Study on the Influencing Factors of Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma

Objective:To investigate the influencing factors of the cervical lymph node metastasis in papillary thyroid microcarcinoma(PTMC) and to provide a theoretical basis for cervical lymph node dissection.Methods:A total of 80 PTMC patients treated in the Department of Breast and Thyroid Surgery of our Hospital from January 2017 to January 2018 were selected in the study.All the patients accepted the first surgical treatment and were confirmed by pathology.The clinical data of all PTMC patients were retrospectively analyzed,and the related factors such as gender,age,number of primary lesions,tumor diameter and extrathyroidal invasions were analyzed.The factors that actually affected the lymph node metastasis of PTMC patients were explored.Results:All patients underwent prophylactic central lymph node dissection.Lymph node metastasis occurred in 26 patients in the central region and in 13 patients in the lateral neck region.The rate of lymph node metastasis in the central region of men was 41.18%,and the rate of lymph node metastasis in the lateral neck region was 23.53%,which were significantly higher than that of women's 30.16% and 14.29%.The differences were statistically significant(P0.05).The regional metastasis rate of the patients of ≤45 years was 45.83%,and the lateral neck region metastasis rate was 20.83%,which were significantly higher than those of patients45 years old(12.50%,9.38%) and the differences were statistically significant(P0.05).The lymph node metastasis rate in the central region and in the lateral neck region of tumor diameter 0.5 cm were 27.27%and 9.09% respectively,which were significantly lower than those of the tumor diameter0.5-1.0 cm(38.89%,25.00%)(P0.05).The rate of lymph node metastasis in the central region of single focus was 20.37%,which was significantly lower than that of57.69% in the multifocal lesions;the rate of lymph node metastasis in the cervical region of the single lesion was 11.11%,which was significantly lower than 26.92% in the multifocal area;the differences were statistically significant(P0.05).The metastasis rate of the patients with extrathyroidal invasions in the central area was 60.00%,which is significantly higher than that without extrathyroidal invasions(30.67%).About the tumor neck invasion of the lateral neck region,the lymph node metastasis rate of the patients with extrathyroidal invasions was 40.00%,which was significantly higher than that without extrathyroidal invasions(14.67%).The differences were statistically significant(P0.05).Logistic regression analysis showed that gender and tumor size were independent influencing factors of lymph node metastasis in the central and lateral neck regions(P0.05).Conclusion:Young,male,multifocal,tumor diameter 0.5-1.0 cm and extrathyroidal invasions are risk factors for cervical lymph node metastasis in patients with PTMC.Gender and tumor size are independent factors affecting central/lateral cervical lymph node metastasis in PTMC patients.     

Expression and significance of HIF-1α and VEGF-C in gastric carcinoma

Objective The present studies aimed at studying the expression and significance of HIF-1α and VEGF-C in gastric carcinoma. Methods SP method was used for the immunohistochemical detection of HIF-1α and VEGF-C proteins in paraffin embedded archival samples from 44 patients with gastric carcinoma and 20 normal gastric tissues. Results In 44 cases, the positive rate of HIF-1αwas 59.09%(26/44)and 23 cases 52. 27%(23/44)showed VEGF-C positive in cytoplasm and they were significantly higher than those in gastric normal tissue. The positive rate of HIF-1α in gastric cancer tissue expression with lymph node metastasis was higher than that without lymph node metastasis(72. 41% 21/29 vs 33.33 % 5/15;x2 = 6.25, P ＜ 0. 05).The positive rate of VEGF-C expression with lymph node metastasis and that without lymph node metastasis was 65. 52%(19/29)and 26. 67%(4/15)respectively(x2 = 4. 53, P ＜ 0. 05). The expression of HIF-1α and VEGF-C was closely correlated with lymph node metastasis and the depth of tumor invasion(x2 = 5. 14,P ＜ 0. 05, and x2 = 4. 38, P ＜ 0. 05), but no relationship with tumor position, sex and age. The positive expression of HIF-1α was consistent with the positive expression of VEGF-C. Conclusion The up regulated expression of HIF-1α and VEGF-C were observed in gastric cancer. The expression of HIF-1α and VEGF-C were correlated with lymph node metastasis and they were of some value for predicting prognosis of gastric carcinoma.     

Immunoexpression and prognostic role of p53 in different subtypes of epithelial ovarian carcinoma

We sought to investigate the significance of p53 expression for epithelial ovarian carcinoma.In this study,we used immunohistochemical method to investigate the expression patterns of p53 in different subtypes of epithelial ovarian carcinoma.We found that the expressions of p53 protein in epithelial ovarian cancer(pituita,serosity and intima) were 88.9%,75% and 100%,respectively,while the recurrence rates among three cancer subtypes were significantly different(33.3%,12.5% and 0%,respectively;P 0.05).Compared with patients without lymph node metastasis,the expression of p53 in patients with lymph node metastasis was significantly strong(68.75% and 100%,respectively;P 0.05).However,the recurrence rate in the patients with lymph node metastasis(40%) was higher than that without lymph node metastasis(6.25%,P 0.05).The expressions of p53 protein in ovarian cancer betweenⅠ-Ⅱ(25%) stage and Ⅱ-Ⅳ stage(100%) were significantly different(P 0.05),and the recurrence rates between the two groups were significantly different(0% and 31.25%,respectively,P 0.05).Therefore,p53 protein has an intimate relationship with the malignant degree and the prognosis of ovarian cancer.     

乳腺癌和乳腺导管内增生性病变Notch1基因甲基化的检测及临床意义

Objective To explore the relevance between the promoter methylation status of Notch1gene and the invasive ductal carcinoma and ductal hyperplastic lesions of the breast.Methods Methylation status of Notch1 gene in human breast invasive ductal carcinoma(IDC,n=89),ductal carcinoma in situ (DOS,n=20),atypical ductal hyperplasia(ADH,,n=11)and usual ductal hyperplasia(UDH,n=20)were quantitatively evaluated by MALDI-TOF MS.The expression of Notch1 protein was detected by immunohistochemical stain(SP method).Results Positive expression rates of Notch1 protein in IDC and DCIS were 91.0%(81/89)and 75.0%(15/20),respectively,which were significandy higller than those 0f ADH(4/11)and UDH(30.0%.6/20;P＜0.05).Notch1 protein expression was correlated significantly with lymph node metastasis,pathological grades and TNM stages of IDC.The mean methylation levels of Notch1 gene at CpG_3,CpC 4.5 and CpG_8 significantly decreased in IDC group compared with those of DCIS.ADH and UDH groups(P＜0.0083).In breast carcinomas, the mean methylation rates of Notch1 gene at CpG-4.5,CpG-10.11,and CpG_14.15.16 loci in cases with axillary node metastasis were significantly lower than those without axillary node metastasis(P＜0.05):and the methylation rates at CpG_14.15.16 and CpG_18 lociin stage Ⅰ were lower than that in stage Ⅱ,further lower than that in stage Ⅲ(P＜0.05);and that in CpG_1.2,CpG_12.13 loci in grade Ⅰ(highly-differentiated group)were higher than that in grade Ⅱ(moderate-differentiated group)and grade Ⅲ(peody-differentiated group) (P＜0.05);and the methylation rates at CpG_3,CpG_8 and CpG_14.15.16 loci in ER+ PR+ HER2-group were lower than that in ER-PR-HER2+ group(P＜0.05).Conclusions There is an overall hypomethylation of Notch1 gene in breast invasive ductal carcinomas with corresponding over-expression of Notehl protein.This inverse correlation show that the alteration of protein expression result from hypomethylation oncogene Notch1,and this change may have important significance in breast tumorigenesis and the development.Specific hypomethylation at CpG_3,CpG_4.5 and CpG_8 loci of Notehl gene may play a role in the pathogenesis of breast carcinoma,suggesting the progression and/or malignant transformation from benign glandular lesions of the breast.     

CD44+/CD24-细胞在乳腺癌组织及细胞系中的数量与分布

Objective To study the distribution and quantity of CD44VCD24- cells in breast cancer tissue and the cell lines,and as well as its correlation with the expression of various breast cancer markers and molecular subtyping of breast carcinoma.Methods The expression of CD44 / CD24,estrogen receptor,progesterone receptor,HER2,human estrogen-induced protein PS2,bcl-2 and nm23 in 60 cases of invasive ductal carcinoma of breast were studied by either single or double immunohistochemical staining.The co-expression of CD44 and CD24 in 3 breast cancer cell lines (MCF-7,MDA-MB-468,and MDA-MB- 231) was also examined.Results The quantity and distribution of CD44 + /CD24- cells varied greatly and no specific patterns were identified.The percentage of CD44 + /CD24- in breast cancer was 65%.The amount of CD44+/CD24- cells did not correlate with the age of patients,lymph node metastasis,tumor　 size,molecular subtypes and expression of various breast cancer markers in breast carcinoma.The proportion of CD44+/CD24- cells in MCF-7,MDA-MB-468,and MDA-MB-231 cell lines was < 1%,5% and > 80% ,respectively.Conclusions CD44+ /CD24- cells are demonstrated in certain breast cancer tissues and cell lines.However,there is no relationship obtained between the quantity or the distribution of these cells and the molecular subtyping or the clinicopathologic parameters in breast cancer.     

CD44+/CD24-细胞在乳腺癌组织及细胞系中的数量与分布

Objective To study the distribution and quantity of CD44VCD24- cells in breast cancer tissue and the cell lines,and as well as its correlation with the expression of various breast cancer markers and molecular subtyping of breast carcinoma.Methods The expression of CD44 / CD24,estrogen receptor,progesterone receptor,HER2,human estrogen-induced protein PS2,bcl-2 and nm23 in 60 cases of invasive ductal carcinoma of breast were studied by either single or double immunohistochemical staining.The co-expression of CD44 and CD24 in 3 breast cancer cell lines (MCF-7,MDA-MB-468,and MDA-MB- 231) was also examined.Results The quantity and distribution of CD44 + /CD24- cells varied greatly and no specific patterns were identified.The percentage of CD44 + /CD24- in breast cancer was 65%.The amount of CD44+/CD24- cells did not correlate with the age of patients,lymph node metastasis,tumor　 size,molecular subtypes and expression of various breast cancer markers in breast carcinoma.The proportion of CD44+/CD24- cells in MCF-7,MDA-MB-468,and MDA-MB-231 cell lines was < 1%,5% and > 80% ,respectively.Conclusions CD44+ /CD24- cells are demonstrated in certain breast cancer tissues and cell lines.However,there is no relationship obtained between the quantity or the distribution of these cells and the molecular subtyping or the clinicopathologic parameters in breast cancer.     

pT1期肺腺癌间质浸润的分级及预后意义

Objective To study the prognostic significance of grading system for stromal invasion in pathologic tumor stage Tl (pTl) adenocarcinoma of lung.Methods Eighty-five cases of surgically resected pTl lung adenocarcinoma with clinicopathologic and follow-up data were retrospectively reviewed.The degree of invasive growth was classified into three grades according to its location in the tumor.The clinicopathologic characteristics and prognostic significance were analyzed.Results Amongst the 85 cases studied,17 cases (20% ) were in grade 1,12 (14% ) in grade 2 and 56 (66% ) in grade 3.The tumor size was smaller and lymphovascular permeation was less frequently encountered in cases with grade 1 stromal invasion than in those with grade 3 (P =0.005 for tumor size and P =0.018 for occurrence of lymphovascular permeation).The rate of lymph node metastasis and pathologic staging in cases with grade 1 and grade 2 were similar and were significantly lower than those with grade 3 ( P = 0.007 for rate of lymph node metastasis in grade 1 versus grade 3 tumors,P = 0.002 for pathologic stage in grade 1 versus grade 3 tumors,P = 0.027 for rate of lymph node metastasis in grade 2 versus grade 3 tumors and P =0.021 for pathologic stage in grade 2 versus grade 3 tumors).There was no statistically significant difference with respect to age,gender and smoking history of the patients,amongst cases in different grades.The overall five-year survival rate was 63%.The five-year survival rates for cases with grade 1,grade 2 and grade 3 were 100% ,83.3% and 46.6% ,respectively.The difference between cases with grade 2 and grade 3 was statistically significant (P =0.027).The death rate during follow-up for cases with grade 1,grade 2 and grade 3 were 0,16.7% and 42.9% ,respectively.The difference between cases with grade 1 and grade 3 was statistically significant ( P - 0.001).Univariate analysis showed that grade of stromal invasion (P = 0.001),pathologic stage (P<0.001),presence of lymphovascular permeation (P < 0.001) and lymph node involvement　(P < 0.001) represented important prognostic factors.Multivariate analysis also showed that pathologic stage (P <0.001) was an independent prognostic factor.Conclusions The grading system of stromal invasion in pulmonary adenocarcinoma correlates with tumor prognosis and other prognostic factors.It represents a useful criterion in prognostic categorization of pTl adenocarcinoma of lung.     

pT1期肺腺癌间质浸润的分级及预后意义

Objective To study the prognostic significance of grading system for stromal invasion in pathologic tumor stage Tl (pTl) adenocarcinoma of lung.Methods Eighty-five cases of surgically resected pTl lung adenocarcinoma with clinicopathologic and follow-up data were retrospectively reviewed.The degree of invasive growth was classified into three grades according to its location in the tumor.The clinicopathologic characteristics and prognostic significance were analyzed.Results Amongst the 85 cases studied,17 cases (20% ) were in grade 1,12 (14% ) in grade 2 and 56 (66% ) in grade 3.The tumor size was smaller and lymphovascular permeation was less frequently encountered in cases with grade 1 stromal invasion than in those with grade 3 (P =0.005 for tumor size and P =0.018 for occurrence of lymphovascular permeation).The rate of lymph node metastasis and pathologic staging in cases with grade 1 and grade 2 were similar and were significantly lower than those with grade 3 ( P = 0.007 for rate of lymph node metastasis in grade 1 versus grade 3 tumors,P = 0.002 for pathologic stage in grade 1 versus grade 3 tumors,P = 0.027 for rate of lymph node metastasis in grade 2 versus grade 3 tumors and P =0.021 for pathologic stage in grade 2 versus grade 3 tumors).There was no statistically significant difference with respect to age,gender and smoking history of the patients,amongst cases in different grades.The overall five-year survival rate was 63%.The five-year survival rates for cases with grade 1,grade 2 and grade 3 were 100% ,83.3% and 46.6% ,respectively.The difference between cases with grade 2 and grade 3 was statistically significant (P =0.027).The death rate during follow-up for cases with grade 1,grade 2 and grade 3 were 0,16.7% and 42.9% ,respectively.The difference between cases with grade 1 and grade 3 was statistically significant ( P - 0.001).Univariate analysis showed that grade of stromal invasion (P = 0.001),pathologic stage (P<0.001),presence of lymphovascular permeation (P < 0.001) and lymph node involvement　(P < 0.001) represented important prognostic factors.Multivariate analysis also showed that pathologic stage (P <0.001) was an independent prognostic factor.Conclusions The grading system of stromal invasion in pulmonary adenocarcinoma correlates with tumor prognosis and other prognostic factors.It represents a useful criterion in prognostic categorization of pTl adenocarcinoma of lung.     

pT1期肺腺癌间质浸润的分级及预后意义

Objective To study the prognostic significance of grading system for stromal invasion in pathologic tumor stage Tl (pTl) adenocarcinoma of lung.Methods Eighty-five cases of surgically resected pTl lung adenocarcinoma with clinicopathologic and follow-up data were retrospectively reviewed.The degree of invasive growth was classified into three grades according to its location in the tumor.The clinicopathologic characteristics and prognostic significance were analyzed.Results Amongst the 85 cases studied,17 cases (20% ) were in grade 1,12 (14% ) in grade 2 and 56 (66% ) in grade 3.The tumor size was smaller and lymphovascular permeation was less frequently encountered in cases with grade 1 stromal invasion than in those with grade 3 (P =0.005 for tumor size and P =0.018 for occurrence of lymphovascular permeation).The rate of lymph node metastasis and pathologic staging in cases with grade 1 and grade 2 were similar and were significantly lower than those with grade 3 ( P = 0.007 for rate of lymph node metastasis in grade 1 versus grade 3 tumors,P = 0.002 for pathologic stage in grade 1 versus grade 3 tumors,P = 0.027 for rate of lymph node metastasis in grade 2 versus grade 3 tumors and P =0.021 for pathologic stage in grade 2 versus grade 3 tumors).There was no statistically significant difference with respect to age,gender and smoking history of the patients,amongst cases in different grades.The overall five-year survival rate was 63%.The five-year survival rates for cases with grade 1,grade 2 and grade 3 were 100% ,83.3% and 46.6% ,respectively.The difference between cases with grade 2 and grade 3 was statistically significant (P =0.027).The death rate during follow-up for cases with grade 1,grade 2 and grade 3 were 0,16.7% and 42.9% ,respectively.The difference between cases with grade 1 and grade 3 was statistically significant ( P - 0.001).Univariate analysis showed that grade of stromal invasion (P = 0.001),pathologic stage (P<0.001),presence of lymphovascular permeation (P < 0.001) and lymph node involvement　(P < 0.001) represented important prognostic factors.Multivariate analysis also showed that pathologic stage (P <0.001) was an independent prognostic factor.Conclusions The grading system of stromal invasion in pulmonary adenocarcinoma correlates with tumor prognosis and other prognostic factors.It represents a useful criterion in prognostic categorization of pTl adenocarcinoma of lung.     

pT1期肺腺癌间质浸润的分级及预后意义

Objective To study the prognostic significance of grading system for stromal invasion in pathologic tumor stage Tl (pTl) adenocarcinoma of lung.Methods Eighty-five cases of surgically resected pTl lung adenocarcinoma with clinicopathologic and follow-up data were retrospectively reviewed.The degree of invasive growth was classified into three grades according to its location in the tumor.The clinicopathologic characteristics and prognostic significance were analyzed.Results Amongst the 85 cases studied,17 cases (20% ) were in grade 1,12 (14% ) in grade 2 and 56 (66% ) in grade 3.The tumor size was smaller and lymphovascular permeation was less frequently encountered in cases with grade 1 stromal invasion than in those with grade 3 (P =0.005 for tumor size and P =0.018 for occurrence of lymphovascular permeation).The rate of lymph node metastasis and pathologic staging in cases with grade 1 and grade 2 were similar and were significantly lower than those with grade 3 ( P = 0.007 for rate of lymph node metastasis in grade 1 versus grade 3 tumors,P = 0.002 for pathologic stage in grade 1 versus grade 3 tumors,P = 0.027 for rate of lymph node metastasis in grade 2 versus grade 3 tumors and P =0.021 for pathologic stage in grade 2 versus grade 3 tumors).There was no statistically significant difference with respect to age,gender and smoking history of the patients,amongst cases in different grades.The overall five-year survival rate was 63%.The five-year survival rates for cases with grade 1,grade 2 and grade 3 were 100% ,83.3% and 46.6% ,respectively.The difference between cases with grade 2 and grade 3 was statistically significant (P =0.027).The death rate during follow-up for cases with grade 1,grade 2 and grade 3 were 0,16.7% and 42.9% ,respectively.The difference between cases with grade 1 and grade 3 was statistically significant ( P - 0.001).Univariate analysis showed that grade of stromal invasion (P = 0.001),pathologic stage (P<0.001),presence of lymphovascular permeation (P < 0.001) and lymph node involvement　(P < 0.001) represented important prognostic factors.Multivariate analysis also showed that pathologic stage (P <0.001) was an independent prognostic factor.Conclusions The grading system of stromal invasion in pulmonary adenocarcinoma correlates with tumor prognosis and other prognostic factors.It represents a useful criterion in prognostic categorization of pTl adenocarcinoma of lung.