ABSTRACT
Objective To investigate the surgical methods for thyroid microcarcinoma (TMC) and prevention of recurrent laryngeal nerve injury. Methods We retrospectively analyzed 238 TMC patients during the January 2006 to December 2013 in 309 Hospital of PLA. All the 238 patients had no clinical symptoms and the diagnosis was made by thyroid ultrasound. Thyroid ultrasound exhibited very small nodules (<1cm). At preoperation, 84 patients received fine needle aspiration (FNA). Among the 84 patients, 72 were diagnosed with TMC and 12 were false-negative for TMC by FNA. The remaining was proved by postoperative pathological examination. All of these 238 cases, 144 were of unilateral and solitary, 46 unilateral and multiple, and the remaining 48 multiple unilateral. Results Ninety-seven patients were operated for affected side and isthmus resection plus contralateral subtotal resection, 56 for affected side plus isthmus resection, 23 for bilateral thyroid resection, 62 for bilateral thyroid subtotal resection. 132 patients underwent cervical lymph node dissection and the remaining 106 did not. During operation, the recurrent laryngeal nerve was exposed in 122 patients, involving a total of 182 recurrent laryngeal nerves. In the postoperative period (1–7 years), 6 cases of recurrent and 6 cases of laryngeal nerve injury were found. Conclusions High-intensity focused ultrasound (HIFU) is an important method for diagnosis of TMC. FNA is the most reliable procedure for preoperative determination of the nature of thyroid nodule. Finally, the reasonable and effective surgery is the key to optimize the long-term therapeutic effect and reduce side-effects. During thyroid surgery, to expose and protect recurrent laryngeal nerve is the best means for preventing injury to the recurrent laryngeal nerve.
ABSTRACT
Objective To compare the long term therapeutic effects of the preoperative regional arterial infusion chemotherapy and the preoperative systemic venous chemotherapy in advanced breast cancer. Methods One hundred and eighty-six patients with advanced breast cancer, admitted to the Department of General Surgery of PLA 309 Hospital from Jan. 2003 to Dec. 2008, were followed up for a long time. Of them 97 patients received preoperative regional arterial infusion chemotherapy (IAIC groups), and 89 patients received preoperative systemic vein chemotherapy (IVIC groups). The local recurrence rate, distant metastasis rate, overall survival rate (OS) and disease free survival rate (DFS) in the two groups were statistically analyzed, and the long term therapeutic effects of the two groups were compared. Results There were no statistically significant difference in distant metastasis rate (15.5% and14.6%), 1-year OS (99.0% and 96.6%) and DFS (81.8% and 68.5%), and 3-year OS (88.7% and 79.8%) between the two groups (P>0.05). While significant differences were found between the two groups (P<0.01) in post-operative local recurrence rate (7.2% and 18.0%), 3-year DFS (70.1% and 52.8%), and 5-year OS and DFS. Conclusion Compared with preoperative systemic venous chemotherapy, pre-operative regional arterial infusion chemotherapy can decrease the local recurrence rate, improve the 5-year total survival rate and disease free survival rate for advanced breast cancer.
ABSTRACT
Objective To study the expression of VEGF-C and its receptor in breast carcinoma tissue and in peritumoral tissue,as well as their clinic significance.Methods Immunohistochemistry SP method was used to examine the expression of VEGF-C and VEGFR3 in 70 cases of breast cancer and in its peritu- moral tissue.Results In all 70 cases of breast cancer,the positive expression rate of VEGF-C in breast car- cinoma tissue was 78.6 %,and its rate in peritumoral tissue was 54.3 %.There was a significant stastistic dif- ference between the two groups(P