Clinical and biological features of familial nonmedullary thyroid carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the clinical and biological features of familial nonmedullary thyroid carcinoma (FNMTC).</p><p><b>METHODS</b>Clinical data of 66 FNMTC cases of 32 pedigrees was retrospectively analyzed, compared with that of 182 control cases taken randomly from the patients with sporadic papillary thyroid carcinoma (SPTC), who were diagnosed and treated in Tianjin Cancer Hospital between January 2008 and November 2012. The features of FNMTC of the first and second generations were objectively analyzed. Some data quoted from the literature were also used for the analysis.</p><p><b>RESULTS</b>The median age at diagnosis of all the 66 FNMTC patients was 44 years, and 57 (86.4%) were females. Moreover, 71.2% (47 patients, 23 pedigrees) of the FNMTC patients exhibited a sibling relationship, and 28.8% (19 patients, 9 pedigrees) of the FNMTC patients exhibited a parent-offspring relationship, and 9 cases in the first generation and 10 cases in the second generation. There were significant differences between the FNMTC group and SPTC group in terms of tumor multicentricity, tumor bilaterality, lymph node metastasis, central lymph node metastasis, concomitant chronic thyroiditis and recurrence (P < 0.05). Compared with SPTC, sibling FNMTC presented a higher rate of central lymph node metastasis, while parent-offspring FNMTC showed frequent tumor bilaterality and a higher rate of recurrence (P < 0.05). Besides, patients in the second generation were diagnosed at an earlier age and had a higher male rate, the tumors were more frequently multifocal and bilateral, and had a higher rate of lymph node metastasis.</p><p><b>CONCLUSIONS</b>FNMTC may be more aggressive than SPTC and patients in the second generation may exhibit the "anticipation" phenomenon. It's necessary to make sufficient detailed interrogation and long-term follow-up of the patients and their family for providing individual recommendations for clinical management.</p>

Correlation of BRAFV600E mutation and clinical characteristics in coexistence of papillary thyroid carcinoma and Hashimoto's thyroiditis / 中华内分泌代谢杂志

Objective To investigate the correlation of BRAFV600E mutation with papillary thyroid carcinoma and coexisting Hashimoto's thyroiditis.Methods A retrospective analysis of clinical characteristics was made in 50 patients with PTC and coexisting HT(research group) and 150 PTC patients(control group) from March,2011 to March,2012,regarding the difference in BRAFV600E mutation.Results In research group,the sensitivity of ultrasound in detecting lymphatic metastasis was 88.9％,while the specificity was 50.0％ ; the levels ofTSH,thyroid globulin antibody,and thyroid peroxidase antibody in research group were higher than those in control group (all P＜ 0.01).Rates of lymphatic metastasis (36.0％ vs 54.0％) and metastasis in Ⅱ-V area(22.2％ vs 63.0％) showed statistically significant differences between research group and control group(P=0.041,P=0.004).The respective rates of mutation of BRAFV600Ein two groups were 34.0％ and 70.7％,showing significant difference (P＜0.01).There was a significant correlation between BRAFV600E mutation and lymphatic metastasis in research group (P ＜ 0.01).Conclusions The sensitivity of ultrasound in detecting lymphatic metastasis of PTC is quite satisfactory while with its poor specificity.Combination of ultrasound with the fast frozen section pathology may help assess the scope of surgery.Reduced BRAF V600Emutation in PTC with coexisting HT results in reduction of lymphatic metastasis and may help to improve the prognosis of patients.

Clinical analysis of 498 papillary thyroid carcinoma cases at cNo stage / 中华普通外科杂志

Objective To explore the relationship between the status of the cervical lymphatic metastasis of papillary thyroid carcinoma(PTC)at cNo stage and tumor recurrence and the patient' s prognosis.Methods The clinical data of 498 cNo PTC patients admitted from 1986 to 1990 were retrospectively analyzed.Results All the patients were followed up for more than 10 years.16 patients died of PTC,among them 3 for metastasis,13 for local recurrence.The total cervical lymphatic metastasis rate in these 498 patients was 52.2％,in 260 cases in which detailed data were available: rate was 14.1％ in zone Ⅱ,27.1％ in zone Ⅲ,24.6％ in zone Ⅳ,12.5％ in zone Ⅴ,and 20.1％ in zone Ⅵ respectively.According to the appearances of microscopic pathology,the cervical lymphatic metastasis rates in 498 cases of cNo PTC were collected as following: uncapsuled group was 65.6％,extracapsular group was 64.5％,extralobal group was 56.5％,involved the surrounding tissue and structure group was 52.0％,focal cancerous focus group was 33.3％,latent sclerosis group was 26.9％,encapsuled and introcapsule group was 0.The cervical recurrence rate was only 2％ in the complete function neck dissection group and 9.9％ in the selective center neck dissection group.Conclusions In cNo PTC the most common cause of death was local recurrence.Prophylactic function complete neck dissection should be performed for cNo PTC cases of highly invasive type such as without tumor capsule,extracapsular,extralobal or surrounding tissue invasion.