1.To analyze the clinical characteristics of elderly patients with papillary thyroid carcinoma
Xuhuizi GUAN ; Tian YU ; Feiliang WANG ; Yunzhe DOU ; Jiankun LI ; Dongdong WANG ; An YAN ; Yao LI ; Gang MIAO
Chinese Journal of Geriatrics 2023;42(4):440-445
Objective:To analyze the clinical characteristics of elderly patients with papillary thyroid cancer(PTC)by age grouping.Methods:The patients were divided into three groups according to age at diagnosis: old(≥60 years, 90 cases), middle(40-59 years, 359 cases)and young patients(<40 years, 203 cases). The clinical data of 652 patients with PTC who were admitted to the Department of Thyroid Surgery of Beijing Hospital from December 2019 to December 2021 were retrospectively analyzed.The patients were divided into elderly group(≥60 years old, 90 cases), middle-aged group(40-59 years old, 359 cases)and young group(<40 years old, 203 cases). The clinical characteristics, ultrasound characteristics and invasion-related factors of patients in different groups were analyzed by statistical methods.Results:Compared with the young and middle-aged group, the elderly patients with PTC had a higher proportion of microcarcinoma(75.6%, 75.2%, 61.4%, χ2=13.054, P=0.001), less cervical lymph node metastasis(24.4%, 34.3%, 58.1%, χ2=41.650, P<0.001), and lower proportion of metastatic lymph nodes(0.08, 0.14, 0.24, χ2=40.618, P<0.001). There was no significant difference in tumor location and extra glandular invasion among the three age groups(35.56%, 36.2%, 38.4%, χ2=0.959, P=0.545). Conclusions:Compared with the young and middle-aged groups, PTC showed low invasiveness in the elderly population.In addition to surgical treatment, for elderly patients with low-risk clinical characteristics, it is worth performing a further study on whether careful observation or palliative treatment can be selected after comprehensive evaluation.
2.Pyogenic granuloma of the gums and lips caused by camrelizumab: case report and literature review
LI Yunzhe ; BU Lingxue ; PANG Baoxing ; WANG Ye ; LIU Fengzhi ; YANG Nan ; CHEN Chen ; WANG Shuangyi
Journal of Prevention and Treatment for Stomatological Diseases 2023;31(3):197-201
Objective:
To investigate the clinical manifestations, pathological features, and treatment of oral and maxillofacial pyogenic granulomas induced by camrelizumab.
Methods:
A case of pyogenic granuloma of the gums and lips caused by camrelizumab was reported along with a literature review.
Results:
After 4 months of treatment with camrelizumab for liver cancer, the patient developed systemic reactive capillary hyperplasia (RCH), followed by multiple masses on the lower lip and gingiva. After periodontal therapy, the masses on the lower lip and the gingiva were removed, and camrelizumab administration was stopped. The pathological result was gingival pyogenic granuloma/granulomatous hemangioma. No new masses were found in the oral cavity during postoperative follow-up. A review of the literature showed that RCH is the most common adverse drug reaction to camrelizumab but it occurs infrequently in the oral cavity. At present, the etiology of RCH has not been clarified, but the research has shown that camrelizumab may trigger tissue proliferation into hemangiomas by activating vascular endothelial cells, and the combined use of camrelizumab is safer than single use. RCH is self-limiting and most cases resolve spontaneously after discontinuation of the drug. If the mass causes dysfunction, surgical excision is feasible.
Conclusion
Camrelizumab can cause oral and maxillofacial reactive capillary hyperplasia complicated by pyogenic granuloma.