Purpose: Identification of novel biomarkers could benefit the clinical therapy and management of papillary thyroid carcinoma (PTC). Human endogenous retrovirus long terminal repeat-associating protein 2 (HHLA2) has been reported to play roles in the development of various cancers. The clinical significance and biological function of HHLA2 in PTC were investigated. Patients and Methods: The expression level of HHLA2 was evaluated in PTC tissues (from 107 PTC patients) and cell lines (TPC1, IHH-4, CGTH-W3, and MDA-T32 cells) by RT-qPCR. The clinical significance of HHLA2 was estimated with a series of statistical analyses. The biological function of HHLA2 was assessed with the CCK8 assay and transwell assay. Results: HHLA2 was upregulated in PTC compared with the normal samples and was associated with the positive lymph node metastasis and advanced TNM stage of PTC patients. HHLA2 was an independent prognostic factor associated with the poor survival of PTC patients. Additionally, HHLA2 functioned as a tumor promoter that enhanced the progression of PTC cells. Conclusion: HHLA2 could serve as a prognostic biomarker and tumor promoter in PTC, providing a novel therapeutic target of PTC.

Background: Papillary thyroid carcinoma (PTC) represents the most frequent subtype of thyroid cancer (TC) with poor prognosis mainly due to the severe invasion and metastasis. As an oncogene, microRNA-421 (miR-421) is involved in the development of various cancers. This study was to investigate the clinical significance of miR-421 in PTC and its effects on the biological function of PTC cells. Methods: The expression level of miR-421 in all tissues and PTC cell lines was measured by quantitative real-time polymerase chain reaction (qRT-PCR). Subsequently, the relationship between miR-421 expression and the clinicopathological feature was detected by chi-square analysis in 106 patients with PTC. In addition, Kaplan-Meier and multivariate Cox regression analysis were used to detect the survival time and the prognostic value of miR-421. Finally, the regulatory effect of miR-421 on the proliferation, migration, and invasion ability of PTC cells was detected by Cell Counting Kit (CCK-8) and Transwell assay. Results: Compared with all control groups, the expression of miR-421 was significantly increased in 106 patients tissues and PTC cell lines ( p < 0.001). In addition, patients with miR-421 upregulated in PTC showed more positive lymph node metastasis ( p = 0.011), positive tumor infiltration ( p = 0.031), and TNM stage III/IV ( p = 0.019), and when miR-421 expression level was elevated, the survival rate of PTC patients was poor (log-rank test, p = 0.023). Furthermore, miR-421 might be an independent prognostic biomarker for PTC (hazard ratio [HR] = 3.172, 95% CI = 1.071-9.393, p = 0.037). Finally, increased levels of miR-421 can significantly promote cell proliferation, migration, and invasion ( p < 0.01). Conclusion: miR-421 is a novel oncogene of PTC and is a valuable prognostic biomarker. Moreover, the upregulation of miR-421 enhances the proliferation, migration, and invasion of PTC cells.

BACKGROUND:The incidence of thyroid cancer is increasing rapidly and there is an urgent need to explore novel therapeutic targets for thyroid cancer. MiR-140 has been reported to affect the progression of various cancers, which makes it possible to play a role in thyroid cancer. This study aimed to investigate the expression and role of miR-140 in thyroid cancer.METHODS:The expression of miR-140 was investigated by reverse transcription-quantitative polymerase chain reaction (qRT-PCR) in thyroid cancer tissues and cell lines. The prognostic value of miR- 140 in thyroid cancer was evaluated by Kaplan-Meier survival and Cox regression. Moreover, the effects of miR-140 on cell proliferation, migration, and invasion of thyroid cancer were investigated by CCK-8 and Transwell assay.RESULTS:MiR-140 was downregulated in thyroid cancer tissues and cells, which correlated with TNM stage and lymph node metastasis of patients. Patients with low miR-140 expression had a shorter survival time compared with that in patients with high miR-140 expression. Furthermore, miR-140 acts as an independent factor for the prognosis of thyroid cancer. Overexpression of miR-140 inhibited cell proliferation, migration, and invasion of thyroid cancer.CONCLUSION:MiR-140 can serve as a potential prognostic factor for patients with thyroid cancer and suppress the progression of thyroid cancer, which provides new insight for the therapeutic target for thyroid cancer.

Abstract Papillary thyroid cancer (PTC) is a major kind of thyroid cancer with increasing recurrence and metastasis. MiR-127 has been demonstrated to play roles in many cancers with dysregulation. However, the function of miR-127 is still unknown. This study aimed to explore a novel biomarker for the progression and prognosis of PTC. A set of 118 patients with PTC were collected from the Affiliated Hospital of Qingdao University. qRT-PCR was used to detect the expression of miR-127 in PTC tissues and cells. The association between miR-127 expression and the clinicopathological features of patients were evaluated by the χ2 test, and the prognostic value of miR-127 was evaluated by Kaplan–Meier analysis and Cox regression analysis. The effect of miR-127 on cell proliferation, migration, and invasion of PTC was analyzed by CCK-8 and transwell assay. miR-127 was found to be upregulated in PTC tissues and cells correlated with the TNM stage and poor prognosis of PTC patients. MiR-127 and the TNM stage were considered as two independent prognostic indicators for PTC. Moreover, overexpression of miR-127 significantly enhanced cell proliferation, migration, and invasion of PTC by targeting REPIN1. miR-127 may be involved in the progression of PTC, which provides a new therapeutic strategy for PTC.

目的 通过分析甲状旁腺全切联合自体移植术在中国尿毒症继发甲状旁腺功能亢进(SHPT)病人中应用的全因病死率、术后并发症、术后复发率、1次手术成功率、术后症状缓解率,评价该术式的临床疗效.方法 检索万方、维普、中国知网、PubMed等中英文数据库.纳入关于甲状旁腺全切联合自体移植术在中国尿毒症SHPT病人中应用的随机对照试验、非随机对照试验、病例对照研究、队列研究、病例报告论文纳入Meta分析.结果 共纳入了12项研究,包含375例中国尿毒症病人.经过分析,甲状旁腺全切联合自体移植术在中国尿毒症SHPT病人中应用的术后并发症发生率P=0.15(95％ CI 0.04～0.31);1次手术成功率P--0.93(95％ CI 0.90～0.96);术后复发率P=0.11 (95％ CI 0.06～0.17);全因病死率P=0.04(95％ CI 0.01～0.07);术后症状缓解率P=0.86 (95％ CI0.61～0.99).结论 甲状旁腺全切联合自体移植术在中国尿毒症SHPT病人中应用的疗效较为显著,术后不易复发且并发症的发生率较低.

BACKGROUND:Prophylactic central lymph node dissection (CLND) in patients with papillary thyroid carcinoma (PTC) remains controversial and predictive factors for central lymph node (CLN) metastasis in unilateral PTC cases are not well defined. The aims of this study were to evaluate the rate of ipsilateral and contralateral CLN metastasis and to determine the clinicopathologic factors predictive for ipsilateral and contralateral CLN metastasis in unilateral PTC cases. METHODS:We retrospectively reviewed 218 PTC patients with clinically negative-node neck who have received total thyroidectomy with bilateral CLND. Pearson χ(2) test or Fisher exact test and multivariate analysis were used to evaluate relationships between CLN metastasis and demographic factors such as age, sex and the clinicopathologic factors. RESULTS:Ipsilateral and contralateral CLN metastasis were present in 47.7% (104/218) and 13.3% (29/218), respectively. Multivariate analysis showed that tumor size (>1 cm) (P=0.016; OR, 2.005) and age <45 years old (P=0.031; OR, 1.539) were the predictors of ipsilateral CLN metastasis, and prelaryngeal lymph node (LN) metastasis (P=0.028; OR, 2.970) and ipsilateral CLN metastasis (P<0.001; OR, 15.128) independently predicted contralateral CLN metastasis. CONCLUSIONS:CLN metastasis was common in PTC patients with clinically node-negative neck and the most common pattern of CLN metastasis was ipsilateral CLN metastasis. Prophylactic ipsilateral CLND may be an optional procedure and should be considered for patients with a tumor size >1 cm. Therapeutic bilateral CLND should be considered in patients with a tumor size >1 cm and especially, if there exists prelaryngeal LN or ipsilateral CLN metastasis on frozen section analysis.

Tumor suppressor p53 directly regulated the abundance of the miR-34b/c. The interaction might contribute to certain cancer. We hypothesized that rs4938723 in the promoter region of pri-miR-34b/c and TP-53 Arg72Pro may be related to the risk of papillary thyroid carcinoma (PTC).A total of 784 patients with PTC and 1006 healthy controls were recruited to participate in this study. The variants were discriminated using a polymerase chain reaction-restriction fragment length polymorphism method (PCR-RFLP). Additionally, the relative expression levels of miR-34b/c and TP-53 in 44 paired samples were revealed by quantitative reverse transcription polymerase chain reaction (qRT-PCR).A significantly increased risk of PTC was observed in the miR-34b/c rs4938723 CT, CC, and CT/CC genotypes compared with the TT genotype (CT vs TT: adjusted odds ratio [OR]=1.51, 95%confidence interval [CI]=1.23-1.85; CC vs TT: adjusted OR=1.89, 95%CI=1.39-2.63; CT/CC vs TT: adjusted OR=1.59, 95%CI=1.30-1.92, respectively). Significantly increased PTC susceptibility was also associated with the TP-53 Arg72Pro CC and CG/CC genotypes compared with the GG genotype (CC vs GG: adjusted OR=2.04, 95%CI=1.54-2.70; CG/CC vs GG: adjusted OR=1.35, 95%CI=1.11-1.67, respectively). Stratification analysis revealed that patients carrying the TP-53 Arg72Pro C allele and CC genotype had a significantly increased risk for developing N1 (C vs. G: OR=1.27, 95%CI=1.03-1.56; CC vs. GG: OR=1.62, 95%CI=1.07-2.46, respectively). Combined analysis showed that the genotypes of rs4938723CT/CC+TP-53CG/CC increased the risk of PTC compared with rs4938723TT+TP-53GG (OR=2.25, 95%CI=1.67-3.03). Additionally, level of miR-34b was significantly upregulated in PTC patients.These findings indicate that the miR-34b/c rs4938723 and TP-53 Arg72Pro polymorphisms may contribute to the susceptibility of PTC.

目的 总结应用甲状腺细胞病理学Bethesda报告系统(The Bethesda System for Reporting Thyroid Cytopathology,TBSRTC)进行甲状腺细胞学诊断的经验,并对TBSRTC的诊断价值进行评价.方法 收集四川大学华西医院病理科2010年1月至2012年12月期间完成甲状腺细胞学TBSRTC分级诊断的2 257个甲状腺结节的病理资料,并计算TBSRTC诊断甲状腺恶性结节的灵敏度、特异度、准确率等诊断价值指标.结果 2 257个甲状腺结节中含Ⅰ级442个,占19.6％;Ⅱ级1 184个,占52.4％;Ⅲ级216个,占9.6％;Ⅳ级38个,占1.7％;Ⅴ级172个,占7.6％;Ⅵ级205个,占9.1％.以TBSRTCⅡ级为诊断良恶性的界点,若不纳入Ⅲ级结节,则TBSRTC分级的灵敏度为93.7％ (236/252),特异度为86.6％ (323/373),准确率为89.4％ (559/625);若将Ⅲ级结节纳入分析,则TBSRTC分级的灵敏度为94.3％ (267/283),特异度为74.9％ (323/431),准确率为82.6％ (590/714).结论 TBSRTC分级在笔者所在医院的应用实践表明其真实性较高,是准确和可靠的甲状腺细胞学分类诊断系统.

Objective To report our experience in using The Bethesda System for Reporting Thyroid Cytopathology(TBSRTC), and to investigate the diagnostic value of the system based on the cytologic-histologic result. Methods Pathological data of 2 257 thyroid nodules classified by TBSRTC which were obtained from the Department of Pathology of West China Hospital between Jan.2010 to Dec.2012 were collected and analyzed, to investigate the diagnostic evaluation indicators, such as the sensitivity, specificity, and diagnostic accuracy of the system based on the cytologic-histologic result. Results Of the 2 257 thyroid nodules, 442(19.6%) were diagnosed as categoryⅠ,1 184(52.4%) were diagnosed as category Ⅱ, 216(9.6%) were diagnosed as category Ⅲ, 38(1.7%) were diagnosed as category Ⅳ, 172(7.6%) were diagnosed as category Ⅴ, 205(9.1%) were diagnosed as category Ⅵ. Using TBSRTC category Ⅱ as the boundary point of diagnosing benign and malignant diseases, the sensitivity, specificity, and diagnostic accuracy were 93.7%(236/252), 86.6%(323/373), and 89.4%(559/625)respectively, while category Ⅲwas excluded from analysis. When including category Ⅲ into analysis, the sensitivity, specificity, and diagnostic accuracywere 94.3%(267/283), 74.9%(323/431), and 82.6%(590/714)respectively. Conclusions The validity of TBSRTC was high at our institution. TBSRTC has proven to be an accurate and reliable approach for the diagnosis of thyroid nodules.

目的 分析原发性甲状旁腺功能亢进症的临床特点、诊断和治疗方法.方法 回顾性分析四川大学华西医院2004年1月至2012年12月期间初次手术治疗且资料完整的原发性甲状旁腺功能亢进患者的临床资料.结果 136例甲状旁腺功能亢进患者中骨型52例(38.23％),肾型17例(12.50％),骨肾型7例(5.15％),生化型24例(17.65％),合并其他临床表现者36例(26.47％).术前甲状旁腺激素(parathyroid hormone,PTH)值为(106.20±88.88) pmol/L (6.91～390 pmol/L),血钙值为(3.12±0.66) mmol/L (2.15～5.77 mmol/L).甲状腺及颈部淋巴结彩超和锝-甲氧基异丁基异腈放射性核素双时相显像(99Tcm-MIBI)定位诊断与手术发现符合率分别为75.00％及85.29％,联合CT检查三者符合率为86.76％.术后病理诊断:良性病变129例(94.85％),甲状旁腺癌7例(5.15％).良性病变中甲状旁腺腺瘤119例(92.25％),其中单发114例(95.80％),多发腺瘤或甲状旁腺瘤合并甲状旁腺增生5例(4.20％);甲状旁腺增生10例(7.75％),其中8例为甲状旁腺不典型增生或增生活跃.124例(91.18％)患者术后3d内PTH降至正常上限以下.124例(91.18％)获随访,随访时间6～112个月,中位随访时间49个月;12例(8.82％)失访.术后6个月有2例(1.47％)甲状旁腺癌患者肿瘤复发,其余病例无复发.3例(2.21％)甲状旁腺癌患者分别于术后18,19及23个月死亡,其中2例死于甲状旁腺癌全身转移,1例死于心血管意外.结论 原发性甲状旁腺功能亢进的临床表现多样,手术是治疗原发性甲状旁腺功能亢进的有效手段.

Objective To investigate ultrasonography features of primary thyroid non-Hodgkin lymphoma(PT-NHL). Methods Ultrasonographic data of patients with PT-NHL(PT-NHL group) and non-Hodgkin lymphoma(control group) who were treated in our hospital from May. 2002 to Jul. 2014 were collected and analyzed. Results Compared with control group,enhancement of posterior echoes was more common in PT-NHL group(P = 0.000),and difference values of transverse diameters,anteroposterior diameters,and sagittal diameters of more involved lobe to another lobe were bigger(P 0.05),but echo pattern of gland,ultrasonographic classification of lesions,classification of vascularity,and condition of cervical lymph nodes were found no statistical difference(P 0.05). In patients with nodular-type lesions(37 patients in PT-NHL group and 12 patients in control group),length of nodule lesions was larger in PT-NHL group(P = 0.000),but there was no statistical difference in shape, boundary,orientation,and echoes of nodules between 2 groups(P 0.05). In Pulsed-Wave(PW) Doppler between 2 groups(17 patients in PT-NHL group and 4 patients in control group),vascular resistance index(RI) was higher in PT-NHL group than those of control group(P = 0.024). Conclusions The enhancement of posterior echoes was a feature in ultrasonography images of PT-NHL.Asymmetrical volume, high value of RI, and big nodule might link to PT-NHL,but diffuse heterogeneous echo with hypoechoic lesions might result in wrong diagnosis as PT-NHL.

<正>纳米碳混悬注射液(卡纳琳,以下简称纳米碳)为纳米级碳颗粒制成的混悬液,颗粒直径为150 nm,具有高度的淋巴系统趋向性[1],是我国唯一批准上市的淋巴结示踪剂。由于毛细血管内皮细胞间隙为20~50 nm,而毛细淋巴管内皮细胞间隙为120~500 nm,且基膜发育不全,故注射到组织内的纳米碳颗粒不进入血管,可迅速进入淋巴管或被巨噬细胞吞噬后进入毛细淋巴管,滞留、聚集在淋巴结,使淋巴结黑染。纳米碳作为一种淋巴

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.

Lahaye MJ, Beets GL, Engelen SM等对39例接受同期放化疗的直肠癌患者分别使用超小超顺磁性氧化铁(ultra-small superparamagnetic iron oxide, USPIO)增强的二维T2加权快速自旋回波、三维T1加权梯度回波和三维T2加权磁共振,测出其淋巴结边界、长短轴直径、淋巴结内白区的估计百分比、Ratio(A)(黑淋巴结中白区与整个淋巴结的表面积测出值之比)、淋巴结与臀肌的信号强度比等数据,并对各项数据的受者作用特征曲线(ROC)下面积进行对比分析来确定使用磁共振成像再分期鉴定累及淋巴结的预估标准.