Purpose To analyze the clinical pathological characteristics and pathological diagnosis and prognosis of spindle cell carci-noma of the breast. Methods Three cases of spindle cell carcinoma of the breast were studied by morphological and immunohisto-chemical EnVision techniques. Results The females were 48, 63 and 71 years old. The tumors located in the right breast with 4. 0 cm × 3. 0 cm × 3. 0 cm, 3. 0 cm × 2. 0 cm × 2. 0 cm and 3. 5 cm × 2. 8 cm × 2. 3 cm in size and showed cystic lesion. The neoplasm was composed of bland spindle cells and mimicking fibromatosis. Immunohistochemical staining showed that spindle cells were positive for CK(AE1/AE3), CK(34βE12), CK14, CK5/6, p63 and vimentin, negative for ER, PR and c-erbB-2. Ki-67 was positive in 20%, 25% and 20% of the cells. Conclusion Spindle cell carcinoma of the breast is a rare subtype of the metaplastic carcinoma which tend to show cystic changes. It is important to make a definite diagnosis which combine histopathologic features and immunophe-notyping.

Objective To investigate the clinical manifestations,laboratory findings and genetic characteristics of two cases with simple virilizing (SV)21-hydroxylase(21OHD). Methods Clinical manifestations and laboratory data were obtained. The promoter and coding areas of CYP21A2 gene were directly sequenced. In silico analysis were used to predict the function of mutations. Results Two patients presented severe virilism. The laboratory examinations showed that plasma ACTH,aldosterone,androstendione and testosterone were significantly increased compared with normal individuals. VCT scan showed hyperplasia of bilateral adrenal. Direct sequencing of CYP21A2 gene showed two complex mutations-H62L/V69L and I2g/10InsL,which were not reported previously. In silico analysis(Polyphen)showed the novel mutation V69L could probably damage the function of CYP21A2 protein. Conclusion The combined mutations,H62L/V69Land I2g/10InsL,could be associated with SV type 21-OHD phenotype.

A total of 1 870 patients who had undergone thyroidectomy were investigated.The mean TSH level in patients with differentiated thyroid cancer (DTC) was significantly higher than that in patients with benign thyroid nodules[(1.95±1.69 vs 1.40±1.98)mIU/L,P＜0.01].DTC patients who had lymphatic metastasis or the diameter of tumor more than 10 mm had higher serum TSH level.Serum thyrotropin is an independent risk predictor for DTC.

Objective To investigate the relationship between serum thyrotrophin(TSH)and dyslipidemia in subclinical hypothyroid and euthyroid subjects. Methods An epidemiological study on diabetes and thyroid diseases was performed in Dadong community, Shenyang city, in 2007. 110 subjects with subclinical hypothyroidism(SCH)and 1 240 euthyroid subjects were enrolled in the study. Neither history of thyroid diseases nor administration of thyroid-related and lipid-regulating medicines were reported in these subjects. The levels of serum thyroid hormones, lipids, fasting plasma glucose(FPG), and insulin were determined. Results (1)Patients with SCH had significantly lower HDL-C levels than those who were euthyroid.(2)According to the guideline of treatment of adult dyslipidemia in China, the lipid profiles were each categorized. Mean TSH levels were higher in subjects in the dyslipidemia subclass than subjects in the normal subclass. The differences were significant in high LDL-C subclass in overweight individuals. In euthyroid overweight women, mean TSH levels were significantly higher in high LDL-C subclass. In the euthyroid population, TSH was positively associated with total cholesterol in overweight population. The association was not modified by the homestasis model assessment for insulin resistance(HOMA-IR)values.(3)TSH was associated positively with serum triglycerides and negatively with serum HDL-C in women. TSH was positively associated with total cholesterol in overweight population and positively associated with total cholesterol and LDL-C in overweight women after adjustment for age, sex, and body mass index. Conclusion Raised serum TSH seems to be a risk factor of dyslipidemia in subclinical hypothyroid and euthyroid subjects, which is independent of insulin sensitivity.

OBJECTIVETo investigate the prevalence of thyroid diseases in a community which did not use iodized salt.

METHODSThe survey was conducted in Panshan, Liaoning Province. 1 103 inhabitants aged 14 years or more attended the examinations, which included questionnaire, physical examination and serum analysis. Iodine in the urine and thyroid B ultrasound examination were also conducted.

RESULTSThe prevalence of overt hyperthyroidism and hypothyroidism was 16.3 per thousand and 2.7 per thousand, respectively. Subclinical hyperthyroidism and hypothyroidism were detected in 37.2 per thousand and 9.1 per thousand of the subjects, respectively. Serum autoantibodies to thyroid were detected in 10.9% of the entire population. The prevalence of goiter was 20.7% (diffuse goiter 16.8% and nodular goiter 3.9%).

CONCLUSIONIn the iodine deficient areas, perhaps autoimmununization is not only related to the development of goiter but is also the main cause of subclinical hyperthyroidism and hypothyroidism.

Adolescent ; Adult ; Aged ; Autoantibodies ; analysis ; China ; epidemiology ; Female ; Goiter ; epidemiology ; Health Surveys ; Humans ; Hyperthyroidism ; epidemiology ; Hypothyroidism ; epidemiology ; Iodine ; deficiency ; urine ; Male ; Middle Aged ; Prevalence ; Residence Characteristics ; Sodium Chloride, Dietary ; Thyroid Diseases ; epidemiology ; immunology ; metabolism ; Thyroid Nodule ; epidemiology

Objective To investigate the changes and related factors of maternal thyroid autoantibodies during early pregnancy. Methods Urinary iodine concentration( UIC) , serum thyroid stimulating hormone( TSH) , free thyroxine ( FT4 ) , thyroid-peroxidase antibody ( TPOAb ) , thyroglobulin antibody ( TgAb ) concentrations were determined in 7 190 women during early pregnancy in an iodine-sufficient region of China. Results The prevalence of TPOAb positivity and TgAb positivity were 8. 7% and 12. 0% respectively. The prevalence of overt hypothyroidism and subclinical hypothyroidism increased significantly in group of thyroid antibody positivity. The prevalence of TPOAb positivity and TgAb positivity presented a U-shaped curve, ranging from mild iodine deficiency to iodine excess, especially increased significantly in the group with UIC<100 μg/L. Conclusion Prevalence of thyroid antibodies positivity became higher during early pregnancy. The positive thyroid autoantibodies during pregnancy were significantly associated with maternal hypothyroidism. Both iodine excess and iodine deficiency are risk factors of positive thyroid antibodies.

Objective To explore the relationship between serum thyrotropin and the components of metabolic syndrome.Methods A total of 1534 adult inhabitants in Dadong district of Shenyang were asked to fulfill the questionnaires and have physical examination and oral glucose tolerance test(OGTT).The vein blood was drawn to measure thyrotropin(TSH),fasting plasma glucose(FPG),OGTT 2hPG,fasting insulin,triglyceride(TG) and high density lipoprotein cholesterol(HDL-C).Results Serum TSH in the MS group was higher than in the Non-MS group(2.54 vs 2.22 mU/L,P