Treatment duration of wrist-ankle acupuncture for relieving post-thyroidectomy pain: A randomized controlled trial / 中西医结合学报

BACKGROUND@#Treatment duration of wrist-ankle acupuncture (WAA) is uncertain for post-thyroidectomy pain relief.@*OBJECTIVE@#This study evaluated the effect of different WAA treatment duration on post-operative pain relief and other discomforts associated with thyroidectomy.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This randomized controlled trial was conducted at a single research site in Guangzhou, China. A total of 132 patients receiving thyroidectomy were randomly divided into the control group (sham WAA, 30 min) and three intervention groups (group 1: WAA, 30 min; group 2: WAA, 45 min; group 3: WAA, 60 min), with group allocation ratio of 1:1:1:1. Acupuncture was administered within 1 hour of leaving the operating room.@*OUTCOMES AND MEASURES@#Primary outcome was patients' pain at the surgical site assessed by visual analogue scale (VAS) at the moment after acupuncture treatment (post-intervention). Secondary outcomes included the patients' pain VAS scores at 6, 12, 24, 48 and 72 h after the thyroidectomy, the 40-item Quality of Recovery (QoR-40) score, the grade of post-operative nausea and vomiting (PONV), and the use of additional analgesic therapy.@*RESULTS@#The adjusted mean difference (AMD) in VAS scores from baseline to post-intervention in group 1 was -0.89 (95% confidence interval [CI], -1.02 to -0.76). The decrease in VAS score at post-intervention was statistically significant in group 1 compared to the control group (AMD, -0.43; 95% CI, -0.58 to -0.28; P < 0.001), and in groups 2 and 3 compared to group 1 (group 2 vs group 1: AMD, -0.65; 95% CI, -0.81 to -0.48; P < 0.001; group 3 vs group 1: AMD, -0.66; 95% CI, -0.86 to -0.47; P < 0.001). The VAS scores in the four groups converged beyond 24 h after the operation. Fewer patients in group 2 and group 3 experienced PONV in the first 24 h after operation. No statistical differences were measured in QoR-40 score and the number of patients with additional analgesic therapy.@*CONCLUSION@#Compared with the 30 min intervention, WAA treatment with longer needle retention time (45 or 60 min) had an advantage in pain relief within 6 h after surgery. WAA's analgesic effect lasted for 6-12 h post-operatively. Please cite this article as: Han XR, Yue W, Chen HC, He W, Luo JH, Chen SX, Liu N, Yang M. Treatment duration of wrist-ankle acupuncture for relieving post-thyroidectomy pain: A randomized controlled trial. J Integr Med. 2023; 21(2): 168-175.

Clinical risk factors analysis of large volume central lymph node metastasis in papillary thyroid carcinoma / 中华内分泌外科杂志

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.

Detection of DNA methylation of HYAL2 gene for differentiating malignant from benign thyroid tumors / 南方医科大学学报

OBJECTIVE@#To assess the value of DNA methylation level of HYAL2 gene as a molecular marker for differential diagnosis of malignant and benign thyroid tumors.@*METHODS@#DNA methylation of HYAL2 gene in tissue specimens of 190 patients with papillary thyroid cancer (PTC) and 190 age- and gender-matched patients with benign thyroid tumors was examined by mass spectrometry, and the protein expression of HYAL2 was detected immunohistochemically for another 55 pairs of patients. Logistic regression analysis was performed to calculate the odds ratio (OR) and evaluate the correlation of per 10% reduction in DNA methylation with PTC. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) was calculated to assess the predictive value of alterations in HYAL2 methylation.@*RESULTS@#Hypomethylation of HYAL2_CpG_3 was significantly correlated with early-stage PTC (OR=1.51, P=0.001), even in stage I cancer (OR=1.42, P=0.007). Age-stratified analysis revealed a significantly stronger correlation between increased HYAL2_CpG_ 3 methylation and early-stage PTC in patients below 50 years than in those older than 50 years (OR: 1.89 vs 1.37, P < 0.05); ROC analysis also showed a larger AUC of 0.787 in younger patients. The results of immunohistochemistry showed that patients with PTC had significantly higher protein expressions of HYAL2 than patients with benign tumors.@*CONCLUSION@#The alterations of DNA methylation level of HYAL2 gene is significantly correlated with early-stage PTC, suggesting the value of DNA methylation level as a potential biomarker for differentiation of malignant from benign thyroid tumors.

Modelo predictivo para la recidiva en pacientes con cáncer de tiroides / Predictive model for recurrence in patients with thyroid cancer

Introducción: El cáncer de tiroides es el tumor maligno más común originado en órganos endocrinos (más del 92 por ciento) y comprende un grupo de tumores que son diferentes clínicamente y epidemiológicamente. En los últimos años se ha incrementado el uso de los modelos predictivos en la práctica médica para determinar la mejor conducta en pacientes con tumores de la glándula tiroides. Objetivo: Desarrollar un modelo probabilístico de predicción de la recidiva en pacientes con cáncer de tiroides. Métodos: Se realizó un estudio prospectivo longitudinal, en el Hospital Militar Central Dr. Carlos J. Finlay, desde enero de 2015 hasta febrero del 2020. Se incluyeron 63 pacientes que ingresaron al estudio por muestreo aleatorio simple con remplazo, se confeccionó un modelo predictivo utilizando una regresión logística binaria en el programa R. Resultados: El grupo de edad más afectado estuvo entre los 40 y 59 años, predominó el sexo femenino y el carcinoma papilar, la vascularización y la irregularidad fueron los elementos ultrasonográficos más detectados. El estadístico de Wald fue significativo con una distribución normal en todas las variables analizadas lo cual indica que sus coeficientes son diferentes de 0 y deben ser incluidos en el modelo La variable con mayor influencia en el índice de recidiva resultó ser la diferenciación celular Conclusiones: Los factores con mayor influencia en la recidiva en la serie estudiada resultaron el grado de diferenciación, la presencia de vascularización e irregularidad en la ecografía y el tamaño tumoral con cifras similares a las reportadas nacional e internacionalmente(AU)

Introduction: Thyroid cancer is the most common malignant tumor originating in endocrine organs (more than 92%) and comprises a group of tumors that are clinically and epidemiologically different. In recent years, the use of predictive models has increased in medical practice to determine the best behavior in patients with tumors of the thyroid gland. Objective: To develop a probabilistic model for predicting recurrence in patients with thyroid cancer. Methods: A longitudinal prospective study was carried out at the Dr. Carlos J Finlay Central Military Hospital, from January 2015 to February 2020. 63 patients who entered the study by simple random sampling with replacement were included; a predictive model was made using a binary logistic regression in program R. Results: The most affected age group was between 40 and 59 years old, female sex predominated and papillary carcinoma, vascularization and irregularity were the most detected ultrasound elements. The Wald statistic was significant with a normal distribution in all variables analyzed, which indicates that their coefficients are different from 0 and should be included in the model. The variable with the greatest influence on the recurrence rate turned out to be cell differentiation. Conclusions: The final binary logistic regression model had an adequate goodness of fit and discrimination was very good, with an acceptable receiving operator area under the curve (AU)

Predictive value of lymph node size for ipsilateral central lymph node metastasis of single papillary thyroid microcarcinoma in CT examination / 中华内分泌外科杂志

Objective:To investigate the predictive value of lymph node size for ipsilateral central lymph node metastasis (ICLNM) of papillary thyroid microcarcinoma (PTMC) in CT examination.Methods:The CT data of 229 patients with single PTMC admitted to the Department of Oncology, Hangzhou First People’s Hospital, Affiliated to Zhejiang University School of Medicine from Jan. 2018 to Jun. 2019 were retrospectively analyzed. All cases were confirmed by surgery and pathology. The ipsilateral central lymph nodes were divided into <0.2 cm group, 0.2-0.4 cm group and ≥0.4 cm group according to their maximun diameters, and the distribution difference of positive and negative ICLNM among the three groups were observed and analyzed by χ 2 test. Results:In 229 PTMCs, the proportion of positive and negative ICLNM were 29.69% (68/229) and 70.31% (108/155) , respectively. Positive ICLNM in <0.2 cm group, 0.2-0.4 cm group and ≥0.4 cm group accounted for 11.43% (16/140) , 64.29% (36/56) and 81.82% (27/33) , respectively. When 0.2 cm and 0.4 cm were used as the threshold to determine positive ICLNM, the values of χ 2 and P between groups were 87.663 and <0.001. The sensitivity and specificity of diagnosing lymph node metastasis were 79.75% (63/79) and 82.67% (124/150) , 34.18% (27/79) and 96% (144/150) , respectively. The proportions of high enhancement, calcification and cystic degeneration were 3.2% (5/155) , 0.7% (1/155) and 0 (0/155) , respectively. Conclusions:In CT examination of patients with PTMC, the diameter of lymph nodes less than 0.2 cm highly indicates negative ICLNM. The proportion of positive ICLNM increased with increasing lymph node diameter, and the diameter of lymph nodes less than 0.4 cm highly indicates positive ICLNM.

Expression of LncRNA-POU3F3 in thyroid cancer tissues and its predictive value for prognosis / 中华地方病学杂志

Objective:To investigate the expression of long non-coding RNA-POU3F3 (LncRNA-POU3F3) in thyroid cancer tissues and its predictive value for prognosis.Methods:Using case-control study, the thyroid cancer tissue samples and paracancerous tissue samples of 118 thyroid cancer patients who underwent surgery in Zhengzhou People's Hospital from May 2013 to August 2015 were collected, and 100 benign thyroid tumor tissue samples in the same period were selected as controls. Quantitative real-time PCR (qRT-PCR) was used to detect the expression of LncRNA-POU3F3 in thyroid tissues, receiver operating characteristic curve (ROC curve) was used to evaluate the diagnostic value of LncRNA-POU3F3 for thyroid cancer, and the correlation between LncRNA-POU3F3 level and clinicopathological characteristics and prognosis of patients was analyzed.Results:The qRT-PCR results showed that the expression level of LncRNA-POU3F3 in thyroid cancer tissues (4.02 ± 0.76) was higher than that in paracancerous tissues (3.18 ± 0.69) and benign thyroid tumor tissues (3.05 ± 0.66, P < 0.05). The area under the ROC curve of LncRNA-POU3F3 expression in the diagnosis of thyroid cancer was 0.886 [95% confidence interval (95% CI): 0.821 - 0.943, P < 0.05], the sensitivity was 83.7%, the specificity was 85.2%, and the diagnostic threshold was 3.45. High expression of LncRNA-POU3F3 (≥3.45) was found in thyroid cancer tissues with clinical stages Ⅲ - Ⅳ, tumor diameter ≥1 cm, multiple tumor foci and lymph node metastasis ( P < 0.05). Kaplan-Meier analysis showed that after 5 years of follow-up, 53 of the 118 patients with thyroid cancer survived. The 5-year survival rate of patients with low expression of LncRNA-POU3F3 ( < 3.45) was 77.42% (24/31), and that of patients with high expression of LncRNA-POU3F3 (≥3.45) was 33.33% (29/87), and there was a statistically significant difference in the 5-year survival rate between the two groups (χ 2 = 17.955, P < 0.05). Multivariate logistic regression analysis showed that clinical stage, tumor diameter, number of tumor foci, lymph node metastasis and LncRNA-POU3F3 expression were correlated with the survival time of patients with thyroid cancer ( P < 0.05). Conclusion:LncRNA-POU3F3 is highly expressed in thyroid cancer tissues, and its expression level is closely related to the clinicopathological characteristics and prognosis of thyroid cancer patients, which can be used as an important indicator for predicting the prognosis of thyroid cancer patients.

Thyroid tumor complicated with tumor thrombus in internal jugular vein: An analysis of 2 cases and literatures review / 中国实用外科杂志

OBJECTIVE: To investigate the clinical features,diagnosis and treatment of thyroid tumor complicated with tumor thrombus in internal jugular vein. METHODS: Case reports of thyroid tumor complicated with tumor thrombus in internal jugular vein published in domestic journals since January 2000 were retrieved. The clinical features and treatment procedures were analyzed combining with the data of 2 patients admitted to the Department of Vascular and Thyroid Surgery of Guizhou Provincial People's Hospital. RESULTS: A total of 10 reports were retrieved,including 23 patients.Of the 25 patients,14 were males and 11 were females,aged 44—84(62.9±9.8)years. The largest diameter of thyroid tumor was 2.8—8.0 cm.The length of tumor thrombus ranged from 1 cm to 30 cm. Among the 19 cases,14 were derived from intravascular spreading tumor thrombus,and 5 were from direct invasive tumor thrombus.There were 4 cases of papillary carcinoma,6 cases of follicular carcinoma,5 cases of poorly differentiated carcinoma,8 cases of undifferentiated carcinoma,1 case of myogenic sarcoma and 1 case of sclerosing epithelioid fibrosarcoma. Of the 13 cases,9 underwent internal jugular vein resection and 4 underwent thrombectomy. CONCLUSION: Thyroid tumors complicated with tumor thrombus in internal jugular vein are mostly tumors with strong vascular invasion ability.The long-term prognosis of the patients is very poor. Surgical treatment should be actively taken to remove the tumor thrombus and improve the prognosis of the patients.

Application of external branch of superior laryngeal nerve monitoring in thyroid surgery of tumor in upper pole / 中华内分泌外科杂志

Objective To explore the value of monitoring techniques of the external branch of superior laryngeal nerve (EBSLN) in thyroid surgery and to study its protective effects on vocal function after thyroid surgery.Methods We retrospectively analyzed the clinical data of 139 patients who underwent primary surgery of papillary thyroid cancer with neurological monitoring from Jun.2017 to Mar.2018 in the General Surgery Department of PLA General Hospital.The tumors of 31 cases were located in the upper pole of the gland and elsewhere in 108 cases.The patients' vocal function was assessed at one week and one month after surgery.The rate of EBSLN identified visually and by the intraoperative nerve monitoring (IONM) were counted.EBSLN recognition efficiency and prevalence of EBSLN damage during the operation of tumor in upper pole of thyroid and in other location were compared.Results In the 139 patients,there were 218 upper poles(218 EBSLN) treated intraoperatively,of which 145 were recognized visually (126(57.8％) confirmed by IONM,and 203(93.1％) were identified by IONM,OR=8.27(x2=59.345,P=0.00).The percentage of EBLSN located in the upper pole accurately identified by the naked eye was 20/46(43.5％) while by IONM was 43/46(93.4％).The percentage of EBSLN at the other position accurately identified visually was 106/172(61.6％),and by IONM was 160/172(93.0％).The number of visually identified cases in different locations showed significantly differences according to the chi-square test (x2=4.901,P=0.027),and no significant difference by IONM identification according to chi-square test (x2=0.012,P=0.914).Five patients had a low voice at one week postoperatively and low voice and vocalization change were not observed after one month.Conclusions IONM can effectively increase the proportion of intraoperative EBSLN identification to ensure the safety of surgery.The difficulty of visual identification of EBSLN during the surgery of tumor in upper pole is greater than that in other locations.IONM can provide more evidences for nerve protection and reduce the risk of injury.

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: A distinct clinicopathologic entity

Objective: The objective of this study is to retrospectively evaluate follicular variant of papillary thyroid carcinoma (FVPTC) and reclassify encapsulated FVPTC as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) according to the criteria proposed by The Endocrine Pathology Society working group in 2015 to correlate with outcome. Materials and Methods: Retrospective review of case records of all patients diagnosed as carcinoma of thyroid between 2015 and 2016 was done for the histologic subtype. Gross and microscopic features on resected specimens of FVPTC were reviewed and subtyped as invasive and encapsulated based on capsular/vascular invasion; the encapsulated forms were further studied for size, number, follicular architecture, nuclear features, presence of psammoma bodies, stromal fibrosis, necrosis, mitoses, and lymph node status. Results: Out of the 383 patients with thyroid carcinomas in the study period, 349 were PTC which included 106 FVPTC. Thirty-three patients fulfilled the criteria to be labeled as NIFTP. Total thyroidectomy was performed in 8 patients and hemithyroidectomy in 25 patients. Lymph node dissection along with total thyroidectomy was done in 3 and completion thyroidectomy following hemithyroidectomy was done in 9. There were 29 single and 4 multiple lesions with size varying from 0.2 to 7 cm including 5 lesions measuring <1 cm. The involvement was confined to one lobe in 31 and both lobes in 2 specimens. Patients are on follow-up with no recurrence till date. Conclusion: Thyroid carcinomas currently diagnosed as FVPTC should be evaluated for criteria of NIFTP to avoid overtreatment as they have an indolent behavior.

Analysis of 75 cases of unilateral thyroid through small incision approach under the ill side necklace / 中国综合临床

Objective To investigate the feasibility and advantages of the treatment of the unilateral thyroid through small incision approach under the ill side necklace. Methods A retrospective analysis was performed on the clinical data of seventy?five patients with unilateral benign thyroid tumor from January 2015 to October 2017 treated in People's Hospital of Jishan with the small incision approach under the ill side necklace. The exposure of recurrent laryngeal nerve and superior laryngeal nerve and related complications after operation were statistically analyzed. Results The exposure rate of recurrent laryngeal nerve was 86. 7％ ( 65/75),and the exposure rate of the superior laryngeal nerve was 69. 3％ (52/75). All the patients had no incision bleeding,laryngeal edema,aspiration or permanent hoarseness and other complications. Conclusion Unilateral thyroidectomy is a safe and feasible treatment with small incision,small injury and easy operation.

PTC: The correlation between sonographic characteristics of ultrasound and metastasis of cervical lymph node / 中国医学装备

Objective: To analyze the correlation between sonographic characteristics of ultrasound and metastasis of cervical lymph node of papillary thyroid carcinoma (PTC). Methods: 498 patients with PTC who once received radical operation of thyroid cancer and cervical lymph node dissection were divided into metastasis group (n=163) and non-metastasis group (n=335) according to results post pathology. Gender, age, the number of lesion, maximum diameter, aspect ratio, margin, whether contacted with tunica, border, halo of ultrasound, whether existed hypoecho in interior, whether the echo was uniform, whether existed difference about some characteristics of calcification and blood flow between the two groups were compared and analyzed. The correlation of characteristics and cervical lymphatic metastasis was analyzed by using single factor analysis, and the malignancy phenomenon of ultrasonogram that was closely relevant with cervical lymph node metastasis of patients with PTC were screened out by using Logistic regression. Results: As the results of single factor analysis, there were a certain correlation between series of factors, such as gender, age, the number of lesion, maximum diameter, margin, whether contacted with tunica, blood flow and whether contained tiny calcification, and cervical lymph node metastasis, and these correlations were significant (x2=33.094, x2=126.566, x2=127.961, x2=145.087, x2=53.757, x2=6.807, P<0.05). The results of Logistic regression indicated that these factors, included multi- lesions, maximum diameter more than 10.0mm, irregular margin, contacted with tunica of thyroid and abundant blood flow, were closely correlative with the malignancy phenomenon of ultrasonogram of cervical lymphatic metastasis of patients with PTC, and their correlation coefficient were significant (OR=3.103, OR=3.595, OR=2.822, OR=6.317, OR=2.078, P<0.05). Conclusion: The characteristics of ultrasonogram contributes to increase the detectable rate of ultrasound for cervical lymph node metastasis of patients with PTC, and it can provide reference for clinical decision.

Tracheal stent in surgery for tracheal stenosis caused by thyroid tumor / 中华内分泌外科杂志

Objective To discuss clinical application,value and effect of tracheal stent in surgical operation for tracheostenosis caused by thyroid tumor.Methods Clinical data of 6 patients with tracheal stenosis and dyspnea caused by thyroid tumor invasiveness or tracheal compression from Oct.2015 to Sep.2016 were retrospectively analyzed.Of the 6 patients,1 case had nodular goiter and 5 cases had differentiated thyroid carcinoma(DTC).Results All patients had dyspnea caused by thyroid tumor invasiveness or tracheal compression.Dyspnea relieved dramatically after tracheal stent was implantated under local anesthesia.Thyroidectomy was given later,with intraoperative tracheal intubation as well as anesthesia,and the surgery finally succeeded.One case with benign multinodular goiter received complete resection and 5 cases with DTC invading the trachea received complete resection of thyroid and neck lymph node dissection,followed by end-to-end anastomosis of invaded trachea sleeve resection.All patients got stage Ⅰ healing in surgical wound.Five cases received radioactive 131I treatment as well as TSH suppression therapy after DTC surgery.All patients were alive and disease-free after a follow-up of 4 to 15 months.Conclusions For patients with tracheostenosis caused by thyroid tumor invasiveness or tracheal compression,operation under cardiopulmonary bypass is necessary if tracheal intubation is difficult.For hospitals without cardiopulmonary bypass,tracheal stent implantation can effectively relieve dyspnea symptom and reduce risk of tracheal intubation under anesthesia,which provides possibility for surgical treatment.

Estruma ovárico maligno con foco de carcinoma papilar / Malignant struma with ovarian carcinoma papillary spotlight

Resumen ANTECEDENTES: El estruma ovárico es una variedad infrecuente de teratoma quístico. CASO CLÍNICO: Paciente de 42 años de edad en quien durante una revisión ginecológica rutinaria se evidenció, por ecografía, un quiste anexial derecho complejo, bilobulado, de 10 cm compuesto por dos formaciones heterogéneas independientes, una de aspecto uniforme ecorrefringente de 52.6 mm y otra ecorrefringencia alternante de 36.7 mm. Se categorizó como teratoma quístico, lo que se confirmó por resonancia magnética nuclear. Se efectuó anexectomía derecha laparoscópica. El estudio anatomopatológico confirmó el diagnóstico microscópico de teratoma quístico maduro, que incluía a la tiroides (menos de 50% de todo el tumor), con un carcinoma papilar de patrón folicular (estruma ovárico). La cirugía ginecológica se complementó con histerectomía total, omentectomía, lavado peritoneal e inspección de la cavidad abdominal por vía laparotómica; se descartó la neoplasia residual. El estudio endocrinológico evidenció la normalidad de la tiroides y el diagnóstico ecográfico de un nódulo; posteriormente se confirmó que se trataba de hiperplasia benigna. Los marcadores tumorales tiroideos fueron negativos y, a pesar de ello, el comité de cáncer de tiroides acordó que se efectuara la tiroidectomía total y luego se indicara tratamiento con iodo radiactivo, sin evidenciar elementos neoplásicos malignos ni ganglios linfáticos afectados. CONCLUSIONES: Debido a la baja incidencia del estruma ovárico su tratamiento comprende a la cirugía ovárica y la tiroidectomía, y al yodo radioactivo en el caso de las variedades malignas; todo esto en un contexto de controversia consecuencia de la poca experiencia acumulada.

Abstract BACKGROUND: Struma ovarii represents a rare form of ovarial quistic teratom that contains thiroid tissue and affects mostly women between 40 and 60 years of age. Its diagnosis is based on the definitive pathological study of the piece, due to the fact that these kind of tumors lack any specific clinic and diagnostic features. CLINICAL CASE: 42 year old patient, in which during a routine gynecological examination a bilobed complex right adnexal cyst of 10 cm composed of two independent heterogeneous formations (a uniform appearance ecorrefringente of 52.6mm and one alternate ecorrefrigencia of 36.7 mm) is evidenced by ultrasound. It is categorized as cystic teratoma and confirmed by nuclear magnetic resonance. Adnexectomy is performed laparoscopically. The pathological study confirmed the microscopic diagnosis of mature cystic teratoma including thyroid tissue (less than 50% of the tumor) with papillary carcinoma follicular pattern: Struma Ovarii. Gynecological surgery was completed with a total hysterectomy, omentectomy, washing and inspection peritoneal abdominal cavity by laparotomy discarding residual neoplasia. Endocrinological study showed normal thyroid function and ultrasound diagnosis of a nodule: benign hyperplasia was confirmed later. Thyroid tumor markers were negative and despite this, the thyroid cancer committee agreed to perform a total thyroidectomy and a treatment with radioiodine, without evidence of malignant neoplastic elements and affected lymph nodes. CONCLUSIONS: Its treatment is still controversial due to its low incidence, and includes not only ovarial surgery but also thyroidectomy and radioactive iodine therapy in the event of a malignant tumor.

Multidisciplinary team in diagnosis and treatment of complicated and refractory thyroid tumors / 中华内分泌外科杂志

Objective To summarize the experience ofmultidisciplinary team (MDT) in diagnosis and treatment of complicated and refractory thyroid tumors.Methods A retrospective review was performed on clinical data of 46 cases with complicated and refractory large thyroid tumors admitted to our hospital from Jan.2010 to Dec.2016.There were 23 cases in MDT group and 23 cases in the control group,respectively.The MDT group received diagnosis and treatment provided by multidisciplinary team during perioperative period whereas the control group received conventional surgery.Results Short-term complications such as trouble breathing and thyroid crisis were not observed in 46 patients after surgery.In the control group,the mean durations were (52±11.5)minutes for anesthesia,(159±38.1) minutes for surgery and (11 ±3.5) days for hospital stay,respectively.After surgery,bleeding occurred in 5 cases,hoarseness in 5 cases,irritating cough when drinking in 7 cases,transient hypocalcemia in 8 cases,permanent hypocalcemia in 6 cases,and neck tracheotomy due to tracheomalacia during surgery in 2 cases.In MDT group,the mean durations were (37±8.5) minutes for anesthesia,(134±28.5) minutes for surgery and (7±1.5) days,respectively.After surgery,bleeding occurred in 0 case,hoarseness in 0 case,irritating cough when drinking in 1 case,transient hypocalcemia in 2 cases,permanent hypocalcemia in 0 case,and neck tracheotomy due to tracheomalacia during surgery in 4 cases.Conclusion Application of multidisciplinary team in diagnosis and treatment of complicated and refractory thyroid tumors can reduce duration of preoperative endotracheal anesthesia as well as surgery,decrease postoperative complications,shorten duration of hospitalization and improve life quality after surgery.

Clinicopathologic analysis of 3299 patients with thyroid tumors in Nanchong / 中国肿瘤临床

Objective:To determine the incident tendency and constituent ratio of thyroid tumors, patient age, and histology, as well as present scientific data for the prevention and treatment of thyroid tumors in Nanchong. Methods:Data were collected in the Affili-ated Hospital of North Sichuan Medical College from 2001 to 2015. Microsoft Excel and SPSS 17.0 were used to analyze the data statis-tically. Results:A total of 3299 cases of thyroid tumors were observed for a span of 15 years. The cases of benign tumors were 2503, while those of malignant tumors were 796. Most cases of benign (33.0%) and malignant (27.3%) tumors occurred in the 40-49 age group. At 35 years old and below, the proportion of patients with thyroid malignant tumors was 23.5%. The number of male patients was 566, while that of female patients was 2733, resulting in a male-to-female ratio of 1:4.8. Conclusion:As the incidence of thyroid tumors increase every year, so does the constituent ratios of thyroid malignant tumors. The onset of tumors in men and women were significantly different. These findings should attract more clinicians' and preventive researchers' attention. Targeted detection, preven-tion, and control need to be carried out immediately.

Research progress in diagnosis and treatment of papillary thyroid microcarcinoma / 实用肿瘤学杂志

Thyroid cancer is one of the most common malignant tumors in the human endocrine system . It is one of the common diseases in head and neck ,thyroid and breast surgery .Its incidence rate is increasing year by year .With the development of ultrasonography and fine needle aspiration biopsy ,as well as the auxiliary exami-nation of gene detection technology ,the detective rate of early diagnosis of papillary thyroid microcarcinoma ( PT-MC) is getting higher and higher .Compared with conventional surgery , highlighting the advantages of minimally invasive surgery , endoscopic and ultrasound guided percutaneous ablation and other new surgical methods are gradually applied in clinical treatment .Combined with the new guideline ,the present paper reviews the progress in the diagnosis and treatment of papillary thyroid microcarcinoma .

Advances of long non-coding RNA in thyroid tumor / 中华内分泌外科杂志

Long non-coding RNA(lncRNA) is non-protein coding transcripts longer than 200 nucleotides,which plays an important role in the development of the metabolic process.Thyroid cancer is the most common cancer of the endocrine system,and as reported,lncRNA is related to the occurrence and development of thyroid tumors.Therefore,this paper reports the latest domestic and foreign research progress about lncRNA in thyroid tumor,in order to provide new ideas for molecular diagnosis and treatment of thyroid cancer.

Circulating RNA in thyroid cancer / 中国癌症杂志

Thyroid cancer is the most common endocrine gland malignanct tumor. Numerous studies have found that the content of peripheral blood circulating RNA in various cancer types is aberrantly expressed, which could be a potential biological diagnostic marker and therapeutic target. Tissue-speciifc messenger RNA has a dysregulated expression and may be used for the diagnosis and residual/metastatic detection of thyroid cancer. Recent studies have showed that non-coding RNA (ncRNA) could act as oncogene or tumor suppressor gene in bacteria, fungi and mam-mals. It plays a regulatory role in occurrence and development of tumors and stably exists in peripheral blood. It is hopeful that it will become a new marker for diagnosis of tumors. This review introduces some latest research progress on circulating RNA associated with thyroid cancer; and emphatically discuss the role of mRNA, microRNA (miRNA), long non-coding RNA (lncRNA) and circular RNA (circRNA) in thyroid tumorigenesis and metastasis.

Myelopathy associated with cervical epidural spinal metastasis of follicular-compact thyroid carcinoma in two dogs / Mielopatia associada à metástase epidural cervical de carcinoma folicular-compacto de tireoide em dois cães

This case report describes the clinical, histopathological and immunohistochemical findings in two dogs with myelopathy associated with metastasis of follicular-compact thyroid carcinoma. Microscopically, both primary neoplasms were characterized by polygonal cells arranged in follicles (occasionally filled with eosinophilic colloid-like material) or in sheets. The neoplastic cells had a moderately eosinophilic cytoplasm and there was moderate anisokaryosis and anisocytosis. Additionally, the neoplastic cells were positive for thyroglobulin on immunohistochemistry, confirming the follicular origin of both tumors. This is a very uncommon presentation of this pathological condition.

Este relato de caso descreve os achados clínicos, histopatológicos e imuno-histoquímicos em dois cães com mielopatia associada à metástase de carcinoma de tireoide. Microscopicamente, ambos os neoplasmas primários eram caracterizados por células poligonais arranjadas em folículos (ocasionalmente preenchidos por material eosinofílico semelhante a coloide) ou em folhetos. As células neoplásicas tinham moderado citoplasma eosinofílico e moderada anisocitose e anisocariose. Adicionalmente, as células neoplásicas foram positivas para tireoglobulina, confirmando a origem folicular dos tumores em ambos os cães. Essa é uma apresentação incomum dessa condição patológica.

A case control study on risk factors for female thyroid tumor in Hohhot of Inner Mongolia / 中华地方病学杂志

Objective To study the major risk factors for female thyroid tumor in Hohhot of Inner Mongolia and to provide a scientific basis for prevention and treatment of the disease.Methods A case control study was carried out,190 female patients who had suffered thyroid tumor and had been operated on in the Affiliated Hospital of Inner Mongoha Medical College and Inner Mongolia Hospital from March 2010 to September 2011 were selected.Meanwhile,190 female patients who were excluded from being suffering this disease were chosen as controls.A formal questionnaire was made,including the following contents:the general situation,the life style and behavior habit,women's physiological and reproductive situation,job and life factors,personal disease,and medicine and genetic factors.Then,trained investigators who had at least got the bachelor degree interviewed all the patients in the two groups and the doctors in the office of ultrasound and pathology made the check-up.All data made up a database;statistical description and analysis was done with software SPSS 17.0.Through Logistic regression analysis,the relationship between all factors and female thyroid tumor was analyzed in order to find major risk factors related to female thyroid tumor in Hohhot.Results The results of Logistic regression analysis showed that the delay of the first pregnancy,the higher Body Mass Index,too much preserved food and seafood in the diet,higher level of education,negative live event were apparently related to female thyroid tumor (OR =1.527,22.729,2.271,4.303,1.117,1.489,all P ＜ 0.05).Conclusions The female thyroid tumor in Hohhot is a result of comprehensive effect of multiple factors.This study found that the delay of the first pregnancy,the higher Body Mass Index,too much preserved food and seafood in the diet,higher level of education,and negative live event are apparently related to female thyroid tumor,and these factors may be major risk factors for thyroid tumor based on the current epidemiological study.