Application of a novel modified Blumgart anastomosis in laparoscopic pancreaticoduodenectomy / 中国医师进修杂志

Objective:To investigate the efficacy and safety of a novel modified Blumgart pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD).Methods:Between May 2021 and January 2022, 13 successive cases from Lihuili Hospital Affiliated to Ningbo University who underwent LPD were enrolled in this retrospective study. The study retrospectively analyzed the demographic characteristics, perioperative outcomes, and pathological results of these cases.Results:Twenty patients underwent LPD success-fully and one required conversion to open surgery. The operative time was (308.6 ± 61.7) min. The duration for PJ was (26.7 ± 4.3) min. The estimated blood loss was (188.1 ± 94.2) ml. The postoperative hospital stay was (14.2 ± 3.5) d. There was one case of biochemical leakage and no case of grade B or grade C pancreatic fistula.Conclusions:The new method is safe, simple and feasible. The novel method could reduce the incidence of pancreatic fistula and other complications after LPD.

Analysis of treatment failure phenotype and prognostic factors of stage Ⅰ non-small cell lung cancer / 中华肿瘤杂志

Non-small cell lung cancer (NSCLC) is one of the most severe malignant tumors worldwide. Lobectomy and systematic nodal dissection remain the standard treatment for stageⅠNSCLC. Stereotactic body radiotherapy (SBRT) has become the standard treatment for medically inoperable patients. Though the prognosis of stage Ⅰ NSCLC patients is generally good, there are still about 20% of patients with local recurrence and distant metastasis. There is significant heterogeneity in the prognosis and failure phenotype of patients, which cannot be precisely distinguished by the pathological TNM classification system. Identification of the risk factors for the prognosis of patients with stage Ⅰ NSCLC is a key step to realize the treatment from experience to precision. Screening the high-risk patients will facilitate to individually develop the adjuvant therapy strategy after surgery or SBRT and improve the overall curative effect. There are many factors that are significantly related to the prognosis of stage Ⅰ NSCLC including individual factors such as gender, age, and systemic inflammatory biomarkers; treatment-related factors such as the extent of surgical resection of the primary tumor and lymph nodes, the choice of different radiation rays, and different dose fractionation; and tumor-related factors such as imaging information, pathology information; and molecular biology information. This review will analyze the treatment failure phenotype and prognostic factors of stageⅠ NSCLC in various perspectives such as individual-, tumor- and treatment-related factors.

Efficacy of Achyranthis Bidentatae Radix Against Cartilage Degeneration in Osteoarthritis： An Exploration Based on Computer Simulation / 中国实验方剂学杂志

Objective:To screen the active components of sovereign medicinal Achyranthis Bidentatae Radix in Rongjin Niantong formula based on bioinformatics and network pharmacology and observe their effects on therapeutic targets of osteoarthritis （OA） in <italic>in vivo</italic> and <italic>in vitro</italic> animal experiments. Method:The main active components and therapeutic targets of Achyranthis Bidentatae Radix were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP）， and the differentially expressed genes relevant to OA from the Gene Expression Omnibus （GEO） database for cross analysis. The effects of main active components in Achyranthis Bidentatae Radix on enriched therapeutic targets of rats with OA <italic>in vivo </italic>and <italic>in vitro</italic> were detected by real-time polymerase chain reaction （Real-time PCR） and Western blot. Result:There were 20 active components for Achyranthis Bidentatae Radix against OA， with quercetin being an important one. Among the three target genes， osteopontin （OPN） and plasminogen activator inhibitor-1（PAI-1） were the key ones in the network. Gene Ontology （GO） analysis yielded 227 related terms， involving the regulation of physiological response to trauma （GO： 1903034）， negative regulation of trauma response （GO： 1903035）， etc. Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway analysis revealed 12 related pathways， involving extracellular matrix receptor interaction （hsa04512） and so on. In animal experiments， compared with the normal group， the model group exhibited increased gene and protein expression of OPN and PAI-1. Compared with the model group， the quercetin group displayed decreased gene and protein expression of OPN and PAI-1 （<italic>P</italic><0.05）. In cell experiments， the OPN and PAI-1 protein expression levels in the model group were increased as compared with those in the normal group， while the Collagen Ⅱ protein expression was decreased. The OPN and PAI-1 protein expression levels in the quercetin group and the inhibitor group were down-regulated in contrast to those in the model group， whereas the Collagen Ⅱ protein expression levels were up-regulated significantly （<italic>P<</italic>0.05）. Conclusion:Achyranthis Bidentatae Radix<italic> </italic>inhibits cartilage degeneration and exerts the preventive and therapeutic effects against OA， which is possibly due to the efficacy of its active component quercetin in down-regulating the expression of OPN and PAI-1 in chondrocytes and up-regulating the Collagen Ⅱ protein expression.

Endoscopic lateral neck dissection via the breast and transoral approaches for papillary thyroid carcinoma: a report of 10 cases / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the feasibility of endoscopic lateral neck dissection via the breast and transoral approaches (ELNDBTOA) for papillary thyroid carcinoma (PTC). Methods: From February 2015 to April 2019, 10 patients with PTC (cN1b) including 1 male and 9 females aged from 22 to 53 years old received ELNDBTOA in the General Surgery Department of Zhongshan Hospital, Xiamen University. Total thyroidectomy, the central lymph node dissection and the selective neck dissection (levels Ⅱ, Ⅲ and Ⅳ) were performed endoscopically via the breast approach, and then the residual lymph nodes were dissected via transoral approach. The medical records, operation time, blood loss, complications and postoperative follow-up outcomes were analyzed retrospectively. SPSS 22.0 software package was used for statistical processing of clinical data of patients. Results: All cases were successfully treated with ELNDBTOA without transfer to open surgery. The average operative time was (362.5±79.7) min, the blood loss was (23.0±14.9) ml, and the postoperative hospital stay was (5.1±1.3) days. The mean number of harvested cervical lymph nodes were (34.2±25.8), and the mean number of positive lymph nodes were (6.5±4.9). Lymph nodes were dissected by the further dissection via oral approach in 6 patients and a total of 9 lateral lymph nodes were havested from 2 of the 6 patients, with 3 positive lymph nodes. Two patients had transient skin numbness in the mandibular area and recovered within two weeks. One patient developed transient hypoparathyroidism and recovered within two months. No secondary bleeding, recurrent laryngeal nerve paralysis, chylous leakage, neck infection, permanent hypoparathyroidism or other complications were observed. The follow-up time was from 16 to 66 months with a median of 42.5 months, no tumor recurrence or metastasis occurred, and also no obvious deformity, abnormal sensation or movement in the chest, neck and mouth was observed. Conclusions: ELNBTOA is safe and feasible, with good cosmetic outcome.

Consistency between nasopharyngeal aspirates and bronchoalveolar lavage fluid in pathogen detection in children with pneumonia: an analysis of 533 cases / 中国当代儿科杂志

OBJECTIVES@#To study the consistency between nasopharyngeal aspirates (NPA) and bronchoalveolar lavage fluid (BALF) in pathogen detection in children with pneumonia@*METHODS@#A retrospective analysis was performed on the data of pathogens detected in 533 children with pneumonia from February 2017 to March 2020. The paired McNemar's test was used to compare the difference in pathogen detection between NPA and BALF groups. The @*RESULTS@#NPA had a sensitivity of 28%, a specificity of 74%, a positive predictive value of 14%, and a negative predictive value of 91% in detecting bacteria, and a @*CONCLUSIONS@#There is poor consistency between NPA and BALF in the detection of bacteria and viruses, and clinicians should be cautious in diagnosing lower respiratory tract infection based on bacteria or viruses detected in NPA. There is moderate consistency between NPA and BALF in the detection of

Therapeutic effect of ureteroscopic pneumatic lithotripsy and percutaneous renal holmium laser lithotripsy for upper ureteral calculi / 局解手术学杂志

Objective To investigate the efficacy of ureteroscopic pneumatic lithotripsy and percutaneous renal holmium laser lithotripsy in the treatment of upper ureteral calculi. Methods A total of 132 patients with upper ureteral calculi admitted to our hospital from December 2016 to December 2017 were randomly divided into observation group and control group, 66 cases in each group. The control group underwent ureteroscopic pneumatic lithotripsy, and the observation group used percutaneous nephrolithotomy holmium laser lithotripsy. The clinical efficacy, surgical index and complication rate between two groups were compared. Results The clinical efficacy of the observation group (90. 91％) was higher than that of the control group(75. 76％),and the difference was statistically significant(P ＜ 0. 05). The operation time of the observation group was (27. 53 ± 3. 97) minutes,which was shorter than (42. 59 ± 4. 34) minutes of the control group,and the postoperative blood loss was (18. 59 ± 5. 21) mL,which was less than (31. 68 ± 4. 72) mL of the control group, the difference was statistically significant(P ＜ 0. 05). There was no significant difference in postoperative hospital stay between observation group[(5. 31 ± 1. 62) days]and control group[(5. 28 ± 1. 48) days](P ＞ 0. 05). There was no significant difference in the incidence of complications between two groups (P ＞ 0. 05). Conclusion Percutaneous nephrolithotomy with holmium laser lithotripsy is more effective than pneumatic lithotripsy in the treatment of upper ureteral calculi. It can shorten the operation time, reduce the amount of bleeding, and has higher safety.

Application of external ureteral clipping in laparoscopic ureterobladder reimplantation / 第二军医大学学报

Objective To explore the feasibility and effectiveness of external ureteral clipping and insertion of double J tube in laparoscopic ureterobladder reimplantation. Methods The clinical data of 21 patients with lower ureteral stricture undergoing laparoscopic ureterobladder reimplantation from Mar. 2014 to Mar. 2016 were retrospectively analyzed. Twelve patients receiving conventional laparoscopic ureterobladder reimplantation were assigned to control group, and 9 patients receiving laparoscopy-assisted external ureterobladder reimplantation were assigned to improvement group. The ureter of the patients in the improvement group was separated under laparoscopy, the narrow ureter was severed, and the proximal ureter was taken out from the 12-mm Trocar. Then, the broken end of ureter was clipped under euthyphoria, and the double J tubes were inserted and fixed on the ureteral mucosa with 4-0 absorbable sutures and then sent back to the pelvis. The bladder was mobilized under laparoscopy, and the bladder and ureter were anastomosed. Results The surgery was successfully completed in all the 21 patients without transferring to open surgery or urine leakage after operation. The operation time was significantly shorter in the improvement group versus the control group ([77±17] min vs [104±20] min, P<0.05). All patients were followed up for at least 6 months after operation. Both ultrasonography and intravenous pyelography showed no ureteral anastomotic stricture. The hydronephrosis was alleviated to some extent. Cystography showed that 2 patients had reflux, with 1 case in each group. Conclusion In laparoscopic ureteral reimplantation, external ureteral clipping and insertion of double J tube are minimally invasive, and can shorten operation time and make the surgery less complex.

Tick-Borne Pathogens in Ixodid Ticks from Poyang Lake Region, Southeastern China

Ticks are the vectors of various pathogens, threatening human health and animal production across the globe. Here, for the first time we detected Ricketssia spp., Borrelia spp. and protozoan in ticks from Poyang Lake region in Jiangxi Province of eastern China. In 3 habitat categories and on 12 host species, 311 ticks from 11 species were collected. Haemaphysalis longicornis was the predominant species, accounting for 55.63%, followed by Rhipicephalus microplus, Haemaphysalis flava and Ixodes granulatus. Of the collected ticks, 7.07% were positive for tick-borne pathogens, and H. longicornis and H. flava were found to be co-infected with Ricketssia spp. and protozoan. H. flava was the most detected positive for tick-borne pathogens, whereas H. longicornis had the lowest infection rate, and the difference in infection rates between tick species was significant (χ²=61.24, P < 0.001). Furthermore, adult ticks demonstrated remarkably greater infection rate than immature ticks (χ²=10.12, P=0.018), meanwhile ticks on Erinaceidae showed significantly higher positivity than ticks collected on other host species (χ²=108.44, P < 0.001). Genetic fragment sequencing and analyses showed at least 4 pathogen species presence in ticks, namely Borrelia yangtzensis, Rickettsia slovaca or Rickettsia raoultii related genospecies, Babesia vogeli and Hepatozoon canis or Hepatozoon felis related genospecies. The finding indicates that the abundant ticks can carry diverse pathogens in Poyang Lake region, and pathogen infection is highly related to species, vertebrate hosts and life stages of ticks.

Protective effect of Qilin Pills on the reproductive function of oligoasthenospermia rats / 中华男科学杂志

Objective@#To study the protective effect of Qilin Pills (QLP) on the reproductive function of rats with oligoasthenospermia (OAS) induced by tripterygium glycosides.@*METHODS@#Twenty-eight male SD rats were randomly divided into a normal control, an OAS model control, a low-dose QLP, and a high-dose QLP group of equal number. OAS models were made in the latter three groups by intragastrical administration of tripterygium glycosides at 40 mg per kg of the body weight per day, and meanwhile the animals in the low- and high-dose QLP groups were treated with QLP at 1.62 and 3.24 g per kg of the body weight per day, respectively, while those in the OAS model group with normal saline, all for 30 consecutive days. Then all the rats were executed for obtaining the testis weight, testis viscera index, epididymal sperm concentration and motility, reproductive hormone levels, and antioxidation indexes and observation of the histomorphological changes of the testis tissue by HE staining.@*RESULTS@#After 30 days of intervention, the low- and high-dose QLP groups, as compared with the OAS model controls, showed significantly improved epididymal sperm concentration (［14.57 ± 3.95］ and ［39.71 ± 11.31］ vs ［4.71 ± 1.25］ ×10⁶/ml, P <0.05) and motility (［3.71 ± 1.11］ and ［4.29 ± 1.80］ vs ［0.57 ± 0.53］%, P <0.05), increased levels of sex hormone binding globulin (SHBG) (［94.83 ± 11.17］ and ［88.05 ± 9.21］ vs ［56.74 ± 8.29］ nmol/L, P <0.05) and free testosterone (FT) (［27.27 ± 3.63］ and ［32.80 ± 2.51］ vs ［22.81 ± 2.75］ nmol/L, P <0.05), decreased level of follicle-stimulating hormone (FSH) (［1.49 ± 0.62］ and ［1.12 ± 0.83］ vs ［1.71 ± 0.52］ mIU/ml, P <0.05), but no significant change in the total testosterone (TT) level. Meanwhile, the level of superoxide dismutase (SOD) was markedly elevated in the low- and high-dose QLP groups in comparison with the OAS model control group (［277.14 ± 15.84］ and ［299.60 ± 20.83］ vs ［250.04 ± 31.06］ U/ml, P <0.05) while that of reactive oxygen species (ROS) remarkably reduced (［397.61 ± 62.71］ and ［376.84 ± 67.14］ vs ［552.20 ± 58.07］ IU/ml, P <0.05). HE staining showed that QLP intervention significantly increased the layers and quantity of spermatogenic cells in the testicular seminiferous tubules of the OAS rats.@*CONCLUSIONS@#QLP can effectively protect the reproductive system of oligoasthenospermia rats by raising sperm quality, elevating reproductive hormone levels, reducing oxidative stress injury, and improving histomorphology of the testis.

ilin Pills for oligoasthenospermia: Advances in clinical studies / 中华男科学杂志

Industrialization and environmental pollution are bringing more problems to human reproduction and increasing the prevalence of male infertility. Western medicine has shown its limitations in the management of male infertility, especially that of oligoasthenospermia. Traditional Chinese medicine (TCM), however, has long and rich experiences in the treatment of oligoasthenospermia, with a large variety of medicinal prescriptions based on the TCM theories, among which Qilin Pills shows a particularly significant therapeutic effect on oligoasthenospermia, especially when combined with Western medicine. At present, published studies on Qilin Pills are mainly in the stage of clinical observation, while basic researches and studies on its relevant mechanisms are rarely seen.

Development of wearable monitor for human vital signs and environment information / 医疗卫生装备

Objective To develop a set of wearable device for dynamic monitoring of human vital signs and environmental information during exercise.Methods By using system integration mode,multiple sensor modules were integrated in the design of the device.A microcontroller was selected as the core of the hardware circuit.Then serial ports simulation was used to connect all sensors to the microcontroller.Wireless data transmission between the handset and the primary control module was implemented with Bluetooth component.Results The device behaved well in low energy consumption,small volume,low weight and data accuracy,and met the design requirements for wearable mobile monitoring device.Conciusion The device provides real-time data monitoring to the users so as to contribute to human health.

Fertility preservation for male adolescent cancer patients / 中华男科学杂志

Fertility preservation is a hotspot of research in reproductive medicine, and that of male adolescent cancer patients is drawing even more attention from reproductive and oncologic clinicians. Both cancer and its treatment can decrease semen quality and even induce irreversible damage to fertility. Sperm cryopreservation is an effective method for fertility preservation. In the past few years, marked advances have been made in the cryopreservation, transplantation, and in vitro culture of testis tissue and stem spermatogonial cells. Although still experimental, these approaches may offer some options to those with no mature sperm in the testis. Unfortunately, very few people know and participate in the studies of fertility preservation and the utilization rate of cryopreserved sperm remains low. Therefor reproductive physicians and oncologists are required to make more efforts to search for effective fertility preservation methods for male adolescent cancer patients.

Inertial Measurement Unit and Fall Risk Assessment in the Elderly (review) / 中国康复理论与实践

@#Falling in the elderly is a major health problem and may cause severe consequences. Fall risk assessment is important for preventing and intervening fall incidence. Inertial Measurement Unit (IMU) has been introduced to evaluate motion/balance function and fall risk among the older people. Some researches indicated that it might have advantages over the usual tools, and can be used in the hospitals, communities, nursing homes, etc. IMU is a good way to measure gait variability, which may be strongly related with the risk of falls.

Testis specific serine/threonine protein kinase 4 (TSSK4) leads to cell apoptosis relying on its kinase activity / 华中科技大学学报（医学）（英德文版）

Testis specific serine/threonine protein kinase 4 (TSSK4) belongs to the TSSK family, and its members play an important role in spermatogenesis and/or spermiogenesis. Mouse TSSK4 has been reported to be expressed exclusively in the testis and can maintain its kinase activity through autophosphorylation at Thr-197. However, its biological function remains poorly understood. Here we found that GFP-TSSK4-overexpressed HeLa cells showed apoptotic bodies, indicating TSSK4 can lead to apoptosis in vitro. Furthermore, TSSK4 induced apoptosis in different cell lines including HeLa, Cos-7 and H1299 tested by flow cytometry but not its kinase-dead mutant TSSK4-K54M. TSSK4 knockout mice showed increased testes weight and decreased apoptotic spermatogonia and spermatocytes at 21st day after birth tested by TUNEL technology. So TSSK4 was able to induce cell apoptosis in vitro depending on its kinase activity, which leads to abnormal testes weight and apoptosis, shedding light on its function in the process of spermatogenesis and/or spermiogenesis.

Testis specific serine/threonine protein kinase 4 (TSSK4) leads to cell apoptosis relying on its kinase activity / 华中科技大学学报（医学）（英德文版）

Testis specific serine/threonine protein kinase 4 (TSSK4) belongs to the TSSK family, and its members play an important role in spermatogenesis and/or spermiogenesis. Mouse TSSK4 has been reported to be expressed exclusively in the testis and can maintain its kinase activity through autophosphorylation at Thr-197. However, its biological function remains poorly understood. Here we found that GFP-TSSK4-overexpressed HeLa cells showed apoptotic bodies, indicating TSSK4 can lead to apoptosis in vitro. Furthermore, TSSK4 induced apoptosis in different cell lines including HeLa, Cos-7 and H1299 tested by flow cytometry but not its kinase-dead mutant TSSK4-K54M. TSSK4 knockout mice showed increased testes weight and decreased apoptotic spermatogonia and spermatocytes at 21st day after birth tested by TUNEL technology. So TSSK4 was able to induce cell apoptosis in vitro depending on its kinase activity, which leads to abnormal testes weight and apoptosis, shedding light on its function in the process of spermatogenesis and/or spermiogenesis.

Pathological findings in a mouse model of Japanese encephalitis infected via the footpad

We have developed and characterised a mouse model of Japanese encephalitis virus (JEV) infection via footpad inoculation in order to better mimic viral transmission by mosquito bites. Two-week-old and 5-week-old mice consistently developed signs of infection such as ruffled fur, weight loss, hunchback posture, tremors, mask-like facies and occasionally, hindlimb paralysis at 4 days post infection (dpi) and 11-13 dpi, respectively. Most of the animals died within 24 to 48 hours following the onset of signs of infection, with mortalities of 100% and 33.3% in 2-week-old and 5-week-old mice, respectively. Mild meningitis and variable parenchymal inflammation with formation of microglial nodules, focal necrosis and neuronophagia, and perivascular cuffing by inflammatory cells were observed in the caudate nucleus, putamen, thalamus, cerebral cortex, brainstem, and spinal cord. Viral antigens/RNA were demonstrated by immunohistochemisty and in situ hybridization, respectively, in most of these areas as well as in the hippocampus and cerebellum, albeit more focally. The pathological findings in this mouse model were generally similar to human Japanese encephalitis (JE) and other established JE models but perhaps, compared to other JEV mouse models, it demonstrates lethal encephalitic infection more consistently. We believe that our mouse model should be useful to study the pathogenesis of JE, and for testing anti-viral drugs and vaccines

Pathological findings in a mouse model of Japanese encephalitis infected via the footpad

We have developed and characterised a mouse model of Japanese encephalitis virus (JEV) infection via footpad inoculation in order to better mimic viral transmission by mosquito bites. Two-week-old and 5-week-old mice consistently developed signs of infection such as ruffled fur, weight loss, hunchback posture, tremors, mask-like facies and occasionally, hindlimb paralysis at 4 days post infection (dpi) and 11-13 dpi, respectively. Most of the animals died within 24 to 48 hours following the onset of signs of infection, with mortalities of 100% and 33.3% in 2-week-old and 5-week-old mice, respectively. Mild meningitis and variable parenchymal inflammation with formation of microglial nodules, focal necrosis and neuronophagia, and perivascular cuffing by inflammatory cells were observed in the caudate nucleus, putamen, thalamus, cerebral cortex, brainstem, and spinal cord. Viral antigens/RNA were demonstrated by immunohistochemisty and in situ hybridization, respectively, in most of these areas as well as in the hippocampus and cerebellum, albeit more focally. The pathological findings in this mouse model were generally similar to human Japanese encephalitis (JE) and other established JE models but perhaps, compared to other JEV mouse models, it demonstrates lethal encephalitic infection more consistently. We believe that our mouse model should be useful to study the pathogenesis of JE, and for testing anti-viral drugs and vaccines

Expression of Six1 and Six4 in esophageal squamous cell carcinoma and their correlation with clinical prognosis / 中华病理学杂志

<p><b>OBJECTIVE</b>Six1 and Six4 are expressed in several tumors, and associated with tumor progress and poor prognosis. The aim of this study was to investigate the expression of Six1 and Six4 in esophageal squamous cell carcinoma (ESCC), and to evaluate their correlation with the clinicopathological factors and prognosis.</p><p><b>METHODS</b>Tissue microarray technology and immunohistochemical method (EnVision) were used to detect the expression of Six1 and Six4 in the tumor tissues and corresponding adjacent normal epithelium of esophagus from 292 ESCC patients.</p><p><b>RESULTS</b>Among the 292 ESCC patients, the positive rates of Six1 and Six4 protein expression in tumor tissues were 72.9% (213/292) and 56.2% (164/292), respectively, significantly higher than the expression rate of 33.2% (97/292) and 32.5% (95/292) in adjacent normal epithelium of esophagus (P < 0.05). Chi square test showed that the expression of Six1 protein was related to tumor size, depth of tumor invasion and patient survival status; higher Six4 protein expression level was related to poor differentiation and increased depth of invasion. Single factor Log-rank analysis revealed that gender, TNM stage, Six1 protein expression level were related to the overall survival of ESCC patients (P < 0.05), while the five-year survival rate was significantly higher in the Six1-negative group than the Six1-positive group [51.9% (41/79) vs. 43.7% (93/213)]. Multi-factor Cox proportional risk model analysis showed that TNM stage and positive expression of Six1 were independent prognostic factors for ESCC patients (P < 0.05).</p><p><b>CONCLUSIONS</b>Six1 and Six4 are highly expressed in ESCC. Their expression levels are closely related to the progress and prognosis of ESCC. Over-expression of Six1 is related to poor prognosis in ESCC patients. Thus, Six1 could be used as an important prognostic indicator for ESCC patients.</p>

Value of cytopathology in endobronchial ultrasound-guided transbronchial needle aspiration / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the role of cytopathology in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for lung tumor diagnosis and staging.</p><p><b>METHODS</b>Two-hundred consecutive cases of lung tumor with EBUS-TBNA performed during the period from April, 2009 to September, 2010 in Shanghai Cancer Hospital were retrospectively reviewed. The cytologic diagnoses were categorized as non-diagnostic, negative, suspicious and malignant. When available, cell block preparation and immunohistochemistry were performed. On the 22 positive cases diagnosed by on-site evaluation, epidermal growth factor receptor (EGFR) mutation study was carried out.</p><p><b>RESULTS</b>In the 200 cases of cytology specimens, 122 cases (69.3%) were diagnosed as malignant, 42 cases (23.9%) as benign and 12 cases (6.8%) as suspicious for malignancy. The non-diagnostic rate was 12.0% (24/200). Amongst the 200 cases studied, 140 cases (70.0%) had histologic correlation available (via core biopsy, mediastinoscopic biopsy or surgical excision). The sensitivity and specificity of EBUS-TBNA cytologic diagnoses were 94.4% and 100%, when using histopathologic findings and clinical follow-up data as gold standard. The cell block preparation and immunohistochemistry were useful in subtyping and diagnosis of extrathoracic malignancy. EGFR mutations were detected in 8 cytology samples (36.4%).</p><p><b>CONCLUSIONS</b>EBUS-TBNA is a sensitive and specific tool for diagnosis and staging of lung cancer. The cytology samples can be used for further ancillary investigations including cell block preparation, immunohistochemistry and molecular studies.</p>