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1.
Int Braz J Urol ; 46(1): 26-33, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31851455

RESUMO

PURPOSE: Clear cell papillary (CCP) renal cell carcinoma (RCC) is a new subtype of RCC that was formally recognized by the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia in 2013. Subsequently, CCP RCC was added to the 2016 World Health Organization Classification of Tumors of the Urinary System and Male Genital Organs. In this study, we retrospectively investigated the computed tomography (CT) findings of pathologically diagnosed CCP RCC. MATERIALS AND METHODS: This study included 12 patients pathologically diagnosed with CCP RCC at our institution between 2015 and 2017. We reviewed the patient's CT data and analyzed the characteristics. RESULTS: Nine solid masses and 3 cystic masses with a mean tumor size of 22.7 ± 9.2mm were included. Solid masses exhibited slight hyper-density on unenhanced CT with a mean value of 34 ± 6 Hounsfi eld units (HU), good enhancement in the corticomedullary phase with a mean of 195 ± 34HU, and washout in the nephrogenic phase with a mean of 133 ± 29HU. The walls of cystic masses enhanced gradually during the corticomedullary and nephrogenic phases. Solid and cystic masses were preoperatively diagnosed as clear cell RCC and cystic RCC, respectively. CONCLUSIONS: The CT imaging characteristics of CCP RCCs could be categorized into either the solid or cystic type. These masses were diagnosed radiologically as clear cell RCC and cystic RCC, respectively.


Assuntos
Carcinoma Papilar/diagnóstico por imagem , Carcinoma de Células Renais/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Carcinoma Papilar/patologia , Carcinoma de Células Renais/patologia , Feminino , Humanos , Imuno-Histoquímica , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estudos Retrospectivos , Carga Tumoral
2.
Eur Radiol ; 30(1): 1-10, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31278580

RESUMO

OBJECTIVES: Various imaging methods have been evaluated regarding non-invasive differentiation of renal cell carcinoma (RCC) subtypes. Dual-energy computed tomography (DECT) allows iodine concentration (IC) analysis as a correlate of tissue perfusion. Microvascular density (MVD) in histopathology specimens is evaluated to determine intratumoral vascularization. The objective of this study was to assess the potential of IC and MVD regarding the differentiation between papillary and clear cell RCC and between well- and dedifferentiated tumors. Further, we aimed to investigate a possible correlation between these parameters. METHODS: DECT imaging series of 53 patients with clear cell RCC (ccRCC) and 15 with papillary RCC (pRCC) were analyzed regarding IC. Histology samples were stained using CD31/CD34 monoclonal antibodies; MVD was evaluated digitally. Statistical analysis included performance of Mann-Whitney U test, ROC analysis, and Spearman rank correlation. RESULTS: Analysis of IC demonstrated significant differences between ccRCC and pRCC (p < 0.001). A cutoff value of ≤ 3.1 mg/ml at IC analysis allowed identification of pRCC with an accuracy of 86.8%. Within the ccRCC subgroup, G1/G2 tumors could significantly be differentiated from G3/G4 carcinomas (p = 0.045). A significant positive correlation between IC and MVD could be determined for the entire RCC cohort and the ccRCC subgroup. Limitations include the small percentage of pRCCs. CONCLUSIONS: IC analysis is a useful method to differentiate pRCC from ccRCC. The significant positive correlation between IC and MVD indicates valid representation of tumor perfusion by DECT. KEY POINTS: • Analysis of iodine concentration using DECT imaging could reliably distinguish papillary from clear cell subtypes of renal cell cancer (RCC). • A cutoff value of 3.1 mg/ml allowed a distinction between papillary and clear cell RCCs with an accuracy of 86.8%. • The positive correlation with microvascular density in tumor specimens indicates correct display of perfusion by iodine concentration analysis.


Assuntos
Carcinoma Papilar/patologia , Carcinoma de Células Renais/patologia , Neoplasias Renais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Papilar/irrigação sanguínea , Carcinoma Papilar/diagnóstico por imagem , Carcinoma de Células Renais/irrigação sanguínea , Carcinoma de Células Renais/diagnóstico por imagem , Transformação Celular Neoplásica/patologia , Meios de Contraste/farmacocinética , Feminino , Humanos , Iodo/farmacocinética , Neoplasias Renais/irrigação sanguínea , Neoplasias Renais/diagnóstico por imagem , Masculino , Microvasos/diagnóstico por imagem , Microvasos/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Estatísticas não Paramétricas , Tomografia Computadorizada por Raios X/métodos , Carga Tumoral
3.
Niger J Clin Pract ; 22(12): 1772-1777, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31793487

RESUMO

Background: There are various endoscopic techniques for thyroid carcinoma dissection but few reports regarding the scarless neck technique and central compartment dissection (CCD) via the breast approach, especially for bilateral CCD are available. In this study, we reported 45 cases with scarless neck endoscopic total or near-total thyroidectomy plus CCD via the breast approach. Materials and Methods: Forty-five female patients with papillary thyroid carcinoma (PTC) were enrolled in the study, from January 2011 to March 2013. In brief, 5 mm ultrasonic coagulation device (Harmonic Scalpel, HS; Ethicon Endosurgery, USA) was used to perform thyroid vessel management and thyroidectomy. Twenty patients underwent total thyroidectomy and 25 underwent near-total thyroidectomy. CCD was performed in all 45 patients, including 13 with bilateral CCD and 32 with ipsilateral CCD. Results: The procedure was successful for all 45 patients. Sixteen patients (35.6%) had lymph node metastases in central compartments. Postoperative transient adverse events included voice changes (9 patients) and hypocalcemia (18 patients), including 7 (21.9%) in the unilateral group and 11 (84.6%) in bilateral group. There was no permanent hypocalcemia or recurrent laryngeal nerve (RLN) palsy. None of the case were converted to open surgical procedure. All patients were satisfied with the cosmetic result of the scarless neck endoscopic thyroidectomy (SET). No evidence of residual or recurrent disease was found during a mean follow-up of 22.84 months (range, 12-34 months). Conclusions: Experienced thyroid surgeons performed the scarless neck endoscopic total or near-total thyroidectomy plus unilateral or bilateral CCD via the breast approach for selected PTC patients. The procedure was safe and feasible with excellent cosmetic results.


Assuntos
Mama/cirurgia , Carcinoma Papilar/cirurgia , Endoscopia/métodos , Esvaziamento Cervical/métodos , Câncer Papilífero da Tireoide/cirurgia , Tireoidectomia/métodos , Adulto , Carcinoma Papilar/patologia , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/patologia , Resultado do Tratamento
4.
Khirurgiia (Mosk) ; (12): 18-27, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825339

RESUMO

OBJECTIVE: To analyze own initial experience of transoral thyroid surgery. MATERIAL AND METHODS: There were 7 patients thyroid nodules who underwent surgery for the period from March 2018 to May 2019. All patients signed an informed consent to be included in the study. Surgical approach was performed through three incisions in the lower arch of the vestibule of the mouth with deployment of 10 mm endoscope and two 5 mm tools. Gas insufflation was used. All patients were females aged 43.3±11.8 years. Thyroidectomy was performed in 2 cases, hemithyroidectomy - in 5 patients. Dimensions of nodules varied from 10 to 42 mm. RESULTS: Mean time of hemithyroidectomy and thyroidectomy was 206.4±63.8 and 232±37.5 min, respectively. Papillary carcinoma was histologically verified in 1 case. Injuries of recurrent laryngeal nerve, postoperative hypocalcemia and local complications were absent. Drainage was not applied. Postoperative hospital-stay was 3.7±1.1 days. CONCLUSION: Transoral approach to the thyroid gland is technically feasible with standard endoscopic instruments, safe for important anatomical structures and more precise due to the optical capabilities of endoscopic equipment. Any types of procedures are possible. Undoubtedly, aesthetic outcome is also favorable.


Assuntos
Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Cirurgia Endoscópica por Orifício Natural/métodos , Nódulo da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Adulto , Carcinoma Papilar/cirurgia , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Boca/cirurgia , Neoplasias da Glândula Tireoide/cirurgia
5.
Anticancer Res ; 39(12): 6915-6921, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31810962

RESUMO

BACKGROUND/AIM: The present study aimed to investigate the role of Homebox B2 (HOXB2) in bladder cancer (BC). MATERIALS AND METHODS: The Cancer Genome Atlas (TCGA) dataset was used to analyse HOXB2 expression in BC. The influence of HOXB2 on the cellular functions of BC cells was determined in both HOXB2 knockdown and HOXB2 overexpressed BC cell lines using in vitro assays. RESULTS: HOXB2 mRNA was significantly upregulated in luminal infiltrated and luminal papillary subtypes of BC. Drug Metabolism Cytochrome P450 was significantly enriched in BCs expressing high levels of HOXB2. Knockdown of HOXB2 from EJ138 cells reduced growth, adhesion and invasion. In contrast, overexpression of HOXB2 in RT112 cells induced growth and adhesion of bladder cancer cells. CONCLUSION: Increased HOXB2 expression in papillary BC can promote cell growth and adhesion of BC cells. Drug Metabolism Cytochrome P450 pathway was enriched in BCs overexpressing HOXB2.


Assuntos
Carcinoma Papilar/genética , Proteínas de Homeodomínio/genética , Fatores de Transcrição/genética , Regulação para Cima , Neoplasias da Bexiga Urinária/genética , Adesão Celular , Linhagem Celular Tumoral , Movimento Celular , Proliferação de Células , Sistema Enzimático do Citocromo P-450/genética , Regulação Neoplásica da Expressão Gênica , Técnicas de Silenciamento de Genes , Humanos , Invasividade Neoplásica
6.
Medicine (Baltimore) ; 98(45): e17859, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702649

RESUMO

BACKGROUND: To investigate the diagnostic performance of cytology (fine-needle aspiration cytology [FNAC]), thyroglobulin (fine-needle aspiration thyroglobulin [FNA-Tg]), and combination of them in the washout of fine-needle aspiration for those patients who have suspicious metastatic lymph nodes of differentiated thyroid cancer. METHODS: Databases, including PubMed, EMbase, Web of Science and Cochrane Library were searched up to June 2019. The quality assessment of diagnostic accuracy scale-2 was used to conduct quality assessments, and publication bias was evaluated using the Deeks funnel plot. STATA version 14.0 was used to perform the meta-analysis. RESULTS: A total of 2257 patients with 2786 samples of suspicious metastatic lymph nodes of differentiated thyroid cancer were included in the meta-analysis. The results showed that the diagnostic value for detecting lymph node metastasis of differentiated thyroid cancer was as follows: combination of FNAC and FNA-Tg > FNA-Tg > FNAC. All differences of superiority among them are statistically significant. The sensitivity of the combination was 0.968 (95% confidence interval [CI]: 0.942-0.983), the specificity was 0.932 (95% CI: 0.856-0.969), the diagnostic score was 6.036 (95% CI: 4.892-7.181), the diagnostic odds ratio was 418.424 (95% CI: 133.167-1314.729), and the score of summary receiver operating characteristic was 0.99 (95% CI: 0.97-0.99). CONCLUSIONS: The combination of FNAC and FNA-Tg is an excellent procedure in diagnosis of lymph nodes metastasis of patients with differentiated thyroid cancer, which should be highly recommended.


Assuntos
Carcinoma Papilar/patologia , Metástase Linfática/patologia , Tireoglobulina/análise , Neoplasias da Glândula Tireoide/patologia , Área Sob a Curva , Biomarcadores Tumorais/análise , Biópsia por Agulha Fina , Humanos , Metástase Linfática/diagnóstico , Valor Preditivo dos Testes
8.
Indian J Pathol Microbiol ; 62(4): 544-548, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31611437

RESUMO

Context: Atypia of undetermined significance/Follicular lesion of undetermined significance [AUS/FLUS] is a heterogeneous category with a wide range of risk of malignancy [ROM] reported in the literature. The Bethesda system for reporting thyroid cytopathology [TBSRTC], 2017 has recommended subcategorization of AUS/FLUS. Aims: To evaluate the ROM in thyroid nodules categorized as AUS/FLUS, as well as separate ROM for each of the five subcategories. Settings and Design: Retrospective analytic study. Methods and Materials: A retrospective audit was conducted for all thyroid fine-needle aspiration cytology (FNAC) from January 2013 to December 2017. Slides for cases with follow-up histopathology were reviewed, classified into the five recommended subcategories, and differential ROM was calculated. Statistical Analysis Used: z test for comparison of proportions was done to evaluate the difference in ROM among different subcategories of AUS/FLUS. The P value of less than 0.05 was taken as statistically significant. Results: Total number of thyroid FNACs reported was 1,630, of which 122 were AUS/FLUS (7.5%). Histopathology was available in 49 cases, out of which 18 were malignant (ROM = 36.7%). The risk of malignancy (ROM) for nodules with architectural and cytologic atypia was higher (43.8%) than ROM for nodules with only architectural atypia (16.7%). Conclusions: The sub-classification of AUS/FLUS into subcategories as recommended by TBSRTC, 2017 may better stratify the malignancy risk and guide future management guidelines.


Assuntos
Neoplasias , Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/classificação , Nódulo da Glândula Tireoide/patologia , Biópsia por Agulha Fina , Carcinoma Papilar/patologia , Humanos , Estudos Retrospectivos , Fatores de Risco , Neoplasias da Glândula Tireoide/patologia
9.
Ann Saudi Med ; 39(5): 345-349, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31580696

RESUMO

BACKGROUND: Thyroid malignancy, the most diagnosed cancer of the endocrine system, represents 2% of all malignancies worldwide. The increasing incidence of thyroid cancer has been linked to the increasing sensitivity of modern diagnostic methods which overdiagnosis small thyroid tumors. OBJECTIVES: Assess the distribution and trends in thyroid cancer among thyroidectomy patients. DESIGN: Descriptive, based on medical record review. SETTINGS: Two tertiary care centers in Riyadh. PATIENTS AND METHODS: We included patients who underwent thyroid surgery from January 1, 2004 to December 31, 2016 who ranged in age from 9-90 years regardless of initial diagnosis. MAIN OUTCOME MEASURES: Distribution of thyroid carcinomas by type, age and sex and trends over the time period. SAMPLE SIZE: 979 patients. RESULTS: Of 979 patients, 84.5% were <55 years old, with the majority being female. Thyroid malignancy ranked second to benign tumors, and the most common type of thyroid cancer was papillary thyroid carcinoma (91% of malignant tumors), followed by follicular thyroid cancer (4.7% of malignant tumors). After thyroid microcarcinomas were isolated from the sample and studied separately, we found the overall trend for thyroid cancer to be stable, and that the annual increases in rates were due to increased diagnosis of thyroid microcarcinoma in the period from 2010 to 2016. CONCLUSION: Our study shows that increases in thyroid cancers may be attributed to a rise in the rates of diagnosis of thyroid microcarcinomas. LIMITATIONS: The main limitation is the retrospective nature of this design. Also, a multicenter collaboration would prove beneficial in evaluating the trends of thyroid cancer in Saudi Arabia on a much larger scale. CONFLICT OF INTEREST: None.


Assuntos
Carcinoma Papilar/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia , Tireoidectomia/métodos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Carcinoma Papilar/patologia , Carcinoma Papilar/cirurgia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Arábia Saudita , Distribuição por Sexo , Centros de Atenção Terciária , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Adulto Jovem
10.
Int J Mol Sci ; 20(19)2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31575031

RESUMO

Hereditary cancers with cancer-predisposing mutations represent unique models of human oncogenesis, as a driving oncogenic event is present in germline. Currently, there are no satisfactory models to study these malignancies. We report the generation of IPSC from the somatic cells of a patient with hereditary c-met-mutated papillary renal cell carcinoma (PRCC). From these cells we have generated spontaneous aggregates organizing in structures which expressed kidney markers such as PODXL and Six2. These structures expressed PRCC markers both in vitro and in vivo in NSG mice. Gene-expression profiling showed striking molecular similarities with signatures found in a large cohort of PRCC tumor samples. This analysis, applied to primary cancers with and without c-met mutation, showed overexpression of the BHLHE40 and KDM4C only in the c-met-mutated PRCC tumors, as predicted by c-met-mutated embryoid bodies transcriptome. These data therefore represent the first proof of concept of "hereditary renal cancer in a dish" model using c-met-mutated iPSC-derived embryoid bodies, opening new perspectives for discovery of novel predictive progression markers and for drug-screening for future precision-medicine strategies.


Assuntos
Carcinoma Papilar/etiologia , Carcinoma de Células Renais/etiologia , Corpos Embrioides/citologia , Células-Tronco Pluripotentes Induzidas/citologia , Células-Tronco Pluripotentes Induzidas/metabolismo , Mutação , Proteínas Proto-Oncogênicas c-met/genética , Alelos , Carcinoma Papilar/diagnóstico , Carcinoma de Células Renais/diagnóstico , Corpos Embrioides/metabolismo , Corpos Embrioides/ultraestrutura , Imunofluorescência , Expressão Gênica , Genótipo , Humanos , Imuno-Histoquímica , Imagem por Ressonância Magnética/métodos , Reprodutibilidade dos Testes
11.
World J Gastroenterol ; 25(36): 5569-5577, 2019 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-31576101

RESUMO

BACKGROUND: Intraductal papillary neoplasm of the bile duct (IPNB) is a type of tumor that presents in the intra- or extrahepatic bile ducts. Cystic-type intrahepatic IPNB often mimics simple liver cysts, making the diagnosis difficult. Because the growth of IPNB is slow, careful follow-up and timely therapeutic intervention is recommended. There are few reports with a follow-up period longer than a decade; thus, we report the case of a patient with an IPNB that grew for over 13 years. CASE SUMMARY: A 65-year-old man was diagnosed, 13 years prior with a cystic hepatic tumor with abnormal imaging findings. The targeted tumor biopsy results showed no malignancy. Biannual follow-up examinations were performed because of the potential for malignancy. The cystic lesions showed gradual enlargement over 11 years and a 4 mm papillary proliferation appeared on the cyst wall, which is compatible with IPNB. The tumor was observed for another 2 years because of the patient's wishes. The imaging findings showed enlargement to 8 mm and a new 9 mm papillary proliferation of the cystic tumor. Contrast-enhanced ultrasonography showed hyperenhancement during the arterial phase in both cyst walls, indicating intraductal tumor progression in both tumors. Thus, liver segment 8 subsegmentectomy was performed. The pathological findings indicated that the tumors contained mucin, and high-grade atypia was observed in the papillary lesions, showing IPNB. CONCLUSION: The development of IPNB should be monitored in patients with cystic lesions and ultrasonography are useful tool for the evaluation.


Assuntos
Neoplasias dos Ductos Biliares/diagnóstico , Ductos Biliares Intra-Hepáticos/patologia , Carcinoma Papilar/diagnóstico , Cistos/patologia , Idoso , Neoplasias dos Ductos Biliares/patologia , Neoplasias dos Ductos Biliares/cirurgia , Ductos Biliares Intra-Hepáticos/diagnóstico por imagem , Biópsia , Carcinoma Papilar/patologia , Carcinoma Papilar/cirurgia , Colangiografia , Cistos/cirurgia , Hepatectomia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia
12.
Horm Metab Res ; 51(10): 634-638, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31578049

RESUMO

Basal thyroglobulin (b-Tg) measured with second-generation assay or stimulated Tg (s-Tg) can be used to define the response to therapy of differentiated thyroid carcinoma. However, they do not always define the same category and guidelines do not establish "if" or "when" s-Tg needs to be obtained. We studied 304 patients without clinically apparent disease or disease detected by neck ultrasonography and without anti-Tg antibodies 9-12 months after therapy. Based on b-Tg, 196 patients had an excellent response and 108 had an indeterminate response. Based on s-Tg, a change in category occurred in 10.2% of the patients with an initial excellent response (all to indeterminate response) and in half the patients with an initial indeterminate response (44.4% to excellent response and 5.5% to biochemical incomplete response). One case of recurrence was observed among patients with an initial excellent response but whose response changed to indeterminate after s-Tg, while no disease was detected among those who remained in the initial category; however, this difference was not significant. In patients with an initial indeterminate response, no recurrence was detected among those whose response changed to excellent after s-Tg, while 11.1 and 33.3% of those who remained in the initial category or whose response changed to biochemical incomplete, respectively, had structural disease. This study suggest that, in low- or intermediate-risk patients, s-Tg better defines the response to therapy with 131I when it is classified as indeterminate based on b-Tg using second-generation assay. However, s-Tg is not necessary when b-Tg defines the response as excellent.


Assuntos
Adenocarcinoma Folicular/terapia , Carcinoma Papilar/terapia , Radioisótopos do Iodo/uso terapêutico , Recidiva Local de Neoplasia/diagnóstico , Tireoglobulina/sangue , Neoplasias da Glândula Tireoide/terapia , Tireoidectomia/métodos , Adenocarcinoma Folicular/sangue , Adenocarcinoma Folicular/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Carcinoma Papilar/sangue , Carcinoma Papilar/patologia , Terapia Combinada , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Prognóstico , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/patologia , Adulto Jovem
13.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(9): 1094-1098, 2019 Sep 30.
Artigo em Chinês | MEDLINE | ID: mdl-31640963

RESUMO

OBJECTIVE: To explore the feasibility of radiomics for predicting lymph node metastasis in the central region of the neck in patients with thyroid papillary carcinoma (PTC). METHODS: A total of 189 patients with PTC confirmed by thyroid fine needle aspiration biopsy were prospectively enrolled in this study. The cross-sectional and longitudinal ultrasound images and the images of both sections were analyzed for predicting central lymph node metastasis using a radiomics approach with pathological results as the gold standard. RESULTS: In the 189 patients, the accuracy, sensitivity and specificity of preoperative thyroid ultrasonography for diagnosis of central lymph node metastasis was 69.39%, 64% and 73%, respectively. Based on the ultrasound images of the cross-sections, longitudinal sections and both sections, the accuracy, sensitivity and specificity of radiomics for predicting central lymph node metastasis was 66.06%/68.12%/77.69%, 53%/46%/40%, and 52%/53%/51%, respectively. CONCLUSIONS: Radiomics with combined analysis of the ultrasound images on the cross-section and longitudinal section images achieves a higher accuracy for predicting central lymph node metastasis than analysis a single section, and its diagnostic accuracy is much higher than that of conventional ultrasound examination.


Assuntos
Carcinoma Papilar/diagnóstico por imagem , Metástase Linfática/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Carcinoma Papilar/patologia , Humanos , Interpretação de Imagem Assistida por Computador , Linfonodos , Pescoço , Estudos Prospectivos , Neoplasias da Glândula Tireoide/patologia , Ultrassonografia
14.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 44(9): 1009-1015, 2019 Sep 28.
Artigo em Chinês | MEDLINE | ID: mdl-31645490

RESUMO

OBJECTIVE: To investigate the experience and efficacy of endoscopic thyroidectomy for papillary thyroid microcarcinoma (PTMC) through total areola approach.
 Methods: A total of 117 PTMC patients, who were diagnosed pathologically in Minimally Invasive Surgical Center, Second Xiangya Hospital, Central South University from June 2016 to December 2017, were divided into a endoscopic surgery group (n=72) and an open surgery group (n=45). The number of dissected central lymph nodes, blood loss, amount of drainage, occurrence of postoperative complication and recurrence were collected and compared.
 Results: Compared with the open surgery group, the blood loss was less and the operative time was longer in the endoscopic surgery group (P<0.05). There were no significant differences between the 2 groups in the number of dissected central lymph nodes, amount of drainage and occurrence of postoperative complication (all P>0.05). The mean follow-up time was more than 20 months, and there was no recurrence in the 2 groups. 
 Conclusion: Endoscopic thyroidectomy with central compartment neck dissection through total areola approach is safe and feasible in patients with PTMC. It has many advantages, such as no scar on neck, less blood loss, shorter hospital stay and more acceptable to young patients.


Assuntos
Carcinoma Papilar/cirurgia , Endoscopia , Neoplasias da Glândula Tireoide/cirurgia , Humanos , Mamilos , Tireoidectomia
17.
Arkh Patol ; 81(5): 35-44, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31626203

RESUMO

The molecular subtypes of urothelial carcinoma in each classification scheme have characteristic immunohistochemical features. At the same time, the results of conducted studies often demonstrate a discrepancy between the genomic profile of urothelial carcinoma and its immunophenotype, which complicates the immunohistochemical verification of the molecular subtypes of these tumors. OBJECTIVE: To compare the morphological and immunophenotypic characteristics of the molecular subtypes of urothelial carcinoma. MATERIAL AND METHODS: Surgical specimens from 196 patients diagnosed with urothelial carcinoma of the renal pelvis and bladder were investigated. Paraffin-embedded sections were immunohistochemically examined using the standard protocol. Antibodies against CK5/6, CK17, Rb1 (Dako), CK14, CK18, CK20, Cyclin D1, Cyclin E1, Cyclin A, Cyclin B, Chromogranin, E-Cadherin, P-Cadherin, p16, Uroplakin II, TUBB2B, Vimentin, ZEB-2 ('Novocastra'), CD44, GATA-3, and Uroplakin III ('Cell Marque') were used. RESULTS: Out of 68 (35%) superficial papillary urothelial carcinomas, 24 (12%) tumors constituted Molecular Class I and 12 (6%) and 32 (16%) ones did Molecular Classes II and III, respectively. Of the 128 (65%) muscle-invasive urothelial carcinomas, 57 (29%) tumors were referred to as the luminal-papillary molecular subtype, and 24 (12%) and 14 (7%) were as the luminal-infiltrated and luminal molecular subtypes, respectively. The basal squamous molecular subtype was verified in 31 (16%) neoplasms and the neuronal phenotype was detected in 2 (1%) cases. CONCLUSION: Most pT1 tissues correspond to Molecular Class II. In the muscle-invasive urothelial carcinoma group, the neoplasms with a luminal phenotype predominate over the tumors with basal and neuronal phenotypes.


Assuntos
Neoplasias Urológicas/classificação , Neoplasias Urológicas/patologia , Biomarcadores Tumorais , Carcinoma Papilar , Humanos , Imuno-Histoquímica
18.
Artigo em Chinês | MEDLINE | ID: mdl-31623036

RESUMO

Objective:To explore the relationships between trefoil factor 3(TFF3) gene polymorphisms and susceptibility to papillary thyroid carcinoma(PTC) in Han population of northern China. Method:A case-control study was performed in 123 PTC patients and 108 healthy controls. Four SNPs in the TFF3 gene, including rs225361, rs533093, rs9981660 and rs225439, were detected by gene sequencing. Result:Compared with healthy people, there was no significant difference in the genotype frequencies of rs225361, rs9981660, rs533093 and rs225439 alleles in the PTC group(P>0.05). The CGTC and CGTT haploids of TFF3 gene were positively correlated with the occurrence of PTC, and CGCC and TGTC haploids were negatively correlated with the occurrence of PTC. TT genotype of rs9981660 had significant differences in the distribution of PTC with and without lymph node metastasis(P<0.05). Conclusion:Polymorphisms in 4 SNP loci in the TFF3 gene may be unrelated to the occurrence of PTC. The CGTC, CGTT, CGCC and TGTC haploids in the TFF3 gene might be related to the development of PTC. The TT genotype at rs9981660 may be associated with lymph node metastasis of PTC.


Assuntos
Câncer Papilífero da Tireoide/genética , Neoplasias da Glândula Tireoide/genética , Fator Trefoil-3/metabolismo , Carcinoma Papilar , Estudos de Casos e Controles , China , Predisposição Genética para Doença , Humanos , Polimorfismo de Nucleotídeo Único
20.
Cir Cir ; 87(S1): 62-67, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31501633

RESUMO

Background: Primary hyperparathyroidism (PHPT) is characterized by an increase in parathyroid hormone (PTH) and hypercalcemia, which, when present during pregnancy, increases both maternal and fetal morbidity and mortality. Objective: Emphasize the importance of surgical intervention in primary hyperparathyroidism during pregnancy. Clinical case: A 27-year-old female with a pregnancy of 27.2 weeks of gestation, with a diagnosis of symptomatic primary hyperparathyroidism secondary to parathyroid adenoma, a history of nephrolithiasis and severe acute pancreatitis, surgery was decided upon finding intrathyroid right parathyroid adenoma, post-surgical course with adequate evolution and remission of hyperparathyroidism. Conclusions: Parathyroidectomy in primary hyperparathyroidism during pregnancy is safe.


Assuntos
Adenoma/complicações , Hiperparatireoidismo Primário/etiologia , Neoplasias das Paratireoides/complicações , Paratireoidectomia , Complicações Neoplásicas na Gravidez/cirurgia , Doença Aguda , Adenoma/diagnóstico , Adenoma/cirurgia , Adulto , Transfusão de Componentes Sanguíneos , Cálcio/metabolismo , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/cirurgia , Feminino , Hormônios/sangue , Humanos , Hipercalcemia/etiologia , Hiperparatireoidismo Primário/sangue , Achados Incidentais , Nefrolitíase/etiologia , Pancreatite/etiologia , Neoplasias das Paratireoides/diagnóstico , Neoplasias das Paratireoides/cirurgia , Gravidez , Complicações Neoplásicas na Gravidez/sangue , Complicações Neoplásicas na Gravidez/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
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