Increased expression of thyroid hormone receptor alpha and estrogen receptor alpha in breast cancer associated with thyroid cancer

IntroductionBreast cancer co-occurred with thyroid cancer might be associated with thyroid hormone receptor (TR) and estrogen receptor (ER), but few have been reported. We aimed to investigate the expression and prognostic significance of ERs and TRs in such settings.Material and methodsTissue microarrays were constructed from 75 patients with breast and thyroid cancer (BC + TC) who were retrospectively recruited between 1999 and 2012 and 147 with breast cancer only (BC controls). The ERα, ERβ, TRα, and TRβ expression levels were analyzed by immunohistochemistry.ResultsTRα expression was more frequently observed in the BC + TC group than the BC control group both in the normal (51.5% vs 23.3%, respectively, p = 0.009) and cancer tissues (21.6% vs 6.8%, respectively, p = 0.001). The BC + TC group showed greater ERα-positivity in the cancer tissues (79.7% vs 58.7%, respectively, p = 0.002) than the BC control group. The degree of ERα- and TRα-positivity was unchanged by radioactive treatment or serum thyroid stimulating hormone levels. In the BC + TC group, ERα-positivity was associated with earlier disease stage I/IIA (81.0% vs 50.0%; p = 0.031) and lower recurrence rates (8.5% vs 40.0%; p = 0.002). TRα-positivity alone was not associated with any recurrence-free survival-related differences, and ERα- and TRα-negativity were associated with significantly shorter recurrence-free survival (p < 0.001).ConclusionEnhanced ERα and TRα expression in breast cancer is associated with thyroid cancer occurrence, and the observed association with prognosis suggests the possible role of ERs and TRs in the link between breast cancer and thyroid cancer.     

MiR-125b在甲状腺癌患者中的表达及其意义

目的探讨miR-125b在甲状腺癌患者中的表达及其意义。方法选取甲状腺乳头状癌组织及其配对的癌旁组织各20例,所有患者均经超声及病理确诊。实时荧光定量PCR检测miR-125b mRNA的表达,Western Blot检测Foxp3、LC 3Ⅰ和LC 3Ⅱ蛋白的表达。将人甲状腺乳头状癌细胞系MDA-T32随机分为3组:对照组(不处理)、阴性对照组(转染无义序列)和miR-125b组(转染miR-125b mimics),实时荧光定量PCR检测miR-125b mRNA的表达,MTT法检测癌细胞对顺铂的敏感性,Western Blot检测Foxp3、LC 3Ⅰ和LC 3Ⅱ蛋白的表达。结果与癌旁组织对比,甲状腺癌组织中MiR-125b mRNA的表达显著降低(P <0.05),Foxp3蛋白表达显著增加(P <0.05)。与对照组相比,miR-125b组细胞中MiR-125b mRNA的表达显著增加(P <0.05),Foxp3蛋白的表达显著降低(P <0.05)。与对照组相比,在顺铂浓度为30μg/ml时,miR-125b组细胞活性显著降低(P <0.05)。在顺铂浓度为0、15、60、120μg/ml时,各组间细胞活性的对比无显著差异(P> 0.05)。与癌旁组织对比,甲状腺癌组织中LC 3Ⅱ蛋白的表达显著增加(P <0.05)。与对照组相比,miR-125b组细胞中LC 3Ⅱ蛋白的表达显著降低(P <0.05)。LC 3Ⅰ蛋白的表达在各组间对比无显著变化(P> 0.05)。结论miR-125b在甲状腺癌中下调,miR-125b介导的Foxp3下调可抑制自噬,并增强甲状腺癌细胞对顺铂的敏感性。     

甲状腺微小乳头状癌颈部中央区淋巴结转移的相关危险因素分析[综述]

近年来甲状腺微小乳头状癌（papillary thyroid microcarcinoma，PTMC）的发病率呈明显上升趋势，目前主要治疗方式为手术治疗，但在行腺叶切除时是否需要同期行颈部中央区淋巴结清扫术仍有较多争议。本文主要叙述性别、年龄、多病灶、病灶大小、肿瘤位置、被膜侵犯、慢性淋巴细胞性甲状腺炎、淋巴结转移相关基因等与甲状腺微小乳头状癌颈部中央区淋巴结转移的关系，总结行颈中央区淋巴结清扫术需要考虑的相关危险因素。     

细胞学性质不确定甲状腺结节分子检测进展[综述]

随着甲状腺结节的发病及检出率日益增高，甲状腺结节的分子标记物在鉴别结节的性质，术前诊断及患者预后都有重要作用。本文总结归纳关于相关分子标记物及检测手段在甲状腺结节诊治中的更新进展，结论表明甲状腺结节的单个致病分子的研究较为成熟，多分子联合检测手段可提高诊断精确率，同时提供更加可靠的分子依据，指导手术及术后药物治疗。尽管其还未能替代“金标准-病理诊断”，但对甲状腺结节的诊断管理和治疗，必将扮演越来越重要的角色，具有广泛的应用前景。     

Can contrast-enhanced harmonic endoscopic ultrasonography accurately diagnose main pancreatic duct involvement in intraductal papillary mucinous neoplasms?

BackgroundMain pancreatic duct (MPD) involvement in branch duct-type intraductal papillary mucinous neoplasms (BD-IPMNs) is a high risk finding for malignant IPMNs. However, discrepancies exist in the identification of MPD involvement between imaging findings and pathological diagnosis. The purpose of this study was to evaluate the diagnostic accuracy of preoperative assessment of MPD involvement in IPMNs using contrast-enhanced harmonic endoscopic ultrasound (CH-EUS).MethodsThis study involved 166 consecutive patients with BD-IPMNs who underwent surgical resection. CH-EUS was used to evaluate the MPD involvement according to the presence of mural nodules (MN) that advanced into the MPD or involved the MPD. The CH-EUS findings were compared with the pathological findings. Additionally, we analyzed the risk factors for malignant BD-IPMNs using multivariate analysis.ResultsA total of 77, 51, and 38 patients were pathologically diagnosed with low-grade or intermediate-grade dysplasia, high-grade dysplasia and invasive IPMNs, respectively. MPD involvement was diagnosed using CH-EUS (MPD-inv.-EUS) in 90 (54.2%) patients with a sensitivity, specificity and accuracy of 83.5%, 87.0% and 84.9%, respectively. The malignancy rate in patients with MPD-inv.-EUS was 71.6% (63/90). Multivariate logistic regression analysis showed that MPD-inv.-EUS (OR, 3.61; 95% CI:1.45–8.98), age (OR, 5.70; 95% CI: 1.47–22.2), cyst size (OR, 2.45; 95% CI:1.04–5.78) and MN size (OR, 7.05; 95% CI:2.48–20.0) were significant for malignant BD-IPMNs.ConclusionsMPD-inv.-EUS accurately represents the pathological involvement of IPMN and may be a useful predictor of malignant BD-IPMNs.     

Can the location of the mural nodule indicate benign or malignant in branch duct-type intraductal papillary mucinous neoplasm of the pancreas?

Background/ObjectivesIntraductal papillary mucinous neoplasms (IPMNs) are classified into main duct (MD)-type IPMNs, branch duct (BD)-type IPMNs, and mixed type IPMNs. While MD-type IPMN has a high risk of malignancy and should therefore be considered for resection if the patient is fit, BD-type IPMN needs to be carefully judged for surgical indication. The decision to resect BD-type IPMN is often based on international consensus Fukuoka guidelines 2017, but further investigation is required. In this study, we focused on whether the location of the mural nodule (MN) could be an indicator of malignancy.MethodsWe enrolled 17 cases who had been diagnosed BD-type IPMNs which were surgically resected from January 2016 to December 2019. These cases were classified into benign and malignant group. Subsequently, a clinicopathological study was conducted based on the localization of MN (MN-central type or MN-peripheral type).ResultsAlthough MN was found in 57% (4/11) in the benign group, 88% (7/8) was noted in the malignant group, indicating the presence of MN to be more common in the malignant group. Those with MN consisted of 6 cases of MN-central type and 5 cases of MN-peripheral type. All cases of central type were malignant compared to only one case of the peripheral group being confirmed on histology as cancer.ConclusionBD-IPMN with central mural nodule should be considered high risk for malignancy.     

Thoracic splenosis: Case report of a symptomatic case

Thoracic splenosis is the autotransplantation of splenic tissue in the left thoracic cavity as a result of a splenic injury. This rare pathology is usually asymptomatic and may be discovered on incidental imaging, but the diagnosis often requires invasive procedures such as surgery in order to eliminate a neoplasic origin. We report a rare symptomatic case of a 39-year-old man presenting with chest pain and multiple nodules revealed on a computed tomography scan. The patient underwent a surgical exploration and the pathological studies concluded to a thoracic splenosis. Indeed, the previous medical history of the patient revealed a left thoraco-abdominal traumatism during childhood. The aim of this paper is to emphasize that the diagnosis can now be performed using only imaging techniques such as technetium-99 sulfur colloid or labelled heat-denatured red blood cell scintigraphy to avoid unnecessary invasive procedures including thoracotomy.     

Differentiated thyroid carcinoma in sporadic and familial presentations of acromegaly: A case series

BackgroundIn acromegaly, chronic growth hormone (GH) and insulin-like growth factor-1 (IGF-1) exacerbate comorbidities in multiple organs. Differentiated thyroid carcinoma (DTC) has been reported as being a comorbid condition in acromegaly. Acromegaly is usuallysporadic, but 5% of cases may be genetic. The most frequent inheritable form of acromegaly is related to germline mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene. Epidemiological data on the relationship between active acromegaly, its familial forms and DTC are sparse. We present the investigation of a FIPA family (familial isolated pituitary adenoma) with homogeneous acromegaly and 6 sporadic acromegaly patients with DTC.Patients and methodsA study of 59 acromegaly patients assessed thyroid nodules on ultrasound and fine-needle aspiration biopsy following the ATA 2015 criteria. We diagnosed 7 differentiated thyroid carcinomas. Resected thyroid carcinoma tissues were stained using an anti-AIP antibody. Analysis of germline and tumor-derived DNA for variants in the AIP and MEN1 genes were performed in the FIPA kindred.ResultsWe describe one FIPA patient and 6 sporadic acromegaly cases with DTC. The FIPA family (AIP mutation negative) consisted of two sisters, one of whom had a DTC with intermediate risk and incomplete structural response to therapy. In our study, DTC in sporadic acromegaly had a low recurrence rate (6/6), and excellent response to therapy (6/6). Immunohistochemistry for AIP showed similar or increased staining intensity in DTC versus normal thyroid tissue.ConclusionIn our cohort of sporadic and familial forms of acromegaly with DTC, AIP did not appear to influence thyroid cancer progression.