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Objective:To investigate the risk factors related to extrathyroidal extension (ETE) of differentiated thyroid carcinoma (DTC) and the specific effects on the prognosis.Methods:The clinical data of 592 patients with newly diagnosed DTC admitted to our hospital from Jun. 2015 to Jun. 2016 were retrospectively analyzed. The data including the maximum tumor diameter and lymph node metastasis were collected, and the survival data were followed up. Chi-square test and Logistic regression were used to analyze the risk factors associated with ETE. Kaplan-Meier method and Cox proportional risk model were used to analyze the effect of ETE on disease-free survival.Results:There were 100 ETE of 592 DTC patients (16.9%) . Univariate analysis showed that the risk factors for ETE were the largest tumor diameter ≥2 cm, multiple lesions, and lymph node metastasis in the lateral cervical region ( P<0.01) . The follow-up time was 29 to 64 months, and the median follow-up time was 60 months. The 3-year and 5-year DFS rates of patients with DTC and ETE were 86.9% and 83.2% respectively, which were significantly lower than those of patients without ETE ( P<0.001) . Univariate analysis showed that ETE ( P<0.001) was a risk factor for postoperative recurrence in patients with DTC. Cox multivariate regression showed that ETE (HR: 10.564, 95% CI 3.712-30.063, P<0.001) was an independent risk factor for postoperative recurrence in patients with DTC. Conclusions:DTC accompanied by ETE is associated with risk factors such as large tumor diameter and multiple lesions, which has a lower 5-year DFS. Patients with the above characteristics should consider the possibility of ETE before surgery, and focus on long-term follow-up after surgery.
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Objective:To investigate the effects of miR-497 on cytobiology behaviors of papillary thyroid carcinoma (PTC) by targetingly regulating the expression of Yes-associated protein 1 (YAP1) .Methods:Human TPC-1 cells were divided into control group, miR-497 group, si-YAP1 group and miR-497+si-YAP1 group. The liposome transfection was conducted by LipofectamineTM3000. The targeted relationship between miR-497 and YAP1 was validated by Luciferase Reporter Assay. The cell proliferation activity in each group was detected by MTT method. The apoptosis rates were analyzed by flow cytometry. The number of invasion cells was detected by Transwell. The cell migration rates were detected by scratch assay. The expression of Cyclin D1, matrix metalloproteinase 2 (MMP-2) , MMP-9, matrix metalloproteinase inhibitor-1 (TIMP-1) and activated caspase 3 (cleaved Caspase-3) was detected by Western blot. SPSS 22.0 was used to analyze data, and normally distributed measurement data were expressed as ( ± s) . One-way ANOVA was analyzed for the difference between multiple groups, and SNK-q were analyzed for the difference between two groups. Results:Compared with the control group, the expression of YAP1 mRNA and protein was decreased in miR-497 group and si-YAP1 group ( q=14.682, 14.597; 23.743, 23.571; P<0.05) , cell proliferation activity, number of invasion cells and migration rate were decreased ( q=4.724, 4.568, 3.841; 4.216, 3.952, 3.274; P<0.05) , apoptosis rate was increased ( q=3.783; 4.336; P<0.05) , expression of CyclinD1, MMP-2, MMP-9 and cleared Caspase-3 proteins was decreased ( q=5.823, 5.981, 6.036, 6.485; 5.934, 6.110, 6.573, 6.614; P<0.05) , and expression of TIMP-1 protein was increased ( q=6.071; 6.148; P<0.05) . Compared with si-YAP1 group, miR-497 level was increased in miR-497+si-YAP1 group ( q=14.726, P<0.05) , the expression of YAP1 mRNA and protein was decreased ( q=3.089, 3.126; P<0.05) , cell proliferation activity, number of invasion cells and migration rate were decreased ( q=2.654, 2.537, 2.246; P<0.05) , apoptosis rate was increased ( q=2.875, P<0.05) , expression of CyclinD1, MMP-2, MMP-9 and cleared Caspase-3 proteins was decreased ( q=4.371, 4.365, 4.383, 4.368; P<0.05) , and expression of TIMP-1 protein was increased ( q=4.275, P<0.05) . Conclusion:MiR-497 can negatively targetingly regulate the expression of YAP1, inhibit proliferation, invasion and migration of TPC-1 cells.
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Objective To explore the effectiveness and safety of ultrasound-guided radiofrequency ablation (RFA) in treatment of thyroid benign nodules.Methods We analyze 573 patients with thyroid benign nodules from June 2014 to September 2017 treated by RFA at Department Ⅱ of Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University.Among these patients,there were 75 males and 498 females,with a median age of 45 years old.All patients were diagnosed as thyroid benign nodules by ultrasound-guided fine needle aspiration biopsy before RFA.A total of 750 benign tumors were treated.To evaluate the thyroid function of the patients before RFA and 3 months after it,and to observe the changes of thyroid benign nodules by ultrasound at 3,6,12 months after RFA.The paired t-test was used to compare the measurement data with normal distribution,and Wilcoxon's signed rank test was used to compare the measurement data with non-normal distribution.To calculate the volume change and reduction rate of thyroid benign nodules.Results RFA was successfully completed in all patients,the volume reduction rate was 67％ (48％,83％) in the 3rd month after RFA,in the 6th month was 81％ (67％,91％),in the 12th month was 89％ (80％,95％).Eighteen patients felt pain during RFA,but the pain was alleviated after stopping ablation.Three patients' tone decreased,but recovered in a week.Hoarseness occurred in 6 patients and recovered in 3 months.Three patients had neck hemorrhage,which was managed with simple compression of the neck.Conclusions RFA is an effective and safe treatment for thyroid benign nodules and has obvious advantages such as less invasiveness,having no influence in thyroid functions.It is clinically prospective for application.
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Objective@#To explore the effectiveness and safety of ultrasound-guided radiofrequency ablation (RFA) in treatment of thyroid benign nodules.@*Methods@#We analyze 573 patients with thyroid benign nodules from June 2014 to September 2017 treated by RFA at Department Ⅱof Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University. Among these patients, there were 75 males and 498 females, with a median age of 45 years old. All patients were diagnosed as thyroid benign nodules by ultrasound-guided fine needle aspiration biopsy before RFA. A total of 750 benign tumors were treated. To evaluate the thyroid function of the patients before RFA and 3 months after it, and to observe the changes of thyroid benign nodules by ultrasound at 3, 6, 12 months after RFA. The paired t-test was used to compare the measurement data with normal distribution, and Wilcoxon's signed rank test was used to compare the measurement data with non-normal distribution. To calculate the volume change and reduction rate of thyroid benign nodules.@*Results@#RFA was successfully completed in all patients, the volume reduction rate was 67%(48%, 83%) in the 3rd month after RFA, in the 6th month was 81%(67%, 91%), in the 12th month was 89%(80%, 95%). Eighteen patients felt pain during RFA, but the pain was alleviated after stopping ablation. Three patients′ tone decreased, but recovered in a week. Hoarseness occurred in 6 patients and recovered in 3 months. Three patients had neck hemorrhage, which was managed with simple compression of the neck.@*Conclusions@#RFA is an effective and safe treatment for thyroid benign nodules and has obvious advantages such as less invasiveness, having no influence in thyroid functions. It is clinically prospective for application.
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Papillary thyroid microcarcinoma (PTMC) is a subtype of papillary thyroid cancer,and there are many debates about its treatments,including extent of thyroidectomy,necessity of prophylactic central-neck nodal dissection,risk-benefit ratio of thyroid-stimulating hormone suppression and indications of observation therapy,et al.The epidemiology and treatment programs of thyroid PTMC were reviewed in this article.
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Objective To investigate expression,significance and relationship of IMP3 and CD44v6 protein in papillary thyroid carcinoma.Methods Immunohistochemical method was used to investigate the expression of IMP3 and CD44v6 protein in 30 cases PTC(10 follicular variant of papillary carcinoma cases,20 conventional papillary thyroid carcinoma cases),20 PTC with lymph node metastasis cases,20 benign tissues of thyroid cases.Quantitative analysis of the detection was conducted by Biosens Digital Imaging System vl.6 (professional image analysis software),and the target integral optical density (IOD) was used for the judgement parameter.Results IMP3 and CD44v6 expression in the PTC is higher than in benign group,the difference was statistically significant (P ＜ 0.05) ; IMP3 and CD44v6 expression in PTC with lymph node metastasis was higher than without lymph node metastasis in the organization to express,the difference was statistically significant (P ＜ 0.05) ; There was a positive correlation between IMP3 and CD44v6 expression and metastasis in PTC (r =0.903,P ＜ 0.05).Conclusions The expression of IMP3 and CD44v6 protein was closely correlated with the invasion and metastasis of PTC.IMP3 and CD44v6 protein might be considered as molecular markers for PTC.