Objective The objective of this study was to analyze the correlation between BRAF^(V600E) and TERT promoter mutations and papillary thyroid microcarcinoma (PTMC) risk factors, and their importance in the risk assessme...Objective The objective of this study was to analyze the correlation between BRAF^(V600E) and TERT promoter mutations and papillary thyroid microcarcinoma (PTMC) risk factors, and their importance in the risk assessment of papillary thyroid microcarcinoma.Methods This study retrospectively analyzed 107 cases of PTMC, which were diagnosed after the surgery in the department of head and neck surgery in Gansu Province Tumor Hospital from October 2014to June 2016. The mutations of BRAFV^(600E) and TERT promoter were detected by PCR direct sequencing.We analyzed the data usingχ~2 test and binary Logistic regression analysis.Results Among 107 patients with PTMC, the BRAFV^(600E) and TERT promoter mutation rates were 68.2%and 11.2%, respectively. Single factor analysis showed that there was a significant difference between the presence of membrane invasion, lymph node metastasis, and BRAFV^(600E) mutations (P<0.01). The age,gender, thyroid capsular invasion, poor pathologic subtype, and lymph node metastasis of patients, was significantly associated with the TERT promoter mutation (P<0.05) and the coexistence of the BRAF^(V600E)and TERT promotor mutations; although, there was a difference between the association of these factors with the TERT promoter mutation and the association of these factors with the coexistence of the BRAF^(V600E)and TERT promotor mutations. The multifactorial analysis showed that the factors closely related to the BRAFV^(600E) mutation included capsular invasion (P=0.012) and lymph node metastasis (P=0.000). The following factors were closely associated with the TERT promoter mutant:male (P=0.004), aged <45 years(P=0.026), capsular invasion (P=0.004), pathological subtype (P=0.030), and lymph node metastasis (P=0.043). The following factors were closely related to the simultaneous mutation of BRAFV^(600E) and TERT:male (P=0.022), capsular invasion (P=0.023), poor pathological subtype (P=0.041), and lymph node metastasis (P=0.030).Conclusion The risk of recurrence increases significantly when mutations in BRAFV^(600E) and TERT promoters occur simultaneously in PTMC and may have adverse outcomes. Combined detection of BRAFV^(600E) and TERT promoter mutations is of great value in risk assessment of PTMC.展开更多
Objective: The aim of our study was to evaluate the pathological features of posterior echo attenuation of papillary thyroid microcarcinoma (PTMC) and cystic degeneration of cervical lymph node metastasis. Methods: We...Objective: The aim of our study was to evaluate the pathological features of posterior echo attenuation of papillary thyroid microcarcinoma (PTMC) and cystic degeneration of cervical lymph node metastasis. Methods: We retrospectively evaluated the ultrasound results from 36 cases of PTMC with 20 nodules of cystic degeneration of cervical lymph node metastasis and correlated the results with the histopathologic findings. Results: The preliminary study indicated certain correlation between histopathologic findings and ultrasound results of posterior echo attenuation of papillary thyroid microcarcinoma and cystic degeneration of cervical lymph node metastasis. Conclusion: Posterior echo attenuation detected by ultrasound was associated with fibrous structures in PTMC nodules, while cystic degeneration and papillary changes of cervical lymph node metastasis in PTMC showed liquefactive necrosis, degenerative changes and enlarged follicular of nodular structures.展开更多
目的探讨甲状腺微小乳头状癌(PTMC)患者应用颈段喉返神经(RLN)顺行解剖切除手术的治疗效果及安全性,为临床诊疗提供依据。方法选取咸阳市第一人民医院2018年1月至2019年11月收治的100例PTMC患者作为研究对象,采用随机数表法分观察组和...目的探讨甲状腺微小乳头状癌(PTMC)患者应用颈段喉返神经(RLN)顺行解剖切除手术的治疗效果及安全性,为临床诊疗提供依据。方法选取咸阳市第一人民医院2018年1月至2019年11月收治的100例PTMC患者作为研究对象,采用随机数表法分观察组和对照组各50例。观察组患者采用RLN顺行解剖整块切除甲状腺叶和同侧中央区域淋巴结治疗,对照组患者先切除甲状腺叶再清除中央淋巴结治疗。术后比较两组患者的手术情况、并发症、术中中转发生情况和患者对手术的满意率。结果观察组和对照组患者的手术时间[(58.13±7.12) min vs(69.79±8.26) min]、引流时间[(2.51±0.41) d vs (3.26±0.62) d]、引流量[(29.13±3.10) mL vs (42.78±3.67) mL]和出血量[(31.02±3.22) mL vs (339.45±3.61) m L]比较,观察组明显短于或少于对照组,差异均有统计学意义(P<0.05);两组患者的淋巴结清扫数量及术中手术中转率比较差异均无统计学意义(P>0.05);两组患者术后均出现淋巴结转移、甲状旁腺损伤及声音嘶哑等并发症,但并发症总发生率比较差异无统计学意义(P>0.05);观察组患者对手术的满意率为92.0%,明显高于对照组的78.0%,差异有统计学意义(P<0.05)。结论颈段RLN顺行解剖手术用于治疗PTMC可较好的识别和保护颈段喉返神经,减少手术时间、引流量和出血量,值得在临床推广使用。展开更多
基金Supported by a grant from the Science and Technology Plan Projects of Lanzhou(No.2017-4-75)
文摘Objective The objective of this study was to analyze the correlation between BRAF^(V600E) and TERT promoter mutations and papillary thyroid microcarcinoma (PTMC) risk factors, and their importance in the risk assessment of papillary thyroid microcarcinoma.Methods This study retrospectively analyzed 107 cases of PTMC, which were diagnosed after the surgery in the department of head and neck surgery in Gansu Province Tumor Hospital from October 2014to June 2016. The mutations of BRAFV^(600E) and TERT promoter were detected by PCR direct sequencing.We analyzed the data usingχ~2 test and binary Logistic regression analysis.Results Among 107 patients with PTMC, the BRAFV^(600E) and TERT promoter mutation rates were 68.2%and 11.2%, respectively. Single factor analysis showed that there was a significant difference between the presence of membrane invasion, lymph node metastasis, and BRAFV^(600E) mutations (P<0.01). The age,gender, thyroid capsular invasion, poor pathologic subtype, and lymph node metastasis of patients, was significantly associated with the TERT promoter mutation (P<0.05) and the coexistence of the BRAF^(V600E)and TERT promotor mutations; although, there was a difference between the association of these factors with the TERT promoter mutation and the association of these factors with the coexistence of the BRAF^(V600E)and TERT promotor mutations. The multifactorial analysis showed that the factors closely related to the BRAFV^(600E) mutation included capsular invasion (P=0.012) and lymph node metastasis (P=0.000). The following factors were closely associated with the TERT promoter mutant:male (P=0.004), aged <45 years(P=0.026), capsular invasion (P=0.004), pathological subtype (P=0.030), and lymph node metastasis (P=0.043). The following factors were closely related to the simultaneous mutation of BRAFV^(600E) and TERT:male (P=0.022), capsular invasion (P=0.023), poor pathological subtype (P=0.041), and lymph node metastasis (P=0.030).Conclusion The risk of recurrence increases significantly when mutations in BRAFV^(600E) and TERT promoters occur simultaneously in PTMC and may have adverse outcomes. Combined detection of BRAFV^(600E) and TERT promoter mutations is of great value in risk assessment of PTMC.
文摘Objective: The aim of our study was to evaluate the pathological features of posterior echo attenuation of papillary thyroid microcarcinoma (PTMC) and cystic degeneration of cervical lymph node metastasis. Methods: We retrospectively evaluated the ultrasound results from 36 cases of PTMC with 20 nodules of cystic degeneration of cervical lymph node metastasis and correlated the results with the histopathologic findings. Results: The preliminary study indicated certain correlation between histopathologic findings and ultrasound results of posterior echo attenuation of papillary thyroid microcarcinoma and cystic degeneration of cervical lymph node metastasis. Conclusion: Posterior echo attenuation detected by ultrasound was associated with fibrous structures in PTMC nodules, while cystic degeneration and papillary changes of cervical lymph node metastasis in PTMC showed liquefactive necrosis, degenerative changes and enlarged follicular of nodular structures.
文摘目的探讨甲状腺微小乳头状癌(PTMC)患者应用颈段喉返神经(RLN)顺行解剖切除手术的治疗效果及安全性,为临床诊疗提供依据。方法选取咸阳市第一人民医院2018年1月至2019年11月收治的100例PTMC患者作为研究对象,采用随机数表法分观察组和对照组各50例。观察组患者采用RLN顺行解剖整块切除甲状腺叶和同侧中央区域淋巴结治疗,对照组患者先切除甲状腺叶再清除中央淋巴结治疗。术后比较两组患者的手术情况、并发症、术中中转发生情况和患者对手术的满意率。结果观察组和对照组患者的手术时间[(58.13±7.12) min vs(69.79±8.26) min]、引流时间[(2.51±0.41) d vs (3.26±0.62) d]、引流量[(29.13±3.10) mL vs (42.78±3.67) mL]和出血量[(31.02±3.22) mL vs (339.45±3.61) m L]比较,观察组明显短于或少于对照组,差异均有统计学意义(P<0.05);两组患者的淋巴结清扫数量及术中手术中转率比较差异均无统计学意义(P>0.05);两组患者术后均出现淋巴结转移、甲状旁腺损伤及声音嘶哑等并发症,但并发症总发生率比较差异无统计学意义(P>0.05);观察组患者对手术的满意率为92.0%,明显高于对照组的78.0%,差异有统计学意义(P<0.05)。结论颈段RLN顺行解剖手术用于治疗PTMC可较好的识别和保护颈段喉返神经,减少手术时间、引流量和出血量,值得在临床推广使用。
