Objective: The purposes of this study were to identify risk factors for cervical lymph node metastasis and to examine the association between BRAF^(V600E) status and clinical features in papillary thyroid microcarcino...Objective: The purposes of this study were to identify risk factors for cervical lymph node metastasis and to examine the association between BRAF^(V600E) status and clinical features in papillary thyroid microcarcinoma(PTMC).Methods: A total of 1,587 patients with PTMC, treated in Tianjin Medical University Cancer Institute and Hospital from January2011 to March 2013, underwent retrospective analysis. We reviewed and analyzed factors including clinical results, pathology records, ultrasound results, and BRAF^(V600E) status.Results: Multivariate logistic regression analyses demonstrated that gender(male) [odds ratio(OR) = 1.845, P = 0.000], age(< 45 years)(OR = 1.606, P = 0.000), tumor size(> 6 mm)(OR = 2.137, P = 0.000), bilateralism(OR = 2.011, P = 0.000) and extrathyroidal extension(OR = 1.555, P = 0.001) served as independent predictors of central lymph node metastasis(CLNM).Moreover, CLNM(OR = 29.354, P = 0.000) served as an independent predictor of lateral lymph node metastasis(LLNM). Among patients with a solitary primary tumor, those with tumor location in the lower third of the thyroid lobe or the isthmus were more likely to experience CLNM(P < 0.05). Univariate analyses indicated that CLNM, LLNM, extrathyroidal extension, and multifocality were not significantly associated with BRAF^(V600E) mutation.Conclusions: The present study suggested that prophylactic neck dissection of the central compartment should be considered in patients with PTMC, particularly in men with tumor size greater than 6 mm, age less than 45 years, extrathyroidal extension, and tumor bilaterality. Among patients with PTMC, BRAF^(V600E) mutation is not significantly associated with prognostic factors. For a better understanding of surgical management of PTMC and the risk factors, we recommend multicenter research and long-term follow-up.展开更多
Lung cancer is one of the leading causes of death with one of the lowest survival rates. However, a subset of lung cancer patients who are of Asian origin and carry somatic mutations in epidermal growth factor recepto...Lung cancer is one of the leading causes of death with one of the lowest survival rates. However, a subset of lung cancer patients who are of Asian origin and carry somatic mutations in epidermal growth factor receptor or EGFR have responded remarkable well to two tyrosine kinase inhibitors, gefitinib and erlotinib. While EGFR mutation profiles have been reported from Japan, South Korea, and Taiwan, there is no such report from mainland of China where the largest pool of patients reside. In this report, we identified ten somatic mutations from a total of 41 lung cancer patients in China. Among them, seven mutations were found in 17 adenocarcinomas. In contrast to previous reports, eight of these mutations are deletions in exon 19 and two of these deletions are homozygous. These results suggest that a large portion of Chinese adenocarcinoma patients could benefit from gefitinib or erlotinib. This unique mutation profile provides a rationale to develop the next generation of EGFR inhibitors more suitable for the Chinese population.展开更多
基金supported by grants from the National Natural Science Foundation of China (Grant No. 81402392, 81472580, 81502322)Tianjin Municipal Science and technology project (Grant No. 15JCQNJC12800 and 17YFZCSY00690)
文摘Objective: The purposes of this study were to identify risk factors for cervical lymph node metastasis and to examine the association between BRAF^(V600E) status and clinical features in papillary thyroid microcarcinoma(PTMC).Methods: A total of 1,587 patients with PTMC, treated in Tianjin Medical University Cancer Institute and Hospital from January2011 to March 2013, underwent retrospective analysis. We reviewed and analyzed factors including clinical results, pathology records, ultrasound results, and BRAF^(V600E) status.Results: Multivariate logistic regression analyses demonstrated that gender(male) [odds ratio(OR) = 1.845, P = 0.000], age(< 45 years)(OR = 1.606, P = 0.000), tumor size(> 6 mm)(OR = 2.137, P = 0.000), bilateralism(OR = 2.011, P = 0.000) and extrathyroidal extension(OR = 1.555, P = 0.001) served as independent predictors of central lymph node metastasis(CLNM).Moreover, CLNM(OR = 29.354, P = 0.000) served as an independent predictor of lateral lymph node metastasis(LLNM). Among patients with a solitary primary tumor, those with tumor location in the lower third of the thyroid lobe or the isthmus were more likely to experience CLNM(P < 0.05). Univariate analyses indicated that CLNM, LLNM, extrathyroidal extension, and multifocality were not significantly associated with BRAF^(V600E) mutation.Conclusions: The present study suggested that prophylactic neck dissection of the central compartment should be considered in patients with PTMC, particularly in men with tumor size greater than 6 mm, age less than 45 years, extrathyroidal extension, and tumor bilaterality. Among patients with PTMC, BRAF^(V600E) mutation is not significantly associated with prognostic factors. For a better understanding of surgical management of PTMC and the risk factors, we recommend multicenter research and long-term follow-up.
基金supported by the GIBH funds provided by the Chinese Academy of Sciences,the City of Guangzhou and Guangdong Province
文摘Lung cancer is one of the leading causes of death with one of the lowest survival rates. However, a subset of lung cancer patients who are of Asian origin and carry somatic mutations in epidermal growth factor receptor or EGFR have responded remarkable well to two tyrosine kinase inhibitors, gefitinib and erlotinib. While EGFR mutation profiles have been reported from Japan, South Korea, and Taiwan, there is no such report from mainland of China where the largest pool of patients reside. In this report, we identified ten somatic mutations from a total of 41 lung cancer patients in China. Among them, seven mutations were found in 17 adenocarcinomas. In contrast to previous reports, eight of these mutations are deletions in exon 19 and two of these deletions are homozygous. These results suggest that a large portion of Chinese adenocarcinoma patients could benefit from gefitinib or erlotinib. This unique mutation profile provides a rationale to develop the next generation of EGFR inhibitors more suitable for the Chinese population.
