thyroid neoplasms

甲状腺肿瘤
  • 文章类型: Journal Article
    要对疗效进行比较分析,安全,以及热消融和手术干预对甲状腺乳头状癌(PTC)患者生活质量的影响。
    进行了一项前瞻性研究,接受射频消融(RFA)的PTC≤5mm患者,激光烧蚀(LA),或者手术,用于分析疗效和安全性结果。在治疗前和治疗后3、6和12个月对所有患者进行甲状腺癌特异性生活质量问卷。
    总共162名符合条件的患者被纳入研究。RFA和LA组未观察到主要并发症,手术组报告了5例,尽管没有观察到统计学上的显着差异。轻微的并发症被记录在两个,三,和14名RFA患者,洛杉矶,和手术组,分别,没有明显的差异。热消融组的手术时间和住院时间明显较短。在最后的后续行动中,在接受RFA治疗的病例中,有71.4%的结节完全消失,在接受LA治疗的病例中,有71.0%的结节完全消失。组间没有显著差异。RFA和LA对生活质量的影响相似,与手术相比,热消融技术显示出更好的功能结果。在所有团体中,不良反应在治疗后3个月时最为明显,但热消融组逐渐恢复至基线水平,与手术组相比。
    对于PTC≤5mm,RFA和LA均表现出相似的癌症控制结局和优于手术的生活质量,同时尽量减少并发症。这些发现强调了RFA和LA作为小型PTC的潜在标准治疗的前景。有待在未来的研究中进一步证实。
    UNASSIGNED: To conduct a comparative analysis of the efficacy, safety, and impact on quality of life outcomes between thermal ablation and surgical interventions in patients diagnosed with papillary thyroid carcinoma (PTC).
    UNASSIGNED: A prospective study was undertaken, enrolling patients with PTC ≤5mm who underwent radiofrequency ablation (RFA), laser ablation (LA), or surgery, for analysis of efficacy and safety outcomes. The Thyroid Cancer-Specific Quality of Life questionnaire was administered to all patients before treatment and at 3, 6, and 12 months post-treatment.
    UNASSIGNED: A total of 162 eligible patients were included in the study. Major complications were not observed in the RFA and LA groups, while five cases were reported in the surgery group, although no statistically significant differences were observed. Minor complications were documented in two, three, and 14 patients in the RFA, LA, and surgery groups, respectively, with no significant variances noted. Surgical duration and hospitalization time were notably shorter in the thermal ablation groups. At the final follow-up, complete disappearance of nodules was seen in 71.4% of cases treated with RFA and 71.0% of cases managed with LA, with no significant disparities between the groups. Both RFA and LA exhibited similar effects on quality of life, with thermal ablation techniques showing better functional outcomes in comparison to surgery. Across all groups, adverse effects were most pronounced at the 3-month post-treatment mark but gradually reverted to baseline levels in the thermal ablation group, contrasting with the surgery group.
    UNASSIGNED: For PTC ≤5mm, both RFA and LA exhibited similar cancer control outcomes and superior quality of life on par with surgery, while minimizing complications. These findings underscore the promise of RFA and LA as potential standard treatments for small PTCs, subject to further confirmation in future studies.
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  • 文章类型: Journal Article
    甲状腺乳头状癌(PTC)是一种常见的内分泌肿瘤,预后良好。放射性碘被认为是有用的个人谁做了全或几乎全甲状腺切除术,但其效果仍有争议。这项研究检查了放射性碘131(I-131)治疗对PTC患者氧化和染色体损伤的影响,对16例新诊断为PTC的患者和20例年龄和性别相似的健康对照者进行了研究。在五个采样时间(甲状腺全切除术前,全甲状腺切除术后,七天,六个月,和治疗后一年)和对照受试者。评估了PTC患者和对照组外周血淋巴细胞中的胞质分裂阻滞微核细胞(CBMN-cyt)测定参数,并测量了血浆8-羟基脱氧鸟苷(8-OHdG)水平。此外,在甲状腺全切除术前评估PTC患者外周血淋巴细胞和血浆的基因组不稳定性和氧化DNA损伤(n=16),甲状腺全切除术后(I-131治疗前)(n=16),七天(n=10),6个月(n=5),治疗后一年(n=5)。PTC患者的CBMN-cyt测定参数(微核;MN和核质桥;NPB)和8-OHdG水平的数量被确定为显着高于对照组,并且这些值显着降低全甲状腺切除术后(I-131治疗前)。虽然MN的数量,凋亡,I-131治疗后坏死细胞增加,治疗后6个月和1年明显下降。这项研究的结果表明,I-131治疗可能对细胞构成威胁,对于甲状腺全切除术后的PTC患者,应避免(如果可能)进行放射性碘治疗。
    Papillary thyroid carcinoma (PTC) is a common endocrine cancer with a good prognosis. Radioactive iodine is thought to be useful for individuals who have had a total or almost total thyroidectomy, but its effects are still controversial. The effects of radioactive iodine-131 (I-131) treatment on oxidative and chromosomal damage in PTC patients were examined in this study, which was carried out with 16 patients newly diagnosed with PTC and 20 healthy control subjects with similar age and gender. Blood samples were taken from patients with PTC at five sampling times (before total thyroidectomy, after total thyroidectomy, and seven days, six months, and one year after treatment) and from control subjects. The cytokinesis block micronucleus cytome (CBMN-cyt) assay parameters in peripheral blood lymphocytes of patients with PTC and controls were evaluated and plasma 8-hydroxydeoxyguanosine (8-OHdG) levels were measured. Furthermore, genome instability and oxidative DNA damage in peripheral blood lymphocytes and plasma of patients with PTC were evaluated before total thyroidectomy (n=16), after total thyroidectomy (before I-131 treatment) (n=16), seven days (n=10), six months (n=5), and one year after treatment (n=5). The numbers of CBMN-cyt assay parameters (micronucleus; MN and nucleoplasmic bridges; NPB) and 8-OHdG levels in patients with PTC were determined to be significantly higher than in those of the control subjects and these values significantly decreased after total thyroidectomy (before I-131 treatment). While the number of MN, apoptotic, and necrotic cells increased after I-131 treatment, it significantly decreased after six months and one year after treatment. The results achieved in this study suggest that I-131 treatment may pose a threat to cells and that radioactive iodine therapy should be avoided (if possible) for patients with PTC after total thyroidectomy.
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  • 文章类型: Letter
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  • 文章类型: Case Reports
    具有胸腺样元件的梭形上皮肿瘤(SETTLE)是一种罕见的甲状腺恶性肿瘤,据信起源于甲状腺内胸腺组织。它主要影响出现不同持续时间的甲状腺肿块的年轻人和儿童,在成人中很少发生。它具有高的总生存率,并有延迟转移的趋势。SETTLE是一种双相分叶状肿瘤,由梭形细胞和组织病理学检查可见的腺体形成组成。尽管其典型的形态,但由于其稀有性和与其他接近的模拟物(如癌)重叠的形态,通常在组织病理学上被误诊。滑膜肉瘤和胸腺瘤。在此,我们报告了一例发生在颈部肿块的中年女性中的病例。鉴于CK的共同表达,她最初诊断为转移性低分化鳞状细胞癌,可能患有口喉原发性癌,p40和p16的免疫组织化学。患者接受了改良颈清扫术的手术切除。在我们医院的检查中,它被诊断为SETTLE,并且在1年的随访期后她仍然没有疾病。勤奋的组织病理学检查与明智的IHC标记物结合临床放射学检查是诊断的主要依据。到目前为止,在文献中尚未记录或评估弥漫性和强p16免疫表达,并需要探索其在这个罕见实体中的诊断效用。
    Spindle epithelial tumor with thymus-like elements (SETTLE) is a rare malignant neoplasm of the thyroid gland which is believed to arise from intrathyroidal thymic tissue. It predominantly affects young adults and children presenting with a thyroid mass of variable duration and rarely occurs in adults. It has a high overall survival with a tendency for delayed metastasis. SETTLE is a biphasic lobulated tumor composed of spindle shaped cells along with glandular formations seen on histopathological examination. Despite its typical morphology it is commonly misdiagnosed on histopathology due to its rarity and overlapping morphology with other close mimics such as a carcinoma, synovial sarcoma and thymoma. Herein we report such a case occurring in a middle aged female presenting with a neck mass. She had an initial diagnosis of metastatic poorly differentiated squamous cell carcinoma possibly with an orophayngeal primary in view of co expression of CK, p40 and p16 on immunohistochemistry. The patient underwent surgical resection with modified neck dissection. On review at our hospital it was diagnosed as SETTLE and she remains disease free after a follow-up period of 1 year. Diligent histopathological examination espoused with a judicious panel of IHC markers in conjunction with clinicoradiological findings forms the mainstay of diagnosis. Diffuse and strong p16 immunoexpression has not been documented or evaluated in literature so far, and needs to be explored for its diagnostic utility in this rare entity.
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  • 文章类型: Journal Article
    多学科技术在内分泌相关癌症管理中的应用对于利用多学科的优势及其在消除肿瘤方面的协调努力至关重要。由于癌细胞的恶性特征,它们具有对化疗和放疗等传统治疗产生抵抗力的能力。然而,尽管努力加强对结果的预测,内分泌相关恶性肿瘤患者的总生存率仍然相当低.因此,研究创新的治疗策略势在必行.治疗策略的最新进展为各种内分泌肿瘤的治疗提供了新的方法。本文研究了纳米药物递送技术的进展以及通过靶向治疗将纳米材料用于精确癌症治疗的应用。这篇综述全面分析了联合药物递送策略在甲状腺癌治疗中的潜力。肾上腺肿瘤,还有胰腺癌.这项研究的目的是更深入地了解当前的治疗方法,刺激新药DDS的开发,并提高这些疾病患者的治疗效果。通过将合成或天然物质植入纳米颗粒中,可以显着提高药物对癌细胞的细胞内摄取,导致内分泌恶性肿瘤的发展大幅减少。
    The application of multidisciplinary techniques in the management of endocrine-related cancers is crucial for harnessing the advantages of multiple disciplines and their coordinated efforts in eliminating tumors. Due to the malignant characteristics of cancer cells, they possess the capacity to develop resistance to traditional treatments such as chemotherapy and radiotherapy. Nevertheless, despite diligent endeavors to enhance the prediction of outcomes, the overall survival rate for individuals afflicted with endocrine-related malignancy remains quite miserable. Hence, it is imperative to investigate innovative therapy strategies. The latest advancements in therapeutic tactics have offered novel approaches for the therapy of various endocrine tumors. This paper examines the advancements in nano-drug delivery techniques and the utilization of nanomaterials for precise cancer cures through targeted therapy. This review provides a thorough analysis of the potential of combined drug delivery strategies in the treatment of thyroid cancer, adrenal gland tumors, and pancreatic cancer. The objective of this study is to gain a deeper understanding of current therapeutic approaches, stimulate the development of new drug DDS, and improve the effectiveness of treatment for patients with these diseases. The intracellular uptake of pharmaceuticals into cancer cells can be significantly improved through the implantation of synthetic or natural substances into nanoparticles, resulting in a substantial reduction in the development of endocrine malignancies.
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  • 文章类型: Journal Article
    间变性甲状腺癌(ATC)是最具侵袭性和转移性的恶性肿瘤之一,通常由于缺乏有效的治疗而导致致命的结果。原位素A(PA),一种在传统中草药中普遍存在的生物活性化合物,已显示出作为抗肿瘤剂对抗各种人类肿瘤的潜力。然而,其对ATC的影响及潜在机制尚不清楚.这里,我们证明了PA在体外和体内通过诱导GSDME依赖性的ATC细胞焦亡表现出显著的抗ATC活性。机械上,PA促进溶酶体膜透化(LMP),导致激活半胱天冬酶8/3以切割GSDME的组织蛋白酶的释放。值得注意的是,PA显著上调V-ATPase-ATP6V1A的三个关键功能亚基,ATP6V1B2和ATP6V0C-导致溶酶体过度酸化。这种过度酸化加剧了LMP和随后的溶酶体损伤。溶酶体管腔酸化或抑制/敲低这些V-ATPase亚基的中和减弱PA诱导的溶酶体损伤,ATC细胞的焦亡和生长抑制,强调溶酶体酸化和LMP在PA抗癌作用中的关键作用。总之,我们的发现揭示了PA与癌细胞中溶酶体损伤依赖性焦亡之间的新联系.PA可以作为靶向溶酶体酸化的V-ATPase激动剂,为ATC治疗提供了新的潜在治疗选择。
    Anaplastic thyroid cancer (ATC) is among the most aggressive and metastatic malignancies, often resulting in fatal outcomes due to the lack of effective treatments. Prosapogenin A (PA), a bioactive compound prevalent in traditional Chinese herbs, has shown potential as an antineoplastic agent against various human tumors. However, its effects on ATC and the underlying mechanism remain unclear. Here, we demonstrate that PA exhibits significant anti-ATC activity both in vitro and in vivo by inducing GSDME-dependent pyroptosis in ATC cells. Mechanistically, PA promotes lysosomal membrane permeabilization (LMP), leading to the release of cathepsins that activate caspase 8/3 to cleave GSDME. Remarkably, PA significantly upregulates three key functional subunits of V-ATPase-ATP6V1A, ATP6V1B2, and ATP6V0C-resulting in lysosomal over-acidification. This over-acidification exacerbates LMP and subsequent lysosomal damage. Neutralization of lysosomal lumen acidification or inhibition/knockdown of these V-ATPase subunits attenuates PA-induced lysosomal damage, pyroptosis and growth inhibition of ATC cells, highlighting the critical role for lysosomal acidification and LMP in PA\'s anticancer effects. In summary, our findings uncover a novel link between PA and lysosomal damage-dependent pyroptosis in cancer cells. PA may act as a V-ATPase agonist targeting lysosomal acidification, presenting a new potential therapeutic option for ATC treatment.
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    文章类型: Journal Article
    孤立性纤维瘤是一种相对罕见的软组织成纤维细胞瘤,约占软组织肿瘤的2%。它主要被描述为胸膜腔的肿瘤;然而,高达70%的病例发生在其他地方,在任何解剖位置,这会使诊断变得困难。如果这是正在考虑的诊断,STAT6抗体目前具有高灵敏度和特异性.在本文中,我们描述了一名72岁的女性患者的情况,随访并由门诊内分泌学家治疗甲状腺多结节性甲状腺肿。由于甲状腺左叶完全结节状重塑和甲状腺右叶几个小结节的超声检查结果,建议患者行甲状腺全切除术.该手术是在Jind之所以伊希夫Hradec医院的耳鼻喉科进行的。随后将手术材料送去进行组织病理学检查。显微镜下在甲状腺右叶发现了几个增生性胶体结节和一个小的嗜酸细胞腺瘤。在左叶,一个不精确的划定,在切片上观察到2x1.8x1.5cm的灰白色病变。微观上,肿瘤由局灶性透明基质中的纺锤形细胞组成。在免疫组织化学检查中,肿瘤细胞与CD34抗体呈阳性反应,对甲状腺球蛋白抗体呈阴性,细胞角蛋白(CKAE1/AE3)和S100蛋白。在较高机构咨询后,补充了具有阳性结果的进一步免疫组织化学检查(Bcl2,CD99,STAT6)。根据形态学和免疫组织化学检查结果,该肿瘤被诊断为甲状腺的孤立性纤维瘤。这在这个地方是一个相对不寻常的发现;根据文献,只描述了几十个案例。
    Solitary fibrous tumour is a relatively rare soft tissue fibroblastic tumour, accounting for approximately 2% of soft tissue tumours. It has been described primarily as a tumour of the pleural cavity; however, up to 70% of cases occur elsewhere, in any anatomical location, which can make diagnosis difficult. If this is the diagnosis being considered, the STAT6 antibody is currently available with high sensitivity and specificity. In this paper we describe the case of a 72-year-old female patient, followed up and treated by an outpatient endocrinologist for a multinodular euthyroid goitre for several years. Due to complete nodular remodelling of the left lobe of the thyroid gland and sonographic findings of several small nodules in the right lobe of the thyroid gland, total thyroidectomy was recommended to the patient. The operation was performed at the ENT department in Jindřichův Hradec Hospital. Material from the operation was subsequently sent for histopathological examination. Several hyperplastic colloid nodules and a small oncocytic adenoma were detected microscopically in the right lobe of the thyroid gland. In the left lobe, an imprecisely delineated, greyish-white lesion measuring 2 x 1.8 x 1.5 cm was observed on the section. Microscopically, the tumour consisted of spindle-shaped cells in a focally hyalinised stroma. In the immunohistochemical examination, tumour cells reacted positively with the CD34 antibody, and negatively with antibodies against thyroglobulin, cytokeratins (CK AE1/AE3) and S100 protein. Further immunohistochemical examinations (Bcl2, CD99, STAT6) with positive results were supplemented upon consultation at a higher facility. Based on morphology and the results of the immunohistochemical examinations, the tumour was diagnosed as a solitary fibrous tumour of the thyroid gland. This is a relatively unusual finding in this location; according to literature, only a few dozen cases have been described.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    目的:近年来,甲状腺癌(TC)的患病率呈上升趋势。加速的证据表明桥本甲状腺炎(HT)与TC之间存在显着关联。本研究包括精心设计的系统评价和荟萃分析,目的是仔细检查TC的风险并阐明HT的性别差异。
    方法:在信誉良好的在线数据库中进行了全面搜索,包括PubMed,科克伦图书馆,EMBASE,和WebofScience。检查了有关HT和TC之间相关性的英语出版物,没有时间限制。两位作者独立筛选了文章并提取了相关数据。使用STATA软件对收集的数据进行统计分析,允许计算合并的赔率比(OR)和95%置信区间(CI)。此外,对纳入性别特异性数据的研究进行了补充分析,以确定OR(女性与男性)和HT中TC的性别患病率。
    结果:共获得2,845条记录,本荟萃分析包括26项回顾性研究.结果表明HT在TC中具有重要作用(OR:2.22,95%CI:1.85-2.67)。补充分析表明,女性患者的TC患病率(0.31,95%CI:0.17-0.45)低于男性(0.37,95%CI:0.21-0.53)。然而,结果无统计学意义.
    结论:本系统综述和荟萃分析提供证据表明HT与TC的几率增加有关。HT患者的定期检讨具有积极的临床意义。
    OBJECTIVE: The prevalence of thyroid cancer (TC) has exhibited an upward trajectory in recent years. An accelerating amount of evidence shows a significant association between Hashimoto\'s thyroiditis (HT) and TC. The present study encompasses a meticulously designed systematic review and meta-analysis with the aim of scrutinizing the risk of TC and clarifying sex disparities in HT.
    METHODS: A comprehensive search was conducted across reputable online databases, including PubMed, Cochrane Library, EMBASE, and Web of Science. English-language publications on the correlation between HT and TC were examined without temporal restrictions. Two authors independently screened the articles and extracted pertinent data. The collected data underwent statistical analysis using the STATA software, enabling the calculation of the pooled Odds Ratio (OR) and 95% confidence intervals (CI). Additionally, a supplementary analysis was conducted on studies incorporating sex-specific data to determine the OR (female vs. male) and the sex-based prevalence of TC in HT.
    RESULTS: A total of 2,845 records were obtained, and 26 retrospective studies were included in this meta-analysis. The results indicated a significant role for HT in TC (OR: 2.22, 95% CI: 1.85-2.67). Supplementary analysis indicated that the prevalence of TC in HT patients was lower in women (0.31, 95% CI: 0.17-0.45) than in men (0.37, 95% CI: 0.21-0.53). However, the result was not statistically significant.
    CONCLUSIONS: This systematic review and meta-analysis provide evidence that HT is associated with increasing odds of TC. Regular review of HT patients holds positive clinical significance.
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  • 文章类型: Journal Article
    儿科年龄组的恶性肿瘤是第二大死因,仅次于事故。儿科年龄组涉及头颈部的各种恶性肿瘤令人困惑。甲状腺横纹肌肉瘤是一种非常罕见的实体。我们介绍了一个青少年的病例,该青少年出现颈部肿块并迅速恶化。只有通过熟练的病理检查发现甲状腺横纹肌肉瘤,才有可能建立最终诊断。甲状腺中出现的肺泡横纹肌肉瘤极为罕见。据我们所知,到目前为止,只有两起上述案件被记录在案。通过这份报告,我们的目标是强调这种情况发生的可能性,并对治疗外科医生保持警惕,以便及时进行干预。
    Malignancies in paediatric age group are the second leading cause of death, next only to accidents. The variety of malignancies involving the head and neck region in paediatric age group is bewildering. Rhabdomyosarcoma of thyroid gland is one such entity very rarely seen. We present the case of an adolescent who presented with a neck mass and suffered rapid deterioration. Establishment of final diagnosis was possible only because of a skilfully performed pathological examination which revealed a thyroid gland rhabdomyosarcoma. An alveolar variety of rhabdomyosarcoma presenting in the thyroid gland is extremely rare. To the best of our knowledge, only two cases of the aforementioned are documented as yet. Through this report, we aim at highlighting the possibility of such an occurrence and vigilance on part of the treating surgeon so that timely intervention can be instituted.
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