简介：Althoughthyroidcarcinomaisarelativelycommonformofmalignancy,metastaticspreadtotheskullisrare.Here,wereportacaseofpapillarythyroidcarcinomawithfrontalandparietalmetastasis.A61-year-oldChinesewomanpresentedwithaoneyearhistoryofagrowingmassonthecenterofthefrontalandparietalbone,initiallythoughttobemeningioma.Biopsyoftheskullbasemassafterintracalvariumexcision,indicatedatumorofthyroidorigin.Onemonthlaterthepatientunderwentatotalthyroidectomy.Pathologicalexaminationconfirmedadiagnosisofpapillarythyroidcarcinomawithfrontalandparietalbonemetastasis.Basedonthisexperience,thekeytosuccessfulmanagementoftheskullmetastasisofthyroidcarcinomaispromptdiagnosisandappropriatetreatment.Skullmetastasisshouldbeconsideredattheoutsetoftheclinicalcourseofpapillarythyroidcancer.Tofacilitatethis,patientsshouldbemeticulouslyinvestigatedbyamultidisciplinaryteamtoimprovequalityoflife.

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简介：Objective:Differentiatedthyroidcarcinomas(DTCs)areclassifiedintopapillarythyroidcarcinoma(PTC)andfollicularthyroidcarcinoma(FTC).DTCsareanalyzedasasinglegroupinclinicalstudiesthatinvestigatedtheprognosticfactorsandprognosisofthesemalignancies.However,thebiologicalbehaviorsofthesecarcinomassignificantlydiffer.Inthepresentstudy,weaimedtodetectdifferencesintheoutcomesbetweenPTCandFTCinMansouraUniversityHospitalinEgypt.Methods:Atotalof558patientswithhistologicallyproventhyroidcarcinomasfromJanuary2003toDecember2012wereretrospectivelyenrolled.Theclinicalandpathologicaldataofpatientswerereviewed.Results:Largeprimarytumorsize,lymphnodeinvolvement,extrathyroidextension,anddistantmetastasisweresignificantpoorprognosticfactorsforoverallsurvival(OS)inoldPTCpatients.Coxhazardanalysisshowedthatthepatient'sage,extrathyroidextension,anddistantmetastasisweretheonlyindependentprognosticfactors.InFTCpatients,onlythedistantmetastasisanddegreeoftumorinvasionweresignificantpoorprognosticfactorsinOSunivariateanalysis.However,thesefactorswerenonsignificantinmultivariateanalysis.The10-yearOSrateswere97%and89%forPTCandFTC,respectively(P=0.003).The10-yeardisease-freesurvival(DFS)rateswere77.2%inPTCvs.65%inFTC(P=0.179).Conclusion:ThesignificantprognosticfactorsvarybetweenthetwotypesofDTCs.Therefore,PTCandFTCpatientsneedtobeanalyzedandreportedindependently.PTCsurvivaliswidelyandsignificantlyaffectedbyage,extrathyroidextension,anddistantmetastasis.Bycontrast,thesefactorswerenonsignificantinFTC,whichshowedpoorersurvivalthanPTC.

简介：AbstractBackground:Accumulating evidence has revealed that circulating microRNAs (miRNAs) can serve as non-invasive biomarkers for cancer diagnosis. This study aimed to identify differentially expressed miRNAs in serum which might become potential biomarkers for non-invasive diagnosis of papillary thyroid carcinoma (PTC).Methods:The experiment was carried out between 2015 and 2017. In the screening stage, the Exiqon miRNA quantitative real-time polymerase chain reaction (qPCR) panel was applied to select candidate miRNAs. In the following training, testing, and external validation stages, the serum samples of 100 patients and 96 healthy controls (HCs) were analyzed to compare the expression levels of the identified miRNAs. The areas under the receiver operating characteristic curves (AUCs) were calculated to assess the diagnostic value of the identified signature.Results:Three miRNAs (miR-25-3p, miR-296-5p, and miR-92a-3p) in serum were consistently up-regulated in PTC patients compared with HCs. A three-miRNA panel was constructed by logistic regression analysis and showed better diagnostic performance than a single miRNA for PTC detection. The AUCs of the panel were 0.727, 0.771, and 0.862 for the training, testing, and external validation stage, respectively. Meanwhile, the panel showed stable capability in differentiating PTC patients from patients with benign goiters, with an AUC as high as 0.969. For further exploration, the three identified miRNAs were analyzed in tissue samples (23 PTC vs. 23 HCs) and serum-derived exosomes samples (24 PTC vs. 24 HCs), and the altered expression in the tumor also indicated their close relationship with PTC disease.Conclusion:We identify a three-miRNA panel in serum which might serve as a promising biomarker for PTC diagnosis.

简介：AbstractObjective:To investigate the risk factors for lateral lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC).Methods:A retrospective analysis of 209 patients with PTC who underwent primary surgery at the Beijing Friendship Hospital affiliated with Capital Medical University from November 2014 to November 2018 was performed. The patients were divided into the LLNM group and the non-LLNM group. The clinical and pathological characteristics of the patients were analysed. The risk factors for LLNM were analysed by univariate and multivariate analyses.Results:The incidence of LLNM was 13.4% in PTC patients. Univariate analysis showed that the maximum diameter of the primary tumour > 2 cm (P < 0.001), bilateral primary tumour (P= 0.020), extrathyroidal extension (ETE) (P < 0.001), central lymph node metastasis (CLNM) (P < 0.001), and CLNM number ≥ 5 (P < 0.001) were significantly associated with LLNM. Multivariate logistic regression analysis showed that the maximum diameter of the primary tumour > 2 cm, ETE, and CLNM were independent risk factors for LLNM (OR values were 3.880, 5.202, and 4.474, respectively). There were 6 patients with skip lateral cervical lymph node metastasis, accounting for 21% of all LLNM patients.Conclusion:This study revealed several independent risk factors for predicting LLNM in PTC patients, such as the maximum diameter of the primary tumour > 2 cm, ETE and CLNM. Lateral neck dissection may be recommended in PTC patients with those risk factors. Paying attention to the occurrence of skip lateral cervical lymph node metastasis during the clinical diagnosis and treatment processes is necessary.

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简介：Theincidenceofpapillarythyroidcarcinoma(PTC)hasexponentiallyincreasedinrecentyears.Papillarythyroidmicrocarcinoma(PTMC)accountsforthemajorityofthereportedcasesofPTC.ThedebatesandcrucialissuesinPTMCmanagementhavereceivedresearchers'attention.TofurtherimprovetheclinicalmanagementofPTMCinChina,

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简介：Giventhehighincidenceofcervicallymphnodemetastasisindifferentiatedthyroidcancer(DTC)andtherapidlyincreasedimportanceofneckdissectioninDTC,thejournalofGlandSurgeryislaunchingaspecialissueon'NeckDissectioninDifferentiatedThyroidCarcinoma'inNovemberIssueof2013,

简介：Objective:BethesdaSystemforReportingThyroidCytopathology(BSRTC)categoriesⅠ,Ⅲ,andⅤaccountforasignificantproportionoffineneedleaspirationcytology(FNAC)diagnoses.ThisstudyaimedtocomparethediagnosticefficacyofBRAFV600EmutationandtheThyroidImagingReportingandDataSystem(TIRADS)classificationindifferentiatingpapillarythyroidcancers(PTCs)frombenignlesionsamongBSRTCI,III,andVnodules.Methods:Atotalof472patientswith479noduleswereenrolledinthisprospectivestudy.Ultrasound,BRAFV600Emutationtesting,andFNACwereperformedineachnodule,followedbysurgeryorregularultrasoundexamination.Results:IntheBSRTCIcategory,BRAFV600Eshowedsimilarsensitivity,higherspecificity,andloweraccuracywhencomparedwithTIRADS.IntheBSRTCIII/Vcategory,thesensitivity,specificity,andaccuracyofBRAFV600EweresimilartothoseofTIRADS.IncomparisontoBRAFV600Ealone,thecombinationofthetwomethodssignificantlyimprovedsensitivity(BSRTCⅠ:93.6%vs.67.7%,P<0.01;BSRTCⅢ:93.8%vs.75.0%,P<0.01;BSRTCV:96.0%vs.85.3%,P<0.001).WhencomparedwithTIRADSalone,thecombinationimprovedsensitivityinBSRTCⅠnodules(93.6%vs.74.2%,P<0.05),increasedsensitivityanddecreasedaccuracyinBSRTCIIInodules(93.8%vs.75.0%,P<0.01,91.0%vs.93.6%,P<0.01),andimprovedbothsensitivityandaccuracyinBSRTCVnodules(96.0%vs.82.0%,P<0.001;94.2%vs.81.3%,P<0.001).Conclusions:BRAFV600EexhibitedhigherspecificityandloweraccuracycomparedwithTIRADSinBSRTCⅠnodules,whilethetwomethodsshowedsimilardiagnosticvalueinBSRTCⅢ/Ⅴnodules.ThecombinationofthetwomethodsdistinctlyimprovedsensitivityinthediagnosisofPTCsinBSRTCⅠ,Ⅲ,andⅤnodules.

简介：Objective:ThepurposesofthisstudyweretoidentifyriskfactorsforcervicallymphnodemetastasisandtoexaminetheassociationbetweenBRAFV600Estatusandclinicalfeaturesinpapillarythyroidmicrocarcinoma(PTMC).Methods:Atotalof1,587patientswithPTMC,treatedinTianjinMedicalUniversityCancerInstituteandHospitalfromJanuary2011toMarch2013,underwentretrospectiveanalysis.Wereviewedandanalyzedfactorsincludingclinicalresults,pathologyrecords,ultrasoundresults,andBRAFV600Estatus.Results:Multivariatelogisticregressionanalysesdemonstratedthatgender(male)[oddsratio(OR)=1.845,P=0.000],age(<45years)(OR=1.606,P=0.000),tumorsize(>6mm)(OR=2.137,P=0.000),bilateralism(OR=2.011,P=0.000)andextrathyroidalextension(OR=1.555,P=0.001)servedasindependentpredictorsofcentrallymphnodemetastasis(CLNM).Moreover,CLNM(OR=29.354,P=0.000)servedasanindependentpredictoroflaterallymphnodemetastasis(LLNM).Amongpatientswithasolitaryprimarytumor,thosewithtumorlocationinthelowerthirdofthethyroidlobeortheisthmusweremorelikelytoexperienceCLNM(P<0.05).UnivariateanalysesindicatedthatCLNM,LLNM,extrathyroidalextension,andmultifocalitywerenotsignificantlyassociatedwithBRAFV600Emutation.Conclusions:ThepresentstudysuggestedthatprophylacticneckdissectionofthecentralcompartmentshouldbeconsideredinpatientswithPTMC,particularlyinmenwithtumorsizegreaterthan6mm,agelessthan45years,extrathyroidalextension,andtumorbilaterality.AmongpatientswithPTMC,BRAFV600Emutationisnotsignificantlyassociatedwithprognosticfactors.ForabetterunderstandingofsurgicalmanagementofPTMCandtheriskfactors,werecommendmulticenterresearchandlong-termfollow-up.

简介：对不完全的肠的阻塞的评估的主要诊断挑战是在传染、恶意的病原学之间区分。我们在场抱怨伴有恶心的腹的疼痛并且呕吐的一个老女人的一个案例，和到通行证气体或凳子的失败。反肺结核药被用来减轻她的腹的疼痛，并且腹洞的针活体检视显示出腹膜(PSCP)的主要的乳突的浆液的癌的证据。这是对在PSCP的背景的肺结核的稀罕描述。这份报告为恶意与风险因素说明恶意的潜在的复杂性质，并且强调需要在病人考虑恶意和感染的共存，特别在那些与抗菌素治疗失败。

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简介：Pheochromocytomaisatumorarisingfromneuroectodermalchromaffintissuesintheadrenalglandorextra-adrenalparaganglia(paragangliomas).Theprevalenceofthetumoris0.1%-0.6%inthehypertensivepopulation,ofwhich10%-20%aremalignant.Pheochromocytomaproduces,stores,andsecretescatecholamines,aswellasleadstohypertensivecrisis,arrhythmia,angina,andacutemyocardialinfarctionwithoutcoronaryarterydiseases.Wereportacaseofacutecoronarysyndrome(ACS)withafinaldiagnosisofmultipleendocrineneoplasiawithpheochromocytomaandmedullarythyroidcarcinoma(MTC).

简介：AbstractAlthough the natural history of recurrence/progression in patients with intraductal papillary mucinous neoplasms (IPMN) of the pancreas has not been studied thoroughly, the three principal mechanisms have been identified: (a) presence of residual disease at the transection margin, (b) presence of intraductal/intraparenchymal metastases and (c) development of new primary lesions. Mechanisms (a) and (b) result in metastatic lesions that are genetically related to the primary, while new primary lesions (mechanism c) are genetically distinct. Interestingly, recurrence/progression in IPMN displays conceptual parallels with the well-established paradigm of disease recurrence in patients with hepatocellular carcinoma (HCC). Specifically, patients with HCC may also develop recurrent tumors due to microscopic residual disease/intrahepatic metastasis which are genetically similar to the primary while the development of genetically unrelated, de novo HCC after curative-intent resection is also common. The latter has been attributed to the presence of a widespread genetic abnormality ( "field defect" ) in the liver (ie, cirrhosis). Given the conceptual similarities between IPMN and HCC, a pancreatic "field defect" may also be hypothesized to exist. This review does not suggest that HCC and IPMN have identical pathogeneses, but rather that they have conceptual similarities in tumor recurrence/progression; thus, lessons learned from HCC could be applied to IPMN research and subsequent management. Conceptual similarities in tumor progression and recurrence may also be observed between IPMN and other malignancies. However, HCC was selected because it is well studied and can serve as a paradigm.

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简介：AbstractBackground:Thermal ablation of thyroid nodules is new modality for the management of the benign and malign lesions. This minimally invasive treatment is performed as an outpatient, local anesthetic, single professional procedure that can treat neoplastic lesions without removing normal thyroid tissue and thus avoiding hypothyroidism.Method:A comprehensive review of the most relevant literature regarding the thermal ablation of benign and malign nodules was performed in order to currently define its role on the management of the nodular thyroid disease. The data was divided into benign and malign literature.Results:The benign nodules can be effectively treated by radiofrequency ablation (RFA) but some limitation exists regarding the nodule’s size but not nodules characteristics. The RFA of primary malign tumors of the thyroid recently demonstrated positive and safe long-term follow-up and encouraged additional investigation and possibly a definitive role in the management of these low risk nodules.Conclusion:RFA is a safe, cost-effective minimally invasive procedure that avoids thyroid tissue removal while destroying neoplastic one thus, preventing hypothyroidism.

简介：Inordertoevaluatetheinvolvementofthethyroidglandinreproduction,thyroidfunc-tioningwasdescribedinfemalecultivatedJapaneseeel(Anguillajaponica)inprogressivestagesofsex-ualmaturationinducedbychumsalmonpituitaryhomogenate(SPH)treatment.Serumthyroidhor-mones,thyroxine(T4)andtriiodothyronine(T3)werealsomeasuredineachstage.Thyroidglandac-tivity(epithelialcellheight)washighbeforeSPHinjection(previtellogenicstage),furtherincreasingattheearlyvitellogenicstage,thereafterdecreasingtolatevitellogenicandmigratorynucleusstages.TheprofilesofbothT3andT4changedduringvitellogenesis,beinghighduringprevitellogenicandearlyvitellogenicstages,andsubsequentlydeclining,thusmimickingthyroidglandactivity.Theseresultssuggestthatthethyroidhasrelationwitheelovariandevelopmentduringartificialmaturation.

简介：为了评估antithyroidantibodie层次，有甲状腺疾病的526个病人和292健康的意义，从Yuci使区域遭到，山西省，中国，被学习。浆液层次为甲状腺荷尔蒙受体抗体(TRAb)被决定，microsomal抗体(TMAb)和thyrogiobulin抗体(TGAb)。在病人之中，为榴状的甲状腺肿和甲状腺腺瘤，坟的疾病，和Hashimoto的甲状腺炎的百分比分别地是44.1%，19.6%和17.7%。到男性的女性的比率是2.0～15.6个.Antibody积极的病人因为TMAb，TGAb和TRAb为Hashimoto的甲状腺炎作为94.6%，76.3%和20.4%可检测，并且40.0%，30.0%和90.3%为格雷夫斯的疾病。为描绘疾病和forusingas的流行病学的基础在结论，在Hashimoto的甲状腺炎和自发的甲状腺机能减退的TGAb/TMAb的在坟的疾病的TRAb的高水平，和那些是有意义的为在单个病人的恶化的预示的指示物。

简介：AbstractLymph node metastasis is common in differentiated thyroid cancer especially papillary thyroid cancer. Presence of lymph node metastasis does not have an impact on survival in younger patients. Therapeutic central and lateral neck dissection in the presence of clinically or radiologically evident lymph nodes has resulted in good overall survival. However, disease persistence in the lymph node/early recurrences may be seen in patients owing to lymph nodes that may be missed during the initial neck dissection. These observed locations are retropharyngeal and parapharyngeal nodal location, retro carotid location, sublingual, axillary, and intraparotid locations, supraclavicular and superficial to the sternothyroid muscle. We aim to highlight these locations with the goal to minimize persistence or early recurrence of disease at these locations.