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Context: We analyzed the clinical features and ultrasound image features of follicular thyroid carcinoma (FTC) and follicular thyroid adenoma (FTA). Aims: This study aimed to identify ultrasonographic differences and correlations between FTC and FTA. Meanwhile, ultrasonographic manifestations of thyroid follicular tumor were also retrospectively analyzed. Settings and Design: Using pathological results as the gold standard, the clinical and ultrasonic image characteristics of FTA and FTC were statistically analyzed, and the differences were analyzed. Materials and Methods: A total of 304 patients who were diagnosed with FTC or FTA by pathology after thyroidectomy from March 2009 to March 2018 were enrolled in this study. Their ultrasonic images were analyzed; image features were extracted and correlation analyses for these features were conducted. Differences in ultrasonic images between FTC and FTA were also compared. Statistical Analysis Used: Independent sample t-test; Wilcoxon rank sum test; A Chi-square test: Univariate and multivariate logistic regression analyses. Results: When performing ultrasound diagnosis, attention should be paid to identify FTC and FTA in terms of age, nodular goiter conditions, nodular boundary conditions, internal echo, calcification, blood flow signals, thyroid imaging reporting and data system (TI-RADS) grading and cystic solidity conditions. Moreover, a multivariate logistic regression showed that the boundaries were unclear, and cystic degeneration, TI-RADS, hypoecho, nodular goiter, macrocalcification and microcalcification were associated with FTC. Among them, macrocalcification is a protective factor for thyroid follicular tumors, and other indicators are risk factors. Conclusion: Ultrasound can provide valuable information for the identification of follicular neoplasms, but further research in this area is still necessary
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Objective@#To explore the molecular characteristics of follicular variant papillary thyroid carcinoma (FVPTC), follicular thyroid adenoma (FTA) and follicular thyroid carcinoma (FTC), and investigate their role in tumorigenesis, differential diagnosis and prognosis evaluation in patients with follicular thyroid neoplasm.@*Methods@#We retrospectively analyzed 50 surgical resection samples of follicular thyroid neoplasm. DNA was obtained from formalin-fixed, paraffin-embedded tissue, and subjected to next-generation sequencing (NGS) to analyze 50 hotspots for mutation in genes.@*Results@#47 samples passed quality control, including 29 FVPTCs, 8 FTAs and 10 FTCs. 75.9% of FVPTCs harbored mutated genes: BRAF V600E (31.0%, 9/29) was the most frequent, followed by TP53 (27.6%, 8/29), and N/KRAS (20.7%, 6/29). In contrast, 37.5% (3/8) FTAs carried NRAS Q61R mutation with 12.5% (1/8) FTA carrying mutated BRAF G466E. 20% (2/10) FTCs harbored NRAS Q61R mutation, and 20% (2/10) FTCs with TP53 mutations. BRAF V600E gene mutation only appeared in FVPTC, and was associated with age of onset and lymph node metastasis. There was no significant correlation between N/KRAS mutations and clinical pathologic features. Patients with lymph node metastasis group seems to have more TP53 mutation.@*Conclusions@#BRAF V600E gene mutation can be used to identity FVPTC from FTA/FTC. N/KRAS mutations cannot be used as the exclusive indicator of benign and malignant in thyroid follicular tumor. TP53 mutations play an important role in the process of follicular thyroid neoplasm, indicating more aggressive behavior and poor prognosis.
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Com o uso da ultra-sonografia de alta resolução, a prevalência de nódulos tem aumentado e, conseqüentemente, o número de punção aspirativa por agulha fina (PAAF), que é o método de escolha para diagnóstico inicial. Um dos maiores dilemas clínicos para o citologista é o diagnóstico diferencial das lesões foliculares comumente agrupadas na classe padrão folicular. Neste artigo de revisão, discutiremos quais são as lesões que podem ser assim classificadas e os marcadores moleculares, identificados por nós ou por outros grupos, que são capazes de distinguir as lesões benignas das malignas.
There are an increasing number of thyroid nodules found by ultrasound and sampled by fine needle aspiration (FNA). A clinical problem is the accurate distinction between benign and malignant forms of follicular lesion. In this review we discuss the thyroid lesions that are common sources of diagnostic error, and grouped together as follicular patterned lesion, and the molecular markers identified by us and others, and that are able to distinguish the benign from the malignant ones.
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Humanos , Adenocarcinoma Folicular/diagnóstico , Adenoma/diagnóstico , Neoplasias de la Tiroides/diagnóstico , Nódulo Tiroideo/diagnóstico , Biomarcadores de Tumor/análisis , Adenocarcinoma Folicular/genética , Adenoma Oxifílico/diagnóstico , Adenoma Oxifílico/genética , Adenoma/genética , Arginina/genética , Biopsia con Aguja Fina , Diagnóstico Diferencial , Perfilación de la Expresión Génica , Inmunohistoquímica , Proteínas de la Membrana/genética , Análisis de Secuencia por Matrices de Oligonucleótidos , Factores de Transcripción Paired Box , PPAR gamma/genética , Sensibilidad y Especificidad , Factor de Transcripción CHOP , Neoplasias de la Tiroides/genética , Nódulo Tiroideo/genética , Biomarcadores de Tumor/genéticaRESUMEN
0.05).Tn-C、CD44v6 were negative expression in group C.Conclusion Tn-C、CD44v6 protein are useful in early diagnosis of follicular thyroid carcinoma.