To investigate the relationship between clinicopathological features and lymph node metastasis in the primary gastric cancer and affer the basis for deciding appropriate extent of lymph node dissection, a total of 192 patients who underwent curative gastrectomy and lymph node dissection for gastric cancer were analyzed retrospectively. Result: The total rate of lymph node metastasis was 60.4%, with 28.9% of the resected lymph nodes involved. The lymph node metastasis of C, M, A region and the whole stomach were 64.6%, 57.7%, 59.1% and 90.9% respectively. The rates of the lymph node metastasis increased successively in carcinoma of early, middle and late stages (Ｐ＜0.05), the rate of the infiltrative tumor (Borr Ⅲ，Ⅳ) being 76.5% which was significantly higher than that of the circumscribed tumor (Borr Ⅰ，Ⅱ) (43.2%)。 Relating with the tumor size ＜4cm in diameter showed lesser rate, while 4-8 cm and ＞8cm in diameter showed increasingly higher metastaticrate (Ｐ＜0.01). As a result, we should decide the appropriate extent of lymph node dissection during the operation on the basis of clinicopathological stages, type of Borrmann’s, site and maximum diameter of gastric cancer along with the state of lymph node metastasis in carcinoma of different region of the stomach.
Objective To summarize the application and advancement of liver transplantation for hepatic metastasis from neuroendocrine tumor. Methods Domestic and overseas publications on the study of liver transplantation for hepatic metastasis from neuroendocrine tumor in recent years were collected and reviewed. Results Liver transplantation can offer good relief of symptoms, long disease-free intervals, and potential cure in individual patients with hepatic metastatic tumor. Important selection criteria are well-differentiated tumors and a low proliferation rate (Ki67＜10%). Conclusion In carefully selected patients with metastatic neuroendocrine tumors, liver transplantation is an appropriate option.
Objective To investigate the correlation among lymph node metastasis and clinical features, postoperative survival rate in rectal cancer. Methods Seventy-nine patients who had accepted total mesorectal excision (TME) were collected, and the correlation among their clinical features (including gender, age, tumor size, gross type, depth of infiltration, histology type, differentiated degree and the level of blood serum CEA), lymph node metastasis, and postoperative survival rate were analyzed. Results There was significant correlation between six factors (namely the tumor size, gross type, depth of infiltration, histology type, differentiated degree and the level of blood serum CEA) and lymph node metastasis in single factor analysis. However， multivariate analysis showed that only gross type of tumor and depth of tumor infiltration were related to lymph node metastasis. The postoperative survival time of 43 non-metastasis cases was remarkably longer than that of 33 cases with lymph node metastasis (χ2=18.806， P=0.000), and it was longer in 22 cases with ＜4 lymph nodes metastasis than that of 11 cases with ≥4 lymph nodes metastasis (χ2=4.659， P=0.031). Conclusion In rectal cancer patients the clinical features can reflect the condition of lymph node metastasis in a certain extent, and it can help doctors to evaluate the lymph node metastasis and prognosis.
【Abstract】Objective To introduce three methods of creating the animal model of bone metastasis from breast cancer and the advances in the application of these models. Methods The related literatures were collected and reviewed.Results In summary, breast cancer cells injected through left ventricles was commonly used. Breast cancer cells injected into medullary cavity of shaft of femur was simple and effective, but it was very different from the real condition of bone metastasis of patients. The development of animal model created by surgical orthotopic implantation gives the researchs an ideal instrument similar with the condition of patients to research the mechanism of bone metastasis and the treatment. Conclusion Each animal model of bone metastasis from breast cancer has itself usefulness. Our destination is to create the real model of bone metastasis from breast cancer that is very similar with the patients.
ObjectiveTo analyze rate of intraperitoneal lymph node metastasis (LNM) in Siewert type Ⅱ/Ⅲ adenocarcinoma of esophagogastric junction (AEG) so as to determine optimal extent of lymph node dissection. MethodsA systematic and comprehensive search of PubMed, Medline, and Cochrane Library databases for study reports on LNM in patients with Siewert type Ⅱ/Ⅲ AEG was performed. The retrieval time ranged from database establishment to October 1, 2021. The pooled LNM rate was analyzed for each lymph node group. In addition, the influencing factors of LNM in AEG were analyzed. ResultsAfter screening, a total of 22 relevant studies were included, with a total of 3 934 cases. For the patients with Siewert type Ⅱ/Ⅲ AEG, the LNM rates of No.1, 2, 1&2, 3, 7 lymph nodes were ≥20%, LNM rates of No.4, 9, 11 (11p+11d), 11p, 16 lymph nodes were 10%–20%, LNM rates of No.4sa, 8a, 10, 11d lymph nodes were 5%–10%, the rest were <5%. For the patients with Siewert type Ⅱ AEG, the LNM rates of No.1, 2, 1&2, 3, 7 lymph nodes were ≥20%, LNM rates of No.4, 9, 11 (11p+11d), 11p lymph nodes were 10%–20%, LNM rates of No.8a, 10 lymph nodes were 5%–10%, and the rest were <5%. For the patients with Siewert type Ⅲ AEG, the LNM rates of No.1, 2, 1&2, 3, 4, 7 lymph nodes were ≥20%, LNM rate of No.11p lymph nodes was 10%–20%, LNM rates of No.4sa, 4sb, 4d, 8a, 9, 10, 11(11p+11d), 11d lymph nodes were 5%–10%, and the rest were <5%. No matter Siewert Ⅱ and (or) Ⅲ AEG patients, the rates of LNM in No.5, 6, and 12a lymph nodes were <5%. The tumor diameter ≥2 cm and higher T stage (T2–T4) increased the probability of LNM in AEG (P<0.05). ConclusionsThe results of this meta-analysis combined with the literature suggest that in clinical practice, No.10 lymph node dissection is not necessary for Siewert Ⅱ and Siewert Ⅲ AEG patients with tumor length diameter <2 cm and T1 of tumor invasion. No matter Siewert Ⅱ or Ⅲ AEG, as long as the tumor length diameter <2 cm and T1 of tumor invasion, the distal perigastric lymph nodes (No.4d, 5, 6) may not be dissected; Siewert type Ⅱ or Ⅲ AEG patients don’t need to clean No.12a lymph nodes.
ObjectiveTo analyze the expression and significance of NF-κBp65 and autophagy-related proteins Beclin1 and p62 in patients with papillary thyroid carcinoma (PTC).MethodsOne hundred and sixty cases of PTC patients' tumor tissue specimens and paracancerous tissue specimens in our hospital from March 2013 to February 2015 were collected, and 90 cases of cervical lymph node metastasis tissue specimens of the above patients were collected. The expressions of NF-κBp65, Beclin1 and p62 in PTC tissues, metastatic lymph node tissues and paracancerous tissues were detected by immunohistochemical method, and the relationship between the above indexes and the clinicopathological characteristics and prognosis of PTC patients was analyzed.ResultsThe positive rates of expression of NF-kappa Bp65 and p62 in PTC tissues and metastatic lymph node tissues were higher than those in paracancerous tissues (P<0.05). The expression rate of Beclin1 in PTC tissues and metastatic lymph node tissues was lower than that in paracancerous tissues (P<0.05). The positive rate of NF-κBp65 expression in PTC tissues was not related to the clinicopathological characteristics of patients (P>0.05). The expression of p62 decreased with the increase of tumor differentiation (P<0.05). The expression of Beclin1 in patients with stage Ⅲ+Ⅳ and lymph node metastasis were lower than those in patients with stage Ⅰ+Ⅱ and without lymph node metastasis (P<0.05), while the expression of p62 was opposite. Spearman correlation analysis showed that the expression of Beclin1 and p62 in PTC tissues was negatively correlated (r=–0.656, P<0.01). In metastatic lymph node tissues, the expression of Beclin1 and p62 was also negatively correlated (r=–0.562, P<0.01). The 3-year survival rates of patients with positive expression of p62 and NF-κBp65 in PTC tissues were lower than that of patients with negative expression (P<0.05). The 3-year survival rate of patients with positive expression of Becrin1 was higher than that of negative expression (P<0.05). TNM stage, lymph node metastasis, NF-κBp65 and p62 were independent risk factors for PTC prognosis, and Beclin1 was protective factor.ConclusionsNF-κBp65 and p62 are highly expressed in PTC tissues and lymph node metastasis tissues, while Beclin1 is poorly expressed, which could be used as independent prognostic factors for PTC patients. In addition, Beclin1 and p62 are related to PTC biological behavior and may become potential indicators for PTC diagnosis.
Objective To evaluate the characteristics of two angiographic manifestation of ocular fundus in choroidal metastatic carcinomas. Methods Fundus fluoresein angiography (FFA) and indocyanine green angiography (ICGA) were performed on 17 patients (24 eyes) with choroidal metastatic carcinomas, and the characteristics of these two kinds of angiograms were analyzed and compared each other. Results According to various clinical features, e.g., locations of metastatic tumor in ocular fundus, disease course, and different kinds of original malignancy, the findings of ocular fundus were divided into (1) Isolation type: FFA showed pinpoint and mottled leaks against hypofluorescence background, increased and confluent fluoresecence in later stage. ICGA showed the similar images as in FFA, except later appearance of leaks and the choroidal vesseles could be seen beneath the thin metastatic tumor mass.(2) Diffusion type: Tumors showed hypofluorescence in early stage and uneven ill-defined hyperfluorescence both in FFA and in ICGA. (3) Small metastatic carcinomas: Hypofluorescence in early stage and mild mottled hyperfluorescence were found in FFA as well as in ICGA. Conclusion Both FFA and ICGA are helpful in the diagnosis of choroidal metastatic tumors and ICGA may be conducive if there are some troubles in diagnosing the tumors with FFA. (Chin J Ocul Fundus Dis, 2002, 18: 92-95)
Objective To study the necessity and feasibility of No.12b lymph node dissection in D2 lymphadenectomy for advanced distal gastric cancer, and the relation between No.12b lymph node metastasis and clinicopathologic factors. Methods Clinical data of sixty cases of advanced distal gastric cancer receiving D2 or D2+ radical correction were collected retrospectively, both of which were all plus No.12b lymph node dissections. The relationships between No.12b lymph node metastasis and clinicopathologic factors were analyzed. Results No death attributed to operation or severe operative complications were found. There were 12 cases (20.00%) with No.12b lymph node metastasis. The rates of No.12b lymph node metastasis in Borrmann Ⅲ-Ⅳ types, N2-3 of lymph node metastasis and T3-4 of tumor infiltration were 31.25% (10/32), 30.30% (10/33) and 29.73% (11/37), which were significantly higher than those in Borrmann Ⅰ-Ⅱ types 〔7.14% （2/28）〕, N0-1 〔7.41% （2/27）〕 and T1-2 〔4.35% （1/23）〕 respectively (Plt;0.05). There was no relationship between tumor size and No.12b lymph node metastasis. Conclusions No.12b lymph node dissection is safe and feasible for advanced distal gastric cancer. Further perspective studies on No.12b lymph node dissection influence on prognosis in more cases are required.
【Abstract】Objective To understand the features of lymphatic vessel, and to summarize the foundation and mechanism of the promotion and inhibition of tumor lymphangiogenesis recorded on the current studies of animal experiments and clinical researches. Methods The related literatures of the structural features of lymphatic vessel, lymphatic endothelial molecular markers, the origin of lymphatic tumors, the molecular mechanisms and regulatory factors were reviewed, and the relationship between tumor lymphangiogenesis and lymphatic metastasis, the treatment targeting at the formation of the anti-tumor lymphatic vessel and its existing problems were also analyzed. Results Hyperplasia of lymphatic vessels occurred during the process of tumor formation and progression. The structural features of the lymphatic vessels in the tumor were conducive to tumor lymphatic metastasis. In recent years, methods of anti-lymphangiogenesis and inhibition of tumor lymphatic metastasis had achieved considerable success in animal experiments. However, there were still a lot of problems need to be solved. Conclusion Tumor lymphangiogenesis has a significantly positive correlation between tumor lymphatic metastasis and patients’ prognosis, which may indicate that treatment against the formation of tumor lymphatic vessel maybe effective.
ObjectiveTo explore the differences and similarities of the featurs of lymph node metatasis of abdominal esophageal carcinoma and cardiac cancer. MethodsPreoperative CT images of abdominal esophageal carcinomas and cardiac cancers were reviewed and analysed on lymph node size and preponderant distribution. ResultsShort diameter ≥10 mm of lymph node at CT was adopted as metastasis criterion. The detection rates of abdominal esophageal carcinomas and cardiac cancers were 73.5%（144/196） and 83.7% （170/203）, respectively. Thoracic lymph node metastasis rate of abdominal esophageal carcinomas was 11.1% （4/36） in 7 area, 27.8% （10/36） in 8 area, 8.3% （3/36） in 9 area, while celiac lymph node metastasis rate was 36.1% (13/36 ） in No.7 group, 19.4% （7/36） in No.1 group, and 11.1% （4/36） in No.2 group primarily. Lymph node metastasis rate of cardiac cancers was 17.9% （5/28） in No.1 group, 28.6% （8/28） in No.2 group, 39.3% （11/28 ） in No.3 group, and 25.0% （7/28） in No.4 group for the first stop lymph nodes, and 35.7% （10/28 ） in No.7 group for the second stop primarily. ConclusionAs metastasis criterion, short diameter ≥10 mm of lymph node at CT is feasible, but there exist certain falsepositive rate. Thoracic lymph node metastasis of abdominal esophageal carcinomas is mainly in the 7, 8, and 9 area, while celiac metastasis is mainly in No.7, No.1, and No.2 groups. Lymph node metastasis of cardiac cancers is in No.1, No.2, No.3, No.4, and No.7 group primarily.