To search for the relationship between immune state and tumor metastases, CD3,CD4,CD8 and CD44 contents in 13 speciments of fine needle aspiration (FNA) from thyroid cancer patients were detected by the flowcytometry (FCM) and comparison between thyroid cancer and benign tumor was made. The result showed :in thyroid cancer group, CD＋3，CD＋4 cells and the ratio of CD＋4/CD＋8 reduced significantly (Ｐ＜0.01),and CD＋8 cell increased significantly (Ｐ＜0.01), in metastases group,this change was much significantly. CD44 expressed significantly higher in cancer group than that of the benign thyroid neoplasms, and the change was related to the tumor metastases. The results indicate that CD44 can be as a marker of tumor and indicator of metastases. The disturbance of immune system results in active expression of CD44 by tumor cells, so, lead to metastases. It is helpful to the diagnosis of thyroid cancer, assessment of metastases and management in surgery.
Objective To study the clinical value ofNa＋/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 best 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.
ObjectiveTo explore the feasibility and safety of clinical application of bipolar coagulation forceps in open thyroid operations and summarize the operation skill.
MethodsThe clinical data of 347 cases performed thyroid operations with bipolar coagulation forceps and Harmonic scalpel respectively from October 2010 to October 2014 in our hospital were analyzed retrospectively.
ResultsNo statistical differences was found on the operative time, intraoperative bleeding, postoperative drainage, and postoperative hospitalization of the two groups (P > 0.05). The complications of transient palsy of recurrent laryngeal nerve and transient functional insufficiency of parathyroid were more in Harmonic scalpel group than in bipolar coagulation forceps group with statistical difference (P < 0.05). But there was no difference of the complications of airway obstruction, permanent injuries of recurrent laryngeal nerve, parathyroid and superior laryngeal nerve in the two groups (P > 0.05).
ConclusionsThyroid operations with bipolar coagulation forceps are safe and feasible. Coagulation tightly along the thyroid capsule followed by incision with explicit subtle dissection is the key point of the decrease of complications.
Objective To explore the change of constitution in thyroid diseases of West China Hospital between 2000 and 2012， in order to provide clinical evidence. Methods Clinical data， including gender， age， and pathological diagnosis of patients with thyroid disease who underwent primary thyroid surgery in our hospital from 2000 to 2012 were collected retrospectively and analyzed statistically. Results A total of 9 642 patients were enrolled， including 1 893 male patients and 7 749 female patients. The ratio of male to female patients was 1 to 4.09. In male patients， the proportion of thyroid carcinoma were significantly higher than those of female group （P=0.02）；in male patients younger than 45 group， the proportion of thyroid carcinoma were significantly higher than those of female group （P＜0.01）. There was no statistical difference on the proportion between male and female patients older than 45 group （P=0.90）. Proportion of thyroid carcinoma， especially proportion of papillary thyroid carcinoma （PTC） increased in general. Proportion of Hashimoto thyroiditis （HT） increased in general too. HT with thyroid carcinoma accounted for an increasing proportion of all patients with HT. Proportion of nodular goiter （NG） increased at first and then declined. Proportion of thyroid adenoma （TA） decreased on the whole. Conclusions Proportion of thyroid carcinoma， especially proportion of PTC increase in recent years on the whole in patients underwent surgery. All these changes need to be given sufficient attention.
ObjectiveTo establish a stable laboratory model of temporary hypoparathyroidism following thyroid operation in rabbits.
MethodsTwenty New Zealand white rabbits were randomized into 2 groups (the four parathyroid glands injured group and the two inferior parathyroid glands injured group, n=10 for each group). In the two inferior parathyroid glands injured group, blood supply vessels of the two inferior parathyroid glands were injured with ligation. In the four parathyroid glands injured group, total thyroidectomy (including two superior parathyroid glands) were performed and blood supply vessels of the two inferior parathyroid glands were injured with ligation. The number of the identified parathyroid glands were counted during operation. Serum calcium and parathyroid hormone (PTH) were evaluated preoperatively and postoperatively on 1 d, 2 d, 3 d, 5 d and in 1 week, 2 weeks, 3 weeks, and 4 weeks. Model achievement rate were calculated.
ResultsFour parathyroid glands were identified in rabbits. The two superior parathyroid glands were in thyroid tissue which were identified with histology, and the two inferior parathyroid glands located in the fascia plane between the sternohyoid, sternothyroid muscles and the carotid artery which can easily be identified with naked eye. There were no significant difference in preoperative calcium and PTH between the two groups (P > 0.05). In the two inferior parathyroid glands injured group, significantly decreased in serum calcium were observed on 1 d, 2 d and 3 d after operation (P < 0.05). In the four parathyroid glands injured group, significantly decreased in blood calcium were observed on 1 d, 2 d, 3 d and 5 d after operation (P < 0.05). The lowest level of serum calcium was observed on 1 d in two groups. Postoperative serum PTH were significantly declined in two groups on 1 d, 2 d, 3 d, 5 d, and in 1 week, 2 weeks and 3 weeks (P < 0.05). The lowest serum PTH was also observed on 1 d in two groups. Significantly lower serum PTH were found in the four parathyroid glands injured group on 1 d, 2 d and 3 d than in the two inferior parathyroid glands injured group (P < 0.05). Lower PTH level were found in the four parathyroid glands injured group on 5 d, and in 1 week, 2 weeks, 3 weeks and 4 weeks, but no significance (P > 0.05). Positive correlation between serum calcium and PTH were noticed (r=0.771, P=0.000). Model achievement rate were higher on 3 d and 5 d in the four parathyroid glands injured group than that of the two inferior parathyroid glands injured group (P < 0.05).
ConclusionsStable animal model of temporary hypoparathyroidism following thyroidectomy can be established by total-thyroidectomy plus ligation the blood vessels of the two inferior parathyroid glands. This model can be used for further study.
ObjectiveTo summarize the new ideas and new instruments in thyroid surgery. MethodsRelated literatures were reviewed and analyzed. ResultsTotal thyroidectomy had become the preferred option for differentiated thyroid cancer and multiple nodule goiter. The key change of surgery was from recurrent laryngeal nerve-protection to parathyroid-protection. Harmonic scalpel, bipolar coagulation forceps and Ligasure were used to thyroid surgery, which could shorten operation time and reduce operative bleeding. ConclusionThe ideas and techniques of thyroid surgery have changed, total thyroidectomy and parathyroid protection are being paid more and more attentions, and new instruments are used more extensively in thyroid surgery.
ObjectiveTo investigate the condition of neck lymph node metastasis and related factors in thyroiditis coexisting thyroid cancer, and make clear the indication of neck lymph node dissection. MethodsA retrospective cohort study was conducted with the clinical data of 147 patients with thyroiditis coexisting thyroid cancer who underwent radical resection of thyroid cancer (total thyroidectomy or subtotal thyroidectomy) and neck lymph node dissection, including age, gender, tumor size, number of focuses, and lymph node metastasis. Results Among 147 patients, 65 patients with neck lymph node metastasis (44.22%), central cervical lymph node metastasis rate was 36.05% （53/147）， which was higher than that of lateral lymph node metastasis rate (20.41%, 30/147), Plt;0.05. Neck lymph node metastasis rate was correlated with patient’s gender and tumor size （Plt;0.05）, while it was not correlated with patient’s age and number of focuses (Pgt;0.05). ConclusionCentral neck lymph node metastasis rate is higher in patients with thyroiditis coexisting thyroid cancer, then routine prophylactic central neck lymph node dissection is significant. Patient’s gender and tumor size are correlated with neck lymph node metastasis. When tumor is larger or in male, ipsilateral lymph node dissection should be considered to done.
【Abstract】Objective To explore the operative technique of endoscopic thyroidectomy and prevent its complications. Methods A retrospective analysis was made on the clinical data of 32 patients with benign thyroid diseases who were treated with endoscopic thyroidectomy between May 2002 and March 2005. Results Thirtytwo cases were successfully treated with the mean operation time 130 min(80～180 min). Twelve cases with thyroid adenomas and 20 cases with thyroid tubers were confirmed by histologic examinations. In this group, the postoperative complications included fat liquefaction in 2 cases and transient hoarseness in 1 case who recovered 3 months after operation. No parathyroid injury occurred. The drainage tubes were removed 2~3 days after operation. All of the patients were discharged 2~5 days after operation.Conclusion Endoscopic thyroidectomy is safe and feasible with favorable cosmetic effect.
Some Chinese traditional medicines were found to inhibit rejection of graft. The antirejection effects of chuanxiong, LCH and HXI in thyroid allografts of rabbits were studied for selecting an immune depressor from Chinese traditional medicine with efficient and less sideeffect. The rabbits were divided into 5 groups in the study, with 7 in each group. Group I: The control group, no drug was used. Group II: dexamethason 0.25mg/kg/day, intramuscularly. Group III: chuanxiong water solution, 5g/kg/day, orally. Group Ⅳ： LCH water solution, 10g/kg/day, orally. Group Ⅴ： HXI water solution, 6g/kg/day, orally. The medication was given for 28 days. The grafted thyroids were removed for histopathological examination on the 28th day postoperatively and were scored and classified. The rejection and the survival of grafts were scored and classfied according to the La Rosa and Warrens criterion. The histopathological findings were as following: in Group I, follicles were badly damaged with much lymphocytes infiltration and fibrosis; in Gracup Ⅱ， two rabbits died, the other three showed damaged of the thyroid tissue and much lymphocytes infiltration; in group Ⅲ and Ⅴ, three cases showed damage of thyroid tissue, however, better revascularization was evident in Group Ⅲ; in Group Ⅳ, there was one case with much lymphocytes infiltration. It seemed that the degree of damage of grafts in the experimental groups was better than that in the control group, and had less lymphocytes infiltration, especially in Group Ⅳ. It was suggested that chuanxiong, LCH, HXI and dexamethason could protect the grafted thyroid, but the sideeffect of dexamethason was more than the other three. The antirejection of LCH was the best of the three. It was worth doing more research.
HXI.
ObjectiveTo summarize the domestic and abroad articles related to the research on the relation between miRNA-221/222 and thyroid cancer, and explore the important effects of miRNA-221/222 in diagnosis and treatment of thyroid cancer.
MethodsDomestic and international publications involving the relationship of miRNA-221/222 to thyroid cancer were screened and reviewed.
ResultsMiRNA-221/222 is a tumor marker with high specificity and sensitivity in thyroid cancer. It has important significance for diagnosis, treatment and prognosis of thyroid cancer.
ConclusionMiRNA-221/222 is not only related to diagnosis of thyroid cancer, but also have provided a new research direction and method for gene therapy of thyroid cancer．
