Clinicopathologic Predictive Factors of Cervical Lymph Node Metastasis in Differentiated Thyroid Cancer

Background

Cervical lymph node metastasis (LNM) has been proven to be a predictor for locoregional recurrence in differentiated thyroid carcinoma (DTC). Clinicopathological features could be effective predictive factors for central and lateral LNM of DTC, and provide references to surgeons for cervical neck dissection.

Metastatic Lymph Node Ratio of Central Neck Compartment Has Predictive Values for Locoregional Recurrence in Papillary Thyroid Microcarcinoma

ObjectivesThis study aimed to evaluate the significance of metastatic lymph node ratio (the ratio between the metastatic lymph node and the harvested lymph nodes; MLNR) in the central neck for the prediction of locoregional recurrence in patients with papillary thyroid microcarcinoma.MethodsAfter reviewing medical records of papillary thyroid microcarcinoma patients who received total thyroidectomy with central neck node dissection, 573 consecutive adult patients were enrolled in this study, with a follow-up period of more than 36 months. Regarding the risk of recurrence, multivariate analyses were performed with the following variables; sex, age, multiplicity of the primary tumor, presence of pathological extrathyroidal extension, the level of postoperative stimulated serum thyroglobulin, the number of harvested lymph nodes, the number of lymph node metastasis and MLNR.ResultsThe MLNR showed a predictive significance for the locoregional recurrence (P<0.05). Most recurrences were occurred in the lateral neck (n=12, 80%) with a median interval of 20 months. The lowest cutoff value of the MLNR for a meaningful separation of disease recurrence was 0.44 (hazard ratio, 8.86; 95% confidence interval, 1.49 to 52.58; P=0.001).ConclusionWhen the MLNR is higher than 0.44, there is an increased risk of locoregional recurrence mostly in the lateral neck. Therefore, MLNR of the central neck in a permanent or frozen biopsy may be helpful in decision making in the extent of thyroidectomy and/or the need for contralateral central neck lymph nodes dissection.     

A Polymorphism (rs1801018, Thr7Thr) of BCL2 is Associated with Papillary Thyroid Cancer in Korean Population

Objectives

Among the apoptosis signals, B-cell CLL/lymphoma 2 (BCL2) is a well-known regulator of apoptosis with anti-apoptotic properties. We investigated here whether single nucleotide polymorphisms (SNPs) of the BCL2 were associated with host susceptibility of papillary thyroid cancer (PTC) occurrence and clinicopathologic parameters.

Methods

Ninety-two PTC patients and 222 control subjects were recruited. One promoter SNP (rs2279115, -938A/C) and one synonymous SNP (rs1801018, Thr7Thr) in the BCL2 gene were selected and genotyped using direct sequencing. Multiple logistic regression models were performed to evaluate odds ratios, 95% confidence intervals, and P-values.

Results

rs1801018 of the BCL2 gene was not associated with the development of PTC. In the clinicopathologic features, rs1801018 SNP was associated with the number and location. The G allele frequency of rs1801018 in PTC patients with multifocality (13.3%) was about four-fold higher than that in PTC patients with unifocality (3.4%). The G allele frequency of rs1801018 in PTC patients with both lobes (15.4%) was increased by about five-fold, compared to PTC patients with one lobe (3.2%).

Conclusion

The results suggest that synonymous SNP rs1801018 and the G allele of the BCL2 gene may be associated with the multifocality and bilaterality of PTC in Korean population.     

乙酰肝素酶和D2-40在儿童甲状腺癌中的表达及临床意义

目的 探讨乙酰肝素酶(Hpa)和D2-40在儿童甲状腺癌(年龄≤18岁)中的表达及临床意义。 方法 采用免疫组化SP法检测儿童甲状腺癌与成人甲状腺癌中Hpa和D2-40的表达情况。 结果 Hpa和D2-40在儿童甲状腺癌及成人甲状腺癌中均呈高表达,且两种蛋白在儿童甲状腺癌中的表达均与淋巴结转移程度密切相关,其中Hpa的表达还与肿瘤组织类型有关,但与年龄、性别和是否侵犯包膜无关。 结论 Hpa和D2-40在儿童甲状腺癌中高表达,且与淋巴结转移密切相关,因此可作为儿童甲状腺癌患者生物学特征的指标。     

D2-40标记微淋巴管密度和血管内皮生长因子D在喉癌中的表达及临床意义

目的研究单克隆抗体D2-40标记的微淋巴管密度（lymphatic microvessel density,LMVD）和血管内皮生长因子D（VEGF-D）在喉鳞状细胞癌（简称喉癌）及癌旁组织中的表达情况,探讨两者与喉癌的发生、发展和淋巴结转移的关系及临床意义。方法选择46例喉癌患者手术切除标本,14例癌旁组织标本。采用免疫组化SP法,观察VEGF-D和LMVD在喉癌及癌旁组织中的表达情况,并结合相关临床病理参数进行分析。结果 VEGF-D在喉癌组织中的阳性表达率为73.9%,高于癌旁组织的表达率14.3%,差异有统计学意义（P〈0.05）。VEGF-D的表达与临床分期、病理分级、淋巴结转移有关（P〈0.05）,LMVD则与肿瘤的原发部位、临床分期、淋巴结转移有关（P〈0.05）。生存分析显示VEGF-D阳性表达和阴性表达与患者生存率差异有统计学意义（P〈0.05）。结论 VEGF-D和LMVD在喉癌组织中的表达均增高,VEGF-D促进喉癌组织中LMVD的生成,两者在喉癌的发生发展及淋巴结转移中可能起重要作用。     

The Effect of Simvastatin on mRNA Expression of Transforming Growth Factor-[H,Bone Morphogenetic Protein-2 and Vascular Endothelial Growth Factor in Tooth Extraction Socket

Aim To determine the effect of local simvastatin application on the mRNA expression level of transforming growth factor-β1 （TGF-β1）, bone morphogenetic protein-2 （BMP-2） and vascular endothelial growth factor （VEGF） in the tooth sockets of rat. Methodology Forty-eight male Wistar rats were randomly divided into experimental and control groups （n=24）. Polylactic acid/polyglycolic acid copolymer carriers, with or without simvastatin, were implanted into extraction sockets of right mandibular incisors. The expression of TGF-β1, BMP-2 and VEGF mRNA was determined by in situ hybridization in the tooth extraction socket at five days, one week, two weeks and four weeks after implantation. Results The fusiform stroma cells in the tooth extraction socket began to express TGF-β1, BMP-2 and VEGF mRNA in both experimental and control groups from one week after tooth extraction until the end of experiment. The expression of TGF-131 and BMP-2 mRNA in the experimental group was significantly up-regulated after one, two and four weeks, and expression of VEGF mRNA was significantly increased after one and two weeks compared with that in the control group. Conclusion The findings indicate that local administration of simvastatin can influence alveolar bone remodeling by regulating the expression of a school of growth factors which are crucial to osteogenesis in the tooth extraction socket.