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Genetic Background May Confer Susceptibility to PTC in Benign multinodular Thyroid Disease

Journal of Cancer Therapy 2012年第6期3卷 997-1001页

作者： Sivatharsiny Thavarajah Frank Weber Department of General Visceral and Transplantation Surgery University Hospital Essen Essen Germany.

Purpose: The incidence of hyperplastic thyroid nodular disease has been consistently rising over the last decades. In addition, unsuspected papillary thyroid carcinoma (PTC) can be found in up to 34% of patients operated for benign thyroid lesions. PTC tends to occur multi-focally and is commonly of polyclonal origin. We set out to test the hypothesis that in benign thyroid disease, a unique genetic signature can already be identified in the benign pathology, which is associated with a susceptibility of the thyroid tissue to neoplastic transformation in the context of additional growth promoting stimuli. Patients and Methods: We obtained a set of 23 samples from patients with multinodular goiter (MNG), 12 of whom also harbored an unsuspected PTC. We used global gene expression analysis to evaluate for dissimilarities in the gene expression patterns between these two groups. We also compared these patterns to the profiles of 3 normal thyroid and 7 PTC samples. Results: We were able to accurately distinguish between hyperplastic nodules of patients with multinodular goiter and those that were associated with a PTC. One of the strongest differentially expressed genes, CDC42, has been implicated to respond to environmental factors such as UVB radiation and might point to novel factors contributing to PTC genesis in the setting of pre-existing benign proliferative disease. Conclusion: While the comparison between histologically identical samples cannot distinguish the two groups of goiters, unsupervised or supervised approaches allowed us to identify a molecular signature associated with PTC susceptibility in multinodular goiter.

关键词： multinodular Goiter Cancer Suceptibility Gene Expression Papillary Thyroid Carcinoma

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Postoperative outcomes and recurrence patterns of intermediatestage hepatocellular carcinoma dictated by the sum of tumor size and number

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World Journal of Gastroenterology 2022年第44期28卷 6271-6281页

作者： Xin-Sheng Hu Hui-Yuan Yang Chao Leng Zhi-Wei Zhang Hepatic Surgery Center Tongji HospitalTongji Medical College of Huazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina

BACKGROUND The selection criteria for Barcelona Clinic Liver Cancer(BCLC)intermediate-stage hepatocellular carcinoma(HCC)patients who would truly benefit from liver resection(LR)remain *** To identify BCLC-B HCC patients more suitable for *** We included patients undergoing curative LR for BCLC stage A or B multinodular HCC(MNHCC)and stratified BCLC-B patients by the sum of tumor size and number(N+S).Overall survival(OS),recurrence-free survival(RFS),recurrence-to-death survival(RTDS),recurrence patterns,and treatments after recurrence in BCLC-B patients in each subgroup were compared with those in BCLC-A *** In total,143 patients who underwent curative LR for MNHCC with BCLC-A(n=25)or BCLC-B(n=118)were retrospectively *** to the N+S,patients with BCLC-B HCC were divided into two subgroups:BCLC-B1(N+S≤10,n=83)and BCLC-B2(N+S>10,n=35).Compared with BCLC-B2 patients,those with BCLC-B1 had a better OS(5-year OS rate:67.4%vs 33.6%;P<0.001),which was comparable to that in BCLC-A patients(5-year OS rate:67.4%vs 74.1%;P=0.250),and a better RFS(median RFS:19 mo vs 7 mo;P<0.001),which was worse than that in BCLC-A patients(median RFS:19 mo vs 48 mo;P=0.022).Further analysis of patients who developed recurrence showed that both BCLC-B1 and BCLC-A patients had better RTDS(median RTDS:Not reached vs 49 mo;P=0.599),while the RTDS in BCLC-B2 patients was worse(median RTDS:16 mo vs not reached,P<0.001;16 mo vs 49 mo,P=0.042).The recurrence patterns were similar between BCLC-B1 and BCLC-A patients,but BCLC-B2 patients had a shorter recurrence time and a higher proportion of patients had recurrence with macrovascular invasion and/or extrahepatic metastasis,both of which were independent risk factors for *** BCLC-B HCC patients undergoing hepatectomy with N+S≤10 had mild recurrence patterns and excellent OS similar to those in BCLC-A MNHCC patients,and LR should be considered in these patients.

关键词： Hepatocellular carcinoma multinodular Intermediate-stage Liver resection Recurrence pattern Prognosis

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Diagnosing Graves’ Disease and Non-Graves Hyperthyroidism Using TSH Receptor Antibody Test versus Non-TSH Receptor Antibody Test Methods of Diagnosis

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Open Journal of Endocrine and Metabolic Diseases 2020年第2期10卷 7-17页

作者： Mohammed Qader Meena Department of Medicine College of Medicine Hawler Medical University Erbil Iraq

Background: Differentiating Graves hyperthyroidism from the other causes of hyperthyroidism, using serum TRAb testing is essential step for diagnosis. Objectives: To study importance of TRAb in the diagnosis of Graves’ disease, distinguishing it from thyroiditis, and comparing it with clinical features and other tests such as TPOAb, US thyroid and thyroid scintiscan. Methods: A cross-sectional study was conducted on 120 patients attending endocrine clinicErbil city. Patients were studied on clinical feature basis and investigated with serum TRAb, TPOAb, TSH, Free T4, and Ultrasound examination of thyroid gland. Fisher exact test and Chi Square test of independence, Correlation coefficient and t-test of independence were used. Results: Fifty-two patients were found to have Graves’ disease;There was significant correlation between TRAb positivity and diagnosis of Graves’ disease p 0.05. Conclusion: A positive correlation was found between TRAb titer and positivity and no significant relation between TPOAb levels between Graves’ disease patients compared with thyroiditis patients, respectively.

关键词： Graves’ Disease Thyrotoxicosis Toxic multinodular Goiter (TMNG) Thyroiditis TSH Receptor Antibodies (TRAb)

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New strategy to distinguish clonal origin of RHCC/MHCC between intrahepatic metastasis and multicentric occurrence

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Hepatoma Research 2018年第5期4卷 12-21页

作者： Han Wang Wen-Ming Cong Department of Pathology Eastern Hepatobiliary Surgery HospitalSecond Military Medical UniversityShanghai 200438China

Hepatocellular carcinoma (HCC) is a kind of malignancy with high potential of metastasis and multicentric occurrence. The treatment of recurrent hepatocellular carcinoma (RHCC) and multinodular hepatocellular carcinoma (MHCC) is always a nodus because of the diverse clonal origin of RHCC/MHCC. Theoretically, the RHCC/MHCC can originate from intrahepatic metastasis (IM type) or multicentric occurrence (MO type). Our previous study proposed that there are at least 6 subtypes of clonal origin patterns in RHCC. RHCC and MHCC with different clonal origins have variant biological behaviors, clinical prognosis as well as treatment strategy. Generally speaking, patients with IM type HCC have a poorer prognosis compared with those with MO type HCC. Therefore, it is essential to emphasize the distribution of the clonal origin in HCC in order to determine the choice of clinical treatment. Undoubtedly, the detection of clonal origin pattern will become a promising breakthrough in the molecular pathological diagnosis of HCC. We should attach more attention to the establishment of a standardized molecular pathological clonal origin detection method and a new stratification of clinical treatment choice for RHCC/MHCC in future.

关键词： Hepatocellular carcinoma clonal origin molecular pathology recurrent hepatocellular carcinoma multinodular hepatocellular carcinoma intrahepatic metastasis multicentric occurrence

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