Jingqiang Zhu

Pri-Mir-34b/C and Tp-53 Polymorphisms are Associated With The Susceptibility of Papillary Thyroid Carcinoma: A Case-Control Study.

AbstractTumor 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 rs4938723 CT/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.

Association Between Genetic Polymorphisms in the Promoter Regions of Let-7 and Risk of Papillary Thyroid Carcinoma: A Case-Control Study.

AbstractThe aim of this study was to investigate the association between 2 polymorphisms (ie, rs10877887 and rs13293512) in the promoter regions of let-7 and the risk of papillary thyroid carcinoma (PTC).A case-control study of 618 PTC patients and 562 controls was conducted. The rs10877887 polymorphism was genotyped by using polymerase chain reaction-restriction fragment length polymorphism and the rs13293512 polymorphism was genotyped by using a TaqMan Genotyping Assay. The results were confirmed by DNA sequencing.The rs10877887 polymorphism had reduced risks of PTC in heterozygous comparison, dominant model, and overdominant model (TC vs TT: adjusted odds ratio [OR] = 0.73, 95% confidence interval [95% CI] = 0.58–0.94, P = 0.01; TC/CC vs TT: adjusted OR = 0.79, 95% CI = 0.63–1.00, P = 0.047; TC vs TT/CC: adjusted OR = 0.73, 95% CI = 0.57–0.92, P = 0.007, respectively). Stratified analyses showed that PTC patients carrying the rs10877887 CC genotype were more likely to have multiple tumors (adjusted OR = 1.71, 95% CI = 1.03–2.86, P = 0.04), and PTC patients carrying the rs13293512 TC + CC or CC were more likely to develop N0 status (TC/CC vs TT: adjusted OR = 0.64, 95% CI = 0.43–0.94, P = 0.02; CC vs TC/TT: adjusted OR = 0.50, 95% CI = 0.33–0.77, P = 0.001, respectively).Our study suggests that the rs10877887 polymorphism may be associated with the risk of PTC and the rs13293512 polymorphism may correlate to lymph node metastasis in PTC.

Association of the preoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios with lymph node metastasis and recurrence in patients with medullary thyroid carcinoma

AbstractThe preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are known to be prognostic factors in several cancers. However, no previous investigation has been performed to evaluate the significance of the NLR and PLR in medullary thyroid carcinoma (MTC).The aim of this study was to identify the ability of the preoperative NLR or PLR to predict lymph node metastasis and recurrence in patients with MTC. Data from all patients with MTC who had undergone surgery at our institution from May 2009 to May 2016 were retrospectively evaluated. Receiver operating characteristic (ROC) analysis was performed to identify optimal NLR and PLR cutoff points, and we assessed independent predictors of lymph node metastasis and recurrence using univariate and multivariate analyses.Based on the inclusion and exclusion criteria, a total of 70 patients were enrolled in this study. The ideal cutoff points for predicting lymph node involvement were 2.7 for the NLR and 105.3 for the PLR. The optimal cutoff points of the NLR and PLR for predicting recurrence were 2.8 and 129.8, respectively. Using the cutoff values, we found that PLR>105.3 (odds ratio [OR] 4.782, 95% confidence interval [CI] 1.4–16.7) was an independent predictor of lymph node metastasis and that PLR>129.8 (OR 3.838, 95% CI 1.1–13.5) was an independent predictor of recurrence.Our study suggests that the preoperative PLR, but not NLR, was significantly associated with lymph node metastasis and recurrence in patients with MTC.

Risk factors of hypoparathyroidism following total thyroidectomy with central lymph node dissection

Abstract The risk factors of hypoparathyroidism after total thyroidectomy (TT) with central lymph node dissection (CND) have not been completely defined. The aim of the study was to evaluate the risk factors of hypoparathyroidism after the surgery. We retrospectively reviewed our patients who underwent TT and CND (including lateral lymph node dissection) for thyroid carcinoma between January 2013 and June 2016. According to the postoperative serum levels of parathyroid hormone within 6 months, the patients were divided into normal, transient hypoparathyroidism, and permanent hypoparathyroidism groups. The clinicopathologic characteristics and surgical details were compared among the 3 groups. The risk factors of hypoparathyroidism were investigated by univariate and multivariate analyses. Of the 903 patients, 399 (44.2%) were found to have transient hypoparathyroidism and 10 (1.1%) had permanent hypoparathyroidism. On multivariate analysis, female gender (P < .001), nonuse of carbon nanoparticles (P = .038), parathyroid autotransplantation (P < .001), accidental parathyroid resection (P = .004), and bilateral CND (BCND, P = .003) were the independent risk factors of transient hypoparathyroidism; nonuse of carbon nanoparticles (P = .041) and a tumor in the upper pole of thyroid gland (P = .031) were the independent risk factors of permanent hypoparathyroidism. Patients with transient hypoparathyroidism were more likely to develop permanent hypoparathyroidism when they had hypertension (P = .026) and a tumor in the upper pole of thyroid gland (P = .010). Precise surgical techniques and carbon nanoparticles suspension should be applied for in situ preservation of parathyroid glands (PGs) in thyroid carcinoma patients, especially in females with hypertension and a tumor in the upper pole of thyroid gland. Autotransplantation is only performed when a PG is resected inadvertently or devascularized. TT with BCND should be better performed by an experienced surgeon to reduce the incidence of hypoparathyroidism.

Predictive factors and prognosis for recurrent laryngeal nerve invasion in papillary thyroid carcinoma

Background Recurrent laryngeal nerve (RLN) invasion in papillary thyroid carcinoma (PTC) is one of the main predictors of poor prognosis. The present study investigated the risk factors for RLN invasion in PTC patients. Methods A total of 3,236 patients who received thyroidectomy due to PTC in Thyroid and Parathyroid Surgery Center of West China Hospital of Sichuan University were reviewed. Demographics and clinical factors, imaging examination (ultrasonography) characteristics, surgical details, postoperative pathological details, recurrence, and postoperative complications were recorded. Univariate and multivariate analyses were used to study the risk factors of RLN invasion, Kaplan–Meier method was performed to compare the outcomes of tumor recurrence. Results Patients with RLN invasion had a higher recurrence rate than those in the control group (p<0.001). Multivariate analyses showed that age greater than 45 years (p<0.001), a largest tumor size bigger than 10 mm (p<0.001), clinical lymph node metastasis (cN1) (p<0.001), posterior focus (p<0.001), extrathyroidal extension (p<0.001), esophageal extension (p<0.001), tracheal extension (p<0.001), and preoperative vocal cord paralysis (p<0.001) were independent predictors for RLN invasion. Conclusion PTC patients with RLN invasion have a negative prognosis and a higher recurrence rate. Meticulous operation and careful follow-up of patients with the above factors is recommended.

Preoperative ultrasound-guided carbon nanoparticles localization for metastatic lymph nodes in papillary thyroid carcinoma during reoperation: A retrospective cohort study

Abstract Due to the damaged anatomical structure and a large amount of fibrous and scar tissues in the surgical field, reoperation of papillary thyroid carcinoma is difficult. This study introduces a new method of locating metastatic lymph nodes during reoperation and evaluates the effectiveness and safety of the preoperative ultrasound-guided carbon nanoparticles (CNs) localization. This retrospective cohort study enrolled 52 patients who were diagnosed with lymph node metastasis by histopathology and underwent reoperation from October 2015 to February 2016. The modified radical neck dissection or selective neck node dissection was performed. A total of 26 patients underwent preoperative ultrasound-guided CNs injection, and other 26 patients did not. Tolerance, the result of injection, the number of resected metastatic lymph nodes, and postoperative complications were recorded and analyzed. In CNs group, 102 suspicious nonpalpable lesions in 26 patients were injected with CNs, and 99 of the 102 lesions were successfully identified by surgeon in the reoperation. The positive rate of resected lymph nodes in total, in the central compartment, and in the lateral compartment were 31.6%, 31.2%, and 32.8%, respectively, which was significantly higher than that in the control group (P < 0.001, P < 0.001, and P = 0.041). In addition, the positive rates of levels III, IV, and V in the CNs group were 35.6%, 21.9%, and 30.5%, respectively, which was significantly higher than that in the control group (P < 0.001, P = 0.005, and P = 0.01). In additional, in the CNs group, the rate of temporary hypoparathyroidism was significantly lower compared with the control group (0% vs 26.9%, P = 0.021). Preoperative ultrasound-guided CNs injection is a safe and effective method for localization of the metastatic lymph nodes during reoperation.

Cell block is a valuable adjunct to conventional smear for thyroid fine-needle aspiration: 2395 cases with histological correlation

Conventional smears (CS) of samples obtained by fine needle aspiration (FNA) have proven useful in thyroid nodules evaluation, but the additional contribution of cell block (CB) has only been investigated in a limited fashion. In this study, we aimed to evaluate whether the auxiliary application of CB adds to the diagnostic accuracy of the CS by a College of American Pathologists‐accredited hospital laboratory.

Long noncoding RNA AB074169 inhibits cell proliferation via modulation of KHSRP-mediated p21 expression in papillary thyroid carcinoma

Long noncoding RNAs (lncRNA) are emerging as a novel class of regulators in gene expression associated with tumorigenesis. However, the role of lncRNAs in papillary thyroid carcinoma (PTC) is poorly understood. Here, we conducted global lncRNA profiling and identified lncRNA AB074169 (lncAB) as significantly downregulated in PTC. Decreased expression of lncAB in PTC was caused by CpG hypermethylation within its gene promoter. Functional studies showed that lncAB overexpression led to cell-cycle arrest and tumor growth inhibition in vitro and in vivo, whereas lncAB knockdown promoted cell proliferation. Mechanistic analyses revealed that lncAB bound KH-type splicing regulatory protein (KHSRP) and also decreased expression of KHSRP, thus increasing CDKN1a (p21) expression and decreasing CDK2 expression to repress cell proliferation. Taken together, these findings demonstrate that lncAB functions as a tumor suppressor during PTC tumorigenesis.Significance: These findings identify a tumor-suppressive long noncoding RNA in papillary thyroid carcinoma.Graphical Abstract: http://cancerres.aacrjournals.org/content/canres/78/15/4163/F1.large.jpg Cancer Res; 78(15); 4163-74. ©2018 AACR.

Protocol for management after thyroidectomy: a retrospective study based on one-center experience

Background and aim The optimal approach to detect and treat symptomatic hypocalcemia (SxH) after thyroidectomy is still uncertain. In our retrospective study, we sought to set a standardized postoperative management protocol on the basis of relative change of parathyroid hormone (PTH) and absolute value of postoperative day 1 (POD1) PTH. Methods Patients who underwent thyroidectomy were identified retrospectively in our prospective database. Blood was collected 1 day before surgery and on POD1. Extra calcium and calcitriol supplement was prescribed when necessary. Meanwhile, postoperative signs of SxH were treated and recorded in detail. Patients were followed up for 1 month after surgery and then 3 months thereafter. Results A total of 744 patients were included in the final analysis. Transient SxH occurred in 86 (11.6%) patients, and persistent SxH occurred in 4 (0.54%) patients in more than half year after surgery. Relative decrease of PTH reached its maximal discriminative effect at 70% (area under the curve [AUC] =0.754), with a sensitivity of 72.1% and a specificity of 75%. In Group 1 (≤70%), 24 (4.67%) patients were interpreted as having SxH, whereas in Group 2, 62 (27.0%) patients had SxH (>70%), P<0.001. Days of symptom relief in Group 1–1 (1, 2) were significantly shorter than those in Group 2–2 (1, 10), P=0.023. In Group 2, 112 (80%) patients with POD1 PTH <1 pmol/L were treated with calcitriol, whereas only 8 (8.89%) patients with POD1 PTH ≥1 pmol/L were treated with calcitriol (P<0.001). According to relief of SxH and recovery of parathyroid function, treating with and without calcitriol showed no difference in patients with POD1 PTH <1 and ≥1 pmol/L. Conclusion Relative decrease of PTH >70% is a significant risk factor for SxH in post-thyroidectomy. The decreasing percent of PTH ≤70% ensures discharge on POD1, but longer hospitalization was advocated for patients with decreasing percent of PTH >70%, who needed extra calcitriol supplement when POD1 PTH <1 pmol/L.

Phyllodes tumors of the breast in 2 sisters: Case report and review of literature

Rationale: Phyllodes tumors (PT) of the breast are rare neoplasm originating from fibroepithelial component. To our knowledge, our report is the first reported case of PT in 2 sisters. Patient concerns: We presented 2 cases of PT of the breast involving in 2 sisters. On physical examination of the younger sister, a firm mass measuring approximately 3 cm in diameter was identified in upper inner quadrant of the right breast. Physical examination of the elder sister revealed a 3 cm lump in upper outer quadrant of the left breast. Diagnoses: Histopathology of the younger sister revealed a malignant PT. The elder sister was diagnosed with borderline PT. Interventions: The younger sister with malignant PT underwent right mastectomy. The elder sister with borderline PT was scheduled for wide resection of the mass in the left breast. Outcomes: After a follow-up of 23 months, no local or distant recurrence was observed. Lessons: Our cases indicate that genetic factor may contribute to the risk of PT of the breast. Markers such as p53 and Ki-67 may have some correlation with PT malignancy.