• 대한두경부종양학회:학술대회논문집
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• 대한두경부종양학회 2008년도 추계학술대회 논문집
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• pp.259-259
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• 2008

• 대한두경부종양학회:학술대회논문집
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• 대한두경부종양학회 2008년도 추계학술대회 논문집
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• pp.253-255
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• 2008

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1267-1272
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• 2012

Background and Objective: The optimal resection extent for clinically unilateral papillary thyroid microcarcinoma (PTMC) remains controversial. The objective was to investigate risk factors associated with occult contralateral carcinoma, and put emphasis on the predictive value of preoperative BRAF mutation. Materials and Methods: 100 clinically unilateral PTMC patients all newly diagnosed, previously untreated were analyzed in a prospective cohort study. We assessed the T1799A BRAF mutation status in FNAB specimens obtained from all PTMC patients before undergoing total thyroidectomy (TT) and central lymph node dissection (CLND) for PTMC. Univariate and multivariate analyses were used to reveal the incidence of contralateral occult cancer, difference of risk factors and predictive value, with respect to the following variables: preoperative BRAF mutation status, age, gender, tumor size, multifocality of primary tumor, capsular invasion, presence of Hashimoto thyroiditis and central lymph node metastasis. Results: 20 of 100 patients (20%) had occult contralateral lobe carcinoma. On multi-variate analysis, preoperative BRAF mutation (p = 0.030, OR = 3.439) and multifocality of the primary tumor (p = 0.004, OR = 9.570) were independent predictive factors for occult contralateral PTMC presence. However, there were no significant differences between the presence of occult contralateral carcinomas and age, gender, tumor size, capsular invasion, Hashimoto thyroiditis and central lymph node metastasis. Conclusions: Total thyroidectomy, including the contralateral lobe, should be considered for the treatment of unilateral PTMC if preoperative BRAF mutation is positive and/or if the observed lesion presents as a multifocal tumor in the unilateral lobe.

• 대한두경부종양학회지
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• 제21권2호
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• pp.121-125
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• 2005

Objectives: To investigate the role of MMP-2 and TIMP-2 in the invasion and metastasis of thyroid papillary microcarcinomas. Materials and Methods: We performed immunohistochemical study on MMP-2 and its tissue inhibitor (TIMP-2) using tissue microarrays containing 2 cores of 40 microPTC and 8 non-neoplastic thyroid tissue. The expression intensity was semiquantitatively scored as -, ${\pm}$, +1, +2, and +3. Results: Both MMP-2 and TIMP-2 expression was observed in all tumors(100%) and in 1 of 8 non-neoplastic tissue(12.5%), and the positive staining was restricted to the epithelial cells. In 17 and 23 tumors with or without extrathyroid invasion, respectively, 8(47%) and 10(43%) cases showed moderate to strong(+23) positivity for MMP-2. TIMP-2 expression was moderate to strong in 13 cases(76%) and 16 cases(70%) in each group. In multifocal and solitary tumors, 3 of 6(50%) and 11 of 21(52%) cases showed moderate to strong MMP-2 expression, and 5/6(83%) and 15/21(71%) showed moderate to strong TIMP-2 expression. Conclusion: There is no relationship between MMP-2 or TIMP-2 expression and extrathyroid invasion or tumor multifocality in papillary microcarcinoma of the thyroid gland.

• 대한두경부종양학회지
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• 제20권2호
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• pp.143-146
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• 2004

Background and Object: The role of fine needle aspiration cytology (FNAC) and frozen section (FS) in management of thyroid neoplasms continues to generate considerable controversy. We reviewed our current experience to determine the clinical utility of FNAC and FS in our surgical management and investigated reliability of FNAC and FS in planning the extent of thyroid resection. Material and Method: 212 patients who had operations for thyroid disease from May 1996 to November 2003 were included our retrospective study. FNAC was undertaken in 175 patients and FS was done in 148 patients. Result: The sensitivity and specificity of FNAC were 72.1% and 100%, respectively, and those of FS were 67.2% and 100%. The results of FNAC were benign (n=72) , malignancy (n=31), indeterminate (n=9), and nondiagnostic (n=63). The results of FS were benign (n=95), and malignancy (n=53). The 9 indeterminate cases on FNAC were benign (n=6) and malignancy (n=3) on final pathology, and benign (n=7) and malignancy (n=2) on FS. The false negative of FNAC were micro papillary carcinoma (n=6) and follicular carcinoma (n=6). The false negative of FS were micropapillary carcinoma (n=10) and follicular carcinoma (n=2). Conclusion: When results of FNAC are interpreted as indeterminate, FS is a valuable tool. FS is helpful in determining the extent of thyroidectomy when results of FNAC were follicular neoplasm. However we always concerned about micropapillary carcinoma and follicular carcinoma although FNAC and FS were benign.

• 대한방사선기술학회지:방사선기술과학
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• 제36권2호
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• pp.149-155
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• 2013

대한갑상선학회는 0.5 cm 보다 큰 경우에만 미세침흡인술을 권고하고 있으나, 본원에서는 0.5 cm 이하의 결절에서도 갑상선 유두암이 많이 발견되고 있다. 이 연구는 건강의학센터에서 미세침흡인술을 시행하여 갑상선 유두암으로 확진된 결절을 토대로 크기에 따른 초음파 특징을 분류해 보고자 한다. 결절의 크기를 장경 0.5 cm 이하, 0.5~1 cm, 1 cm 보다 큰 결절의 세 그룹으로 나누어 각각에서의 악성을 시사하는 초음파 소견에 차이가 있는지 알아보았다. 288개의 악성결절 중 0.5 cm 이하 크기는 21.5 % (62/288), 0.5~1 cm 54.9 % (158/288), 1 cm 보다 큰 결절은 23.6 % (68/288)로 나타났다. 앞뒤가 긴모양의 특징은 0.5 cm 이하 그룹 90.3 % (56/62), 1 cm 보다 큰 그룹 48.5 % (33/68)로 나타나 통계적으로 유의한 차이를 보였다(p<0.001). 0.5 cm이하 그룹에서 well defined smooth 결절은 1예도 없었으며, 침상(spiculated) 혹은 불규칙한 경계는 크기가 클수록 빈도가 증가하였다(p=0.024). 내부에코는 0.5 cm 이하 그룹에서 고에코(hyperechogenicity)와 동에코(isoechogenicity)의 결절은 1예도 없었으며, 각 그룹별로 현저한 저에코(marked hypoechogenicity)보다 저에코(hypoechogenicity)가 많았다(p=0.034). 미세 혹은 거대석회화는 0.5 cm 이하에서 77.4 % (48/62)가 관찰되지 않았으며, 0.5 cm 이하 그룹부터 21.0 % (13/62), 48.1 % (76/158), 64.7 % (44/68)로 결절 크기가 증가할수록 관찰빈도가 증가하였다(p<0.001). 초음파에서 0.5 cm 이하의 결절은 앞뒤가 긴 모양과 침상 혹은 불규칙한 경계, 불분명한 경계를 보였고, 저에코 혹은 현저한 저에코가 많았다. 그러나 미세 혹은 거대석회화는 없는 것이 특징적이었다. 따라서 0.5 cm 이하의 작은 크기의 결절에서 악성을 시사하는 초음파적 특징은 미세침흡인 술이나 추적검사에 대한 유용한 지침을 제공할 수 있을 것으로 사료된다.

• 대한임상검사과학회지
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• 제46권3호
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• pp.99-105
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• 2014

Isolating total DNA from small samples using traditional methods is difficult and inefficient mainly due to loss of DNA during filtration and precipitation. With advances in molecular pathology, DNA extraction from micro-dissected cells has become essential in handling clinical samples. Genomic DNA extraction using small numbers of cells can be very important to successfully PCR amplify DNA from small biopsy specimens. We compared our experimental genomic DNA extraction method (A) with two other commercially available methods: using spin columns (B), and conventional resins (C), and determined the efficacy of DNA extraction from small numbers of cells smeared on a glass slide. Approximately 50, 100, 200, 500 and 1000 cells were isolated from fine needle aspiration biopsy (FNAB) slides aspirated from histologically proven papillary thyroid carcinoma masses. DNA was extracted using the three techniques. After measuring DNA quantity, PCR amplification was performed to detect the ${\beta}$-globin and $BRAF^{V600E}$ gene mutations. DNA extracted by method (A) showed better yield than the other methods in all cell groups. With our method, a suitable amount of genomic DNA to produce amplification was extracted from as few as 50 cells, while more than 100 to 200 cells were required when methods (B) or (C) were applied. Our genomic DNA extraction method provides high quality and improved yields for molecular analysis. It will be especially useful for paucicellular clinical samples which molecular pathologists often confront when handling fine needle aspiration cytology, exfoliative cytology and small biopsy specimens.