Cervical metastasis in papillary carcinoma of the thyroid: a histopathological study

The tendency of well differentiated thyroid carcinoma to remain localised, and the slow progression of these tumours, have supported the belief that this disease behaves as a low grade malignancy. However, with differentiated carcinomas of the thyroid the incidence of nodal metastasis is highest in the papillary subgroup, and the importance of cervical metastases is being increasingly recognised. We have performed and prospectively analysed 17 neck dissections in 13 patients with clinically N+ve necks and papillary carcinoma of the thyroid. In all 17 neck dissections, metastatic deposits of papillary carcinoma of the thyroid were seen, with metastases found in all levels. Our findings of positive lymph nodes in all levels of the neck, with no predictable pattern of spread, and skip metastases, support an aggressive surgical approach to the treatment of cervical metastatic papillary carcinoma of the thyroid.     

POM121 overexpression is related to a poor prognosis in colorectal cancer

ABSTRACT

Background: Nuclear pore membrane protein 121 (POM121) plays a crucial role in nucleocytoplasmic transport, but its significance in tumorigenesis and the progression of colorectal cancer (CRC) remains unknown. The aim of this study was to evaluate the relationship between POM121 and CRC.

Methods: POM121 expression in colorectal tissues was analyzed at both the gene and protein levels. We investigated the connection between POM121 expression and clinicopathological features, as well as overall survival. A gene set enrichment analysis (GSEA) was performed, and a protein-protein interaction (PPI) network was constructed to determine the mechanism of POM121 in CRC.

Results: CRC tissues displayed a striking increase in POM121 expression compared with colonitis and pericarcinomatous mucosa tissues (66.61% vs 24.36% vs 24.11%, respectively, p < 0.0167). POM121 overexpression was significantly associated with lymph node metastasis, distant metastasis, TNM stage, venous invasion, perineural invasion, preoperative CEA and CA19-9 levels, and Ki67 expression. CRC patients with high POM121 levels tended to have poor overall survival rates. POM121 may participate in the regulation of the cell cycle and DNA repair in CRC.

Conclusions: Our results suggest that POM121 has the potential to serve as a novel prognostic biomarker in CRC patients.     

甲状腺髓样癌16例临床病理分析

目的　探讨甲状腺髓样癌 (MTC)的临床病理学特点。方法　对 16例经病理诊断为甲状腺髓样癌患者的临床资料、免疫组化、组织化学及光镜进行回顾性分析与研究。结果　患者大多以颈部肿块就诊 ,可伴腹泻症状。术后 5年、10年生存率分别为 85. 7%和 5 7.1%。散发型甲状腺髓样癌 15例 ,家族型甲状腺髓样癌 1例。癌组织中降钙素 (CT)阳性 16例、CgA阳性 15例、NSE阳性 10例、Syn阳性 7例、3例见甲状腺球蛋白 (Tg)阳性细胞 ,淀粉样物质染色均阳性。结论　MTC具有多分化肿瘤的特点 ,可以表达多种神经内分泌标志物 ,少数可出现类癌综合征或顽固性腹泻。其诊断依赖于组织病理学、免疫组化和组织化学 ,并须结合其临床资料。MTC的治疗以根治性切除为原则     

Anaplastic carcinoma of the thyroid: a clinicopathologic study of 82 cases

Anaplastic carcinoma of the thyroid accounts for about 10% to 15% of all thyroid carcinomas in the United States. Its lethality is evidenced by a 5-year survival rate of 3.6% and a median survival of 4 months. Rapid growth of a thyroid mass, frequently in a preexisting goiter, is the most common manifestation; the diagnosis should be considered and expeditiously pursued in all patients who present with this finding. Relatively favorable prognostic features seem to be unilateral tumors, a tumor diameter of less than 5 cm, no invasion of adjacent tissue, and absence of nodal involvement. For resectable lesions, thyroid lobectomy with wide margins of adjacent soft tissue on the side of the tumor seems to constitute a safe, appropriately aggressive surgical approach. Total thyroidectomy and radical neck dissection results in an increased complication rate and has no advantage over a more conservative approach. Radiotherapy, chemotherapy, immunotherapy, and combination radiotherapy and chemotherapy need further evaluation.     

774例甲状腺癌的临床及护理分析

目的研究甲状腺癌的临床特点及护理对策。方法分析1992～2008年甲状腺癌检出率、构成比、碘营养、健康体检频率的变化及护理方法。结果17年外检总量122900例,甲状腺癌774例,总外检率0．63％,2000年后甲状腺癌发病率、检出率、甲状腺乳头状癌在甲状腺癌中的构成、微小癌占PTC比例增高（P〈0．05）。所有甲状腺癌手术患者通过整体观个性化护理恢复良好,顺利出院。结论随着健康体检观念增强、诊断水平提高及碘饮食增多,甲状腺微小癌检出率增加。整体观个性化护理是甲状腺癌手术护理的关键。     

Molecular rearrangements in papillary thyroid carcinomas

Papillary thyroid cancer is unusual among epithelial malignancies in that it is associated with a number of chromosomal rearrangements. The most common of these is the Ret oncogene, normally silent in the follicular cell, but which has been shown to be rearranged to the promoter region of a variety of different genes, all of which are constituently expressed in the thyroid follicular cell. It has been suggested that chromosomes in the thyroid cell are arranged within the nucleus in such a way as to predispose the cell to inappropriate fusion in the advent of DNA double-strand breakage.The presence of tumour specific fusion genes, and their transcribed proteins, presents a possible therapeutic target for thyroid cancer, but the relative contribution of the gene rearrangement in the growth and development of the tumour will need careful evaluation before clinical studies could take place.     

Characteristics of thyroid carcinomas in aging patients

BACKGROUND: To investigate the clinical features of thyroid cancer in aging patients and to present the results of treatment. From this we can provide bases for earlier diagnoses and better treatment of thyroid malignancies in older patients. MATERIALS AND METHODS: In this study a retrospective analysis was performed with 204 thyroid cancer patients aged 60 years or older (132 women, with a mean age of 68.3 +/- 6.6 years; 72 men, with a mean age of 67.0 +/- 5.3 years). RESULTS: Of the 204 patients, 142 had well-differentiated thyroid carcinomas (96 papillary thyroid carcinomas, 43 follicular carcinomas, three Hürthle cell carcinomas) and three medullary carcinomas. Sixty-nine (33.8%) of the 204 patients died after treatment. Of these, three patients died of causes not related to thyroid cancer. For well-differentiated thyroid carcinomas, male gender, follicular carcinoma, and a larger tumour size indicated a poor prognosis. Of the 59 non-well-differentiated thyroid carcinomas, 39 were anaplastic thyroid carcinomas, nine metastatic cancers of the thyroid, seven lymphomas, and four squamous cell carcinomas. After treatment, 40 (67.8%) of the 59 patients died. In multivariant analysis of the differences in clinical parameters between aging and younger thyroid cancer patients, the current status, tumour size, follow-up period, sex, and stage at diagnosis were independent factors. From this data the delayed diagnosis of aging patients with thyroid cancer was of note when compared with younger patients. CONCLUSION: Thyroid cancer in older patients is not a benign clinical disorder. Early diagnosis and urgent aggressive treatment are recommended courses of action for this type of cancer, especially for non-well-differentiated thyroid cancers.     

电镜在甲状腺髓样癌诊断中的应用价值

目的 了解电镜在甲状腺髓样癌诊断中的应用价值。方法 通过对6例甲状腺髓样癌的光镜和电镜研究，结合文献分析甲状腺髓样癌的电镜诊断特点。结果 甲状腺髓样癌电镜观察要点为胞质内有大小不一的神经内分泌颗粒。结论 所观察到的结果在腺样型髓样癌与滤泡肿瘤、嗜酸细胞型髓样癌与嗜酸细胞腺瘤(癌)、玻璃样变梁状腺瘤样型髓样癌与玻璃样变梁状腺瘤的鉴别诊断中有重要价值。     

甲状腺岛状癌2例报道

甲状腺岛状癌是起源于原已存在的乳头状癌和滤泡癌或来源未定的一种少见的低分化甲状腺肿瘤,国内外文献报道仅200余例.     

Hematopoietic cells in thyroid fine-needle aspirates for cytologic study: report of two cases

In two patients, hematopoietic cells were found on cytologic study of fine-needle aspirates from the thyroid gland. The cells were thought to have been aspirated from ossified laryngeal tissues and to have no significance for hematologic disorders in these two patients.     

一家4例家族性甲状腺髓样癌报道

甲状腺髓样癌来源于分泌降钙素的滤泡旁细胞(C细胞),又称甲状腺C细胞癌,约占甲状腺癌的5%～10%。临床上有散发性和家族性两种类型,前者常见,呈单发结节,一般无明显症状,部分患者伴顽固性腹泻;家族性约占10%～20%,其发病年龄低于散发性,多为青年及儿童,属常染色体     

手术治疗肾癌121例临床分析

目的探讨手术治疗肾癌的临床效果及影响其预后的相关因素。方法回顾性分析行手术治疗的121例肾癌患者临床资料,观察生存率情况及影响预后的因素。结果121例肾癌患者行。肾癌根治性切除术99例,保留肾单位手术20例,射频消融1例,姑息手术1例;术后1、3、5a总生存率分别为97％、84％、63％,中位生存时间为66．8个月;病理分级、TNM分期、淋巴结转移、年龄、病理类型、有无症状、高血压及静脉瘤栓是肾癌预后的影响因素（P〈0．05）。结论年龄、组织病理分级、TNM分期、淋巴结转移、有无症状,高血压及静脉瘤栓对判断肾癌手术后患者的预后有重要价值。     

嗜酸性粒细胞性胃肠炎9例临床病理分析

目的探讨嗜酸性粒细胞性胃肠炎临床、病理学特点及鉴别诊断要点。方法对9例嗜酸性粒细胞性胃肠炎进行临床及病理分析。结果所有嗜酸性粒细胞性胃肠炎患者都有消化道症状，伴有外周血嗜酸性粒细胞增多，其中黏膜病变8例，分布在胃、小肠和结肠；肌层病变1例。8例黏膜性病变患者对类固醇治疗有效。结论嗜酸性粒细胞性胃肠炎是以嗜酸性粒细胞浸润消化道为特征的少见疾病。     

Dubin-J0hnson综合征4例临床病理分析

目的：探讨Dubin-Johnson综合征的临床病理特征、诊断和及鉴别诊断。方法：收集4例临床病理资料，切片作常规HE染色及特殊染色，镜下观察。结果：肝细胞内见大量棕黄色色素存在，脂褐素染色阳性，黑色素染色阴性，含铁血黄素染色阴性，部分病例胆色素染色阳性。结论：Dubin-Johnson综合征是一种良性病变过程，肝细胞内的色素可合并胆色素存在，这种色素与其他黄疸性疾病的胆汁淤积不同。     

甲状腺间叶性软骨肉瘤临床病理观察

目的探讨甲状腺间叶性软骨肉瘤(MC)的临床病理学特征、免疫表型、诊断以及鉴别诊断。方法分析1例甲状腺MC的临床特征、组织学形态、免疫表型及特殊染色结果,并复习相关文献。结果患者男性,33岁。以颈部无痛性肿块半年就诊。肿瘤位于甲状腺被膜内,似有完整包膜;切面灰白、灰黄色相间,有光泽,中央可见点、片状钙化、骨化,质硬。镜下肿瘤由未分化小细胞及分化较好岛状软骨细胞交织而成,小细胞区细胞丰富,由圆形、短梭形细胞组成,可见核分裂象;富于血管,可见血管外皮瘤样结构;软骨细胞多分化较好,细胞核有异型,可见钙化、骨化。免疫组化:小细胞CD99(+)、部分Leu-7和vimentin(+),而S-100、TG、AE1/AE3、FⅧRag、LCA、NSE、Syn、CgA、GFAP、NF和CD117均(-);软骨细胞S-100、NSE、GFAP和FⅧRag(+)。术后无复发和转移。结论甲状腺MC极其罕见,具有典型的病理组织学特征,需与伴有软骨化生的甲状腺未分化癌、非典型腺瘤及有软骨成分的癌肉瘤鉴别。预后可能有别于其他部位MC,尚需进一步随访。     

卵巢移行细胞癌十例临床病理分析

目的分析卵巢移行细胞癌的临床病理特点。方法收集2000~2013年收检的10例卵巢移行细胞癌病例,复习临床资料,并观察病理形态学特点。结果患者年龄36~61岁,中位年龄56岁。10例均行手术治疗,术后化疗采用TP方案或CAP方案。8例获得随访,2例死亡,6例存活。病理组织学检查显示移行细胞癌的特点,不伴有Brenner瘤结构。免疫组化表达WT-1、CK7、P53、CA125,不表达CK20和UroplakinⅢ。结论卵巢移行细胞癌具有特殊的形态学和免疫组化特点,不同于Brenner肿瘤,支持卵巢移行细胞癌实际是高级别的浆液性癌的观点。     

甲状腺显示胸腺样分化的癌9例免疫组化与超微病理研究

目的探讨甲状腺显示胸腺样分化的癌(CASTLE)临床病理、免疫表型、超微结构特征及生物学行为。方法回顾性分析9例CASTLE的临床病理资料,行免疫组化标记和电镜观察,并采用原位杂交法检测EBER表达情况。结果 CASTLE多发生于甲状腺下极,以膨胀性生长为主。肿瘤排列方式和细胞特点与发生于胸腺的鳞状细胞癌或淋巴上皮瘤样癌相似。免疫组化示9例肿瘤细胞CD5、CD117、p63、HMWK、GLUT-1、Pax8、E-cadherin、bcl-2和p53均(+),5例CAⅨ(+),6例CEA(+),3例神经内分泌标记(+)。超微结构显示肿瘤细胞含较多的线粒体及张力原纤维,细胞间桥粒丰富,其中1例胞质内见神经内分泌颗粒。随访4~65个月(平均31月),9例均健在,其中2例分别于首次术后18.5个月和22个月发生局部复发。结论 CASTLE是一种低度恶性的甲状腺癌,其组织学和免疫组化与胸腺癌相似。GLUT-1可作为CASTLE新的免疫标记物,与CD5、CD117联合检测有助于该肿瘤的确诊与鉴别。