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ObjectiveTo investigate the correlationship between clinical and histopathological results of adrenocortical hyperplasia,adenoma and adenocarcinoma in the adrenocortical glomerular,fascicular and reticular zones. MethodsA total number of 167 702 surgical specimens were collected by the Department of pathology at the General Hospital of Tianjin Medical University from 1993 -2008.Of these,there were 631 adrenocortical specimens.Statistic analysis was done with Run test,t or t'test and x2 test on data in the aspects of proportion rate,mean age,sex proportion and relationship between clinical and pathological results of adrenocortical diseases.ResultsThe total number of adrenal diseases and adrenocortical diseases were 910 cases (0.54％) and 631 cases (0.38％),respectively.The number of adrenocortical glomerular,fascicular,reticular diseases were 310 cases (49.13％),319 cases (50.55％) and 2 cases (0.32％),respectively.The rate of adrenal diseases and adrenocortical diseases specimens did not change during the 16 year study period.The trend in proportion of hyperplasia,adenoma,adenocarcinoma in adrenocortical glomerular,fascicular and reticular zones did not change as well.The proportion pattern showed that there were more cases of adenoma than of hyperplasia and adenocarcinoma.The functional diseases of adrenocortical glomerular,fascicular and reticular zone (90.97％,79.00％,100.00％ ) were higher than nonfunctional diseases in the corresponding zones (9.03％,21.00％,0％ ) and both were higher in female patients.The mean age of nonfunctional patients with adenoma,glomerular zone adenocarcinoma and hyperplasia,adenoma of fascicular zone was higher than that in functional diseases.Interestingly,the mean age of glomerular zone adenocarcinoma patients (62.7 yrs) was higher than that in hyperplasia patients (47.8 yrs) and in adenoma patients (44.8 yrs).The mean and male diagnostic ages of adenocarcinoma of fascicular (44.3 yrs,50.0 yra) were higher than that in adenoma (44.0 yrs,49.1 yrs) and hyperplasia (41.5 yrs,40.9 yrs) respectively.But the female mean diagnostic age of fascicular adenocarcinoma (38.7 yrs) was lower than that in adenoma (42.4 yrs) and hyperplasia (41.9 yrs) respectively and the lowest average age was for nonfunctional adenocarcinoma (34.4 yrs).The diameters of the functional and nonfunctional adenocarcinoma were large (4.3 cm and 4.0 cm in glomerular zone,7.1 cm and 8.0 cm in fascicular zone).The carcinoma cells were in serious atyrpia,haemorrhage,necrosis and capsular or vascular infiltration.The rates of functional hyperplasia,adenoma with hypertension in Conn,Cushing or adrenogenital syndrome of adrenocortical glomerular,fascicular,reticular zone were higher than that without hypertension,but their tumor diameters were similar.The diameters of functional adenoma in glomerular or fascicularer ( 1.7 cm,2.3 cm ) were lower than that of nonfunctional adenoma (2.3 cm,2.4 cm ) and the diameters of glomerular tumors were smaller than that of fascicular tumors.Nonfunctional adenoma ( 2.5 cm,2.0 cm ) of glomerular or fascicular by check up finding were bigger than that of non-endocrine adenoma ( 2.5 cm,2.3cm).There were seven cases with adrenogenital syndrome (2 male cases,5 female cases ),among these,there were 4 fascicularer adenoma cases,1 adenocarcinoma case,1 network hyperplasia case and 1 adenoma case.ConclusionsGenetic abnormality plays an important role in pathogenesis of adrenocortical disease and environment had less influence.Radiological examinations (CT and MRI) of adrenocortical diseases are the first choice and have important roles in evaluating tumor characteristics.There is close relationship between clinical manifestation and pathology.However,the exact diagnosis of definite type of disease and nature of tumor needs to be made by pathologic examination.
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ObjectiveTo study the roles of cytokeratin-19 ( CK-19 ),vimentin,vascular endothelial growth factor-C( VEGF-C ),and cyclooxygenase-2 ( COX-2 ) played in the occurrence and development of Graves'disease(GD) and Hashimoto's thyroiditis(HT).Methods57 cases of GD and 58 cases of HT were enrolled in our study.Immunohistochemistry using SP method was carried out for assessment of the expression of CK-19,vimentin,VEGF-C,and COX-2 in the thyroid tissues.Results CK-19,VEGF-C,and COX-2 were expressed in the cytoplasm of thyroid follicular epithelial cells.Vimentin was expressed both in the mesenchyma and in the cytoplasm of thyroid follicular epithelial cells.The positive rates and expression intensities of CK-19 and VEGF-C in HT ( 86.2％,96.6％ ) were significantly higher than those in GD ( 43.9％,56.1％,all P＜0.05 ).The expression intensities of vimentin and COX-2 in GD ( 100.0％,93.1％ ) were similar to those in HT ( 100.0％,91.2 ％ ),while the expression intensity of COX-2 in HT was significantly higher than that in GD( all P＜0.05 ).The positive rates of CK-1 9 were much higher in type Ⅲ ( 81.3％ ) of GD than in type Ⅰ ( 1 5.8％ ) and type Ⅱ ( 40.9％ ) of GD,and also higher in type P( 100％ ) of HT than in type L(66.7％ ) of HT.The positive rates of VEGF-C were much higher in type Ⅲ ( 87.5％ ) of GD than in typeⅠ ( 36.8％ ) and type Ⅱ ( 50.0％,all P ＜ 0.05 ) of GD.ConclusionImmunohistochemical detection of the expression of CK-19,vimentin,VEGF-C,and COX-2 may carry clinical significance in revealing the occurrence and development as well as evaluating the prognosis of Graves'disease and Hashimoto's thyroiditis.
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The mRNA expressions of chemerin and its receptor CMKLR1 in adipose tissue of OLETF rats and LETO rats were detected by real-time PCR. The results showed that the two genes mRNA expressions in subcutaneous and visceral adipose tissue in OLETF group were significantly higher than those in LETO group (P< 0.05 or P<0.01) and expressions of them in visceral adipose tissue were higher than those in subcutaneous adipose tissue(P<0. 05 or P<0. 01), suggesting that chemerin and CMKLR1 may be involved in the pathogenesis of obesity, insulin resistance, and type 2 diabetes mellitus.
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<p><b>OBJECTIVE</b>To investigate the relationship between expression of cell adhesion molecular CD44, epithelial cadherin (E-cad) and metastatic suppressor gene nm23-H1 as well as the clinicopathologic features including cell differentiation, invasion and metastasis of thyroid follicular-derived carcinoma.</p><p><b>METHODS</b>Forty two (42) thyroid follicular carcinomas (FTC) and 54 papillary carcinomas (PTC) were collected for studying the expression of CD44, E-cad and nm23-H1 using immunohistochemical staining.</p><p><b>RESULTS</b>Neoplastic epithelium and infiltrating lymphocyte expressed CD44 in an intense plasma membrane pattern. CD44 expression rates in poorly differentiated FTC (80%) and PTC cases with metastasis (78%) were significantly higher than those of well-differentiated FTC cases (64%) and PTC without metastasis cases (59%) respectively. Thyroid carcinoma tissue was positive for E-cad and nm23-H1 in a cytoplasm pattern. Well-differentiated FTC presented a higher E-cad and nm23-H1 expression rate than poorly-differentiated FTC, but both had a lower expression rate than that of PTC (70% and 76%, P < 0.01). The expression rate and intensity of E-cad and nm23-H1 were lower and less in metastatic PTC than those in primary PTC. Expression rate of CD44 (72%) in thyroid follicular-derived carcinoma was higher than those of E-cad (54%, P < 0.01) and nm23-H1 (61%, P < 0.05). E-cad expression was adversely correlated with that of nm23-H1 (chi(2) = 15.75, P < 0.011, r = 0.522 2). There was a reverse relationship between expression of CD44 and E-cad or nm23 (P > 0.05).</p><p><b>CONCLUSIONS</b>Cell differentiation degree in FTC and metastasis in PTC have positive correlation with the expression of E-cad and nm23, but have a reverse correlation with the expression of CD44. There was a relationship between expression of CD44, E-cad, nm23 and the characteristics of the degree of differentiation, metastatic potential and the prognosis of thyroid follicular-derived carcinoma.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Cadherins , Carcinoma, Papillary, Follicular , Chemistry , Pathology , Hyaluronan Receptors , Immunohistochemistry , Monomeric GTP-Binding Proteins , NM23 Nucleoside Diphosphate Kinases , Neoplasm Invasiveness , Nucleoside-Diphosphate Kinase , Thyroid Neoplasms , Chemistry , Pathology , Transcription FactorsABSTRACT
Objective To investigate the effects of dendritic cell (DC) and HLA-DR antigen expression in the generation and development of Graves′ disease (GD), Hashimoto′s thyroiditis (HT) and subacute thyroiditis (SAT). Methods A morphologic study was performed on the thyroid tissue of 53 GD with pronounced lymphocytic infiltration, 52 HT and 31 SAT to investigate the pathologic changes of DC and HLA-DR antigen positive cell in the parenchymal cells and intestitial tissue by histochemical, immunohistochemical and electron microscopic technique and statistic analysis. Results The observation on DC and HLA-DR positive infiltrating cell in GD, HT and SAT showed a similar increase with the degree of cellular infiltation. The highest peaks of DC and HLA-DR positive thyroid follicular epithelium were in HT O-type and granulomatous area of SAT. The highest peaks of HLA-DR positive immunoactive cells was in HT P-type and fibrous area of SAT. Conclusion DC and HLA-DR positive cells may play an important role in the antigen-presenting step as well as in their direct cytotoxicity. These processes are related to the pathogenesis of AITD (GD and HT) and SAT. The thyroid follicules may be destroyed in the autoimmune reaction, and initially the patient presents hyperthyroidism and finally hypothyroidism follows because of the fibnosis of the follicules.
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A morphologic study was performed on the thyroid tissues of Hashimoto thy-roiditis (HT) and subacute thyroiditis (SAT) with histochemical and immunohistochemical methods. The results showed that the number and proportion of Ig and T positive cells were quite similar between these two diseases, suggesting that autoimmunoaction may play an important role in the generation and development of SAT.
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ObjectiveTo analyze the change in the incidence of papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) in the past 27 years and to probe the relationship between iodine and these carcinomas. MethodsStatistical analysis was performed on data of thyroid diseases, thyroid malignant tumors, PTC , FTC and their complications in Department of Pathology from 1978 to 2004 in General Hospital of Tianjin Medical University with Run test、Cox-Stuart test, ANOVA, t or t′ test and Chi-square test. ResultsIn 27 years there were 231837 cases of biopsies (average 8587cases/year). The biopsies were performed in the thyroid diseases as a whole 6276 cases (2.70%),thyroidmalignanttumors644cases(0.28%), PTCs 465 cases (0.20%), and FTCs 80 cases (0.03%) in 27 years. Biopsies in thyroid diseases as a whole showed a descending tendency since 1982 but an ascending tendency after 1995. Biopsy in malignant thyroid tumor did not show a significant change, and biopsy in PTC showed an ascending tendency and that in FTC showed a descending tendency after 1995. The average age, both in male and female patients, at the time of diagnosis of PTC and FTC showed no significant change during 27 years, but the mean age of male at the time of diagnosis was older than that of female. The ratios of male to female in PTC and FTC were 1:3.31、1:2.81 respectively,and showed no significant change either. There were more biopsies with lymph node metastasis in PTC (33.76%) than those in FTC (10.00%) and more biopsies with blood vessel involved or nodular goiter in FTC (11.25% and 13.75%) than those in PTC (0.65% and 4.52%). Mean age of patients with PTC and nodular goiter (44.3 years old) was older than those without goiter (38.1 years old). The ratios of male to female with PTC and FTC with lymph node metastasis were higher than those without lymph node metastasis. ConclusionThe incidence of thyroid malignant tumors in 27 years has no significant change. The contrary tendency of PTC and FTC suggests that the decreasing malignant degree of carcinoma. It suggests that this area is not in high iodine condition and the change have no relationship with the iodine intake.