p27及Ki-67对鉴别良、恶性甲状腺滤泡状肿瘤的价值

目的 探讨p17及Ki－67联合检测对于良、恶性甲状腺滤泡状肿瘤的鉴别价值。方法 采用S－P免疫组化法检测53例甲状腺泡状肿瘤（滤泡状腺瘤20例，滤泡状腺癌33例）p27和Ki－67的表达指数（LI）。结果 p27蛋白水平在正常甲状腺组织表达最高，滤泡状腺瘤次这，滤泡状腺癌最低；而Ki－67在正常甲状腺组织几乎不表达（LI＜0．01％），滤泡状腺癌最高，滤泡状腺瘤次之。滤泡状腺瘤与腺癌的p27和Ki－67标记指数相比较差异有显著性意义（P＜0．001），p27在甲状腺滤泡状腺癌、腺癌两类的最佳分界值为LI＝28．3；Ki－67的最佳界值为LI＝10．85。结论 p27和Ki－67的检测可有效的区别良、恶性甲状腺滤泡状肿瘤，也有助于术前甲状腺针吸细胞学对滤泡状腺癌的诊断。     

分化型甲状腺癌的诊断和治疗

分化型甲状腺癌包括乳头状腺癌(病理可细分为单纯乳头状癌、乳头-滤泡混合性癌、乳头状腺癌滤泡样变和有包膜的变异等类型)、滤泡状腺癌(病理可分为微小浸润有包膜的滤泡状腺癌、中度血管浸润性滤泡状腺癌等)。也有作者将许特尔(H櫣rthle)细胞癌列于此分类。乳头状腺癌约占甲状腺癌总数的70%,此型分化好,生长缓慢,恶性程度低,显微镜下肿瘤呈乳头状,由圆形上皮细胞组成;滤泡状腺癌约占15%,此型发展较快,属中度恶性,且有侵犯血管倾向。显微镜下滤泡状腺癌很难与正常甲状腺组织区分,包膜及血管受侵可与滤泡状腺瘤鉴别。尽管近年基因分子生物学…     

p27和nm23蛋白在胃癌组织中的表达及临床意义

目的：探讨胃癌组织中p27、nm23蛋白的表达及其临床意义。方法：采用免疫组织化学法检测20例正常胃黏膜、58例胃癌组织中p27、nm23的表达,分析p27、nm23蛋白表达与患者年龄、组织学分级、临床分期、淋巴结转移的关系。结果：p27、nm23蛋白在胃癌组织中的表达水平低于胃正常黏膜中的表达,p27蛋白在正常胃黏膜、胃癌组织中阳性表达率分别为85.0%、37.9%,差异有统计学意义（P〈0.05）;nm23蛋白在正常胃黏膜、胃癌组织中阳性表达率分别为80.0%、34.5%,差异有统计学意义（P〈0.05）。p27、nm23蛋白的表达与患者年龄无关（P〉0.05）,与胃癌组织分化程度和浸润深度相关（P〈0.05）;p27蛋白的表达还与淋巴结转移相关（P〈0.05）。结论：p27、nm23蛋白表达水平与胃癌的进展及恶性程度相关,p27蛋白表达水平降低可能出现淋巴结转移。p27、nm23蛋白有望成为判断胃癌恶性程度及评价预后的指标。     

p14ARF、p53及脆性组氨酸三联体蛋白在甲状腺肿瘤中的表达

目的探讨p14ARF、p53及脆性组氨酸三联体(FHIT)蛋白在甲状腺肿瘤组织中的表达及其意义。方法采用免疫组织化学法检测20例甲状腺腺瘤和28例甲状腺癌组织(其中包括11例甲状腺滤泡癌(FTC)、12例乳头状癌(PTC)、4例髓样癌(MTC)以及1例未分化癌(UDTC)中p14ARF、p53及FHIT蛋白的表达。结果p14ARF、p53及FHIT蛋白在甲状腺腺瘤和甲状腺癌中阳性率分别为90%、36%;15%、75%;90%、7%,这3种蛋白在甲状腺腺瘤及甲状腺癌的表达差异均有统计学意义(P<0.05)。p14ARF、p53及FHIT蛋白的表达在FTC与腺瘤之间,PTC与腺瘤之间有统计学意义(P<0.05),p53及FHIT的表达在MTC与腺瘤间差异有统计学意义(P<0.05)。p14ARF、p53及FHIT蛋白的表达与甲状腺肿瘤的恶性进程有关,与患者年龄、性别以及淋巴结转移无关。另外p14ARF与FHIT蛋白的表达正相关,并且它们与p53均负相关。结论肿瘤抑制蛋白p14ARF和FHIT的缺失以及癌蛋白p53的高表达是甲状腺肿瘤发生的重要原因之一;联合检测p14ARF、p53及FHIT蛋白有助于区分甲状腺腺瘤和甲状腺滤泡癌。     

直肠癌P27基因表达及血清转化生长因子β1水平的变化

目的 探讨直肠癌中p27的表达和血清转化生长因子β1(TGF-β1)的水平。以及TGF-β1对p27的调控关系。方法 对37例直肠癌、22例直肠腺瘤和19例正常对照者用免疫组化二步法检测其p27的表达情况。用酶联免疫吸附法(ELISA)测定血清TGF-β1水平。结果 p27在正常直肠组织和直肠腺瘤组织中呈高表达。其表达阳性率分别为89．47％和90．91％，阳性表达定位于细胞核；直肠癌组织中p27表达阳性率降为64．87％，与前两者比较，差异有统计学意义(P=0．025)，且伴有p27细胞浆表达者占45．83％。血清TGF-β1在正常对照组的表达阳性率为21．05％，直肠腺瘤组为27．27％，而直肠癌组则升至51．35％(P=0．045)。p27的表达与直肠癌的分化程度、淋巴结转移和浸润深度有关；血清TGF-β1表达水平与直肠癌的淋巴结转移、浸润深度和CEA水平有关。血清TGF-β1阴性组中p27表达阳性率为88．89％，血清TGF-β1阳性组中p27表达阳性率降为42．11％。差异有显著性意义(Mantel-Haenszel χ^2=6．755，P=0．009)。结论 p27对于判断直肠癌的恶性程度和预后有指导作用，血清TGF-β1可作为直肠癌的辅助诊断指标，TGF-β1可下调直肠癌中p27的蛋白表达。     

端粒酶活性在甲状腺肿瘤中的表达及意义

目的探讨端粒酶活性在甲状腺癌各病理类型中的表达及其作为甲状腺肿瘤标志物的可能性。 方法采用以PCR技术为基础的TRAP-银染定性和半定量法,检测73例不同种甲状腺组织中的端粒酶活性。 结果正常甲状腺组织中的端粒酶活性阳性率为0（0/8）,结节性甲状腺肿为15.0%（3/20）,甲状腺腺瘤为10.0%（1/10）,乳头状腺癌为75.0%（15/20）,滤泡状腺癌为80.0%（8/10）,髓样癌为100.0%（3/3）,未分化癌为100.0%（2/2）。良恶性组中的端粒酶活性阳性率差异有统计学意义（χ²=36.24,P<0.01）。 结论端粒酶活性在甲状腺癌各个类型中都有高表达,可作为甲状腺肿瘤诊断的理想标志物,尤其是对良恶性甲状腺滤泡性腺瘤的鉴别。端粒酶活性与甲状腺癌组织的分化程度无关,与甲状腺癌的预后可能有关,即端粒酶活性愈强,其预后愈差。     

结直肠腺瘤—腺癌组织微阵列制作及上皮钙黏附素和β—链接素的检测

目的 建立结直肠癌组织微阵列,探讨上皮钙黏附素和β－链接素的表达在结直肠癌发生、发展过程中的作用。方法 应用微阵列制作机制作结直肠正常黏膜－腺瘤－腺癌微阵列,用免疫组织化学法检测组织微阵列22例结直肠腺瘤和结直肠癌63例中上皮钙黏附素和β－链接素的表达。结果 制作了85例患的结直肠腺瘤－腺癌组织微阵列;原发各层腺癌组织及其转移灶中出现不同程度的β－链接素核阳性表达,与正常黏膜相比（远处转移灶除外）,β－链接素细胞核内表达增加,差异有显性意义（P＜0．01）;上皮钙黏附素和β－链接素膜表达在结直肠癌的发生、发展过程中呈下降趋势,肌层内癌、浆膜层内癌和淋巴结转移癌灶与正常黏膜、腺瘤及黏膜、黏膜下癌相比,β－链接素膜表达减少（P＜0．01）,差异有显性意义;正常黏膜与各癌灶,淋巴结转移灶与原发各层癌组织之间上皮钙黏附素的膜表达差异有显性意义（P＜0．05）。结论 结直肠腺瘤－腺癌组织微阵列的建立使得结直肠癌相关基因或蛋白的筛选工作快捷、简便,黏附分子上皮钙黏附素和β－链接素的表达水平及表达部位异常与结直肠癌的发生、浸润转移有密切的关系。     

CD10表达在甲状腺滤泡性癌和滤泡型乳头状癌诊断中的作用

目的研究CD10表达在甲状腺滤泡性癌和滤泡型乳头状癌诊断中的作用。方法收集70例甲状腺良、恶性病变组织，其中包括15例滤泡性腺瘤、15例腺瘤性甲状腺肿、30例乳头状癌（包括9例滤泡型乳头状癌）和10例滤泡性癌，采用免疫组织化学方法检测CD10在上述组织中的表达。结果9例滤泡型乳头状癌中，7例表达CD10（77．8％），10例滤泡性癌中8例表达CD10（80．0％）；CD10在非滤泡型乳头状癌、滤泡性腺瘤、腺瘤性甲状腺肿和正常甲状腺组织中均不表达。结论对CD10表达的检测有助于对甲状腺滤泡性癌和滤泡型乳头状癌的诊断。     

甲状腺Hurthle细胞肿瘤

复习相关文献，对甲状腺Hurthle细胞肿瘤作综述性报道如下：（1）Hurthle细胞肿瘤与滤泡状肿瘤在分子水平存在很大差异；（2）临床与细胞形态学标准不能准确区发Hurthle细胞肿瘤良恶性及预测肿瘤复发；（3）Hurthle细胞腺瘤应采取腺叶加峡部切除要，腺癌宜行全甲状腺切除，存在转移淋巴结时附加颈淋巴结清除要，对所有病人应进行长期随记；（4）Hurthle细胞肿瘤应列为一种独立的病理类型；（5）区发腺瘤与腺癌的标准需进一步明确以指导临床治疗；（6）目前Hurthle细胞肿瘤病人宜采取个体化原则治疗。     

Galectin-3在甲状腺癌中的表达及其临床意义

目的：探讨 Galectin-3在甲状腺肿瘤组织中的表达及其临床意义。方法：运用免疫组织化学方法，检测50 例甲状腺癌(其中甲状腺乳头状癌32例，甲状腺滤泡状癌18例)、45例甲状腺腺瘤及20例正常甲状腺组织中 Galectin-3的表达。结果：50例甲状腺癌中，Galectin-3表达阳性者达45例(90． 0%)，其中29例为强阳性；45例甲状腺 腺瘤中，仅2例(4． 4%)Galectin-3阳性者，且均为弱阳性；20例正常甲状腺 Galectin-3均为阴性。Galectin-3表达阳性 率在甲状腺癌中显著高于甲状腺腺瘤及正常甲状腺(P＜0． 01) 。甲状腺乳头状癌与滤泡状癌 Galectin-3表达阳性率无 显著差异(P＞0． 05) 。淋巴结转移者 Galectin-3表达阳性率与无淋巴结转移者相比无显著差异(P＞0． 05) ，但淋巴结转移 者 Galectin-3阳性表达强度显著高于无淋巴结转移者(P＜0． 05) 。结论：Galectin-3可作为鉴别甲状腺良、恶性肿瘤的重 要参考指标，其表达强度的检测有助于甲状腺癌转移的预测。     

Mitochondrial DNA Mutations in Differentiated Thyroid Cancer with Respect to the Age Factor

Introduction Increased numbers of mitochondria in differentiated thyroid cancer and, most strikingly, mutations in human mitochondrial DNA (mtDNA) in older people have led to speculation that mtDNA mutations might contribute to aging or accumulate in postmitotic tissues with age. Mutation analyses of mtDNA in papillary (PTCs) and follicular (FTCs) thyroid carcinomas have been limited to date. The significance and frequency of mtDNA mutations in PTC and FTC are therefore controversial, as is age dependence. Methods We analyzed eight sample pairs of PTC and six of FTC tissue with the corresponding normal thyroid tissue. DNA was extracted from frozen and formaldehyde-fixed tissue using the QIAmp Tissue Kit. Sequence differences in the mtDNA between tumor and normal tissue were detected using appropriate polymerase chain reaction (PCR) products for heteroduplex analysis in a denaturing high performance liquid chromatography (HPLC) Wave System (Transgenomic). Mutations were confirmed and identified by sequencing the PCR products of conspicuous chromatograms. The samples were obtained from 346 patients with PTC and 105 patients with FTC. We analyzed the whole mitochondrial genome from seven PTC and three FTC tumors along with the corresponding normal thyroid tissue. 3/7 PTC samples showed two heteroplasmic mutations and one polymorphism; all 3 FTCs showed homoplasmic and/or heteroplasmic mutations. Results All but one of these tumors are well documented in the mitochondrial database MITOMAP. MtDNA mutations were found in all three patients aged 45 years and older. There was no correlation, however, in this small group to clinical prognostic factors for recurrence and especially for survival in differentiated thyroid carcinomas, such as histology, tumor size, lymph node metastases, distant metastases, and gender, most likely because of the short follow-up. While univariate analysis of the findings in the whole cohort of 346 patients with PTC suggested that age is a significant prognostic factor for survival (P = 0.0237) but not for recurrence (P = 0.65), this was not the case in the 105 patients with FTC. Conclusions Although we found accumulation of mutations in two older patients with PTC and one patient with FTC (all three patients older than 45 years had mtDNA mutations), the low frequency of these mutations in the small group of 10 analyzed patients did not correlate with statistically validated clinical prognosticators for recurrence or survival, especially not with age. The low power of our data are therefore not able to support or refute the hypothesis that these mtDNA mutations are related to age-dependent tumor progression in the thyroid or that they “may be involved in thyroid tumorigenesis.”     

Galectin-3在甲状腺良恶性病变中的表达

摘要：目的 探讨Galectin 3在甲状腺病变中的表达及其对于良、恶性甲状腺肿瘤的鉴别价值。方法 采用SP免疫组织化学法对99例甲状腺手术切除标本进行Galectin 3的检测。结果 67例甲状腺癌中59例表达阳性，阳性率88.1%，阳性细胞弥漫性分布，其中，甲状腺滤泡癌22例（91.7%）、乳头状癌24例（88.9%）、髓样癌10例(83.3%)、未分化癌3例(75.0%)阳性。13例甲状腺乳头状增生中Galectin 3表达全部阴性。19例腺瘤仅 3例呈弱阳性(15.8%)，阳性细胞呈小灶性分布。良、恶性病变之间比较，差异有高度显著性（P<0.01）。甲状腺癌各组织学类型之间比较，差异无显著性意义（P>0.05）。 结论 Galectin 3可有效地区别良、恶性甲状腺病变，可作为甲状腺肿瘤的鉴别诊断标志。     

Importance of lymph node metastases in follicular thyroid cancer

There are many concepts of risk and prognostic factor analysis for differentiated thyroid cancer. The prognostic role of lymph node metastases in follicular thyroid cancer (FTC), however, is still controversial. We performed a retrospective trial in 186 patients with FTC (124 women, 62 men; mean follow-up 5.5 years) questioning whether lymph node metastases and radical thyroid surgery with neck dissection contribute to the prognosis of FTC. Univariate analysis demonstrated that lymph node metastasesp <0.005), tumor size (p <0.005), tumor stage (p <0.005), distant metastases p = 0.0063), and gender (p = 0.003) are significant prognostic factors for recurrence (Kaplan-Meier). Tumor size (p = 0.004), lymph node metastases p = 0.0478), and distant metastases p = 0.0064) influenced mortality. Age and extent of surgery were not significant for recurrence nor was gender for mortality. Multivariate analysis (Cox regression test) characterized tumor size (p <0.005) and lymph node metastases p = 0.004) as prognostic factors for recurrence of FTC. No significant difference was detected between patients being treated by thyroidectomy when compared to patients treated by thyroidectomy plus neck dissection in relation to recurrence. Our data demonstrate lymph node metastases to be a significant prognostic factor for recurrence of FTC and the patient’s survival. We advocate thyroidectomy plus central lymph node dissection as the basic surgical strategy. For T3 and T4 tumors, unilateral modified neck dissection is an all but optional procedure. Whether radical surgery with thyroidectomy plus neck dissection has an impact on survival remains questionable.     

Downregulation of p27KIP1 and Ki67/Mib1 labeling index support the classification of thyroid carcinoma into prognostically relevant categories.

The cyclin-dependent kinase inhibitor p27KIP1 has been proposed as a valuable prognostic indicator for a variety of human neoplasms. Immunohistochemical reactivity for p27KIP1 and the proliferation marker Ki67/Mib1 were investigated in 90 thyroid carcinomas of follicular cell origin. The neoplasms were divided into three prognostic groups on the basis of their morphologic features: group 1, well-differentiated papillary or follicular carcinomas with favorable pathologic features (43 papillary carcinomas and 4 minimally invasive follicular carcinomas); group 2, papillary or follicular carcinomas with unfavorable pathologic features (21 poorly differentiated carcinomas and 2 papillary carcinomas, tall cell variant); and group 3, undifferentiated, or anaplastic, carcinomas. p27KIP1 expression (p = 0.007) and Ki67/Mib1 labeling index (p = 0.02) showed a strong correlation with the subdivision of the thyroid carcinomas in the three prognostic groups with a significant linear trend for tumors with low p27KIP1 (p = 0.002) and high Ki67/Mib1 labeling index (p = 0.005) to segregate into the unfavorable categories (groups 2 and 3). Low p27KIP1 expression, but not cellular proliferation, was related to adverse prognostic factors, such as large tumor size (p = 0.03) and extrathyroidal extension (p = 0.01), but the correlation was not independent of the subdivision in the three groups. Low p27KIP1 expression (p = 0.03) and high proliferative rate (p = 0.02) were associated with poor survival, reflecting the close association between patient morbidity and mortality rates and tumor differentiation. No significant association could be seen between p27KIP1 or cellular proliferation and clinicopathologic parameters (e.g., age, sex, tumor size, extrathyroidal extension, vascular invasion, lymph node metastases, distant metastases, tumor stage, and survival rate) within any of the groups, or the histologic diagnosis of papillary versus follicular carcinoma irrespective of their degree of differentiation. Modulation of p27KIP1 and cellular proliferation patterns in thyroid carcinoma correlate with tumor differentiation and support the morphologic classification of thyroid carcinoma into prognostically relevant categories.     

Follicular variant of papillary thyroid carcinoma: a long-term follow-up

HYPOTHESIS: The clinical behavior of the follicular variant of papillary thyroid carcinoma (FVPTC) is similar to pure papillary thyroid carcinoma (PPTC) and completely different from follicular thyroid carcinoma (FTC). DESIGN: Retrospective analysis of prospectively documented data. SETTING: Referral center of a university hospital. PATIENTS: Two hundred thirty-seven consecutive patients with follicular cell-derived thyroid carcinomas were operated on in our institution during a 15-year period, from January 1, 1980, to December 31, 1994. Of the 154 PTC patients, 37 (24%) had FVPTC. The mean follow-up was 128.2 months (10.7 years). MAIN OUTCOME MEASURES: Demographic features, tumor characteristics, local and distant spread, persistence or recurrence of disease, and carcinoma-related mortality were compared between the groups with FVPTC, PPTC, and non-Hürthle cell FTC (NHFTC). RESULTS: The frequency of multicentricity was significantly higher in the FVPTC group than in the PPTC group (P =.03) or in the NHFTC group (P =.01) (12 [32%] of 37 patients vs 17 [15%] of 117 patients vs 6 [10%] of 58 patients, respectively). The incidence of cervical lymph node metastases was lower in the FVPTC group than in the PPTC group (P =.30) and higher than in NHFTC group (P =.004) (12 [32%] of 37 patients vs 53 [45%] of 117 patients vs 6 [10%] of 58 patients, respectively). At diagnosis, no patient with FVPTC showed distant metastases, compared with 5 patients (4%) with PPTC (P =.34) and 19 (33%) with NHFTC (P<.001). There was no carcinoma-related death in the FVPTC group. The strikingly poorer prognosis for the NHFTC group was statistically significant (P<.001), whereas the difference in carcinoma-specific survival between the PPTC and the FVPTC groups did show a trend toward better survival in the FVPTC group. CONCLUSION: The clinical behavior of the FVPTC group did not differ significantly from that of the PPTC group, whereas compared with the NHFTC group, the FVPTC group showed statistically significant differences for most of the analyzed variables.     

Serum levels of interleukin-1 receptor antagonist (IL-1ra) in thyroid cancer patients

Background and aims There is growing evidence that cytokines and their antagonists are important in the pathogenesis of various malignancies. While there are several reports on interleukin-1 receptor antagonist (IL-1ra) gene polymorphism and tissue expression, there is only little data available on the impact of IL-1ra serum levels. Therefore, we performed a prospective study, analyzing IL-1ra in thyroid cancer patients. Materials and methods We measured preoperative IL-1ra serum levels of 52 consecutive patients with thyroid cancer, 15 with benign adenoma and 27 healthy volunteers. The final histological diagnosis revealed 21 patients with papillary and 8 patients with follicular carcinoma (FTC), while 12 cases of medullary and 11 cases of anaplastic carcinoma (ATC) were observed. Results Compared to the control group, serum concentrations of IL-1ra were significantly higher in ATC and FTC patients. Concerning gender differences, this effect reached significance only in women with ATC and FTC. Except for the stage IV disease in ATC, there was no correlation between IL-1ra levels and International Union Against Cancer staging. Conclusion The findings of our study indicate that IL-1ra may play an important role in the development of ATC and FTC. Future efforts should focus on the possible application of IL-1ra as a biomarker for the above-mentioned thyroid malignancies.     

Cyclin D3、Cyclin D1、p27KIP1在膀胱尿路上皮细胞癌中的表达及其关系

目的 探讨膀胱尿路上皮细胞癌(UCCB)组织中Cyclin D3、Cyelin D1和p27KIP1的表达及关系.方法 采用免疫组织化学方法测定50例UCCB组织、癌旁组织及15例正常膀胱黏膜组织的Cyelin D3、Cyelin DI和p27KIP1表达情况;逆转录-聚合酶链反应(RT-PCR)方法测定CyclinD3 mRNA的表达情况.结果 Cyclin D3蛋白在UCCB、癌旁黏膜及正常膀胱黏膜中的表达率分别为32.00%(16/50)、12.00%(6/50)和6.67%(1/15),在UCCB组织中的表达高于癌旁黏膜和正常膀胱黏膜中的表达,差异有统计学意义(P<0.05),和病理分级、肿瘤大小及1年内肿瘤复发明显相关(P<0.05);Cyelin D3 mRNA在膀胱癌组织与癌旁组织和正常组织间,差异均有统计学意义(P<0.01).CycLin D1阳性率为80.00%(40/50),和病理分级及1年内肿瘤复发明显相关(P<0.05);p27KIP1阳性率为46.00%(23/50),和病理分级及1年内肿瘤复发明显相关(P<0.05).p27KIP1蛋白与Cyclin D3蛋白、Cyefin D1蛋白在UCCB中的表达呈负相关(r=-0.5472,P<0.01:r=-0.5417,P<0.01).Cyelin D3和Cyclin D1蛋白表达呈正相关(r=0.3430,P(0.05).结论 UCCB组织中Cyclin D3、Cyclin D1和p27KIP1表达明显相关,三者联合检测对UCCB的诊断治疗和估计预后有一定意义.     

Minimal-invasives follikuläres Schilddrüsenkarzinom

Current treatment guidelines for follicular thyroid carcinoma (FTC) recommend total thyroidectomy, lymphadenectomy and radioiodine ablation. Considering the low malignant potential of minimally invasive follicular thyroid carcinoma (MIFTC), a limited radical therapeutic procedure may be adequate. MIFTC is an intensely discussed group of tumors and a review of the literature reveals disagreement among experts concerning the criteria for a distinct definition. Therefore, in 2005 Rosai proposed a clinically more significant classification of FTC based on the extent of capsular and vascular invasion: MIFTC with capsular invasion only, with limited (≤3) vascular invasion, encapsulated FTC with extensive (>3) vascular invasion and broadly invasive FTC with extensive invasive growth. For the diagnosis of MIFTC a complete investigation of the encapsulated follicular lesion should be performed by the pathologist and examination of at least 10 tissue blocks is mandatory. Due to the excellent prognosis hemithyroidectomy constitutes an adequate therapeutic approach in MIFTC with capsular invasion only and may also be considered for MIFTC with limited vascular invasion. There are no indications for systematic lymphadenectomy.