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．
Objective The expression of CD15 antigen and oncoprotein bcl-2 in thyroid cancer were examined in order to study the correlation between them. Methods The expression of CD15 and bcl-2 in 50 thyroid cancers, 20 adjacent noncancerous portion, 45 adenoma and 10 normal thyroid tissue were respectively investigated by microwave-LSAB immunohistochemical technique. Results The positive rate of CD15 and bcl-2 in thyroid cancer was 68.0% and 46.0% respectively, which was significantly higher than that in adenoma or adjacent noncancerous (Ｐ＜0.05). The percentage of CD15 and bcl2 positive expression were found to be significantly correlated with the tumor metastasis (Ｐ＜0.05), but not correlated with histological feature. Expression of CD15 was significantly correlated with bcl-2.Conclusion Expression of CD15 and bcl-2 can be regarded as a parameter to evaluate tumor metastasis and prognosis of thyroid cancer.
ObjectiveTo investigate the expressions of chemokine receptor CXCR4 and CCR7 in thyroid cancer and its clinicopathologic significance. MethodsFifty-five patients with thyroid cancer were selected in the Affiliated Hospital of North Sichuan Medical College from 2006 to 2009, and 30 patients with thyroid adenoma were selected in the same hospital during 2009. The expressions of CXCR4 and CCR7 were detected in all the selected cases samples (including thyroid cancer and thyroid adenoma) by immunohistochemical SP technique. ResultsThe positive expression rates of CXCR4 and CCR7 in the thyroid cancer were higher than those in the thyroid adenoma (Plt;0.01), which in the thyroid cancer with clinical stage Ⅲ+Ⅳ were higher than those of the clinical stage Ⅰ+Ⅱ (Plt;0.05). The positive expression rate of CCR7 in the thyroid cancer with lymph node metastasis was higher than that of the thyroid cancer without lymph node metastasis (Plt;0.05), which of CXCR4 in the patients with thyroid cancer was independent of lymph node metastasis (Pgt;0.05), and which of CXCR4 and CCR7 were also independent of the age and gender of the patients with thyroid cancer (Pgt;0.05). The positive expressions of CCR7 and CXCR4 in all the patients with thyroid cancer was positively correlated (rs=0.491, P=0.000). ConclusionsCXCR4 and CCR7 are involved in the coordination of thyroid cancer progression. They can be used as prognostic indicators of thyroid cancer. High expression of CCR7 is prone to lymph node metastasis of thyroid cancer.
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.
ObjectiveTo compare the diagnostic efficacy of serum thyroglobulin (Tg), diagnostic 131I whole-body scan (D-WBS), neck ultrasound for diagnosing metastasis and recurrence of differentiated thyroid carcinoma (DTC). MethodsFrom May to June 2011, fifty follow-up DTC patients were collected retrospectively 6 months or more after 131I ablation therapy following total-thyroidectomy or near-total thyroidectomy. The diagnostic standard for DTC metastasis and relapse were based on serum Tg, D-WBS, neck ultrasound and chest CT. Diagnostic 2 by 2 table was employed for calculating the sensitivity, specificity, accuracy of the methods. ResultsThe sensitivity, specificity, accuracy, positive predictive value, negative predictive value of TgIMA and D-WBS parallel experiments were 100.0%, 92.9%, 96.0%, 91.7%, and 100.0% respectively. ConclusionTgIMA combined with D-WBS parallel test in diagnosis of DTC metastasis and recurrence has the highest accuracy.
ObjectiveTo review the recent progress of the molecular targeted therapy for thyroid cancer. MethodsThe literatures of molecular etiology for thyroid cancer, mechanism and evaluation of targeted therapy via Medline and CHKD database were reviewed. ResultsSo far, four molecular targeted drugs (Sorafenib, Lenvatinib, Vandetanib, and Cabozantinib) have been approved for treatment of advanced thyroid cancer by FDA. They can mainly improve the patient's progression-free survival. Besides, several new molecular targeted drugs have accomplishedⅠphase or Ⅱ phase clinical trials. These drugs may be new options for treatment of advanced thyroid cancer in the future. ConclusionsMolecular targeted drugs have been the main therapeutic method for advanced thyroid cancer. However, we should invent more effective new drugs and investigate the drug combination to improve the therapeutic effect.
Objective To sum up experiences in diagnosis and treatment for thyroid malignancy. Methods Clinical records of 8 patients diagnosed as Hashimoto’s disease associated with thyroid malignancy by histologic examination at our hospital from Jan. 1998 to Dec. 1998 were analyzed. Results There were 1 male and 7 females with average age of 37.6 years. The incidence of Hashimoto’s disease associated with thyroid cancer and malignant lymphoma were 7.7% and 2.6%, respectively. No operative mortality and complication was found. Conclusion Hashimoto’s disease is not uncommon. The combined thyroid cancer is small with papillary carcinoma predominance and the prognosis is good. If it is complicated with malignant lymphoma, the thyroid is rapidly enlarged with pain and dyspnea.
ObjectiveTo discuss whether central lymph node dissection (CLND) should be performed for papillary thyroid cancer (PTC) patients. MethodsThe related domestic and foreign literatures were retrieved, the necessity of CLND and the risk of recurrent laryngeal nerve (RLN) injury in CLND were reviewed, and the application value of intraoperative nerve monitoring (IONM) in CLND were analyzed. Results① CLND can reduce the recurrence rate of PTC, improve postoperative survival rate, ease the difficulty of reoperation, and help to clarify tumor stage. ② CLND can increase the risk of RLN injury. ③ Application of INOM can decrease the risk of RLN injury. ConclusionsThe application of IONM during CLND effectively decrease the risk of RLN injury for surgeons, especially low seniority surgeons, and improve the survival quality and the prognosis. This combination will promote the implementation of routine CLND therapeutic strategy in thyroid cancer patients.
Objective To summarize the progress in the diagnosis and treatment of thyroid cancer related genes. Methods By using the method of literature review, The literatures of thyroid cancer related gene were reviewed on the study of emerging diagnosis and treatment strategy. Results Combined detection of BRAF oncogene, RAS oncogene, RET/PTC rearrangement, PAX8-PPARγ fusion gene and its related genes, can effectively improve the prediction accuracy of the malignant thyroid nodule form benign, and has become a basis of targeted drug therapy. Conclusion In preoperative thyroid cancer, Joint detection of related gene can provide a molecular basis for the patients to guide the operation and drug treatment.
Objective To explore the effectiveness of detailed physiotherapy in perioperative rehabilitation of patients undergoing thyroid cancer surgery with lymph node dissection. Methods A total of 97 patients with thyroid malignancy who underwent surgical treatment in West China Hospital of Sichuan University between February and June 2021 were selected and randomly divided into the trial group (n=50) and the control group (n=47). The patients in the trial group received detailed physiotherapy, and the patients in the control group received routine perioperative rehabilitation. The degree of pain within the operation area and the degree of neck and shoulder discomfort associated with surgery within 4 weeks, and the scores of Neck Dissection Impairment Index 4 weeks after surgery were compared between the two groups. The pain score, which was non-normally distributed, was described by median (lower quartile, upper quartile) and compared by generalized estimation equation; the discomfort score and score of Neck Dissection Impairment Index, which were normally distributed, were described by mean ± standard deviation, and the former was compared by multivariate analysis of variance, and the latter was compared by Student’s t-test. Results In the 1st, 2nd, 3rd, and 4th week after surgery, the pain scores within the operation area were 2.2 (1.7, 3.3), 1.5 (1.0, 2.2), 1.5 (0.0, 2.3), and 0.0 (0.0, 1.2), respectively in the trial group, and 3.4 (2.7, 5.2), 2.6 (1.5, 3.5), 2.4 (1.1, 3.4), and 1.5 (1.1, 2.0), respectively in the control group; the surgery-related neck and shoulder discomfort scores were 8.72±4.14, 5.28±2.98, 5.89±2.78, and 3.57±1.83, respectively in the trial group, and 10.56±5.30, 7.54±4.51, 7.37±3.49, and 5.05±2.59, respectively in the control group. Within 4 weeks after operation, the surgical-area pain scores and surgery-related neck and shoulder discomfort scores in the trial group were lower than those in the control group, and the differences were statistically significant (Wald χ2=28.826, P<0.001; F=7.695, P=0.007). In the post-operative week 4, the Neck Dissection Impairment Index in the trial group was higher than that in the control group, and the difference was statistically significant (75.23±20.40 vs. 63.83±19.52; t=2.809, P=0.006). Conclusion For patients undergoing thyroid cancer surgery with lymph node dissection, detailed physiotherapy intervention is more effective than routine perioperative rehabilitation.