【Abstract】Objective To study the relation between iodine and experimental autoimmune thyroiditis(EAT). Methods Establishment of animal model was performed with iodine and thyroglobulin(TG).The rats were randomly divided into 5 groups: normal control group(NC), low iodine group (LI,500 μg/L), high iodine group(HI,500 mg/L), TG+Freund adjuvant group(TG) and TG+Freund adjuvant+HI group(TG+HI). The rats in TG group and TG+HI group were rejected hypodermically with TG emulsified by complete Freund adjuvant, and strengthen immunity was conducted with TG emulsified by incomplete Freund adjuvant on 15 days. After that, strengthen immunity was done weekly till the end of the experiment. Serum TGAb and TPOAb were measured by radioimmunoassay. Observation of the pathological changes of thyroid gland was also done. Results Thyroid follicular destruction and lymphocytic infiltration in the TG+HI group (3.83±1.72) and HI group (3.00±0.89) were significantly higher than that of the NC group(0.67±0.82)，P＜0.05. The results of the TG group were higher compared with the NC group, but there were no significant differences between them（Pgt;0.05）. The levels of TGAb in the TG+HI (4.990±1.505)，HI (3.589±1.240) and TG group (4.883±1.198) were significant higher than those of the NC group (0.642±0.454) and the LI group (0.707±0.240)，P＜0.01. The levels of TPOAb in TG+HI group (1.475±0.523) and TG group (1.316±0.606) were significantly higher than those of the NC group (0.365±0.196) and the LI group（P＜0.01）. Serum TGAb and TPOAb levels were positively correlated with the histological grades of lymphocytic thyroiditis(r=0.9,P＜0.05）. Conclusion Excessive iodine intake may induce the occurrence of EAT. The induction of EAT with excessive iodine and TG may be more efficient.
From May 1982 to September 1994, 13 cases patients with acute suppurative thyroiditis were treated. Their ages ranged from 6 to 39 years with a mean of 13. 9 years (nine of them were children). In this group, 8 cases had a pre-existing thyroid mass. Correct diagnosis were made preoperatively in 11 cases and the other two were misdiagnosed before operation. Eleven patients underwent incision and drainge, amony them 6 cases had been followed up with no recurrence. Based on this result and re-viewing literatures, the author draw the conclusion that acute suppurative thyoiditis is related with fistula of pyriform fossa, incision and drainage must be carried out and if there is fistula present, fistulectomy should be performed.
摘要:目的: 探讨儿童慢性淋巴细胞性甲状腺炎的临床特点、诊断方法、治疗及预后。 方法 : 对77例CLT患儿的临床资料进行回顾性分析。 结果 : 77例CLT患儿男女比例1:67,平均年龄1021±233岁(5～15岁)。86％患儿有甲状腺肿大;初诊时表现甲亢患儿51例,甲低20例,甲功正常6例; TGAb阳性率的94％,TPOAb阳性率96％;1例甲状腺细针吸取细胞学检查诊断合并甲状腺乳头状癌。治疗随访1～39月,77例患儿中出现甲低37例。 结论 : 儿童CLT多见于青春期女性,儿童和青春期患者病初表现甲亢较成人多见,TGAb 和TPOAb是CLT诊断的重要指标,随着病程延长,表现甲低患儿比例逐渐增高。Abstract: Objective: To study the clinical feature, diagnosis, treatment and prognosis of Chronic lymphocytic thyroiditis in children. Methods : Analyze the clinical data of 77 children with Chronic lymphocytic thyroiditis. Results : The proportion of men to women was 1:67 in all 77 children, and the mean age at diagnosis was 1021±233(age range 5~15 years). The percentage of positive TGAb and TPOAb were 94% and 96%, respectively in all the 77 children. One children was diagnosed Chronic lymphocytic thyroiditis coexistent with thyroid papillary carcinoma by FNAB. There were 37 children had hypothyrodism in all the 77 after 1～39 months. Conclusion : CLT is more frequent in females, and at the time of diagnosis more children and adolescents had hypethyrodism than adults. TGAb and TPOAb are important markers for the diagnosis of CLT. The percentage of children had hypothyrodism is increasing along with the course of disease.
Objective To explore the expressions of galectin-3 （Gal-3） and cytokeratin-19 （CK-19） in different tissues of Hashimoto thyroiditis （HT） complicated with papillary thyroid microcarcinoma （PTMC）. Methods The tumor tissue， 0.5 cm near tumor tissue， and opposite lateral lobe thyroid tissue in 25 HT with benign nodus patients， 25 PTMC patients， and 25 HT with PTMC patients were collected. The expressions of Gal-3 and CK-19 in these tissues were detected by immunohistochemical methods. Results ①The positive rates of Gal-3 and CK-19 expressions in the tumor tissueof HT with PTMC patients and PTMC patients were significantly higher than those of HT with benign nodus patients （P＜0.05）.②The positive rates of Gal-3 and CK-19 expressions in the opposite lateral lobe thyroid tissue of HT with PTMC patients and HT with benign nodus patients were significantly higher than those of PTMC patients （P＜0.05）．③The positive rates of Gal-3 and CK-19 expressions in the 0.5 cm near tumor tissue of HT with PTMC patients and HT with benign nodus patients were significantly higher than those of PTMC patients （P＜0.05）. ④The middle and b positive rates of Gal-3 and CK-19 expressions in the 0.5 cm near tumor tissue of HT with PTMC patients were significantly higher than those of HT with benign nodus patients and the PTMC patients （P＜0.05）．Conclusions ①Gal-3 and CK-19 protein are helpful to differentiate the benign thyroid tumor and malignant one. ② The expressions of Gal-3 and CK-19 protein in patients with HT are clear higher than those in patients without HT that means the prognosis evaluation in HT canceration. ③ Gal-3 combined with CK-19 protein are help for early diagnosis， the pathogenesis and prognosis evaluation in thyroid cancer. The b positive means canceration. ④ In HT with PTMC， it needs an operation therapy and a larger one， which is appropriate for lateral and opposite lobe partial resection or total resection.
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.
Objective To summarize the relationship between IgG4 and IgG4 related thyroid diseases. Methods Domestic and international publications involving the pathological features of IgG4-related thyroid diseases and relationship with IgG4 were retrieved and reviewed. Results IgG4-related disease was a newly recognized class of chronic and systemic lymphocytes disease， which may be solitary or involving multiple body organs， as well as thyroid. The expression of IgG4 was found in leisons of Hashimoto thyroiditis， Riedel thyroiditis， and papillary thyroid carcinoma. Conclusions IgG4-related thyroid disease is a new concept of thyroiditis. The knowledge of this new disease will provide appropriate treatment for patients with thyroiditis.
ObjectiveTo investigate the structure, ligand, and tissue distribution of galectin-3, the relationship of galectin3 with tumor and the expression of galectin-3 in several thyroid diseases. MethodsRelated articles were reviewed. ResultsGalectin-3 was expressed in normal and tumor cell that regulated cell growth, differentiation, adhesion, apoptosis, and angiogenesis, which participated invasion and metastasis of tumor. ConclusionGalectin-3 may be used to discriminate benign and malignant thyroid tumor.
【Abstract】ObjectiveTo summarize the experience in diagnosis and treatment for chronic lymphocytic thyroiditis or complicated with other thyroid diseases． MethodsSeventyseven patients were diagnosed as chronic lymphocytic thyroiditis or complicated with other thyroid diseases by operation and histological examination at this department from November 2002 to March 2005. All their clinical records including general information, the results of careful physical examination， thyroid correlated hormone tests， color Doppler, fine needle aspiration cytological examination and some intraoperative examinations have been retrospectively analyzed in this report. ResultsThere were 53 cases of simple chronic lymphocytic thyroiditis, 10 cases complicated by papillary carcinoma， 1 case complicated by follicular carcinoma， 2 cases complicated by nonHodgkin’s lymphoma, 6 cases complicated by nodular goiter, 4 cases complicated by follicular adenoma, and 1 complicated by parathyroid adenoma. Almost all the operations were successfull and the symptoms of the diseases were alleviated. Seventytwo patients had been followed up ranging from two months to two years differently and none of them relapsed. Sixtythree of these patients have received thyrine inhibition and vicariousness treatment, 2 patients who complicated by nonHodgkin’s lymphoma had been hospitalized and 7 patients complicated by carcinoma were treated with iodine131. ConclusionThe clinical manifestations of chronic lymphocytic thyroiditis are complex, and it often complicated with other thyroid disease, which make it difficult to diagnose the diseases before operation. However, some ancillary methods such as careful physical examination， thyroid correlated hormone tests， color Doppler and fine needle aspiration cytological examination may improve the accuracy of preoperative diagnosis. Intraoperative thyroid lamellar section and frozen histological examination are also very important for intraoperative diagnosis and operative modality selection．
ObjectiveTo analyze clinical manifestation, diagnosis, therapy, and prognosis of primary thyroid lymphoma. MethodFrom April 2012 to September 2015, the clinical data of 9 patients with primary thyroid lymphoma admitted to The Affiliated Hospital of Xuzhou Medical College, including clinical manifestation, diagnosis procedure, treatment project, and prognosis, were reviewed retrospectively. ResultsThe thyroids or nodules of 4 patients increased rapidly in 1-3 months, with the surrounding tissues and organs oppression symptoms. The preoperative examination revealed that there were 5 patients with swollen lymph nodes. Eight patients were received preoperative thyroid function examination, there were 4 patients with subclinical hypothyroidism, 4 patients with rose TSH, 6 patients with rose thyroglobulin antibody. There were 5 cases of primary thyroid lymphoma associated with Hashimoto thyroiditis. Eight patients were underwent surgical treatment in our hospital, 1 patient was underwent surgery in the other hospital. The results of pathological histology showed that 5 patients with mucosa associated lymphadenoma were stageⅠE, 3 patients with diffuse large B cell lymphoma were stageⅠE, 1 patient with diffuse large B cell lymphoma was stageⅡE. Two patients with diffuse large B cell lymphoma were received chemotherapy, the scheme was CHOP and COP respectively. Seven patients were received follow-up, the follow-up time was 2-42 months, the median follow-up time was 20 months, all of them were survived. ConclusionsPrimary thyroid lymphoma should be considered for patients with rapid growth of thyroid mass in a short term, which relies on the histopathologic and immunohistochemical diagnosis finally. The individualized treatment should be performed for primary thyroid lymphoma according to pathological classification.
Objective To summarize research status of correlation of chronic lymphocytic thyroiditis (CLT) and papillary thyroid carcinoma (PTC), in order to provide a basis for early diagnosis, prognosis, and prevention of PTC. Method The literatures about the recent studies of the correlation of the CLT and PTC were reviewed according to the results searched from PubMed database, SpringerLink database, Web of Science database, Wanfang database, CNKI database, and VIP database. Results The most of patients with CLT combined with PTC are young women, the characteristics are multifocal and occult, the prognosis is good. Its genesis might be related to the ionizing radiation, iodine intake, endocrine disorders, immune disorders, molecular biology, and other factors. But there are still different controversies about its specific pathogenesis and surgical treatment. Conclusions CLT is closely related to PTC. However, relationship between CLT combined with PTC and changing regularity of molecular biology, pathogenesis, or prognosis needs further to be studied and followed-up for a longer-term.