1.Variant-related clinicopathological features in papillary thyroid carcinoma: an analysis of 600 cases
Jingtai ZHI ; Xiangqian ZHENG ; Ming GAO
Chinese Journal of General Surgery 2017;32(3):194-197
Objective To investigate the distinct clinicopathological characteristics among different variants of papillary thyroid microcarcinoma(PTMC).Methods The clinicopathological data of 600 PTMC patients treated in Tianjin Medical University Cancer Hospital from July 2015 to December 2015 were analyzed retrospectively.Chi-square test was used to compare the distinct clinicopathological features among different variants and multivariate Logistic regression analysis was performed for independent predictors for lymph node metastasis (LNM).Results Conventional variant (43.0%),follicular variant (46.7%),and encapsulated variant (7.7%),accounted for 97.3% of all cases.Follicular variant had the largest tumor size and encapsulated variant had highest rate of calcification and no extrathyroidal extension.The incidence of LNM was the highest in conventional variant followed by follicular variant and then by encapsulated variant.Maleness,age < 45,calcification,minimal extrathyroidal extension and multifocality were independent risk predictors for LNM.Conclusions Follicular variant are the most common in PTMC,whose aggressiveness is far below conventional variant PTMC patients.Independent risk predictors for cervical LNM were maleness,age < 45,tumor calcification,minimal extrathyroidal extension and multifocality.
2.Clinical biological characteristics of metastatic carcinoma of the thyroid: a report of 30 cases
Yu WU ; Xiangrui MENG ; Linfei HU ; Xiukun HOU ; Jingtai ZHI ; Jun ZHANG ; Huijuan WANG ; Hui LIU ; Xiangqian ZHENG ; Ming GAO
Chinese Journal of General Surgery 2019;34(6):489-492
Objectives To study the clinical characteristics,diagnosis,treatment and prognosis of cancer metastases to the thyroid gland.Methods At Tianjin Medical University Cancer Hospital,from 1980 to 2016 30 patients were identified with a metastatic malignant tumor of the thyroid gland.Results Primary tumor sites were in the esophagus (26.7%),lung (16.7%),and kidney (13.3%).The median age at discovery of thyroid metastasis was 56 years old.The time lapse ranged from 0 to 108 months.There were 18 patients with metachronous metastasis with median survival of 36 months,12 patients were with synchronous metastasis,and the median survival was 8 months (P < 0.01).20 patients were treated with thyroid surgery,and of which 15 patients were given post-op radiotherapy and chemotherapy.Patients who underwent thyroid resection had a median survival of 15 months,while that was 8 months in those without thyoid surgery (P < 0.01).Conclusions Metastases to the thyroid gland is a rare clinical phenomenon,the prognosis of patients is mainly related to the biological behavior of primary tumors,but surgical resection and combined treatment can increase the survival rate.
3.Clinicopathological characteristics of papillary thyroid carcinoma in obese children and adolescents
Weiwei YANG ; Jingtai ZHI ; Xiangqian ZHENG ; Wei WANG
Chinese Journal of General Surgery 2021;36(6):432-435
Objective:To analyze the clinicopathological characteristics of papillary thyroid carcinoma (PTC) in obese children and adolescents.Methods:From Jan 2012 to Dec 2015, 59 school-age PTC children and adolescents admitted to Tianjin First Central Hospital and Tianjin Medical University Tumor Hospital were recruited for retrospective case-control study. By using the chi-square test, the clinicopathological characteristics of obese children and adolescents with papillary thyroid carcinoma were analyzed. Kaplan-Meier method was used to analyze the factors significantly related to the recurrence.Results:Compared with patients of normal weight, overweight and obese patients were older (χ 2=4.250, P=0.039), and had multifocal tumors (χ 2=5.281, P=0.022) and higher recurernce rate (χ 2=4.861, P=0.027) .Compared with normal-weight children and adolescents with PTC, overweight or obese children and adolescents with PTC significantly had higher recurrence rate (χ 2=4.466, P=0.035); In addition, tumor diameters >1 cm (χ 2=5.453, P=0.020) and patients with multifocal tumors (χ 2=7.218, P=0.007) were also more likely to suffer recurrence. Conclusion:Among children and adolescent patients with papillary thyroid cancer, obesity is significantly related to multifocal tumors and higher recurernce rate.
4.Total thyroidectomy versus lobectomy for unilateral sporadic medullary thyroid carcinoma
Jinming ZHANG ; Jingzhu ZHAO ; Dongmei HUANG ; Pengfei GU ; Jingtai ZHI ; Xiangqian ZHENG
Chinese Journal of General Surgery 2022;37(8):579-583
Objective:To compare the prognosis of patients with unilateral sporadic medullary thyroid carcinoma treated by different surgical selection, and analyze the independent risk factors affecting the prognosis.Methods:One hundred and twenty-six patients at Tianjin Medical University Cancer Institute and Hospital from Feb 2011 to Oct 2018 were retrospectively divided into group A (total thyroiclectomy) and group B (unilateral lobectomy).Results:There were no significant differences in postoperative recurrence rate ( χ2=0.394, P=0.530), mortality ( χ2=3.175, P=0.146), biochemical cure rate ( χ2=0.613, P=0.434), progression free survival and overall survival ( P=0.278, 0.175) between group A and group B; Tumor diameter ≥4 cm and lateral cervical lymph node metastasis were independent risk factors affecting the overall survival. The incidence of postoperative temporary hypocalcemia ( χ2=5.068, P=0.024) and permanent hypocalcemia ( χ2=6.590, P=0.010) in group A was higher than that in group B. Conclusions:Ipsolateral thyroidectomy can be applied to patients with unilateral sporadic medullary thyroid carcinoma with similar long term prognosis and tower incidence of temporary hypocalcemia and permanent hypocalcemia compared to total thyroidectomy.