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1.
Zhonghua Bing Li Xue Za Zhi ; 50(11): 1234-1239, 2021 Nov 08.
Artigo em Chinês | MEDLINE | ID: mdl-34719160

RESUMO

Objective: To investigate the clinicopathological and molecular genetic characteristics of tall cell variant and hobnail variant of papillary thyroid carcinoma (PTC). Methods: Twenty-one cases of tall cell variant (TCV-PTC) of PTC (TCV-PTC) and ten cases of hobnail variant of PTC (HV-PTC), as the highly aggressive group, were collected from Xuanwu Hospital from August 2009 to August 2015. Twenty-two cases of follicular variant and 21 classical PTC cases were included as control. Relevant clinical and pathologic data were obtained, and in some cases, paraffin samples were selected for gene mutation spectrum analysis using second generation sequencing. Results: There were 18 males and 56 females; 57 patients were younger than 55 years of age, and 17 patients were 55 years or older. The mean tumor size was 1.6 cm for the high-aggressive group (TCV-PTC and HV-PTC), 1.1 cm for the follicular subtype, and 1.6 cm for the classical type. There were 54 cases with thyroid capsule invasion, 24 cases with extra-thyroidal invasion, and 45 patients with lymph node metastases. Regional recurrence occurred in 7 cases, no recurrence in 54 cases, and 13 patients were lost to follow-up. The highly aggressive group was more likely to show extra-thyroidal invasion, lymph node metastases and recurrence than those with classical PTC (P<0.05). Within this cohort, BRAF V600E mutation was detected in 53 cases and TERT promoter mutation in 6 cases. Compared with the single mutation group and no mutation group, BRAF and TERT promoter co-mutation group was more commonly detected in older age, male, larger tumor size and more prone to extra-thyroid invasion (P<0.05). In addition, among BRAF and TERT co-mutation cases, the highly-aggressive group accounted for the highest proportion (5/6). Conclusions: TCV-PTC and HV-PTC, as highly-aggressive variants of PTC, show more aggressive biologic behavior (more lymph node metastasis, external thyroid invasion and recurrences) than the classical and follicular variants of PTC. Coexisting BRAF and TERT promoter mutations may be associated with invasive biologic behavior.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Idoso , Carcinoma Papilar/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Proteínas Proto-Oncogênicas B-raf/genética , Câncer Papilífero da Tireoide/genética , Neoplasias da Glândula Tireoide/genética
2.
Int J Hyperthermia ; 38(1): 1548-1557, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34719323

RESUMO

BACKGROUND: The optimal treatment method for papillary thyroid microcarcinoma (PTMC) is lacking consensus. Here we aimed to compare the efficacy and safety of surgery and microwave ablation (MWA) for PTMC. METHODS: The clinical data of 644 patients with PTMC treated between July 2013 and June 2020 were retrospectively analyzed. A total of 320 and 324 patients underwent MWA and surgery, respectively. We observed lesion changes in the MWA group and compared the recurrence, metastasis, complications, and other health economic indicators between the 2 groups. RESULTS: The mean follow-up time was 890.7 ± 532.9 (187.9-2679.0) days in the MWA group and 910.9 ± 568.4 (193.8-2821.5) days in the surgery group. In the MWA group, lesion volume increased significantly after ablation and then gradually decreased. The final lesion volume reduction rate was 90.73% ± 7.94%, and 193 lesions (60.3%) disappeared completely. There were no significant intergroup differences in recurrence or metastasis. The incidence of main complications (temporary hypothyroidism, hypoparathyroidism, and temporary hoarseness) was significantly lower in the MWA group than in the surgery group (p < 0.001). The treatment time, intraoperative blood loss, and hospital stay were significantly lower in the MWA group than in the surgery group (p < 0.001). CONCLUSIONS: MWA is effective for treating PTMC, with a low incidence of complications and less trauma. The rates of post-treatment recurrence and metastasis are similar to those of surgery, indicating that MWA is a suitable alternative to surgery.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Carcinoma Papilar/cirurgia , Estudos de Coortes , Humanos , Micro-Ondas/uso terapêutico , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/cirurgia , Resultado do Tratamento
3.
BMJ Case Rep ; 14(11)2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34789524

RESUMO

Follicular dendritic cell sarcoma is a rare low-grade sarcoma of mesenchymal origin. It involves the lymph nodes more commonly and rarely extranodal sites. The most common lymph node is cervical and usually presents as a painless asymptomatic mass. More often, it is a misdiagnosis, and there is a delay in treatment. It is rarely associated with Castleman disease, myasthenia gravis. Diagnosis of this condition is by histopathology and immunochemistry. Surgery is the primary modality of treatment, and adjuvant therapy has been tried with no definite trials due to the rarity of the disease. Here, we report a case of concomitant follicular dendritic sarcoma of the right cervical lymph node and papillary carcinoma of the thyroid managed in our institute. There was a line of investigations approaching towards a diagnosis, and she underwent total thyroidectomy and right modified radical neck dissection.


Assuntos
Carcinoma Papilar , Sarcoma de Células Dendríticas Foliculares , Neoplasias da Glândula Tireoide , Carcinoma Papilar/cirurgia , Sarcoma de Células Dendríticas Foliculares/diagnóstico por imagem , Sarcoma de Células Dendríticas Foliculares/cirurgia , Feminino , Humanos , Linfonodos/diagnóstico por imagem , Linfonodos/cirurgia , Metástase Linfática , Esvaziamento Cervical , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
8.
Medicine (Baltimore) ; 100(40): e27308, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34622829

RESUMO

ABSTRACT: Various researches demonstrated that transcription factors (TFs) played a crucial role in the progression and prognosis of cancer. However, few studies indicated that TFs were independent biomarkers for the prognosis of thyroid papillary carcinoma (TPC). Our aim was to establish and validate a novel TF signature for the prediction of TPC patients' recurrence-free survival (RFS) from The Cancer Genome Atlas (TCGA) database to improve the prediction of survival in TPC patients.The genes expression data and corresponding clinical information for TPC were obtained from TCGA database. In total, 722 TFs and 545 TPC patients with eligible clinical information were determined to build a novel TF signature. All TFs were included in a univariate Cox regression model. Then, the least absolute shrinkage and selection operator Cox regression model was employed to identify candidate TFs relevant to TPC patients' RFS. Finally, multivariate Cox regression was conducted via the candidate TFs for the selection of the TF signatures in the RFS assessment of TPC patients.We identified 6 TFs that were related to TPC patients' RFS. Receiver operating characteristic analysis was performed in training, validation, and whole datasets, we verified the high capacity of the 6-TF panel for predicting TPC patients' RFS (AUC at 1, 3, and 5 years were 0.880, 0.934, and 0.868, respectively, in training dataset; 0.760, 0.737, and 0.726, respectively, in validation dataset; and 0.777, 0.776, and 0.761, respectively, in entire dataset). The result of Kaplan-Meier analysis suggested that the TPC patients with low scores had longer RFS than the TPC patients with high score (P = .003). A similar outcome was displayed in the validation dataset (P = .001) and the entire dataset (P = 2e-05). In addition, a nomogram was conducted through risk score, cancer status, C-index, receiver operating characteristic, and the calibration plots analysis implied good value and clinical utility of the nomogram.We constructed and validated a novel 6-TF signature-based nomogram for predicting the RFS of TPC patients.


Assuntos
Carcinoma Papilar/genética , Nomogramas , Neoplasias da Glândula Tireoide/genética , Fatores de Transcrição/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , Bases de Dados Factuais , Intervalo Livre de Doença , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Medição de Risco , Adulto Jovem
9.
Int J Hyperthermia ; 38(1): 1476-1485, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34645358

RESUMO

OBJECTIVE: The choice of the most appropriate therapeutic approach for a diagnosed papillary thyroid microcarcinoma (PTMC) remains controversial. The present study aimed to evaluate the efficacy of microwave ablation (MWA) for unifocal PTMC with a diameter of ≤0.6 cm. METHODS: A total of 63 consecutive patients with PTMC treated with MWA were studied retrospectively. MWA was performed using the hydrodissection technique and multidimensional fixed-needle principle. We analyzed the absorption of the MWA area and evaluated the prognosis over a follow-up period of 24 months. In addition, 83 patients with PTMC who underwent surgery were selected. The operating room characteristics and procedural complications of the two groups were compared. RESULTS: In the MWA group, the volume of nodules (p < 0.05) decreased from 0.04 ± 0.03 cm3 to 0.0001 ± 0.0004 cm3 at the 24-month follow-up after MWA, and the volume reduction rate (p < 0.05) was 99.43 ± 1.58%. The incidence of temporary reactive hyperplastic lymphadenectasis was higher and that of other complications was lower in the MWA group than in the surgery group. One percent of the patients in the surgery group had recurrence or metastasis, but none were detected in the MWA group. The loss of thyroid tissue volume (p < 0.001), operating room time (p < 0.001), and the mean length of hospital stay (p < 0.001) were significantly lower in the MWA group than in the surgery group. CONCLUSION: Ultrasound-guided MWA is an effective treatment strategy for unifocal PTMC with a diameter of ≤0.6 cm.


Assuntos
Carcinoma Papilar , Micro-Ondas , Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/cirurgia , Humanos , Micro-Ondas/uso terapêutico , Estudos Retrospectivos , Neoplasias da Glândula Tireoide , Ultrassonografia de Intervenção
10.
Kyobu Geka ; 74(11): 972-975, 2021 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-34601485

RESUMO

Ciliated muconodular papillary tumor( CMPT) is a rare true pulmonary tumor consisting of bronchiolar cellular elements. Although this tumor cannot be classified as benign or malignant, it is mostly believed to be a benign bronchiolar adenoma. Recently, CMPT has been divided into two subtypes: proximal and distal. Herein, we report a case of a proximal type of CMPT containing abundant mucus cells in a 70-year-old woman. Thoracoscopic resection of the tumor in the left lower lobe was successfully performed, and the patient has been well without recurrence or metastasis for more than three years after surgery.


Assuntos
Adenoma , Carcinoma Papilar , Neoplasias Pulmonares , Idoso , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Recidiva Local de Neoplasia
11.
Pan Afr Med J ; 39: 267, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34707768

RESUMO

Introduction: there is a dearth of data on the epidemiology of breast tumors in the Kingdom of Saudi Arabia (KSA). This study aimed to determine the demographics, clinical patterns, and their association with histopathological types of breast tumors among females presently residing in KSA. Methods: a multi-centric, cross-sectional study including female patients with symptoms suggestive of breast tumor was conducted at three hospitals in KSA from February 2019 to February 2020. The patient´s electronic health records were used to collect information related to their demographics, clinical findings including comordbities and symptoms and investigations. Binary logistic regression models were used to determine factors associated with the breast tumors. Results: a total of 270 female patients were included in the study. The most frequently encountered symptom was a breast lump (95.9%, n = 259), followed by pain (18.9%, n = 51). More than half the population (53%, n = 143) had a histopathological diagnosis of fibroadenoma. Multivariate analysis revealed that patients > 46 years of age were less likely to present with fibroadenoma (AOR: 0.049 95% CI 0.02 - 0.15; p < 0.005). Those in the 31 - 45 years age group were less likely to present with ductal/lobular/papillary carcinomacompared to the less than 30 years group (AOR: 0.42, 95% CI 0.18 - 0.97; p = 0.04). Conclusion: in this population of Saudi women with symptoms suggestive of breast tumor, those aged less than 40 years were more likely to have a fibroadenoma whereas those above 40 years were more likely to have breast cancer.


Assuntos
Neoplasias da Mama/patologia , Fibroadenoma/patologia , Adolescente , Adulto , Fatores Etários , Idoso , Neoplasias da Mama/epidemiologia , Carcinoma Ductal de Mama/epidemiologia , Carcinoma Ductal de Mama/patologia , Carcinoma Lobular/epidemiologia , Carcinoma Lobular/patologia , Carcinoma Papilar/epidemiologia , Carcinoma Papilar/patologia , Estudos Transversais , Feminino , Fibroadenoma/epidemiologia , Hospitais , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Adulto Jovem
12.
Clin Nucl Med ; 46(12): 1013-1015, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34619698

RESUMO

ABSTRACT: Papillary thyroid carcinoma commonly metastasizes to regional lymph nodes. However, metastasis to liver alone is extremely rare. Here we present a 36-year-old woman who underwent total thyroidectomy and bilateral neck lymph nodes dissection for papillary thyroid carcinoma and received radioiodine (131I) ablation therapy for 2 times 1 month and 5 months after surgery, respectively. The images after the 131I therapy showed a solitary occult metastasis in the liver.


Assuntos
Carcinoma Papilar , Neoplasias Hepáticas , Neoplasias da Glândula Tireoide , Adulto , Feminino , Humanos , Radioisótopos do Iodo/uso terapêutico , Neoplasias Hepáticas/diagnóstico por imagem , Metástase Linfática , Câncer Papilífero da Tireoide
13.
Medicina UPB ; 40(2): 2-12, 13 oct. 2021. tab, Ilus
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1342173

RESUMO

Objetivo: describir los datos sociodemográficos, las manifestaciones clínicas, los paraclínicos, el tratamiento y la recurrencia, en un grupo de pacientes con lesiones papilares. Metodología: estudio analítico de cohorte retrospectiva con fuentes secundarias de información, historias clínicas. Se incluyeron pacientes evaluados entre el 1º enero de 2016 y el 31 de diciembre de 2019. Se recopilaron datos demográficos, clínicos y paraclínicos, que fueron analizados con estadística descriptiva. Resultados: la prevalencia en la muestra fue de 4.7%; todos los casos fueron en mujeres, la media de edad fue 55,5 años; el motivo de consulta más frecuente fue alteración en la imagen de mama (n=79, 54.9%), el tamaño medio de la lesión fue 1,9 cm (rango 0,1-20). Se encontró discordancia entre el diagnóstico por biopsia cortante y el espécimen de patología en 70 (48.6%) casos, en estos se encontró infraestimación de lesiones con mayor riesgo en el 36,1% (n=52). Según la clasificación histológica, el tipo más frecuente de lesión fue el papiloma intraductal 34.7% (n=50), seguido por el carcinoma papilar en 11,8% (n=17). El tipo de cirugía más efectuado fue la cuadrantectomía, con un 68.7% (n=99). La media de seguimiento fue de 28.5 meses y se encontró recaída en siete casos (4.9%). Conclusión: las lesiones papilares comprenden un grupo heterogéneo, que incluye desde las benignas hasta aquellas con potencial maligno. Afectan a las mujeres en la quinta década de la vida, se presentan como una masa, pequeña, unilateral, sin predominio de lateralidad, de crecimiento lento. El tratamiento óptimo para las lesiones de riesgo y con atipias es la cirugía con márgenes negativos, el riesgo de recurrencia es clínicamente relevante.


Objective: to describe the sociodemographic data, the clinical and paraclinical ma-nifestations, the treatment and the recurrence, in a group of patients diagnosed with papillary lesions.Methodology:analytical study of a retrospective cohort with secondary sources of information from users' medical records in the period of January 1, 2016 to December 31, 2019. The demographic, clinical and paraclinical data collected were analyzed using descriptive statistics.Results:the prevalence in the sample was 4.7%; all cases were women, the mean age was 55.5 years; the most frequent reason for consultation was abnormal breast imaging examination (n=79, 54.9 %), the mean size was 1.9 cm (range 0,1-20). Disagreement was found between the diagnosis by sharp biopsy and the pathology specimen in 48.6% of cases (n=70); lesion underestimation with higher risk was found in 36.1% of them (n=52). According to the histological classification, the most frequent was intraductal papilloma in 34.7% (n=50), followed by papillary carcinoma in 11.8% (n=17). The type of surgery most performed was quadrantectomy, 68.7% (n=99). The mean follow-up was 28.5 months and relapse was found in 4.9% (n=7).Conclusion:papillary lesions comprise a heterogeneous group, with a spectrum that includes both benign lesions and those with malignant potential. The lesions affect women in their fifties. They become apparent as a small, unilateral mass, without a pre-dominance of laterality, and of slow growth. The optimal treatment in risk lesions and with atypia is surgery with negative margins. The risk of recurrence is clinically important.


Objetivo: descrever os dados sociodemográficos, manifestações clínicas e paraclínicas, tratamento e recorrência, em um grupo de pacientes com lesões papilares.Metodologia: estudo analítico de coorte retrospectivo com fontes secundárias de informação, prontuários. Foram incluídos os pacientes avaliados entre 1º de janeiro de 2016 e 31 de dezembro de 2019. Foram coletados dados demográficos, clínicos e paraclínicos, os quais foram analisados com estatística descritiva.Resultados: a prevalência na amostra foi de 4,7%; todos os casos eram em mulheres, a média de idade foi de 55,5 anos; o motivo de consulta mais frequente foi a alteração da imagem da mama (n = 79, 54,9%), o tamanho médio da lesão foi de 1,9 cm (variação de 0,1-20). Houve discordância entre o diagnóstico por biópsia cortante e o espécime anatomopatológico em 70 (48,6%) casos, nestes casos subestimação das lesões de maior risco em 36,1% (n = 52). De acordo com a classificação histológica, o tipo de lesão mais frequente foi o papiloma intraductal em 34,7% (n = 50), seguido do carcinoma papilífero em 11,8% (n = 17). O tipo de cirurgia mais realizada foi a quadrantectomia, com 68,7% (n = 99). O seguimento médio foi de 28,5 meses e recidiva foi encontrada em sete casos (4,9%).Conclusão: as lesões papilares constituem um grupo heterogêneo, que inclui desde as benignas até as com potencial maligno. Atingem mulheres na quinta década de vida, aparecem como uma massa, pequena, unilateral, sem predomínio da lateralidade, de crescimento lento. O tratamento ideal para lesões de risco e com atipia é a cirurgia com margens negativas, o risco de recorrência é clinicamente relevante.


Assuntos
Humanos , Feminino , Gravidez , Papiloma Intraductal , Biópsia , Mama , Carcinoma Papilar , Classificação
14.
BMC Surg ; 21(1): 335, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488715

RESUMO

BACKGROUND: The coexistence of primary hyperparathyroidism and papillary thyroid carcinoma (PTC) is common and may be associative with more aggressive PTC, with higher rates of extrathyroidal extension and multicentricity. However, it is unclear whether secondary hyperparathyroidism (SHPT) is associated with more invasive PTC in terms of morbidity, tumor pathological characteristics, and prognosis. The aim of this study was to evaluate the rate and tumor characteristics of PTC in patients with SHPT. METHODS: A total of 531 patients diagnosed with SHPT who underwent surgery from August 2013 to December 2018 at the First Affiliated Hospital of Zhejiang University were evaluated retrospectively. Patient demographics, surgical records, and follow-up information were recorded and analyzed. Control subjects were matched to the enrolled patients in a 1:4 ratio in terms of age, sex and pathological subtype. RESULTS: Among the 531 patients with SHPT who underwent surgery, 34 had coexisting PTC and PTC + SHPT (6.4%). The mean tumor diameter in the PTC + SHPT group was smaller than that in the PTC group (5.57 mm vs 9.00 mm, p < 0.001). The proportion of papillary thyroid micro-carcinoma in the PTC + SHPT group was significantly higher than that in the PTC group (29 [85.29%] vs. 86[63.24%], p = 0.014). There were no statistically significant differences between groups in terms of tumor multicentricity (15 [44.12%] vs 39 [28.68%], p = 0.066), tumor bilaterality (9 [26.47%] vs. 29 [21.32%], p = 0.499), tumor extrathyroidal extension (2 [5.88%] vs. 19 [13.97%], p = 0.255), or lymph node (LN) metastasis rate (12 [35.29%] vs. 49 [36.03%], p = 1.000). However, the PTC + SHPT and PTC groups were significantly different in terms of contralateral thyroidectomy (10 [29.41%] vs. 70 [51.47%], p = 0.023) and lymph node dissection (22 [64.71%] vs. 125 [91.91%], p < 0.001).There was no significant difference between the PTC + SHPT and PTC groups in terms of prognostic staging (33 [97.06%] vs. 122 [89.71%], p = 0.309) or recurrence (mean follow-up time: 36 months vs. 39 months, p = 0.33). CONCLUSIONS: The prevalence of PTC is high in patients with SHPT; compared with PTC in the general population, most papillary thyroid carcinomas with SHPT are occult thyroid carcinomas and present no significant difference in terms of tumor pathological features and prognostic staging. It is necessary for surgeons to perform more adequate preoperative examination and be more careful during surgery to avoid missing the coexistence of PTC in patients with SHPT.


Assuntos
Carcinoma Papilar , Hiperparatireoidismo Secundário , Neoplasias da Glândula Tireoide , Carcinoma Papilar/complicações , Carcinoma Papilar/cirurgia , Humanos , Recidiva Local de Neoplasia/epidemiologia , Estudos Retrospectivos , Câncer Papilífero da Tireoide/complicações , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
15.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 43(4): 584-589, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34494530

RESUMO

Objective To investigate the clinical value of core-needle biopsy(CNB)for low-risk papillary thyroid microcarcinoma(PTMC)after radiofrequency ablation(RFA). Methods A total of 190 patients(including 142 females and 48 males,20-74 years old)with unifocal low-risk PTMCs[mean volume of(106.29±96.15)mm3]treated by RFA from June 2016 to September 2018 were evaluated in this study.During the RFA procedure,enlarged ablation was performed.Patients were followed up 1,3,6,12 months after RFA and every 6 months thereafter.The volume of ablation area and the volume reduction ratio(VRR)were calculated.To evaluate the ablation performance,CNB was performed to the central zone,the peripheral zone,and surrounding thyroid parenchyma 3 or 6 months after RFA. Results The mean follow-up time was(30.04±12.41)months.The mean volume of tumor significantly decreased from(106.29±96.15)mm3 to(1.47±8.00)mm3.Two ablated tumors were diagnosed to have residue by CNB and underwent additional RFA.No recurrence,metastatic lymph nodes,or distal metastasis were found during the follow-up.All the patients were tolerable to RFA and CNB procedure. Conclusion CNB can be used to evaluate the ablation performance after RFA for low-risk PTMC.


Assuntos
Carcinoma Papilar , Ablação por Radiofrequência , Adulto , Idoso , Biópsia por Agulha , Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide , Ultrassonografia de Intervenção , Adulto Jovem
16.
Zhonghua Zhong Liu Za Zhi ; 43(9): 944-948, 2021 Sep 23.
Artigo em Chinês | MEDLINE | ID: mdl-34530577

RESUMO

Objective: To investigate the correlation between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and central lymph node metastasis (CLNM) in patients with cN0 papillary thyroid microcarcinoma (PTMC). Methods: The clinicopathological data of PTMC patients confirmed by surgery and pathology in the 81st Military Hospital of People's Liberation Army from 2016 to 2019 were collected, and the relationship between preoperative NLR, PLR levels and postoperative PTMC CLNM were analyzed. Logistic regression analysis was used for multivariate analysis. Receiver operating characteristic (ROC) curve was used to determine the cutoff value of NLR and PLR. The interaction relative excess risk was used to analyze the relationship between NLR, PLR and CLNM. Results: Among 220 patients with cN0 stage PTMC, 92 were CLNM. The ROC curve showed that when the cutoff value of NLR was 2.5 and the cutoff value of PLR was 175, the highest Youden index was 0.318 and 0.264, respectively. NLR and PLR were both related to CLNM (P<0.05). The tumor long diameter, multifocality, NLR≥2.5 and PLR≥175 were independent impact factors of CLNM (P<0.05). The results of the interaction showed that the relative excess risk of the interaction was 5.531 (95%CI: 0.160, 10.901, P=0.016), the attribution ratio was 0.512 (95%CI: 0.230, 0.794, P=0.009), and the synergy index was 2.294 (95%CI: 1.492, 4.579, P=0.022), suggested that NLR and PLR had an interactive effect, and these two synergistically promoted CLNM. Conclusions: NLR and PLR are independent risk factors for cN0 stage PTMC CLNM. When NLR≥2.5 and PLR≥175, preventive central lymph node dissection should be routinely performed.


Assuntos
Neutrófilos , Neoplasias da Glândula Tireoide , Carcinoma Papilar , Humanos , Linfonodos/cirurgia , Metástase Linfática , Linfócitos , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/cirurgia
17.
BMC Cancer ; 21(1): 995, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488682

RESUMO

BACKGROUND: Pathological grading of non-invasive urothelial carcinoma has a direct impact upon management. This study evaluates the reproducibility of grading these tumours on glass slides and digital pathology. METHODS: Forty eight non-invasive urothelial bladder carcinomas were graded by three uropathologists on glass and on a digital platform using the 1973 WHO and 2004 ISUP/WHO systems. RESULTS: Consensus grades for glass and digital grading gave Cohen's kappa scores of 0.78 (2004) and 0.82 (1973). Of 142 decisions made on the key therapeutic borderline of low grade versus high grade urothelial carcinoma (2004) by the three pathologists, 85% were in agreement. For the 1973 grading system, agreement overall was 90%. CONCLUSIONS: Agreement on grading on glass slide and digital screen assessment is similar or in some cases improved, suggesting at least non-inferiority of DP for grading of non-invasive urothelial carcinoma.


Assuntos
Carcinoma Papilar/diagnóstico , Testes Diagnósticos de Rotina/normas , Variações Dependentes do Observador , Patologistas/normas , Neoplasias da Bexiga Urinária/diagnóstico , Humanos , Gradação de Tumores , Reprodutibilidade dos Testes , Estudos Retrospectivos
18.
Georgian Med News ; (316-317): 178-184, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34511468

RESUMO

Urothelial carcinoma represents the most common type of bladder cancer (>90%) and is the most frequent malignancy of the urinary tract. Most of the urothelial carcinomas are non-invasive at the time of diagnosis, however they are characterised with the risk of recurrence after surgical treatment. The aim of our study was to investigate the characteristics of tumor heterogeneity and markers of its progression in urothelial papillary carcinomas. Study included following groups: normal urothelial epithelium, urothelial papilloma, urothelial neoplasms with low malignant potential (PUNLM), non-invasive low grade papillary urothelial carcinomas (LGPUC) and non-invasive high grade papillary urothelial carcinomas (HGPUC). In addition, study included relapsed cases of non-invasive LGPUC and HGPUC. Nuclear features and mitotic counts was assessed using digital pathology software QuPath in standard H&E stained specimens. In addition, the presence of mitosis was detected as PHH3 labelled cells by immunohistochemistry. Proliferation was measured as Ki67 labelling index by immunohistochemistry. Tumor heterogeneity was investigated by the differential expression pattern of CK5, CK7 and CK20 by immunohistochemistry. Study results showed, that Nuclear features, as well as the number of mitosis, proliferation index and intratumoral heterogeneity significantly correlate with the presence of higher grade non-invasive urothelial lesions. In addition, it is possible to distinguish two major groups of non-invasive LGPUC and HGPUC, based on nuclear and phenotypic heterogeneity and mitotic and proliferative activity, I group which is characterised with higher intratumoral heterogeneity, higher mitotic count and higher proliferative activity, represents the high risk group of non-invasive LGPUC and HGPUC recurrence.


Assuntos
Carcinoma Papilar , Carcinoma de Células de Transição , Neoplasias da Bexiga Urinária , Biomarcadores Tumorais/genética , Carcinoma de Células de Transição/genética , Humanos , Neoplasias da Bexiga Urinária/genética , Urotélio
19.
BMC Res Notes ; 14(1): 369, 2021 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-34551814

RESUMO

OBJECTIVE: Papillary Thyroid carcinoma accounts for more than 60% of adult thyroid carcinomas. Finding a helpful marker is vital to determine the correct treatment approach. The present study was aimed to evaluate the expression of the B cell-specific Moloney murine leukemia virus integration site 1 (BMI-1) gene in papillary carcinoma, adenoma, and adjacent healthy thyroid tissues. Pathology blocks of thyroid tissues at the pathology department of patients who have undergone thyroid surgery between 2015 and 2019 were examined; papillary carcinoma, adenoma, and healthy tissues were selected and sectioned. Total RNA was extracted, and the relative expression level of the BMI-1 gene was examined using the Real-Time qPCR method. RESULTS: In the papillary and adenoma tissues, BMI-1 was overexpressed (1.047-fold and 1.042-fold) in comparison to healthy tissues (p < 0.05 for both comparisons). However, no statistically significant differences were observed between adenoma and papillary carcinoma tissues regarding BMI-1 gene expression. This study demonstrated a new biomarker for thyroid malignancies and found that the mRNA levels of the BMI-1 gene were higher in tumor tissues compared with healthy tissues. Further studies are needed to evaluate the BMI1 gene expression in other thyroid cancers.


Assuntos
Adenoma , Carcinoma Papilar , Neoplasias da Glândula Tireoide , Adenoma/genética , Animais , Índice de Massa Corporal , Carcinoma Papilar/genética , Humanos , Camundongos , Proto-Oncogenes , Neoplasias da Glândula Tireoide/genética
20.
Ann Ital Chir ; 92: 479-487, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34584032

RESUMO

AIM: We aimed to find out unnecessarily overdiagnosed and overtreated patients, their preventable morbidities, expenditures which might not have occurred in the last decade concerning newly proposed nomenclature MATERIAL AND METHODS: Among 1553 patients operated between 2010-2019, 197 were recorded. Pathology specimens were re-evaluated by two experienced pathologists to reveal those patients who could have diagnosed as NIFT-P. RESULTS: According to the changes first suggested by Nikiforov in 2016 and partially revised in 2018; 55 of 197 patients were diagnosed with NIFT-P. Four (7.2%) patients had NIFT-P (operated after 2016), 14 patients (25.5%) had follicular adenoma, 13 patients (23.6%) had unknown malign potential, five patients (9.1%) had papillary microcarcinoma, two patients (3.6%) had papillary microcarcinoma encapsulated, five patients (9.1%) had papillary carcinoma follicular and two patients (3.6%) had papillary carcinoma encapsulated. 40 patients (72.7%) underwent thyroidectomy (bilateral total), 12 patients (21.8%) thyroidectomy (lobectomy, unilateral), two patients (3.6%) thyroidectomy (completion, total) and one patient (1.8%) neck dissection + thyroidectomy (bilateral, total). DISCUSSION: The follicular variant of the papillary thyroid carcinoma was re-defined with a novel nomenclature as a noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFT-P) according to its indolent behavior that did not require aggressive treatment,so lobectomy is sufficient, was suggested in 2016. CONCLUSIONS: We found out that if we hadn't applied thyroidectomy (total or completion) to those 43 patients concerning new nomenclature, we could have prevented complications (2 patients, %3,6) and cut down the expenses caused by overtreatment in the last decade. NIFT-P has an excellent prognosis for its low locoregional or distant recurrence, so lobectomy is sufficient. KEY WORDS: Bethesda, NIFT-P, Total Thyroidectomy, Complication.


Assuntos
Adenocarcinoma Folicular , Carcinoma Papilar , Neoplasias da Glândula Tireoide , Adenocarcinoma Folicular/cirurgia , Carcinoma Papilar/cirurgia , Humanos , Estudos Retrospectivos , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
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