The Significant Predicting Factors Influencing Lateral Neck Node Metastasis in Papillary Thyroid Carcinoma

PURPOSE: A lateral neck node metastasis is common in patients with papillary thyroid carcinoma. If a preoperative diagnosis is not made or is uncertain, an intraoperative biopsy for a frozen examination should be considered. The aims of this study were to evaluate the factors predicting a lateral neck node metastasis and to suggest guidelines for an intraoperative neck node biopsy. METHODS: From March 2003 to January 2006, 79 patients (7 males, 72 females) with 89 intraoperatively biopsied lateral neck nodes were enrolled in this study. The median age was 45 years. Among these patients, two or more lateral neck nodes were biopsied intraoperatively in 9 patients and one node was biopsied in the others. The clinicopathological features and radiological findings were reviewed. RESULTS: Among the 79 patients with 89 lateral neck nodes, 25 patients with 26 lateral neck nodes (29%) showed a metastasis. Univariate analysis revealed the computed tomography (CT) findings of lateral neck nodes such as a longitudinal size >1 cm (P=0.001), postcontrast Hounsefield Unit (HU) >110 (P2 cm (P=0.008), extracapsular invasion (P=0.005) had significant impact on a lateral neck node metastasis. Multivariate analysis revealed a longitudinal size >1 cm (P=0.039), postcontrast HU >110 (P110 HU were the most important factors. CONCLUSION: The most significant factors influencing lateral neck node metastasis were multifocal, bilateral, large size (2 cm < or = ), extracapsular invasion of the primary tumor, and the CT findings of lymph nodes such as a large longitudinal size (1 cm < or =), necrosis, the absence of hilum, irregular margin and increased postcontrast HU (110 < or =).

p53 Mutation in Gastric Carcinoma Detected by PCR - SSCP and Direct - Sequencing / 대한암학회지

PURPOSE: p53 gene mutations, one of the most common alterations found in human tumors, has also been detected in gastric carcinoma, and shown to have a crucial and early role in gastric carcinogenesis of intestinal type and mainly associated with tumor progression in the cancer of diffuse type. We tried to investigate the frequency of p53 mutations in 27 gastric carcinomas. MATERIALS AND METHODS: Fresh tumor tissue from a series of gastric carcinoma was screened for p53 mutations by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) with silver staining and confirmed by direct-sequencing in 27 cases of gastric carcinoma. Immunohistochemical method for p53 protein accumulation was also performed in the same cases. RESULTS: Immunohistochemistry revealed 20 of 27 cases of gastric carcinoma, positive for p53. PCR-SSCP analysis of p53 exons 5-8 detected mobility shift in 4 out of 20 p53-positive tumors; three from exon 5 and the other from exon 7, respectively. DNA sequencing of exon 5 showed CGC to CAC point mutation in one of three cases; exon 7, ATC to AAC point mutation. It seemed that there was no correlation between genetic alterations of p53 gene detected by PCR-SSCP and expression of p53 protein by immunohistochemistry. CONCLUSIOAS: Our results suggest that mutations of the p53 gene are rare genetic events in carcinogenesis of gastric carcinomas. There was discrepancy between mutations screened by PCR-SSCP and overexpressions in immunohistochemical staining.