ObjectiveTo summarize potential related proteins in thyroid papillary carcinoma metastasis and explore its mechanism.MethodThe relevant literatures on the potential related proteins of papillary thyroid carcinoma metastasis at home and abroad were reviewed.ResultsThe previous studies had shown that many biological indicators might be associated with the metastasis of papillary thyroid carcinoma, such as the interleukin-13 receptor alpha 2, chemokine receptor 7, low-density lipoprotein receptor-related protein 4, cytokine receptor-like factor 1, Rho-related protein kinase 1, and astrocyte up-regulated gene-1 were involved in the proliferation, migration, and metastasis of papillary thyroid carcinoma, which might be the potential therapeutic target for the papillary thyroid carcinoma.ConclusionsThyroid papillary carcinoma metastasis-associated proteins play an important role in tumor metastasis. Some progress has been made in study of metastasis mechanisms, its role and mechanism in lymphatic metastasis should be further studied.
ObjectiveTo detect the expression of programmed cell death ligand 1 (PD-L1) in papillary thyroid carcinoma (PTC) and PTC with coexistent Hashimoto’s thyroiditis (HT) tissues, and to explore its clinical significance of its expression.MethodsThe PTC patients who underwent thyroidectomy at the Thyroid Surgery Department of the Affiliated Hospital of Guizhou Medical University from March 2017 to May 2019 were retrospectively collected. Immunohistochemical staining was used to detect the expression of PD-L1 in the PTC tissues, PD-L1 staining positive cells ≥20% was judged as positive expression, <20% was judged as negative expression. The relationship between PD-L1 positive expression rate and clinicopathologic characteristics of patients with PTC were analyzed, and the correlation between the presence of HT in PTC tissues and PD-L1 positive expression was studied.ResultsA total of 138 patients with PTC were included in this study, including 104 patients with PTC alone and 34 PTC patients with coexistent HT. The positive rate of PD-L1 expression in the 138 cases of PTC tissues was 35.5% (49/138), among which was 43.3% (45/104) in the pure PTC tissues, and 11.8% (4/34) in the PTC tissues with HT, the latter was significantly lower than the former (P=0.001). The results of univariate analysis showed that the positive rate of PD-L1 expression was related to the tumor size, the presence or absence of extraglandular invasion and HT in PTC patients (P<0.05), and the results of Spearman correlation analysis showed that the positive rate of PD-L1 expression was positively correlated with tumor size (rs=0.173, P=0.041) and extraglandular invasion (rs=0.197, P=0.021), and negatively correlated with whether TH was merged (rs=–0.284, P=0.001). The multivariate analysis results showed that the positive rate of PD-L1 expression was closely related to whether PTC with coexistent HT [OR=5.720, 95%CI (1.879, 17.411), P=0.002], and it was not found to be related to tumor size and presence of extraglandular invasion (P>0.05).ConclusionsPositive rate of PD-L1 expression has a certain relationship with tumor size and presence or absence of extraglandular invasion, and which in PTC patients with or without HT is significantly different, that is, positive rate of PD-L1 expression in PTC with HT is lower suggests that coexistent HT might be an inhibitory factor in occurrence of PTC, and immune microenvironment-related factors of PTC might be involved in occurrence and development of thyroid cancer.
Objective To analyze the expression differences of FoxP3 protein in papillary thyroid carcinoma (PTC) and nodular goiter, and to explore the correlation between FoxP3 and the clinicopathological characteristics of PTC patients and the therapeutic dose of 131I. Methods Immunohistochemical method was used to detect the expression of FoxP3 protein in 128 cases of PTC tissues (42 cases were treated with 131I after operation) and 20 cases of nodular thyroid tissues, and the relationship between it and the clinicopathological characteristics of PTC patients and the dose of 131I treatment was also analyzed. Results The positive rate of FoxP3 protein expression in PTC tissues was 46.09%, which was higher than that in nodular goiter tissues (0.00%), and the difference was statistically significant (P<0.001). The expression of FoxP3 protein in PTC was correlated with gender, extraglandular invasion and tumor diameter (P values were 0.041, 0.039, and 0.007, respectively), but had no correlation with age, capsular invasion, TNM staging, lymph node metastasis, and distant metastasis (P>0.05). The results of binary logistic regression analysis suggest that tumor diameter was an independent risk factor affecting FoxP3 protein expression [OR=0.389, 95%CI (0.180, 0.840), P=0.016]. By drawing the receiver operating characteristic (ROC) curve, it was shown that the area under the curve (AUC) was 0.643 when the tumor diameter was 1.05 cm, the sensitivity to predict the increase in FoxP3 protein expression was 64.41%, and the specificity was 57.97%, P=0.006. Among 42 patients with PTC who underwent 131I treatment after surgery, the therapeutic dose of 131I was related to the expression of FOXP3 protein (P=0.031). It was shown that patients with positive expression of FoxP3 protein were given more dose of 131I after surgery. Conclusions The positive rate of FoxP3 protein expression in PTC is higher than that of nodular goiter. Its high expression means that the patient has poor pathological characteristics and larger 131I treatment dose, suggesting that FoxP3 may be involved in the malignant progression of PTC.
Objective To investigate the function and survival of parathyroid tissue transplanted into the rectus of rat by different pre-treatment. Methods Male，adult Wistar rats （seventy）as donors and adult SD rats （thirty-five）as receptors. Model rats were established by resection of parathyroid and randomly divided into five groups （digital random method）：direct transplantation group， high-oxygen culture group， ciclosporin A （CsA） group， 60Co irradiated group， and integrated treatment group. Each receptor received four PTG from two donors and the PTG were transplanted into the rectus of the receptors. Changes in concentration of serum calcium and PTH at different time points before and after parathyroid transplantation in each group recipient rats were observed. Results Serum calcium and PTH could reach or remain normal level after thyroid tissue transplantation in all groups in 1 week after operation， which significantly differed from those of pre-transplanted （P＜0.01）. The survival time among the five groups were different： the duration for keeping serum calcium and PTH at normal level（only 3 week and 4 weeks）in direct transplantation group was shortest than that in high-oxygen culture group （5 weeks and 8 weeks）， CsA group （6 weeks and 8 weeks）， 60Co irradiated group （5 weeks and 7 weeks）, and integrated treatment group （5 weeks and 9 weeks）. Compared with direct transplantation group， the levels of serum calcium and PTH in high-oxygen culture group，CsA group，60Co irradiated group, and integrated treatment group were significantly higher in 4-9 weeks point （P＜0.05， except high-oxygen culture group in 9 weeks and 60Co irradiated group in 8 weeks after operation had no significant difference）. Compared with integrated treatment group， the levels of serum calcium and PTH in high-oxygen culture group，CsA group， and 60Co irradiated group were significantly lower in 7-9 weeks point （P＜0.05）. Conclusions PTG tissues transplanted in rectus can maintain serum calcium level at normal range，and measurement on graft or receptors can prolong the survival period of parathyroid graft. Tissue transplantation of parathyroid after culture may provide a potent way to cure hypothyroidism.
ObjectiveTo investigate relationship of long non-coding RNA FoxP4-AS1 expression with lymph node metastasis (LNM) of papillary thyroid carcinoma (PTC).MethodsReal time fluorescent quantitative polymerase chain reaction was used to detect the expression level of FoxP4-AS1 in 52 cases of PTC tissues and corresponding adjacent tissues, PTC cells (TPC-1, B-CPAP, K1), and normal thyroid follicular epithelial cells (Nthy-ori3-1). Univariate and multivariate analysis were used to identify the influencing factors of LNM in PTC. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of influencing factors of LNM in PTC.ResultsThe expression level of FoxP4-AS1 in the PTC tissues was significantly decreased as compared with the corresponding adjacent tissues (t=7.898, P<0.001), which in the different cells had statistical difference (F=29.866, P<0.001): expression levels in the TPC-1 and K1 cells were lower than Nthy-ori3-1 cells (P<0.05) and in the B-CPAP cells and Nthy-ori3-1 cells had no statistical difference (P>0.05) by multiple comparisons. Univariate analysis showed that the extraglandular invasion (χ2=4.205, P=0.040)and low expression of FoxP4-AS1 (χ2=7.144, P=0.008) were the influencing factors of LNM in PTC. Binary logistic regression analysis showed that extraglandular invasion [OR=9.455, 95%CI (1.120, 79.835), P=0.039] and low expression ofFoxP4-AS1[OR=5.437, 95%CI (1.488, 19.873), P=0.010] were risk factors for LNM of PTC. The area under the ROC curve ofFoxP4-AS1,extraglandular invasion alone, and combination of the two were 0.679, 0.656, and 0.785, respectively.ConclusionsFoxP4-AS1 is down-regulated in PTC. Low level of FoxP4-AS1 is a risk factor for LNM of PTC. Combined detection of expression level of FoxP4-AS1 and extraglandular invasion has a high predictive value for LNM of PTC.
Objective To analyze the expressions of galectin-3， human bone marrow endothelial cell-1 （HBME-1），cytokeratin （CK）19， and RET in benign and malignant thyroid tumor and to discuss their clinical significances. Methods The clinicopathologic and immunohistochemical staining data of 131 patients with benign and malignant thyroid tumor were analyzed retrospectively， including 45 patients with malignant thyroid tumor， 86 patients with benign thyroidtumor. The expressions of galectin-3， HBME-1， CK19， and RET in the benign and malignant thyroid tumor were detectedby immunohistochemical staining. Results The positive expression rates of the galectin-3， HBME-1， CK19， and RET in the malignant thyroid tumor were 97.8% （44/45）， 88.9% （40/45）， 100% （45/45）， and 71.1% （32/45）， respectively，which in the benign thyroid tumor were 9.3% （8/86）， 12.8% （11/86）， 37.2% （32/86）， and 8.1% （7/86）， respectively， the differences were statistically significant （P＜0.05）. The diagnostic sensitivity， specificity， and accordance rates were 97.8 %， 90.7%， and 93.1% for the galectin-3， respectively；88.9%， 87.2%， and 87.8% for the HBME-1， respec-tively；100%， 62.8%， and 75.6% for the CK19， respectively；71.1%， 91.9%， and 84.7% for the RET， respectively. Conclusions The expression levels of galectin-3， HBME-1， CK19， and RET in malignant thyroid tumor are significantly higher than those in benign thyroid tumor. Galectin-3， HBME-1， CK19， and RET can be important factors for identifying the benign and malignant tumor and their biological behaviors. Galectin-3 has a high reference value in the diagnosis of thyroid carcinoma.
Objective To explore the pattern and clinical influencing factors of cervical lymph node metastasis in papillary thyroid carcinoma （PTC）， and provide a basis for the choice of surgical approach for the PTC neck lymph node processing. Methods The clinical data of 98 patients with PTC treated in Affiliated Hospital of Guiyang Medical College from Jan. 2009 to Dec. 2011 were collected， and the pattern and clinical influencing factors of cervical lymph node metastasis were analyzed. Results Ninety eight consecutive patients underwent neck dissection in a total of 114 sides. The lymph node metastasis rate of cervical lymph node， districtⅥ， districtⅡ＋Ⅲ＋Ⅳ， and districtⅤwas 77.55% （76/98）， 74.49% （73/98）， 42.86% （42/98）， and 5.10% （5/98）， respectively. Results of univariate analysis showed that lymph node metastasis rates were higher in patients with diameter of tumor greater than 1 cm， tumor invaded thyroid capsule， multi-focal tumor， and old than 45 years （P＜0.05）. Results of multivariate analysis showed that the age of patients， diameter of tumor， tumor invaded thyroid capsule， and multifocal tumor were independent risk factors of cervical lymph node metastasis （P＜0.05）. Tumor invaded thyroid capsule， multifocal tumor， combined with districtⅥmetastasis， and combined with districtⅡ＋Ⅲ＋Ⅳ metastasis were independent risk factors of prelaryngeal lymph node metastasis （P＜0.05）. Tumor invaded thyroid capsule and multifocal tumor were independent risk factors of skip lymph node metastasis （P＜0.05）. Conclusions DistrictⅥ is found to be the predominant site for lymph node metastasis of PTC， the districtⅢ and the districtⅣinvolved in addition， so it is necessary to clean lymph nodes at districtⅥ routinely. The regularity of cervical lymph node metastasis can provide the basis for surgeon to choose a reasonable type of neck dissection.
Objective To summarize the diagnosis and treatment of Hashimoto thyroiditis （HT） coexistence withthyroid cancer （TC）. Methods One hundred and eighty-four patients with HT treated in The Affiliated Hospital of Guiyang Medical College from Jan. 2008 to Dec. 2011 were collected， and clinical data of 32 patients with TC of them were analyzed retrospectively. Results Thirty two patients combined with TC of the 184 patients with HT， and the incidence rate was 17.4%. All of the 32 patients were treated surgically according to the principle of surgery treatment for TC. Of the 32 cases of HT coexistence with TC， 15 patients were diagnosed by preoperative fine needle aspiration cytology （FNAC）， and the sensitivity of FNAC was 46.9% （15/32）. Twenty seven patients were diagnosed by intraop-erative frozen section pathological examination， and the sensitivity of it was 84.4% （27/32）， which was significantly higher than those of FNAC （χ2=7.563，P=0.004）. Thirty patients were diagnosed as papillary thyroid carcinoma （PTC）， and 2 patients were diagnosed as follicular thyroid carcinoma （FTC） by postoperative paraffin section pathological exam-ination and （or） immunohistochemistry， respectively. All patients were treated with levothyroxine （L-T4） after operation，and 5 patients were treatment with 131I therapy in addition. One patient suffered convulsion， and 2 patients suffered mild hoarsenessthere after operation. Only 29 patients were followed up for 3-49 months （average 35 months）， and during the followed up， there were no tumor recurrence， metastasis， and death. Conclusions The rate of preoperative diagnosis of HT coexistence with TC is low， and auxiliary examinations play an important role in diagnosis and guiding treatment. Surgery is the preferred treatment， but auxiliary therapies after surgery are indispensable too.
ObjectiveTo investigate the expression of tumor suppressor gene Tat interacting protein 30 (TIP30) gene in papillary thyroid carcinoma and it’s clinical significance in treatment of thyroid carcinoma. Methods Thirty cases of pathological specimens wax pieces of papillary thyroid carcinoma from 2003 to 2006 in our hospital were selected, in which there were 7 male, 23 female； and the age was from 15 to 70 years old, average 44.7 years. Six cases were nodular goiter with carcinomatous change in local area (papillary), 2 cases were thyroid capsular invasion. Distant lymph node metastasis and lesions surrounding the thyroid tissue were not confirmed by pathology. Every specimen was divided into tumor tissue and adjacent tissue (1-2 cm far away from tumor and non-cancerous tissue was confirmed by pathology). The expression of TIP30 in specimen was detected by immunohistochemical method with staining index and the average absorbance. ResultsTIP30 was expressed in the cell membrane and cytoplasm, which was showed as brown particles. ①Staining index: TIP30 in adjacent tissues was expressed highly with 21 (70.0%) positive cases (gt;2 points) and 9 (30.0%) negative cases (≤2 points), while its expression in cancer tissues was reduced or missed with 11 (36.7%) positive cases (gt;2 points) and 19 (63.3%) negative cases (≤2 points). There was a statistical difference between them (P＜0.05), and it was not related to age and gender of patients (Pgt;0.05). ②The average absorbance of TIP30 in cancer tissues was significantly lower than that in adjacent tissue (P＜0.05). ConclusionThe expression of TIP30 in papillary thyroid carcinoma is reduced or deleted, which can supply some theory support for its gene therapy.