Updates in the Pathologic Classification of Thyroid Neoplasms: A Review of the World Health Organization Classification

Advances in medical sciences and evidence-based medicine have led to momentous changes in classification and management of thyroid neoplasms. Much progress has been made toward avoiding overdiagnosis and overtreatment of thyroid cancers. The new 2017 World Health Organization (WHO) classification of thyroid neoplasms updated the diagnostic criteria and molecular and genetic characteristics reflecting the biology and behavior of the tumors, and newly introduced the category of borderline malignancy or uncertain malignant potential. Some neoplasms were subclassified, renamed, or redefined as a specific entity. This review introduces changes in the fourth edition WHO classification of thyroid tumors and updates the contemporary diagnosis and classification of thyroid tumors. We also discuss several challenges with the proposal of new diagnostic entities, since they have unique histopathologic and molecular features and clinical relevance.

Updates in the Pathologic Classification of Thyroid Neoplasms: A Review of the World Health Organization Classification

Advances in medical sciences and evidence-based medicine have led to momentous changes in classification and management of thyroid neoplasms. Much progress has been made toward avoiding overdiagnosis and overtreatment of thyroid cancers. The new 2017 World Health Organization (WHO) classification of thyroid neoplasms updated the diagnostic criteria and molecular and genetic characteristics reflecting the biology and behavior of the tumors, and newly introduced the category of borderline malignancy or uncertain malignant potential. Some neoplasms were subclassified, renamed, or redefined as a specific entity. This review introduces changes in the fourth edition WHO classification of thyroid tumors and updates the contemporary diagnosis and classification of thyroid tumors. We also discuss several challenges with the proposal of new diagnostic entities, since they have unique histopathologic and molecular features and clinical relevance.

Clinicopathologic characteristics and histogenesis of mucinous tumor of peritoneum / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic characteristics, prognosis and histologic origin of the mucinous tumor of the peritoneum.</p><p><b>METHODS</b>According to 2010 WHO classification of tumours of the digestive system, 34 cases diagnosed as "pseudomyxoma peritonei (PMP) " were reevaluated and divided into low grade and high grade. Immunohistochemistry was applied to investigate the expression of SATB2 and the histologic origin of the mucinous tumor of the peritoneum, using antibodies against SATB2, CK7, CK20 and CDX-2. The relationship between clinicopathologic characteristics and prognosis of the low grade and high grade tumors were analyzed.</p><p><b>RESULTS</b>Twenty five patients had low grade mucinous tumors (two of them were no cell type), nine patients had high grade mucinous tumors. There was no significant difference between low grade and high grade mucinous tumors in age, sex, recurrence and organs involvement (P>0.05). Thirty patients were followed up, the overall survival rates of patients with low grade and high grade mucinous tumors were 13/21 (61.9%) and 3/9, respectively. The median survival time was 74 and 24 months in low and high grade patients, and the difference was statistically significant (P=0.002).Immunohistochemistry showed the expression rates of CDX-2, CK20, and CK7 in totally 32 cases (excluding 2 cases of no cell type) were 30/32(93.8%), 31/32 (96.9%), and 3/16, respectively; the expression rates of CDX-2, CK20, and CK7 in 16 cases with distinct primary site were 15, 16, and 1, respectively; fifteen of 16 cases of tumors of unknown primary site were positive for CDX-2 and CK20, two of the them were positive for CK7. There was no difference in the expression of CDX-2, CK20 and CK7 between tumors with distinct primary site and tumors with unknown primary site (P>0.05). The expression rate of SATB2 in the cases was 56.3% (18/32), excluding 2 cases of no cell type. There was no significant difference between low grade and high grade tumors in the expression of SATB2 [15/23(65.2%) vs 3/9, P=0.102], also SATB2 was not related to the prognosis of the tumor (P=0.786).</p><p><b>CONCLUSION</b>The prognosis of the mucinous tumor of the peritoneum was significantly different between low grade and high grade according to WHO 2010 classification, and most mucinous tumor of the peritoneum originated from the appendix.</p>

Inhibition of glucosylceramide synthase expression and reversal of multidrug resistance in human breast cancer cells by shRNA / 基础医学与临床

Objective To construct the plasmid containing short hairpin RNA (shRNA) of GCS in order to suppress the expression of GCS and to reverse the multidrug resistance in drug-resistant breast cancer cells. Methods Two reverse repeated motifs of sequence targeting GCS with 6 bp spacer were designed and synthesized in vitro,then they were inserted into the plasmid pSUPER. The recombinant plasmids were transfected into human breast cancer cells. GCS expression was detected by Western blot and immunocytochemistry. caspase-3 expression and its activity were assessed using Western blot and colorimetry,flow cytometry was performed to analyze the ratio of apoptosis. Results MTT method was used to evaluate the 50% inhibition concentration. Enzyme digestion analysis and DNA sequencing confirmed that the recombinant plasmids were successfully constructed. GCS protein content decreased 80%,82% respectively after transfection with recombinant plasmids. The positive rate of GCS expression reduced to 18.1%,16.7% respectively. caspase-3 expression and its activity were significantly higherand the apoptosis of cells increased dramatically. The drug resistance of breast cancer cells to antineoplastic drugs declined significantly. Conclusion shRNA can suppress GCS expression in human drug-resistant breast cancer cells effectively and restore the sensitivity to several antineoplastic drugs.