BACKGROUND Esophageal cancer is one of the most common causes of cancer-related death.Some patients with esophageal cancer have distant metastases at the time of diagnosis,but metastasis to the thyroid gland(MTG)and m...BACKGROUND Esophageal cancer is one of the most common causes of cancer-related death.Some patients with esophageal cancer have distant metastases at the time of diagnosis,but metastasis to the thyroid gland(MTG)and multifocal thyroid lesions alone are extremely rare.CASE SUMMARY In this case report,we present a case of a 69-year-old male with esophageal MTG.The patient visited our hospital for a routine body check-up,which revealed multifocal nodules in his thyroid lobes and enlarged cervical lymph nodes.A fine needle aspiration biopsy showed malignancies in both thyroid lesions and lymph nodes.The patient was initially diagnosed with primary bilateral thyroid cancer that spread to his lymph nodes,and a total thyroidectomy was performed.The histology showed MTG and therefore,a diagnostic work-up was implemented to determine the primary tumor.A fluorine-18-deoxyglucose positron emission tomography scan showed that the lower part of the esophagus and the lymph nodes in the neck,chest,and abdomen were involved.An esophagogastroscopy and corresponding pathology revealed distal esophageal squamous cell carcinoma.The esophageal MTG diagnosis was confirmed with pathological immunohistochemistry.CONCLUSION This case report highlights the difficulty in diagnosing esophageal MTG.Patients may have no malignancy history and be asymptomatic.Further diagnostic procedures are necessary after MTG is confirmed by cytology or histology,and the final diagnosis should be made according to the identification of the primary malignancy combined with pathological immunohistochemistry findings.展开更多
AIM:To explore the prevalence of autoimmune gastritis in chronic hepatitis C virus (HCV) patients and the influence of α-interferon (IFN) treatment on autoimmune gastritis. METHODS:We performed a prospective study on...AIM:To explore the prevalence of autoimmune gastritis in chronic hepatitis C virus (HCV) patients and the influence of α-interferon (IFN) treatment on autoimmune gastritis. METHODS:We performed a prospective study on 189 patients with positive anti-HCV and viral RNA enrolled in a 12-month IFN protocol.We evaluated:a) the baseline prevalence of autoimmune gastritis,b) the impact of IFN treatment on development of biochemical signs of autoimmune gastritis (at 3,6 and 12 months),c) the evolution after IFN withdrawal (12 months) in terms of anti-gastric-parietal-cell antibodies (APCA),gastrin,anti-thyroid,and anti-non-organ- specific antibodies. RESULTS:APCA positivity and 3-fold gastrin levels were detected in 3 (1.6%) and 9 (5%) patients,respectively,at baseline,in 25 (13%) and 31 (16%) patients at the end of treatment (both P<0.001,vs baseline),and in 7 (4%) and 14 (7%) patients 12 months after withdrawal (P=0.002 and P=0.01 respectively,vs baseline;P=not significant vs end of treatment).The development of autoimmune gastritis was strictly associated with the presence of autoimmune thyroiditis (P=0.0001),no relationship was found with other markers of autoimmunity. CONCLUSION:In HCV patients,IFN frequently precipitates latent autoimmune gastritis,particularly in females.Following our 12-month protocol,the phenomenon generally regressed.Since APCA positivity and high gastrin levels are associated with the presence of antithyroid antibodies, development of autoimmune thyroiditis during IFN treatment may provide a surrogate preliminary indicator of possible autoimmune gastritis to limit the need for invasive examinations.展开更多
目的利用原子力显微镜(atomic force microscopy,AFM)观察并分析不同浓度碘化钠(0、10^(-3)、10^(-2)、10^(-1)、1μg/ml)作用下Graves病(graves' disease,GD)患者甲状腺上皮细胞膜表面纳米级形态学改变和差异,进而探讨碘在GD发病...目的利用原子力显微镜(atomic force microscopy,AFM)观察并分析不同浓度碘化钠(0、10^(-3)、10^(-2)、10^(-1)、1μg/ml)作用下Graves病(graves' disease,GD)患者甲状腺上皮细胞膜表面纳米级形态学改变和差异,进而探讨碘在GD发病中的可能机制。方法外科手术中取GD患者组织,加入不同浓度的NaI溶液进行体外甲状腺细胞培养,收集各浓度组细胞后利用AFM扫描并分析膜表面相关参数。结果 (1)NaI浓度在0、10^(-3)、10^(-2)μg/ml时,培养的甲状腺上皮细胞膜表面形态表现为高低不平的山峦样凸起,部分区域相互融合,个别区域凸起呈"屏风状"排列;而在10^(-1)μg/ml和1μg/ml浓度时,细胞膜表面的凸起明显减少,排列极不规则且呈扁平状,每个扫描范围内表面均较粗糙,个别区域发现空洞和"沟渠状"裂隙。(2)0μg/ml和10^(-3)μg/ml浓度组甲状腺细胞膜表面凸起的平均粗糙度、平均峰高度和表面积差值的参数分析比较无统计学意义(P>0.05),而10^(-2)、10^(-1)、1μg/ml浓度组甲状腺细胞膜表面蛋白的参数分析与0μg/ml和10^(-3)μg/ml浓度组相比较差异有统计学意义(P<0.01或P<0.05)。结论 AFM对高浓度碘作用下GD患者甲状腺细胞的观察,其形态学上产生损伤性改变,从纳米级水平揭示了高碘在GD发病机制中具有重要作用。展开更多
文摘BACKGROUND Esophageal cancer is one of the most common causes of cancer-related death.Some patients with esophageal cancer have distant metastases at the time of diagnosis,but metastasis to the thyroid gland(MTG)and multifocal thyroid lesions alone are extremely rare.CASE SUMMARY In this case report,we present a case of a 69-year-old male with esophageal MTG.The patient visited our hospital for a routine body check-up,which revealed multifocal nodules in his thyroid lobes and enlarged cervical lymph nodes.A fine needle aspiration biopsy showed malignancies in both thyroid lesions and lymph nodes.The patient was initially diagnosed with primary bilateral thyroid cancer that spread to his lymph nodes,and a total thyroidectomy was performed.The histology showed MTG and therefore,a diagnostic work-up was implemented to determine the primary tumor.A fluorine-18-deoxyglucose positron emission tomography scan showed that the lower part of the esophagus and the lymph nodes in the neck,chest,and abdomen were involved.An esophagogastroscopy and corresponding pathology revealed distal esophageal squamous cell carcinoma.The esophageal MTG diagnosis was confirmed with pathological immunohistochemistry.CONCLUSION This case report highlights the difficulty in diagnosing esophageal MTG.Patients may have no malignancy history and be asymptomatic.Further diagnostic procedures are necessary after MTG is confirmed by cytology or histology,and the final diagnosis should be made according to the identification of the primary malignancy combined with pathological immunohistochemistry findings.
文摘AIM:To explore the prevalence of autoimmune gastritis in chronic hepatitis C virus (HCV) patients and the influence of α-interferon (IFN) treatment on autoimmune gastritis. METHODS:We performed a prospective study on 189 patients with positive anti-HCV and viral RNA enrolled in a 12-month IFN protocol.We evaluated:a) the baseline prevalence of autoimmune gastritis,b) the impact of IFN treatment on development of biochemical signs of autoimmune gastritis (at 3,6 and 12 months),c) the evolution after IFN withdrawal (12 months) in terms of anti-gastric-parietal-cell antibodies (APCA),gastrin,anti-thyroid,and anti-non-organ- specific antibodies. RESULTS:APCA positivity and 3-fold gastrin levels were detected in 3 (1.6%) and 9 (5%) patients,respectively,at baseline,in 25 (13%) and 31 (16%) patients at the end of treatment (both P<0.001,vs baseline),and in 7 (4%) and 14 (7%) patients 12 months after withdrawal (P=0.002 and P=0.01 respectively,vs baseline;P=not significant vs end of treatment).The development of autoimmune gastritis was strictly associated with the presence of autoimmune thyroiditis (P=0.0001),no relationship was found with other markers of autoimmunity. CONCLUSION:In HCV patients,IFN frequently precipitates latent autoimmune gastritis,particularly in females.Following our 12-month protocol,the phenomenon generally regressed.Since APCA positivity and high gastrin levels are associated with the presence of antithyroid antibodies, development of autoimmune thyroiditis during IFN treatment may provide a surrogate preliminary indicator of possible autoimmune gastritis to limit the need for invasive examinations.
文摘1病例报告患者为女性,64岁,主因“左肾癌术后11余年,发现双侧甲状腺结节5余年”于2016年8月8日收入中日友好医院普外科二部。患者11余年前因左肾癌在中日友好医院行“左肾癌根治术、脾切除术”,术后病理为肾透明细胞癌（当时未行免疫组织化学检查）。5余年前患者常规复查时发现胰腺占位,后行“胰体尾切除术”,术后病理为肾透明细胞癌胰腺转移,同期患者甲状腺彩超发现甲状腺多发囊实性结节,左叶最大约2.0 cm×1.3 cm,
