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41.
目的 探讨中国版甲状腺影像数据与报告系统(C-TIRADS)、BRAFV600E 基因检测及二者联合对细针穿刺细胞学难以定性的甲状腺结节的诊断价值。方法 纳入我院2020年1月—2021年4月的甲状腺手术患者53例行回顾性分析,术前完成超声、细针穿刺抽吸及BRAFV600E基因检测,选取细针穿刺细胞学难以定性的患者作为研究对象,53例患者共62个结节。以手术病理结果作为金标准,比较C-TIRADS、BRAFV600E基因检测及二者联合诊断对甲状腺结节的诊断效能。结果 C-TIRADS诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为92.50%、50.00%、77.08%、78.57%、77.42%。BRAFV600E基因诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为55.00%、100.00%、100.00%、55.00%、70.97%。C-TIRADS联合BRAFV600E基因诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为95.00%、50.00%、77.55%、84.62%、79.03%。C-TIRADS及联合诊断对甲状腺癌诊断的敏感性高于BRAFV600E基因检测(P<0.001),BRAFV600E基因检测特异性及阳性预测值高于C-TIRADS及联合诊断(P<0.05)。C-TIRADS、BRAFV600E基因检测及联合诊断对甲状腺癌诊断的阴性预测值和准确性差异无统计学意义(P>0.05)。结论 C-TIRADS及BRAFV600E基因检测对于细胞学难以定性的甲状腺结节均有良好的诊断效能,术前联合应用可以更好地评估甲状腺结节 相似文献
42.
Page C Laude M Legars D Foulon P Strunski V 《Surgical and radiologic anatomy : SRA》2004,26(3):182-185
This surgical anatomy study aimed to evaluate the possibility of identifying the external laryngeal nerve during thyroid surgery and the possible variations of nerves at risk. Fifty patients underwent total thyroidectomies during a period of 12 months. Using a neurostimulator, the distal motor branch of the external laryngeal nerve was searched. Electrical stimulation of a nervous branch aimed to provoke a global contraction of the cricothyroid in order to identify with certitude the external laryngeal nerve. The external laryngeal nerve was identified in 20% of cases. Its course was, with almost equal frequency, either (1) between the vessels of the superior thyroid pedicle or (2) superficial and anterior to the fascia of the cricothyroid muscle. The external laryngeal nerve is hard to find during thyroid surgery, even with a neurostimulator. It can be vulnerable during thyroid surgery but only in cases of anatomic variations. Searching for the nerve systematically during thyroid surgery does not seem to be useful. Several precautions when dissecting the superior pole of the thyroid gland seem to be necessary and sufficient to respect the external laryngeal nerve. 相似文献
43.
Schmid KW Bankfalvi A Mucke S Ofner D Riehemann K Schroder S Stucker A Totsch M Dockhorn-Dworniczak B 《Endocrine pathology》1996,7(2):121-130
Routinely processed tissues from a series of benign and malignant thyroid lesions were immunohistochemically investigated
with antibodies against p53 and mdm-2. p53 was immunolocalized in <10% of nuclei in 2/80 nodular goiters, 2/60 follicular
adenomas, 26/68 follicular carcinomas, 7/40 papillary carcinomas, 3/10 “insular” carcinomas, and 10/31 anaplastic carcinomas.
More than 10% positively stained nuclei were found in 2 widely invasive follicular, 2 insular, and 15 anaplastic carcinomas.
All p53-positive cases showed a concomitant immunohistochemical mdm-2 expression; an immunohistochemical colocalization on
serial section was demonstrated in 12 anaplastic carcinomas. Screening by polymerase chain reaction single-strand conformation
polymorphism (PCR-SSCP) analysis of these 12 cases revealed no relevant mutations in the coding regions of exons 2–11 of the
p53 gene. Additionally, 1 follicular adenoma, 6 follicular carcinomas (4 minimally and 2 widely invasive), 1 papillary, and
2 poorly differentiated insular carcinomas were mdm-2 positive without immunohistochemically detectable p53 expression. These
results provide evidence that wild-type p53 expression in thyroid carcinomas may be associated with mdm-2 induced formation
of stable complexes. However, the role of p53 mutations and p53 protein inactivation owing to other factors (e.g., mdm-2)
in the progression of thyroid carcinomas is still poorly understood. 相似文献
44.
甲状腺疾病患者血清可溶性白细胞介素2受体测定的临床意义 总被引:2,自引:0,他引:2
某些甲状腺疾病时血清可溶性白细胞介素2受体(sIL-2R)水平及其与游离甲状腺素(FT_4)、游离三碘甲腺原氨酸(FT_3)和促甲状腺素(TSH)水平的相关性比较。结果发现甲状腺机能亢进症(甲亢)未治疗组(A)及甲亢未治疗伴突眼组(D)血清sIL-2R明显升高;甲状腺机能减退症(甲减)经治疗甲状腺功能灭常组(G)sIL-2R明显高于甲减未治疗组(F);10例毒性弥漫性甲状腺肿(Graves病)患者经抗甲状腺药物治疗后sIL-2R明显降低;Graves病及甲减患者血清sIL-2R均与FT_3呈正相关。提示除自身免疫外,甲状腺素水平也是甲状腺疾病患者血清sIL-2R水平的重要调节因素。 相似文献
45.
自体甲状腺组织与干细胞移植治疗甲状腺功能减退症的研究进展 总被引:1,自引:0,他引:1
不可逆性甲减患者需要终身服用甲状腺激素,对患者的日常工作和生活造成了很大的不便。随着近年来对自体甲状腺组织与干细胞移植研究的进展,有望解决甲减病人终身服药这一问题。自体甲状腺组织移植的动物实验以及人体试验均表明:甲状腺移植物不但能够存活,而且能够发挥作用。最新的胚胎干细胞(Embryonic stemcell,ESC)研究证明,ESC可以分化为甲状腺滤泡细胞。 相似文献
46.
目的:探索全身炎症反应综合征(SIRS)患者的正常甲状腺病态综合征(ESS)的发生规律。 方法: 测定50例SIRS病人的总三碘甲状腺原氨酸(TT3)、总四碘甲状腺原氨酸(TT4)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺素(TSH),并根据是否多脏器功能障碍综合征(MODS)分组。计算急性生理和慢性健康评估Ⅱ(APACHEⅡ)评分,记录病人转归以及从发病到检测的时间(患病时间)。 结果: TT3或FT3降低的45例。TT3与APACHEⅡ评分呈对数负相关(r=-0.330,P<0.05),TT3/TT4与患病时间呈对数负相关(r=-0.316, P<0.05)。MODS组的TT3、TT4、FT3水平显著低于无MODS组(P<0.05)。 结论: SIRS和MODS病人发生低T3、低T4可能性大,反映炎症反应对甲状腺轴的影响,随着病情加重、患病时间延长,影响进一步深化。 相似文献
47.
48.
García-González M Abdulkader I Boquete AV Neo XM Forteza J Cameselle-Teijeiro J 《Virchows Archiv : an international journal of pathology》2005,447(1):12-17
This study was undertaken to investigate cyclooxygenase-2 (COX-2) expression in follicular cells of the human thyroid. COX-2 expression was studied immunohistochemically in a total of 174 samples. COX-2 immunoreactivity was confined to the cell cytoplasm with the nuclei remaining unlabelled. COX-2 expression was observed in five cases (17.2%) of normal follicular cells and in one case (16.6%) of solid cell nests. Follicular carcinoma expressed COX-2 more frequently than follicular adenoma (93.4% vs 21.1%) (p0.001). A higher percentage of cases of papillary microcarcinomas up-regulated COX-2 in comparison with all papillary carcinomas (p0.05). However, we could not establish any relationships among COX-2, patients ages or lymph node metastases in papillary carcinomas. COX-2 expression was found in 12 (92.3%) poorly differentiated carcinomas and in 13 (92.8%) undifferentiated carcinomas. We found that COX-2 is not always useful as a marker of malignancy. Our results suggest that COX-2 plays a role in progression of all thyroid carcinomas, but in papillary carcinomas, seems more important only in the early stages. COX-2 expression in the undifferentiated carcinoma deserves special consideration due to its prognosis and to the fact that selective COX-2 inhibitors were found to enhance tumour response to radiation in some studies. 相似文献
49.
Foulet-Rogé A Josselin N Guyetant S Gardet JJ Besancon A Saint-André JP Fabiani B 《Endocrine pathology》2002,13(3):227-233
We report a case of a 42-yr-old woman with Langerhans cell histiocytosis (LCH) confined to the thyroid and associated with
lymphocytic thyroiditis and a papillary microcarcinoma. This patient remains free of symptoms 14 mo after surgery. Thyroid
LCH is rare. In children, it usually occurs as part of a multisystemic disease, whereas it is usually exclusive in adults.
Isolated thyroid LCH is frequently associated with another thyroid disease, especially lymphocytic thyroiditis, suggesting
that it is a reactive process rather than a neoplastic proliferation. The prognosis of isolated thyroid LCH is good. However,
because it can rarely precede or reveal a multisystemic disease, additional investigations as well as a prolonged follow-up
are justified. 相似文献
50.
The presence of areas exhibiting a solid/trabecular pattern of growth within an otherwise differentiated thyroid carcinoma represents a source of controversy as regards its proper classification and biologic and prognostic significance. The aim of the current study was to investigate the ultrastructural features of solid/trabecular areas in differentiated thyroid carcinoma and to compare those features with the submicroscopic profile of differentiated, poorly differentiated (insular), and undifferentiated (anaplastic) variants of thyroid cancer. The study series included differentiated carcinoma with solid/trabecular areas (3 cases), conventional papillary carcinoma (4 cases), follicular variant of papillary carcinoma (4 cases), poorly differentiated (insular) carcinoma (3 cases), and undifferentiated (anaplastic) carcinoma (3 cases). It was found that the solid/trabecular areas in differentiated carcinoma and poorly differentiated (insular) carcinoma share similar ultrastructural features and overall retain, even if attenuated, many of the submicroscopic attributes of differentiated carcinomas. In particular, nests of neoplastic cells were observed showing a highly developed cytosecretory apparatus and the presence of numerous abortive/rudimentary follicles, and intercellular and intracellular (intracytoplasmic) lumina/canaliculi of variable morphology. The study supports the hypothesis that the solid/trabecular areas do not merely represent an architectural pattern but rather should be regarded as the expression of a process of reduced differentiation similar to that of poorly differentiated (insular) carcinoma. 相似文献