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Objective:To examine the expression of MHC class Ⅱ in medullary thyroid carcinoma(MTC) and analyze its clinical significance.Methods:98 MTC patients treated at Tumor Hospital of Tianjin Medical University from Jan 2010 to Dec 2018 were included for the study. Immunohistochemistry was used to detect the expression of MHC class Ⅱ molecule .Results:The high expression of MHC class Ⅱ was not correlated with age (χ 2=0.900, P=0.410), multifocal (χ 2=0.295, P=0.672), bilateral (χ 2=2.957, P=0.127), T stage (χ 2=0.554, P=0.457), but correlated with gender (χ 2=5.227, P=0.025), preoperative calcitonin level (χ 2=6.663, P=0.019), lymph node metastasis (χ 2=21.651, P<0.001) and AJCC stage (χ 2=19.522, P<0.001). Overall survival rate of patients with high expression of MHC class Ⅱ was 97.4%.It was significantly higher than that of patients with low expression 66.1% ( P=0.016 3). COX regression model showed that age >55 years old ( HR=4.129, P=0.009), T stage ( HR=3.265, P=0.024) were independent risk factors for the prognosis of MTC patients. High expression of MHC class Ⅱ molecules ( HR=0.103, P=0.030) was a protective factor for the prognosis of MTC patients. Conclusion:The MTC patients with high expression of MHC class Ⅱ have a better prognosis.
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Objectives To study the clinical characteristics,diagnosis,treatment and prognosis of cancer metastases to the thyroid gland.Methods At Tianjin Medical University Cancer Hospital,from 1980 to 2016 30 patients were identified with a metastatic malignant tumor of the thyroid gland.Results Primary tumor sites were in the esophagus (26.7％),lung (16.7％),and kidney (13.3％).The median age at discovery of thyroid metastasis was 56 years old.The time lapse ranged from 0 to 108 months.There were 18 patients with metachronous metastasis with median survival of 36 months,12 patients were with synchronous metastasis,and the median survival was 8 months (P ＜ 0.01).20 patients were treated with thyroid surgery,and of which 15 patients were given post-op radiotherapy and chemotherapy.Patients who underwent thyroid resection had a median survival of 15 months,while that was 8 months in those without thyoid surgery (P ＜ 0.01).Conclusions Metastases to the thyroid gland is a rare clinical phenomenon,the prognosis of patients is mainly related to the biological behavior of primary tumors,but surgical resection and combined treatment can increase the survival rate.
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Thyroid carcinoma is the most common cancer that affects the endocrine system.With the development of research meth-ods and techniques of various disciplines,the clinical diagnosis,treatment,and understanding of thyroid carcinoma are constantly pro-gressing.In the latest edition of the National Comprehensive Cancer Network(NCCN)guidelines,the preoperative evaluation of thy-roid nodules,the mode and range of the operation,and the treatment involving postoperative thyroid stimulating hormone(TSH)sup-pression have changed,all of which can provide a reference for the diagnosis and treatment of thyroid nodules.
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Objective To investigate the retrobulbar hemodynamic changes in elderly patients with ischemic ophthalmopathy(IOP).Methods Three groups of 35 elderly unilateral IOP(n=35 patients),32 elderly normal eye(n=32 volunteers)and 30 non-elderly normal eye(n=30 volunteers) were recruited in our hospital for the IOP or not,for elderly(aged≥60)or not(aged ＜60).The peak systolic velocity(PSV),end-diastolic velocity(EDV),resistance index(RI),color Doppler blood stream spectrum form and arm-retinal circulation time(A-RCT) in both ophthalmic artery(OA) and central retinal artery(CRA)were measured on three groups by color Doppler flow imaging(CDFI)and fundus fluorescein angiography(FFA).Results Compared with elderly normal eye group,or with non-elderly normal eye group,the elderly unilateral IOP group showed that PSV and EDV of both OA and CRA were decreased,RI was increased,CD blood stream spectrum form was changed and A-RCT was prolonged(all P＜0.05).Compared the non-elderly normal eye group,the elderly normal eye group showed that the difference in PSV,EDV,RI,A-RCT had no statistical significance(all P ＞0.05),while CD blood stream spectrum form was changed(P＜0.05).Conclusions In the elderly unilateral IOP patients,PSV and EDV of both OA and CRA are decreased,RI is increased,blood stream spectrum form is changed,and A-RCT is prolonged.The color Doppler uhrasound-detected hemodynamic changes are displayed clearly so that CDFI can provide a reliable evidence for clinical diagnosis of IOP.