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Objective To study the correlation between clinicopathological characteristics and lymph node metastasis and prognosis of rectal neuroendocrine tumors (NET),and try to explore the choice of surgical approach.Methods The clinicopathological data of 48 postoperative rectal NET patients were collected.The univariate and multivariate analysis of the correlation between clinicopathologic characteristics and lymph node metastasis were performed by chi-square test and Logistic regression.The prognosis single factor survival analysis was analyzed by Kaplan-Meier method.The survival rates were compared by Log-rank test.The prognosis multivariate survival analysis was performed by the use of Cox model.Results The results of univariate analysis indicated that clinicopathological characteristics related with lymph node metastasis were tumor distance from anal verge less than six cm,tumor diameter over two cm,muscularis invasion,distant metastasis and histological grade 3.The results of multivariate analysis showed that histological grade 3 was an independent risk factor of lymph node metastasis (OR=9.333,95 ％CI:1.054 to 82.635,P=0.045).The results of univariate survival analysis suggested that factors correlated with poor prognosis were tumor distance from anal verge less than six cm,tumor diameter over two cm,muscularis invasion,lymph node metastasis,distant metastasis and histological grade 3.The results of multivariate survival analysis indicated that tumor distance from anal verge less than six cm (HR=0.215,95 ％CI:0.047 to 0.980,P=0.047),distant metastasis (HR=8.788,95％CI:2.612 to 29.571,P＜0.01) and histological grade3 (HR=5.510,95％CI:1.692-17.944,P=0.005) were independent factors associated with poor prognosis.Conclusions For histological grade 1 and 2 rectal NET patients without distant metastasis,radical surgery is recommended when tumor diameter over two cm or muscularis invasion exists.For histological grade 3 rectal NET patients without distant metastasis,radical surgery is recommended.
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Objective To study and analyze the cause, prevention and treatment for complications in patients with serious hypospadias repaired by one-stage urethroplasty. Methods From 1987 to 2002,275 patients with serious hypospadias were repaired by one-stage urethroplasty, there were 35 cases had complications. The classifications were penoscrotal 148 cases, scrotal 95 cases and perineal 32 cases. The lengths of new urethras were from 3.0 to 8.4 cm, the mean was (4.1?0.7) cm. Thirty-two cases were received endocrinotherapy before urethroplasty. Results The rate of complications was 12.7% for 1～3 years following survey. There were urethral fistulas 24 cases (8.7%),urethral strictures 6 (2.2%), diverticulums 3 (1.1%), chordees 2 (0.7%).The rate of urethral fistulas was the first and urethral stricture was the second, they were higher than those of other complications (P
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Background and purpose:Blood vessel metastasis often occurs after the operation of rectal cancer of stage Ⅱ and Ⅲ,angiogenesis is an important step of the procedure.Cycloxygenase-2(COX-2) and vascular endothelial growth factor(VEGF-C) are correlated to angiogenesis. The purpose of this study is to investigate the expressions of Cycloxygenase 2(COX-2) and vascular endothelial growth factor(VEGF-C) in rectal cancer of stage Ⅱ and Ⅲ,to explore the relationships between them and the tumor biological characteristics,tumor angiogenesis.Methods:The expressions of COX-2,VEGF-C and the microvessel density(MVD) were detected by immunohistochemical staining.Results:①The positive rates of COX-2 and VEGF-C expression in rectal cancer were 72.5%,higher than those in peritumoral normal tissue(P
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Objective To investigate the clinical characteristics of isolated renal mucormycosis in children. Methods The clinical manifestations,CT,IVU and surgical findings of 3 children with isolated renal mucormycosis were analyzed. Results A three-month newborn presented asymptomatically except for renal mass.The other two children had fever,lumbar pain,hematuria,renal enlargement and tenderness.CT scan showed multiple low density foci in the kidneys.All of the three children underwent nephrectomy and systemic amphotericin B treatment,and the diagnoses were confirmed by pathological examination. Conclusions Isolated renal mucormycosis is a rare fungal infection without predisposing factors,and its clinical characteristics are different from the usual systemic mucormycosis.Early diagnosis,nephrectomy and systemic amphotericin B treatment are necessary for improving the prognosis.
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Purpose:To study the clinical and pathologica l features of rectal carcinoid and factors influencing the prognosis.Metho ds:Data of 43 rectal carcinoid patients were analyzed retrospectively.4 2 patients were followed up postoperatively. Primary tumors were classified by s ize and muscularis invasion respectively.Results:The 5-year su rvival rate was 100% for the patients with tumor 2cm. the 5-year survival rate was 100% for the patients without muscularis invasion, and 50% for those with muscularis invasion.Conclusions:Tumor size and muscularis invasion are important pr ognostic factors for rectal carcinold.