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Objective To study the risk factors for thyroid papillary carcinoma in patients aged over 65 years,and to investigate the etiology of thyroid papillary carcinoma.Methods A total of 784 patients with thyroid nodules screened by ultrasound were grouped according to different iodine intakes,gender,age,diet,smoking history and history of radiation therapy.The incidence of thyroid papillary carcinoma was compared among the different groups.Pathogenic factors for thyroid papillary carcinoma were analyzed.Results 55 patients (7.0％) were diagnosed as thyroid papillary carcinoma among 784 patients.Gender,age,iodine intake,smoking history and history of radiation therapy were the pathogenic factors for papillary thyroid carcinoma.Thyroid papillary carcinoma was common in older women,patients with high-iodine intake and patients with the history of radiation therapy.The incidence of thyroid papillary carcinoma was higher in patients with high iodine intake than with normal-iodine intake or low-iodine intake [22.8％ (31/136) vs.1.9％％ (10/517),10.7％ (14/131),x2 =75.07,P＜0.01].The incidence of thyroid papillary carcinoma was higher in female than in male elderly patients [8.0％ (49/612) vs.3.5％ (6/172),P＜0.05].The incidence of thyroid papillary carcinoma was higher in patients with the history of radiation therapy than without the history of radiation [11.6％ (14/121) vs.6.2％ (41/663),P＜0.05].Conclusions The main risk factors for thyroid papillary carcinoma are living environment,gender,age,diet,smoking history and history of radiation therapy,which are more influenced by external factors.
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En esta revisión de literatura, proponemos aclarar conceptos almomento de tomar decisiones en la consulta por carcinomamedular de tiroides (CMT). Lo hemos dividido en 4 etapas:diagnóstica, terapéutica, seguimiento, recurrencias òpersistencias. El CMT es un tumor originado en las células Cparafoliculares, capaz de secretar calcitonina y con característicasclínico-terapéuticas que lo diferencian de los tumoresdiferenciados y lo acercan a los anaplásicos (no responden a laTSH y no captan yodo131). Representa el 5 al 10% de los cancerestiroideos y es responsable del 14% de las muertes debido a cáncertiroideo. Se dividen en esporádico (80%) y familiar (20%), estosúltimos pueden ser MEN2a (70%) y MEN2b (28%) y no MEN (2%),todos de transmisión autosómica dominante. Por ahora la cirugíasigue siendo el único tratamiento que permite la curaciónbioquímica y clínica de la enfermedad. Tanto la quimioterapia comola radioterapia carecen de resultados beneficiosos para losenfermos.
In this literature review, we intended to clarify on concepts to makedecisions in the consultation for thyroid medullary carcinoma(CMT). We divided it in 4 stages: diagnostic, treatment, follow-up,relapsing or persistence. The CMT is a tumor originated in the "C"parafollicular cells, which is able to secrete calcitonin (CT) and withclinical-therapeutic characteristics that differentiate it of the welldifferentiated tumors and make them similar to the anaplastic type,as they do not respond to the TSH and nor capture Iodine131. It5epresents 5 to 10% of thyroid cancers and it is responsible for 14%of the deaths due to thyroid cancer. They are divided in sporadic(80%), and familiar (20%), these last ones being MEN2a (70%) andMEN2b (28%) and non-MEN (2%), all having dominant autosomictransmission. Up to now, surgery continues being the onlytreatment that allows the biochemical and clinic cure of the illness.Both chemotherapy and radiation therapy lack beneficial results.
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Objctive:To investigate the immunohistochemical and morphological characteristics of the papillary thyroid microcarcinoma(PTM) ,and differential diagnosis of the related disease.Methods:The morphological characteristics of 223 patients with PTM were observed under light microscope.Seventy-four cases of PTM and 32 cases of proliferative lesion of thyroid were observed under light microscope with stains of hematoxylin and eosin and immunohistochemical staining.The antibody included CK19,MC,Galectin-3 and CD56.Results:Eighty-six cases were follicular-patterned and 31 cases nuclear features were untypical in 223 cases of PTM.The positive expression rates of CK19、MC、 Galectin-3、CD56 were 100.0%,98.6%,98.6% and 4.1% in 74 cases of PTM,and were 37.5%,12.5%,18.8%,68.8% in proliferative lesion of thyroid,respectively.Conclusion:Some cases of PTM show a follicular-patterned and the nuclear features.It is untypical compared with classical papillary thyroid carcinoma.It can be differentiated from proliferative lesion with absence of envelope,obviously various and unusually proliferated follicular cells,sclerotic stroma,neoplastic follicles among the collagen and normal follicles.The wide and intensive expression of CK19,Galectin-3,and the negative expression of CD56 are extremely useful in the diagnosis of PTM,four-marker panel with CK19,Galectin-3,MC and CD56 can improve the specificity and accuracy of the differential diagnosis of PTM.