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Objective To explore the risk factors of central neck lymph node metastases in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) and the rationality of prophylactic central neck dissection. Methods The clinical data of 1359 patients who had underwent PTC treatment at the Department of Head and Neck Surgery , Henan Provincial Cancer Hospital during the five years (from 2011-01 to 2015-12) were analyzed retrospectively. Results There were 376 patients (27.67％, 376/1359) with central neck lymph node metastases. Single factor analysis and multivariate Logistic regression analysis showed that the central neck lymph node metastases were related to tumor max diameter≥10 mm, extrathyroidal extension (P<0.01), age<55 years old (P<0.01), multifocality (P<0.01), and PTC located at the isthmus (P<0.01). Conclusions Risk stratification should be performed on cN0 PTC. Prophylactic central neck dissection should be performed in cN0 patients with the tumor max diameter ≥ 10 mm, capsule invasion, age <55 years, multiple tumors, isthmus PTC and Hashimoto thyroiditis patients.
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Objective@#To investigate the expression of integrin αvβ3, CXC chemokine receptor (CXCR)4 and CXCR7 and their relationship with lymph node metastasis in squamous cell carcinoma of head and neck (SCCHN).@*Methods@#The expression of integrin αvβ3, CXCR4 and CXCR7 was detected by immunohistochemistry SABC in 92 cases of primary SCCHN, metastatic lymph node, normal oral mucosa tissues and normal lymph nodes.@*Results@#The positive rate of the expression of integrin αvβ3, CXCR4 and CXCR7 was 75% (69/92), 81%(75/92) and 76%(70/92), respectively in primary SCCHN, and was 82%(75/92), 76%(70/92) and 65%(60/92), respectively in metastatic lymph node. The expression of integrin αvβ3 and CXCR4 in primary SCCHN (r=0.813, P<0.05) and lymph node metastasis (r=0.541, P<0.05) was positively correlated. Integrin αvβ3 and CXCR7 expression in primary SCCHN (r=0.683, P<0.05) and lymph node metastasis (r=0.708, P<0.05) was positively correlated. CXCR4 and CXCR7 expression in primary SCCHN (r=0.644, P<0.05) and lymph node metastasis (r=0.707, P<0.05) had a positive correlation. The expression level was associated with tumor size (P=0.040, 0.001, 0.009), lymph node metastasis (P=0.001, 0.000, 0.000) and surrounding tissue invasion (P=0.046, 0.002, 0.001), but not related to age (P=0.097, 0.274, 0.162), gender (P=0.103, 0.309, 0.187).@*Conclusions@#The overexpression of integrin αvβ3, CXCR4 and CXCR7 in primary head and neck squamous carcinoma and metastatic lymph nodes was related to lymph node metastasis. The co-expression of integrin αvβ3, CXCR4 and CXCR7 may play a synergistic role in lymphatic metastasis of SCCHN.
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OBJECTIVE@#To investigate postoperatively repairing methods and their clinical effects of the olders over 80 years old with head and facial skin malignancies.@*METHOD@#Eighteen cases of skin cancers in the head and face, whose malignancies were resected with Mohs microscopic surgery, according to the local or systemic condition of patients after surgery we choose different repairing methods: free skin flap grafting in 2 cases, local skin flap transferring 12 cases; including rotation skin flap grafting 6 cases, sliding flap 4 cases, nasolabial flap 2 cases; transposition flap 4 cases.@*RESULT@#Operations of the 18 cases went well without special complications. All of the flaps were alive with partial flap necrosis in 1 case, which was cured 1 month later by dressing changes. During the follow-up period ranged from 6 months to 2 years,no tumor recurred,the functional recovery and appearance were satisfactory.@*CONCLUSION@#Choosing operating methods in head and facial skin malignancies should consider patients' age, disease state and general condition. Reparing methods of Head and facial skin malignancies in the advanced ages should be selected according to their specific circumstances, especially the simple, convenient and rapid with less trauma way.
Subject(s)
Humans , Face , Pathology , Free Tissue Flaps , Head , Pathology , Neoplasm Recurrence, Local , Postoperative Period , Plastic Surgery Procedures , Skin , Pathology , Skin Neoplasms , General Surgery , Skin TransplantationABSTRACT
OBJECTIVE@#To investigate the clinical manifestations and diagnostic method of hyperparathyroidism due to parathyroid tumors and to evaluate the intra-operative detection of parathyroid hormone in surgical treatment.@*METHOD@#Thirty-seven cases with functional parathyroid tumors from January 2003 to October 2012 were retrospectively analyzed. The clinical manifestation, examination and operation method, changes of parathyroid hormone before and after operation were collected.@*RESULT@#All cases were definitely diagnosed before operation. The sensitivity and the positively predictive values of neck ultrasonography were 86.5% and 97.6% respectively, and the same data of Tc-99m-MIBI was 97.2% and 100.0%. The PTH levels declined by 84.9% ten minutes after tumor resecting compared with the level before operation. The serum calcium and PTH returned to normal levels and symptomatic relief occurred after operation.@*CONCLUSION@#Recurrent bone disease, long-term urinary calculus and obscure gastrointestinal symptoms were common symptoms of hyperparathyroidism due to parathyroid tumors. The neck ultrasonography and Tc-99m-MIBI were suitable for location of parathyroid tumors. Surgical operation was an effective treatment for parathyroid tumor. Intra-operative PTH assay would be able to ensure the radical excision and the operative safety for functional parathyroid tumors.