ObjectiveTo identify the risk factors of central lymph nodal (CLN) metastasis in papillary thyroid carcinoma (PTC) and indicate central neck dissection.
MethodsFifty cases were analyzed retrospectively. The BRAFV600E gene mutation was analyzed by sequencing and expression of VEGF-C was analyzed by using immunohistochemically. The clinicopathologic and molecular marker factors relating to CLN metastasis were analyzed.
ResultsThe BRAFV600E gene mutation was found in 30 of 50 (60.0%) patients of PTC. Univariate analysis showed that BRAFV600E gene mutation of PTC patients was significantly correlated with high expression of VEGF-C (87.5% vs. 34.6%,P=0.000), not with clinicopathologic factors. High expression of VEGF-C was significantly correlated with CLN metastasis in PTC (87.5% vs. 57.7%, P=0.019). Multivariate analysis showed that invasion of the surrounding tissues (P=0.009,OR=9.082,95% CI:1.748-47.185) and the high expression of VEGF-C (P=0.009,OR=9.082,95% CI:1.748-47.185) were independent risk factors for the presence of CLN metastases.
Conclusions①The BRAFV600E gene mutation for PTC patients is significantly correlated with high expression of VEGF-C, not with CLN metastasis in PTC. ②High expression of VEGF-C is significantly correlated with CLN metastasis in PTC. ③Tumor extrathyroidal extension, especially invasion of the surrounding tissues is significantly correlated with CLN metastasis in PTC.
ObjectiveTo investigate the structure, ligand, and tissue distribution of galectin-3, the relationship of galectin3 with tumor and the expression of galectin-3 in several thyroid diseases. MethodsRelated articles were reviewed. ResultsGalectin-3 was expressed in normal and tumor cell that regulated cell growth, differentiation, adhesion, apoptosis, and angiogenesis, which participated invasion and metastasis of tumor. ConclusionGalectin-3 may be used to discriminate benign and malignant thyroid tumor.
ObjectiveTo investigate the value of central lymph node dissection in patients with cN0 papillary thyroid carcinoma.
MethodThe clinical data of 128 patients with cN0 papillary thyroid carcinoma who had been performed central lymph node dissection during their hospitalization from December 2010 to July 2012 in Chinese PLA General Hospital were analyzed retrospectively.
ResultsThe central neck lymph node metastasis rate was 35.94%(46/128) in 128 patients with cN0 papillary thyroid carcinoma, which in the patients with aged less than 45 years, with the tumor diameter larger than 1 cm, and with capsule or extrathyroidal invasion were significantly higher than those in the patients with aged larger than 45 years, with the tumor diameter less than 1 cm, and without capsule or extrathyroidal invasion (P < 0.05). After the operation, there were 22(17.19%) patients with temporary hypoparathyroidism as well as 3(2.34%) patients with temporary recurrent laryngeal nerve injury. However, no permanent recurrent laryngeal nerve injury and permanent hypoparathyroidism occurred. During the 14-32 months follow-up with an average 23.4 months, 2 cases of lateral neck lymph node metastases were observed.
ConclusionAs an essential, effective, and safe operation to the patients with cN0 papillary thyroid carcinoma, central lymph node dissection should be performed by experienced hands.
ObjectiveTo investigate the expressions of Snail and N-cadherin protein in thyroid papillary carcinoma (PTC) tissues and cell lines, and then discuss the clinical value of Snail and N-cadherin expressions.
MethodsImmunohis-tochemical SP technique was performed to detect the expressions of Snail and N-cadherin protein in 60 cases of PTC, and the relation between the expression of Snail or N-cadherin and clinicopathologic indicators was analyzed. Western blot was used to investigate the constitutive and inducible expressions of Snail and N-cadherin protein.
Results①The positive rates of Snail and N-cadherin protein expressions were 85.0% (51/60) and 78.3% (47/60) respectively in the PTC tissues of 60 patients with PTC, which were significantly higher than those (0, 0, respectively) in the corresponding normal tissues adjacent to the cancer (P < 0.01).②The positive rates of Snail and N-cadherin protein expressions in the PTC with lymph node metastasis were significantly higher than those in the PTC without lymph node metastasis (P < 0.01), which were not related with the gender, age, tumor size of the patients (P > 0.01).③There was a positive correlation between Snail and N-cadherin protein positive expression (rs=0.721, P < 0.001).④The constitutive and inducible expressions of Snail and N-cadherin in the PTC tissues and cell lines further were identified by Western blot.
ConclusionsSnail and N-cadherin could constitutively express in PTC, which might play important roles in the development and metastasis of PTC. Snail and N-cadherin might be used as effective indicators.
ObjectiveTo investigate the primary culture method of human papillary thyroid carcinoma (PTC) cells for a long term and establish a monitoring and verification measures. MethodsPTC cells were isolated following routine procedures and cultured in the DMEM supplemented with 10% fetal bovine serum, glutamine, and 20 ng/ml epidermal growth factor (EGF). Thyroglobulin (Tg) and thyroperoxidase (TPO) in nutrient solution and specific antigen Tg expression of PTC cells cultured for different days were observed. ResultsThe PTC cells grew satisfactorily up to 45 days of incubation. Tg content in nutrient solution expressed the training period of a linear singular parabolic, achieved peak value (985.2 μg/L) at about 14 d. TPO had not been detected in nutrient solution. The Tg expressed positively by immunization fluorescent dyeing. ConclusionsPTC cells cultured in the present method can survive to over 45 days. A brief monitoring and evaluation systems of PTC cells has been established. This report prompts that cultured cells within 14 days maybe more suitable to gene research and provide alternative to the basic research of PTC events and features.
ObjectiveTo discuss the correlation of BRAFV600E mutation with clinicopathologic characteristics or thyroglobulin (Tg) in papillary thyroid carcinoma (PTC) and its clinical significance.
MethodsThe BRAFV600E mutations of 55 patients with PTC were detected by nested PCR. The relations between BRAFV600E mutation and the clinicopathologic characteristics were analyzed.
Results①The BRAFV600E mutations happened in 29 patients with PTC, the mutation rate was 52.7% (29/55).②The BRAFV600E mutation rate was related with extracapsular spread, multiple lesions, regional lymph node metastasis or average Tg value > 1.0μg/L during 2 years after standardized treatment (P value was 0.01, 0.02, 0.02, 0.03, respectively), but which not related with the gender, age, tumor diameter, or TNM stage (P > 0.05).
ConclusionThe BRAFV600E mutation in PTC might lead to increased tumor aggressiveness and it might be related with increased Tg value after standardized treatment.
Objective To explore the manifestations and features of multi-slice spiral CT （MSCT） in the diagnosisof papillary thyroid carcinoma （PTC）. Methods Preoperative MSCT data of 35 cases of PTC proved by operation and pathology in our hospital form May. to Jun. in 2013 were observed retrospectively， to analyze the manifestations and characteristics of MSCT for it. Results Of 35 patients with PTC， MSCT totally showed 48 lesions， 68.6% （24/35） of patients with single lesion， 31.4% （11/35） of patients with 2-3 lesions， and 62.9% （22/35） of patients with lymph node metastasis. Of the 48 lesions， 29.2% （14/48） of lesions located in the left lobe， 70.8% （34/48） of lesions located in the right lobe；the lesions’ maximum diameter were 0.4-5.8cm， with the average maximum diameter of 1.3cm. There were 39.6% （19/48） of lesions with uneven density， 25.0% （12/48） of lesions with irregular shape， 47.9% （23/48） of lesions with blurred edges， 18.8% （9/48） of lesions had papillary enhanced tumor nodules， 10.4% （5/48） of lesions had peritumoral incomplete enhanced ring sign， 22.9% （11/48） of lesions invaded surrounding tissue or organs. There were 35.4% （17/48） of lesions had calcification， in which 76.4% （13/17） of lesions were fine granular calcification， 11.8% （2/17） of lesions were mixed calcification， and 11.8% （2/17） of lesions were coarse calcification. Conclusion MSCT manifestations of PTC have certain characteristics， which can provide imaging basis for clinical treatment options.
ObjectiveTo explore the value of fluorescence tracer technique in sentinel lymph node (SLN) orientation of cN0 papillary thyroid cancer.
MethodsThe total clinical data of 40 cT1-3N0M0 thyroid cancer patients admitted from January 2015 to January 2016 in our hospital were collected, and the SLN with indocyanine green (ICG) as fluorescent trace agent were observed and detected, and the effect of ICG detecting SLN and the guide role of SLNB on the dissection of the central area of neck lymph nodes by intraoperative frozen biopsy pathology and postoperative paraffin pathology were analyzed.
ResultsA total of 40 thyroid cancer patients were treated by SLNB and then conducted by the dissection of the central area of neck lymph nodes, and 37 cases detected SLN, so the detection rate was 92.5% (37/40). And a total of 98 SLNs were detected, 1-5 for each case, average of 2.65/case. Intraoperative frozen pathological detected 28 cases of patients with metastases in SLN, and 9 patients without metastasis, including 1 case with postoperative pathology detecting micrometastasis in SLN and other 8 cases without metastasis in the central area of neck lymph nodes. Three cases who were not detected the SLN showed no metastases in final postoperative paraffin pathology. The SLNB of ICG fluorescent tracer was with a sensitivity of 96.6% (28/29), false-negative rate of 3.45% (1/29).
ConclusionThe fluorescent tracer technique can guide the dissection of the central of neck lymph node of cN0 thyroid cancer patients accurately with a high detection rate and advantages of high sensitivity in detecting the SLN of thyroid cancer.
ObjectiveTo study the expressions of BRAF gene in papillary thyroid microcarcinoma (PTMC) and papillary thyroid carcinoma (PTC) >1 cm in diameter, and the invasiveness of PTMC and PTC.
MethodsThe data of 275 patients with PTC received surgical treatment and with BRAF gene mutation results in West China Hospital of Sichuan University from 2011 September to 2013 September were retrospectively analyzed. According to the size of tumors, the patients were divided into three groups, was the diameter <1 cm group, 1 cm< diameter≤2 cm group, and diameter >2 cm group,respectively. The ratio of BRAF gene mutation, and the degree of risk of extrathyroidal invasion and lymph node metastasis were compared.
ResultsUnivariate analysis showed that tumor size was not related with the age, gender, and BRAF gene mutation rate (P>0.05), while the tumor size was related with the extrathyroidal invasion and lymph node metastasis (P<0.05), and the ratio of BRAF gene mutation was related with the extrathyroidal invasion and lymph node metastasis (P<0.05). Multivariate analysis showed that tumor size was associated with extrathyroidal extension (P=0.009) and lymph node metastasis (P=0.000).
ConclusionsBRAF gene mutation can increase the extrathyroidal invasion and lymph node metastasis risk of PTC, and it is no significantly correlated with tumor size of PTC. The invasiveness of PTC increases with the increased of tumor size, but the PTMC of BRAF gene mutation positive is still require positive treatment.
ObjectiveTo evaluate the frequency of BRAFV600E mutation and the association between BRAFV600Emutation and clinicopathologic characteristics of papillary thyroid carcinoma (PTC) in Chinese population by Meta-analysis.
MethodsThe relevant published studies before January 2014 were reviewed according to the defined selection criteria using the PubMed,Embase,VIP,China Biology Medicine Database,Wanfang and China Knowledge Resource Integrated Database. The effect sizes of outcome parameters were estimated by odds ratio (OR) or weighted mean difference with a 95% confidence interval (CI). The quality of the included trials was assessed and Meta-analyses were conducted by RevMan 5.1 software.
ResultsThe study included 46 studies with a total of 5 831 patients. The prevalence of BRAFV600E mutation ranged from 25% to 83%,with an overall prevalence of 54.6%. The clinicopathologic characteristics of 5 542 patients were analyzed. There were statistical significances in association between BRAFV600E mutation and the presence of classical type [OR=2.30,95%CI (1.32,4.01),P=0.003],follicular type [OR=0.44,95%CI (0.23,0.86),P=0.02],extrathyroidal extension [OR=2.18,95%CI (1.83,2.59),P<0.00001],multifocality [OR=1.31,95%CI (1.07,1.60),P=0.009],lymphocytic thyroiditis [OR=0.31,95%CI (0.23,0.42),P<0.00001],lymph node metastasis [OR=1.95,95%CI (1.40,2.72),P<0.000 1],advanced TNM stage [OR=2.41,95%CI (2.01,2.88),P<0.00001] and recurrence [OR=3.22,95%CI (2.04,5.09),P<0.00001],but the correlation of BRAFV600E mutation was not significant with gender,mean age,mean tumor size,age being ≥45 years,tumor size being ≥10 mm,tall cell type,and distant metastases (P>0.05).
ConclusionIn Chinese patients,PTC with BRAFV600E mutation has more aggressive clinicopathologic characteristics than that without BRAFV600E mutation. The BRAFV600E mutation may be used as an important prognostic marker for patients with PTC.
