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Objective To explore the ultrasonographic and CT imaging features of predominantly cystic thyroid carcinoma (PCTC).Methods The retrospective analysis was performed on 30 cases of thyroid carcinoma with predominantly cystic composition confirmed by pathololy in the General Surgery Department of the First Affiliated Hospital of China Medical University from Jan.2011 to Dec.2016.The distribution of their solid portion's ultrasound characters including the eccentric configuration,irregular margin and increased vascularity were observed in all PCTCs.The CT images of 9 cases were analyzed,and the distribution of their solid portion's CT characters including irregular margin,uneven enhancement and papillary structure were observed in 9 PCTCs.Results In the ultrasound images of 30 PCTCs' whole shapes,26 cases (86.7％) showed oval and 24 cases (80.0％) showed smooth margin.26 cases (86.7％) showed eccentric configuration,20 cases (66.7％) showed rich blood flow and 19 cases (63.3％) showed irregular margin in the solid portion's ultrasound image.Only 7 cases(23.3％) showed microcalcification.Every ultrasound image of 30 PCTCs showed at least one or more of the three ultrasound characters,including eccentric configuration,irregular margin and increased vascularity.In the solid portion of 9 PCTCs,7 cases (77.8％) showed irregular margin,6 cases (66.7％) showed uneven enhancement and 6 cases(66.7％) showed papillary structure in the CT image,and every one of them showed at least one or more of the above 3 CT characters.Conclusion When the solid portion of predominantly cystic thyroid nodule appears to have some suspicious malignant characters in the image of ultrasound or CT,we should be vigilant that the nodule may be malignant.
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Lung squamous cell carcinoma (LUSC) causes approximately 400 000 deaths each year worldwide. The occurrence of LUSC is attributed to exposure to cigarette smoke, which induces the development of numerous genomic abnormalities. However, few studies have investigated the genomic variations that occur only in normal tissues that have been similarly exposed to tobacco smoke as tumor tissues. In this study, we sequenced the whole genomes of three normal lung tissue samples and their paired adjacent squamous cell carcinomas.We then called genomic variations specific to the normal lung tissues through filtering the genomic sequence of the normal lung tissues against that of the paired tumors, the reference human genome, the dbSNP138 common germline variants, and the variations derived from sequencing artifacts. To expand these observations, the whole exome sequences of 478 counterpart normal controls (CNCs) and paired LUSCs of The Cancer Genome Atlas (TCGA) dataset were analyzed. Sixteen genomic variations were called in the three normal lung tissues. These variations were confirmed by Sanger capillary sequencing. A mean of 0.5661 exonic variations/Mb and 7.7887 altered genes per sample were identified in the CNC genome sequences of TCGA. In these CNCs, C:G→T:A transitions, which are the genomic signatures of tobacco carcinogen N-methyl-N-nitro-N-nitrosoguanidine, were the predominant nucleotide changes. Twenty five genes in CNCs had a variation rate that exceeded 2%, including ARSD (18.62%), MUC4 (8.79%), and RBMX (7.11%). CNC variations in CTAGE5 and USP17L7 were associated with the poor prognosis of patients with LUSC. Our results uncovered previously unreported genomic variations in CNCs, rather than LUSCs, that may be involved in the development of LUSC.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Biomarkers, Tumor , Genetics , Carcinoma, Squamous Cell , Genetics , Case-Control Studies , Genome, Human , Genomic Structural Variation , Lung Neoplasms , Genetics , MutationABSTRACT
Objective To evaluate the changing trend of serum thyrotropin (TSH) levels for hemithyroidectomy patients,and to discuss the necessity and strategy of TSH suppression for low-risk differentiated thyroid carcinoma(DTC). Methods One hundred and twenty-seven patients with benign thyroid nodules undergoing hemithyroidectomy between January 2013 and June 2014 were retrospectively studied. Serum thyroid hormones levels FT3,FT4,TSH,thyroid peroxidase antibody(TPOAb),and thyroglobulin antibody(TGAb)were detected at 1 month after surgery for all patients and at 3 month for 54 patients. Results (1)Mean TSH level at 1 month after surgery was significantly higher than preoperative TSH level(2.45 mIU/L vs 2.20 mIU/L,n=127,P<0.01). The mean TSH level at 3 month after operation was significantly higher than preoperative ones(2.46 mIU/L vs 2.35 mIU/L,n=54, P<0.05). (2)TSH<2. 0 mIU/L was found in 52 patients(40. 9%) and TSH>4. 94 mIU/L in 18 patients (14.17%) at 1 month after operation. TSH<2.0 mIU/L was found in 28 patients(51.85%)and TSH>4.94 mIU/L in 8 patients(14.81%) at 3 month after operation. (3)A preoperative TSH≥2.0 mIU/L and the coexistence of Hashimoto's thyroiditis were found to be independent risk factors for the TSH levels higher than 2.0 mIU/L. Among the patients with TSH≥2. 0 mIU/L at 1 month, 13 exhibited spontaneous recovery at 3 month, coexistence of Hashimoto's thyroiditis was related to this phenomenon. Among the patients with TSH<2.0 mIU/L at 1 month,TSH levels were elevated over 2. 0 mIU/L in 7 patients by 3 month comparing to that by 1 month. Coexistence of Hashimoto's thyroiditis was independent risk factor for the TSH elevation. Conclusion TSH suppression may still be performed to patients with low risk DTC after operation especially to whom the preoperative TSH≥2.0 mIU/L and the coexistence of Hashimoto's thyroiditis. Suppression therapy should be carefully considered with close follow-up.
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Objective To investigate the characteristics and risk factors of central lymph node metastasis in clinically node negative (cN0) papillary thyroid carcinoma (PTC) (T1 or T2 stage) coexisting with Hashimoto' s thyroiditis (HT).Methods A total of 398 patients undergoing thyroidectomy with central lymph node dissection were enrolled in the study.Patients were divided into the trial group (PTC with HT)and the control group (PTC without HT).The difference of the clinicopathological characteristics between the 2 groups and risk factors for central lymph node metastasis were analyzed.Results Among the total 398 patients,98 (24.6％)had coexistent HT.Central lymph node metastasis rate was similar in the 2 groups (40.8％ vs 41.3％).The number of dissected central lymph nodes was significantly more in the trial group than in the control group (4.9 vs 2.9,P＜0.01) while the number of metastatic lymph nodes had no statistical significance between the 2 groups (1.0 vs 1.0).Univariate analysis showed that tumor size＞1 cm was significantly associated with central lymph node metastasis in the trial group (P＜0.01).Male,＜45 years,tumor size＞1 cm,and tumor located in the middle/lower third of lobe were all significantly associated with central lymph node metastasis in the control group (P＜0.01).Multivariate analysis showed that tumor size＞1 cm was independent predictor for central lymph node metastasis in the trial group,while female,＜45 years,tumor size＞1 cm,and tumor located in the middle/lower third of lobe were all independent predictors for central lymph node metastasis in the control group.Conclusions The number of central lymph nodes was larger in cN0 PTC coexisting with HT patients than that in PTC patients,but there was no statistical difference in the number of metastatic lymph nodes between cN0 PTC with and without HT.Central lymph node dissection is recommended when tumor size 1 cm in cN0 PTC coexisting with HT patients.
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Objective To investigate the effects of PTD4-GFP-Apoptin protein on proliferation inhibition and apoptosis-inducing of different types of leukemia cells. Methods Genetic engineering was used to restructure a carrier containing PTD4-GFP-Apoptin gene, and MTT was applied to detect the expressed PTD4-GFP-Apoptin fusion protein and its effect on the leukemia cell proliferation. Flow cytometry (FCM) was used to detect the effects on cell apoptosis. Results MTT cell proliferation inhibitory experiment showed that PTD4-GFP-Apoptin had different degree of proliferation inhibition on different types of leukemia cells;furthermore, the inhibitory effect presented positive correlation with time and concentration. FCM showed that PTD4-GFP-Apoptin had apoptosis-inducing effect on HL-60 cells, and the apoptotic rate had significant difference compared with the control group (P <0.05). Conclusions PTD4 can carry large proteins to penetrate the cell membrane, and PTD4-GFP-Apoptin may produce the inhibiting proliferation in vitro for a variety of leukemia cells. Apoptin can induce tumor cell apoptosis without affecting normal cells, which might become a new agent for the clinical treatment of leukemia.
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Objective To evaluate the diagnostic value of medical imaging for primary thyroid malignant lymphomathe(PTML). Methods The medical imaging of 45 PTML cases admitted between January 2000 and December 2014 in the First Hospital of China Medical University were ana?lyzed retrospectively. Results In ultrasound imaging,PTML exhibits a hypoechoic mass and enhancement of posterior echoes,the uninvolved thy?roid tissues also exhibit low echoes but they have clear boundaries with extremely low echo areas of PTML.CT imaging of PTML often shows homoge?neous enlargement of the lobes of the thyroid gland and isthmus with densities lower than the adjacent muscles. In contrast?enhanced CT images,le?sions are moderately enhanced,but they are obviously enhanced in the edge or internal area and the degree of enhancement remains lower than that of the adjacent muscle. Calcification is uncommon. A lesion withcold nodulecan be observed in ECT imaging. Conclusion The characteristic im?aging findings are helpful for preoperative diagnosis of PTML.