62例甲状腺癌的MRI与CDFI比较分析

目的探讨甲状腺癌在超声、MRI及1H-MRS的影像特点,比较不同方法对甲状腺癌的诊断价值。方法回顾性分析经手术病理证实的62例甲状腺癌的影像表现。结果甲状腺癌的发展变化、形态、内部回声、彩色血流显像、磁共振成像、波谱分析及浸润、颈部淋巴结转移征象均有不同表现。结论超声对甲状腺癌有重要诊断价值,结合MRI、1H-MRS能提高对甲状腺癌的确诊率。     

Beclin 1在甲状腺癌中的表达及临床意义

目的 探讨Beclin 1在甲状腺癌中的表达及其意义,并探讨其与甲状腺采用免疫组化法检测45例甲状腺癌中Beclin 1蛋白表达并分析.结果 Beclin 1在甲状腺癌组织中的表达显著下调,并与甲状腺癌淋巴结转移有相关性.结论 Beclin 1在甲状腺癌组织中表达下调,可能与甲状腺癌的发生、发展有关.     

高频超声在甲状腺癌诊断中的应用价值

<正>临床上,甲状腺癌属于一种常见的头颈部恶性肿瘤,女性发病率高于男性~([1])。甲状腺癌的病理类型共有4种,包括乳头状甲状腺癌、滤泡性甲状腺癌、髓样甲状腺癌、未分化甲状腺癌,其中乳头状甲状腺癌发病率最高,在甲状腺癌发病率中约占85%,任何年龄段均可发病,且发病率呈现出逐年上升趋势~([2])。近年来,随着彩色多普勒技术以及高频探头的应用,高频超声被广泛应用于甲状腺癌诊断中,具有无创、价格低廉、可重复等诸多优点~([3])。为提高甲状腺癌诊断准确率,本研究在该疾病诊断中应用了高频超声,诊断价值显著,报告如下。     

2011至2017年沧州市区甲状腺癌发病趋势分析

目的 调查沧州市区甲状腺癌的发病趋势,为制定甲状腺癌防治策略提供基础依据.方法 收集、整理沧州市区2011至2017年新发病的甲状腺癌病例数据,计算粗发病率、标化发病率、发病率的年度变化百分比(annual percent change,APC)等指标,分析甲状腺癌的发病趋势.结果 2011至2017年沧州市区甲状腺癌...     

甲状腺癌的超声检查研究

目的研究并分析甲状腺癌超声检查的声像表现,总结超声检查方式在甲状腺癌临床诊治中的意义与价值。方法对54例确诊为甲状腺癌的患者的资料进行回顾式分析,对比同期124名良性结节患者的资料,分析甲状腺癌患者超声检查声像图的表现,以此评价超声检查在甲状腺癌诊断中的应用价值。结果甲状腺癌患者的声像图有以下特点:形态为圆形和不规则形、边界较模糊、结节内低回声、沙粒状钙化、结节内血流紊乱,速度快、颈部存在肿大淋巴结。结论超声检查在甲状腺癌诊断中具有较高的应用价值。     

甲状腺癌患者围术期的护理干预效果观察

目的了解甲状腺癌患者围术期护理干预效果。方法将我院收集2017年1月至2018年8月的60例甲状腺癌患者,随机分组,常规组用护理常规,围术期护理组用围术期护理干预。比较两组满意度;甲状腺癌围术期相关指标;护理前后生命体征情况、生存质量分值;甲状腺癌术后并发症概率。结果围术期护理组满意度、生命体征情况、生存质量分值、甲状腺癌围术期相关指标、甲状腺癌术后并发症概率方面相较常规组更好,P <0.05。结论甲状腺癌患者实施围术期护理干预效果理想。     

甲状腺癌相关基因生物信息分析

目的:通过分析甲状腺癌文献基因报道频率、COSMIC数据库中基因突变频率、文献基因差异表达情况以及蛋白质相互作用,评价基因对甲状腺癌的重要价值。方法:检索甲状腺癌相关文献,检索COSMIC数据库甲状腺癌基因突变频率,计算已经发表相关文献数据中的差异表达基因,计算基因的蛋白质作用次数,利用这些信息计算基因关注指数。结果:共找到382个与甲状腺癌密相关的基因,其中282个基因未被文献报道。结论:利用生物信息学方法多方面分析甲状腺癌切相关基因,能找到一些新的对甲状腺癌十分重要的基因。     

核医学在甲状腺癌诊断和治疗中的应用

甲状腺癌是一种内分泌系统中最常见的恶性肿瘤,在全身各种恶性肿瘤中约占1%～2%。甲状腺癌的发病率随年龄增大而升高,女性的发病率约是男性相比的2～3倍。甲状腺癌按病理类型可以分为乳头状腺癌、滤泡状腺癌、未分化癌和髓样癌。又因为乳头状癌和滤泡状癌的分化程度较高,因此又被称为分化型甲状腺癌(differentiated thyroid carcinoma,DTC),分化型甲状腺癌因为具有摄取碘的能力,被有些学者称为有功能性甲状腺癌。目前,甲状腺癌的诊断和治疗主要是应用核医学,具有重要的临床意义。     

内科疾病处方用药解析（57）

6.11甲状腺癌 甲状腺癌是来源于甲状腺上皮细胞的恶性肿瘤。根据肿瘤分化的程度,甲状腺癌根据组织学可以分为分化型和未分化型。根据组织学来源,分化型甲状腺癌又可以分为乳头状甲状腺癌和滤泡状甲状腺癌。手术治疗是甲状腺癌的首选治疗方法。一旦确诊,只要条件许可,就应彻底清除原发灶和转移灶,以防转移和复发,从而达到治愈的目的。     

雌激素作为甲状腺癌治疗靶点的研究进展

甲状腺癌是最普遍且最流行的内分泌恶性肿瘤．占所有内分泌相关癌肿的95％。治疗晚期转移性甲状腺癌仍是癌症治疗研究中面临的最大挑战之一。目前正迫切需要新的甲状腺癌治疗方法,随着对肿瘤相关生物学知识和甲状腺癌发病机制的进一步掌握,将有助于评估甲状腺癌风险以及发展甲状腺癌治疗方案。     

分化型甲状腺癌分子靶向治疗进展

分化型甲状腺癌(differentiated thyroid carcinoma,DTC)是最常见的内分泌系统恶性肿瘤。虽然DTC通常有较好的预后,但目前针对那些已经发生局部侵犯、转移和(或)对放射性核素治疗抵抗的患者还没有很好的治疗方法。随着对增殖性肿瘤相关突变分子的深入研究,已经获得了一些新的肿瘤治疗分子靶点。一些蛋白在DTC的致病机制中发挥重要作用,如RET/PTC-RAS-RAF-MAPK途径。此外,血管的异常和再生也与肿瘤的生长有关。尽管这些靶向治疗药物会带来一些不良反应,但靶向治疗的研究进展以及初期较具说服力的实验结论给难治性DTC治疗带来了新的希望。     

Emerging therapeutics for advanced thyroid malignancies: rationale and targeted approaches

INTRODUCTION: Thyroid cancer is an emerging public health concern. In the USA, its incidence has doubled in the past decade, making it the eighth most commonly diagnosed neoplasm in 2010. Despite this alarming increase, most thyroid cancer patients benefit from conventional approaches (surgery, radioiodine, radiotherapy, TSH suppression with levothyroxine) and are often cured. Nevertheless, a minority have aggressive tumors resistant to cytotoxic and other historical therapies; these patients sorely need new treatment options. AREAS COVERED: Herein the biology and molecular characteristics of the common histological types of thyroid cancer are reviewed to provide context for subsequent discussion of recent developments and emerging therapeutics for advanced thyroid cancers. EXPERT OPINION: Several kinase inhibitors, especially those targeting VEGFR and/or RET, have already demonstrated promising activity in differentiated and medullary thyroid cancers (DTC, MTC). Although of minimal benefit in DTC and MTC, cytotoxic chemotherapy with anti-microtubule agents and/or anthracyclines in combination with intensity-modulated radiation therapy appears to extend survival for patients with locoregionally confined anaplastic thyroid cancer (ATC), but to have only modest benefit in metastatic ATC. Further discovery and development of novel agents and combinations of agents will be critical to further progress in treating advanced thyroid cancers of all histotypes.     

Emerging therapeutics for advanced thyroid malignancies: rationale and targeted approaches

Introduction: Thyroid cancer is an emerging public health concern. In the USA, its incidence has doubled in the past decade, making it the eighth most commonly diagnosed neoplasm in 2010. Despite this alarming increase, most thyroid cancer patients benefit from conventional approaches (surgery, radioiodine, radiotherapy, TSH suppression with levothyroxine) and are often cured. Nevertheless, a minority have aggressive tumors resistant to cytotoxic and other historical therapies; these patients sorely need new treatment options.

Areas covered: Herein the biology and molecular characteristics of the common histological types of thyroid cancer are reviewed to provide context for subsequent discussion of recent developments and emerging therapeutics for advanced thyroid cancers.

Expert opinion: Several kinase inhibitors, especially those targeting VEGFR and/or RET, have already demonstrated promising activity in differentiated and medullary thyroid cancers (DTC, MTC). Although of minimal benefit in DTC and MTC, cytotoxic chemotherapy with anti-microtubule agents and/or anthracyclines in combination with intensity-modulated radiation therapy appears to extend survival for patients with locoregionally confined anaplastic thyroid cancer (ATC), but to have only modest benefit in metastatic ATC. Further discovery and development of novel agents and combinations of agents will be critical to further progress in treating advanced thyroid cancers of all histotypes.     

分子靶向药物治疗难治性甲状腺癌的疗效及安全性的meta分析

目的　对分子靶向药物治疗难治性甲状腺癌的疗效及安全性进行meta分析,为临床应用提供有价值的循证医学证据。方法　检索PubMed、Embase、the Cochrane Library、Web of Science、中国知网、万方数据知识服务平台以及中国生物医学文献服务系统从建库到2022年4月13日关于甲状腺癌分子靶向治疗的文献,筛选文献提取数据,评价纳入研究的偏倚风险,采用RevMan5.4软件进行meta分析。结果　共纳入8项研究,试验组（分子靶向药物）样本量为1 201例,对照组（安慰剂）样本量为748例。meta分析结果显示,相比于安慰剂,分子靶向药物有更佳的客观缓解率（objective response rate,ORR）（RR=14.19,95%CI 4.12～48.93,P<0.000 1）以及疾病控制率（disease control rate,DCR）（RR=1.40,95%CI 1.20～1.63,P<0.000 1）,并且明显提高了难治性甲状腺癌患者的无进展生存期（progression-free survival,PFS）（HR=0.35,95%CI 0.25～0.51,P<0.000 01）。试验组≥3级不良事件（adverse events,AEs）发生率高于对照组（RR=3.85,95%CI 2.90～7.10,P<0.000 1）,主要为腹泻、高血压、疲劳、手足综合征、食欲下降以及体质量下降。结论　分子靶向药物具有良好的疗效,并且通过调整剂量和给予支持治疗可使大部分AEs得以控制。因此,分子靶向药物可成为治疗难治性甲状腺癌新的选择。                         

LRRC52-AS1 is associated with clinical progression and regulates cell migration and invasion in papillary thyroid cancer

The incidence of thyroid cancer has increased in recent decades. The potential molecular mechanisms of papillary thyroid cancer (PTC) are still to be uncovered. In recent years, a number of studies reported that LRRC super family members are up-regulated in cancer cells. Cancer cells can experience a feature change from an epithelial to a mesenchymal phenotype, which is called epithelial–mesenchymal transition (EMT) during cancer progression. We found that LRRC52-AS1 is highly expressed in PTC cell lines rather than normal tissues and this observation was consistent with The Cancer Genome Atlas (TCGA) cohort. In a word, LRRC52-AS1 is associated with clinical progression in papillary thyroid cancer. In vitro experiments showed that knocking down LRRC52-AS1 significantly decreased the migration and invasion of the PTC cell lines (BCPAP and TPC). Meanwhile, LRRC52-AS1 may influence the progress of papillary thyroid cancer via mesenchymal markers N-cadherin, vimentin and TAZ. The LRRC52-AS1 gene is up-regulated in papillary thyroid cancer, and knockdown of LRRC52-AS1 could restrain cellular migration, and invasion in vitro. This study indicated that LRRC52-AS1 is a gene associated with PTC and might become a potential therapeutic target in PTC.     

分子核医学在甲状腺癌影像诊断与靶向治疗中的应用分析

目的探讨分子核医学在甲状腺癌影像诊断与靶向治疗中的应用效果。方法选取我院2011年²012年间收治的60例甲状腺癌患者作为研究对象,将患者随机分为观察组与对照组,观察组40例,应用分子核医学进行诊断和治疗。结果经过分子核医学的相关技术进行影像诊断,观察组患者的病情更直观的表现出来,为临床诊治提供了重要的参考资料。观察组患者的有效率为85%,对照组有效率为60%,两组数据结果比较差异具有统计学意义(P<0.05)。结论分子核医学在甲状腺癌影像诊断与靶向治疗中具有良好的应用效果。     

Cyanidin as potential anticancer agent targeting various proliferative pathways

A natural compound cyanidin, which is a type of anthocyanin present in pigmented leaves, fruits, and flowers; distributed widely in berries, apples, and oranges possess anticancer activities, thus curing various types of cancer such as breast, liver, lung, prostate, and thyroid cancer. The article provides an insight into the potential of using a single phytochemical, cyanidin to treat various cancer types including breast, liver, lung, prostate, and thyroid cancer. Information about cyanidin and its pharmacological impact on cancer was collected from books, scientific journals, and reports through electronic data search (Web of Science, Scifinder, PubMed, Scopus, Google Scholar, Elsevier, Springer, Wiley, ACS, Science Direct, CNKI as well as Kew Plants of the Word Online) and library. Cyanidin produces its effects against cancer probably by inhibiting (RAS, MAPK) and activating (caspases-3 and P-38) innovative molecular pathways. It may cause cell cycle arrest, cell differentiation processes and changes in redox status which trigger the cytotoxic chemotherapeutic effects. However, it also optimizes the chemotherapeutic targets which are cancer cells less responsive to chemotherapy. Cancer is considered the most widely spread disease and cyanidin from natural origin provides an essential role in treatment of cancer by approaching various mechanistic pathways.     

Platelet-Derived Growth Factor Receptor-α Subunit Targeting Suppresses Metastasis in Advanced Thyroid Cancer In Vitro and In Vivo

Thyroid cancer is the most common endocrine malignancy. Patients with well-differentiated thyroid cancers, such as papillary and follicular cancers, have a favorable prognosis. However, poorly differentiated thyroid cancers, such as medullary, squamous and anaplastic advanced thyroid cancers, are very aggressive and insensitive to radioiodine treatment. Thus, novel therapies that attenuate metastasis are urgently needed. We found that both PDGFC and PDGFRA are predominantly expressed in thyroid cancers and that the survival rate is significantly lower in patients with high PDGFRA expression. This finding indicates the important role of PDGF/PDGFR signaling in thyroid cancer development. Next, we established a SW579 squamous thyroid cancer cell line with 95.6% PDGFRA gene insertion and deletions (indels) through CRISPR/Cas9. Protein and invasion analysis showed a dramatic loss in EMT marker expression and metastatic ability. Furthermore, xenograft tumors derived from PDGFRA gene-edited SW579 cells exhibited a minor decrease in tumor growth. However, distant lung metastasis was completely abolished upon PDGFRA gene editing, implying that PDGFRA could be an effective target to inhibit distant metastasis in advanced thyroid cancers. To translate this finding to the clinic, we used the most relevant multikinase inhibitor, imatinib, to inhibit PDGFRA signaling. The results showed that imatinib significantly suppressed cell growth, induced cell cycle arrest and cell death in SW579 cells. Our developed noninvasive apoptosis detection sensor (NIADS) indicated that imatinib induced cell apoptosis through caspase-3 activation. In conclusion, we believe that developing a specific and selective targeted therapy for PDGFRA would effectively suppress PDGFRA-mediated cancer aggressiveness in advanced thyroid cancers.     

DNA含量及细胞周期调控基因的表达在甲状腺肿瘤发生中的作用

目的探讨DNA含量及细胞周期调控基因表达在不同类型甲状腺肿瘤组织中的变化。方法应用流式细胞术定量分析DNA含量及细胞周期调控基因在甲状腺肿瘤中的表达。结果DNA含量和异倍体率在甲状腺癌组明显增高，细胞周期素（CyclinD1）、细胞周期素依赖性激酶（CDK4）在甲状腺癌组表达明显增高，而视网膜母细胞瘤基因（Rb）、细胞周期素依赖性激酶抑制剂（P27）表达呈下降趋势。结论在甲状腺癌，DNA含量和异倍体率增加，CyclinD1、CDK4表达明显增高，而Rb、P27表达下降，说明甲状腺癌形成时，已有多个分子事件发生。     

甲状腺结节伴钙化与甲状腺癌

近年来甲状腺癌的发病率明显上升,随着高频超声检查的广泛应用,甲状腺结节伴钙化与甲状腺癌的关系日益得到重视。甲状腺结节伴钙化既可见于良性甲状腺疾病,亦可见于甲状腺癌,但后者更为常见。在各种类型的钙化中,微钙化与甲状腺癌,特别是甲状腺乳头状癌的关系最为密切,而且微钙化被认为是超声检查诊断甲状腺癌的特异性指标之一。甲状腺癌结节伴钙化,尤其是微钙化的机制目前尚未完全明确。对甲状腺结节伴钙化的诊断受超声仪器,探头频率及操作者的影响。虽然超声检查诊断对甲状腺癌特异性高,发现甲状腺结节伴钙化时,需结合其他参数才能提高诊断的准确性,必要时行细针穿刺活检。