ObjectiveTo summarize the research status of normocalcemic parathormone elevation after parathyroidectomy for patients with primary hyperparathyroidism. MethodsThe related literatures on normocalcemic parathormone elevation after parathyroidectomy were collected and reviewed. ResultsMost of the patients with primary hyperparathyroidism received radical treatment postoperation. NPE didn't predict failure of operation. The relationship between normocalcemic parathormone elevation and recurrent primary hyperparathyroidism remained to be further explored. Patients with normocalcemic parathormone elevation after parathyroidectomy had a higher risk of cardiovascular disease. Postoperative vitamin D and calcium supplementation could reduce the incidence of normocalcemic parathormone elevation. ConclusionsThe clinical significance of normocalcemic parathormone elevation is still unknown at present. Further researches of multicenter, huge sample, and long-term follow-up will be necessary.
Objective To summarize the clinical and research status in the surgical management of medullary thyroid carcinoma. Methods The related literatures on treatment of medullary thyroid carcinoma were collected and reviewed. Results A total thyroidectomy and dissection of the lymph nodes in the central compartment were effective treatments for patients with medullary thyroid carcinoma. The extent of lateral compartment lymph-node dissection did not reach an agreement. Prophylactic thyroidectomy was suggested for patients with a RET (rearranged during transfection) germline mutation. Palliative therapy was the main treatment of metastatic medullary thyroid carcinoma. Conclusions Surgery is the mainstay of treatment for medullary thyroid carcinoma. The combination of preoperative assessment, genetic testing, and appropriate surgical strategy may improve the prognosis of patients with medullary thyroid carcinoma.
ObjectiveTo summarize the clinical and genetic characteristics of parathyroid disease associated with CDC73 gene mutation.MethodsThe related literatures on CDC73 gene mutation and parathyroid diseases were collected and reviewed.ResultsCDC73 gene is a tumor suppressor gene which encodes parafibromin protein. CDC73 gene mutation may lead to the decrease or absence of expression of parafibromin protein. CDC73 gene mutation was directly associated with hyperthyroid-jaw tumor syndrome and 15% to 20% patients were associated with parathyroid carcinoma. Their first-degree relatives may also carry CDC73 gene mutation. Partial sporadic parathyroid carcinoma was associated with CDC73 mutation.ConclusionsCDC73 gene mutation is associated with various kinds of parathyroid diseases. Detection of CDC73 gene sequences and immunohistochemical analysis of parafibromin protein may be applied in the diagnosis and improve the prognosis of parathyroid diseases.
Objective To summarize the changes of serum vitamin D level in patients with primary hyperparathyroidism (pHPT), the correlation between vitamin D and clinical manifestations, and feasible pathogenesis of pHPT. Method The literatures related to vitamin D and pHPT in recent years were reviewed. Results The level of vitamin D was decreased in patients with pHPT. Vitamin D level was negatively correlated with the weight of parathyroid adenoma, parathyroid hormone and blood calcium level, and positively correlated with bone mineral density. Conclusions Vitamin D nutritional status affects the severity of symptoms, main biochemical indexes and main clinical complications of patients with pHPT. There are various reasons accounted for the decline of vitamin D level, and the specific pathogenesis needs to be further explored. For patients with pHPT, vitamin D should be supplemented carefully and appropriately before surgical operation.
ObjectiveTo investigate the growth characteristics of pancreatic cancer cells in the twodimensional culture system (monolayer) and threedimensional culture system (type Ⅰ collagen and extracellular matrix gel). MethodsThree pancreatic cancer cell lines (SW1990, PCT, and ASPC1) were cultured in monolayer, type Ⅰ collagen, and extracellular matrix gel, respectively. The growth patterns were observed, growth curves were detected by CCK8 test, and the cell cycle distributions were analyzed by propidium iodide staining. Results In the twodimensional culture system, cells grew in monolayer. In the type Ⅰ collagen and the ECM gel threedimensional culture system, cells formed multicellular spheroids (MCS), of which the growth rates were slower than those of the cells in monolayer. The proportions of S phase of SW1990, PCT, and ASPC1 cells in twodimensional culture system were significantly more than those in the type Ⅰ collagen on 4 d and 8 d 〔(29.6±3.0)% vs. (18.2±5.1)%, (33.6±2.1)% vs. (14.5±3.2)%, (33.1±1.8)% vs. (24.7±2.6)%; Plt;0.05〕, while the difference of proportion of three cell lines in G2/M phase was not different between twodimensional culture system and type Ⅰ collagen (Pgt;0.05). The proportions of G0/G1 phase of SW1990 and PCT cells cultured in the type Ⅰ collagen on 4 d and 8 d and ASPC1 cells cultured in the type Ⅰ collagen on 4 d were significant more than those cultured in twodimensional culture system (Plt;0.05). The proportions of S phase of ASPC1 cells and SW1990 cells cultured in the type Ⅰ collagen on 4 d were significant more than those cultured in the type Ⅰ collagen on 8 d (Plt;0.05). ConclusionsThe characteristics of pancreatic cancer cells in twodimensional and threedimensional culture systems are different. MCS culture system can better mimic the in vivo growth environment of cells in tumors.
Objective To evaluate the utility of collagen-gel droplet embedded-culture drug sensitivity test (CD-DST) in pancreatic carcinoma cell by compared with WST-8. Methods The chemosensitivity to 5-fluorouracil (5-FU), gemzar (GEM) and oxaliplatin (OXA) of pancreatic adenocarcinoma cells SW1990, PCT-3 and ASPC-1 were tested by WST-8 and CD-DST respectively. Results In a certain living cell number range (500-10 000), there was a linear correlation (r=0.991 1, P＜0.05) between the integral optical density in CD-DST and the cell number. The inhibition ratios of three kinds of cell growth tested by CD-DST were higher than those tested by WST-8 (P＜0.05). The results of drug chemosensitivity to 5-FU， GEM and OXA detected by two methods were uniform. Conclusion The CD-DST can be used to assay the drug chemosensitivity in vitro for pancreatic carcinoma.
【摘要】 目的 探讨原发性胰腺淋巴瘤( PPL) 的临床特点及治疗方法。方法 回顾性分析我院2002～2006年期间收治的6 例PPL 的临床资料。结果 本组6 例患者中3 例病灶位于胰头,3 例位于胰体尾。临床症状以上腹不适、黄疸为主。术前仅1 例通过影像学检查获得诊断。2 例行胰十二指肠切除术,3 例行胰体尾联合脾切除术,1 例行剖腹探查、组织活检术。术后病理诊断均为胰腺非霍奇金淋巴瘤。患者术后均行化疗,除1 例失访以外,其余5 例均存活。结论 PPL 的临床症状、影像学表现及实验室检查结果不具特异性,与胰腺癌难以区分,明确诊断有赖于病理组织学检查。对术前未能确诊的胰腺淋巴瘤患者,外科手术治疗结合术后化疗、放疗安全有效。