Carbon nanoparticle lymph node tracer improves the outcomes of surgical treatment in papillary thyroid cancer.

BACKGROUND: Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy which is generally accompanied by lymph node metastasis. OBJECTIVE: Our study evaluated whether carbon nanoparticle lymph node tracer can improve the outcomes of surgical treatment in papillary thyroid cancer (PTC). METHODS: Ninety-two patients were selected and underwent total thyroidectomy and lymph node resection. Our study placed 45 individuals into the treatment group (carbon nanoparticle group) and 47 cohorts in the control group (no carbon nanoparticle group). RESULTS: Carbon nanoparticle application remarkably improved lymph nodes detection rate in patients (4.7 ± 3.0; P< 0.05) compared to those in control groups (3.5 ± 2.3). The rate of parathyroid accidental resection in the carbon nanoparticle group significantly decreased (6.67%) compared to the control group (21.28%). Incidents of hypoparathyroidism and hypocalcaemia significantly decreased among the carbon nanoparticle cohorts. CONCLUSIONS: Our study definitively showed that carbon nanoparticles can be used to effectively treat lymphatic carcinoma. Our study presented clinical evidences for potential application of carbon nanoparticle in improving the management of PTC patients.

LncRNA PTCSC3 affects drug resistance of anaplastic thyroid cancer through STAT3/INO80 pathway.

BACKGROUND: LncRNA PTCSC3 is a tumor suppressor in thyroid cancer, and its role in drug resistance of anaplastic thyroid cancer (ATC) to chemotherapy drug doxorubicin was investigated in this study. METHODS: Expression of RNA and protein was analyzed by qRT-PCR and western blot, respectively. Flow cytometry was used to analyze the expression rate of CD133+ cells. The endogenous expression of related genes was modulated by recombinant plasmids and cell transfection. Combination condition and interaction between PTCSC3 and STAT3 were determined by RIP and RNA pull-down assay, respectively. MTT assay was performed to detect cytotoxicity. Chromatin immunoprecipitation was conducted to identify interactions between STAT3 and DNA promoter of INO80. RESULTS: LncRNA PTCSC3 was low-expressed in ATC tissues and cells. Over-expressed PTCSC3 inhibited the drug resistance of ATC to doxorubicin. PTCSC3 negatively regulated STAT3, and STAT3 promoted expression of INO80. PTCSC3 regulated INO80 through STAT3. PTCSC3 suppressed stem cells properties and drug resistance of ATC to doxorubicin. CONCLUSION: LncRNA PTCSC3 inhibits INO80 expression by negatively regulating STAT3, and thereby attenuating drug resistance of ATC to chemotherapy drug doxorubicin.

Stimulating dissecting instruments during neuromonitoring of RLN in thyroid surgery.

OBJECTIVES/HYPOTHESIS: During intraoperative neuromonitoring (IONM) of recurrent laryngeal nerve (RLN) in thyroid surgery, the need for frequent shifting between the dissecting instruments and stimulating probe is troublesome and time-consuming. Therefore, use of these two instruments in combination would be a noticeable future direction. This study aimed to investigate the feasibility and safety of using stimulating dissecting instruments (SDIs) that combine the function of surgical dissection and nerve stimulation during IONM. STUDY DESIGN: Prospective outcomes research. METHODS: One hundred consecutive patients with 168 RLNs at risk were enrolled. We developed prototypes of SDIs and applied them to early detect adverse EMG changes during the risky phase of RLN dissection. In the case of substantial EMG change (amplitude decrease > 50%) during dissection, the surgical maneuver was paused and thyroid traction was released immediately. RESULTS: The application of SDIs was feasible in all cases and did not result in any morbidity. Nineteen RLNs were detected with substantial EMG change that was caused by traction stress during dissection with SDIs and that featured progressive gradual EMG recovery after releasing thyroid traction. After thyroid resection, 10 RLNs had a weak point of nerve conduction detected at region of Berry's ligament, but only one nerve with 79% amplitude reduction developed postoperative temporary vocal palsy. CONCLUSION: The application of SDIs is a simple and effective way to monitor the nerve's function instantly during the risky phase of RLN injury in thyroid surgery. It provides surgeons with real-time feedback of EMG response and can be applied as a tool for the early detection of adverse EMG change caused by traction distress. LEVEL OF EVIDENCE: 4.

Differential expression profiling and functional analysis of microRNAs through stage I-III papillary thyroid carcinoma.

OBJECTIVE: To elucidate the mechanisms undergoing the pathogenesis of PTC, this study try to find stage specific microRNAs (miRNAs) using microarray chip in stage I, II and III papillary thyroid carcinoma (PTC) tissues as well predict miRNAs binding target genes and their molecular functions. METHODS: PTC specimens of stage I, II, and III and their paired adjacent non-tumor tissue (one patient for each stage) were collected. The expressions of miRNAs were examined using miRNA microarray chip. The most significant changed miRNAs from microarray were verified by using quantitative RT-PCR. The Potential miRNAs regulating target genes and their preliminary biological functions were forecasted with variety function prediction software. RESULTS: Ten miRNAs exhibited sequential up regulation expression profiles and five miRNAs performed sequential down regulation throughout stage I to III (p<0.05). After normalization, Fifteen miRNAs showed significant different compared to adjacent non-tumor tissues (p<0.05). Among of them, the most significant up regulation and down regulation miRNAs were miR-146b-5p and miR-335, respectively. Both of them were verified with qRT-PCR. 34 target genes for miR-146-5p and 36 target genes for miR-335 was predicted. CONCLUSION: MicroRNA profile assay successfully detected a branch of differential expression miRNAs between PTC and normal tissue. Some of them also showed stage specific. Biological function analysis showed that target genes were involved in five aspects including cell proliferation, differentiation, apoptosis, cycle, and signaling transduction pathway, suggesting the regulatory role of abnormal expression of critical miRNAs in the pathogenesis of PTC.

[Correlation of FHIT expression to cell proliferation and metastasis of laryngeal squamous cell carcinoma].

BACKGROUND & OBJECTIVE: Fragile histidine triad (FHIT) gene, a candidate tumor suppressor gene, located at 3pl4.2, spans the most common fragile site, FRA3B, in human genomes. It is altered in many human cancers, such as head and neck squamous cell carcinoma. This study was to investigate correlation of FHIT expression to cell proliferation and metastasis of laryngeal squamous cell carcinoma (LSCC). METHODS: Expression of FHIT protein, and proliferating cell nuclear antigen (PCNA) was detected by SP immunohistochemistry in 41 specimens of LSCC and their matched adjacent non-cancerous epithelium (NCE). RESULTS: Positive rates of FHIT in NCE, and LSCC were 100.0% (41/41), and 46.3% (19/41) (P< 0.01); in LSCC of stage I-II, and stage III-IV were 69.6% (16/23), and 16.7% (3/18) (P< 0.01); in lymph node metastasis group, and no metastasis group were 20.0% (3/15), and 61.5% (16/26) (P< 0.05). PCNA labeling indexes in NCE, and LSCC were (9.98+/-2.34)%, and (50.71+/-13.64)% (P< 0.01). In LSCC, expression of FHIT negatively correlated with PCNA (P< 0.05). CONCLUSION: Low expression of FHIT might play an important role in cell proliferation and metastasis of LSCC, FHIT might be a useful marker for evaluating biological behaviors of LSCC.

Surgical treatment of 1360 cases of Budd-Chiari syndrome: 20-year experience.

BACKGROUND: Budd-Chiari syndrome (BCS) is a disease caused by blood flow obstruction of the main hepatic veins (MHVs) and/or the outlet of the inferior vena cava (IVC), characterized by retrohepatic portal hypertension (PHT) and/or IVC hypertension. In the past decade, over 3000 cases of BCS have been reported in China. This study was to sum up our 20-year experience in surgical treatment of BCS and to investigate its pathological classification and principles of surgery. METHODS: The data from 1360 BCS patients were analyzed retrospectively. RESULTS: Four types (6 subtypes) were classified according to IVC angiography and hepatovenography: type Ia (594 patients), type Ib (123), type II (292), type IIIa (237), type IIIb (112), and type IV (2). Surgical procedures included: improved splenopneumopexy (265 cases), finger or balloon membranotomy (407), radical resection of membrane and thrombus (275), IVC bypass (88: cavocaval transflow 71 cases, and cavoatrial transflow 17 cases), mesocaval C-shape shunt (192), splenocaval shunt (32), splenoatrial shunt (23), splenojugular shunt (57), mesoatrial shunt (8), and combined methods (6), including plenal-cavoatrial shunt (4), and mesocavoatrial shunt (2), splenorenal shunt (4), mesojugular shunt (2), and other methods (1). The perioperative death rate and the complication rate after operation was 3.09% (42/1360) and 14.8% (201/1360) respectively. 885 cases were followed up from 9 months to 15 years (average 6.8+/-1.2 years. The 791 (89.4%) of 885 patients were successfully treated, 61 patients (6.89%) had a recurrence, and 33 died. CONCLUSION: Surgical treatment of BCS is dependent on a correct diagnosis and classification of the disease.