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OBJECTIVE: To investigate the association of concomitant BRAFV600E mutation with central lymph node metastases in papillary thyroid carcinoma (PTC). METHODS: The clinicopathological data of 126 PTC patients who underwent surgical treatment within a period of 2 years were retrospectively analyzed. The BRAF V600E gene mutation was detected by quantitative fluorescence PCR. RESULTS: The BRAF mutation rate was 69.0% (87/126). The univariate analysis showed that BRAF mutation status was significantly associated with central lymph node metastasis (P<0.05), while the gender, multiple lesions, tumor size, extra-thyroidal invasion, Hashimoto's thyroiditis and tumor stage were not significantly associated with the BRAF mutation (P>0.05 for all). The multivariate analysis showed that only central lymph node metastasis was significantly correlated with BRAF mutation (P<0.05). When the diameter of tumor was ≤10 mm, BRAF mutation was statistically not significantly correlated to central lymph node metastasis (P>0.05). When the diameter of tumor was >10 mm, the central lymph node metastasis rate was significantly higher in patients with positive BRAF mutation than that in patients with a negative BRAF mutation (P<0.05). CONCLUSIONS: The presence of BRAF mutation is an independent predictive factor for central lymph node metastasis. When PTC is with preoperative positive BRAF mutation, the cervical dissection should be routinely performed. The larger the tumor diameter is, the more important is the central lymph node dissection. There should be re-evaluated the necessity of preventative central lymph node dissection when the tumor diameter was ≤5 mm in patients with negative BRAF mutation.
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Carcinoma/genética , Metástasis Linfática/diagnóstico , Proteínas Proto-Oncogénicas B-raf/genética , Neoplasias de la Tiroides/genética , Carcinoma/epidemiología , Carcinoma/metabolismo , Carcinoma Papilar , Enfermedad de Hashimoto , Humanos , Escisión del Ganglio Linfático , Ganglios Linfáticos , Metástasis Linfática/genética , Mutación , Reacción en Cadena de la Polimerasa , Estudios Retrospectivos , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides/epidemiología , Neoplasias de la Tiroides/metabolismoRESUMEN
MicroRNAs (miRNAs) are fundamental regulators of cell proliferation, differentiation, and apoptosis, and are implicated in tumorigenesis of many cancers. MiR-34a is best known as a tumor suppressor through repression of growth factors and oncogenes. Growth arrest specific1 (GAS1) protein is a tumor suppressor that inhibits cancer cell proliferation and induces apoptosis through inhibition of RET receptor tyrosine kinase. Both miR-34a and GAS1 are frequently down-regulated in various tumors. However, it has been reported that while GAS1 is down-regulated in papillary thyroid carcinoma (PTC), miR-34a is up-regulated in this specific type of cancer, although their potential roles in PTC tumorigenesis have not been examined to date. A computational search revealed that miR-34a putatively binds to the 3'-UTR of GAS1 gene. In the present study, we confirmed previous findings that miR-34a is up-regulated and GAS1 down-regulated in PTC tissues. Further studies indicated that GAS1 is directly targeted by miR-34a. Overexpression of miR-34a promoted PTC cell proliferation and colony formation and inhibited apoptosis, whereas knockdown of miR-34a showed the opposite effects. Silencing of GAS1 had similar growth-promoting effects as overexpression of miR-34a. Furthermore, miR-34a overexpression led to activation of PI3K/Akt/Bad signaling pathway in PTC cells, and depletion of Akt reversed the pro-growth, anti-apoptotic effects of miR-34a. Taken together, our results demonstrate that miR-34a regulates GAS1 expression to promote proliferation and suppress apoptosis in PTC cells via PI3K/Akt/Bad pathway. MiR-34a functions as an oncogene in PTC.
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Apoptosis , Carcinoma/genética , Carcinoma/patología , Proteínas de Ciclo Celular/genética , Regulación Neoplásica de la Expresión Génica , MicroARNs/fisiología , Neoplasias de la Tiroides/genética , Neoplasias de la Tiroides/patología , Carcinoma Papilar , Línea Celular Tumoral , Proliferación Celular , Regulación hacia Abajo , Proteínas Ligadas a GPI/genética , Silenciador del Gen , Humanos , MicroARNs/genética , Fosfatidilinositol 3-Quinasas/metabolismo , Proteínas Proto-Oncogénicas c-akt/metabolismo , Transducción de Señal , Cáncer Papilar Tiroideo , Regulación hacia Arriba , Proteína Letal Asociada a bcl/metabolismoRESUMEN
This paper interweaved scaffolds with poly(ether ether ketone) (PEEK) and poly(lactic acid)/Walnut shell/hydroxypatite (PLA/WS/HA) composites by using fused filament fabrication technology, although there was a huge difference in thermal property term between PLA and PEEK. In order to keep mechanical properties of PEEK scaffold and remedy the stress loss produced by pores, PLA/WS/HA composites were used to fill the pores with gradient form outside-in (0.4-0.8 mm, 0.6-1.0 mm, 0.8-1.2 mm and 1.6-2.0 mm). The thermal stability, tensile and compression properties, tensile fracture surface morphology, cytotoxicity and in vivo experiment were investigated. The results showed: the scaffolds were intact without any flashes and surface destruction, and kept a well thermal stability. Compared with the PEEK porous scaffolds, the tensile fracture stress and strain, compression yield stress and strain of interweaved scaffolds were dramatically enhanced by 24.1%, 438%, 359.1% and 921.2%, respectively, and they climbed to the climax at 8 wt% of WS. In vivo experiment showed that the degradation of PLA/WS/HA composites synchronized with the adhesion, proliferation and ingrowth of bone cells, keeping the stable biomechanical properties of interweaved scaffolds. Those experiments showed that interweaved PEEK-PLA/WS/HA scaffolds had the potential to be used as bone implant in tissue engineering.
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Éter , Cetonas , Ensayo de Materiales , Poliésteres , Éteres , Éteres de Etila , Andamios del TejidoRESUMEN
In this work, fused deposition modeling (FDM) technology was used to prepare poly(lactic acid)/walnut shell/hydroxyapatite (PLA/WS/HA) composite filaments. HA was treated with silane and characterized by Fourier transform infrared spectroscopy (FTIR). The composites were investigated by using simultaneous thermal analyzer, scanning electron microscopy (SEM) and a universal mechanical testing machine. The results showed that incorporating either HA or WS improved the thermal stability and water absorption of PLA, but lowered the tensile and compression strength. Fillers toughened the PLA matrix, resulting in higher tensile elongation and compressive strain. The tensile and compressive strengths of samples significantly dropped after water-immersion for 6 weeks. Finally, scaffolds were manufactured by using FDM. The compression modulus and structural feature of scaffolds indicated that the PLA/WS/HA composites have the potential to be applied in structural parts, such as bone implants.
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Durapatita , Juglans , Durapatita/química , Poliésteres/química , Agua/químicaRESUMEN
BACKGROUND/AIMS: Studies investigating the association between p53 codon 72 polymorphism and colorectal cancer risk report conflicting results. In order to clarify this, we carried out a meta-analysis using published data to obtain more precise estimates of risk. METHODOLOGY: Electronic searches of PubMed and EMBASE were conducted to select studies for this meta- analysis. The principal outcome measure was the odds ratio (OR) with 95% confidence interval (CI) for the risk of colorectal cancer associated with p53 codon 72 genotype. RESULTS: We identified seven epidemiological studies, which included 1964 colorectal cancer cases and 2943 controls. The combined results based on all studies showed that there was no significant difference in genotype distribution [Arg/Arg (OR=0.86, 95% CI=0.68, 1.08); Pro/Pro (OR=1.27, 95% CI=0.96, 1.68); Pro/Arg (OR=1.04, 95% CI=0.92, 1.17)] between colorectal cancer and non-cancer patients. When stratifying for race, we found that patients with colorectal cancer had a significantly higher frequency of Pro/ Pro (OR=1.79, 95% CI=1.37, 2.35) and lower frequency of Arg/Arg (OR=0.66, 95% CI=0.44, 0.98) than controls among Asians. No statistical association was found between this genotype and alcohol, tobacco, stage, histological differentiation, lymph node metastasis of colorectal cancer. CONCLUSIONS: Our meta-analysis suggests that the p53 codon 72 polymorphism may be associated with colorectal cancer among Asians.
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Codón , Neoplasias Colorrectales/genética , Genes p53 , Polimorfismo Genético , Neoplasias Colorrectales/patología , Genotipo , Humanos , Metástasis LinfáticaRESUMEN
In this work Macadamia nutshell (MS) was used as filler in fused deposition modeling (FDM) of Poly (lactic acid) (PLA) composites filaments. Composites containing MS both treated and untreated with alkali and silane were investigated by means of Fourier transform infrared spectroscopy (FTIR), X-Ray diffraction (XRD), Thermogravimetry (TG), scanning electron microscopy (SEM). The results showed that the treated MS composites had better thermal stability. Furthermore, compression tests were carried out. The PLA with 10 wt% treated MS composite was found possessing the best mechanical properties which was almost equivalent to that of the pure PLA. Finally, porous scaffolds of PLA/10 wt% treated MS were fabricated. The scaffolds exhibited various porosities in range of 30-65%, interconnected holes in size of 0.3-0.5 mm, micro pores with dimension of 0.1-1 µm and 37.92-244.46 MPa of elastic modulus. Those values indicated that the FDM of PLA/MS composites have the potential to be used as weight lighter and structural parts.
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The long noncoding RNA (lncRNA) LINC00520 is an important modulator of the oncogenicity of multiple human cancers. However, whether LINC00520 is involved in the malignancy of papillary thyroid carcinoma (PTC) has not been extensively studied until recently. Therefore, the present study aimed to detect LINC00520 expression and evaluate its clinical significance in PTC. Functional experiments were conducted to test the biological role(s) and underlying mechanisms of LINC00520 in PTC progression. Reverse transcription quantitative polymerase chain reaction was performed to detect LINC00520 expression in PTC. A series of functional experiments, including Cell Counting Kit-8 assay, flow cytometry, Transwell migration assay, and tumor xenograft assay, was employed to investigate the biological roles of LINC00520 in PTC cells. High LINC00520 expression was verified in PTC tissues and cell lines, and this high expression was associated with the unfavorable clinicopathological parameters and short overall survival of patients. Functionally, LINC00520 interference resulted in a significant decrease in PTC cell proliferation, migration, and in vitro invasion and an increase in cell apoptosis. Further, its downregulation impaired tumor growth in vivo. Mechanistically, LINC00520 functioned as a competing endogenous RNA by sponging microRNA-577 (miR-577) and thereby increasing sphingosine kinase 2 (Sphk2) expression. Rescue experiments revealed that inhibiting miR-577 or restoring Sphk2 could abrogate the effects of LINC00520 silencing on the malignant phenotypes of PTC. LINC00520 functioned as an oncogenic lncRNA in PTC, and it facilitated PTC progression by regulating the miR-577/Sphk2 axis, suggesting that the LINC00520/miR-577/Sphk2 axis is an effective target in anticancer management.
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Progresión de la Enfermedad , Regulación Neoplásica de la Expresión Génica , MicroARNs/metabolismo , Fosfotransferasas (Aceptor de Grupo Alcohol)/genética , ARN Largo no Codificante/metabolismo , Cáncer Papilar Tiroideo/genética , Neoplasias de la Tiroides/genética , Adulto , Animales , Apoptosis/genética , Línea Celular Tumoral , Movimiento Celular/genética , Proliferación Celular/genética , Femenino , Silenciador del Gen , Humanos , Masculino , Ratones Endogámicos BALB C , Ratones Desnudos , MicroARNs/genética , Persona de Mediana Edad , Fenotipo , Fosfotransferasas (Aceptor de Grupo Alcohol)/metabolismo , Pronóstico , ARN Largo no Codificante/genética , Cáncer Papilar Tiroideo/enzimología , Regulación hacia Arriba/genéticaRESUMEN
BACKGROUND: Pyruvate kinase is an enzyme that catalyzes the conversion of phosphoenolpyruvate and ADP to pyruvate and ATP in glycolysis and plays a role in regulating cell metabolism. It is reported that the activity of pyruvate kinase is increased in cancers. Phosphoribosyl amidotransferase (PPAT) is reported to be a crucial regulator for pyruvate kinase activity in lung cancer. However, its role in thyroid cancer remains largely unknown. MATERIALS AND METHODS: Immunohistochemical analysis and qRT-PCR were used to detect the expression of PPAT in thyroid cancer samples. Both gain-of-function and loss-of-function models were constructed in thyroid cancer cell lines and the biological functions of PPAT on cellular phenotypes were studied using CCK-8 assay and transwell assay in vitro, respectively. Then, Western blot was used to evaluate the change of PKM2 and downstream signal pathways after PPAT was overexpressed or knocked down. RESULTS: Immunohistochemical analysis showed increased expression of PPAT in thyroid cancer tissues, and it was associated with unfavorable pathological characteristics. Knockdown and overexpression assays suggested that altering PPAT expression modulated cell proliferation, migration, and invasion. In terms of mechanism, PPAT could positively regulate the expression of PKM2 and activate ERK and STAT3 signaling pathways. CONCLUSION: PPAT plays crucial roles in regulating proliferation, migration, and invasion of thyroid cancer cells via activating PKM2, ERK, and STAT3.
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As a treatment option for cancer, thermal ablation has satisfactory effects on many types of solid tumors (such as liver and renal cancers). However, its clinical applications for the treatment of thyroid nodules and metastatic cervical lymph nodes are still under debate both in China and abroad. In 2015, the "Zhejiang Expert consensus on thermal ablation for thyroid benign nodules, microcarcinoma, and metastatic cervical lymph nodes (2015 edition)," was released by the Thyroid Cancer Committee of Zhejiang Anti-Cancer Association, China. To further standardize the application of thermal ablation for thyroid tumors, the Thyroid Tumor Ablation Experts Group of Chinese Medical Doctor Association has organized many seminars and finally produced a consensus to formulate the "Expert consensus workshop report: Guidelines for thermal ablation of thyroid tumors (2019 edition)."
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Ablación por Catéter/métodos , Ganglios Linfáticos/patología , Recurrencia Local de Neoplasia/terapia , Guías de Práctica Clínica como Asunto/normas , Neoplasias de la Tiroides/cirugía , Nódulo Tiroideo/cirugía , Conferencias de Consenso como Asunto , Humanos , Recurrencia Local de Neoplasia/patología , Neoplasias de la Tiroides/patología , Nódulo Tiroideo/patologíaRESUMEN
Thyroid cancer keeps rapidly increasing worldwide and the most frequent type is papillary thyroid carcinoma (PTC). MicroRNAs (miRNAs) are proved dysregulated in many types of malignancies, including thyroid cancer. Although miR-let-7e has been implicated in several types of cancer regulation, relatively little is known about the function of miR-let-7e in PTC. In this study, we showed that the overexpression of miR-let-7e or knockdown of high mobility group box 1 (HMGB1) inhibited cell migration and invasion. MiR-let-7e downregulates HMGB1 expression by directly targeting the HMGB1 3'-UTR. Furthermore, HMGB1 reintroduction reversed the anti-proliferation, anti-migration, and anti-invasion roles of miR-let-7e. miR-let-7e might function as a tumor suppressor in papillary thyroid carcinoma through HMGB1. Therefore, our study demonstrates that miR-let-7e plays an important role in papillary thyroid carcinoma progression and might represent a new potential therapeutic target for treatment.
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Movimiento Celular/fisiología , Regulación Neoplásica de la Expresión Génica , Proteína HMGB1/biosíntesis , MicroARNs/biosíntesis , Cáncer Papilar Tiroideo/metabolismo , Neoplasias de la Tiroides/metabolismo , Animales , Línea Celular Tumoral , Proteína HMGB1/antagonistas & inhibidores , Proteína HMGB1/genética , Humanos , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , MicroARNs/genética , Invasividad Neoplásica/genética , Invasividad Neoplásica/patología , Cáncer Papilar Tiroideo/genética , Cáncer Papilar Tiroideo/patología , Neoplasias de la Tiroides/genética , Neoplasias de la Tiroides/patologíaRESUMEN
Chemotherapy is one of the most effective forms of cancer treatment and has been used in the treatment of various malignant tumors. We have gained significant insight into the mechanisms of chemoresistance but the details of the molecular mechanisms remain unclear. In the present study, we found that tripartite motif 8 (TRIM8) expression was downregulated in anaplastic thyroid cancer (ATC) tissues and cell lines. This downregulation of TRIM8 was significantly correlated with the upregulation of miR-182 in human ATC tissues. Bioinformatic analysis and luciferase reporter assays identified TRIM8 as a direct target of miR-182 in ATC. A functional assay using an MTT assay and colony formation showed that miR-182 induced cellular growth by repressing TRIM8 expression. Additionally, overexpressed miR-182 contributed to the chemoresistance of ATC cells by the repression of TRIM8 expression. In conclusion, these results demonstrate that miR-182/TRIM8 may be a therapeutic target for the treatment of chemoresistant human thyroid papillary cancer.
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Anaplastic thyroid carcinoma (ATC) is one of the most lethal carcinoma with a poor prognosis; however, molecular mechanisms underlying the aggressiveness of ATC remain unclear. Our goal was to examine the expression of X-linked inhibitor of apoptosis protein (XIAP) in ATC, as well as its role in ATC tumorigenesis. This is a retrospective study of ATC patients from the Second Affiliated Hospital of Harbin Medical University during June 2003 to October 2013. The expression of XIAP in tumor specimens of ATC patients was examined by immunohistochemical staining. The roles of XIAP in proliferation, migration, invasion, and chemoresistance were investigated by shRNA mediated-knockdown of XIAP in human ATC cell lines. The effect of XIAP on tumorigenesis was evaluated using a xenograft tumor model with nude mice. XIAP expression was significantly higher in the invasive area of ATC samples, whereas XIAP expression was negative in either normal thyroid follicular epithelial cells or the differentiated papillary thyroid carcinoma. XIAP-depleted ATC cells showed a remarkable decrease in the proliferation, migration, and invasion compared with the scramble group. Knockdown of XIAP expression significantly enhanced the chemosensitivity of WRO and SW1736 cells to docetaxel or taxane. Moreover, knockdown of XIAP significantly suppressed ATC tumorigenesis in vivo. XIAP is highly expressed in ATC cells and tumors. XIAP play important roles in tumor behaviors and chemosensitivity of ATC cells. XIAP may function in ATC aggressiveness and may serve as a potential therapeutic target for ATC treatment.
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We compared the clinical effects and prognosis of patients receiving lymph node dissection after surgical removal of the thyroid tissues and those not receiving it after the removal. A total of 80 patients diagnosed with differentiated thyroid carcinoma (DTC) by our hospital from March 2012 to March 2014 were successively included in the study. The cases were divided into the control group (n=36 cases) and observation group (n=44 cases), and the two groups underwent total or subtotal resection of the thyroid. In the control group, patients underwent preoperative high-frequency color ultrasonography, and the most suspicious lymph node was removed. In the observation group, patients underwent preoperative high-frequency color ultrasonography, and the surgeons cleared the lymph node of the widest range. Difference in clinical effects and prognosis of the two groups were compared. After nearly a year's follow-up observation, the tumor recurrence rate of the observation group was significantly lower than that of the control group and the survival rate of the observation group was significantly higher than that of the control group (P<0.05). The rate of surgery complications and comparative difference of the two patient groups had no statistical significance (P>0.05). When comparing the data of lymphatic metastasis tested by preoperative high-frequency color ultrasonography with intraoperative diagnosed figures, sensitivity was 97.4%, specificity 33.3%, positive predictive value 90.2% and the negative predictive value 66.7%. In conclusion, removal of the lymph node for DTC patients having undergone thyroid tissue excision with preoperative high-frequency color ultrasonography can be beneficial to improve the effects along with reduction in the recurrence rate.
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OBJECTIVE: To improve the resectable rate of massive hepatic tumors and operative tolerance of hepatectomy in the treatment of advanced liver cancers. METHODS: Sixteen cases of massive hepatic tumors were reviewed. The selective exclusion of hepatic outflow and inflow in hepatectomy was discussed. RESULTS: All the patients had normal course after the operative procedure and no hepatic coma or other severe hepatic disturbances were observed. CONCLUSION: While the selective exclusion of hepatic outflow and inflow were applied, the resectable rate of massive hepatic tumors and operative tolerance of hepatectomy were improved.
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Carcinoma Hepatocelular/cirugía , Hemangioma Cavernoso/cirugía , Hepatectomía/métodos , Circulación Hepática , Neoplasias Hepáticas/cirugía , Adulto , Carcinoma Hepatocelular/fisiopatología , Femenino , Hemangioma Cavernoso/fisiopatología , Arteria Hepática/cirugía , Venas Hepáticas/cirugía , Humanos , Neoplasias Hepáticas/fisiopatología , Masculino , Persona de Mediana EdadRESUMEN
The progression mechanism of papillary thyroid carcinoma (PTC) remains largely unknown. Accumulating evidence has suggested that various targets of pigment epithelium-derived factor (PEDF) are able to inhibit cancer progression. The aim of the present study was to examine PEDF expression in PTC patients and to investigate its relationship with aggressive clinicopathological features, as well as to explore whether PEDF affects the progression of PTC via the hypoxia-inducible factor 1α (HIF1α)-vascular endothelial growth factor (VEGF) pathway. A total of 271 patients with PTC, including 24 men and 247 women, were enrolled in the present study. Relevant patient data, including demographic features, preoperative clinical features and pathological features, were collected for analysis. The protein expression levels of PEDF in PTC tissues were detected using immunohistochemical staining, and the mRNA expression levels of PEDF, VEGF and HIF1α in 15 PTC tissues with lymph node metastasis (LNM) and 10 tissues without LNM were detected using reverse transcription-quantitative polymerase chain reaction. Immunohistochemical staining with an anti-PEDF antibody detected PEDF expression in 74.5% of the PTC tissues. PEDF expression levels were significantly correlated with LNM, extrathyroid invasion, a high TNM stage, the presence of the BRAFV600E mutation and tumor size. PEDF mRNA expression levels were significantly decreased in PTC tissues with LNM, as compared with PTC tissues without LNM, while the mRNA expression levels of HIF1α and VEGF were markedly increased in PTC tissues with LNM. Taken together, the results of the present study suggested that PEDF plays a role in the progression of PTC, and that PEDF may exert an anti-angiogenesis role by affecting the HIF1α-VEGF pathway, eventually inhibiting the metastasis of PTC.
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The aim of this study was to determine the effects of nanocarbon particles in combination with meticulous capsular dissection on enhancing the identification and protecting the function of parathyroid glands in thyroid cancer surgery.The data of 97 patients with papillary thyroid tumors diagnosed and treated at the Second Affiliated Hospital, Harbin Medical University between January 2014 and February 2015 were reviewed. Data regarding the sex, age, calcium and parathyroid hormone (PTH) levels, tumor size, multifocality, T stage, and extrathyroid invasion were collected. The incidence of surgeries in which the parathyroid glands were cut mistakenly, the concentration of serum calcium and parathyroid hormone before surgery (baseline) and after surgery on days 1, 3, and 7, and 1 and 6 months in the patients of the two groups (the nanocarbon and control groups) were analyzed.Fifty-two patients underwent meticulous capsular dissection combined with nanocarbon treatment (nanocarbon group), and 45 underwent meticulous capsular dissection alone (control group). The nanocarbon group showed a significantly higher total and average number of revealed parathyroid glands (average number is the mean for different individuals have different number) and a lower incidence of the parathyroid glands being mistakenly cut, in addition to a lower level of hypoparathyroidism than control group following surgery (Pâ<â0.05). Serum calcium and PTH levels were significantly lower in patients from both groups after surgery on days 1, 3, and 7 and after 1 month, compared with the preoperative levels (Pâ<â0.05). Compared with the control group, the serum calcium and PTH levels were significantly higher in the nanocarbon group after surgery on days 1, 3, 7, than in the control group.Treatment with nanocarbon in combination with meticulous capsular dissection can significantly facilitate the identification of the parathyroid in thyroid cancer surgery, reduce the risk of mistakenly cutting the parathyroid, and reduce the incidence of postoperative hypoparathyroidism.
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Carbono , Complicaciones Intraoperatorias/prevención & control , Nanopartículas , Glándulas Paratiroides , Neoplasias de la Tiroides/cirugía , Tiroidectomía/métodos , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Glándulas Paratiroides/anatomía & histología , Glándulas Paratiroides/fisiología , Estudios Retrospectivos , Adulto JovenRESUMEN
OBJECTIVE: To investigate the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC) for surgery by comparing the difference between PTMC and larger papillary thyroid carcinoma (LPTC). METHODS: We analyzed the differences in the clinicopathological characteristics, prognosis, B-type RAF kinase (BRAF)V600E mutational status and expression of angiogenic factors, including pigment epithelium-derived factor (PEDF), Vascular Endothelial Growth Factor (VEGF), and hypoxia-inducible factor alpha subunit (HIF-1α), between PTMC and LPTC by retrospectively reviewing the records of 251 patients with papillary thyroid carcinoma, 169 with PTMC, and 82 with LPTC (diameter >1 cm). RESULTS: There were no significant differences in the gender, age, multifocality, Hashimoto's thyroiditis, TNM stage, PEDF protein expression, rate of recurrence, or mean follow-up duration between patients with PTMC or LPTC. The prevalence of extrathyroidal invasion (EI), lymph node metastasis (LNM), and BRAF mutation in patients with PTMC was significantly lower than in patients with LPTC. In addition, in PTMC patients with EI and/or LNM and/or positive BRAF (high-risk PTMC patients), the prevalence of extrathyroidal invasion, Hashimoto's disease, lymph node metastasis, tumor TNM stage, PEDF positive protein expression, the rate of recurrent disease, and the mRNA expression of anti-angiogenic factors was almost as high as in patients with larger PTC, but with no significant difference. CONCLUSIONS: Extrathyroid invasion, lymph node metastases, and BRAFV600E mutation were the high risk factors of PTMC. PTMC should be considered for the same treatment strategy as LPTC when any of these factors is found. Particularly, PTMC with BRAFV600E gene mutations needed earlier surgical treatment. In addition, the high cell subtype of PTMC with BRAFV600E gene mutation is recommended for total thyroidectomy in primary surgery to reduce the risk of recurrence.
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Carcinoma Papilar/diagnóstico , Carcinoma/patología , Regulación Neoplásica de la Expresión Génica , Mutación Puntual , Proteínas Proto-Oncogénicas B-raf/genética , Glándula Tiroides/patología , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/patología , Adulto , Carcinoma/diagnóstico , Carcinoma/genética , Carcinoma/cirugía , Carcinoma Papilar/genética , Carcinoma Papilar/patología , Carcinoma Papilar/cirugía , Proteínas del Ojo/genética , Femenino , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia/genética , Metástasis Linfática/diagnóstico , Metástasis Linfática/genética , Metástasis Linfática/patología , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico , Recurrencia Local de Neoplasia/genética , Recurrencia Local de Neoplasia/patología , Factores de Crecimiento Nervioso/genética , Pronóstico , Serpinas/genética , Cáncer Papilar Tiroideo , Glándula Tiroides/metabolismo , Glándula Tiroides/cirugía , Neoplasias de la Tiroides/genética , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Factor A de Crecimiento Endotelial Vascular/genéticaRESUMEN
Hyperlipemic pancreatitis and pseudocyst formation late in pregnancy is a rare event. We report a case of hyperlipemic pancreatitis occurring in a G1P0 oriental woman at 32 weeks gestation. The initial serum lipase level was 1070 U/L, serum cholesterol level was 38.50 mmol/L and triglyceride level was > 57 mmol/L. She was treated conservatively with fasting, narcotic analgesia, and fluid resuscitation. Her symptoms resolved rapidly and lipase returned to normal within 2 days. During the first week in hospital she developed peripancreatic fluid collections and became symptomatic from a collection that extended down into the right pelvis. One week after admission she developed pre-term labor and delivered a healthy infant vaginally. There was an excellent outcome for both mother and infant. Serum lipid levels returned to near normal by 6 weeks post delivery.
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Hiperlipidemias/diagnóstico por imagen , Seudoquiste Pancreático/diagnóstico por imagen , Pancreatitis/diagnóstico por imagen , Complicaciones del Embarazo/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Colesterol/sangre , Extracción Obstétrica , Femenino , Estudios de Seguimiento , Humanos , Hiperlipidemias/terapia , Recién Nacido , Lipasa/sangre , Lípidos/sangre , Masculino , Pancreatitis/terapia , Embarazo , Complicaciones del Embarazo/terapia , Tercer Trimestre del Embarazo , Trastornos Puerperales/diagnóstico por imagen , Triglicéridos/sangreAsunto(s)
Hiperlipidemias , Pancreatitis , Adulto , Femenino , Humanos , Embarazo , Complicaciones del Embarazo , Tercer Trimestre del EmbarazoRESUMEN
OBJECTIVE: To investigate the clinical manifestations, diagnosis and treatment of gastrointestinal stromal tumor (GIST). METHODS: Clinicopathological data of 29 cases with GIST from 2003 to 2005 were retrospectively analyzed. RESULTS: The most common clinical manifestations were abdominal pain, distention or discomfort in 16 cases (55.2%), abdominal mass in 9 (31.0%), melena and hematemesis in 5 cases (17.2%). The tumor was located in the stomach in 16 cases, the small intestine in 9, the colorectum in 2, the esophagus in one, and the duodenum in one case. All the cases underwent operation, included total gastrectomy in one case, subtotal gastrectomy in 8, partial gastrectomy in 4, local excision of the tumor in 5 cases, partial small intestine resection in 9 and right colectomy in 2 cases. The resection rate was 100% and no complication and death occurred. The positive rates of CD117(+) and CD34(+) were 93.1% and 51.7% respectively. After follow up from one to 2 years after operation, 2 cases died of tumor recurrence and metastasis, the others survived. CONCLUSIONS: Immunohistochemical examinations of CD117 and CD34 are important diagnostic markers. Surgery is the main method of final diagnosis and treatment.