Objective To evaluate the markers which contribute to diagnosis and prognosis of thyroid neoplasm. Methods The references about thyroid markers in recent years were reviewed. Results CD26 and galectin-3 could be regarded as a simple, potent markers to differentiate thyroid carcinoma in preoperative diagnosis, CD97 was a specific marker for undifferentiated thyroid carcinoma and its metastasis, CD15 and telomerase could be used in fine-needle aspirate biopsy (FNAB) of thyroid mass, and to improve its diagnostic evaluation, RET/PTC was mainly expressed in thyroid medullary carcinoma, oncofetal fibronectin (oncFN) was specific to papillary and anaplastic carcinoma, thyroid peroxidase was used to identify benign and malignant thyroid tumor. Conclusion Although there are a lot of markers for thyroid neoplasm, but there is no marker which are completely specific to certain histotype of thyroid neoplasm at present.
ObjectiveTo investigate the prevalence of thyroid nodules and its influencing factors among medical staff of a hospital in Hengshui. MethodsA total of 2 190 medical workers in a hospital in Hengshui who underwent physical examinations in the Medical Examination Center of Harrison International Peace Hospital from January 2012 to July 2013 were included as the study subjects. Through physical examination, thyroid ultrasonography and questionnaire, we collected data and investigated the prevalence of thyroid nodules and its influencing factors. ResultsThe prevalence rate of thyroid nodules was 39.45% (864/2 190) in these medical staff. The prevalence rates of thyroid nodules in males and females were 32.34% (238/736) and 42.92% (624/1 454), respectively, with statistically significant difference between them (χ2=22.913, P<0.001). With increasing age, the prevalence of thyroid nodules increased gradually, and the prevalence of the same sex increased gradually too (P<0.001). The prevalence rate of women was significantly higher than that of men for each age group (P<0.05). Among the 864 subjects, there were 550 (63.66%) with multiple nodules and 314 (36.34%) with solitary nodules; there were 454 (52.55%) with nodules in both lobes of thyroid, 238 (27.54%) with nodules in the right lobe of thyroid, and 172 (19.91%) with nodules in the left lobe of thyroid; there were 504 (58.33%) with solid modules, 172 (19.91%) with cystic nodules, 114 (13.19%) with solid and cystic nodules, and 74 (8.56%) with calcification. Logistic regression analysis showed that gender, age, educational degree, drinking history, taste habit, stress, agitation were correlated with the development of thyroid nodules. ConclusionThe prevalence of thyroid nodules is high among medical staff of this hospital. Thyroid nodules can be prevented through healthy lifestyle, limiting alcohol intake, emotional control, and relieving stress. Early diagnosis and early treatment should be done to prevent the development and spread of thyroid nodules.
Objective To investigate the role of expression in the differential diagnosis of thyroid follicular carcinoma and follicular variant of papillary carcinoma. Methods Seventy cases of thyroid lesions (including 15 cases of follicular adenomas, 15 cases of adinomatous goiters, 30 cases of papillary carcinomas and 10 cases of follicular carcinomas) were collected, and CD10 expression was detected by means of immunohistochemistry in above thyroid lesions. Results Seven of 9 cases of follicular variant of papillary carcinoma were CD10 positive (77.8%), and 8 of 10 cases of follicular carcinoma were CD10 positive (80.0%). However, CD10 was negative in all cases of non-follicular variant of papillary carcinoma, follicular adenoma, adinomatous goiter and normal thyroid tissue. Conclusion The detection of CD10 expression is useful to the differential diagnosis of thyroid follicular carcinoma and follicular variant of papillary carcinoma.
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.
Objective To analyze the clinical relationship between primary hyperthyroidism and thyroid carcinoma, and diagnosis and treatment for the combination of the two. Methods The clinical data of 15 patients with primary hyperthyroidism complicated with thyroid carcinoma from January 1998 to December 2008 were retrospectively analyzed. Results Fifteen cases were smoothly discharged. The morbidity was 2.56% (15/585) of primary hyperthyroidism complicated with thyroid carcinoma. There were no operative complications. Five cases showed thyroid nodules and all cases were performed thyroidectomy. Neither hyperthyroidism nor thyroid carcinoma recurred during 9 months to 10 years (average 5.5 years) follow-up.Conclusions The diagnosis of primary hyperthyroidism complicated with thyroid carcinoma is still difficult to be made preoperatively and chiefly depend on postoperative pathology. Rational surgical treatment can result in good effectiveness and better prognosis.
ObjectiveTo investigate the diagnosis, treatment, classification, and epidemiology of thyroid tuberculosis. MethodsA retrospective study of 5 cases of thyroid tuberculosis and a review of the literatures were analyzed, which related to the clinical characteristics, the gist of the diagnosis and treatment, the causes of misdiagnosis and the methods of operation. ResultsAll of the cases were misdiagnosed before operation. Two cases were diagnosed by the frozen sections during the operations and three cases were diagnosed by postoperative pathology. Subtotal resection or lobectomy and local excision (3 cases) were performed respectively. Debidement and anti-tuberculosis medicine were given locally in 2 unresectable cases. All patients underwent standard chemotherapy for 6－8 months after operations and recovered finally. Four cases were caseous necrosis, 1 case was hyperplasia, all of which were chronic infections thyroid tuberculosis, and no acute thyroid tuberculosis be found. No recurrence was found in the 2－15 years of follow-up. ConclusionsUsually, it is difficult to establish a definite preoperative diagnosis for thyroid tuberculosis. Treatment, such as resection, debridement with local medication or systemic chemotherapy, shall be taken individually according to pathology types, focal features, and comorbidities. For hyperplasia cases, surgical resection shall be the best choice, while, for caseous necrosis cases, sometime difficult to remove, debridement with local medication may be suitable.
ObjectiveTo set reference intervals of the levels of thyroid hormones among normal pregnant women without presence of thyroid antibodies during three trimesters of pregnancy in Quanzhou city, Fujian province. MethodsA total of 490 pregnant women during 4-39 week pregnancy without presence of thyroid antibodies were enrolled in Quanzhou city, Fujian province. Levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4) and thyroid peroxidase antibodies (TPO-Ab) were detected through the electrochemistry immunoassay (ECL) method. In addition, a total of 51 healthy women without pregnancy were enrolled to set the reference intervals of levels of thyroid hormones among normal pregnant women without presence of thyroid antibodies. ResultsThe median levels of TPO-Ab were in the reference intervals provided by the pharmaceutical factory. Levels of FT3 and FT4 gradually decreased from the first to the third trimester (P < 0.01), levels of serum TSH gradually increasd from the first to the third trimester (P < 0.01). Compared with those of pregnant women, levels of thyroid hormone in normal non-pregnant women were higher in the first trimester, lower in the second and the third trimesters (P < 0.01). During three trimesters, the reference intervals of FT3 in the three trimesters were (first: 3.75 to 7.23; second 3.31 to 4.9; and third: 3.16 to 4.48 pmol/L); the reference intervals of FT4 were (first: 12.85 to 25.3; second: 12.03 to 20.14; and third: 11.02 to 19.43 pmol/L); and the reference intervals of TSH were (first: 0.01 to 3.79; second: 1.09 to 4.19; and third: 1.08 to 5.95 mIU/L), respectively. ConclusionThrough this detection, we set the levels of thyroid hormones among normal pregnant women without presence of thyroid antibodies during three trimesters of pregnancy in Quanzhou city.
Objective To investigate the possible interaction between the ras and p53 genes overexpression in thyroid carcinoma, and whether there is correlation between the ras and p53 overexpression and clinico-pathological criteria. Methods Thyroid lesions from eighty patients were examined for expression of ras and p53 genes by the LSAB immunohistochemistic method. Of these patients, 54 were diagnosed as malignant lesions and 26 benign nodular thyroid disorders. Results The positive immunostain rate for ras and p53 genes was 90.7%, 23.0% and 55.5%, 30.7% in carcinoma and benign lesions respectively with statistically significance between thyroid carcinomas and benign disorders (Ｐ＜0.05). Both ras and p53 overexpressions coexisted in 30 thyroid carcinomas and follow-up showed that 3 of them died and 5 of them had recurrence within 4 years.Conclusion Activation of ras gene and inactivation of p53 gene are cooperatively associated in thyroid tumorigenesis. The concurrent overexpression of ras and p53 could result in a poor prognosis.
ObjectiveTo investigate the clinical value of cervical vascular color Doppler ultrasound for dignosis of nonrecurrent laryngeal nerve before thyroid surgery. MethodsThere were 1931 cases of thyroid patients treated between January 2010 to Jule 2014, group these patients according to the results of preoperative chest radiograph examination, the chest radiograph shows abnormal vessels image were group A (45 cases), no abnormalities were group B (1886 cases). Before operaton, made patients of group A to have routine carotid duplex ultrasound to identify whether the right subclavian artery abnormalities. All patients were exposed to conventional methods of recurrent laryngeal nerve during surgery. ResultsThe 45 patients of group A, chest angiography showed 17 cases with right subclavian artery abnormalities, they were confirmed that all the 17 patients were nonrecurrent laryngeal nerve by surgery, no damage cases. The other 28 cases showed a normal right subclavian artery and no cases of nonrecurrent laryngeal nerve. The 1886 patients in group B, surgical exploration found four cases with nonrecurrent laryngeal nerve, injury in 1 case. The 21 patients whose nonrecurrent laryngeal nerve were on the right side, there were no left side with nonrecurrent laryngeal nerve and no co-exist cases of nonrecurrent and recurrent laryngeal nerve. The average exposure time of nonrecurrent laryngeal nerve in patients of group A (17 cases) was significantly shorter than that group B[(4.28±1.08) min vs. (15.50±2.08) min, t=-15.978, P=0.000]. ConclusionsThe cervical vascular color Doppler ultrasound examination before thyroid surgery can be adjuvant used, if there is the right subclavian artery abnormalities, it showes that there is the right side nonrecurrent laryngeal nerve. So as to effectively prevent the damage of nonrecurrent laryngeal nerve during thyroid surgery.
【Abstract】Objective To investigate the correlation of adhesive molecule expressions with potential of invasion and metastasis in papillary thyroid carcinoma (PTC). Methods S-P immunohistochemical method was used to detect CD44v6 and E-cadherin expression in 58 cases of PTC. Results The positive rates of CD44v6 and E-cadherin in PTC were 72.40%and 41.4% respectively. There was a positive correlation between CD44v6 expression and tumor invasive and metastatic potential in PTC (P＜0.05), and a reverse correlation between E-cadherin expression and the potential (P＜0.01).Moreover,there was a reverse correlation between the CD44v6 and E-cadherin expression in PTC(P＜0.05). Conclusion These data show a correlation between the adhesive molecule expression and the potential of invasion and metastasis in PTC. CD44v6 and E-cadherin may be prognostic indicators in PTC.