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Objective:To investigate clinicobiological characteristics and treatment principles of diffuse calcified variant of papillary thyroid carcinoma.Methods:Twenty one patients with diffuse calcified thyroid glands admitted to the Department of Head and Neck Surgery of Tianjin Medical University Cancer Hospital from Jan 2011 to Dec 2015 were enrolled in the study group. One humdred and five patients with papillary thyroid carcinoma (PTC) confirmed by postoperative pathology (non-diffuse calcified thyroid nodules) during the corresponding period were included into the control group. The clinicobiological characteristics of different cases were analyzed by collecting the following information: gender, age, ultrasonic features, thyroid function, pathological type, lymph node metastasis, BRAF V600E mutation and follow-up.Results:No significant difference was found between the study group and the control group in gender, age or the number of patients complicated with Hashimoto′s thyroiditis; while there were significant differences in bilateral involvement of central lymph node metastasis, lateral neck lymph node metastasis and positive rate of BRAF V600E mutant protein expression in postoperative specimens ( P<0.01). As found by postoperative follow-up, there was no significant difference in the rate of neck lymph node recurrence between the two groups. Conclusions:Diffuse calcified variant of papillary thyroid carcinoma is a new subtype of PTC with unique clinicobiological characteristics, and more active clinical treatment programme should be adopted for the diffuse calcified thyroid carcinoma.
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Objective To explore the clinico-pathological characteristics and treatment of thyroid carcinoma in patients under 14 years old.Method The clinical and pathological data of 61 children 14 years old or younger treated for differentiated thyroid carcinoma (DTC) from Jan 2005 to Dec 2014 were retrospectively analyzed.Results There were 26 males and 35 females with the sex ratio of 1 ∶ 1.35.All the 61 patients underwent surgery including lobectomy for ipsilateral foci in 11 cases and total or near total thyroidectomy for bilateral or multi-foci in 50 cases.5 patients had not lymph node metastasis.56 patients had central compartment metastasis and 47 patients had lateral cervical lymph node metastasis.9 patients had distant metastasis and the affected organ was lung.Pathology for all the 61 patients was thyroid papillary carcinoma,35 patients were of highly invasive subtype.The median follow-up time was 3 years and 6 months (30-116 months) with a total survival rate of 100％ while 4 patients suffered from recurrence.Conclusions For below 14 years old DTC patients,the prognosis is better than in adults.The rate of bilateral lesions or multiple foci in ipsilateral lobe and central compartment lymph node or lateral neck lymph node metastasis was higher than in adults.Furthermore,highly invasively pathological subtype is more common in younger patients.
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Objective To investigate the correlation between iodine intake,BRAF mutation in thyroid gland and clinical biologic characteristics in papillary thyroid carcinoma(PTC) cases.Methods A total of 159 PTC patients and 200 healthy controls were enrolled in this study.Urine iodine was tested,BRAFV600E mutation was detected by PCR.The correlation was analyzed between BRAF mutation and iodine intake,BRAF mutation and clinical biologic characteristics of PTC respectively.Results The median urinary iodine (MUI) of the patients and healthy controls was 336 μg/L and 196 μg/L respectively (P =0.004).The overall prevalence of the BRAFV600E mutation in this series of PTC was 63.5％,showing a clear correlation of BRAFV~E mutation with iodine intake (P =0.006).There was no correlation of BRAFV600E mutation with age,gender,tumor size,extrathyroid extension or nodulor goiter in PTC (P ＞ 0.05).But there was a significant association of BRAFV~E mutation with lymph node metastasis (P =0.008) and Hashimoto's thyroiditis (P =0.037).Conclusions High iodine intake may be a risk factor for PTC occurrence.In PTC cases,high iodine intake may be a risk factor of BRAFV600E mutation.BRAFV600E mutations increase both in PTC with cervical lymph node metastases and uncoexisting Hashimoto' s thyroiditis.