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Background: Papillary thyroid carcinoma (PTC) is the most prevalent cancer type in the endocrine system. Metastases to parapharyngeal lymph nodes (PPLNs) are rare. Herein, we reported a case series of PTC patients with PPLN metastases operated on by using the minimally invasive video-assisted (MIVA) technique to evaluate the safety and effectiveness of this technique. Method: In this single-institutional study, six consecutive PTC patients with PPLN metastases between January 2012 and July 2018 were enrolled. All PPLNs were managed by the MIVA technique. Result: Six patients (three women and three men) who underwent surgery were enrolled in the current study. The median age of patients was 40.5 years (39-66). Five patients (83.3%) were diagnosed with primary PTC with PPLN metastases, and one patient had PTC recurrence in the PPLNs 17 years after her first PTC surgery. Surgical treatment was successful in all patients, and the median operative time and bleeding volume were 185 (100-280) min and 85 (30-120) ml, respectively. None of the patients experienced post-operative complications except for one patient who experienced dysphagia, which resolved within 3 months. During a median follow-up of 15 months (10-31), none of the patients exhibited recurrence or persistent disease. Conclusion: The MIVA transcervical approach was technically feasible and reliable, with less invasiveness for PTC patients with PPLN metastases. Future studies are needed to accumulate more experience, investigate the indications of the technique, and determine the long-term oncological safety.
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BACKGROUND: To investigate the clinicopathologic characteristics and prognostic factors of trichilemmal carcinoma (TC), and to determine an optimal treatment strategy for these patients. METHODS: This retrospective study enrolled consecutive patients who were admitted to the Sun Yat-sen University Cancer Center between 1998 and 2012. RESULTS: The key prognostic factors influencing the survival were lymph nodes metastasis and surgery margin. Multivariate analysis revealed that there was no risk factor for patient survival. CONCLUSIONS: Surgery margin and lymph nodes metastasis were prognostic factors that influenced the treatment outcome. Simple excision with 1 cm margins is safe, inexpensive and effective for the treatment of TC; and postoperative follow-up of the patient to facilitate early diagnosis of the recurrence and distant metastasis is necessary. Systemic chemotherapy should be considered for the distance metastases patients.
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This study evaluated the predictive value of the preoperative albumin/globulin ratio (AGR) in laryngeal squamous cell carcinoma (LSCC) retrospectively, which has not been reported before. The current study enrolled 241 newly diagnosed LSCC patients in the Second Affiliated Hospital of Nanchang University between January 2005 and December 2010. The optimal AGR cut-off value for overall survival (OS) was determined to be 1.28. Univariate survival analysis identified sex, low AGR, T classification, histological grade and nodal metastasis as factors associated with poor OS. Additionally, a low AGR, T classification, nodal metastasis, and histological grade were associated with poor disease-free survival (DFS) in LSCC patients. In multivariate survival analysis, nodal metastasis and a low AGR remained significant for OS and DFS. Our preliminary study revealed that low preoperative AGR could serve as a valuable and easily-assessed blood-based indicator to predict the prognosis of LSCC patients.
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Carcinoma de Células Escamosas/sangre , Carcinoma de Células Escamosas/mortalidad , Neoplasias Laríngeas/sangre , Neoplasias Laríngeas/mortalidad , Albúmina Sérica , Seroglobulinas , Adulto , Anciano , Biomarcadores de Tumor , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Terapia Combinada , Femenino , Humanos , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/cirugía , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Metástasis de la Neoplasia , Estadificación de Neoplasias , Periodo Preoperatorio , Pronóstico , Modelos de Riesgos Proporcionales , Curva ROCRESUMEN
BACKGROUND: Thymosin beta 10 (TMSB10) has recently been recognized as being an important player in the metastatic cascade including tumor angiogenesis, invasion, and metastasis. However, a role for this protein in papillary thyroid carcinoma (PTC) has not yet been established. METHODS: Real-time polymerase chain reaction was used to examine the expression of TMSB10 messenger RNA in 36 cases of thyroid tissue samples: normal thyroid, PTC without lymph node metastases (LNM) and PTC with LNM (n = 12 cases in each subgroup). For immunohistochemistry, 130 patients with PTC were selected during the period of 2004-2005, 91 with and 39 without LNM. Statistical analysis was applied to evaluate the correlation between TMSB10 expression and LNM of PTC. RESULTS: By real-time polymerase chain reaction analysis, the expression of TMSB10 messenger RNA in normal thyroid tissue, PTC without LNM, and PTC with LNM tissue were significantly different (P < 0.0001). On immunohistochemistry analysis of 130 patients with PTC, in which 91 cases had cervical LNM and 69 cases had central neck LNM, high expression levels for TMSB10 were more common in patients with cervical LNM compared with patients without (81% versus 33%, P < 0.001). Similarly, high expression levels of TMSB10 were more common in patients with central neck LNM compared with those without (87.0% versus 44.3%, P < 0.001). CONCLUSIONS: High expression levels of TMSB10 correlated with LNM in PTC, especially in the central neck region. Patients with PTC with low levels of TMSB10 expression may be unlikely to have central neck LNM and could therefore avoid prophylactic central neck dissection.
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Carcinoma , Regulación Neoplásica de la Expresión Génica , Ganglios Linfáticos/patología , Timosina/genética , Neoplasias de la Tiroides , Adolescente , Adulto , Biomarcadores de Tumor/genética , Biomarcadores de Tumor/metabolismo , Carcinoma/genética , Carcinoma/metabolismo , Carcinoma/secundario , Carcinoma Papilar , Femenino , Bocio Nodular/genética , Bocio Nodular/patología , Bocio Nodular/fisiopatología , Humanos , Ganglios Linfáticos/metabolismo , Metástasis Linfática , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , ARN Mensajero/metabolismo , Curva ROC , Reacción en Cadena en Tiempo Real de la Polimerasa , Timosina/metabolismo , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides/genética , Neoplasias de la Tiroides/metabolismo , Neoplasias de la Tiroides/secundario , Adulto JovenRESUMEN
BACKGROUND: The study was designed to explore the regular patterns of level V lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC), and to indicate whether level V should be included in the management of lateral neck dissection when treating PTC. METHODS: This retrospective study consisted of 330 patients diagnosed with PTC from January 1994 to July 2009 who underwent an operation that included therapeutic lateral neck dissection (levels II to V). The patterns of lateral neck LNM were analyzed and the relevant risk factors of level V LNM were analyzed with univariate and multivariate analysis, respectively. RESULTS: All the patients underwent lateral neck dissection at levels II to V. The predominant site of metastasis was level III (247/330 (74.8%)), followed by level IV (233/330 (70.6%)), and level II (215/330 (65.3%)). Simultaneous multilevel involvement (level II, III, and IV) of lymphatic metastases presented in 46.1% (152/330) of the cases. Level V showed 28.8% (95/330) of nodal metastasis. Multivariate analysis showed that level V LNM was significantly associated with location (whole thyroid), gross extrathyroidal extension and simultaneous multilevel involvement (level II, III and IV). (P <0.05). CONCLUSIONS: Due to relatively high rate of level V involvement and its correlation with location (whole thyroid), gross extrathyroidal extension and multilevel involvement, we consider that it may be more rational to include level V in the therapeutic lateral neck dissection when treating PTC, especially for those who have any one of these three independent risk factors.
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Carcinoma Papilar/patología , Escisión del Ganglio Linfático , Recurrencia Local de Neoplasia/patología , Neoplasias de la Tiroides/patología , Adolescente , Adulto , Anciano , Carcinoma Papilar/cirugía , Niño , Femenino , Estudios de Seguimiento , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/cirugía , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Adulto JovenRESUMEN
INTRODUCTION: This study aimed to evaluate the diagnostic value of Bub1 and Mad2 together in endometrial cancer. MATERIALS AND METHODS: Sixty-three patients with endometrial cancer, including EECs and NEECs, were examined statistically. Bub1 and Mad2 in patient tissues were detected by indirect streptavidin-biotin-peroxidase complex method. RESULTS: 39 cases (61.9 %) were in clinical stage I, 17 cases (27 %) in stage II, 5 (7.9 %) in stage III and 2 cases (3.2 %) in stage IV. Bub1 positive and Mad2 positive rate were identified in 18 and 54 patients. The lower positive of Bub1 and higher positive rate of Mad2 were related to clinical stage and histological grade of endometrial cancer (P = 0.009, 0.002, respectively), especially in NEECs. The expression of Bub1 was negatively correlated with Mad2 and Mtp53 (both P < 0.05). The expression of Mad2 with Mtp53 was positively correlated (P < 0.05). Statistically significant difference between Bub1/Mad2 expression and survival was discovered in endometrial cancer. Specificity and sensitivity of combination between Bub1 negative and Mad2 positive cases were higher than those alone in NEEC subtype. Bub1 and Mad2 are associated with histological differentiation, clinical stage and decreased postoperative survival in endometrial cancer. CONCLUSIONS: The combination analysis of Bub1 and Mad2 might be the valuable prognostic, even diagnostic clinicopathologic factor which can be applicable in routine examination.