Assessment of age as different variable types for determining survival in differentiated thyroid cancer.

PURPOSE: The current tumor, node, metastasis (TNM) system uses an age of 55 years as a threshold for differentiated thyroid cancer (DTC). The aim of our study was to explore the concept of using age as a continuous variable. METHODS: A total of 36,559 patients with DTC in the Surveillance, Epidemiology, and End Results (SEER) database and 7491 patients in our centers were enrolled. Overall survival (OS) and cancer-specific survival (CSS) were compared. Furthermore, the different statistical model performance of the 6th edition TNM system and age cutoffs for papillary (PTC) and follicular thyroid cancer (FTC) were assessed. Then, a nomogram was built and validated to evaluate the efficacy of age as a continuous variable for predicting survival. RESULTS: The OS and CSS of patients with DTC were significantly increased in patients <55 years compared with those aged ≥55 years. However, no significant differences in prognosis were observed in certain groups as patients between 50 and 60 years were stratified by 1-year increments. Furthermore, the highest concordance index (C-index) was observed in the TNM staging without an age cutoff in SEER database (0.895), our two centers (0.877) and receiver operating characteristic (ROC) curves showed different age cutoffs for PTC and FTC. More importantly, the nomogram incorporating age as a continuous variable showed a favorable area under the ROC curve and calibration for training and validation groups. CONCLUSIONS: The utilization of age as a continuous variable is a rational approach for predicting outcome in DTC patients.

Prognostic implications of extranodal extension in papillary thyroid carcinomas: A propensity score matching analysis and proposal for incorporation into current tumor, lymph node, metastasis staging.

BACKGROUND: The current American Joint Committee on Cancer tumor, lymph node, metastasis cancer staging system for papillary thyroid carcinoma places low weight on extranodal extension. This study examined the prognostic implications of extranodal extension in papillary thyroid carcinoma patients and attempted to design a new staging system incorporating extranodal extension. METHODS: We reviewed data from 6,165 consecutive papillary thyroid carcinoma patients from 2012 to 2018. Patients with extrathyroidal extension or extranodal extension were included and then divided into 3 groups: extrathyroidal extension (papillary thyroid carcinoma with extrathyroidal extension but without extranodal extension, N = 457); extranodal extension (papillary thyroid carcinoma with extranodal extension but without extrathyroidal extension, N = 116); and extrathyroidal extension and extranodal extension (papillary thyroid carcinoma with both extrathyroidal extension and extranodal extension, N = 116). Recurrence-free survival and cancer-specific survival were compared before and after adjusting for differences using propensity score matching owing to observed heterogeneity in baseline characteristics in the original cohort. Recurrence-free survival and cancer-specific survival were also compared between patients with and without extranodal extension after matching at a 1:1 ratio. Cox proportional hazards regression analyses were used to identify the relationships of factors associated with structural recurrent disease in the node-positive subset. Then a new staging system incorporating extranodal extension was established, and the discrimination of the new staging system for recurrence-free survival and cancer-specific survival was investigated. RESULTS: Of the 6,165 patients with papillary thyroid carcinoma, extrathyroidal extension was found in 573 (9.3%) patients, and extranodal extension was observed in 232 (3.8%) patients. The recurrence-free survival and cancer-specific survival rates of patients with extranodal extension were similar to those of patients with extrathyroidal extension (all P > .05). Patients with extrathyroidal extension and extranodal extension experienced worse recurrence-free survival than patients with extrathyroidal extension or extranodal extension and even worse cancer-specific survival than patients with extrathyroidal extension (all P < .05). The recurrence-free survival and cancer-specific survival rates of patients with extranodal extension were worse than those of patients without extranodal extension (P = .003; P = .048). Cox proportional hazards regression analysis demonstrated that after propensity score matching, extranodal extension (hazard ratio 1.911; 95% confidence interval 1.568-3.609; P < .001) remained an independent predictor of structural recurrent disease in patients with node-positive papillary thyroid carcinoma. After incorporating extranodal extension into the current tumor, lymph node, metastasis classification, the new staging system presented a better discrimination for recurrence-free survival and cancer-specific survival for those with lymph node metastasis. CONCLUSION: Papillary thyroid carcinoma patients with extranodal extension present worse prognosis, and incorporating extranodal extension in tumor, lymph node, metastasis classification identifies poor-risk patients more accurately.

Effect of preoperative 25 hydroxyvitamin D deficiency on posoperative parathyroid function in patients with papillary thyroid cancer / 中华内分泌外科杂志

Objective:To investigate the effect of 25 hydroxyvitamin D [25 (OH) D] on postoperative parathyroid function in patients with papillary thyroid carcinoma (PTC) .Methods:426 patients who diagnosed as PTC and underwent at least total thyroidectomy plus central lymph node dissection (including lateral lymph node dissection) in Center of Thyroid and Parathyroid Surgery of West China Hospital, Sichuan University, from Jun. 2017 to Sep. 2019 were retrospectively analyzed. Among them, 313 were women and 113 were men, they were divided into vitamin D deficient (VDD) group ( n=297) and normal group ( n=129) according to preoperative 25 (OH) D levels ≤ 20ng/ml and > 20ng/ml. SPSS 23.0 statistical software was used for data processing. Pearson χ2 test or Fisher exact test were used to compare the incidence of clinical hypoparathyroidism, biochemical temporary and biochemical permanent hypoparathyroidism between the two groups. Univariate and multivariate logistic regression analysis were used to analyze the related factors of postoperative hypoparathyroidism between the two groups. Results:Preoperative 25 (OH) D level was significantly correlated with postoperative biochemical temporary hypoparathyroidism ( P=0.04, OR=1.11) . Compared with patients with adequate preoperative vitamin D, preoperative vitamin D deficiency increased the risk of biochemical transient hypoparathyroidism by 6.67 times ( P=0.03;OR=6.67) . There was no significant correlation between preoperative vitamin D deficiency and early postoperative clinical hypoparathyroidism (2.7% vs 3.9%, P=0.55) . Conclusion:Correction of vitamin D deficiency before operation may reduce the incidence of postoperative temporary hypoparathyroidism caused by 25 (OH) D deficiency.

Mucin-type O-glycosylation Landscapes of SARS-CoV-2 Spike Proteins

The densely glycosylated spike (S) proteins that are highly exposed on the surface of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) facilitate viral attachment, entry, and membrane fusion. We have previously reported all the 22 N-glycosites and site-specific N-glycans in the S protein protomer. Herein, we report the comprehensive and precise site-specific O-glycosylation landscapes of SARS-CoV-2 S proteins, which were characterized using high-resolution mass spectrometry. Following digestion using trypsin and trypsin/Glu-C, and de-N-glycosylation using PNGase F, we determined the mucin-type (GalNAc-type) O-glycosylation pattern of S proteins, including unambiguous O-glycosites and the 6 most common O-glycans occupying them, via Byonic identification and manual validation. Finally, 43 O-glycosites were identified in the insect cell-expressed S protein. Most glycosites were modified by non-sialylated O-glycans such as HexNAc(1) and HexNAc(1)Hex(1). In contrast, 30 O-glycosites were identified in the human cell-expressed S protein S1 subunit. Most glycosites were modified by sialylated O-glycans such as HexNAc(1)Hex(1)NeuAc(1) and HexNAc(1)Hex(1)NeuAc(2). Our results are the first to reveal that the SARS-CoV-2 S protein is a mucin-type glycoprotein; clustered O-glycans often occur in the N- and the C-termini of the S protein, and the O-glycosite and O-glycan compositions vary with the host cell type. These site-specific O-glycosylation landscapes of the SARS-CoV-2 S protein are expected to provide novel insights into the viral binding mechanism and present a strategy for the development of vaccines and targeted drugs.

Intraoperative application of inactivated Pseudomonas aeruginosa in patients undergoing lateral neck dissection for metastatic thyroid cancer: A randomized, parallel group, placebo-controlled trial.

BACKGROUND: We hypothesize that the intraoperative, prophylactic application of Pseudomonas aeruginosa can decrease postoperative chylous fistula and enhance recovery after surgery in patients with thyroid cancer undergoing lateral neck lymph node dissection. METHOD: In this single-center trial, we assigned randomly 200 patients with thyroid cancer who had proven lateral lymph node metastasis to groups receiving either 2 mL Pseudomonas aeruginosa spray (Pseudomonas aeruginosa group) or 2 mL saline spray (control group) in the lateral cervical surgical field. The primary end points were the rate of chylous fistula, mean difference in the duration and volume of drainage fluid, days of postoperative hospital stay, and overall cost. The secondary end points included the red blood cell count and triglyceride level in the drainage, the white blood cell count in the blood, fever, local pain, development of a pleural effusion, and tumor recurrence. RESULTS: Patients treated with Pseudomonas aeruginosa had a decrease in macroscopic chylous fistula compared with controls (0 vs 6%, P = .025). There were fewer days to drain-tube removal, a less volume of drainage fluid, fewer postoperative days of hospital stay, and a lesser red blood cell count in the drainage fluid in the Pseudomonas aeruginosa group than in the control group (all P < .05). No severe side effects of the Pseudomonas aeruginosa spray with respect to fever, pain, or pleural effusion were observed. Pseudomonas aeruginosa spraying did not affect postoperative recurrence of the thyroid cancer. CONCLUSION: Intraoperative spraying of inactivated Pseudomonas aeruginosa in the lateral neck compartment can decrease the development of chylous fistula and enhance postoperative recovery.

The use of The Bethesda System for Reporting Thyroid Cytopathology in a Chinese population: An analysis of 13 351 specimens.

AIMS: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has been widely adopted since its introduction. In this study, we aimed to report our experience using this reporting system at a College of American Pathologists (CAP)-accredited hospital laboratory in a large series of Chinese patients. METHODS: All patients who underwent preoperative ultrasound-guided thyroid fine-needle aspiration (FNA) from January 2011 to August 2016 were retrospectively analyzed. Thyroid FNAs were classified according to the Bethesda System. For patients who underwent subsequent surgery at our institution, the diagnostic performance of the preoperative FNA was further analyzed according to four different calculation criteria. All of the follicular variants of papillary thyroid carcinoma specimens were reviewed to exclude NIFTP (noninvasive follicular thyroid neoplasm with papillary-like nuclear features). RESULTS: A total of 13 351 thyroid FNAs were included in this analysis. Of the 12 530 sampled patients, 3594 (28.7%) underwent thyroidectomy, and the malignancy rates for each cytological category were as follows: 66.7% unsatisfactory, 14.2% benign, 53.5% undetermined significance, 30.2% follicular neoplasm, 82.0% suspicious, and 99.1% malignant. Only 12 (0.36% of all PTC) patients were reclassified as having NIFTP. The sensitivities of the preoperative FNAs were all above 95.0% and were as high as 99.0%. The specificities ranged from 50.3% to 63.9%, depending on which criteria were used. The positive predictive value was 95.4% for criteria 1 and 2 and was 94.2% for criteria 3 and 4. The negative predictive values ranged from 64.5% to 85.8%. The diagnostic accuracies all exceeded 90.0%, with the highest being 94.8%. CONCLUSION: This study revealed the great efficacy and accuracy of TBSRTC in a large Chinese population for the first time.

Using a nomogram based on preoperative serum fibrinogen levels to predict recurrence of papillary thyroid carcinoma.

BACKGROUND: Hyperfibrinogenemia is increasingly being recognized as an important risk factor related to cancer stage, development and outcomes. We evaluated whether preoperative serum fibrinogen levels predict recurrence of papillary thyroid carcinoma (PTC). METHODS: We retrospectively collected data for 1023 PTC patients who underwent surgery at our institution from Aug 2014 to Aug 2016. In total, 414 patients (from Aug 2014 to Dec 2015) were used as the training set to build the model, and 609 patients (from Jan 2016 to Aug 2016) were used as the testing set to validate the model. RESULTS: In the training set, PTC cases with high serum fibrinogen levels were more likely to have multiple PTCs (P = 0.001) and to exhibit surrounding tissue or organ invasion (both P < 0.01). Moreover, PTC patients with higher serum fibrinogen levels were also more likely to have an advanced tumor stage (T, P = 0.001) and distance metastasis (P < 0.001), and these patients had a significantly higher rate of postoperative PTC recurrence (P = 0.002). All of these findings were validated in the testing set. The results of univariate and multivariate analyses indicated that hyperfibrinogenemia was a risk factor for PTC recurrence. The identified risk factors were incorporated into a nomogram and validated using the testing set (C-index = 0.811, 95% CI: 0.762-0.871). CONCLUSION: PTC cases with hyperfibrinogenemia are more likely to have an advanced TNM stage and have a higher rate of PTC recurrence. Our nomogram could be used to objectively and accurately predict PTC recurrence in a clinical setting.

A Nomogram Based on the Characteristics of Metastatic Lymph Nodes to Predict Papillary Thyroid Carcinoma Recurrence.

BACKGROUND: The extent of metastatic lymph node (LN) invasion was not considered in the postoperative stratification of the recurrence risk of papillary thyroid carcinoma (PTC) in the 2015 American Thyroid Association (ATA) guidelines, and the recommended risk stratification cannot be applied to individuals. A nomogram based on these risk factors was developed based on the risk factors to predict individual recurrence risk. METHODS: Data from 1788 PTC patients at the West China Hospital and 306 cases from the Shang Jin Nan Fu Hospital between August 2013 and July 2015 were included in this study. The 1788 cases were randomized into two groups-the training set (896 cases) and the testing set (896 cases)-and 306 cases were used as the external evaluation set. RESULTS: Univariate and multivariate analyses identified the following independent prognostic factors associated with recurrence in the three independent sets and the combined set (p < 0.01): LN invasion in the capsule or organ, more than five metastatic LNs, and a largest metastatic LN diameter >3 cm. Importantly, PTC patients showed significantly different recurrence rates depending on the extent of LN invasion in the three sets and in the combined set (p < 0.001). The nomogram was developed based on the risk factors in the training set and was validated in the independent testing and validation sets. CONCLUSION: The largest LN metastasis diameter, number of metastatic LNs, and the extent of extranodal invasion had significant prognostic value for predicting the risk of recurrence. Based on the characteristics of the thyroidal PTC lesion and metastatic LNs, the nomogram showed good prediction of recurrence in individual PTC patients.

Independent predictors and lymph node metastasis characteristics of multifocal papillary thyroid cancer.

The multifocal papillary thyroid cancer (PTC), with more aggressive and poorer prognosis, is not rare in papillary histotype. Few studies evaluated risk factors and lymph node metastasis in multifocal PTC. The aim of this present study focusing on risk factors and lymph node metastasis characteristics in multifocal PTC was excepted to assist clinical decisions regarding surgery.It was a retrospective study. The 1249 consecutive patients with PTC were reviewed. Of these, 570 patients who met the criteria were selected: 285 with solitary papillary thyroid cancer and 285 with multifocal PTC. The risk factors and lymph node metastasis in multifocal PTC were investigated by univariate and multivariate analysis.Multifocal PTC showed a higher positive rate of capsular invasion, extrathyroidal extension, tumor size >10 mm, pathological T classification, N+ stage, local recurrence, and radioactive iodine ablation (RAI). Capsular invasion (hazard ratio [HR], 1.589; 95% confidence interval [CI],1.352-1.984), advanced pathological T classification (HR, 3.582; 95% CI, 2.184-5.870), and pathological N+ stage (HR, 1.872; 95% CI, 1.278-2.742) were related to increased risk of multifocality and there was a significant increased HR for central neck compartment involvement in male sex (HR, 2.694; 95% CI, 1.740-4.169), advanced pathological T classification (HR, 2.403; 95% CI, 1.479-3.907) and multifocality (HR, 1.988; 95% CI, 1.361-2.906).There is a significant association between capsular invasion, advanced pathological T classification, N+ stage, and multifocal PTC. Total thyroidectomy plus prophylactic bilateral central lymph node dissection should be recommended during surgery due to a stronger predilection for level VI lymph node metastasis in multifocal PTC.

Preoperative adjuvant transarterial chemoembolization cannot improve the long term outcome of radical therapies for hepatocellular carcinoma.

Combinations of transarterial chemoembolization (TACE) and radical therapies (pretransplantation, resection and radiofrequency ablation) for hepatocellular carcinoma (HCC) have been reported as controversial issues in recent years. A consecutive sample of 1560 patients with Barcelona Clinic Liver Cancer (BCLC) stage A/B HCC who underwent solitary Radiofrequency ablation (RFA), resection or liver transplantation (LT) or adjuvant pre-operative TACE were included. The 1-, 3- and 5-year overall survival rates and tumor-free survival rates were comparable between the solitary radical therapy group and TACE combined group in the whole group and in each of the subgroups (RFA, resection and LT) (P > 0.05). In the subgroup analysis, according to BCLC stage A or B, the advantages of adjuvant TACE were also not observed (P > 0.05). A Neutrophil-lymphocyte ratio (NLR) more than 4, multiple tumor targets, BCLC stage B, and poor histological grade were significant contributors to the overall and tumor-free survival rates. In conclusions, our results indicated that preoperative adjuvant TACE did not prolong long-term overall or tumor-free survival, but LT should nevertheless be considered the first choice for BCLC stage A or B HCC patients. Radical therapies should be performed very carefully in BCLC stage B HCC patients.

Risk factors of hypoparathyroidism after total thyroidectomy and bilateral central lymph node dissection in patients with papillary thyroid carcinoma / 中华内分泌外科杂志

Objective To investigate the risk factors of hypoparathyroidism after total thyroidectomy and bilateral central lymph node dissection in patients with papillary thyroid carcinoma.Methods Data of patients with PTC who accepted total thyroidectomy and bilateral central lymph node dissection in the Department of Thyroid Surgery from Jan.2013 to Jun.2016 were collected and analyzed retrospectively.The patients were divided into normal group,transient hypoparathyroidism group and permanent hypoparathyroidism group according to the level of serum parathyroid hormone within 6 months after surgery.Clinical data were collected for comparison between the three groups.The risk factors of hypoparathyroidism were indentified with univariate analysis and multivariate analysis.Results A total of 468 patients,241 in the normal group and 227 in the hypoparathyroidism group (220 in the transient hypoparathyroidism group and 7 in the permanent hypoparathyroidism group),were included in the study.Univariate analysis showed that without application of carbon nanoparticles (P=0.04) and autotransplantation of more than one parathyroid gland (P＜0.001) were risk factors of hypoparathyroidism,and without application of carbon nanoparticles (P=0.047),incidental parathyroidectomy of one parathyroid gland (P=0.04),gross extrathyroidal extension (P=0.006) and c N1a were risk factors of permanent hypoparathyroidism.Multivariate analysis showed that without application of carbon nanoparticles (OR,0.437;95％ CI,0.243-0.789;P=0.006) and autotransplantation of more than one parathyroid gland (OR,3.025;95％ CI,1999-4579;,P=0.000) were independent risk fact ors of hypoparathyroidism,and without application of carbon nanoparticles (OR,0.197;95％ CI,0.039-0.982;P=0.048) and gross extrathyroidal extension (OR,12.381;95％ CI,1.432-107.036;P=0.022) were independent risk factors of permanent hypoparathyroidism.Conclusion When total thyroidectomy and bilateral central lymph nodes dissection were performed,carbon nanoparticles were routinely applied.Although autotransplantation of more than one parathyroid gland can increase the incidence of transient hypoparathyroidism,it can reduce the incidence of permanent hypoparathyroidism.If extrathyroidal extension is suspected,hypoparathyroidism should be emphasized to patient,and accurate operation should be done to reduce the incidence of hypoparathyroidism.

Current status and consideration of parathyroid autotransplantation / 中华外科杂志

Hypoparathyroidism is one of the most common complications of thyroid surgery. Permanent hypoparathyroidism would bring great pain to patients, seriously affect the postoperative quality of life, is becoming the source of medical disputes. Parathyroid autotransplantation can effectively reduce the incidence of postoperative permanent hypoparathyroidism. However, there are still some dispute about the choice, including the time, the number, the method and the location of parathyroid autotransplantation, which need to be further researched. As a result, the program and survival rate of parathyroid autotransplantation will be optimized and improved, respectively.

STAT3, a Poor Survival Predicator, Is Associated with Lymph Node Metastasis from Breast Cancer / 한국유방암학회지

PURPOSE: The aim of this study is to explore signal transducer and activator of transcription 3 (STAT3) expression in breast cancer and to analyze the detailed mechanism that STAT3 contributes to the progression of breast cancer. METHODS: We retrospectively analyzed the clinicopathologic characteristics and overall survival (OS) of 140 breast cancer patients after curative surgery, and detected STAT3 expression, phosphorylated STAT3 (pSTAT3) expression, Ki-67 expression, vascular endothelial growth factor (VEGF)-C and -D expression in breast cancer tissues, and adjacent nontumor tissues. Survival analysis and relationship analysis were adopted for demonstrated the important mechanism of STAT3 contribution to progression of breast cancer. RESULTS: STAT3 expression, pSTAT3 expression, Ki-67 expression, VEGF-C expression, and VEGF-D expression in breast cancer tissues were significantly higher than those in adjacent nontumor tissues, respectively. With survival analysis, only number of lymph node metastasis (N stage) was identified as the independent predictors of the OS of breast cancer patients. Besides, we demonstrated there was the most prominent correlation between STAT3 expression and lymph node metastasis in breast cancer tissues by using the multinominal regression method. CONCLUSION: STAT3, a poor survival biomarker potential association with lymph node metastasis, was suitable for predication the OS of breast cancer patients after curative resection.

Real-Time Monitoring of Recurrent Laryngeal Nerve During Thyroid Reoperation / 中国普外基础与临床杂志

Objective To assess the value and usage of real-time monitoring of the recurrent laryngeal nerve (RLN) during thyroid reoperation by RLN monitor. Methods One hundred and one patients were under general anesthesia and thyroidectomy. NIM-Response electromyographic (EMG) monitor system was used for assistant of dissection,exposure and protection of the RLN during the surgical procedures. Results There were 192 RLN were exposed during the surgeries in all 101 patients. The unilateral RLN injured in 10 patients was not specially explored the same side nerve. Among them 190 nerves were confirmed intact,the rest 2 nerves were resected because of tumor involving. Conclusion s NIM-Response electromyographic monitor system is sensitive and accurate for preserving the integrity of RLN during the thyroid reoperations. It is valuable for protecting RLN against iatrogenic injury. This system deserves general utilization for thyroid surgery,especially reoperation.

Study on The Use of Harmonic Scalpel vs Conventional Knot Tying in Open Thyroid Surgery / 中国普外基础与临床杂志

Objective To compare the disadvantages and advantages of open thyroid surgery when using the harmonic scalpel (HS) vs conventional hemostasis (CH). MethodsOne hundred and fifty-one patients and 70 patients underwent thyroid surgery with HS or CH respectively. The tumor diameter, incisional length, the total operative time, thyroidectomy time, intraoperative bleeding volume, postoperative drainage volume and surgical complications were compared. The incisional length and the surgical complications in and after learning curve with harmonic scalpel were compared. ResultsThere was no significant difference between the HS and CH group at baseline. Incisional length, total operative time, thyroidectomy time, intraoperative bleeding volume and postoperative drainage volume in HS group were significantly lower than those of CH group (P0.05); the incisional length after learning curve was shorter than that in learning curve in HS group (P

Investigation of Value of Na~+/I~- Symporter Expression on Diagnosis of Thyroid Carcinoma and Prediction of ~(131)Ⅰ Therapeutic Effects / 中国普外基础与临床杂志

Objective To study the clinical value of Na+/I-symporter(NIS)expression on thyroid carcinoma diagnosis and 131I therapeutic effects prediction.Methods Thirty-one cases of thyroid carcinomas enrolled in this hospital from 1998 to 2006 were included.Using immunohistochemical method,NIS expression location,positive cell staining and expression intensity were observed,which was calculated by immunohistochemical scores(IHS)and NIS expression level was compared between primary and metastatic carcinoma.Results NIS was over-expressed on the basolateral membrane in positive control——Grave disease tissue,and showed no staining in negative control.NIS was expressed in cytoplasm in all 31 primary carcinomas,and IHS was over or equaled to 4 in 80.65% of them.Except for 2 no staining,NIS was expressed in cytoplasm in the rest 28 metastatic carcinomas.NIS expression was related to the pathological type of thyroid carcinoma,the strongest in PTC,then FTC,and the weakest in fvPTC.NIS expression in metastatic carcinoma was related to that in primary carcinoma.Conclusion NIS is over-expressed in cytoplasm in most thyroid carcinoma,and the iodide uptaking defect is mainly due to its wrong location.It has great potential to be applied in clinic by that it can help with the differential diagnosis of benign and malignant thyroid diseases,especially between FTA and FTC,and that it can help predict the therapeutic effects of 131I therapy following thyroid operation.

Relation Between Iodide Transporters and Thyroid Diseases / 中国普外基础与临床杂志

Objective To investigate the clinical significance of the three iodide transporters in thyroid diseases. Methods Literatures about the Na+/I-symporter (NIS), pendrin and human apical iodide transporter (hAIT) in recent years were reviewed and their expressions in different thyroid diseases were also analyzed. Results NIS proteins express at the basolateral membrane of thyrocytes in normal thyroid tissue, while pendrin and hAIT proteins are limited to the apical membrane of thyrocytes lining in the follicular lumen. In the tissues of thyroid carcinomas, it was found that the NIS proteins expressed in the cytoplasm and their expressions decreased; The mutation of NIS gene may be one of the main causes of congenital hypothyroidism. The expression of prendrin protein may be related to the function of follicles: its expression level increased significantly both in Graves diseases and toxic adenomas, but significantly decreased in differentiated thyroid carcinoma. However, the correlation between the decrease and the degrees of differentiation of carcinoma cell line are still disputable. The expression of hAIT protein does not significantly altered in hyperfunctioning tissues. It only slightly decreased occasionally in hypofunctioning adenomas, but it decreased significantly in thyroid carcinomas. Conclusion The abnormal expressions of the three iodide transporters may be related closely with the type of thyroid diseases. However, their pathogenic mechanisms and the causes of their abnormal expression are still unknown, which need to be studied further.

Diagnostic value of needle stereotaction marking by steel wire under mammography for nonpalpable breast carcinoma / 中国普通外科杂志

Objective To explore the diagnostic value of needle stereotaction marking by steel wire(NSMSW) under mammography for nonpalpable early stage breast carcinoma (BC). Methods 29 patients with nonpalpable breast lesions were performed NSMSW under mammography,and the lesions were removed for biopsy to make the diagnosis. Results Nine patients(31.0%) were definited as early stage BC and twenty(69.0%) benign disease.The pathologic results in freezing sections and in parafin sections were the same. Conclusions NSMSW under mammography can resolve the problem of accurate location of nonpalpable breast lesions during operation .It is a credible, useful and practical method for diagnosis of nonpalpable early stage BC.