Significance of VEGF and NF-κB Expression in Thyroid Carcinoma

OBJECTIVE To investigate the significance of vascular endothelial growth factor (VEGF) and nuclear factor-kappaB (NF-κB) expression in thyroid carcinoma.METHODS The expression of NF-κB and VEGF was determined by immunohistochemistry in formalin-fixed and paraffin-embedded specimens obtained from 10 normal thyroid tissues (NT), 12 cases of thyroid adenoma (TA) and 68 cases of thyroid carcinoma (TC).Differences in expression between NT, TA and TC were statistically analyzed. In addition, in cases of TC, the relationship of NF-κB and VEGF expression with various clinicopathological factors, including histological typing, clinical staging and lymph node metastasis, as well as the correlation between NF-κB and VEGF expression was examined.RESULTS In contrast to the negative immunoreactivity for VEGF in NT,there was a significantly higher positive incidence (PI) in TA (41.7%, P=0.040) and TC (75.0%, P＜0.001), and a significant difference between TA and TC (P=0.036). Immunoreactivity for NF-κB in NT was negative and significantly higher in TC (63.2%, P＜0.001),but not in TA (16.7%, P=0.481). However the PI difference between TA and TC (P=0.003) was significant. Between the histological types of TC, a significantly higher PI was found in undifferentiated thyroid carcinoma (UTC),namely, 100% for VEGF and 90.0% for NF-κB. We also found significant positive relationships of VEGF and NF-κB expression with the clinical stage and lymph node metastasis. Furthermore, a significant positive correlation between VEGF and NF-κB expression in TC was observed.CONCLUSION Our data showed that the expression of VEGF and NFκB/P65 was greater in TC and UTC, and documented their significant positive correlations with the clinical stage and lymph node metastasis in TC. In addition there was a significant positive relationship between their expression, suggesting that they have important roles in TC and that they may be potential targets for gene therapy in TC patients.     

Cutaneous nodes in a patient with advanced papillary carcinoma of the thyroid

Cutaneous metastasis from thyroid carcinoma is infrequent. Leukemia as a second malignancy after treatment of thyroid cancer is also rare. We present a patient with a relapsed thyroid carcinoma treated with thyroid ablation with I 131 and loco-regional radiotherapy, who consulted by global worsening, weight lost, and multiple cutaneous nodes. Our patient is unusual in that she showed multisystem involvement at the time of hospital admission, and the specific skin lesions were the first sign of her acute monocytic leukemia.     

自身免疫性甲状腺疾病的针吸细胞学诊断探讨

目的:探讨细针活检细胞学(FNAC)检查对自身免疫性甲状腺疾病(AITD)的诊断价值。方法:采用FNAC检查法诊断AITD,细胞学诊断把AITD分为弥漫性毒性甲状腺肿(GD)Ⅰ、Ⅱ、Ⅲ3个亚型和桥本氏甲状腺炎(HT)L、O、P、F4个亚型。结果:1106例甲状腺的FNAC资料中有术后病理诊断为AITD的58例,其中细胞学诊断正确55例(占94.8%),误诊者3例,(占5.2%)。诊断正确的55例中分型基本正确者51例(占92.7%)。结论:FNAC对AITD的诊断准确可靠。其中对GDⅠ、Ⅱ和HTO、P、F的分型诊断准确率较高,GD-Ⅲ与HT-L容易混淆。     

甲状腺弥漫性疾病的彩色多普勒超声诊断价值

目的:探讨甲状腺弥漫性疾病的超声显像特点及其诊断价值。方法:应用超声诊断技术对85例甲状腺弥漫性疾病患者及60例甲状腺正常人群进行检查,分析甲状腺弥漫性疾病的声像图特点和诊断依据。结果:异常组85例弥漫性甲状腺患者中结节性甲状腺肿28例,单纯甲状腺肿10例,桥本甲状腺炎19例,Graves病16例,亚急性甲状腺炎12例。结论:超声检查可以较准确的诊断甲状腺弥漫性疾病,为临床诊断及合理用药提供依据。     

甲状腺肿瘤手术中解剖喉返神经的意义

背景与目的：目前临床对甲状腺肿瘤手术是否常规显露喉返神经仍存在争议，我们探讨术中解剖喉返神经的方法及其利弊。方法：对手术治疗的甲状腺肿瘤患者456例进行回顾性分析，266例手术常规显露喉返神经，190例手术常规不显露喉返神经，采用解剖区域保护法行甲状腺次全切除术。结果：解剖喉返神经术式组无喉返神经损伤，不显露喉返神经术式者喉返神经损伤4例（暂时性喉返神经损伤3例，永久性喉返神经损伤1例）占2．1％。暂时性喉返神经损伤3例，其中1例因一侧肿瘤较大，2例因结节性甲状腺肿位于甲状腺后背侧造成损伤，永久性喉返神经损伤1例为肿瘤复发再次手术。结论：熟悉喉返神经的解剖和变异，行甲状腺切除术时解剖显露喉返神经可以降低喉返神经损伤的发生率。     

甲状腺乳头状癌与乳头状增生的病理研究

  目的 探讨Galectin3，CK19及Ki-67在甲状腺乳头状癌与乳头状增生中的表达，寻找有助于两者鉴别诊断的标志物。方法 运用免疫组化方法检测100例甲状腺乳头状癌、100例良性乳头状增生中Galectin3，CK19及Ki-67的表达。结果 Galectin3，CK19及Ki-67在甲状腺乳头状癌阳性表达率分别为100 %，97 %及93 %，而在乳头状增生中表达率分别为13 %，30 %及1 %，3种蛋白在乳头状癌与良性乳头状增生间差异有统计学意义（P＜0.05）。在乳头状癌中2种或3种蛋白同时阳性表达为94.3 %，而乳头状增生为0。结论 Galectin3，CK19及Ki-67是鉴别诊断甲状腺乳头状癌与乳头状增生的有用标志物，尤其联合使用更有价值。     

原发性双侧乳腺癌预后分析

目的探讨原发性双侧乳腺癌的预后。方法回顾了119例原发性双侧乳腺癌患者的临床病理资料。分析双侧乳腺癌的预后情况及年龄和月经因素对预后的影响。结果双侧乳腺癌占同期可手术乳腺癌的3．67％（119／3239）。双侧乳腺癌患者中位年龄46岁，双侧发病中位间隔时间为48个月。双侧癌发生间隔时间按24个月来划分同时性（43／119）和异时性乳腺癌。从第二侧原发肿瘤手术算起，中位随访48个月，单侧和双侧乳腺癌的总生存率（OS）差异无显著性，但后者的无病生存率（DFS）较低（P=0．0469）；同时性和异时性乳腺癌的DFS（P=0．5399）和OS（P=0．5829）的差异无显著性。单因素分析发现第二原发癌发病≤45岁、双侧均绝经前发病或分别绝经前后发病的患者预后较差；多因素分析发现第二原发癌发生年龄是独立预后因素。结论从第二原发肿瘤手术起随访，单侧和双侧乳腺癌的OS无显著差别，但后者DFS较差；同时性和异时性双侧乳腺癌的预后相似。第二原发癌发病年龄是双侧乳腺癌患者的重要预后指标。     

甲低功大鼠肝、肺、肾线粒体中α-磷酸甘油脱氢酶活性的变化

目的:观察甲状腺功能低下(甲低功)时大鼠肝、肺、肾线粒体中α-磷酸甘油脱氢酶(-αGPD)活性变化。方法:用0.5%N aC lO4饮水复制实验大鼠甲低功模型,分实验组(N aC lO4)和对照组(自来水)。肝、肺、肾线粒体制备按本室改进的Schne ider氏法,α-GPD测定采用L ee法。结果:实验组肝、肺、肾-αGPD活性明显低于对照组(P<0.01),甲状腺含碘量及血清T4含量明显低于对照组(P<0.01),TSH高于对照组。结论:实验组肝、肺、肾α-GPD酶活性明显下降,提示研究实验动物甲低功的同时应注意到靶器官的功能变化。     

Thyroid Lymphoma of Mucosa-Associated Lymphoid Tissue with Monoclonal Gammopathy Occurring in an Atomic Bomb Survivor: Report of a Case

(Received for publication on Dec. 14, 1998; accepted on July 13, 1999)     

甲状腺癌再手术临床分析

目的　探讨甲状腺癌再手术的原因 ,选择合理的手术方式。　方法　对 95例分化型甲状腺癌再手术的资料进行回顾性分析结合文献进行讨论。结果　 95例分化型甲状腺癌二次手术发现总的残癌率( 5 3/ 95 ) 5 5 .7% ,其中原发部位残癌率 ( 43/ 95 ) 4 2 .76 %。外院行甲状腺肿物局部切除和次全切除术喉返神经损伤发生率 ( 8/ 95 ) 8.4%。结论　甲状腺肿瘤手术应行甲状腺腺叶切除 ,术中强调喉返神经的解剖 ,疑有颈淋巴结转移 ,应行规范化的颈淋巴结清扫术。