甲状腺动态显象鉴别良恶性肿瘤的价值

报告甲状腺动态显象鉴别良恶性肿瘤60例的结果，并经病理证实。从肘静脉“弹丸”式注入^99mTCO4^-，以帧／2s速度摄片20帧为动态显象，20min后再做静态显象。冷（凉）结节与温结节56例，诊断为良性者51例，恶性者5例，均与病理对照一致，热结节4例均为良性，亦与病理对照一致。实践证明本法可用于甲状腺良恶性肿瘤的鉴别诊断。     

Morphological and physiological characteristics of lymph nodes,thyroid gland,and testes of rats during stress-induced adaptation and activation

Laboratory for the Search for New Antitumor Agents and Laboratory of Biophysics of Cancer, Oncologic Research Institute, Ministry of Health of the RSFSR, Rostov-on-Don. (Presented by Academician of the Academy of Medical Sciences of the USSR N. V. Vasil'ev.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 108, No. 11, pp. 634–637, November, 1989.     

抗人甲状腺素单克隆抗体的制备及其初步的临床应用

本文用甲状腺素(T_4)甲酯—BSA抗原免疫BALB/C小鼠,获得4株分泌抗人甲状腺素单克隆抗体的杂交瘤细胞系。亚类鉴定均属IgG_1型。将单克隆抗体应用在放射免疫分析(RIA)中,取代多克隆抗体,证实其在甲状腺疾病诊断中,甲状腺机能亢进的诊断符合率高于多克隆抗体,显示其特异性强、灵敏度高、亲和力好(亲和常数K=1.26x10~(10)L/M)、反应平衡时间短等优点。     

IgG heavy-chain subclass restriction of thyrotropin-binding inhibitory immunoglobulins in Graves'' disease

The IgG subclass composition of antibodies is an important determinant of their function. Thyrotropin receptor antibodies cause the hyperthyroidism of Graves' disease but their subclass distribution has been incompletely investigated. We have therefore purified IgG subclasses from Graves' sera by passage over affinity columns designed to deplete all but a single subclass, and then assayed those pure subclass fractions for their ability to displace radiolabelled thyrotropin from its solubilized receptor as a measure of thyrotropin receptor antibody activity. Sufficient activity was recovered for analysis in nine of 10 Graves' patients, in five of whom activity was almost completely (97-100%) restricted to the IgG1 subclass; in the remaining four patients the response was predominantly IgG1 and IgG4 with marked under-representation of the IgG2 subclass. This contrasts with the unrestricted subclass response, in the same fractions, for autoantibodies against thyroglobulin and microsomes. These results suggest that there may be a primary defect at the B-cell level in Graves' disease.     

2O例甲状腺髓样癌临床病理分析

目的探讨甲状髓样癌的临床病理、组化及免疫组化特点。方法对20例甲状腺髓样癌行常规检查、组化及免疫组化染色分析并文献复习。结果甲状腺髓样癌的癌组织主要以多角形及梭形细胞组成，可呈现多种组织学类型，其中巢状型12例（60％），束状／带状型4例（20％），其他类型4例（20％），免疫组化：降钙素、嗜铬素A均为（＋），17例神经特异性烯醇化酶（＋），18例癌胚抗原（＋），组织化学：刚果红染色（＋），结论甲状腺髓样癌的病理形态学特点、刚果红染色阳性及降钙素阳性是诊断的关键。     

Tissue harmonic imaging of thyroid nodules: initial experience.

OBJECTIVE: To determine the impact of tissue harmonic imaging on visualization of the thyroid and gray scale contrast between thyroid nodules and adjacent thyroid parenchyma. METHODS: A prospective study was performed on 144 patients (148 lesions) undergoing sonographically guided fine-needle biopsy. The fundamental frequency and tissue harmonic images were obtained on a scanner with a wideband 7.5-MHz linear probe. One hundred forty-two benign nodules, 2 papillary carcinomas, 1 anaplastic carcinoma, and 1 metastatic lesion were found. In 1 case a suggestion of a follicular carcinoma was raised, and in 1 case no diagnostic material was obtained. The gray scale intensity of the lesions and adjacent thyroid tissue was measured with graphics software, and the gray scale contrast between lesions and adjacent thyroid tissue was calculated. Additionally, the overall conspicuity and border definition were evaluated by 2 independent observers. RESULTS: Tissue harmonic imaging improved the gray scale contrast between thyroid nodules and adjacent thyroid parenchyma in 116 lesions (78.4%). The overall conspicuity and border definition were improved or equal in the harmonic mode for most lesions. CONCLUSIONS: The tissue harmonic imaging technique used as an adjunct to conventional thyroid sonography may improve lesion detectability and characterization.     

Hyalinizing trabecular tumor of the thyroid gland: characteristic features on ultrasonography

We report a case of hyalinizing trabecular tumor of the thyroid gland and describe the characteristic ultrasonographic features of this tumor. This was a rare tumor of follicular cell origin with a trabecular pattern of growth and marked intratrabecular hyalinization. The tumor had an irregular shape, a delicately jagged border, and hypoechoic and heterogeneous internal echoes on B-mode ultrasonography. Very rich intratumoral blood flow, the so-called “tumor inferno” was evident on power Doppler ultrasonography. In the clinical management of thyroid nodules, clinicians should be aware of this peculiar type of thyroid tumor and its characteristic ultrasonographic findings.     

细胞角蛋白 19 通过调控 MAPK 和 PTEN 通路促进甲状腺癌细胞 的增殖、 侵袭及转移

目的 探究细胞角蛋白 19 对甲状腺癌细胞生物学过程的影响及相关机制。 方法 将人甲状腺癌 细胞 (human thyroid cancer cells, B-CPAP) 作为研究对象, 使用不同浓度的角蛋白 19 处理细胞, 通过 MTT 实验、 细胞划痕实验和肿瘤细胞侵袭实验探究细胞角蛋白 19 对 B-CPAP 增殖、 侵袭及转移的影响。 最后通 过研究相关蛋白分析细胞角蛋白 19 对 B-CPAP 的作用机制。 结果 MTT 实验发现, 随着角蛋白 19 浓度升 高, 其对 B-CPAP 的增殖率也明显提高。 Transwell 实验发现, 与空白对照组比较, 角蛋白 19 处理后通过小 室的细胞数明显增加。 细胞划痕实验发现, 角蛋白 19 能够促进 B-CPAP 的迁移能力, 并且 B-CPAP 的迁移 能力与角蛋白 19 浓度呈正相关。 此外, 角蛋白 19 的这一作用与 PTEN 和 MAPK 通路有关。 结论 细胞角 蛋白 19 能够明显提高 B-CPAP 增殖、 侵袭以及转移的能力, 同时角蛋白 19 的这一作用与 PTEN 和 MAPK 通 路有关。     

Peripheral calcification in thyroid nodules: ultrasonographic features and prediction of malignancy.

OBJECTIVE: The purpose of this study was to investigate the association between peripheral calcification in thyroid nodules detected on ultrasonography and thyroid malignancy. METHODS: We retrospectively analyzed the ultrasonographic features of 65 pathologically proven thyroid lesions showing peripheral calcification for their correlation with histopathologic results. The following ultrasonographic parameters were assessed for each nodule: size (maximal dimension), shape (anteroposterior dimension/transverse dimension ratio), internal echogenicity (hypoechoic, isoechoic, hyperechoic, or invisible), halo sign (present or absent), type of calcification (stippled, curvilinear/smooth margin, or curvilinear/irregular margin), and extent of calcification (arc or rim). RESULTS: Twelve (18.5%) of 65 thyroid nodules with peripheral calcification were malignant, and 53 (81.5%) were benign. Patient demographics (age and sex) and ultrasonographic features of the nodules (size, shape, internal echogenicity, halo sign, and type and extent of calcification) did not show any significant differences between benign and malignant groups. CONCLUSIONS: The relatively high prevalence of malignancy and no reliable criterion for malignancy in thyroid nodules with peripheral calcification indicate that fine-needle aspiration or careful ultrasonographic follow-up may be warranted in these cases.     

Ultrasound thyroid elastography using carotid artery pulsation: preliminary study.

OBJECTIVE: The purpose of this study was to evaluate the feasibility of ultrasound thyroid elastography using carotid artery pulsation as the compression source and its potential for differential diagnosis of thyroid nodules. METHODS: Baseband sonographic data were acquired for 16 thyroid nodules from 12 patients. The natural pulsation of the carotid artery was used as the compression source, and thyroid strain was estimated offline. For quantitative assessment of thyroid tissue stiffness, a new metric called the thyroid stiffness index (TSI) was computed as the ratio of strain near the carotid artery (high-strain region) to that of a stiff region (low-strain region) inside a thyroid nodule. The stiffness information from elastography was correlated with histopathologic findings. RESULTS: The TSI for papillary carcinoma (n = 9) was higher than the TSI for a benign nodular goiter (n = 6), indicating that papillary carcinoma is stiffer than a benign nodular goiter (P < .05). In 1 patient, we were able to distinguish a papillary carcinoma nodule and a benign nodular goiter located in the same thyroid lobe based on the stiffness information obtained from elastography. This suggests that elastography could be used for guiding fine-needle aspiration biopsy to a thyroid nodule with a high probability of cancer. CONCLUSIONS: The results from this preliminary study indicate the feasibility of the pulsation-induced thyroid elastography. Ultrasound thyroid elastography using carotid artery pulsation appears to have the potential for noninvasively differentiating papillary carcinoma from benign nodular goiter. Future studies are needed to evaluate the efficacy of elastography in detecting thyroid cancer and guiding thyroid biopsies.