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.

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.

Thyroid carcinoma (TC) is the most common endocrine cancer and its incidence has been increasing globally over the past decades.With the development of the genetic technology,more and more evidences showed that many genes affect the biological behaviors of TC,making sense to early diagnosis,predicting the prognosis and targeted therapy for TC.BRAF mutation is specific to papillary thyroid carcinoma (PTC).It can not only predict the prognosis,but also have diagnosis value.RET rearrangements are identified as a specific genetic event in PTC.Though the preoperative detection of RET/ PTC rearrangements has not proven useful in choosing the appropriate surgical management,new medications which are capable of inhibiting RET protein kinase activity may help to therapy the PTCs.RET mutation has specific meaning for detecting familial medullar thyroid carcinoma.Though RAS mutation can be discovered in follicular thyroid carcinoma (FTC),follicular variant of papillary thyroid carcinoma (FvPTC),poorly differentiated thyroid carcinoma (PDTC) and undifferentiated thyroid carcinoma (UTC),the relationship between RAS mutation and prognosis remains controversial.P53 can be detected in more invasive variants of PTC,PDTC and UTC.P53 can be used as a prognosis-predictor.Rescuing the function of mutant p53 (mutp53) protein is an attractive anticancer therapeutic strategy.30％-35％ FTC and 37.5％ FvPTC have PAX8-PPAR-γ rearrangement,which can distinguish carcinomas from adenomas in follicular neoplasms of the thyroid.Pioglitazone may have therapeutic efficacy in patients with PPFP-positive TCs.FTC and PTC have TERT promoter mutation,usually predicting poor prognosis.Other genes also influence on the biological behavior of TC,having diagnosis value and prognostic significance.Though the gene study about TC develops rapidly,many problems remain unclear.Further studies on TC-related genes are needed.

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.

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.

Objective:To analyze the correlations between serum thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) and clinicopathological features in children and adolescents with papillary thyroid carcinoma (PTC).Methods:A retrospective analysis was conduced on the clinicopathological data of children and adolescents (age≤21 years old) with PTC admitted to Tianjin Medical University Cancer Hospital from 2011 to 2019, and then, we used χ 2 test or Fisher′s exact probability test to compare the differences in clinicopathological characteristics between groups with different TgAb and TPOAb status and multivariate logistic regression model analysis to evaluate independent predictors of cervical lymph node metastasis. Results:A total of 304 patients, including 89 males and 215 females, aged 5-21 years (median age 19 years), were enrolled in this study. The comparison between groups with different TgAb and TPOAb status showed that there were significant differences in gender, preoperative thyroglobulin (Tg) level, primary tumor location, number of primary tumors and maximum tumor diameter (all P<0.05), which suggested that TgAb +group ( n=81) and TPOAb +group ( n=84) had relatively better primary tumor characteristics. Patitents with TgAb +and TPOAb +were more common in females and their preoperative Tg level was mostly within the normal range, and there were significant differences in primary tumor location, number of primary tumors and maximum tumor diameter between TgAb +and TgAb -(223 cases) groups (all P<0.05). There was significant difference in the maximum tumor diameter between TPOAb +and TPOAb -(220 cases) groups ( P<0.05). Analysis of risk factors for cervical lymph node metastasis showed that independent risk factors for central lymph node metastasis were maximum tumor diameter>2 cm ( OR=2.84, 95% CI: 1.59-5.07, P<0.001) and extra-thyroid extension ( OR=0.32, 95% CI: 0.17-0.60, P<0.001), and independent risk factors for lateral neck lymph node metastasis included age≤14 years old ( OR=0.34, 95% CI: 0.18-0.67, P=0.002), preoperative Tg +( OR=2.16, 95% CI: 1.10-4.24, P=0.026) and maximum tumor diameter>2 cm ( OR=3.99, 95% CI: 2.33-6.82, P<0.001). Conclusion:It is recommended to test routinely serum TgAb and TPOAb before surgery in children and adolescents with PTC. Preoperative Tg +, age≤14 years, maximum tumor diameter>2 cm, and extra-thyroid extension are risk factors for cervical lymph node metastasis.

Objective:By conducting a retrospective analysis of the clinical data of 14 patients diagnosed with invasive fungal rhinosinusitis (IFRS) confirmed by metagenomics next generation sequencing (mNGS) technology, we aim to explore the rapid diagnosis value of mNGS in IFRS.Methods:The clinical data of 14 IFRS patients admitted to TianJin First Central Hospital were retrospectively analyzed from February 2021 to October 2023. The study cohort comprised 8 males and 6 females, with ages ranging from 14 to 77 years. All patients were diagnosed as IFRS by performing mNGS sequencing technology of nasal sinus lesion biopsy specimens. Clinical data such as laboratory examination, imaging examination, histopathological examination results, treatment plan and prognosis were summarized and analyzed.Results:All 14 patients were diagnosed as IFRS, with mNGS detecting pathogens such as Rhizopus (7 cases), Aspergillus (5 cases), Trichoderma (1 case), and Scedosporium apiospermum (1 case). Follow-up evaluations were conducted for a period ranging from 2 months to 2 years post-treatment. At the end of follow-up, 11 out of 14 IFRS patients achieved a complete cure with no signs of recurrence, while the symptoms of the remaining 3 patients significantly improved with comprehensive treatment. Conclusion:mNGS emerges as a highly effective diagnostic tool for IFRS, providing valuable microbiological evidence for clinical diagnosis and demonstrating promising clinical utility.