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Objective@#To investigate the difference of prognostic factors and recurrence rates between papillary thyroid microcarcinoma (PTMC) and lager papillary thyroid carcinoma (PTC) and analyze the clinical pathological characteristics of PTMC suitable for surgery.@*Methods@#A retrospective analysis on the clinicopathological features, expression level of of v-raf murine sarcoma viral oncogene homolog B1 (BRAF) V600E gene mutation and pigment epithelium-derived factor (PEDF), and postoperative follow-up results of the 251 PTC patients who underwent surgical treatment from October 2011 to October 2013, including 169 cases with PTMC and 82 with lager PTC (Tumor diameter>1 cm).@*Results@#The BRAF V600E mutation rates of PTMC and lager PTC patients are 65.1%(110/169)and 78.0% (64/82) respectively, and the difference is statistically significant (P<0.05). The prevalence of extrathyroidal invasion (7.1%) and lymph nodes metastasis (27.2%) of the patients with PTMC were significantly lower than those of the patients with larger PTC (15.9% and 46.3%, respectively)(P<0.01). The follow-up durations for PTMC and lager PTC were (45.6±3.6) months and (45.0±3.4) months, respectively (P>0.05). There was no statistic significance for the difference in age, gender, coexistent hashimoto′s thyroiditis, PEDF expression, and recurrence rate between the patients with PTMC and with larger PTC (P>0.05). The recurrence rate of the patients who have the high risk factors of PTMC was 1.6%(2/122)and that of larger PTC was 4.9% (4/82).@*Conclusions@#Extrathyroid invasion, lymph node metastases and BRAF V600E gene mutation are the high risk factors of recurrent PTMC. The same treatment strategy should be considered for PTMC with coexistent high risk factors as that for larger PTC. For PTMC with BRAF V600E gene mutation, earlier surgical treatment is suggested. PTMC patients with BRAF V600E gene mutation and high cell subtype are suggested to undergo total thyroidectomy for the first operation in order to reduce the potential risk of recurrence.
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Objective To evaluate carbon nanoparticles suspension in protection and identification of parathyroid in total thyroidectomy for thyroid papillocarcinoma.Methods This retrospective analysis included the clinical and pathological data of 97 patients from January 2014 to December 2014,52 cases injected carbon nanoparticles suspension (the test group).Serum calcium and parathyroid hormone (PTH) were measured preoperatively and on lst,3rd,7th day and one month postoperatively.Results Incidental parathyroidectomy occurred in 1 case (1.9％,1/52) in test group and in 7 cases (15.6％,7/45) in control group(P ＜0.05).The mean numbers of parathyroid glands identified intraoperatively were 3.1 ± 0.4/case and 2.6 ± 0.3/case respectively (P ＜ 0.05).The occurrence of temporary PTH hypofunction was 19.2％ (10/52) and 42.2％ (19/45) respectively (P ＜ 0.05).Also,test group had a higher level of PTH on postoperative day 1,3,7 and one month (P ＜ 0.05).Conclusions Carbon nanoparticles suspension significantly improved the identification of parathyroid gland during thyroid cancer surgery and reduced the risk of incidental parathyroid ectomy in total thyroidectomy.
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<p><b>OBJECTIVE</b>To investigate the association of concomitant BRAFV600E mutation with central lymph node metastases in papillary thyroid carcinoma (PTC).</p><p><b>METHODS</b>The clinicopathological data of 126 PTC patients who underwent surgical treatment within a period of 2 years were retrospectively analyzed. The BRAF V600E gene mutation was detected by quantitative fluorescence PCR.</p><p><b>RESULTS</b>The BRAF mutation rate was 69.0% (87/126). The univariate analysis showed that BRAF mutation status was significantly associated with central lymph node metastasis (P<0.05), while the gender, multiple lesions, tumor size, extra-thyroidal invasion, Hashimoto's thyroiditis and tumor stage were not significantly associated with the BRAF mutation (P>0.05 for all). The multivariate analysis showed that only central lymph node metastasis was significantly correlated with BRAF mutation (P<0.05). When the diameter of tumor was ≤10 mm, BRAF mutation was statistically not significantly correlated to central lymph node metastasis (P>0.05). When the diameter of tumor was >10 mm, the central lymph node metastasis rate was significantly higher in patients with positive BRAF mutation than that in patients with a negative BRAF mutation (P<0.05).</p><p><b>CONCLUSIONS</b>The presence of BRAF mutation is an independent predictive factor for central lymph node metastasis. When PTC is with preoperative positive BRAF mutation, the cervical dissection should be routinely performed. The larger the tumor diameter is, the more important is the central lymph node dissection. There should be re-evaluated the necessity of preventative central lymph node dissection when the tumor diameter was ≤5 mm in patients with negative BRAF mutation.</p>
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Humans , Carcinoma , Epidemiology , Genetics , Metabolism , Carcinoma, Papillary , Hashimoto Disease , Lymph Node Excision , Lymph Nodes , Lymphatic Metastasis , Diagnosis , Genetics , Mutation , Polymerase Chain Reaction , Proto-Oncogene Proteins B-raf , Genetics , Retrospective Studies , Thyroid Neoplasms , Epidemiology , Genetics , MetabolismABSTRACT
Objective To investigate the calcification of thyroid nodules detected by ultrasound and its relation with thyroid carcinoma.Methods Four thousand one hundred and eighty-six cases of thyroid disease were surgically treated during a period of five years.Retrospective analysis was made to compare preoperative color Doppler ultrasound and postoperative pathology.Results The incidence of calcification,non-microcalcification,and microcalcification were significantly higher in thyroid carcinoma than that in benign diseases(P＜0.05).For predicting thyroid cancer,microcalcification was more significant than non-microcalcification(P＜0.01).There was a significant difierence in the microcalcification between the different age groups(2.4%for patients of 45 and older,16.8%for patients younger than 45;P＜0.05):There was no difference in the calcification between male and female groups(P＞0.05);There was a significant difierence in malignant calcified nodules between difierent nodule groups(70.7%for patients of solitat'y.49.1%for patients of muhiple:P＜0.05).Conclusion Microcalcifications in the thyroid is related to thyroid cancer.especially to micro-papillary carcinoma.
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Objective To summarize our experience in the diagnosis and treatment of thyroid Hurthle cell neoplasms. Methods Clinical data of thyroid Hurthle cell neoplasm patients admitted from 1972 to 2003 were analyzed retrospectively. Results The main symptoms were thyroid solitary node or mass (37 cases) and multiple nodule (9 cases). 4 cases had cervical lymph node metastasis. With BUS、CT、ECT and FNAC,only 10 cases were diagnosed as HCNs preoperatively, 36 cases were misdiagnosed as nodular benign single or multiple node. Twenty-eight cases were diagnosed by FNAC and quick freezing pathology. Benign HCNs was treated by isolateral thyroidectomy and malignant HCNs by additional contralateral subtotal thyroidectomy. Eighteen cases were diagnosed by postoperative paraffin pathology, and retrival second operation was performed according to the benignity or malignancy of the thyroid lesion. All cases were followed-up for 2 to 10 years and doing well without recurrence. Conclusions We should realize thyroid Hurthle cell neoplasms fully, if HCNs is suspected intraoperatively, quick freezing pathology is helpful. With appropriate therapy, the prognosis is satisfactory.
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Objective To evaluate the effect of FTY720 on pancreas islet xenograft rejection by setting up the rat-to-mouse islet xenotransplantation model. Methods Rat islets were harvesed by means of pancreatic duct irregution with collagenase and purified by discontinuous density gradient method. Then the islets were transplanted under the kidney capsule of the mouse. The recipients were divided into 3 groups randomly: control group,the mouth was administrated with saline without any immunosuppressant; experiment group 1,the mouth was administrated with FTY720 (1.0 mg/kg) orally from the operation day to day 14 after operation; experiment group 2,the mouth was administrated with combination of FTY720(1.0 mg/kg) with CsA(15 mg/kg) from the operation day to day14 after operation. The xenograft were removed with the kidney at day 3, 5, 7 and 14 after transplantation, and the rejection was analyzed. Results In the control group and experiment group 1, the xenografts were completely destroyed within one week; on day 7, no intact islets could be seen, but numerous lymphocytes infiltration were found. In experiment group 2, many intact islets were still seen under the kidney capsule in day7 and 14 after operation; and infiltrated lymphocytes could hardly or just occasionally be found. Conclusions FTY720 alone can not inhibit the rejection of islet xenotransplantation; FTY720 combination with CsA can inhibited islet xenograft rejection effectively in the rat-to-mouse model.
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0.05).There was a significant difference in the percentage of malignant calcified nodules between the patients of 45 years and older with those younger than 45 years(39.2% and 69.3%,respectively;P
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To determine the feasibility and safety of separating close adhesion between the portal vein, superior mesenteric vein (SMV) and pancreas after combined vascular occlusion was employed. Methods: By means of occluding SMV below the pancreata, splenic arteries and veins posterior to the pancreata and portal veins superior to the pancreata consecutively, adhesion between SMV, portal vein and the head of lump pancreatitis, which is hard to deal with by fingers, was separated in 3 cases. Results: During separating procedures, 4～7 sites on portal veins and SMV were injured, with a small amount of hemorrhage (57ml, 81ml and 102ml, respectively), and were easilyrepaired. The vascular blocking time of the 3 cases was 36, 39 and 39.5 minutes. The following whipple procedures were smoothly fulfilled and all 3 patients recovered well. Conclusion: Blood flow of portal vein and SMV and traumatic hemorrhage can be radically controlled by the method of vascular occlusion, which was proved safe, performable and could be a protective method with great effect in separating close adhesion between pancreas and portal and SMV.
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OBJECTIVE To investigate the risk factors of infection after incisional wound in colon cancer patients for better prevention and treatment. METHODS To retrospectively analyze the colon cancer patients in whom the incision infection happened from Jan 2002 to Apr 2008. RESULTS The incidence of postoperative wound infections of the patients was 2.7%. In univariate analysis,the difference whether infections were happened in patients with diabetes was significant(P
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With the combined interruption of the superior mesenteric vein, the splenic artery and vein and the portal vein, we successfully separated the adhesion between the collum pancreatis and the portal vein which is difficult to separate in 8 cases During the separation, the portal vein was damaged in 2～5 parts, and the size of wounds of vein were of 2～6mm in length, but the amount of bleeding was small and the bleeding speed was slow All the wounds were easily repaired under direct vision We consider that the mothod of the combined interruption is safe and effective for the separation of the adhesion between the collum pancreatis and the portal vein, and is helpful to increasing the success rate of removing carcinoma of the head of pancreases The interruption is safe for 20～25 minutes under normothermia
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Objective To investigate the protective effect of edaravone on ischemia reperfusion injury(IRI) in rat liver.Methods Sixty rats were randomly divided into experimental group and controll groups(30 in each) after establishing animal liver IRI model with partial reperfusion injury under normal temperature.Just after initiation of reperfusion and 1h later,edaravone was administered in the experiment group,and the same volume of normal saline was administered in the control group.The lipid peroxidation(LPO) hepatic enzymes and the level of TNF-? mRNA and E-selectin mRNA in plasma were measured at 0,2,4 h after initiation of reperfusion.We also serially quantified hepatic expression of mRNAs for TNF-? and E-selectin with RT-PCR.Results In the experiment group,hepatic LPO and hepatic enzyme were significantly less than that in the saline group(P