The role of thyroglobulin in diagnosis of lateral cervical lymph node recurrence in papillary thyroid cancer after radioiodione therapy / 中华普通外科杂志

Objective:To evaluate the role of Tg in diagnosis of lateral cervical lymph node recurrence in papillary thyoid cancer(PTC)after radioactive iodine(RAI) therapy.Methods:From Jan 2012 to Aug 2018, 22 PTC patients who received RAI therapy after operation were reoperated for lateral cervical lymph node recurrence. The clinical data was retrospectively analyzed.Results:The median recurrence time was 30.5 (5-86) months. All 22 patients received RAI therapy after the first operation, and the median dose of RAI was 250mCi(100-700 mCi) and the episode of RAI therapy ranged from 1 to 4. All 22 PTC patients underwent neck reoperation, among which 20 cases were identified to have lymph node metastasis. The median number of lymph nodes dissected was 31 (8-83) and median number of metastatic lymph nodes was 4 (1-19) . The diagnostic accuracy of ultrasonography in detecting lymph node metastasis was 90.9%. Before reoperation, the median Tg was 1.305 (0.10-99.51) μg/L, with the cutoff value of Tg being 0.2 μg/L, and its sensitivity and specificity were 80.0% and 100%, respectively. The median stimulated Tg was 5.89 (0.14-255.80) μg/L in the 10 patients, with the cutoff value of stimulated Tg of 2 μg/L, and its sensitivity and specificity were 88.9% and 100%, respectively.Conclusions:The serum Tg level is helpful for monitoring the recurence of PTC, but recurrence cannot be completely ruled out for those with low Tg.

Correlation between BRAF mutation and clinicopathological characteristics in pediatric papillary thyroid carcinoma / 中华实用儿科临床杂志

Objective:To investigate the BRAF(V600E)gene mutation of pediatric papillary thyroid carcinoma (PTC) and refine their clinicopathological correlates. Methods:Tumor tissue samples of pediatric PTCs (≤18 years old) were collected from tumor tissue bank of Tianjin Medical University Cancer Institute and Hospital from January 2012 to December 2016.The medical records of 22 patients with pediatric PTC were reviewed retrospectively.The frequencies of BRAF(V600E) mutation were evaluated and the correlation between BRAF(V600E) mutation and clinical characteristics were analyzed. Results:BRAF(V600E) mutations were present in 45.5% of cases (10 cases). BRAF(V600E) mutation in pediatric PTC was obviously lower than that in adults PTC(77.7%) ( χ2=11.250, P=0.001). BRAF(V600E) mutation in>12-year-old group (66.7%) was remarkably higher than that in ≤12-year-old group (20.0%) ( P<0.05). BRAF(V600E) mutation in female (69.2%) was greatly higher than that in male (11.1%) ( P<0.05). There was no significant correlation with BRAF(V600E) mutation and multiple tumor, tumor size, highly invasive subtype, extrathyroidal extension, lymph node metastasis and radiological history of infants (all P>0.05). The median follow-up time was 45 months.No patients died and BRAF(V600E) mutation was not associated with the increase of recurrence rate ( P>0.05). Conclusions:BRAF(V600E)gene mutation in pediatric PTC is lower than that in adults. BRAF(V600E) mutation does not portend a more aggressive clinical biological behavior in pediatric PTC.

Establishing and identification of an immortal cell line of familial papillary thyroid carcinoma with MLH1 R217C/BRAF V600E mutations / 天津医药

Objective To establishing an immortal cell line of familial papillary thyroid carcinoma (FPTC), and explore a new approach for studying familial non-medullary thyroid carcinoma (FNMTC). Methods The specimen from a patient with FPTC was selected, separated, and the primary cells were cultured using DMEM/F12 medium (with TSH, T3, EGF and hydrocortisone). To inducing cell immortalization, the exogenous genes SV40T/TERT were transfected into cells by two ways. RT-PCR was used to detect the expressions of thyroid peroxidase (TPO), thyroid globulin (TG), thyroid stimulating hormone receptor (TSHR) and sodium/iodide co-transporter (NIS). Immunofluorescence method was used to detect the expressions of TPO and GPC3. In order to detect the genomic mutations, the peripheral blood DNA of the patient was extracted. The cell genome was detected. Results The FPTC cells adhered to the plate and showed an irregular polygon shape. The cells can stably grow for six months, FPTC-S (with SV40T transfected) passaged to p26, FPTC cells passaged to p23 and FPTC-ST (with SV40T/TERT transfected) passaged to p19. Both FPTC-S and FPTC-ST can stably express TPO, TG and TSHR in mRNA level. MLH1 R217C mutation existed in the peripheral blood of the patient, and BRAF V600E mutation existed in the primary cultured cells. Either the primary or the immortal cells showed MLH1 R217C mutation. Conclusion This study preliminarily established an immortal cell line of familial papillary thyroid carcinoma with MLH 1 R217C and BRAF V600E mutations. This cell line provides a research model for studying these mutations in FPTC.

Angiosarcoma of the head and face: a retrospective study of 15 patients / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical and pathological characteristics of angiosarcoma of the head and face.</p><p><b>METHODS</b>The data of 15 patients with angiosarcoma of the head and face underwent treatment between January 1993 and January 2003 were reviewed. Of 15 cases 10 were men and 5 women; 11 tumors in scalp and 4 in face; 6 cases of stage I, 3 cases of stage II, 1 case of stage III and 5 cases of stage IV. Clinical symptoms included a focal mass or bruiselike patches. Surgery alone in 5 cases, chemotherapy alone in 3 cases, comprehensive treatment in 5 cases, no treatment in 2 cases. Immunohistochemical staining with CD31, CD34 and FVIIIRag was performed in 8 cases.</p><p><b>RESULTS</b>Follow-up time was 3-240 months with a median of 28 months. One patient of stage I by surgery alone and 2 patients of stage I with comprehensive treatment survived for 121, 209 and 240 months respectively and no recurrence. One patient of stage I with comprehensive treatment was survival for 127 months with tumor burden. Eleven cases died in 3-78 months after diagnosis, the median follow-up time was 20 months. Three year and five year survival rates were 46.7% and 33.3%, respectively. Immunohistochemical staining showed CD31- and CD34-positive for 8 cases and FVIIIRag-positive for 6 cases.</p><p><b>CONCLUSIONS</b>Angiosarcoma of the head and face is a high-risk sarcoma. It is rare and easily misdiagnosed but can be diagnosed properly based on pathological feature. Comprehensive treatment including surgery, radiotherapy and chemotherapy can improve survival rate for the patients with early stage angiosarcoma.</p>

Correlation of BRAFV600E mutation and clinical characteristics in coexistence of papillary thyroid carcinoma and Hashimoto's thyroiditis / 中华内分泌代谢杂志

Objective To investigate the correlation of BRAFV600E mutation with papillary thyroid carcinoma and coexisting Hashimoto's thyroiditis.Methods A retrospective analysis of clinical characteristics was made in 50 patients with PTC and coexisting HT(research group) and 150 PTC patients(control group) from March,2011 to March,2012,regarding the difference in BRAFV600E mutation.Results In research group,the sensitivity of ultrasound in detecting lymphatic metastasis was 88.9％,while the specificity was 50.0％ ; the levels ofTSH,thyroid globulin antibody,and thyroid peroxidase antibody in research group were higher than those in control group (all P＜ 0.01).Rates of lymphatic metastasis (36.0％ vs 54.0％) and metastasis in Ⅱ-V area(22.2％ vs 63.0％) showed statistically significant differences between research group and control group(P=0.041,P=0.004).The respective rates of mutation of BRAFV600Ein two groups were 34.0％ and 70.7％,showing significant difference (P＜0.01).There was a significant correlation between BRAFV600E mutation and lymphatic metastasis in research group (P ＜ 0.01).Conclusions The sensitivity of ultrasound in detecting lymphatic metastasis of PTC is quite satisfactory while with its poor specificity.Combination of ultrasound with the fast frozen section pathology may help assess the scope of surgery.Reduced BRAF V600Emutation in PTC with coexisting HT results in reduction of lymphatic metastasis and may help to improve the prognosis of patients.

Clinico-biological characteristics and prognosis of salivary duct carcinoma in 12 cases / 中华普通外科杂志

Objective To explore the clinico-biological characteristics, treatment and prognosis of salivary duct carcinoma. Methods This study included 12 cases of salivary duct carcinoma treated in our hospital. Clinical data were retrospectively analyzed for patients admitted between April 1995 and October 2006. The clinical characteristics, histological features, imaging, therapy methods and prognosis were analyzed. Results Of 12 salivary duct carcinoma, there were 10 males, 2 females. The age of onset ranged from 53 to 73 year old and the average was 56 year old. Physical examination revealed a firm and unboundary mass accompanied by nerve infiltrating symptom. The histological appearance was characterized by solid cell nests with ductal structures and central comedonecrosis. Extensive resection and radical neck dissection was performed in 11 patients, postoperation radiation done in 10 patients and chemotherapy in 3 patients. One year survival rate was 83. 33% , that of 3 years was 41. 67% , and of 5 years was 25. 00% , the median survival time was 36 months. Conclusion Salivary duct carcinoma is a rare malignant salivary tumor and most patients are men. Regional extensive resection and postoperative radiation or chemotherapy are the mainstay of therapy. Lymph node metastases in level Ⅰ ,Ⅱ , Ⅲ are a common finding in patients with SDC and the prognosis is poor.