Objective To understand the latest research developments of the formation mechanism of psammoma body in human tumors and related issues. Methods Related domestic and foreign literatures were widely referred, analyzed, and reviewed. Results Psammoma body is unique pathological calcification in some tumors, which is arranged in concentric, laminar circles microscopically. Psammoma body is commonly seen in thyroid papillary carcinoma, meningiomas, ovarian serous papillary carcinoma, and so on. Conclusions Although arranged in concentric, laminar circles microscopically in tumor, the formation process of psammoma body is not entirely the same in different tumors. A comprehensive and objective understanding of psammoma body would be useful in cancer diagnosis and treatment.
Secondary and tertiary hyperparathyroidism are common complications in patients with chronic kidney disease, especially in end stage renal disease. Surgery is an important method for the treatment of secondary and tertiary hyperparathyroidism. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism is the first evidence based guideline focus on renal hyperparathyroidism surgical management. Recommendations using the best available evidence by a panel of 10 experts in secondary and tertiary renal hyperparathyroidism constructed this guideline, which provides evidence-based, individual and optimal surgical management of secondary and tertiary renal hyperparathyroidism. This paper made a guideline interpretation on the indications of surgery, imaging examination, preoperative and perioperative management, relevant evaluation and treatment during perioperative period, and intraoperative parathyroid hormone monitoring during operation, and so on.
【Abstract】Objective To find out if apoptosis is induced after intra-radiotherapy and its effects on pericarcinomal tissue. Methods From 1994 to 1998, 44 patients with unresectable liver cancer received 32P-GMS intra-radiotherapy. After 2 to 6 months the tumors in 3 cases could be resected and we used this cases as the treatment group. We use 4 patients with resectional HCC of same age, diseased region, differentiated but without anyother therapy as the control group. The TUNEL staining was used to stain the resected tissue, and the apoptosis index was counted. Results The apoptosis index of carcinoma was 29%～34%, average (31±16)% in the treatment group and that of the control group was 4%～6%, average (5±12.2)%. The apoptosis index of pericarcinomal tissue was 27%～37%, average (35±11)% in the treatment group and that of the control group was 0.3%～5%, average (4.1±3.3)%. Conclusion 32P-GMS intra-radiotherapy can enhance the apoptosis of HCC and its adjacent tissue.
ObjectiveTo investigate the impact of postoperative application of Pseudomonas aeruginosa injection on recurrence free survival (RFS) and overall survival (OS) in patients with abnormal serum calcitonin levels following surgery for medullary thyroid carcinoma (MTC). MethodsA retrospective collection of data was conducted for 214 patients with abnormal serum calcitonin levels following MTC surgery at West China Hospital of Sichuan University from January 2015 to April 2024. Propensity score matching (1∶2) was utilized to match patients’ data to reduce confounding bias, comparing RFS and OS between patients who used (Pseudomonas group) and did not use (control group) Pseudomonas aeruginosa injection. ResultsAfter propensity score matching, 72 patients with abnormal postoperative calcitonin levels were included, with 24 in the Pseudomonas group and 48 in the control group. The median follow-up time for the 72 patients was 66 months (11–168 months). The 1-year RFS rates for the Pseudomonas group and the control group were 100% and 75.0%, respectively, and the 2-year RFS rates were 87.5% and 56.3%, respectively. The RFS in the Pseudomonas group was superior to that in the control group (χ2=4.791, P=0.029). The 5-year OS rates for the Pseudomonas group and the control group were 90.9% and 93.5%, respectively, with no significant difference between the two groups (χ2=0.469, P=0.491). The Cox proportional hazards regression model indicated that the median RFS was extended in the Pseudomonas group [25 months vs. 21 months, RR=0.350, 95%CI (0.135, 0.900), P=0.029], but there was no significant impact on OS [66 months vs. 69 months, RR=2.22, 95%CI (0.229, 21.444), P=0.503]. ConclusionPostoperative use of Pseudomonas aeruginosa injection in MTC patients with abnormal serum calcitonin level shows significant improvement in RFS, but no significant change in OS.
ObjectiveTo analyze the epidemic trend of thyroid cancer in China from 2005 to 2018, and understand the estimated epidemiological situation of thyroid cancer in China in 2022 based on the thyroid cancer registration data reported by the National Cancer Registration Center and the China Cancer Registration Annual Report. MethodsThe cases of new thyroid cancer and deaths in China were analyzed according to the data of approximately 700 cancer registries in 2018 and the data of 106 cancer registries from 2005 to 2018, then stratified by sex, age, urban and rural areas, and main regions in China. And the estimated incidence and mortality of thyroid cancer in China in 2022 were analyzed based on the population data in 2020. Results① The age standardized incidence rate (ASIR) and age standardized mortality (ASMR) of thyroid cancer in China from 2005 to 2018: in the whole population, the ASIR showed a relatively rapid upward trend and the ASMR showed a relatively slower upward trend; The ASIR and ASMR of men were lower than those of women and the trend of change was also slower than that of women; The ASIR of thyroid cancer in the whole urban population was markedly higher than that in the rural population and the average annual rising rate (AARR) in the urban and rural areas was 6.31% and 0.38% respectively, while the ASMR had no obviously difference between the urban and rural populations (the AARR was 3.23% and 2.33% respectively); The ASIR of thyroid cancer was the highest in the eastern region with a markedly rising, but its ASMR had a relatively lower rising rate, while the ASIR in the western region was relatively lower and the ASMR also showed a downward trend, and the ASMR in the central region had a relatively obvious rising rate. ② The estimated incidence and mortality of thyroid cancer in China in 2022: the estimated ASIR and ASMR of the whole population in 2022 was still rising as compared with in 2018 (ASIR: 24.64 per 100 000 vs. 12.01 per 100 000; ASMR: 0.45 per 100 000 vs. 0.37 per 100 000 ); The estimated ASIR and ASMR in women were still much higher than in men (ASIR: 36.51 per 100 000 vs. 13.25 per 100 000; ASMR: 0.55 per 100 000 vs. 0.35 per 100 000); Among the urban and rural populations, the estimated ASIR in urban was still higher than in rural areas (27.87 per 100 000 vs. 17.66 per 100 000), while the estimated ASMR had no marked difference between them (0.41 per 100 000 vs. 0.52 per 100 000). Compared with 2018, the development trend of the ASIR was still rising (urban: 27.87 per 100 000 vs. 15.58 per 100 000; rural: 17.66 per 100 000 vs. 8.95 per 100 000). The age specific ASIR of thyroid cancer showed a marked sex differences, that is, it began to rise rapidly from the 20–30 years old group, and reached the peak at the 45–50 years old group (the highest ASIR was 97.00 per 100 000) in women; However, which had been in a slower upward trend from the 0 to 20 years old group, while it had been rising rapidly from the 20 to 25 years old group, reaching the peak at the 30–35 years old group (the highest ASIR was 31.60 per 100 000) in men. The overall trend of age specific ASMR for thyroid cancer was similar for both males and females, with a slower increase starting from the 0–35 years old age group and continuous rising till 85 years old and above. ConclusionsThe incidence and mortality of thyroid cancer in China are rising, and the disease burden is still severe and the differences are existed in urban and rural areas, sex, age, and main regions. Overall, the prevention and control situation is complex and severe in China.
ObjectiveTo summarize the experience of diagnosis and treatment of 2 cases of intrathyroid thymic carcinoma(ITTC).MethodThe clinical data of 2 patients with ITTC treated in West China Hospital of Sichuan University since July 2019 were analyzed retrospectively.ResultsAfter the discussion of the multidisciplinary team (MDT), the diagnosis and treatment of 2 cases of ITTC were discussed together, and the prognosis of the patients was actively improved through multidisciplinary cooperation.ConclusionMDT cooperative therapy mode should be adopted in the clinical diagnosis and treatment of patients with ITTC in order to provide a better treatment plan.
Objective To compare the disadvantages and advantages of open thyroid surgery when using the harmonic scalpel (HS) vs conventional hemostasis (CH). Methods One 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. Results There 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 (P＜0.001); the surgical complications showed no significant difference between the HS and CH group (Pgt;0.05); the incisional length after learning curve was shorter than that in learning curve in HS group (P＜0.05); the surgical complications after learning curve were significantly lower than that in learning curve in HS group (P＜0.001). Conclusion HS provides significant advantages over conventional hemostasis in open thyroid surgery. However, it can’t be used in a blindly exclusive way but be combined with conventional knot tying appropriately.
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.
Objective The aim of this study is to review the association between long non-coding RNA (lncRNA) and papillary thyroid carcinoma (PTC). Method The relevant literatures about lncRNA associated with PTC were retrospectively analyzed and summarized. Results The expression levels of noncoding RNA associated with MAP kinase pathway and growth arrest (NAMA), PTC susceptibility candidate 3 (PTCSC3), BRAF activated non-coding RNA (BANCR), maternally expressed gene 3 (MEG3), NONHSAT037832, and GAS8-AS1 in PTC tissues were significantly lower than those in non-thyroid carcinoma tissues. The expression levels of ENST00000537266, ENST00000426615, XLOC051122, XLOC006074, HOX transcript antisense RNA (HOTAIR), antisense noncoding RNA in the INK4 locus (ANRIL), and metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in PTC tissues were upregulated in PTC tissues, comparing with the non-thyroid carcinoma tissues. These lncRNAs were possibly involved in cell proliferation, migration, and apoptosis of PTC. Conclusion LncRNAs may provide new insights into the molecular mechanism and gene-targeted therapy of PTC and become new molecular marker for the diagnosis of PTC.
目的 分析經病理證實的頸部無痛性腫大淋巴結的聲像圖特點，比較良、惡性疾病中異常淋巴結的聲像圖特征，為臨床醫師的鑒別提供可靠的診斷依據。 方法 將2007年7月－2009年12月以頸部無痛性腫大淋巴結就醫、并經病理證實的良、惡性疾病的97例患者作為研究對象，其中男56例，女41例；共檢出淋巴結365個，依據病理診斷結果將研究對象分為良性組（98個）和惡性組（267個）。 結果 ① 大多數良性淋巴結：L/S＞2，形態接近橢圓形、門部回聲規則無移位、皮質較薄、髓質形態規則，居中； 大多數惡性淋巴結短徑相對增大，L/S≤2，形態趨于類圓形，包膜不完整，門部大多數偏離中心，皮質不均勻增厚，髓質變形移位或消失。② 良性淋巴結多表現為無血流型或門部規則血流型；惡性淋巴結多表現為周邊血流或混合血流型。③ 大多數良性淋巴結血流阻力指數偏低，RI＜0.60；大多數惡性淋巴結血流阻力指數偏高，RI＞0.70。 結論 高頻超聲在頸部無痛性淋巴結腫大的良惡性鑒別中能夠提供重要的診斷信息。