Objective To explore the expression of chemokine receptor CCR7 in thyroid papillary microcarcinoma tissues and the relationship with clinicopathological features. Methods The CCR7 expressions in 31 cases of thyroid papillary microcarcinoma, 34 cases of thyroid papillary carcinoma which diameter＞1cm, 34 cases of nodular goiter, and 12 cases of thyroid papillary microcarcinoma contralateral normal thyroid tissues were detected by using immunohistochemistry S-P method. Results The expression positive rates of CCR7 in thyroid papillary microcarcinoma and papillary thyroid carcinoma which diameter＞ 1cm were both 100%, the difference had not statistically significant （P＞0.05）. In nodular goiter and normal thyroid tissues, the expression positive rate of CCR7 was 64.7% and 33.3%, respectively, and compared with thyroid papillary microcarcinoma, the difference had statistically significant （P＜0.05）. There were not relations between the expression of CCR7 and patient’s gender, age, capsule invasion, and lymph node metastasis （P＞0.05）. Conclusions The CCR7 in thyroid papillary microcarcinoma and thyroid papillary carcinoma which diameter＞ 1cm are both high expressions, and have the same bionomics, both prone to cervical lymph node meta-stasis, and the radical neck dissection （central area） are both need to take.
Objective The present study is to compare the quality of life and anxiety of patients with low-risk papillary thyroid microcarcinoma who received different managements to guide clinical therapy and nursing. Methods Thiswas a cohort study. Patients with low-risk papillary thyroid microcarcinoma were divided into observation group (puncture confirmed only) and surgery group (confirmed and surgery) according to their wishes, and patients’ survival quality and state of anxiety were compared by using Short-Form 36 Health Survey Scale (SF-36) and Hamilton Anxiety Scale (HAMA) between the 2 groups during the follow up period. Results There was no significant difference in physical component summary (PCS) score between the 2 groups and different observation time points (P>0.05). The mental component summary (MCS) scores and SF-36 scores of the observation group and the surgery group were different (P<0.05), and the MCS scores and SF-36 scores were different at different time points (P<0.05). The HAMA scores of patients in the observation group and the surgery group were different (P<0.001), and the change of HAMA scores in the observation group and the surgery group were different (P=0.004), but the HAMA scores at different time points were similar (P=0.152). Conclusion Surgery can effectively reduce the anxiety and improve the MCS score and quality of life.
Objective To explore the potential indicators of cervical lymph node metastasis in papillary thyroid microcarcinoma (PTMC) patients and to develop a nomogram model. Methods The clinicopathologic features of PTMC patients in the SEER database from 2004 to 2015 and PTMC patients who were admitted to the Center for Thyroid and Breast Surgery of Xuanwu Hospital from 2019 to 2020 were retrospectively analyzed. The records of SEER database were divided into training set and internal verification set according to 7∶3. The patients data of Xuanwu Hospital were used as the external verification set. Logistic regression and Lasso regression were used to analyze the potential indicators for cervical lymph node metastasis. A nomogram was developed and whose predictive value was verified in the internal and external validation sets. According to the preoperative ultrasound imaging characteristics, the risk scores for PTMC patients were further calculated. The consistency between the scores based on pathologic and ultrasound imaging characteristics was verified. Results The logistic regression analysis results illustrated that male, age<55 years old, tumor size, multifocality, and extrathyroidal extension were associated with cervical lymph node metastasis in PTMC patients (P<0.001). The C index of the nomogram was 0.722, and the calibration curve exhibited to be a fairly good consistency with the perfect prediction in any set. The ROC curve of risk score based on ultrasound characteristics for predicting lymph node metastasis in PTMC patients was 0.701 [95%CI was (0.637 4, 0.765 6)], which was consistent with the risk score based on pathological characteristics (Kappa value was 0.607, P<0.001). Conclusions The nomogram model for predicting the lymph node metastasis of PTMC patients shows a good predictive value, and the risk score based on the preoperative ultrasound imaging characteristics has good consistency with the risk score based on pathological characteristics.