Expression of Cyclin D1, Vimentin and Thyroglobulin in Papillary Thyroid Cancer and Its Correlation with Clinicobiological Factors

PURPOSE: An increased expression of cyclin D1 has been observed in several tumors. Vimentin is known to be present in undifferentiated thyroid cancer. The serum thyroglobulin level can be a useful laboratory parameter to detect tumor recurrence in patients suffering with treated, well-differentiated thyroid carcinoma. We performed immunohistochemical assay for the cyclin D1, vimentin and thyroglobulin (Tg) expression in 97 papillary thyroid cancer tissue specimens to investigate their clinical implication for the prognosis of papillary thyroid carcinoma patients. METHODS: Immunohistochemical assays for cyclin D1, vimentin and Tg were performed on 97 consecutive thyroid carcinoma specimens. The correlation between these factors and the clinicobiological parameters weas analyzed. RESULTS: In 97 papillary thyroid carcinoma specimens, the expression of cyclin D1, vimentin and Tg was seen in 64 cases (66.0%), 36 cases (37.1%) and 55 cases (56.7%), respectively. Only the cyclin D1 expression was significantly increased in the larger tumors (P=0.01). However, there was no evident correlation between these factors and gender, age, tumor size, the lymph node status, the TNM stage and the number of tumors. CONCLUSION: An increased expression of cyclin D1 was present in the larger tumors. Overexpression of cyclin D1 seemed to play a role in carcinogenesis and tumor growth. However, the clinical utility of cyclin D1, vimentin and Tg in thyroid cancer patients has to be further defined by prospective studies with larger sample sizes.

Safety of Conservative Treatment of Colonoscopic Perforation

PURPOSE: Colonoscopy is a relatively safe procedure. However, various complications, such as hemorrhage or perforation, can occur, and among them, perforation can lead to death. This study was designed to evaluate the clinical characteristics and the treatment of colonoscopic perforation, as well as the availability of conservative treatment as the initial management. METHODS: We reviewed the medical records of the 11 patients who had been treated for colonoscopic perforation from May 2003 to April 2005. RESULTS: Six perforations were related to diagnostic colonoscopy whereas five occurred from therapeutic colonoscopy. The sigmoid colon was the most common perforation site (6 patients), followed by the cecum 2 patients and the transverse colon, splenic flexure, and the rectum 1 patient each. Five patients were diagnosed during colonoscopy. Six patients were diagnosed 12~48 hours after the colonoscopy. Three patients who showed definite signs of peritonitis underwent emergency operations. A conservative treatment was done in eight patients; among them, one patient had an operation on the 3rd. day after the perforation. The remaining seven patients underwent conservative treatment and were followed for up to 1 month without complications. Among these patients, one patient had a recurrent perforation on the 33rd day after the initial perforation, and an operation was done. CONCLUSIONS: These results suggest that conservative treatment in patients with colon perforations is safe and effective unless there are obvious signs of generalized peritonitis.