简介：AIMTodeterminewhetherthenumberofexaminedlymphnodes(LNs)iscorrelatedwiththeoverallsurvivalofgallbladdercarcinoma(GBC)patients.METHODSPatientswerecollectedfromtheSurveillanceEpidemiologyandEndResultsdatabase(2004-2013)andcategorizedbythenumberofLNsintosixgroups:1LN,2LNs,3LNs,4LNs,5LNs,and≥6LNs.SurvivalcurvesforoverallsurvivalwereplottedwithaKaplan-Meieranalysis.Thelog-ranktestwasusedforunivariatecomparisons.RESULTSInacohortof893patients,themediannumberofexaminedLNswastwofortheentirecohort.Thesurvivalforthe1LNgroupwassignificantlypoorerthanthoseofthestageⅠandⅡdiseasegroupsandfortheentirecohort.BydichotomizingthenumberofLNsfrom1to6,wefoundthattheminimumnumberofLNsthatshouldbeexaminedwasfourforstageⅠ,fourorfiveforstageⅡ,andsixforstageⅢAdisease.Therefore,fortheentirecohort,thenumberofexaminedLNsshouldbeatleastsix,whichisexactlyconsistentwiththeAmericanJointCommitteeonCancercriteria.CONCLUSIONTheexaminationofhighernumbersofLNsisassociatedwithimprovedsurvivalafterresectionsurgeryforN0GBC.TheguidelinesforGBCsurgery,whichrecommendthatsixLNsbeexaminedatleast,arestatisticallyvalidandshouldbeappliedinclinicalpracticewidely.

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简介：Objectives:ToexploretheprognosticrelevanceofthenumberandratioofmetastaticlymphnodesinresectedCarcinomaoftheampullaofVater(CAV).Methods:Theclinicaldataof155patientswhounderwentpancreaticoduodenectomy(PD)forcanceroftheampullaofVaterbetweenJanuary1990andDecember2010wereretrospectivelyanalyzed.KaplanMeiermethodwasusedinsurvivalanalysisandLogrankmethodincomparison.MultivariateanalysiswasperformedusingCoxproportionalhazardsmodel.Results:Amongthese155patients,thein-hospitalmortalityratewas4.5%,lymphnodepositivediseasewas21.3%,andthe5-yearsurvivalratewas51.6%.Patientswithalymphnoderatio(LNR)>20%weremorelikelytohavetumordifferentiation,depthofduodenalinvolvement,depthofpancreaticinvasion,T-stageandTNM-Stage.ThenumberofthemetastaticlymphnodesisimportantprognosticfactorsoftheCAV.Univariateanalysisshowedthatthefactorsassociatedwiththeprognosisincludedtumorsize(P=0.036),tumordifferentiation(P=0.019),LNR(P=0.032),numberofmetastaticlymphnodes(P=0.024),lymphnodemetastasis(P=0.03),depthofpancreaticinvasion(P=0.001),T-stage(P=0.002),TNMstage(P=0.001),elevatedCA19-9(P=0.000),andjaundice(P=0.021).Multivariateanalysisshowedthatthefactorsassociatedwiththeprognosiswerethenumberofmetastaticlymphnodes(P=0.032;RR:1.283;95%CI:1.022-1.611),tumorsize(P=0.043;RR:1.736;95%CI:1.017-2.963),andelevatedCA19-9(P=0.003;RR:3.247;95%CI:1.504-7.010).Conclusions:LNRisausefulfactorforpredictingtheprognosisoftheradicaltreatmentforCAV,whereasthenumberofmetastaticlymphnodesisthemostimportantfactor.Furtherresearchonthelocations,number,andLNRwillbeclinicallymeaningfultoimprovesurvivalinpatientswithCAV.

简介：瞄准：检验矩阵metalloproteinase-2(MMP-2)在胃的癌症纸巾并且到的表示与淋巴节点评估它的关系微转移。方法：作者从30学习了850淋巴结resected与淋巴腺切除术经历了胃切除术用的有胃的癌的病人颠倒抄写聚合酶链反应(RT-PCR)试金除了他染色。肿瘤纸巾的MMP-2表示被免疫检测组织化学的技术(EliVision加)。结果：MMP-2表示在21是积极的(70%)在9的盒子和negative(30%)盒子。没有重要关联在象年龄，性，肿瘤地点，肿瘤直径，Lauren分类和淋巴的侵略那样的MMP-2表示和另外的变量之间被发现。相反，MMP-2表示与肿瘤渗入的深度显著地相关(P=0.022)，淋巴节点转移(P=0.030)并且肿瘤区别(P=0.043)。淋巴节点微转移在77被检测(12.5%)14的淋巴节点(46.7%)胃的癌病人。MMP-2表示在12是积极的(85.7%)有淋巴节点的14个病人微转移，并且在9(56.3%)没有淋巴节点的16个病人微转移(P=0.118)。结论：我们的结果证明那MMP-2表情与肿瘤侵略，肿瘤区别和淋巴节点转移有重要关联。MMP-2表示可以是一个重要生物特征和胃的癌的重要预示的参数。我们也断定MMP-2可以参予淋巴节点的发展胃的癌的微转移。进一步的调查被需要得出一个结论。

简介：AIM:Tostudyhowlymphnodemetastasis(LNM)riskisstratifiedinundifferentiated-typeearlygastriccancer(undiff-EGC)dependentoncombinationsofriskfactors.METHODS:Fivehundredandsixty-sevencaseswithundiff-EGCundergoinggastrectomywithlymphadenectomywereexaminedretrospectively.Usingclinicopathologicalfactorsofpatientage,location,size,anendoscopicmacroscopictumorform,ulceration,depth,histology,lymphaticinvolvement(LI)andvenousinvolvement(VI),LNMriskwasexaminedandstratifiedbyconventionalstatisticalanalysisanddatamininganalysis.RESULTS:LNMwaspositivein44of567cases(7.8%).Univariateanalysisrevealed>2cm,protrusion,submucosal(sm),mixedtype,LIandVIassignificantprognosticfactorsand>2cmandLI-positivewereindependentfactorsbymultivariateanalysis.InpreoperativelyevaluablefactorsexcludingLVI,smand>2cmwereindependentfactors.Accordingtothedepthandsize,caseswerecategorizedintothelow-riskgroup[mand≤2cm,0%(LNMincidence)],themoderateriskgroup(mand>2cm,5.6%;andsmand≤2cm,6.0%),andthehigh-riskgroup(smand>2cm,19.3%).Ontheotherhand,LNMoccurredin1.4%inallLI-negativecases,greatlylowerthan28.2%inallLI-positivecases,andLNMincidencewaslowinLInegativecaseseveninthemoderate-andhigh-riskgroups.CONCLUSION:LNM-relatedfactorsinundiff-EGCweredepthandsizepreoperativelywhilethosewereLIandsizepostoperatively.Amongthesefactors,LIwasthemostsignificantlycorrelatedfactor.

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

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简介：Objective:TostudyexplorestheeffectofHLEConthesecretedproteinsofepithelialovariancancer(EOC)cells(SKOV3-PM4)withdirectionalhighlylymphaticmetastasis.Methods:Supernatantsoffourgroupsofculturedcells,namely,SKOV3(A),SKOV3+HLEC(B),SKOV3-PM4(C),SKOV3-PM4+HLEC(D),werecollected,andtheirproteinsweredetectedbyantibodyarraysandiTRAQ-2D-LC-MALDITOF/TOF/MS.SignificantlydifferentialproteinswerefurtheranalyzedviabioinformaticsandvalidatedinhumanserumsandcellmediaviaELISA.Results:ResultsofantibodyarraysandmassspectrometrydemonstratedthatGRNandVEGFAwereupregulatedingroupC(comparedwithgroupA),whereasIGFBP7andSPARCweredownregulatedingroupD(comparedwithgroupC).ComprehensivebioinformaticsanalysisresultsshowedthatIGFBP7andVEGFAwerecloselylinkedtoeachother.FurthervalidationwithserumsshowedstatisticalsignificanceinVEGFAandIGFBP7levelsamonggroupsofpatientswithovariancancers,benigntumors,andcontrolgroups.Twoproteinswereupegulatedinthefirstgroup.VEGFAinthecontrolgroupwasdownregulated.ForIGFBP,upregulationinthecontrolgroupanddown-regulationinthefirstgroupwerealsoobserved.Conclusion:TheHLECmicroenvironmentiscloselyassociatedwithdirectionalmetastasistolymphnodesandwithdifferentialproteinsincludingcellstromalproteinsandadhesionfactors.TheupregulationofVEGFAandGRNandthedownregulationofSPARCandIGFBP7arecloselyassociatedwithdirectionalmetastasistolymphnodesinEOCcells.

简介：淋巴的系统在在人和动物模型装有免疫力的回答到外国抗原和肿瘤是重要的。肝生产大量淋巴，和它的淋巴的系统被划分成三个主要部件：门，sublobular和表面的淋巴管。尽管老鼠是最通常使用的实验室动物，对解剖地点的详细描述和排干肝的淋巴节点(行)的功能是令人惊讶地不在的。在这研究，我们发现门和邻近老鼠肝的腹的行在5-8min以内与Evans蓝色被染色。从肝的积极房间也排干进二上述的行的提高的绿荧光蛋白质(EGFP)。这些数据显示门和腹的行排干鼠标肝。识别的排干肝的行的Lymphadenectomy导致了肝炎B在免疫能力的老鼠的病毒(HBV)坚持与假冒的组相比。另外，CD8+T房间的频率和树枝状的房间(DC)在HBVplasmid的水动力学注射以后在排干肝的行显著地增加了。在HBV注射plasmid的老鼠的排干肝的行房间也在vitro与recombinant肝炎B核心抗原响应刺激显示出重要抗原特定的增长。进Rag1−/−老鼠的这些房间的采纳转移在uninjected老鼠与排干肝的行房间相比在肝炎B表面抗原(HBsAg)的浆液集中导致了减小。总的来说我们的数据描绘排干肝的行并且提供排干肝的行导致为HBV负责的anti-HBV-specific免疫者回答的证据清理。

简介：AbstractThis review attempts to unveil the possible mechanisms underlying how gut lymph affects lung and further gives rise to acute respiratory distress syndrome, as well as potential interventional targets under the condition of ischemia-reperfusion injury. We searched electronic databases including PubMed, MEDLINE, Cochrane Central Register of Controlled Trials, Google Scholar, Web of Science, and Embase to identify relevant literatures published up to December 2019. We enrolled the literatures including the Mesh Terms of "gut lymph or intestinal lymph and acute lung injury or acute respiratory distress syndrome." Gut is considered to be the origin of systemic inflammation and the engine of multiple organ distress syndrome in the field of critical care medicine, whereas gut lymph plays a pivotal role in initiation of ischemia-reperfusion injury-induced acute respiratory distress syndrome. In fact, in the having been established pathologic model of sepsis leading to multiple organ dysfunction named by Gut Lymph theory, a variety of literatures showed the position and role of changes in gut lymph components in the initiation of systemic inflammatory response, which allows us to screen out potential intervention targets to pave the way for future clinic and basic research.

简介：AbstractBackground:Breast cancer patients with ipsilateral supraclavicular lymph node metastasis (ISLNM) but without distant metastasis are considered to have a poor prognosis. This study aimed to develop a nomogram to predict the overall survival (OS) of breast cancer patients with ISLNM but without distant metastasis.Methods:Medical records of breast cancer patients who received surgical treatment at the Affiliated Cancer Hospital of Zhengzhou University, Jiyuan People’s Hospital and Huaxian People’s Hospital between December 21, 2012 and June 30, 2020 were reviewed retrospectively. Overall, 345 patients with pathologically confirmed ISLNM and without evidence of distant metastasis were identified. They were further randomized 2:1 and divided into training (n = 231) and validation (n = 114) cohorts. A nomogram to predict the probability of OS was constructed based on clinicopathologic variables identified by the univariable and multivariable analyses. The predictive accuracy and discriminative ability were measured by calibration plots, concordance index (C-index), and risk group stratification.Results:Univariable analysis showed that estrogen receptor-positive (ER+), progesterone receptor-positive (PR+), human epidermal growth factor receptor 2-positive (HER2+) with Herceptin treatment, and a low axillary lymph node ratio (ALNR) were prognostic factors for better OS. PR+, HER2+ with Herceptin treatment, and a low ALNR remained independent prognostic factors for better OS on multivariable analysis. These variables were incorporated into a nomogram to predict the 1-, 3-, and 5-year OS of breast cancer patients with ISLNM. The C-indexes of the nomogram were 0.737 (95% confidence interval [CI]: 0.660-0.813) and 0.759 (95% CI: 0.636-0.881) for the training and the validation cohorts, respectively. The calibration plots presented excellent agreement between the nomogram prediction and actual observation for 3 and 5 years, but not 1 year, OS in both the cohorts. The nomogram was also able to stratify patients into different risk groups.Conclusions:In this study, we established and validated a novel nomogram for predicting survival of patients with ISLNM. This nomogram may, to some extent, allow clinicians to more accurately estimate prognosis and to make personalized therapeutic decisions for individual patients with ISLNM.

简介：AbstractObjective:To investigate the risk factors for lateral lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC).Methods:A retrospective analysis of 209 patients with PTC who underwent primary surgery at the Beijing Friendship Hospital affiliated with Capital Medical University from November 2014 to November 2018 was performed. The patients were divided into the LLNM group and the non-LLNM group. The clinical and pathological characteristics of the patients were analysed. The risk factors for LLNM were analysed by univariate and multivariate analyses.Results:The incidence of LLNM was 13.4% in PTC patients. Univariate analysis showed that the maximum diameter of the primary tumour > 2 cm (P < 0.001), bilateral primary tumour (P= 0.020), extrathyroidal extension (ETE) (P < 0.001), central lymph node metastasis (CLNM) (P < 0.001), and CLNM number ≥ 5 (P < 0.001) were significantly associated with LLNM. Multivariate logistic regression analysis showed that the maximum diameter of the primary tumour > 2 cm, ETE, and CLNM were independent risk factors for LLNM (OR values were 3.880, 5.202, and 4.474, respectively). There were 6 patients with skip lateral cervical lymph node metastasis, accounting for 21% of all LLNM patients.Conclusion:This study revealed several independent risk factors for predicting LLNM in PTC patients, such as the maximum diameter of the primary tumour > 2 cm, ETE and CLNM. Lateral neck dissection may be recommended in PTC patients with those risk factors. Paying attention to the occurrence of skip lateral cervical lymph node metastasis during the clinical diagnosis and treatment processes is necessary.

简介：AbstractBackground:Methylene blue is the most commonly used tracer for sentinel lymph node (SLN) biopsy (SLNB) in China. This study aimed to investigate the feasibility of clinical application of SLNB using methylene blue dye (MBD) for early breast cancer and the prognosis of patients with different SLN and non-SLN statuses.Methods:We retrospectively analyzed the clinicopathological data of patients with early breast cancer treated at the Peking University First Hospital between 2013 and 2018. We calculated the SLN identification rate (IR) in SLNB with MBD and the false-negative rate (FNR), and analyzed the prognosis of patients with different SLN and non-SLN statuses using Kaplan-Meier curves.Results:Between January 2013 and December 2018, 1603 patients with early breast cancer underwent SLNB with MBD. The SLN IR was 95.8% (1536/1603). Two SLNs (median) were detected per patient. There were significant differences in FNR between patients with SLN micrometastasis and macrometastasis (19.0% vs. 4.5%, χ2 = 12.771, P < 0.001). Chi-square test showed that there were significant differences in SLN successful detection rates among patients with different vascular tumor embolism status (96.3% vs. 90.8%, χ2 = 9.013, P = 0.003) and tumor (T) stages (96.6% vs. 94.1%, χ2 = 5.189, P = 0.023). Multivariate analysis showed that vascular tumor embolism was the only independent factor for SLN successful detection (odds ratio: 0.440, 95% confidence interval: 0.224-0.862, P = 0.017). Survival analysis showed a significant difference in disease-free survival (DFS) between patients with non-SLN metastasis and patients without non-SLN metastasis (P = 0.006).Conclusion:Our single-center data show that, as a commonly used tracer in SLNB in China, MBD has an acceptable SLN IR and a low FNR in frozen sections. This finding is consistent with reports of dual tracer-guided SLNB. Positive SLNs with non-SLN metastasis are associated with DFS.

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:Toexploretheeffectsofpostmastectomyradiotherapy(PMRT)onthelocoregionalfailure-freesurvival(LRFFS)andoverallsurvival(OS)ofbreastcancerpatientsunderdifferenttumorstagesandwithonetothreepositiveaxillarylymphnodes(ALNs).Methods:Weconductedaretrospectivereviewof527patientswithonetothreepositivelymphnodeswhounderwentmodifiedradicalorpartialmastectomyandaxillarydissectionfromJanuary2000toDecember2002.ThepatientsweredividedintotheT1-T2N1andT3-T4N1groups.TheeffectsofPMRTontheLRFFSandOSofthesetwopatientgroupswereanalyzedusingSPSS19.0,Pearson’sχ2-test,Kaplan-Meiermethod,andCoxproportionalhazardmodel.Results:ForT1-T2N1patients,nostatisticalsignificancewasobservedintheeffectsofPMRTonLRFFS[hazardratio(HR)=0.726;95%confidenceinterval(CI):0.233-2.265;P=0.582]andOS(HR=0.914;95%CI:0.478-1.745;P=0.784)ofthegeneralpatients.Extracapsularextension(ECE)andhighhistologicalgradeweretheriskfactorsforLRFFSandOSwithstatisticalsignificanceinmultivariateanalysis.StratificationanalysisshowedthatPMRTstatisticallyimprovedtheclinicaloutcomesinhigh-riskpatients[ECE(+),LRFFS:P=0.026,OS:P=0.007;histologicalgradeIII,LRFFS:P<0.001,OS:P=0.007]butnotinlow-riskpatients[ECE(–),LRFFS:P=0.987,OS:P=0.502;histologicalgradeI-II,LRFFS:P=0.816,OS:P=0.296].ForT3-T4N1patients,PMRTeffectivelyimprovedthelocalcontrol(HR=0.089;95%CI:0.210-0.378;P=0.001)ofthegeneralpatients,whereasnostatisticaleffectwasobservedonOS(HR=1.251;95%CI:0.597-2.622;P=0.552).Absenceofestrogenreceptorsandprogesteronereceptors(ER/PR)(–)wasanindependentriskfactor.FurtherstratificationanalysisindicatedastatisticaldifferenceinLRFFSandOSbetweenthehigh-riskpatientswithER/PR(–)receivingPMRTandnotreceivingPMRT[ER/PR(–),LRFFS:P=0.046,OS:P=0.039].However,PMRThadabeneficialeffectonthereductionoflocoregionalr

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.

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