Objective To improve the diagnosis and treatment of primary adenocarcinoma of the duodenum. MethodsLiteratures were reviewed.ResultsThe morbidity of primary duodenal adenocarcinoma was low and its clinical manifestation had no characteristics.The most effective methods in the diagnosis of the disease were gastrointestinal radiography and endoscopy with the accuracy of 88% and 89% respectively.The disease could be cured by resection of the lesion. The selection of operative type depended on the stage and position of the tumor.Radical resection and tumor stage played an important role in the prognosis.Conclusion Early diagnosis and rational operation are the major ways to improve the resectability and to modify the therapeutic result.
ObjectiveTo study the epidemiologic characteristics of primary liver cancer (PLC). MethodsThe literatures about regional distribution and etiologic epidemiology of PLC were reviewed. Results PLC was mainly distributed on caostland in the south-east of China. The main cause of PLC was hepatitis B virus, aflatoxin and contamination of drinking water. Otherwise, PLS was also related with lack of some trace element, sex horemones, genealogy cause and so on.Conclusion The genesis of PLC was by multiple factors.
【Abstract】ObjectiveTo evaluate the value of MR imaging with a contrast-enhanced multi-phasic isotropic volumetric interpolated breath-hold examination (VIBE) in diagnosis of primary liver carcinoma. MethodsThirty-two consecutive patients with surgical-pathologically confirmed 42 foci of primary carcinoma of liver underwent comprehensive MR examination of the upper abdomen, routine two-dimensional (2D) T1WI and T2WI images were acquired before administration of Gd-DTPA for contrast enhancement. Then, contrast-enhanced multi-phasic VIBE was acquired followed by 2D T1WI images. The lesion appearances on hepatic arterial, portal venous and equilibrium phases of VIBE sequence were carefully observed along with delineation of hepatic arterial and portal venous structures. The lesion detection rates and lesion characterization ability were compared among various MR sequences. Results33(78.6%), 30(71.4%), 38(90.5%) and 42(100%) foci were displayed respectively on T2WI, non-enhanced T1WI, enhanced T1WI and enhanced 3D-VIBE images (P＜0.05). The hepatic arterial anatomy of 30 patients （93.8%） and the portal venous structure of 31 patients （96.9%） were clearly depicted on enhanced 3D-VIBE images. Using MIP and MPR reconstruction techniques, the feeding arteries of 14 foci and draining vein of 12 foci were clearly displayed.ConclusionHigh-quality 3D-VIBE images are not only better than 2D images in lesion detection and characterization for primary liver carcinoma, but also able to provide much more information about hepatic vascular anatomy.
ObjectiveTo identify SCN9A gene mutation in a family with severe primary erythermalgia. MethodsClinical data of family were collected and the encoding exons and their flanking sequences of SCN9A gene were amplified and sequenced from genomic DNA samples. ResultsA heterozygous c.1185C→G was found in exon 9 of the proband, which resulted in N395K amino acid substitution. The mutation was not detected in the proband’s healthy mother or 50 unrelated healthy controls. ConclusionThe missense mutation of SCN9A gene is the underlying cause of the patient’s clinical phenotype.
Thirty patients of primary cholangiolithiasis were treated by the use of a rigid choledochoscope passing through the left lateral liver lobe for removal. 20 cases of them were manipulated with mini-incisions, the stones in 14 patients (70.0%) were completely removed. In the remaining 10 cases of conventional laparotomy, left lateral liver incised in 4, left lateral lobectomy in 6 before rigid choledochoscopic lithotomy; the stons were completely removed in eight patients (80.0%). No case had complications, the short-term effect of the method is obviously better than that of other various operative treatments. It has the advantages of less trauma, less pain, and quick recovery. It is a economical and effective new technique and has prospects of application.
Objective To investigate ultrasonography features of primary thyroid non-Hodgkin lymphoma (PT-NHL). Methods Ultrasonographic data of patients with PT-NHL(PT-NHL group) and non-Hodgkin lymphoma (control group) who were treated in our hospital from May. 2002 to Jul. 2014 were collected and analyzed. Results Compared with control group, enhancement of posterior echoes was more common in PT-NHL group (P=0.000), and difference values of transverse diameters, anteroposterior diameters, and sagittal diameters of more involved lobe to another lobe were bigger(P < 0.05), but echo pattern of gland, ultrasonographic classification of lesions, classification of vascularity, and condition of cervical lymph nodes were found no statistical difference(P > 0.05). In patients with nodular-type lesions(37 patients in PT-NHL group and 12 patients in control group), length of nodule lesions was larger in PT-NHL group (P=0.000), but there was no statistical difference in shape, boundary, orientation, and echoes of nodules between 2 groups(P > 0.05). In Pulsed-Wave(PW) Doppler between 2 groups(17 patients in PT-NHL group and 4 patients in control group), vascular resistance index(RI) was higher in PT-NHL group than those of control group (P=0.024). Conclusion The enhancement of posterior echoes was a feature in ultrasonography images of PT-NHL. Asymmetrical volume, high value of RI, and big nodule might link to PT-NHL, but diffuse heterogeneous echo with hypoechoic lesions might result in wrong diagnosis as PT-NHL.
The serum level of testosterone (T), estradiol (E2) and progesterone (P) in 86 cases with primary liver cancer (PLC) (male：76 cases; female：10 cases) was determined by RIA method. The result showed that for male cases, serum level of T and ratio of T/E２ in operation group and nonoperation group was significantly higher than that in benign hepatic diseases group (BHD group) and normal control group (NC group), but the value of E２ obviously lower than the later two groups. After tumor resection, the level of E2 increased, while serum level of T and value of T/E２ decreased, which had no significant difference as contrasted with BHD group and NC group. The serum level of T,E2 in female PLC group made no difference to BHD group and NC group, but the value of T/E2 much higher than NC group. No obvious changes of the serum level of progesterone can be observed in both male and female cases. Our research showed that high serum testosterone level and low estradiol level may be concerned with PLC. The possibility and importance of sex hormone imbalance on initializing and developing of PLC is suggested.
Objective To investigate the clinicopathological features, treatment and prognosis of primary pulmonary lymphoepithelioma-like carcinoma (PPLELC). Methods Forty-five patients with PPLELC admitted to Sichuan Cancer Hospital from April 2016 to March 2023 were retrospectively analyzed. Their clinical data and survival were collected and summarized. Results Of the 45 patients, 28.9% (13/45) were asymptomatic, 97.2% (35/36) were positive for Epstein-Barr virus encoded small RNA, 83.3% (10/12) were positive for programmed cell death-ligand 1 (PD-L1), and the tumor proportion score (TPS) fluctuated between 10.0% to 95.0%. Genetic testing revealed 1 case of EGFR gene 19-Del mutation. Among the 45 patients, 28 cases received surgical treatment, of which 16 received adjuvant chemotherapy, 8 received adjuvant radiotherapy, and 2 received neoadjuvant chemotherapy. As of the follow-up cut-off date, 33 patients survived and 12 patients died, with a median survival time not reached and an overall survival rate of 70.2% and 63.2% at 3 and 5 years, respectively. The 3- and 5-year disease-free survival rates were 67.2% and 57.6% for the 28 operated patients, respectively, and the progression-free survival rates were 58.3% and 29.2% for the 13 stage Ⅳ patients, respectively. Conclusions PPLELC is associated with Epstein-Barr virus infection and is a rare subtype of non-small cell lung cancer (NSCLC). Most patients do not have common gene mutations such as EGFR or ALK and have a high rate of positive PD-L1 expression. The disease is usually treated with a multi-method combination of mainly surgery, and is sensitive to radiotherapy and chemotherapy and has a better prognosis than other types of NSCLC.
Objective To study the association and the effect of the expression of p16 and p53 protein on the occurence and development of gallbladder carcinoma. Methods The expression of p16 and p53 protein were detected in 40 cases of gallbladder carcinoma with immunohistochemical method. Results The expressions of p16 and p53 protein were closely correlated to the tumor pathological grade, lymph mode metastasis and prognosis. p16 protein was correlated to the Nevin classifications. Conclusion The results indicate that the low expression rate of p16 protein occurred in the advanced stage of gallbladder carcinoma. The expression of p16 and p53 protein are helpful in judging the malignant degree and prognosis of primary gallbladder cancer.
Objective?To summarize our experience of surgical treatment of Boerhaave’s Syndrome. Methods We retrospectively analyzed clinical records of 14 patients with Boerhaave’s syndrome in West China Hospital between January 1998 and December 2011. There were 11 male patients and 3 female patients with a mean age of 55.2±14.4 years and mean time interval between onset and admission of 49.6±21.2 h. Primary repair was performed in 11 patients.Esophagectomy and reconstruction of digestive track was performed in 1 patient and intra-luminal stent implantation was applied in 1 patient. Intercostal catheter insertion was performed in 1 patient.?Results?Thirteen patients underwent surgical therapy, and their survival rate was 84.6% (11/13). Among the eleven patients who underwent primary repair, 8 patients (72.7%)were cured and 3 patients experienced postoperative leakage resulting 2 deaths. The other one patient was cured with in-hospital time of 22.3±7.0 d. Two patients underwent digestive track reconstruction and intra-luminal stent implantation respectively and all survived with in-hospital time 39.0±5.7 d. Another patient underwent bedside chest drainage and died 10 d after admission.?Conclusion?Aggressive surgical management is an effective way to treat Boerhaave’s syndrome, and primary repair can lead to ideal prognosis in delayed patients whose time interval between onset and admission is beyond 24 h. Digestive track reconstruction and intra-luminal stent implantation are alternative methods on condition that primary repair can not be accomplished.