Objective To summarize the diagnosis and treatment of synchronous multiple primary malignant tumors in lung. Methods The clinical and pathological data of 5 cases with intrapulmonary synchronous multiple primary cancer, who were diagnosed in recent 10 years in Xinhua Hospital, were retrospectively analyzed. Results The incidence of intrapulmonary synchronous multiple primary cancer was 0. 21%( 5 /2380) in all lung cancer cases diagnosed in respiratory department of Xinhua Hospital. There were 4 males and 1 female, with the average age of 60. 2 years old. Five patients were all treated with surgical operation. Four patients with bilateral synchronous multiple primary lung cancer underwent staging operation treatment( larger lesions on one side of lung underwent conventional thoraceotomy and lobectomy, and smaller lesions on another side underwent thoracoscopic lobectomy or wedge resection afer 1 month) . For 1 patients with ipsilateral synchronous multiple primary lung cancer, simultaneous operation was performed. There was no death during perioperative period or severe cardiopulmonary complications. They were followed up for 3 years. The survival rate was 80. 0%( 4 /5) at 1 year and 60. 0% ( 3/5) at 3 years, respectively. Conclusions With the development of medical science and awareness of pulmonary multiple primary cancer, early diagnosis improves continuously. Active treatment with operation can achieve better prognosis.
ObjectiveTo investigate the clinicopathological characteristics and prognosis of elderly patients with colon cancer. MethodsThe clinicopathological and followup data of patients with colon cancer were compared retrospectively between those older than 60 years (405 patients) and those younger than 40 years (146 patients). ResultsFamily history, comorbidities, preoperative intestinal obstruction, and differentiation grade were significantly different between two groups (P＜0.05). The 5-year survival rate of patients in elder group and younger group was 64.9% and 56.8% respectively, and there was significant difference （P＜0.05）. The multivariate analysis indicated that the independent predictors of survival were comorbidities, perioperative CEA level, preoperative intestinal obstruction, tumor gross type, lymph node metastasis, hepatic metastasis, and TNM stage. ConclusionPatients older than 60 years with colon cancer have unique clinicopathological characteristics and better prognosis. The independent predictors of survival are comorbidities, perioperative CEA level, preoperative intestinal obstruction, tumor gross type, lymph node metastasis, hepatic metastasis, and TNM stage.
Cytogenetic study of 18 colorectal carcinomas confirmed the extensive heterogeneity and the complexity of the karyotypic picture in this tumor.Karyotypic analysis showed that chromosomes 7 and 3 were of the highest chromosomal gaining frequencies(72%,66%) and chromosomal losses were shown in chromosome 17(50%),chromosome5(44%) and chromosome 18(33%).The structual rearrangements frequently involved were 17p(78%),5q(61%),6q,7q,8p,12q,2p,etc.A great number of marker chromosomes and polyploid chromosomes had bad prognosis relatively.According to these results,we conclude that chromosomes 17,5,and 18 may play an important role in the evolution of colorectal cancer.
ObjectiveTo systematically review the prognostic value of E-cadherin expression in stage I non-small cell lung cancer (NSCLC). MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 1, 2015), CNKI, CBM and WanFang Data were searched to collect cohort studies about the prognostic value of E-cadherin expression in stage I NSCLC from inception to Jun. 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 9 cohort studies, involving 1028 patients were included. The results of meta-analysis showed that, the lower E-cadherin expression group had a lower overall survival rate than that of the higher E-cadherin expression group (HR=1.74, 95%CI 1.36 to 2.24, P＜0.00001). However, there was no significant difference between two groups in disease free survival (HR=2.08, 95%CI 0.8 to 5.40, P=0.13). Subgroup analysis showed that, the lower E-cadherin expression group had a worse overall survival when groups were divided by different cut-off values, E-cadherin location site or different nations (all value P＜0.05). ConclusionCurrent evidence shows that, reduced E-cadherin expression could predict poor prognostic outcome in patients with stage I NSCLC. Due to the limited quantity and quality of included studies, the above conclusions need to be verified by more high quality studies.
Objective To systematically review the prognostic significance of extranodal extension in gastric cancer, esophageal cancer and gastroesophageal junction cancer. Methods We searched EMbase, The Cochrane Library (Issue 9, 2016), PubMed, CBM, CNKI, VIP and WanFang Data databases from inception to August 2016, to collect cohort studies about the prognostic significance of extranodal extension. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.2 software. Results A total of 16 studies involving 9 445 participants were included. The results of meta-analysis showed that for gastric cancer patients, the overall survival (OS) (HR=1.71, 95%CI 1.49 to 2.00,P<0.000 01), disease free survival (DFS) (HR=1.39, 95%CI 1.12 to 1.73,P=0.003) and cancer specific survival (HR=1.52, 95%CI 1.18 to 1.96,P=0.001) in ENE(+) group were lower than ENE(–) group. For esophageal cancer and gastroesophageal junction cancer patients, the overall survival (OS) (HR=1.84, 95%CI 1.49 to 2.27,P<0.000 01), disease free survival (DFS) (HR=2.18, 95%CI 1.70 to 2.81,P<0.000 01) and cancer specific survival (HR=1.73, 95%CI 1.19 to 2.52,P=0.004) in ENE(+) group were lower than ENE(–) group. Conclusion Current evidence indicates that ENE(+) was correlated with a poor prognosis in gastric cancer, esophageal cancer and gastroesophageal junction cancer patients. Due to the quantity and quality limitations of included studies, more high quality cohort studies are needed to verify the above conclusions.
Objective To assess the effects of lung transplantation (LT) in the treatment of end-stage pulmonary arterial hypertension (PAH) and evaluated its impact on quality of life (QoL). Methods A total of 54 patients with end-stage PAH admitted to the LT center of Wuxi People’s Hospital between January 2007 and June 2019 were retrospectively analyzed. The patients were divided into surgical and non-surgical groups. Clinical data were compared between the groups. The clinical data such as symptoms, signs, biochemistry, survival rate and quality of life were compared between the two groups. The effects of lung transplantation on survival and quality of life were analyzed. The quality of life was scored by SF-36 scale. Results A total of 54 patients with end-stage pulmonary arterial hypertension who met the indications for lung transplantation were enrolled. Among them, 36 patients underwent lung transplantation and 18 patients did not undergo surgery. There were no statistical differences in gender, course of disease, disease type, symptoms between the two groups. The uric acid of the non-operation group was significantly higher than that of the lung transplantation group (P=0.014). The systolic pulmonary artery pressure (SPAP) of the non-operation group was significantly lower than that of the lung transplantation group (P=0.046). Kaplan-Meier survival curve showed that the survival rate of the operation group was higher than that of the non-operation group (P=0.0087). The quality of life assessment showed that after lung transplantation, the physical component summary and mental component summary scores of operation group were higher than those before operation (P<0.01), and also higher than non-operation group in the same period (P<0.05). Preoperative low systemic circulation blood pressure, poor cardiac function, high NT-proBNP and high uric acid may be the risk factors for early death of patients with pulmonary arterial hypertension after lung transplantation. Conclusions Lung transplantation can effectively improve survival and also QoL for patients with end-stage PH. Early detection of risk factors and preoperative assessment can help improve the perioperative survival.
The overexpression of C-erb B-2 oncogene in breast cancer was examined in 245 cases with immunohistochemical techniques.The results showed that:①Significant associations of C-erb B-2 overexpression with high histological grade (Ｐ＜0.05), positive axillary node status (Ｐ＜0.05)， advanced clinical stage (Ｐ＜0.05) and the absence of hormone receptor(Ｐ＜0.05) were identified in breast cancer.②Overexpression of C-erb B-2 oncogene was related with 5-year and 10-year survival rate, and considered as a prognostic factor for breast cancer independent of axillary node status. Detection of C-erb B-2 oncogene overexpression could be arranged as a regular pathological examination in breast cancer.Combined with axillary node and estrogen receptor, progestin receptor status, the results can be used in determining the prognosis and planing the treatment programme in breast cancer.
Objective To evaluate the markers which contribute to diagnosis and prognosis of thyroid neoplasm. Methods The references about thyroid markers in recent years were reviewed. Results CD26 and galectin-3 could be regarded as a simple, potent markers to differentiate thyroid carcinoma in preoperative diagnosis, CD97 was a specific marker for undifferentiated thyroid carcinoma and its metastasis, CD15 and telomerase could be used in fine-needle aspirate biopsy (FNAB) of thyroid mass, and to improve its diagnostic evaluation, RET/PTC was mainly expressed in thyroid medullary carcinoma, oncofetal fibronectin (oncFN) was specific to papillary and anaplastic carcinoma, thyroid peroxidase was used to identify benign and malignant thyroid tumor. Conclusion Although there are a lot of markers for thyroid neoplasm, but there is no marker which are completely specific to certain histotype of thyroid neoplasm at present.
ObjectiveTo evaluate the effect of preoperative regional intraarterial infusion chemotherapy on the prognosis of advanced gastric cancer. MethodsThe clinical data of 80 patients who underwent curative resection for advanced gastric cancers were summarized.Among them,33 patients carried out preoperative regional intraarterial infusion chemotherapy were as the interventional chemotherapy group,and the remaining 47 patients were the control group.Eleven factors including clinical and pathological data,treatment procedures and molecular biological makers that contributed to the longterm survival rate were analyzed by Cox multivariate regression analysis.ResultsThe 5year survival rate of the interventional group was 59.3%,and the control group 47.6%.There was significant difference between two groups (P＜0.05).Multivariate regression analysis revealed that the preoperative regional intraarterial infusion chemotherapy was one of the independent factors affecting the longterm survival of patients with advanced gastric cancers.ConclusionThe preoperative regional intraarterial infusion chemotherapy has important value for improving the prognosis of gastric cancer.
ObjectiveTo investigate the prognostic value of serum procalcitonin (PCT) level and its change for patients with severe trauma and sepsis. MethodsEighty-two patients with severe trauma and sepsis treated between June 2013 and June 2014 were chosen to be our study subjects. According to the clinical outcome at day 28, they were divided into survival group (n=54) and death group (n=28). Serum procalcitonin levels at hour 0, 24, 48, 72, 96, and 120 after admitted to the emergency intensive care unit were detected in all the patients. Then we calculated the rate of procalcitonin change in each time points, injury severity score (ISS) score, acute physiology and chronic health evaluation (APACHE)Ⅱ score and white blood cells (WBC) count. ResultsProcalciton level at hour 24, 48, 72, 96 and 120 of the survival group was significantly lower than the death group (P<0.05); the rate of procalcitonin change at hour 24, 48, 72, 96 and 120 was significantly lower than the death group (P<0.05), and the APACHE Ⅱ score was significantly lower than the death group (P<0.01). There was no significant difference in the ISS score and WBC count between the two groups (P>0.05). ConclusionEarly procalcitonin level and its dynamic change are good indicators in judging the prognosis of patients with severe trauma and sepsis, especially the early dynamic change in the rate of procalcitonin.