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1.
Medicine (Baltimore) ; 100(16): e25517, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879689

RESUMO

RATIONALE: Primary schwannoma of the thyroid gland is very rare, and its preoperative diagnosis is difficult. PATIENT CONCERNS: We report the case of a thyroid nodule in an 18-year-old woman, who presented with a mass in her left neck with stiffness and normal thyroid function. However, the patient complained of numbness in her left upper extremity, and ultrasound (US) features were suspicious of malignancy. DIAGNOSES: Multimodal US imaging was performed using B-mode, color doppler, ultrasonic elastography (UE), and contrast-enhanced ultrasound (CEUS). CEUS revealed heterogeneous enhancement and "target sign" within the tumor. The nodule was suspicious for malignancy and classified as TI-RADS 4b, while the elasticity values measured by UE indicated a benign lesion. Fine needle aspiration (FNA) was subsequently performed in the markedly contrast-enhanced area for biopsy. Cytological results revealed a benign schwannoma. INTERVENTION: The patient underwent left lobe resection. Postoperative pathology confirmed it to be a primary benign schwannoma of the thyroid. OUTCOMES: After thyroidectomy, the patient was followed-up with US. At present, all laboratory tests and thyroid imaging are normal, and the numbness of the left upper limb has disappeared. LESSONS: The combination of different US modalities is useful for the diagnosis of thyroid lesions. FNA performed under CEUS guidance improves the accuracy of biopsy sampling.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Neurilemoma/diagnóstico , Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico , Ultrassonografia Doppler em Cores/métodos , Adolescente , Biópsia por Agulha Fina , Meios de Contraste/administração & dosagem , Feminino , Humanos , Imagem Multimodal/métodos , Neurilemoma/patologia , Neurilemoma/cirurgia , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Resultado do Tratamento
2.
Ann Transl Med ; 8(7): 495, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32395539

RESUMO

Background: Thyroid carcinoma constitutes the vast majority of all thyroid cancer, most of which is the solid nodule type. No previous studies have examined combining both conventional and elastic sonography to evaluate the diagnostic performance of partially cystic thyroid cancer (PCTC). This retrospective study was designed to evaluate differentiation of PCTC from benign partially cystic nodules with a machine learning-assisted system based on ultrasound (US) and elastography. Methods: Patients with suspicious partially cystic nodules and finally confirmed were included in the study. We performed conventional US and real-time elastography (RTE). The US features of nodules were recorded. The data set was entered into 6 machine-learning algorithms. Sensitivity, specificity, accuracy, and area under the curve (AUC) were calculated. Results: A total of 177 nodules were included in this study. Among these nodules, 81 were malignant and 96 were benign. Wreath-shaped feature, micro-calcification, and strain ratio (SR) value were the most important imaging features in differential diagnosis. The random forest classifier was the best diagnostic model. Conclusions: US features of PCTC exhibited unique characteristics. Wreath-shaped partially cystic nodules, especially with the appearance of micro-calcifications and larger SR value, are more likely to be malignant. The random forest classifier might be useful to diagnose PCTC.

3.
J Ultrasound Med ; 39(6): 1203-1211, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31891216

RESUMO

OBJECTIVES: By analyzing the B-mode ultrasound and color Doppler flow imaging characteristics of breast lymphoma (BL) and breast infiltrating ductal carcinoma (BIDC), we expected to discriminate these diseases. METHODS: Thirty-two patients with BL and 30 with BIDC confirmed pathologically were selected. The BL group was divided into nodular and diffuse groups. We analyzed and compared the general and imaging characteristics of the BL subgroups and the BIDC group. RESULTS: The mean maximum diameter of BL was 54.93 ± 43.74 cm, and that of BIDC was 23.90 ± 6.79 cm (P < .05). The differences between the nodular BL and BIDC groups in a circumscribed margin (60.00% versus 20.00%), calcification (20.00% versus 53.33%), aggregation characteristics (0.00% versus 53.33%), and density (73.33% versus 10.00%) were statistically significant (P < .05). The differences between the diffuse BL and BIDC groups in calcification (6.67% versus 53.33%), aggregation characteristics (6.67% versus 53.33%) and density (40.00% versus 10.00%) were statistically significant (P < .05). The difference in a circumscribed margin (60% versus 13.33%) between the BL subgroups was statistically significant (P < .05). The blood flow signal in BL lesions was richer than that in BIDC lesions (P < .05). CONCLUSIONS: Extrasuperior-quadrant single lesions in the BL group were larger than those in the BIDC group. The edges of the lesions in the nodular BL group were circumscribed and dense. Lesions in the diffuse BL group did not have a circumscribed margin, calcification, aggregation characteristics, or density. The blood flow signal in BL lesions was richer than that in BIDC lesions.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/diagnóstico por imagem , Linfoma/diagnóstico por imagem , Ultrassonografia Mamária/métodos , Adulto , Idoso , Mama/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
4.
Medicine (Baltimore) ; 98(32): e16379, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393347

RESUMO

BACKGROUND: More and more automated efficient ultrasound image analysis techniques, such as ultrasound-based computer-aided diagnosis system (CAD), were developed to obtain accurate, reproducible, and more objective diagnosis results for thyroid nodules. So far, whether the diagnostic performance of existing CAD systems can reach the diagnostic level of experienced radiologists is still controversial. The aim of the meta-analysis was to evaluate the accuracy of CAD for thyroid nodules' diagnosis by reviewing current literatures and summarizing the research status. METHODS: A detailed literature search on PubMed, Embase, and Cochrane Libraries for articles published until December 2018 was carried out. The diagnostic performances of CAD systems vs radiologist were evaluated by meta-analysis. We determined the sensitivity and the specificity across studies, calculated positive and negative likelihood ratios and constructed summary receiver-operating characteristic (SROC) curves. Meta-analysis of studies was performed using a mixed-effect, hierarchical logistic regression model. RESULTS: Five studies with 536 patients and 723 thyroid nodules were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) for CAD system were 0.87 (95% confidence interval [CI], 0.73-0.94), 0.79 (95% CI 0.63-0.89), 4.1 (95% CI 2.5-6.9), 0.17 (95% CI 0.09-0.32), and 25 (95% CI 15-42), respectively. The SROC curve indicated that the area under the curve was 0.90 (95% CI 0.87-0.92). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR for experienced radiologists were 0.82 (95% CI 0.69-0.91), 0.83 (95% CI 0.76-0.89), 4.9 (95% CI 3.4-7.0), 0.22 (95% CI 0.12-0.38), and 23 (95% CI 11-46), respectively. The SROC curve indicated that the area under the curve was 0.96 (95% CI 0.94-0.97). CONCLUSION: The sensitivity of the CAD system in the diagnosis of thyroid nodules was similar to that of experienced radiologists. However, the CAD system had lower specificity and DOR than experienced radiologists. The CAD system may play the potential role as a decision-making assistant alongside radiologists in the thyroid nodules' diagnosis. Future technical improvements would be helpful to increase the accuracy as well as diagnostic efficiency.


Assuntos
Diagnóstico por Computador/métodos , Diagnóstico por Computador/normas , Radiologistas/normas , Nódulo da Glândula Tireoide/diagnóstico , Inteligência Artificial , Diagnóstico Diferencial , Humanos , Curva ROC , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Ultrassonografia
6.
J Biomed Nanotechnol ; 13(4): 393-408, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29384603

RESUMO

In this work, docetaxel (DTX) was encapsulated in monomethoxy poly(ethylene glycol)-poly(ε-caprolactone) (mPEG-PCL) micelles and monomethoxy poly(ethylene glycol)-poly(D, L-lactic acid) (mPEG-PLA) micelles, respectively. For the further application, the acute/genetic toxicity evaluation and pharmacokinetic/pharmacodynamic study of the two kinds of micellar nanomedicines were performed. In the study of anticancer activity in vitro and in vivo, DTX micelles showed better tumorgrowth inhibition than free DTX. The pharmacokinetic and tissue distribution studies showed that the DTX incorporated in micelles (especially in DTX-mPEG-PCL) retained significantly higher concentration in plasma and tumor tissue compared with free DTX. The acute toxicity and genotoxicity studies indicated that DTX micelles were safer than the docetaxel injection in cancer therapy and DTX-mPEG-PCL had less damage to DNA than DTX-mPEG-PLA. So the micelles had a pronounced effect on reducing acute toxicity and genotoxicity of docetaxel. In conclusion, DTX micelles were efficient and safe on breast carcinoma chemotherapy.


Assuntos
Nanocápsulas/administração & dosagem , Nanocápsulas/toxicidade , Neoplasias Experimentais/tratamento farmacológico , Neoplasias Experimentais/metabolismo , Taxoides/administração & dosagem , Taxoides/farmacocinética , Animais , Antineoplásicos/administração & dosagem , Antineoplásicos/farmacocinética , Apoptose/efeitos dos fármacos , Docetaxel , Relação Dose-Resposta a Droga , Humanos , Células MCF-7 , Taxa de Depuração Metabólica , Camundongos , Micelas , Nanocápsulas/ultraestrutura , Neoplasias Experimentais/patologia , Especificidade de Órgãos , Tamanho da Partícula , Taxoides/toxicidade , Distribuição Tecidual , Resultado do Tratamento
7.
Medicine (Baltimore) ; 96(50): e9065, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29390301

RESUMO

RATIONALE: Co-occurrence of medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) in the same thyroid gland with liver metastasis is a rare condition. To our knowledge, the utility of contrast-enhanced ultrasound (CEUS) to diagnose it is much less. PATIENT CONCERNS: A 33-year-old female was referred to our hospital due to the increase in plasma calcitonin concentration and carcino-embryonic antigen 12 months after her total thyroidectomy. To find metastasis, she received laboratory tests, gray-scale US, and CEUS. In our paper, ethical approval was not necessary, as this article is a case report, which is based on the clinical information of the patient. Because our case does not refer to the patient's privacy, informed consent is not necessary. DIAGNOSES: Gray-scale abdominal ultrasound image demonstrated a mildly hyperechoic nodule in the liver. In CEUS, the nodules were hyperenhanced in the arterial phase. In the late arterial phase, the enhancement was washed out quickly. The nodules presented hypoenhancement in the portal and parenchymal phase, which conformed to the hepatic metastasis. INTERVENTIONS: The patient received thyroid and liver surgery. OUTCOMES: She was free of disease for 10 months at the time of this report. LESSONS: In this case, liver metastases from MTC can be detected and characterized reliably as hypoenhancing lesions during the portal venous and late phases of CEUS, washing out starts early, and is marked. We suspect MTC is a kind of tumor that tends to have rich blood supply and consider contrast-enhanced ultrasound as a suitable method for the follow-up of patients with MTC.


Assuntos
Carcinoma Neuroendócrino/patologia , Carcinoma Papilar/patologia , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Neoplasias da Glândula Tireoide/patologia , Ultrassonografia/métodos , Adulto , Carcinoma Neuroendócrino/cirurgia , Carcinoma Papilar/cirurgia , Meios de Contraste , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Hepáticas/cirurgia , Fosfolipídeos , Hexafluoreto de Enxofre , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
8.
Oncol Lett ; 11(5): 3293-3297, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27123105

RESUMO

Distant metastases are more common in follicular thyroid carcinoma (FC) than in papillary thyroid carcinoma. However, FC metastasis to the kidney with eggshell calcification, as observed in the present case, is rare. The current report presents a case of a 67-year-old woman exhibiting a solitary tumor in the mid pole of the left kidney. Radical nephrectomy was performed, as the tumor was diagnosed as a primary renal carcinoma using contrast-enhanced computed tomography. Once the tumor was confirmed to be FC, total thyroidectomy was performed. Following administration of an oral therapeutic dose of 100 mCi 131I, functional imaging demonstrated the presence of multifocal metastases in the chest and abdomen. Euthyrox® was prescribed orally to aid normal thyroid function. Follow-up 6 months later using radionuclide imaging demonstrated the disappearance of the multifocal metastases in the chest and abdomen. The distant metastasis of FC may represent the initial symptom of the primary lesion, which was neglected. Ultrasound is an effective method to examine nodules located on the thyroid.

9.
World J Gastroenterol ; 22(1): 326-37, 2016 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-26755879

RESUMO

Human hepatocellular carcinoma (HCC) heavily endangers human heath worldwide. HCC is one of most frequent cancers in China because patients with liver disease, such as chronic hepatitis, have the highest cancer susceptibility. Traditional therapeutic approaches have limited efficacy in advanced liver cancer, and novel strategies are urgently needed to improve the limited treatment options for HCC. This review summarizes the basic knowledge, current advances, and future challenges and prospects of adeno-associated virus (AAV) and adenoviruses as vectors for gene therapy of HCC. This paper also reviews the clinical trials of gene therapy using adenovirus vectors, immunotherapy, toxicity and immunological barriers for AAV and adenoviruses, and proposes several alternative strategies to overcome the therapeutic barriers to using AAV and adenoviruses as vectors.


Assuntos
Carcinoma Hepatocelular/terapia , Terapia Genética/métodos , Neoplasias Hepáticas/terapia , Adenoviridae/genética , Dependovirus/genética , Terapia Genética/efeitos adversos , Terapia Genética/tendências , Vetores Genéticos , Humanos , Imunoterapia , Terapia Viral Oncolítica
10.
J Pak Med Assoc ; 64(8): 954-7, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25252527

RESUMO

Ultrasound guided fine needle aspiration biopsy (FNAB) is the first-line procedure in diagnosing thyroid nodules. However, emerging studies have reported its unsatisfactory cell sample for cytology evaluation. In this case report, shear wave elastography (SWE) guided FNAB on a thyroid nodule is presented. Biopsies were performed on both hard and soft areas of the same nodule on the SWE image. Cytological results demonstrated the sufficient diagnostic components and typical nuclear features of papillary carcinoma found on the specimen from the hard area. This case study indicates SWE is a useful complementary tool to conventional B-mode ultrasound in guiding thyroid nodule FNAB.


Assuntos
Biópsia por Agulha Fina/métodos , Técnicas de Imagem por Elasticidade , Nódulo da Glândula Tireoide/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Nódulo da Glândula Tireoide/patologia
11.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 45(6): 997-1000, 2014 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-25571732

RESUMO

OBJECTIVE: To investigate the findings of contrast enhanced ultrasound for papillary thyroid carcinoma and its pathological bases. METHODS: Seventy two (72) patients with thyroid nodules underwent routine conventional ultrasound and color Doppler examination, and 86 nodules with TI RADS 3 were examined by contrast-enhanced ultrasound (CEUS . Histopathological examination was kept as standard reference and the findings of CEUS were analyzed. Pathological studies of all nodules were made after post-operative CD34 immunohistochemistry staining examination. RESULTS: Of the total 86 nodules, Adler CDFl classification grades were: grade 0-26. grade I-34. grade II-23 and grade III-3 nodules respectively. Enhancement pattern on CEUS showed that there was low enhancement on 71 nodules, iso enhancement on 12 and high enhancement on 3 nodules. The differences of echo mean intensity. the peak intensity, area under the curve for enhancement intensity and CD34 count between the nodules and surrounding tissue were statistical significant (P < 0. 001). CONCLUSION: Low enhancement pattern on CEUS is the most common finding for papillary thyroid carcinoma, which is related to the difference of microvessel density between the nodules and surrounding tissues in papillary thyroid carcinoma.


Assuntos
Carcinoma/diagnóstico por imagem , Meios de Contraste , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Carcinoma/patologia , Carcinoma Papilar , Humanos , Imuno-Histoquímica , Período Pós-Operatório , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/patologia , Ultrassonografia
12.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 45(6): 1005-9, 2014 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-25571734

RESUMO

OBJECTIVE: To determine the perfusion pattern of lymphadenopathy in contrast-enhanced ultrasonography (CEUS) under different reference conditions. METHODS: The CEUS perfusion patterns of 78 superficial lymph node lesions were compared with their pathology results. Time-intensity curves were used for comparison between benign and malignant lymph nodes. RESULTS: Inhomogeneous hyperenhancement was the main perfusion pattern (7/17, 41. 2%) in metastatic lymph nodes; compared with homogeneous hyperenhancement (2/4, 50. 0%) in lymphoma, homogeneous hyperenhancement and isoenhancement (6/52, 11. 5%) in reactive lymph nodes, and circle enhancement (2/4,50. 0%) in tuberculosis. Benign lymph nodes showed different mean value, peak intensity and area under the curve compared with their surrounding arteries (P<0. 05). But the differences in mean value, rise time, time to peak, peak intensity and the area under the curve between benign lymphadenopathy and their surrounding tissues were not statistically significant (P>0. 05). Malignant lymph nodes showed different mean value and peak intensity compared with their surrounding arteries and tissues (P<0. 05). The differences in time to peak between malignant lymph nodes and their surrounding tissues were also statistically significant (P< 0. 05). CONCLUSION: Different CEUS perfusion patterns are associated with different types of lymph node lesions. Time intensity curves with surrounding tissues as reference condition offer great values for the differential diagnosis of superficial lymphadenopathy.


Assuntos
Meios de Contraste , Linfonodos/patologia , Doenças Linfáticas/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Linfonodos/diagnóstico por imagem , Ultrassonografia
13.
Acta Pharmacol Sin ; 34(4): 531-40, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23503473

RESUMO

AIM: The tumor suppressor in lung cancer-1 (TSLC1) is a candidate tumor suppressor of lung cancer, and frequently inactivated in primary non-small cell lung cancer (NSCLC). In this study, we investigated the effects of TSLC1 mediated by a dual-regulated oncolytic adenovirus on lung cancer, and the mechanisms underlying the antitumor actions. METHODS: The recombinant virus Ad·sp-E1A(Δ24)-TSLC1 was constructed by inserting the TSLC1 gene into the dual-regulated Ad·sp-E1A(Δ24) vector, which contained the survivin promoter and a 24 bp deletion within E1A. The antitumor effects of Ad·sp-E1A(Δ24)-TSLC1 were evaluated in NCI-H460, A549, and H1299 lung cancer cell lines and the normal fibroblast cell line MRC-5, as well as in A549 xenograft model in nude mice. Cell viability was assessed using MTT assay. The expression of TSLC1 and activation of the caspase signaling pathway were detected by Western blot analyses. The tumor tissues from the xenograft models were examined using H&E staining, IHC, TUNEL, and TEM analyses. RESULTS: Infection of A549 lung cancer cells with Ad·sp-E1A(Δ24)-TSLC1 induced high level expression of TSLC1. Furthermore, the Ad·sp-E1A(Δ24)-TSLC1 virus dose-dependently suppressed the viability of NCI-H460, A549, and H1299 lung cancer cells, and did not affect MRC-5 normal fibroblast cells. Infection of NCI-H460, A549, and H1299 lung cancer cells with Ad·sp-E1A(Δ24)-TSLC1 induced apoptosis, and increased activation of caspase-8, caspase-3 and PARP. In A549 xenograft model in nude mice, intratumoral injection of Ad·sp-E1A(Δ24)-TSLC1 significantly suppressed the tumor volume, and increased the survival rate (from less than 15% to 87.5% at d 60). Histological studies showed that injection of Ad·sp-E1A(Δ24)-TSLC1 caused tumor cell apoptosis and virus particle propagation in tumor tissues. CONCLUSION: The oncolytic adenovirus Ad·sp-E1A(Δ24)-TSLC1 exhibits specific antitumor effects, and is a promising agent for the treatment of lung cancer.


Assuntos
Adenoviridae/fisiologia , Moléculas de Adesão Celular/genética , Imunoglobulinas/genética , Neoplasias Pulmonares/terapia , Vírus Oncolíticos/fisiologia , Proteínas Supressoras de Tumor/genética , Animais , Apoptose/fisiologia , Molécula 1 de Adesão Celular , Moléculas de Adesão Celular/metabolismo , Linhagem Celular , Linhagem Celular Tumoral , Feminino , Fibroblastos/metabolismo , Fibroblastos/virologia , Terapia Genética/métodos , Vetores Genéticos/genética , Vetores Genéticos/metabolismo , Células HEK293 , Humanos , Imunoglobulinas/metabolismo , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/virologia , Camundongos , Camundongos Endogâmicos BALB C , Terapia Viral Oncolítica/métodos , Distribuição Aleatória , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Proteínas Supressoras de Tumor/metabolismo
14.
Artigo em Chinês | MEDLINE | ID: mdl-23141398

RESUMO

OBJECTIVE: To study the pattern of lymph node spread in papillary thyroid carcinoma (PTC) with clinically negative node (cN0). METHODS: A total of 106 patients with cN0 PTC who underwent total or subtotal thyroidectomy plus unilateral or bilateral lateral neck dissection (LND, level II-V or level I-V) at West China Hospital of Sichuan University between April 2004 and August 2010 were analyzed retrospectively. RESULTS: The lateral neck lymph node metastasis in cN0 PTC was significantly associated with sex (male, P = 0.007), tumor stage (T3/T4, P = 0.006), tumor size (> 1 cm, P = 0.014) and the number of positive central lymph nodes (≥ 2, P < 0.001), but not with age and multifocal tumor. Level III (47/116, 40.5%) was the most prevalent metastatic site, followed by level IV (41/116, 35.3%), level II (18/116, 15.5%) and level V (2/29, 6.9%). Of the cases with lymph node metastases in level III and IV, 89.8% (79/88) of primary thyroid tumors existed in the lower and middle sites of the thyroid lobes, while in the cases with lymph node metastases in level II, 77.8% (14/18) of primary thyroid tumors in the upper sites of the thyroid lobes, and 83.3% of cases with level II metastases were accompanied with level III metastases. Two cases with level V metastases were accompanied with metastases in levels II, III and IV. CONCLUSIONS: LND should be considered for cN0 PTC in male, with T3/T4 lesions and positive central lymph nodes ≥ 2, and the range of dissection should include level III and IV. Dissection of level II should be considered in cN0 PTC with primary tumor localized in the upper site of the thyroid lobe or with level III metastasis. Dissection of level V should be considered at present of metastases in level II, III, and IV. For cN0 PTC with tumor size < 1 cm, confined to the thyroid and without lymph node metastasis in the central compartment, LND is not recommended.


Assuntos
Carcinoma/patologia , Linfonodos/patologia , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Carcinoma Papilar , Criança , Feminino , Humanos , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Estadiamento de Neoplasias , Estudos Retrospectivos , Câncer Papilífero da Tireoide , Adulto Jovem
15.
Artigo em Chinês | MEDLINE | ID: mdl-22932241

RESUMO

OBJECTIVE: To study the related factors of central lymph node (CLN) metastasis in papillary thyroid carcinoma (PTC),the indications and the extent of central neck dissection (CND). METHODS: A total of 153 cases treated between Jan. 2009 and Dec. 2010 was analysed retrospectively. Of the cases 28 males and 125 cases females, with a mean age of (44 ± 14) years. T1, T2, and T3 diseases accounted for 51, 10 and 81 cases, respectively; I, II, III and IV diseases for 88, 3, 26 and 36 cases, respectively. Multifocal tumors were found in 63 cases. The related clinicopathologic factors were analyzed, including sex, age, tumor size, extrathyroidal extension, and multifocal tumor. RESULTS: All the cases had total/near total thyroidectomy and CND, of them 64 cases had unilateral neck dissection and 18 cases had bilateral neck dissection. CLN metastases existed in 68.6% (105/153) cases, 37.2% (57/153) for unilateral and 31.4% (48/153) for bilateral respectively. The rates of CLN metastasis were 86.6% (71/82) in cN1 cases and 47.9% (34/71) cN0 cases, respectively,and the rates of bilateral CLN metastases were 45.1% (37/82) in cN1 cases and 15.5% (11/71) in cN0 cases. Multivariate analysis showed that extrathyroidal extension (P = 0.002, OR = 3.502) was an independent risk factor for CLN metastasis and that lateral neck lymph node metastasis (P = 0.028, OR = 3.080), surrounding tissue invasion (P = 0.014, OR = 3.113), and maximum tumor diameter greater than 1 cm (P = 0.012, OR = 3.732) were independent risk factors for bilateral CLN metastases. CONCLUSIONS: It is indicated that ipsilateral CND should be obligatory for PTC. Intraoperative frozen section examination should be routine. Bilateral CND should be conducted when ipsilateral CLN metastases accompanied by one of following issues such as more invasive tumor (surrounding tissue invasion, T3 or T4 disease), maximum tumor diameter greater than 1 cm, and lateral neck lymph node metastasis.


Assuntos
Carcinoma/patologia , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Papilar , Criança , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Estudos Retrospectivos , Câncer Papilífero da Tireoide , Adulto Jovem
16.
BMC Cancer ; 12: 155, 2012 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-22536942

RESUMO

BACKGROUND: To construct the Bifidobacterium infantis-mediated soluble kinase insert domain receptor (sKDR) prokaryotic expression system and to observe its inhibitory effect on growth of human umbilicus vessel endothelial cells (HUVECs) in vitro and Lewis lung cancer (LLC) on mice in vivo. METHODS: The Bifidobacterium infantis-mediated sKDR prokaryotic expression system was constructed through electroporation and subsequently identified through PCR and Western blot analysis. HUVECs were added to the products of this system to evaluate the anti-angiogenesis effect through MTT assay in vitro. The LLC mice models were divided into three groups: one group treated with saline (group a); one group treated with recombinant Bifidobacterium infantis containing pTRKH2-PsT plasmid group (group b); and one group treated with recombinant Bifidobacterium infantis containing pTRKH2-PsT/sKDR plasmid group (group c). The quality of life and survival of mice were recorded. Tumor volume, tumor weight, inhibitive rate, and necrosis rate of tumor were also evaluated. Necrosis of tumor and signals of blood flow in tumors were detected through color Doppler ultrasound. In addition, microvessel density (MVD) of the tumor tissues was assessed through CD31 immunohistochemical analysis. RESULTS: The positively transformed Bifidobacterium infantis with recombinant pTRKH2-PsT/sKDR plasmid was established, and was able to express sKDR at gene and protein levels. The proliferation of HUVECs cultivated with the extract of positively transformed bacteria was inhibited significantly compared with other groups (P < 0. 05). The quality of life of mice in group c was better than in group a and b. The recombinant Bifidobacterium infantis containing pTRKH2-PsT/sKDR plasmid enhanced the efficacy of tumor growth suppression and prolongation of survival, increased the necrosis rate of tumor significantly, and could obviously decrease MVD and the signals of blood flow in tumors. CONCLUSION: The Bifidobacterium infantis-mediated sKDR prokaryotic expression system was constructed successfully. This system could express sKDR at gene and protein levels and significantly inhibit the growth of HUVECs induced by VEGF in vitro. Moreover, it could inhibit tumor growth and safely prolong the survival time of LLC C57BL/6 mice.


Assuntos
Bifidobacterium/genética , Carcinoma Pulmonar de Lewis/genética , Neovascularização Patológica/genética , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/genética , Animais , Carcinoma Pulmonar de Lewis/metabolismo , Carcinoma Pulmonar de Lewis/mortalidade , Carcinoma Pulmonar de Lewis/patologia , Linhagem Celular Tumoral , Feminino , Expressão Gênica , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Camundongos , Camundongos Endogâmicos C57BL , Neovascularização Patológica/metabolismo , Carga Tumoral , Fator A de Crescimento do Endotélio Vascular/farmacologia , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/metabolismo
17.
Eur J Radiol ; 81(3): e338-43, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22153745

RESUMO

OBJECTIVE: To assess role of contrast-enhanced ultrasound (CEUS) in decision support for diagnosis and treatment of hepatic artery thrombosis (HAT) after liver transplantation. MATERIALS AND METHODS: Between January 2005 and January 2011, 605 patients underwent liver transplantation in our medical center. All the liver transplant recipients received Doppler ultrasound scanning and CEUS examination was performed in 45 patients with suspected HAT on Doppler ultrasound. Sensitivity, specificity, accuracy, positive predict value and negative predictive value of CEUS in diagnosing HAT were determined based on the results from angiography, surgery and clinical follow-up. RESULTS: Fourteen HATs, including one late HAT, were diagnosed by CEUS. Twelve HAT cases were confirmed by angiographic and/or surgical findings, while the late HAT and other 31 patients with negative CEUS finding were confirmed by the clinical follow-up. There was a false positive HAT diagnosed by CEUS in which angiography revealed a patent hepatic artery. The sensitivity, specificity, accuracy, positive predict value and negative predictive value of CEUS in diagnosing HAT were 100%, 96.9%, 97.8%, 92.9% and 100%, respectively. In our series of 605 liver transplants, the incidence and mortality of HAT was 2.2% (13/605) and 53.8% (7/13), respectively. CONCLUSIONS: Our study demonstrates the important role of CEUS in decision support for diagnosis and treatment of HAT after liver transplantation. When HAT is suspected by Doppler ultrasound, CEUS shall immediately be performed to elucidate its nature. A negative CEUS finding shall avoid invasive angiography. Such as, CEUS may alter the clinical workflow on HAT detection after liver transplantation.


Assuntos
Técnicas de Apoio para a Decisão , Artéria Hepática/diagnóstico por imagem , Transplante de Fígado , Complicações Pós-Operatórias/diagnóstico por imagem , Trombose/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Adulto , Idoso , Angiografia Digital , Meios de Contraste , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fosfolipídeos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/cirurgia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Hexafluoreto de Enxofre , Trombose/epidemiologia , Trombose/cirurgia
18.
Surg Today ; 41(3): 358-62, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21365416

RESUMO

PURPOSE: To evaluate the clinical features, diagnosis, and treatment of chylous mesenteric cysts (CMCs) in children. METHODS: We analyzed retrospectively the clinical records of 10 children with a CMC, treated in the Department of Pediatric Surgery, West China Hospital of Sichuan University, between 1987 and 2008. RESULTS: This series comprised five girls and five boys. The CMC manifested as abdominal distention (n = 9), acute abdomen (n = 8), or an asymptomatic abdominal mass (n = 1), and included five mesojejunal cysts and five mesoileal cysts. Intestinal volvulus occurred in four patients with mesoileal cysts and acute chylous effusion occurred in two patients with mesojejunal cysts. All ten children were treated surgically. The cystic content was positive for Sudan III staining and the chylous test. CONCLUSIONS: Chylous mesenteric cysts manifest as an abdominal mass, abdominal distention, and/or acute abdomen more often in children than in adults. The clinical presentation suggests some association with the localization of the cysts. A good prognosis can be expected with removal of the cyst and the affected intestinal segment.


Assuntos
Quilo , Laparoscopia/métodos , Laparotomia/métodos , Cisto Mesentérico/cirurgia , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Lactente , Masculino , Cisto Mesentérico/complicações , Cisto Mesentérico/diagnóstico , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
19.
World J Gastroenterol ; 13(34): 4636-40, 2007 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-17729421

RESUMO

AIM: To study the postoperative complications in patients with preoperative portal vein thrombosis (PVT) undergoing liver transplantation (LT) and to evaluate the complications with Doppler ultrasonography. METHODS: Retrospective studies were performed on 284 patients undergoing LT (286 LT) with respect to pre- and postoperative clinical data and Doppler ultrasonography. According to the presence and grade of preoperative PVT, 286 LTs were divided into three groups: complete PVT (c-PVT), partial PVT (p-PVT) and non-PVT, with 22, 30 and 234 LTs, respectively. Analyses were carried out to compare the incidence of early postoperative complications. RESULTS: PVT, inferior vena cava (IVC) thrombosis, hepatic artery thrombosis (HAT) and biliary complications were found postoperatively. All complications were detected by routine Doppler ultrasonography and diagnoses made by ultrasound were confirmed by clinical data or/and other imaging studies. Nine out of 286 LTs had postoperative PVT. The incidence of the c-PVT group was 22.7%, which was higher than that of the p-PVT group (3.3%, P < 0.05) and non-PVT group (1.3%, P < 0.005). No difference was found between the p-PVT and non-PVT groups (P > 0.25). Of the 9 cases with postoperative PVT, recanalizations were achieved in 7 cases after anticoagulation under the guidance of ultrasound, 1 case received portal vein thrombectomy and 1 case died of acute injection. Ten LTs had postoperative IVC thrombosis. The c-PVT group had a higher incidence of IVC thrombosis than the non-PVT group (9.1% vs 2.6%, P < 0.05); no significant difference was found between either the c-PVT and p-PVT groups (9.1% vs 6.7%, P > 0.5) or between the p-PVT and non-PVT groups (P > 0.25). Nine cases with IVC thrombosis were cured by anticoagulation under the guidance of ultrasound, and 1 case gained natural cure without any medical treatment after 2 mo. HAT was found in 2 non-PVT cases, giving a rate of 0.7% among 286 LTs. Biliary complications were seen in 12 LTs. The incidence of biliary complications in the c-PVT, p-PVT and non-PVT groups was 9.1%, 3.3% and 4.3%, respectively (P > 0.25 for all), among which 2 stenosis led retransplantations and others were controlled by relative therapy. CONCLUSION: C-PVT patients tend to have a higher incidence of PVT and IVC thrombosis than non-PVT patients after LT. The incidence of postoperative complications in p-PVT patients does not differ from that of non-PVT patients. A relatively low incidence of HAT was seen in our study. Doppler ultrasonography is a convenient and efficient method for detecting posttransplant complications and plays an important role in guiding treatment.


Assuntos
Doenças Biliares/diagnóstico por imagem , Artéria Hepática/diagnóstico por imagem , Transplante de Fígado/efeitos adversos , Veia Porta/diagnóstico por imagem , Trombose/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Veia Cava Inferior/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem , Adolescente , Adulto , Doenças Biliares/etiologia , Doenças Biliares/terapia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Trombose/epidemiologia , Trombose/etiologia , Trombose/terapia , Trombose Venosa/complicações , Trombose Venosa/epidemiologia , Trombose Venosa/etiologia , Trombose Venosa/terapia
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