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Objective To investigate a method to detect the sentinel lymph nodes(SN) of thyroid papillary carcinoma and its predictive value for cervical metastasis of carcinoma. Methods Intraoperative methylene blue dye mapping was performed in 24 cases of thyroid papillary carcinoma. The coincidence rate of frozen section pathology and routine section pathology of SN was observed,and the predictive value of SN for (metastasis) of the cervical lymph nodes was noted. Results SN was successfully detected in 21(87.5%) of 24 cases. The average number of SN was 3 nodes. There was one false negative case, the false negative rate was 4.8%(1/24), and no false positive cases were found. The predictive value of sentinel lymph nodes to (cervical) lymph node metastasis was 83.3%.Conclusions Methylene blue staining to identify sentinel lymph nodes could accurately predict the status of cervical lymph node metastasis of thyroid papillary carcinoma.
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Objective To investigate the expression of C-MET in papillary thyroid carcinoma(PTC) with (cervical) lymph node metastases, PTC without cervical lymph node metastases,follicular thyroid carcinoma and benign thyroid disease and the clinical significance. Methods The expression level of C-MET was examined by immunohistochemical analysis with C-MET monoclonal antibody in 62 cases of PTC with cervical lymph node metastases, 50 cases of PTC without cervical lymph node mestastases, 10 cases of follicular (thyroid) (carcinoma) and 30 cases of benign thyroid disease. Results PTC with cervical lymph node metastases (expressed) significantly greater level of C-MET than the other forms of thyroid carcinoma and benign thyroid disease(P
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Objective To investigate the pathogenistic, clinical and pathologic characteristics and treatment in elder patients with thyroid carcinoma(TC). Methods The clinical and pathologic manifestation, the treatment and prognosis of forty elder patients with thyroid carcinoma were analysed. Results The incidence of TC in elder patients was 14.2% in all of the thyroid carcinomas in the same period. The clinical course was longer and the neoplasm was bigger. A majority of the pathology was follicular adenocarcinoma(35%), followed by adenocarcinoma, undifferentiated carcinoma and pipallary adenocarcinoma. Surgerical management was the primary therapy. 17 cases underwent redical thyroidectomy with neck dissection, 13 total thyroidectomy or subtotal thyroidectomy, 4 palliative resection. Isotopic or radiotherapy as an adjuvant therapy was done if necessary. Five year survival rat was 52.0%, mortality was 45.0% in follow up period. Conclusions The main causes of the poorer prognosis of elder patients with thyroid carcinoma are follows: ① the malignant degree of the tumor is higher; ② the reaction for the tumor in elder patients is duller. So it is important to pay attention to elder patients with thyroid nodule, and an operation should be done as quick as possible.
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Objective To study the relationship between the expression of p16 protein and the biological behavour of thyroid tumor. Methods The expression of p16 protein was examined in fifty cases of thyroid tumor by immunohistochemical staining technique(SABC method). The relationship between p16 protein expression and tumor size, pathological type, differention grading and clinical stage of thyroid tumors were analysed. Results In thyroid adenoma, p16 protein expression was detected in 13 out of 15 cases(86.7%); in thyroid carcinoma p16 protein was expressed only in 16 out of 35 cases(45.7%), the difference was significant(P
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Objective To summary the experience in diagnosis and surgical treatment of differentiated thyroid carcinoma (DTC). Methods The clinical data and follow-up results of 167 cases of DTC were retrospectively analysed. Results (1) The accurate rate of preoperative cytology diagnosis was 76.9%(97/126). (2)121 patients were diagnosed as thyroid carcinoma before or during operation. Histologic examination after primary operation revealed that the carcinoma spread to the isthmus and the opposite lobe in 5 cases. 57 cases were followed up with only 2 cases recurred 2 and 3 years after the operation, and 3 died 6 to 10 months after operation. (3)87.5%(42/48)cases of the reoperation were due to misdiagnosis as benign lesions in primary operation. Histologic examination revealed that residual tumor in the remnant thyroid tissue was found in 45.2%(19/42)cases, and residual tumor in the lymph nodes of the suffered side in 19.0%(8/42)cases. 30 cases were followed up without any recurrence. Conclusions (1) Cytological diagnosis must be paid great attention to preoperatively; (2) Excision of the suffered lobe, isthmus and greater partial of the opposite lobe, along with clearing the enlarged lymphnodes of the isolateral side are generally performed for the DTC; (3) Reoperation due to misdiagnosis as benign lesions in primary operation must remove the remnant tissue of thyroid and the isolateral lymphnodes. The cases should also be followed up even if enough excising is performed in primary operation.
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Objective To study the management and curative effect of the thyroid cancer suspected clinically but with inconclusive frozen-section intraoperatively. Methods The clinical data of 29 consecutive cases of thyroid cancer suspected clinically but with inconclusive frozen-section intraoperatively admitted to our hospital during Jan 1980 to Dec 1999 were analyzed retrospectively. Results Among these 31 suspected patients 29 were negative on frozen-section but confirmed thyroid cancer on postoperative paraffin-section. 20 underwent total involved lobe thyroidectomy in one-stage and other 11 as a second stage. No case recurred or metastased in the follow-up. Complication incidence was significantly different between one-stage and two-stage procedure (P
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Objective To study the diagnosis and treatment of occult thyroid cancer with metastasis. Methods The clinical data of 18 cases of occult thyroid cancer with metastasis were analyzed retrospectively . Results All cases underwent operations. No death occurred during the operation and hospitalization .Postoperative metastasis occurred in 5 cases(27.8%). There was significant difference between the patients with metastasis and the other 100 patients without metastasis(P