简介：

简介：Objective:Toinvestigatethefeaturesofthepreoperativeclinicopathologiccharacteristicsincorrelationwithlymphnodemetastasis.Methods:Thepreoperativeclinicopathologiccharacteristicsandlymphnodemetastasisof265patientswithearlygastriccarcinomawereanalyzedretrospectively.Results:Thethreeclinicopathologiccharacteristics,maximumcancerdiameter>2cmunderendoscope,poordifferentiationandexcavatedtypeweresignificanthighriskindependentpreoperativeclinicopathologiccharacteristics(P<0.05).Thepatientswhohadnoneofthethreepreoperativeclinicopathologiccharacteristicshadnolymphnodemetastasis,while27.27%ofthepatientswhohadallthethreepreoperativeclinicopathologiccharacteristicshadN2lymphnodemetastasis.Conclusion:Thethreepreoperativeclinicopathologiccharacteristics,maximumcancerdiameterunderendoscope,celldifferentiationandgrosstypewereveryusefultoevaluatetheextentoflymphnodemetastasis.

简介：

简介：雷文东，张汝刚，阎水忠，王秀琴，牟巨伟，张大为，吴Ｎｍ２３ＧＥＮＥＥＸＰＲＥＳＳＩＯＮＡＮＤＩＴＳＣＯＲＲＥＬＡＴＩＯＮＷＩＴＨＬＹＭＰＨＮＯＤＥＭＥＴＡＳＴＡＳＩＳＩＮＨＵＭＡＮＬＵＮＧＣＡＮＣＥＲ￥ＬｅｉＷｅｎｄｏｎｇ；ＺｈａｎｇＲｏｕｇｉｎｇ；...

简介：Objective:ThepurposesofthisstudyweretoidentifyriskfactorsforcervicallymphnodemetastasisandtoexaminetheassociationbetweenBRAFV600Estatusandclinicalfeaturesinpapillarythyroidmicrocarcinoma(PTMC).Methods:Atotalof1,587patientswithPTMC,treatedinTianjinMedicalUniversityCancerInstituteandHospitalfromJanuary2011toMarch2013,underwentretrospectiveanalysis.Wereviewedandanalyzedfactorsincludingclinicalresults,pathologyrecords,ultrasoundresults,andBRAFV600Estatus.Results:Multivariatelogisticregressionanalysesdemonstratedthatgender(male)[oddsratio(OR)=1.845,P=0.000],age(<45years)(OR=1.606,P=0.000),tumorsize(>6mm)(OR=2.137,P=0.000),bilateralism(OR=2.011,P=0.000)andextrathyroidalextension(OR=1.555,P=0.001)servedasindependentpredictorsofcentrallymphnodemetastasis(CLNM).Moreover,CLNM(OR=29.354,P=0.000)servedasanindependentpredictoroflaterallymphnodemetastasis(LLNM).Amongpatientswithasolitaryprimarytumor,thosewithtumorlocationinthelowerthirdofthethyroidlobeortheisthmusweremorelikelytoexperienceCLNM(P<0.05).UnivariateanalysesindicatedthatCLNM,LLNM,extrathyroidalextension,andmultifocalitywerenotsignificantlyassociatedwithBRAFV600Emutation.Conclusions:ThepresentstudysuggestedthatprophylacticneckdissectionofthecentralcompartmentshouldbeconsideredinpatientswithPTMC,particularlyinmenwithtumorsizegreaterthan6mm,agelessthan45years,extrathyroidalextension,andtumorbilaterality.AmongpatientswithPTMC,BRAFV600Emutationisnotsignificantlyassociatedwithprognosticfactors.ForabetterunderstandingofsurgicalmanagementofPTMCandtheriskfactors,werecommendmulticenterresearchandlong-termfollow-up.

简介：Objective:Tocreateanomogramtopredicttheincidenceoflymphnodemetastasis(LNM)inearlygastriccancer(EGC)patientsandtoexternallyvalidatethenomogram.Methods:Toconstructthenomogram,weretrospectivelyanalyzedaprimarycohortof272EGCpatients.Univariateanalysisandabinarylogisticregressionwereperformed.AnomogrampredictingtheincidenceofLNMinEGCpatientswascreated.Thediscriminationabilityofthenomogramwasmeasuredusingtheconcordanceindex(c-index),andthenomogramwasalsocalibrated.Then,anotherprospectivecohortof81patientswasanalyzedtovalidatethenomogram.Results:Intheprimarycohort,LNMwaspathologicallyconfirmedin37(13.6%)patients.Inmultivariateanalysis,thepresenceofanulcer,themaximumlesiondiameterobservedviagastroscopy,thethicknessofthelesionobservedviaendoscopicultrasonography,andthepresenceofenlargedlymphnodesoncomputedtomography(CT)wereindependentriskfactorsforLNM.Anomogramwasthencreatedbasedontheregressionmodelwiththec-indexof0.905,andthecalibrationcurveofthenomogramfellapproximatelyontheideal45-degreeline.Thecut-offscoreofthenomogramwas110,andthesensitivity,specificity,positivepredictiveandnegativepredictivevaluesofthenomogramintheprimarycohortwere81.1%,86.0%,47.6%and96.7%,respectively,andintheprospectivevalidationcohortwere75.0%,91.0%,60.0%and95.5%,respectively.Thecalibrationcurveoftheexternalvalidationcohortwasalmostonthe45-degreeline.Conclusions:WedevelopedaneffectivenomogrampredictingtheincidenceofLNMforEGCpatients.

简介：Objective:TheUnionforInternationalCancerControl(UICC)Node(N)classificationisthemostcommonusedstagingmethodfortheprognosisofgastriccancer.Itdemandsadequate,atleast16lymphnodes(LNs)tobedissected;thereforedifferentstagingsystemswereinvented.Methods:BetweenMarch2005andMarch2010,164patientswereevaluatedattheDepartmentofGeneralSurgeryintheKenézyGyulaHospitalandattheDepartmentofGeneral,ThoracicandVascularSurgeryintheKaposiMórHospital.The6th,7thand8thUICCN-stagingsystems,thenumberofexaminedLNs,thenumberofharvestednegativeLNs,themetastaticlymphnoderatio(MLR)andthelogoddsofpositiveLNs(LODDS)weredeterminedtomeasuretheir5-yearsurvivalratesandtocomparethemtoeachother.Results:Theoverall5-yearsurvivalrateforallpatientswas55.5%withamedianoverallsurvivaltimeof102months.Thetumorstage,gender,UICCN-stages,MLRandtheLODDSweresignificantprognosticfactorsforthe5-yearsurvivalwithunivariateanalysis.The6thUICCN-stagedidnotfollowtheadequateriskincomparingN2vs.N0andN3vs.N0withmultivariateinvestigation.ComparisonofperformancesoftheresidualNclassificationsprovedthattheLODDSsystemwasfirstinthepredictionofprognosisduringtheevaluationofallpatientsandincaseswithlessthan16harvestedLNs.TheMLRgavethebestprognosticpredictionwhenadequate(morethanorequalto16)lymphadenectomywasperformed.Conclusions:WesuggesttheapplicationofLODDSsystemroutinelyinwesternpatientsandtheusageofMLRclassificationincaseswithextendedlymphadenectomy.

简介：Objective:Thisrandomizedstudyaimedtocomparetheclinicalefficacybetweenthenoveldualtracercomposedofindocyaninegreen(ICG)andbluedye(BD)andtheconventionaldualtracercomposedofradioisotopeandBDforsentinellymphnode(SLN)mappinginpatientswithbreastcancer.Methods:Thisstudyenrolled471clinicallylymphnode-negativepatientswithprimarybreastcancer.Allpatientsunderwentmastectomy,andthoseundergoingsentinellymphnodebiopsy(SLNB)wererandomizedtoreceivebluedyeplusradioisotope(RBgroup)orBDplusICG(IBgroup).ThedetectionperformancesonSLNidentificationrate,positiveSLNcounts,detectionsensitivity,andfalse-negativeratewerecomparedbetweenthetwogroups.Results:IntheIBgroup,97%(194/200)ofthepatientswhounderwenttheICGandBDdualtracerinjectionshowedfluorescentpositivelymphaticvesselswithin2–5min.TheidentificationrateofSLNswascomparablebetweentheIBgroup(99.0%,198/200)andtheRBgroup(99.6%,270/271)(P=0.79).NosignificantdifferenceswereobservedintheidentificationrateofmetastaticSLNs(22.5%vs.22.9%,P>0.05,RBgroupvs.IBgroup,thesamebelow),positiveSLNcounts(3.72±2.28vs.3.91±2.13,P>0.05),positivemetastaticSLNcounts(0.38±0.84vs.0.34±0.78,P>0.05),SLNBdetectionsensitivity(94.4%vs.92.5%,P>0.05),orfalse-negativerate(5.6%vs.7.5%,P>0.05)betweenthetwogroups.Conclusions:ICGcanbeusedasapromisingalternativetracerforradioisotopeinSLNmapping,andwhenitiscombinedwithBDinlymphangiography,itofferscomparabledetectionsensitivitycomparedtotheconventionallymphaticmappingstrategiesthatarewidelyusedinclinicalpractice.

简介：