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Objective:To investigate the clinical risk factors of large volume lymph node metastasis (LV-LNM) in the central region of papillary thyroid cancer (PTC) .Methods:The clinical data of 1367 PTC patients admitted to the Department of Oncological Surgery, Hangzhou First People’s Hospital, Affiliated to Zhejiang University School of Medicine from Jan. 2016 to Jan. 2019 were retrospectively analyzed. There were 310 males and 1057 females. A total of 1644 cases of central region were included in the study.According to the number of lymph node metastasis in the central area, they were classified into small-volume lymph node metastasis (SV-LNM) group and LV-LNM group.71 cases of LV-LNM, 1573 cases of SV-LNM.The correlation between CLNM and LV-LNM and various clinicopathological features such as the sex, age, tumor size and so on of PTC patients was analyzed by chi-square test and Logistic regression analysis.Results:The proportion of CLNM in the affected side was 35.28% (580/1 644) , and the incidence of LV-LNM in the central area of the affected side was 4.32% (71/1644) . Univariate analysis showed that the LV-LNM in the central region of the affected side was closely correlated with gender, age, bilateral lesions, multiple lesions, size of lesions, membranous invasion and lateral cervical lymph node metastasis on the affected side were closely related ( P<0.05) . Multivariate regression analysis showed that male (OR=2.115, P=0.006) , age < 38 years old (OR=0.586, P=0.004) , multiple lesions on the affected side (OR=2.837, P=0.004) , lesions >7mm on the affected side (OR=1.762, P=0.002) and cervical lymph node metastasis on the affected side (OR=7.023, P<0.001) were independent predictors of LV-LNM in the central region of the affected side ( P<0.001) . The receiver operating characteristic curve (ROC) , sensitivity and specificity of LV-LNM predicted by the model were 0.839, 81.69% and 78.39%. The incidence of ipsilateral cervical lymph node metastasis in the affected central region of LV-LNM was 11.57 times higher than that of SV-LNM. Conclusion:PTC with male, age < 38 years old, multiple lesions on the affected side, lesion >7 mm and lateral cervical lymph node metastasis are prone to LV-LNM in the affected central region.
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Objective:To investigate the predictive value of the clinicopathological features of breast cancer for pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) and to establish a predictive model based on the clinicopathological features.Methods:Clinicopathological data collected from 182 patients who underwent NAC and surgical treatment in Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine from Jan. 2013 to Dec. 2019 were retrospectively analyzed. The univariate and multivariate analysis were used to analyze the relationship between clinicopathological features and pCR after neoadjuvant chemotherapy. The predictive value in predicting the efficacy of NAC was evaluated, the receiver operating characteristic (ROC) curve and Nomogram prediction model were constructed.Results:Multivariate Logistic regression analysis showed that progesterone receptor (PR) , human epidermal growth factor 2 (HER2) and platelet distribution width (PDW) were independent predictors of pCR after NAC for breast cancer. The area under the curve (AUC) of model for predicting efficacy of NAC was 0.810 (95% CI:0.745-0.864) and the sensitivity and specificity was 68.75% and 82.67% respectively when the Jordan Index is at its maximum. Conclusion:ER-, HER2+ and PDW≤13.4% show better efficacy of NAC. The Nomogram model based on them can accurately predict the efficacy of NAC and can provide a reference for the selection of treatment options in clinical diagnosis and treatment.
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Objective:To investigate the clinical significance of Delphian lymph node (DLN) dissection in papillary thyroid cancer (PTC) .Methods:The correlation of DLN detection and metastasis in 208 PTC patients with various clinical and pathological features was analyzed retrospectively. The value of DLN metastasis in predicting PTC high-risk features was evaluated, and the tendency of surgical selection for PTC with DLN metastasis was also discussed.Results:① Of 208 PTC patients, DLN was detected in 144 patients (69.23%) . The detection rate of DLN was related to gender, number of central lymph nodes (excluding DLN) removed and metastasis (all P<0.05) . Male, greater number of nodes in the central compartment (excluding DLN) was more favorable for DLN detection. ② The rate of DLN metastasis was 18.27% (38/208) . In the univariate analysis, DLN metastasis was significantly associated with the following variables:gender, whether it is microcarcinoma, isthmus involvement, number of lesions, extrathyroidal extension, tumor size, number of central lymph nodes (excluding DLN) removed and metastasis (all P<0.05) . In the multivariate analysis, tumor size larger than 1 cm, isthmus involvement and greater number of central lymph nodes (excluding DLN) metastasis were independent risk factors of DLN metastasis ( P<0.05) . ③ The sensitivity of DLN metastasis to predict extranodal invasion, central and lateral lymph node metastasis was 54.54%, 37.36% and 62.86%, with specificity of 78.69%, 92.45% and 55.56%, respectively. ④ Patients with DLN metastasis were more likely to receive total thyroidectomy, bilateral central lymph node dissection, and lateral cervical lymph node dissection. Conclusions:Due to high rate of DLN detected and metastasis, DLN should be routinely dissected. Patients with DLN metastasis predict high risk characteristics of PTC and extensive lymph node metastasis, which is of clinical significance for lymph node dissection.
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Objective:To investigate the value of CT enhancement degree in diagnosing cervical lymph node metastasis of papillary thyroid carcinoma (PTC) .Methods:CT data of 535 neck lymph nodes with pathological diagnosis in 251 cases were retrospectively analyzed. The ratio and difference between the density of CT enhancement and plain scan were calculated. Mann-Whitney test was used to analyze the distribution of ratio and difference in lymph node metastasis group and non-metastasis group. The optimal thresholds of ratio and difference in the two groups were obtained by receiver operating characteristic (ROC) curve analysis.Results:535 cervical lymph nodes including 271 in metastatic group and 264 in non-metastatic group. The ratios of two groups were 2.30 (2.04, 2.76) and 1.66 (1.51, 1.81) ( Z=-16.94, P<0.05) respectively, and the differences were 58 (49, 76) Hu and 31 (22, 36) Hu ( Z=-18.045, P<0.05) respectively. When the ROC area under curve of ratio and difference between the two groups were 0.923 and 0.951 respectively, the optimal thresholds were 1.93 and 39.5Hu respectively. The sensitivity and specificity of diagnosing lymph node metastasis were 84.9% and 87.1%、91.5% and 86.0%respectively.The sensitivity and specificity of combination of the two diagnosing lymph node metastasis were 82.3% and 91.7%. Conclusions:The ratio of enhancement and plain scan density ≥1.93 and the difference ≥39.5Hu have a high diagnostic efficiency for cervical lymph node metastasis of PTC. The specificity of the two is similar, but the latter has higher sensitivity. The combination of the two can significantly improve the specificity, thereby reducing unnecessary surgical trauma.
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Objective:To explore the predictive value of various ultrasonic signs for papillary thyroid microcarcinoma (PTMC) .Methods:The ultrasonic data of of 603 micronodular goiter (MNG) in 396 cases and 640 PTMC in 539 cases, which were confirmed by pathology from Jan. 2013 to Dec. 2016, were retrospectively analyzed. According to the different inspection time, all nodules were divided into model group (2013-2014 years) and test group (2015-2016 years) . The tumor morphology, internal echo, microcalcification, and aspect ratio (A/T) were observed. Chi-square test and multivariate Logistic regression analysis were used to analyze the distribution differences of the four ultrasound features in PTMC and MNG, and their diagnostic value was evaluated.Results:There were statistical difference between model group and test group in ultrasonic signs including tumors shape, internal echo, microcalcification and aspect ratio according single factor analysis (chi square value was 283.540 and 298.119, 63.130 and 87.400, 26.342 and 50.152, 169.918 and 181.405; P<0.05) ;Multivariable Logistic regression analysis showed that irregular shape, hypoecho, A/T>1 and microcalcification were more common in PTMC ( P< 0.05) . OR values were 18.410 and 19.231, 2.560 and 6.380, 9.379 and 6.724, 3.102 and 8.830, and AUC prediction probability values were 0.916 and 0.911 respectively. Conclusions:Irregular shape, internal hypoechoic, microcalcification and A/T>1 are stable important ultrasonographic signs in predicting PTMC. Comprehensive analysis of various ultrasonic signs can improve the diagnostic efficiency.
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Objective:To investigate the clinical application value of serum carcinoembryonic antigen (CEA) level in predicting lymph node metastasis of resectable medullary thyroid carcinoma (MTC) .Methods:140 patients of resectable MTC from Zhejiang Cancer Hospital and Hangzhou First People’s Hospital from Jan. 2009 to Feb. 2019 were included. The relationship of serum CEA and lymphatic metastasis was retrospectively analyzed in 140 patients of resectable MTC, and the clinical significance of serum CEA for predicting total lymph node, central lymph node, lateral lymph node and upper mediastinal lymph node metastasis was also evaluated.Results:The positive rate of serum CEA in resectable MTC was 77.14%. The expression level of serum CEA in resectable MTC with lymph node metastasis was significantly higher than those without lymph node metastasis ( P<0.001) . Spearman correlation analysis further indicated that the level of serum CEA expression was positively correlated with the number of lymph node metastases of resectable MTC patients ( P<0.001) . The area under curve of predicting lymphatic metastasis of total lymph node, central lymph node, lateral lymph node and upper mediastinum was 0.773, 0.768, 0.827 and 0.847. When the cut-off value of serum CEA was 6.58, 11.43, 15.74 and 30.45 ng/ml, respectively, the sensitivity of serum CEA to predict total, central, lateral neck and upper mediastinal lymph node metastasis was 88.46%, 81.43%, 85.00%, 95.00%, and the specificity was 56.45%, 60.00%, 71.25%, and 69.17%, respectively. Conclusion:Serum CEA has a high positive expression rate in resectable MTC, and its expression level has important clinical significance in evaluation of lymphatic metastasis.
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Objective To investigate the relationship between Hashimoto thyroiditis (HT) and thyroid papillary carcinoma (PTC) by analyzing the expression of BRAF V600E mutation and (N-,H-,K-) RAS codons 12,13 and 61 mutants in cases of multifocal PTC with HT.Methods 80 tumor samples in 37 multifocal PTC with HT cases,were analyzed for the genotypic changes of BRAF V600E,as well as the (N-,H-,K-)RAS codons 12,13 and 61 mutants by DNA sequencing assay and amplification refractory mutation system (ARMS).Results BRAF V600E mutation was detected in 51 samples and RAS gene mutations was found in 3 samples (N-RAS codon 61 mutant in 2 samples and H-RAS codon 61 mutant in 1 sample).Different clonal origin was present in 20 cases of multifocal PTC with HT (54.1％,20/37).There was no statistical significance (P ＞ 0.05) in the incidence of the difference in the origin of tumor cells,compared with the results (61.7％,37/60) of multifocal PTC without HT in the related literature.Conclusion In more than half of multifocal PTC with HT cases,the tumor cells originate from different clones.Our results do not support the opinion that HT predisposes patients to develop PTC,because HT does not have a significant effect on expression of BRAF and RAS gene mutation in PTC,accordingly HT is more likely to be a part of the host tumor immune response system.
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Objective To investigate the diagnostic value of lymph node size and distribution in ipsilateral central lymph node metastasis (ICLNM) of single papillary thyroid carcinoma (PTC) in CT examination.Method The CT data of 278 single PTC with diameter ＞ 1.0 cm confirmed by operation and pathology were retrospectively analyzed.According to the ipsilateral central lymph node diameter,these cases were divided into ＜ 0.2 cm group,0.2-0.4 cm group and ≥0.4 cm group,and the distribution difference of ICLNM positive and negative between the three groups were analyzed.Then according to the lymph node distribution,0.2 to 0.4 cm group were divided into turbidity group (≥ 3) and non-turbidity group (1-2),and ≥0.4 cm group were divided into cluster group (≥ 3) and non-cluster group (1-2).The differences betweeen turbidity group and non-turbidity group,cluster group and non-cluster group were analyzed.Results In 278 PTC,the proportion of ICLNM positive and negative was 65.8％(183/278) and 34.2％(95/278),respectively.ICLNM positive in ＜0.2 cm group,0.2-0.4 cm group and ≥0.4 cm group accounted for 37.3％ (31/83),68％ (66/97) and 87.8％ (86/98),respectively.x2 value and P value in between groups and within groups were 51.082 and 0,16.956 and 0,49.955 and 0,11.022 and 0.001,respectively.ICLNM positive in turbidity group and non-turbidity group accounted for 74.0％ (57/77) and 45％ (9/20),respectively.x2 value and P value were 6.151 and 0.013,respectively.ICLNM positive in cluster group and and non-cluster group accounted for 92.6％(50/54) and 82％(36/44),respectively.x2 value and P value were 2.619 and 0.106,respectively.Conclusions Among CT examination of patients with PTC,with the increase of the diameter and number of lymph nodes in central group,the positive proportion of ICLNM positive increases.For the 0.2-0.4 cm group,the turbidity phenomenon suggests that the possibility of metastasis is greater.The accurate identification of these signs can help surgeons take a more thorough surgical treatment and have great significance to reduce postoperative recurrence.
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Objective To investigate the predictive value of multiple CT signs in the diagnosis of benign and malignant thyroid nodules.Methods The CT data of 1 009 nodules with diameter >1.0 cm confirmed by histology from 931 patients was retrospectively analyzed, including 548 benign nodules from 484 patients and 461 malignant nodules from 447 patients.According to the inspection time, all nodules were divided into model group(2009—2014)and test group(2015—2016).The distribution of nodules with irregular shape, bite cake syndrome, micro calcification, enhanced range reduction/blur, cystic and high enhancement were evaluated in two groups.Univariate and multivariate logistic regression analysis were performed to evaluate the predicting value of multiple CT sighs for benign and malignant thyroid nodules in two groups.Results The numbers of benign and malignant nodules were 252 and 233 in model group,and were 296 and 228 in test group.The univariate logistic analysis of the model group and the test group showed that irregular shape, bite cake syndrome, micro calcification, enhanced range reduction/blur were more common in malignant nodules.OR values were 4.172 and 6.327,3.927 and 3.493,5.354 and 6.674, 11.814 and 5.082,8.680 and 14.562,respectively.The areas under the predicted probability curve were 0.946 and 0.936, respectively.The micro calcification was an independent predictive factor in the multivariate logistic regression analysis in the model group but not in the test group.Conclusion Irregular shape,bite cake syndrome and enhanced blur/range reduction are the CT signs of the stable malignant nodules,cystic and high enhancement are the CT signs of stable and benign nodules.Combination of multiple CT signs could improve the accuracy of diagnosis for Benign and Malignant Thyroid Nodules.
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Objective To investigate the diagnostic value of computed tomography (CT) histogram analysis for thyroid malignant solitary coarse calcification nodules (MSCN).Methods A total of 89 thyroid solitary coarse calcification nodules (coarse calcification ≥5 mm,no definite soft tissue around calcification) confirmed either by surgery or histopathological examination in 86 patients enrolled in this study from Jan.2009 to Dec.2015 were evaluated,including 33 MSCN from 32 patients and 56 benign solitary coarse calcification nodules (BSCN) from 56 patients.Overall,27 cut-off values were calculated by N (4 ≤ N ≤ 30) times of 50 Hounsfield units (HU) in the range of 200 HU to 1500 HU,and each cut-off value and the differences in the corresponding area percentages in the CT histogram were recorded for MSCN and BSCN.The optimal cut-off value and the corresponding area percentage were established by receiver operating characteristic (ROC) curve analysis.Results In the 24 groups with an ROC area under the curve (AUC) of more than 0.7,at a cut-off value of 1150 HU and at an area percentage of no less than 98.4％,the ROC AUC reached a maximum of 0.86,and the accuracy,sensitivity,and specificity were 70.8％,93.9％,and 57.1％,respectively.At a cut-off value of 450 HU and at an area percentage of no less than 46.3％,the accuracy,sensitivity,and specificity were 76.4％,48.5％,and 92.9％,respectively.At a cut-off value of 550 HU and at an area percentage of no less than 81.5％,the accuracy,sensitivity,and specificity were 75.3％,33.3％,and 100％,respectively.Conclusions In comparison with the cut-off value of 1150 HU with an area percentage of no less than 98.4％,the sensitivities for the cut-off value of 450 HU with an area percentage of no less than 46.3％ and for the cut-off value of 550 HU with an area percentage of no less than 81.5％ were lower;however,the specificities increased significantly,providing an important basis for reducing the misdiagnosis of MSCN.
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Objective To investigate diagnostic value of CT signs in papillary thyroid carcinoma (PTC) by comparing CT signs of PTC with different sizes.Methods CT signs of 406 PTC from 396 patients confirmed by histology were analyzed retrospectively.Based on the largest tumor diameter,PTC were divided into 1.1-2.0 cm group,2.1-3.0 cm group and＞3.0 cm group.Distribution of irregular shape,cookie bite sign,enhanced narrow/ fuzzy and microcalcification in each group was analyzed.Results There were 318 pieces in 1.1-2.0 cm group,60 pieces in 2.1-3.0 cm group and 28 pieces in ＞3.0 cm group,respectively.The rate of irregular shape was 89.6％(285/318),75.0％(45/60) and 64.3％(18/28) in each group,the rate of cookie bite sign was 83.6％(266/318),71.7％(43/60) and 64.3％ (18/28),and enhanced narrow/fuzzy was 84％(267/318),78.3％ (47/60) and 67.9％ (19/28) in each group,and microcalcification was 35.5％ (113/318),40.0％ (24/60) and 59.3％ (16/27) in each group.The rate of irregular shape (x2=20.092,P=0.000)and cookie bite sign (x2=9.695,P=0.008)had statistical difference among the three groups,while the rate of enhanced narrow/fuzzy(x2=5.175,P=0.075)and microcalcification (x2=5.277,P=0.071) had no statistical difference among each group.Furthermore,irregular shape and cookie bite sign were compared between groups.Rate of irregular shape in 1.1-2.0 cm group and 2.1-3.0 cm (x2=9.746,P=0.002)group,1.1-2.0 cm group and ＞ 3.0 cm group (x2=15.180,P=0.000) was statistically different.Rate of cookie bite sign in 1.1-2.0 cm group and ＞3.0 cm(x2=6.560,P=-0.010)was statistically different.There was no statistical difference between other groups.Conclusions Although irregular shape,cookie bite sign,enhanced narrow/fuzzy and microcalcification are important CT signs in diagnosing PTC,distribution of different signs varies with tumor sizes.Correct identification of these differences will help to improve the accuracy of preoperative diagnosis,and reduce occurrence of misdiagnosis.
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Objective To investigate the diagnostic significance of CT in thyroid benign solitary coarse calcification nodules (BCCN).Methods A total of 56 BCCN confirmed by surgical pathology in 55 patients were evaluated,and they were compared with 33 papillary thyroid carcinoma (PTC) in 32 patients.The distribution differences of the average CT values and the maximum CT values in BCCN and PTC were observed.The optimal thresholds of the average CT values and the maximum CT values in BCCN and PTC were established by re ceiver operating characteristic(ROC) curve analysis.Results The average CT values in BCCN and PTC were significantly different (t=4.992,P=0.000).The ROC area under curve (AUC) was 0.757 (95％ confidence interval 0.0657-0.0857).When the critical value was 743.4 Hu,Youden index was the largest and the sensitivity and specificity was 48.2％ and 93.9％,respectively.When the critical value was 891.1 Hu,the sensitivity and specificity was 21.4％ and 100％,respectively.The maximum CT values in BCCN and PTC were significantly different (t=5.029,P=0.000).The ROC AUC was 0.775 (95％ confidence interval 0.0681-0.0869).When the critical value was 1201.5 Hu,Youden index was the largest and the sensitivity and specificity was 51.7％ and 91.0％,respectively.When the critical value was 1373.5 Hu,the sensitivity and specificity was 42.9％ and 100％,respectively.Conclusions CT value is of great significance to the diagnosis of BCCN and has high specificity.Compared with the average CT value,the maximum CT value has a relatively higher sensitivity,providing an important base for reducing unnecessary surgical trauma.
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Objective To analyze long noncoding RNAs (lncRNAs) expression profiles in papillary thyroid carcinoma (PTC) with Hashimoto's thyroiditis (PTC-HT,group A) and PTC only (PTC,group B).Methods 55 cases of thyroid species were collected.High-throughput microarray lncRNh was used to detect the expression difference of lncRNAs between group A and group B.Real-time quantitative PCR (QRT-PCR) was used to verify.Results 1031 lncRNAs and 1338 mRNAs were detected abnormally expressed in tissue samples of group A compared to B.GO and Pathway analysis of mRNAs suggested some biological processes changed obviously,such as immune system and immune reaction.QRT-PCR showed that the expression of uc002stn.1,ENST00000452578 and uc002sti.1 in group A and group B was significantly different.Conclusion IncRNAs expression was significantly different in PTC with or without HT,which may play important roles in the pathogenesis of PTC with HT.
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OBJECTIVE To investigate the clinical value of the lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN, right VI-2) dissection in papillary thyroid carcinoma (PTC). METHODS We studied the relationships between LN-prRLN metastasis and the clinicopathological characteristics in 408 patients with right or bilateral PTC who underwent LN-prRLN dissection. RESULTS Right VI-2 lymph node metastasis was 16.67％. Single factor analysis showed that there were statistically significant correlations between right VI-2 metastasis and gender, age, size and number of right thyroid lobe tumor, capsular invasion, right VI-1 lymph node metastasis and their size, and also metastatic lymph node in the right cervical lateral compartment. Multivariate Logistic regression analysis showed that Right VI-2 lymph node metastasis was related to right tumor size, capsular invasion, the right VI-1 metastasis and right lateral lymph node metastasis(P＜0.05). The receiver-operator characteristic (ROC) analysis showed that the risk factors of LN-prRLN: age ＜35.5 years, right tumor size ＞0.85 cm, lymph node (right VI-1) number ＞1.5, metastatic lymph node (right VI-1) size ＞0.45 cm, lymph node number in the right cervical lateral compartment ＞0.5 and the areas under the ROC curves were 0.585, 0.787, 0.788, 0.725, 0.719. CONCLUSION The dissection of LN-prRLN should be considered when patient with the risk factors such as male, age ＜35.5 years, right tumor size ＞0.85 cm, capsular invasion, lymph node (right VI-1) number ＞1.5, metastatic lymph node (right VI-1) size ＞0.45 cm, lymph node number in the right cervical lateral compartment ＞0.5.
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OBJECTIVE To explore the feasibility of detection for mutated BRAF V600E gene based on amplification refractory mutation system(ARMS),and to evaluate its clinical significance of BRAF V600E gene mutation in thyroid nodules.METHODS The method of ARMS was used to detect BRAF V600E mutation status in 179 patients with PTC and 115 patients with benign lesions.The diagnosis index of BRAF V600E mutation status for identifying the nature of the thyroid nodule was calculated.The potential correlation between BRAF V600E mutation and PTC clinicpathological characteristics was also analyzed.RESULTS Detection of BRAF V600E mutation status in thyroid lesions based on ARMS was feasible and believable.The positive rate of mutated BRAF V600E gene in PTC was 82.68％,whereas the rate in benign lesions was only 1.74％,indicating statistical differences between the two groups(x2=183.568,P＜0.01).The diagnostic sensitivity of BRAF V600E mutation was 82.68％,specificity was 98.26％,accuracy was 88.76％,and Youden index was 0.8094.There was no associations between the BRAF V600E mutation status and PTC clinicpathological characteristics(eg.gender,age,tumor size,numbers of lesions,bilateral lesions,extrathyroidal extension and lymph node metastasis).CONCLUSION Detection of BRAF V600E mutation based on ARMS has higher sensitivity and specificity in distinguishing PTC from benign lesions,indicating BRAF V600E gene is an ideal marker of PTC for clinical early diagnosis.
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OBJECTIVE To investigate the expression of serum miR-222-3p in papillary thyroid carcinoma and its clinical significance.METHODS Total RNA in serum was extracted from 121 patients of papillary thyroid carcinoma and benign thyroid diseases.The reverse transcription quantitative real-time polymerase chain reaction(qRT-PCR) method was used to detect the expression of miR-222-3p,and then the potential correlation between serum miR-222-3p and clinical pathological characteristics of papillary thyroid carcinoma was analyzed.The receiver operating characteristic area under the curve(ROCAUC) and their index for diagnosis evaluation were also calculated.RESULTS The median expression level of serum miR-222-3p in papillary thyroid carcinoma patients was significantly higher than that of control group (2.2188 vs 0.7022,P=0.002).Although the expressions of serum miR-222-3p was not associated with the gender,age,capsule invasion,TNM stage,but it was positively correlated with tumor size,bilateral involvement,lesion quantity and lymph node status.ROC curve analysis showed that the specificity and sensitivity of the miR-222-3p diagnosis of papillary thyroid cancer were 79.75％ and 61.90％,respectively,while the ROC-AUC was 0.717.CONCLUSION The serum miR-222-3p is over expressed in papillary thyroid carcinoma and its expression is significantly correlated with tumor progression.It will be helpful for PTC diagnosis.
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OBJECTIVE The aim of the study was to evaluated the difference and consistency in tumor size measured by sonographic and pathological examination in papillary thyroid carcinoma(PTC).METHODS A total of 114 patients with PTC, including 122 malignant nodules, was collected from Hangzhou First People's Hospital between Jun 2012 and Jun 2014. The tumor sizes were measured by preoperative sonographic and postoperative pathologic evaluation. Pearson correlation analysis, paired t-test, and Bland-Altman plot were used to evaluate the correlation and consistency in tumor size measured by the two methods.RESULTS Pearson correlation analysis showed that the largest tumor size measured by sonography were positively correlated with pathologic size (r=0.957, P=0.000). Paired t-test showed that there were statistically difference between sonographic size and pathological size (8.24±5.06) mmvs (7.79±4.75) mm,P=0.001. The absolute difference value of the largest tumor size measured by the two methods was from zero to 6.5 mm, with the average of (1.03±1.14) mm. Bland-Altman analysis showed that the limits of agreement (LoA) of difference was from -2.41 mm to 3.33 mm, with the 95% confidence interval from -2.87 mm to 3.78 mm.Within the limit of the consistency, the maximum moduli was 2.9 mm.CONCLUSION There is a significant discrepancy between the preoperative sonographic and the pathologic size of the papillary thyroid carcinoma, which should be taken into account in clinical practice.
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Objective To investigate the diagnostic value of hyperenhancement sign on ultrasound,CT and their combination in diagnosis of thyroid benign and malignant nodules.Methods The contrast-enhanced ultrasound and enhanced CT datas of 172 thyroid nodules in 144 cases confirmed by operation and pathology were retrospectively analyzed,including 97 benign nodules and 75 malignant nodules.According to the degree of enhancement,these nodules were divided into iso-or low-enhancement and hyperenhancement.The distributions of ultrasound hyperenhancement,CT hyperenhancement and both of them in thyroid benign and malignant nodules,adenomatoid lesions and nodular goiters were analyzed,followed byx2 test for statistical analysis.Results In 172 thyroid nodules,the proportions of ultrasound hyperenhancement,CT hyperenhancement and both of them in thyroid benign and malignant nodules were 53.6％(52/97) and 20.0％(15/75)(x2＝20.090,P＜0.05),34.0％ (33/97) and 4.0％ (3/75) (x2＝23.033,P＜0.05),31.0％ (30/97) and 0％ (0/75) (x2＝28.096,P＜0.05),respectively.Their sensitivity and specificity of diagnosing benign nodules were 53.6％ (52/97) and 80.0％ (60/75),34.0％ (33/97) and 96％ (72/75),30.9％ (30/97) and 100％ (75/75),respectively.The proportions of ultrasound hyperenhancement,CT hyperenhancement and both of them in adenomatoid lesions and nodular goiters were 96.9％(31/32) and 32.3％(21/65)0x2＝35.946,P＜0.05),65.6％(21/32) and 18.5％(12/65)(x2＝21.250,P＜0.05),65.6％(21/32) and 13.8％ (9/65)(x2＝26.912,P＜0.05).Their sensitivity and specificity of diagnosing adenomatoid lesions were 96.9％(31/32) and 67.7％(44/65),65.6％(21/32) and 81.5％(53/65),65.6％(21/32) and 87.2％(56/65).Conclusions Ultrasound hyperenhancement,CT hyperenhancement for diagnosing thyroid benign nodules are of significant value.Especially for adenomatoid nodules,ultrasound hyperenhancement has a higher sensitivity,while CT hyperenhancement has a higher specificity.Their combination can further improve the diagnostic specificity,thus reducing the unnecessary surgical trauma.
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OBJECTIVE The objective of this study is to discuss when to dissect the lymph nodes behind the right recurrent laryngeal nerve (LN-prRLN) from the standpoint of the right cervical level Ⅵ-1 (superficial layer to the recurrent laryngeal nerve) lymph nodes in papillary thyroid carcinoma (PTC) patients.METHODS The clinical data of 306 bilateral or right PTC patients from the Hangzhou First People's Hospital who underwent dissection of level Ⅵ-1 lymph nodes and LN-prRLN between March 2014 and September 2015 were analyzed. We measured the number of level Ⅵ-1 metastatic lymph nodes and size of level Ⅵ-1 lymph nodes metastasis loci to predict the metastasis of LN-prRLN.RESULTS The number of level Ⅵ-1 metastatic lymph nodes and size of level Ⅵ-1 lymph nodes metastasis loci were risk factors of LN-prRLN metastasis(P<0.05). When the number of the level Ⅵ-1 metastatic lymph nodes was greater than 1.5, the AUC was 0.813 (the sensitivity was 78.43%, the specificity was 76.65%). The ROC showed that when the size of level Ⅵ-1 lymph nodes metastasis loci were more than 0.45 cm, the AUC was 0.726 (sensitivity was 90.20%, specificity was 48.90%).CONCLUSION In bilateral or right PTC patients with metastasis of level Ⅵ-1 lymph nodes, especially when the number of level Ⅵ-1 metastatic lymph nodes was greater than 2cm and the metastasis loci were more than 0.45 cm, we should dissect the LN-prRLN.
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MiRNAs represent a class of short endogenous non-coding RNAs regulating gene expression at mRNA post-transcriptional level in many biological processes,including differentiation,proliferation,development and apoptosis.The deregulation of miRNA expression is believed to be an important regulator of tumor development.Increasing evidence has revealed the abnormal expression of miRNA in papillary thyroid carcinoma,indicating the important role in PTC invasion mechanism,clinical diagnostic value,efficacy evaluation,recurrence monitoring and prognosis judgement.