RESUMEN
The accurate determination of the risk of cancer recurrence is a critical unmet need in managing thyroid cancer (TC). Although numerous studies have successfully demonstrated the use of high throughput molecular diagnostics in TC prediction, it has not been successfully applied in routine clinical use, particularly in Chinese patients. In our study, we objective to screen for characteristic genes specific to PTC and establish an accurate model for diagnosis and prognostic evaluation of PTC. We screen the differentially expressed genes by Python 3.6 in The Cancer Genome Atlas (TCGA) database. We discovered a three-gene signature Gap junction protein beta 4 (GJB4), Ripply transcriptional repressor 3 (RIPPLY3), and Adrenoceptor alpha 1B (ADRA1B) that had a statistically significant difference. Then we used Gene Expression Omnibus (GEO) database to establish a diagnostic and prognostic model to verify the three-gene signature. For experimental validation, immunohistochemistry in tissue microarrays showed that thyroid samples' proteins expressed by this three-gene are differentially expressed. Our protocol discovered a robust three-gene signature that can distinguish prognosis, which will have daily clinical application.
RESUMEN
Although the mortality rate of papillary thyroid carcinoma (PTC) is relatively low, the recurrence rates of PTC remain high. The high recurrence rates are related to the difficulties in treatment. Gene expression profiles has provided novel insights into potential therapeutic targets and molecular biomarkers of PTC. The aim of the present study was to identify mRNA signatures which may categorize PTCs into high-and low-risk subgroups and aid with the predictions for prognoses. The mRNA expression profiles of PTC and normal thyroid tissue samples were obtained from The Cancer Genome Atlas (TCGA) database. Differentially expressed mRNAs were identified using the 'EdgeR' software package. Gene signatures associated with the overall survival of PTC were selected, and enrichment analysis was performed to explore the biological pathways and functions of the prognostic mRNAs using the Database for Visualization, Annotation and Integration Discovery. A signature model was established to investigate a specific and robust risk stratification for PTC. A total of 1,085 differentially expressed mRNAs were identified between the PTC and normal thyroid tissue samples. Among them, 361 mRNAs were associated with overall survival (P<0.05). A 5-mRNA prognostic signature for PTC (ADRA1B, RIPPLY3, PCOLCE, TEKT1 and SALL3) was identified to classify the patients into high-and low-risk subgroups. These prognostic mRNAs were enriched in Gene Ontology terms such as 'calcium ion binding', 'enzyme inhibitor activity', 'carbohydrate binding', 'transcriptional activator activity', 'RNA polymerase II core promoter proximal region sequence-specific binding' and 'glutathione transferase activity', and Kyoto Encyclopedia of Genes and Genomes signaling pathways such as 'pertussis', 'ascorbate and aldarate metabolism', 'systemic lupus erythematosus', 'drug metabolism-cytochrome P450 and 'complement and coagulation cascades'. The 5-mRNA signature model may be useful during consultations with patients with PTC to improve the prediction of their prognosis. In addition, the prognostic signature identified in the present study may reveal novel therapeutic targets for patients with PTC.
RESUMEN
OBJECTIVE: To compare clinical outcomes of endoscopic thyroidectomy via mammary areola approach and conventional via chest wall and breasts approach. METHODS: A total of 480 cases undergoing endoscopic thyroidectomy for thyroid nodules between September 2002 and September 2012 were reviewed, including 280 cases via the chest wall and breasts approach between September 2002 and August 2009 and 190 cases via mammary areola approach between September 2002 and September 2012. The mean operation time, the location and diameter of the puncture pore, intraoperative bleeding volume, the mean hospital stay after surgery, postoperative pain score scaled by visual analog scores (VAS) were compared between groups. After 3-month follow-up, long term post-surgical complications, the recurrence rates of nodules and scar cosmetic satisfaction evaluation were also compared. Statistical methods including χ(2) test, Students' test and ANOVA analysis were applied. RESULTS: Two groups were followed for 12 months. The differences between groups were statistically obvious in variables of diameters of the puncture pore (15.5 mm ± 4.9 mm vs. 20.6 mm ± 7.6 mm, t = 2.42, P = 0.046) , intraoperative bleeding volume (16.2 ml ± 4.5 ml vs. 30.5 ml ± 11.4 ml, t = 2.53, P = 0.032) , pain score on the first day after operation (1.5 ± 0.4) and (1.0 ± 0.2), (t = 4.68, P = 0.020) , scar cosmetic satisfaction evaluation 3 months after operation (χ(2) = 6.20, P < 0.05) , chest wall numbness (0 vs. 72.4%,χ(2) = 380, P = 0.000) . But there were no significant differences in the mean operation time, the mean hospital stay after surgery, and the recurrence rates of nodules between two groups. CONCLUSION: Minimally invasive endoscopic thyroidectomy via mammary areola approach is a safe and effective method for the surgery of thyroid nodules with good aesthetic outcome.
