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<p><b>OBJECTIVE</b>To study the expression of EpCAM and E-cadherin in papillary thyroid carcinoma and to analyze its correlation with various clinicopathologic parameters.</p><p><b>METHODS</b>Immunohistochemical study for EpCAM and E-cadherin was carried out in 91 cases of papillary thyroid carcinoma. Twenty-four cases of papillary hyperplasia of thyroid were used as controls.</p><p><b>RESULTS</b>In all of the 24 cases of papillary hyperplasia, EpCAM was located on the cell membrane, while in the 91 cases of papillary thyroid carcinoma studied, EpCAM was located within the cytoplasm, with 36.3% (33/91) showing nuclear localization as well. In all the papillary hyperplasia cases studied, E-cadherin showed membranous expression. E-cadherin expression was reduced in 84.6% (77/91) of papillary thyroid carcinoma, as compared with the surrounding native thyroid parenchyma. Amongst the 33 cases of papillary thyroid carcinoma which showed nuclear localization of EpCAM, 30 cases also showed reduced E-cadherin expression. There was a positive correlation between nuclear expression of EpCAM and loss of E-cadherin expression (P = 0.000; Spearman correlation coefficient = 0.857). Nuclear expression of EpCAM correlated with follicular variant of papillary thyroid carcinoma and presence of extrathyroidal extension ( P = 0.037 and 0.033, respectively). Loss of E-cadherin expression correlated with age of patients and presence of lymph node metastasis (P = 0.018 and 0.010, respectively).</p><p><b>CONCLUSIONS</b>E-cadherin expression is reduced in papillary thyroid carcinoma, as compared with native thyroid parenchyma and papillary hyperplasia. Papillary thyroid carcinoma shows loss of EpCAM membranous expression and increased cytoplasmic/nuclear accumulation. Detection of these two markers may provide a valuable reference in defining the biologic behaviors of papillary thyroid carcinoma, including extrathyroidal extension and lymph node metastasis.</p>
Subject(s)
Humans , Antigens, Neoplasm , Metabolism , Cadherins , Metabolism , Carcinoma, Papillary , Metabolism , Cell Adhesion Molecules , Metabolism , Cell Membrane , Metabolism , Cytoplasm , Metabolism , Epithelial Cell Adhesion Molecule , Lymphatic Metastasis , Neoplasm Proteins , Metabolism , Thyroid Neoplasms , Metabolism , PathologyABSTRACT
Objective To investigate the clinical features,surgical treatment and prognosis of female breast cancer patients under 35 years.MethodsThe clinical data of 140 cases of female breast cancer patients in the young group ( ≤ 35 years) and 326 cases of female breast cancer patients in the control group ( 45 - 59years) undergoing surgical treatment from 2002 to 2009 in our hospital were analyzed retrospectively.All the data were analyzed with the statistical software of SPSS13.0.ResultsThe difference between the 2 groups had no statistical significance in tumor size or pathologic types( P ＞0.05).The axillary lymph node metastasis rate was obviously higher in the young group than in the control group ( P ＜ 0.05 ). Modified radical mastectomy and breast-conserving surgery were mainly performed.The proportion of patients in stage Ⅲ and Ⅳ in the young group was higher than that in the control group.The positive rate of ER and PR was lower while the positive rate of HER-2 was higher in the young group than those in the control group( P ＜ 0.05 ).ConclusionsBreast cancer in young women has the features of high clinical stage,high lymph node metastasis rate,low positive rate of ER and PR,high positive rate of HER-2,high recurrence rate and poor prognosis.The treatment principle of the diseaseis comprehensive therapies mainly based on surgical treatment.
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ObjectiveTo discuss the diagnosis method and management of Gallbladder polypoeid lesions (GPL).MethodA ten-year (2002-2011) retrospective reviews of all patients result underwent in ultrosenography (US) was conducted.ResultsTotal 591 peatients with GPL detected on US were identified,349 patients (59.1％) were women,the age ranges 20 to 93 years.395 patients had abdominal symtoms,of which 39.9％ patients had a single polyp and 9.8％ had gallstones.The specifisity of the diagnosis of GPL in US was 92.5 ％.Laparascopic cholecystectomy (LC) is the treatment of 136 chosen cases.In cases suspicious of malignancy,it is advisable to do cholecystectomy.ConclusionsMost small GPL are benign and remain static for years.Age more than 50 years old and size of polyp more than 10 mm are the two main important risk factors predicting malignancy in GPL.Other risk factors include concurrent gallstones,solitary polyp,and symptomatic polyp.LC is the treatment of unless since the suspicion of malignancy is high.
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Laparoscopic hepatectomy (LH) has been an incredible proliferation worldwide. many series have demonstrate that LH decreases intraoperative bleeding, postoperative compliceations and the duration of hospital stay. When compared with open hepatectomy(OP). Since the first LH was reported in 1992, near to 3000 cases have been reported,it's morbidity and mortality are 10. 5% and 0. 3% respectively. There are three terms should be used describe LH: pure laparoscopy, hand-assisted laparoscopy, and hybrid technique. In the beginning of LH, both resections were performed using the ultrasonic dissector and electrocautery,the operation included small wedge resection, liver cyst resection, and liver briopsy, however, while improvements in technology,as harmornic scalpel, endovasculer stapling devices, water jet, LigaSure, TissurLink, Habib etc. With increased experience, surgeons became holder and began to performe larger LH. But the keypoint of LH was use of portal inflow occlusion,and technique of paranchymal transection.
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Objective To discuss the standard diagnosis and treatment for thyroid nodule.Methods 2 581 patients with thyroid nodule from 2005 to 2009 were studied.Common methods of examination and treatment were analyzed to avoid over-examination and over-treatment.Results 90%of the patients underwent ultrasound examination with a 92.9%sensitivity and 44.3%specificity when there were two or more risk characters.All patients underwent certain kinds of surgery according to their clinical conditions.The recurrence rate was 4%two and half years after lateral thyroid adenectomy or thyroid surgery without excision of thyroid isthmus.Conclusions There are many approaches to thyroid nodule examination and treatment,in which ultrasound is recommended for preoperative examination because of its higher sensitivity,specificity and lower cost,and surgery is still the most useful and effective treatment.Choosing the proper method for thyroid nodule diagnosis and treatment is the key point to avoid over-examination and over-treatment.
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Objective To discuss the diagnosis and treatment of normotensive pheochromocyto-ma. Methods The clinical data of 22 patients with normotensive pheochromocytoma were reviewed. Inclusion criteria for normotensive pheochromocytoma were no previous history of hypertension and episode of symptoms suggesting high blood pressure. The blood pressure on admission was 90-130/ 60-90 mm Hg with an average of 113/72 mm Hg. Seven patients were found adrenal mass by routine ultrasonic examination. Twelve patients presented with superior abdominal or flank pain. Four pa-tients were present with fatigue, and 2 patients had fever. Headache and palpitation were found in 1 patient. Most of patients were present with large and round mass with low density area in the center of the tumor by uhrosonography and CT. Four patients had elevated level of plasma epinephrine and nor-epinephrine. 24 hours urine CA and VMA were elevated in 5 and 4 patients respectively. Seven pa-tients were prepared with infusion preoperatively to expand intravascular volume, and 2 patients were given prazosin 1.5 mg/d for 5 to 7 days. Results During the operation, seventeen patients had ele-vated blood pressure and 5 patients had no changed. One of seven patients with preoperative prepara-tion had obvious hypertension during operation, and 11 of 15 patients without preoperative preparation had obvious hypertension. The tumors were removed successfully in 21 patients. All the patients were diagnosed pheochromocytoma pathologically. Twenty-one patients had normal blood pressure with no recurrence during the follow-up from 1 month to 7 years. Conclusions The patients with normotensive pheochromocytomas may have lower catecholamine in their plasma and urine. The application of α-blockers and the expanding intravascular volume before operation could be important for the patients safe.
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Objective To evaluate the diagnostic value of multi-slice spiral CT urography (MSCTU)in kidney tuberculosis. Methods Thirty cases(16 men and 14 women)of kidnev tuberculosis diagnosed by clinic and pathology were retrospectively analyzed.The patients' mean age was 44 years(range,19-73 years).Of them,17 cases were on the left and 13 on the right.Eighteen cases had irritation symptoms,18 cases had low back pain,6 cases had hematuria,2 cases had a fever; renal tuberculosis was incidentally detected in 2,1 case had left scrotal swelling.The enhancement scanning and three-dimensional reconstruction of multi-slice spiral CT were conducted in all patients. Resuits Among the 30 cases,29 cases of renal tuberculosis were diagnosed with CTU(97%).The low density area in renal parenchyma was seen in 25 cases without expansion and fluidify of pelvis,tubercle calcification was seen in 18 cases,the thickening of renal pelvis and ureter wall was seen in 17 cases,the thinning of cortex of kidney was seen in 12 cases,and the contracture of bladder and poor filling was seen in 2 cases.IVU diagnosed 9 cases of renal tuberculosis(30%).Twenty cases of renal pelvis,calyceal failed to show contrast filling. Conclusion MSCTU has advantages in the diagnosis of renal tuberculosis compared with IVU.