ABSTRACT
Objective To investigate the application value of ultrasound-guided fine-needle aspiration cytology of lymph nodes in the pre-radiotherapy evaluation of superficial lymph nodes metastases in patients with lung cancer and esophageal cancer. Methods A total of 115 patients with lung cancer and esophageal cancer prepared for thoracic radiotherapy from February 2017 to September 2018 in Cancer Hospital of Huanxing Chaoyang District Beijing were retrospectively analyzed. Ultrasound-guided fine-needle aspiration cytology examination was performed in 166 lymph nodes. Puncture tissues were prepared for cytology production. Then cytological specialist read the film to evaluate if the cancer cells metastasis were present after conventional papanicolaou staining. The effects of short diameter of lymph nodes, blood flow signal and tumor characteristics of patients on the results of cytological examination were analyzed. Results The ultrasound results showed the median short diameter of lymph nodes was 0.6 cm (0.2-3.5 cm), and 25 (15.1％) lymph nodes had blood flow signals, 50 (30.1％) lymph nodes had positive results of puncture tissues cytology. The positive rate of puncture tissues cytology was 10.0％(4/40), 21.6％(21/97) and 86.2％(25/29) in the shortdiameter of lymph nodes <0.5 cm group, ≥0.5 cm and <1 cm group, and ≥1 cm group, respectively (P<0.01). Cytology positive rate of lymph nodes with or without blood flow signal detected by ultrasound was 48.0％ (12/25) and 27.0％ (38/141), and there was a statistical difference (P = 0.034). Location of primary tumor, T stage and chemotherapy history had no significant influence on the cytological results in patients with lung cancer (all P> 0.05). Pathological types had a significant influence on cytological results (χ2= 8.050, P= 0.045). Lymph node metastasis of the upper mediastinum was a risk factor for lymph node metastasis in lower neck and supraclavicular region (χ2= 9.699, P= 0.002). Location of primary tumor, T stage and chemotherapy history had no significant influence on cytological results in patients with esophageal cancer (all P> 0.05). Conclusions Ultrasound-guided fine-needle aspiration cytology is safe and efficient. It can be used to evaluate the metastasis status of superficial lymph nodes in pre-radiotherapy patients with lung cancer and esophageal cancer.
ABSTRACT
Objective To compare the effect of nutritional support with and without tube feeding on the incidence of adverse reactions in radiotherapy for esophageal cancer.Methods A total of 120 esophageal cancer patients with high-risk factors receiving radiotherapy were selected and randomly assigned into the tube feeding (TF,n=60) and non-tube feeding groups (NTF,n=60) according to the random number method.Nutritional interventions were performed during radiotherapy in both groups.The incidence of esophagitis and myelosuppressioa,aulmonary infectioa,autritional status and the completion of radiotherapy were observed and statistically compared between TF and NTF groups.Results In the TF groua,ahe incidence of ≥ grade 2 esophagitis was lower than that in the NTF group.The incidence of grade 3 esophagitis significantly differed between two groups (P＜ 0.05).The incidence of grade 1-2 myelosuppression did not differ between two groupa,ahereas the incidence of grade 3 myelosuppression in the TF group was significantly lower than that in the NTF group (P＜0.05).In the TF groua,ahe incidence of pulmonary infection was remarkably lower than that in the NTF group (P＜0.05).The changes of BMI and prealbumin in the TF group were better than those in the NTF group (both P＜0.05).One patient in the NTF group failed to complete the radiotherapy due to grade Ⅳ esophagitia,and 5 cases in the NTF group (P＜ 0.05).In the TF groua,ahe length of hospital stay was significantly shortened by 6.2 d on average (P＜ 0.05).Conclusions During radiotherapy for esophageal cancer patients with high-risk factora,autritional support with tube feeding can effectively reduce the incidence of adverse reactiona,amprove the completion rate of treatmena,and shorten the average length of hospital stay.