Objective To investigate the predictive value of integrating clinical pathological characteristics with genetic testing for occult lymph node metastasis(OLNM)in patients with papillary thyroid microcarcinoma(PTMC).Methods A total of 104 PTMC patients admitted to our hospital between May 2023 and May 2025 were included in the study.All patients showed no evidence of suspicious lymph node metastasis on preoperative imaging and underwent standard thyroidectomy with central lymph node dissection.Based on postoperative pathological con-firmation of central lymph node metastasis status,patients were classified into an OLNM-positive group(n=53)and an OLNM-negative group(n=51).Baseline characteristics,clinicopathological features,BRAFV600E gene mutation status,and TERT promoter mutation status were compared between the two groups.To identify factors independently associated with OLNM in PTMC patients,multivariate logistic regression analysis was conducted.The area under the receiver operating characteristic curve(AUC)was utilized to assess the predictive performance of a combined model incorporating clinical,pathological,and genetic features for OLNM.Results Compared with the OLNM-negative group,the OLNM-positive group exhibited significantly higher preoperative thyroid-stimulating hormone(TSH)levels(P<0.05).Moreover,the OLNM-positive group demonstrated significantly greater proportions of tumors with diameter>0.5 cm,multifocality,microcalcifications,capsule invasion,extrathyroidal extension,T3 stage,BRAFV600E mutation,and TERT promoter mutation(all P<0.05).Multivariate logistic regression analysis identified preoperative TSH level,tumor diameter>0.5 cm,multifocal lesions,capsule invasion,extrathyroidal extension,T stage,BRAFV600E mutation,and TERT promoter mutation as independent risk factors for OLNM in patients with PTMC(all P<0.05).ROC curve analysis demonstrated that the integrated model combining clinical pathological features-including tumor diameter,number of lesions,microcalcification,capsule invasion,extrathy-roidal extension,and T stage-with genetic markers(BRAFV600E and TERT promoter mutations)exhibited the highest predictive performance,yielding an AUC of 0.940.This was significantly higher than the model based solely on clinical pathological features(AUC=0.736)or those relying exclusively on genetic testing(BRAFV600E:AUC=0.860;TERT:AUC=0.882),with all comparisons reaching statistical significance(P<0.05).Conclusions The integration of clinical pathological features with genetic testing significantly improved the predictive accuracy of OLNM in PTMC patients,surpassing models based solely on individual clinical pathological characteristics or genetic tests alone.This multimodal strategy offers a robust,evidence-based foundation for personalized surgical planning and enhances the precision of clinical decision-making in the management of PTMC.

Objective To investigate the predictive value of integrating clinical pathological characteristics with genetic testing for occult lymph node metastasis(OLNM)in patients with papillary thyroid microcarcinoma(PTMC).Methods A total of 104 PTMC patients admitted to our hospital between May 2023 and May 2025 were included in the study.All patients showed no evidence of suspicious lymph node metastasis on preoperative imaging and underwent standard thyroidectomy with central lymph node dissection.Based on postoperative pathological con-firmation of central lymph node metastasis status,patients were classified into an OLNM-positive group(n=53)and an OLNM-negative group(n=51).Baseline characteristics,clinicopathological features,BRAFV600E gene mutation status,and TERT promoter mutation status were compared between the two groups.To identify factors independently associated with OLNM in PTMC patients,multivariate logistic regression analysis was conducted.The area under the receiver operating characteristic curve(AUC)was utilized to assess the predictive performance of a combined model incorporating clinical,pathological,and genetic features for OLNM.Results Compared with the OLNM-negative group,the OLNM-positive group exhibited significantly higher preoperative thyroid-stimulating hormone(TSH)levels(P<0.05).Moreover,the OLNM-positive group demonstrated significantly greater proportions of tumors with diameter>0.5 cm,multifocality,microcalcifications,capsule invasion,extrathyroidal extension,T3 stage,BRAFV600E mutation,and TERT promoter mutation(all P<0.05).Multivariate logistic regression analysis identified preoperative TSH level,tumor diameter>0.5 cm,multifocal lesions,capsule invasion,extrathyroidal extension,T stage,BRAFV600E mutation,and TERT promoter mutation as independent risk factors for OLNM in patients with PTMC(all P<0.05).ROC curve analysis demonstrated that the integrated model combining clinical pathological features-including tumor diameter,number of lesions,microcalcification,capsule invasion,extrathy-roidal extension,and T stage-with genetic markers(BRAFV600E and TERT promoter mutations)exhibited the highest predictive performance,yielding an AUC of 0.940.This was significantly higher than the model based solely on clinical pathological features(AUC=0.736)or those relying exclusively on genetic testing(BRAFV600E:AUC=0.860;TERT:AUC=0.882),with all comparisons reaching statistical significance(P<0.05).Conclusions The integration of clinical pathological features with genetic testing significantly improved the predictive accuracy of OLNM in PTMC patients,surpassing models based solely on individual clinical pathological characteristics or genetic tests alone.This multimodal strategy offers a robust,evidence-based foundation for personalized surgical planning and enhances the precision of clinical decision-making in the management of PTMC.

Objective:To explore the advantage of thyroid biopsy and evaluate detection in the application of thyroid cancer cervical lymph node dissection operation guidance, and provide evidence-based basis for guiding PTC patients whether to receive lateral dissection.Methods:The data of 258 patients with thyroid papillary carcinoma admitted to Department of Thyroid Surgery, Affiliated Hospital of Chengde Medical College from April 2018 to December 2019 were retrospectively analyzed. All patients were admitted to the hospital for ultrasonic examination of cervical lymph nodes. According to the examination results, thyroid biopsy and puncture eluent were performed for patients with suspicious signs of metastasis. Patients with positive test results and with metastatic signs in initial ultrasonic examination received lymph node dissection in the cervical region. All patients underwent pathological examination postoperatively to diagnose the lymph node metastasis, and to evaluate the sensitivity, specificity and accuracy of the detection of the patients with lateral clearance.The measurement data was expressed as mean±standard deviation ( Mean± SD), and the count data was expressed as n(%). The software of SPSS21.0 was used to conduct statistical analysis. Results:All 258 patients were successfully completed the diagnosis of various diagnostic methods. Combined with the postoperative pathological diagnosis results, the accuracy rate of ultrasonic diagnosis of lymph node metastasis was 74.42%, the accuracy rate of FNAC diagnosis was 82.95%, the accuracy rate of FNAC-Tg diagnosis was 87.98%, and the accuracy rate of FNAC-Tg diagnosis was 94.96%. The diagnostic sensitivity of ultrasound, FNAC, FNAC-Tg and FNAC-Tg was 73.60%, 81.72%, 91.01% and 95.83%, respectively, and the diagnostic specificity was 76.25%, 86.11%, 79.71% and 88.41%, respectively. In every four months for a time span since April 2018, the average length of hospital stay for patients with each span was (9.17±1.30), (8.39±1.21), (7.94±1.03), (7.46±0.94), (7.33±0.82) d, their neck area incidence of lymph node metastasis were 17.6%, 21.3%, 15.7%, 12.9%, 11.8%, side clear surgical patients accounted for 42.3%, 37.5%, 30.9%, 26.6%, 19.4%. The incidence of lymph node metastasis was 86.8%, 79.4%, 84.5%, 93.2% and 98.1%, respectively.Conclusion:FNAC-Tg method is used in the diagnosis of thyroid papillary carcinoma patients with high sensitivity and specificity of lymph node metastasis, which has certain value in guiding patients whether to perform lymph node dissection.

Objective:To investigate the value of exocrine LncRNA SPINT1-AS1 in diagnosis and prognosis of papillary thyroid carcinoma (PTC) .Methods:qRT-PCR was used to detect the expression of SPINT1-AS1 in PTC tissues, cell lines (TPC-1, BCPAP, K1 and IHH4) , serum exocrine bodies of patients and normal tissues adjacent to cancer, human thyroid normal cell line Nthy-ori 3-1 and healthy volunteers. CCK-8 and colony formation assay were used to detect the effects of SPINT1-AS1 on the proliferation and colony formation of PTC cells. The interaction between SPINT1-AS1 and miR-128-3p, miR-128-3p and ITGA3 was verified by double luciferase report test.Results:The expression of SPINT1-AS1 in PTC tissues and cell lines was significantly higher than that in adjacent normal tissues and Nthy-ori 3-1 cell lines. Knockdown of SPINT1-AS1 inhibited the proliferation and colony formation of PTC cells. Bioinformatics analysis showed that there was a SPINT1-AS1/miR-128-3p/ITGA3 interaction regulatory network in PTC. The direct interaction of SPINT1-AS1, miR-128-3p and ITGA3 was verified by double luciferase reporter test. In addition, SPINT1-AS1 was significantly up-regulated in serum exocrine bodies of patients with PTC.Conclusion:Our study shows that SPINT1-AS1 regulates the miR-128-3p/ITGA3 axis to promote the proliferation and colony formation of PTC cells. Exocrine SPINT1-AS1 may be an effective molecular target for PTC in diagnosis and treatment of PTC.

Objective:To detect the expression of DKK1 in plasma and cancer tissues of patients with papillary thyroid carcinoma (PTC) , to analyze its relationship with clinicopathological parameters and β-catenin expression, and to explore the occurrence and development of DKK1 and PTC relevance.Methods:80 patients with PTC undergoing surgical treatment in Department of Thyroid Surgery, the Affiliated Hospital of Chengde Medical University from Jan. 2017 to Dec. 2019 and 100 healthy controls were included in the study. PTC tissues and paracancerous tissues of the patients were taken, and the morning fasting venous blood of the patients and healthy controls were retained. The concentrations of DKK1 and β-Catenin in plasma were detected by enzyme-linked immunosorbent assay, and the expression of DKK1 and β-Catenin in tissue was detected by immunohistochemistry.Results:The plasma DKK1 level of PTC patients was significantly lower than that of healthy controls ( t=5.863, P<0.001) , while the plasma β-catenin level was significantly higher than that of the healthy controls ( t=6.223, P<0.001) , and the plasma DKK1 and β-catenin levels of PTC patients were negatively correlated ( r=-0.724, P<0.001) ; the positive expression rate of DKK1 in PTC tissues was significantly lower than that in paracancerous tissues ( χ2=44.545, P<0.001) , while the positive expression rate of β-catenin was significantly lower than that in paracancerous tissues ( χ2=44.545, P<0.001) . The positive expression rate of DKK1 and β-catenin in PTC was significantly higher than that in paracancerous tissues ( χ2=26.243, P<0.001) , and the expression of DKK1 and β-catenin in PTC was negatively correlated ( χ2=13.637, P<0.001) . The level of plasma DKK1 in PTC patients was related to disease stage ( t=3.040, P=0.003) and lymph node metastasis ( t=5.452, P<0.001) . The positive expression rate of DKK1 in PTC tissue was also related to lymph node metastasis ( χ2=7.486, P=0.006) . In addition, the area under curve (AUC) of the diagnostic effect of plasma DKK1 level on PTC was 0.821 (95% CI=0.750-0.892, P=0.002) . Conclusion:The down-regulation of DKK1 expression in plasma and tissue is related to the occurrence and development of PTC, which has certain clinical application value.

Objective To elucidate the features of the expression of P53,proliferation and apoptosis in gestational trophoblastic tumor(GTT).Methods Ten cases of normal placenta,10 cases of complete hydatidiform mole(CM),20 cases of invasive hydatidiform mole(IM)and 19 cases of choriocarcinoma(CCA)paraffin-embedded tissues were studied.P53 and PCNA were detected with immunohistochemistry,apoptosis was detected with terminal deoxy-nucleotidyl transferase-mediated dUTP-biotin nick end labeling(TUNEL).Results In NP,CM,IM and CCA,the P53 indexes(P53-Ⅰ)were 4.12%,21.68%,39.61% and 27.39% respectively with significant differences among them(P