ObjectiveTo investigate the effect of surgery and influence of posttreatment with non-standardized and standardized operation by reviewing and analyzing the sporadic medullary thyroid carcinoma operation cases. MethodsThe clinical data of 26 patients with sporadic medullary thyroid carcinoma treated by surgery from January 2000 to March 2013 in this hospital were analyzed retrospectively.These patients were divided into non-standardized operation group and standardized operation group (total thyroidectomy with lymph node dissection) according to the operation models.The biochemical cure rate, the complication rates of recurrent laryngeal nerve injury and hypopara-thyroidism of these two groups were investigated and compared. ResultsThe 1-year biochemical cure rate had no statistical difference between the non-standardized operation group and standardized operation group (84.21% versus 100%, χ2=1.249 4, P > 0.05), the 1-year recurrence rate was 15.79% and 0, respectively.The 5-year biochemical cure rate of the standardized operation group was significantly higher than that of the non-standardized operation group (100% versus 16.67%, χ2=4.444 4, P < 0.05).The 5-year recurrence rate was 0 and 83.33%, respectively.However, there was no obvious difference between the two groups on the injury rate of recurrent laryngeal nerve (χ2=0.070 8, P > 0.05), as well as the rate of hypoparathyroidism (χ2=2.722 7, P > 0.05). ConclusionsCompared with the non-standardized model, the standardized operation model (total thyroidectomy with lymph node dissection) shows a higher cure rate and a lower recurrent rate, and it does not increase the complication rates of hypoparathyroidism and recurrent laryngeal nerve injury
Objective To summarize the value of serum thyroglobulin (Tg) in diagnosis before surgery and monitoring after surgery for differentiated thyroid cancer (DTC). Methods By using the method of literature review, the literatures related to the diagnosis and monitoring value of serum Tg for DTC were studied. Results ① Serum thyroglobulin had a certain value in diagnosis of thyroid nodules, especially in follicular cancer or Hürthle cancer whose diagnosis undetermined by fine-needle aspiration biopsy (FNAB), and it was closely linked with the tumor’s size and distant metastasis of the DTC. ② Raise of serum Tg postoperatively was important for judging the recurrence and metastasis of DTC. However, how to establish an appropriate threshold of serum Tg, identify the differences of results for different measurement methods, make the accurate judgment for false positive and false negative, and combine with other imaging methods appropriately, needed our attention. Conclusion Serum Tg plays a very important role in diagnosis before surgery and monitoring after surgery of DTC, clinical doctors need pay high attention on it.
Objective To summarize the clinical and pathological manifestation, therapy, and prognosis of primary thyroid lymphoma(PTL). Methods The clinical and pathological data of 20 patients with PTL treated in our hospital from Jan.2002 to Feb.2014 were retrospectively analyzed. Results Of the 20 patients, 14 patients were female, 6 patients were male. The median age were 63.5 years old (45-77 years old). Seven patients (35.0%) were diffused large B-cell lymphoma (DLBCL), and 12 patients (60.0%) were extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma, 1 patient (5.0%) was follicular lymphoma (FL). Twelve patients complicated with Hashimoto thyroiditis. Six patients(30.0%) accepted surgery only, 13 patients(65.0%) were supplemented with chemotherapy and (or) radiotherapy, 1 patient (5.0%) accepted chemotherapy and radiotherapy only. Two patients lost during follow-up, but 18 patients were followed-up for 6-104 months with the median time of 46.5 months. During the follow-up period, 6 patients died of PTL. The cumulative survival rates of 2-year and 5-year were 74.4% and 66.9%, respectively. Conclusion Most PTL are B-cell original non-Hodgkin lymphoma. In order to get good prognosis, chemotherapy and (or) radiotherapy are mostly needed, while surgery is performed for definitive pathological diagnosis.