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Objective To study the pathogenic features, diagnosis and treatment of aberrant thyroid cancer.Methods A retrospective analysis of clinical and pathological data of 29 cases of aberrant thyroid cancer was made.Results All of the 29 patients underwent operative treatment and postoperative adjuvant radiation therapy and chemotherapy. On postoperative follow up, the 5-year survival rate was 52.0%. The longest survivor patient was alive 24 years after operation.Conclusions The key to increase the survival rate of patients is early detection and timely surgical treatment. Postoperative adjuvant radiation therapy and chemotherapy are conducive to increase survival rate.
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Objective To study the approach to improving the diagnosis and treatment of thyroid cancer(TC). Methods Problems regarding to the diagnosis and treatment of TC had arisen based on the combination of auther's clinical experience and recent literatures review. Results and Conclusions (1) In the diagnosis of TC, attention should be paid to the following conditions: cystocarcinoma, multicentral cancer, bilateral TC, coexist of benign thyroid diseases with TC, and the microcancer of thyroid etc. (2) Biopsy should be done during and after operation for the thyroid nodule needed to be operated, to avoid misdiagnosis of TC. (3) Except undifferentiated carcinoma, the choice of treatment of TC is surgery. The choice of operative procedure should be according to the pathological type and clinical stage of TC, and patient's condition. (4) Thyroid hormone suppression therapy should be administrated after operation. (5) Posterative radiotherapy can promote the long term survival rate. (6) Reoperation should be performed immediately, if the thyroid nodule is TC and comfired by pathological examination posteratively, and a subtotal thyroidectomy or nodule local resection performed on for that nodule initially, to avoid the residual cancer and cancer recurrence in the residual thyroid tissues.
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Objective To improve the recognition, diagnosis and treatment of synchronous bilateral thyroid carcinoma(SBTC). Methods The diagnosis and treatment of 11 patients with SBTC were analysed. Results Of them, 9 patients were well differentiated cancer, 1 medullary cancer, 1undifferentiated cancer. The diagnosis was comfirmed by needle aspiration biopsy(NAB) in 2 cases preoperatively, by frozen section in 4 cases intraoperatively. Among the 11 patients, total thyroidectomy was performed on 4 patients, near total thyroidectomy on 7 patients; functional neck dissection(FND) on 7 patients. Ten patients were followed up for 1～2 years (average 4 years and 9 months), only 1 patient died; 9 patients were alive and 8 were free of cancer. Conclusions The diagnosis of SBTC is difficult before operation, so for suspicions patient of SBTC, preoperative NAB or intraoperative frozen section should be done to make the diagnosis. The choice of surgery for SBTC is near total thyroidectomy. FND should be done, if the patient has indication of FND, but a preventing FND is not advocated.
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Objective To investigate the value of detection of telomerase activity by fine needle aspiration biopsy (FNAB) of thyroid mass in the preoperative diagnosis of thyroid cancer. Methods Comparation of the results of detection of telomerase activity and biopsy of the of samples of thyroid masses aspirated by fine needle guided by B-us were performed .The results were compared to the postoperative pathological results. Results Of the 32 cases of thyroid carcinomas, the correct diagnostic rate of FNAB was 43.8%, while the positive rate of telomerase activity was 75.0%, the difference between the two examinations was significant ( P
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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 clinical characteristics, surgical treatment and prognosis of thyroid carcinoma in children. Method The clinical data of 25 children with thyroid carcinoma undergoing operative treatment from 1980 to 2001 were analyzed retrospectively. Results 25 children all underwent surgical treatment .Of them,17 were papillary carcinomas,3 papillary carcinomas with follicular elements,3 follicular carcinomas,1 medullary carcinoma and 1 fibrosarcoma. 21 children were followed up periodically from 4 months to 18 years (average time 6years). There were two deaths in the followed-up period,1 died of pulmonary insufficiency in extensive pulmonary and cervical lymph nodes metastases two years after the operation; 1 died of fibrosarcoma recurrence. The other children were all alive in good condition. Conclusions Most of the thyroid carcinoma in children are papillary carcinomas, and the prognosis is usually excellent. Operation is the main therapeutic method. A proper surgical procedure is major approach in treatment. Re-operation is also necessary, and might get a long-term survival even if the patient has recurrent thyroid carcinoma with cervical lymph node metastases.
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Objective To study the value of p27 and Ki-67 detection in differentiating benign from malignant thyroid follicular neoplasms. Methods Labelling index (LI) of thyroid neoplasms from thyroidectomy specimens were detected immunohistochemically Results The normal thyroid group had the highest expression of p27 , and the lowest expression of Ki-67. There was significant difference in the expressions of p27 and Ki-67 between follicular thyroid adenomas (FA) and follicular thyroid cancers (FTC) (P
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Objective To investigate the diagnosis and treatment of nodular goiter with thyroid carcinoma.Methods The clinical data of forty cases of nodular goiter with thyroid carcinoma admitted to our hospital from January 2005 to December 2007 were retrospectively analyzed.Results Among the 40 cases,only four cases were preoperatively diagnosed as nodular goiter with thyroid carcinoma.All cases received operation and the diagnosis were comfirmed by frozen section examination.Various modes of thyroidectomy were performed according to the pathological results,including four cases had unilateral total thyroidectomy,27 had unilateral total thyroidectomy combined with opposite subtotal thyroidectomy,one case had bilateral subtotal thyroidectomy,and eight cases of bilateral total thyroidectomy.Of all 40 cases,11 cases received unilateral cervical lymph node dissection.There were only three cases occurred convulsion or numbness,and no hoarseness occurred postoperatively.Compared to simple nodular goiter,the incidence of calcification in nodular goiter with thyroid carcinoma was significantly increased(P
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Objective To study the clinical characteristics of thyroid carcinoma in young females,in order to improve the diagnosis and treatment of this disease.Methods The clinical data of 74 consecutive young female patients with thyroid carcinoma treated in our hospital in the recent ten years were analysed.In most of the cases,there was no firm texture or fixation of the thyroid nodules to surrounding structures on physical examination before operation.Ultrasonography was performed in all patients and multiple thyroid nodules were found in 61 cases(82.43%).Thyroid scintiscans were performed in 43 cases,and thyroid nodules were found in 41 cases.The cold,cool and warm nodules were found in 14,18 and 9 cases,respectively,by scintiscans.Fine needle aspiration biopsy(FNAB) was performed in 11 cases,and in 2 cases were negative,1 case showed abnormal cell,3 cases were suspicious of carcinoma,and 5 cases were confirmed papillary carcinoma.Results Papillary carcinoma was found in 70 cases,follicular carcinoma in 3 cases and medullary carcinoma in 1 case by histological examination,and benign disease was also accompanied in most cases.Lymph node metastases was found in 28 cases(37.84%),and the rate of metastases was significantly different than that of older female patients(16.46%) at the same time.There were 2 cases who died 3 years after operation because of metastases.Conclusions The lymph node metastases were prevalent in young female patients with thyroid carcinoma.The texture and mobility of the nodules cannot be used to differentiate benign from malignant nodules.We should carefully analyze every nodule found on ultrasonography.For the solid nodules with diameter larger than 1.0cm,we suggest operation;for the non-solid nodules with diameter larger than 2.0cm,we prefer scintiscans and FNAB for diagnosis.