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Objective To observe the RAS gene mutations in papillary thyroid carcinoma,and to analyse the effects of mutation on clinical characteristics and prognosis.Methods In this study,354 papillary thyroid carcinoma patients were divided into 2 groups according to RAS mutation by DNA sequence analysis.The pathological type,disease progression,recurrence and prognostic difference between the two groups were compared,and regression analysis was performed to evaluate the relationship between different variables and RAS mutation.Results There were 86 patients with RAS positive mutation.A significant difference was found with primary sites (P =0.004),distant metastasis (P =0.027),AJCC stage (P =0.004) and ATA risk stratification (P =0.000) between two groups.RAS positive patients have higher recurrence rate and shorter recurrence-free survival time (P ＜ 0.005) than the negative patients.Furthermore,in the multivariate analysis,the RAS mutation was significantly associated only with the ATA stratification.Conclusions RAS mutation increases risk of recurrence,RAS mutation and ATA stratification might be a valuable diagnostic and prognostic marker of papillary thyroid carcinoma.
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Objective To analyze expression of Bmi-1 gene in thyroid tissues and the relationship between Bmi-1 gene and metastasis of papillary thyroid carcinoma.Methods RT-PCR was used to detect expression of Bmi-1 in normal thyrroid tissues(8 eases),nodular goiters(18 cases)and papillary thyroid carcinomas (24 cases).The result was analyzed by Fisher exact propability test.Results Bmi-1 expression was detected only in 1 case(12.5%)in normal thyroid tissues group,3 cases(16.7%)in nodular goiters group,and 19 cases(79.2%)in papillary thyroid carcinoma group.The difference of Bmi-1 expression between the 3 groups had statistical significance(P<0.05).There were 16 cases of lymph node metastasis(66.67%)in the 24 cases of papillary thyroid carcinoma.The difference of Bmi-1 expression between cases with cervical lymph node metastasis and those without metastasis had statistical significance(P<0.05).Among the 19 thyroid carcinoma cases in which Bmi-1 expression was positive,12 eases(63.2%)were over45 years old,and 7 cases(36.8%)were under 45 years.The difference had statistical significance(P<0.05).Conclusions Expression of Bmi-1 gene in papillary thyroid carcinoma tissue is significantly higher than that in nodular goiters and normal thyroid tissues.Bmi-1 expression is closely relevant to lymph node metastasis and age,implying that Bmi-1 expression has clinical significance of distinguishing thyroid malignant tumors from benign diseases and it may provide clues to unravel the mechanism and prognosis of papillary thyroid carcinoma metastasis.
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Objective To study core needle biopsy in diagnosis of palpable breast cancer.Methods Retrospectively analyze core needle biopsy in 200 cases of palpable breast cancer.We recorded the clinical and pathology data and used crosstable test to analyze the effect of maximal and minimal tumor size.and TNM stage on the results. Results The ratio of success was 97%. No significant difference was found among the groups of different maximal tumor size, minimal tumor size and TNM stage (P ＞ 0.05 ). Conclusion ( 1 )For the diagnosis of the suspicious malignant palpable mass, core needle biopsy is effective, safe, microtraumatic and suitable to be used in different-class hospitals ; (2) The success of core needle biopsy for palpable breast cancer is correlated with dexterity of operator; (3)Biopsy channel should be in the range of operation and avoid of affecting sentinel lymphatic channels.
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Objective To summarize the experience for diagnosis and treatment of parathyroid carcinoma(PTC).Methods The clinical data of 6 patients with PTC were retrospectively analyzed.Results Five patients complained of primary hyperparathyroidism,3 patients had manifestations of palpable neck mass,4 patients were admitted for hypercalcemia with calcium level of(3.62?0.56)mmol/L,and in 4 patients the parathyroid hormone(PTH) level was higher than two fold of the normal upper limit.Frozen section histopathology established diagnosis in 3 patients,routine histopathology combined with immunohistochemistry established the diagnosis in 2 patients,and routine histopathology combined with immunohistochemistry and clinical data established the diagnosis in 1 patient.Parathyroidectomy and ipsilateral subtotal thyroidectomy was performed in 5 patients,who were followed up for 1-5 years,recurrence in 1 patient 3 years after operation;tumor resection alone was performed in 1 patient with parathyroid cancer complicated with multiple bone metastasis,and the patient died of MOF 16 days postoperation.Conclusions The diagnosis of PTC is difficult before operation.Routine blood examinations,blood PTH,99mTc-MIBI scintigraphy,ultrasonography,CT,observation of specimen,and frozen section histopathology during operation are helpful to diagnosis.The surgical procedure of choice is parathyroidectomy and ipsilateral subtotal thyroidectomy.