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<p><b>OBJECTIVE</b>To evaluate the prognostic impact of tumor size, ultrasonography, central neck lymph node involvement, and age of patients in papillary thyroid microcarcinoma (PTMC).</p><p><b>METHODS</b>Two hundred and fifty-four patients who underwent total thyroidectomy and central neck dissection for PTMC between 2012 and 2014 were included in this retrospective study. Statistical correlation between tumor size and various clinicopathological parameters was assessed by univariate and multivariate analyses. The ultrasound findings were also evaluated.</p><p><b>RESULTS</b>A total of 254 patients (199 females and 55 males) were included in this study. PTMC showed a predilection for female patients, 41-50 years of age (43.3% of all cases, 110/254), and ultrasound showed hypoechoic nodules. Statistically significant correlation was demonstrated between central neck lymph node involvement and the following factors: age and tumor size. A tumor diameter greater than 0.5 mm (67.3% of all cases) most commonly occurred in patients older than 41 years, and was associated with a higher risk of metastatic central neck lymph node involvement (P<0.05). Hashimoto's thyroiditis was noted in the background in 39.4%(100/254) of cases.</p><p><b>CONCLUSIONS</b>Tumor size appears to have a prognostic impact in PTMC, and larger size is more likely to be associated with a higher risk of central neck lymph node involvement. It is controversial whether the etiology of papillary thyroid carcinoma is related to Hashimoto's thyroiditis.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Age Factors , Analysis of Variance , Carcinoma , Carcinoma, Papillary , Diagnostic Imaging , Pathology , General Surgery , Hashimoto Disease , Diagnosis , Lymphatic Metastasis , Neck , Neck Dissection , Prognosis , Retrospective Studies , Risk Factors , Thyroid Neoplasms , Diagnostic Imaging , Pathology , General Surgery , Thyroidectomy , Tumor Burden , UltrasonographyABSTRACT
<p><b>OBJECTIVE</b>To study the significance of P504s in differential diagnosis between solid pseudopapillary tumor of the pancreas (SPTP) and pancreatic neuroendocrine tumors (PanNET).</p><p><b>METHODS</b>Forty-three patients with SPTP and 41 patients with PanNET encountered during the period from 2007 to 2014 were recruited. Immunohistochemical study for vimentin, CD10, chromogranin A, synaptophysin, beta-catenin, CD99 and P504s in SPTP and PanNET was performed. The diagnostic value of P504s in differentiating SPTP from PanNET was analyzed.</p><p><b>RESULTS</b>Immunohistochemical study showed that vimentin, CD10, chromogranin A, synaptophysin and CD99 were expressed both in SPTP and PanNET. All cases of SPTP showed granular cytoplasmic expression of P504s, whereas those of PanNET were negative.</p><p><b>CONCLUSION</b>P504s is a sensitive and useful marker for SPTP and can be used in the distinction between SPTP and PanNET.</p>
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Objective To evaluate the expressions of TBX2 and MDM2 protein in urothelial carcinoma of bladder.Methods The expressions of TBX2 and MDM2 protein were examined by immunohistochemistry EnvisionTM Plus method in 90 cases of urothelial carcinoma of bladder and 20 cases of normal bladder mucosa tissue.Results The positive rate of TBX2 and MDM2 protein was 0 in normal bladder mucosa tissues.The positive rate of TBX2 in urothelial carcinoma of bladder was 65.6％ (59/90).With the increased of TBX2 expression degree,the carcinoma tissue was worse cell differentiation,later clinical stage,more prone to recurrence (P ＜ 0.01).The positive rate of MDM2 in urothelial carcinoma of bladder was 31.1％(28/90).With the decreased of carcinoma tissue differentiation degree,the positive rate of MDM2 was increased (P ＜ 0.01).The positive rate of MDM2 in recurrence patients was 57.5％ (23/40),in non-recurrence patients was 10.0％ (5/50),there was statistical difference (P ＜ 0.01).The positive rate of MDM2 in pTNM stage Ta-T1 was 0,in pTNM stage T2-T3 was 73.7％ (28/38),there was statistical difference (P ＜0.01).There was positive correlation between the expression of TBX2 and MDM2 in carcinoma tissue (r =0.487,P ＜ 0.05).Conclusions The over expression of TBX2 and MDM2 protein may closely associated with aggressive biological behavior and recurrence in urothelial carcinoma of bladder.Combined analysis of TBX2 and MDM2 may provide a theoretical basis for prognostic information and treatment of patients with urothelial carcinoma of bladder.
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Objective To investigate the clinical presentation, morphological features, immunohistochemical staining of the gastrointestinal stromal tumor (GIST), and its histogenesis as well. Methods The morphologic characteristics of GISTs were studied in 58 cases using light microscopy. The expression of c-kit(CD117), CD34 and vimentin were detected in all of the cases with EnVision staining. Results Among 58 cases of GISTs, 41 were spindle cell type, 5 epithelioid cell type and 12 mixture type, equivalent to 86.6 %(58 of 67) of all of the mesenchymal tumors of gastrointestinal tract admitted in the same period. The epithelioid cell type tumors were mainly composed of the epitheloid cells, predominantly short spindle, oval or round in pattern, with an overall eosinophilic cytoplasm by hematoxylin-eosin stain. Focal cytoplasmic vacuolization was often seen. Sometimes signet-ring like cells and cells with a clear cytoplasm were seen in the epithelioid stromal tumor. The tumor cells arranged in interlacing fascicles forming whorls or sometimes cell clusters. All of the 58 stromal tumors were strongly positive for vimentin (100 %), 55 out of 58 tumors positive for CD117 (94.8 %) and 46 out of 58 positive for CD34(79.3 %). Some cases also expressed SMA, actin, S-100 and MBP. Conclusions GISTs were the most common mesenchymal tumor seen in the gastrointestinal tract. Under light microscope, the morphology of stromal tumors sometimes looks like a leiomyoma or Schwannoma. The application of immunohistochemical markers (particularly CD117 and CD34) is considered necessary for the differential diagnosis. GISTs may originate from the pluripotential precursor cells like the interstitial cells of Cajal.
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Objective To study the value of expression of carcinoma-associated antigens in early diagnosis and prediction of prognosis of gallbladder carcinoma. Methods The expression of PCNA, CEA, CA50 and E-cad were detected by immunohistochemistry in 50 cases of gallbladder carcinoma, 10 gallbladder adenomas and 10 cholecystitis. Results The positive rates of CEA, CA50 and PCNA LI in gallbladder carcinomas were significantly higher than that of gallbladder adenomas and cholecystitis(P
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Objective To study the clinical, pathological and immunohistochemical characteristics of gastrointestinal stromal tumors (GISTs). Methods 87 cases of GISTs were studied with conventional histopathological and immunohistochemical stains. Results All patients were adults, age range 28 to 73 years (mean 53 year), the tumors were situated in stomach (56 cases), in small intestine (29 cases), in colon (2 cases). The tumors had two kinds of cells: spindle cells and epithelioid cells, they were different in proportion. Immunohistochemically, vimentin were all positive, CD117 and CD34 showed diffuse strong expression, SMA and S-100 were positive when the tumors differentiated to smooth muscle and nerve. Conclusion GISTs predominantly occurred in middle aged or old patients, the tumors were composed of spindle cells and epithelioid cells. The immunohistochemical characters were positive for CD117 and CD34.