average counts of lymph node posterior to fight recurrent laryngeal nerve in carbon nonoparticle group (1.62±1.95)were more than those in the control group at (0.76±1.21)lymph nodes,(t＝2.66,P＝0.01).The numbers of metastasized lymph nodes was 2.02±2.40 in carbon nonoparticle group and 1.84±2.61 in the control group.The difference had no statistical significance(t＝0.36,P＞0.05).The amount of PTH and the decrease of PTH discrepancy one day after surgery between the two groups had no statistical difference (t＝0.23,P＞0.05),(t＝l.04,P＞0.05).The carbon nonoparticle group had 2％(1/50)mistakenly parathyroid gland removed incidence,on contrary,the control group had 6％(3/50)mistakenly removed incidence.The difference had no statistical significance(x2＝0.26,P＞0.05).Conclusion Carbon nonoparticle can improve the central lymph node detection rate,but the protection of the parathyroid glands is more likey to depend on the experience of the operator and the vascular protection.
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Objective To evaluate the risk factors for postoperative hypoparathyroidism.Methods Tolally 200 patients with thyroid diseases undergoing total thyroidectomy at Department of General Surgery,Ruijin Hospital from Sep 2012 to Oct 2015 were followed up.The related risk factors were analyzed.x2 test and Fisher's exact test were used to analyze the correlation between hypoparathyroidism after total thyroidectomy and the other clinical factors.Multiple logistic regression analysis was performed to identify these risk factors.We analyzed the receiver operating characteristic (ROC) curve and calculated the area under the curve (AUC).The highest accuracy cutoff levels of intact parathyroid hormone (iPTH) level at 1 day after thyroidectomy (iPTH 1 d) and ％ iPTH decline were determined from the ROC curves.Results Of the 200 patients,66.5％ developed hypoparathyroidism on the first day,6.5％developed hypoparathyroidism in 6 months after surgery.That was 3.5％ in 1 year.The femaleness(OR =2.966,95％ CI:1.480-5.945,P =0.002),age (OR =0.972,95％ CI:0.946-0.999,P =0.039),and bilateral center lymph node dissection (OR =5.508,95％ CI:1.693-17.923,P =0.005) were independently correlated with postoperative hypoparathyroidism.The parathyroid hormone concentration on postoperative day 1 (OR =0.738,95％ CI:0.556-0.979,P =0.035) and 131I remnant ablation therapy (OR =12.887,95％ CI:3.434-48.367,P =0.000) were independent risk factors for postoperative hypoparathyroidism in 6 month.Both iPTH ＜ 3.05 pg/ml and ＞ 92.5％ iPTH decline on post-op dl could accurately predict significant hypoparathyroidism postoperative 6 month with accuracy of 82.1％ and 78.2％.Conclusions Bilateral center lymph node dissection and 131I remnant ablation therapy are risk factors for postoperative hypoparathyroidism,the iPTH1 d and ％ iPTH decline can predict hypoparathyroidism in postoperative 6 month.
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Objective To investigate the clinical features,diagnosis and treatment of medullary thyroid microcarcinoma (MTMC).Methods The clinical data of 14 patients with MTMC from Mar.2012 to Sep.2016 were retrospectively reviewed.All cases were treated with surgery and pathologically proved to be MTMC.Results All patients were sporadic MTMC.Calcitonin and CEA levels were measured before surgery in 11 patients.The median values were 81.61 (3.36-1187) pg/ml and 7.42 (0.81-90.75) ug/ml,respectively.All patients were followed up postoperatively.During a median follow-up of 24 months (8-63 months),no death happened.Regional lymph node metastasis occurred in 8 patients (57.14％),and lateral lymph node metastasis in 5 cases (35.71％).The rate of postoperative calcitonin abnormal was significantly higher in patients with lateral lymph node metastasis (P＜0.01).6 cases (42.86％) had abnormal postoperative calcitonin,among whom 5 cases had preoperative baseline calcitonin level higher than 100 pg/ml.Patients having abnormal postoperative calcitonin suffered from higher calcitonin and CEA baseline (P＜0.05).The tumor size was similar in two groups (P＞0.05).Conclusions For patients with thyroid nodules,preoperative screen of calcitonin can effectively detect MTC.Patients with elevated CEA also need to exclude the possibility of MTC.Compared with tumor size,calcitonin baseline is more important to surgical options and postoperative outcomes.Lateral lymph node metastasis,baseline calcitonin ＞100 pg/ml indicates abnormal postoperative calcitonin.