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As a treatment option for cancer, thermal ablation has satisfactory effects on many types of solid tumors (such as liver and renal cancers). However, its clinical applications for the treatment of thyroid nodules and metastatic cervical lymph nodes are still under debate both in China and abroad. In 2015, the “Zhejiang Expert consensus on thermal ablation for thyroid benign nodules, microcarcinoma, and metastatic cervical lymph nodes (2015 edition),” was released by the Thyroid Cancer Committee of Zhejiang Anti-Cancer Association, China. To further standardize the application of thermal ablation for thyroid tumors, the Thyroid Tumor Ablation Experts Group of Chinese Medical Doctor Association has organized many seminars and finally produced a consensus to formulate the “Expert consensus workshop report: Guidelines for thermal ablation of thyroid tumors (2019 edition).”
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Objective@#To explore the positive expressions of P16 and Ki-67 proteins in cervical biopsy lesions of patients with high-risk HPV infection and abnormal detection of liquid-based thin-layer cytology test(TCT), and the clinical value in predicting occurrence of early cervical cancer.@*Methods@#A total of 120 patients with high-risk HPV infection(16 and 18 subtypes positive) and abnormal TCT in the Traditional Chinese Medicine Hospital of Linhai from January 2016 to July 2017 were enrolled in the study.The colposcopy was used to get cervical biopsy lesions for pathological diagnosis, immunohistochemical staining was used to detect P16 and Ki-67 proteins.@*Results@#There were up to 66 patients with HPV-16 positive, 34 cases with HPV-18 positive, other 20 cases with 16 and 18 positive; 6 cases of atypical squamous epithelial cells(ASC), 46 cases of low-grade squamous intraepithelial lesions (LSIL), 60 cases of high-grade SIL(HSIL), other 8 cases of cervical squamous cell carcinoma(SCC) were diagnosed by TCT; 5 cases of inflammation, 105 cases of CIN and 10 cases of SCC by pathologically diagnosis.The positive rates of P16 and Ki-67 proteins were gradually increased in patients with inflammation, CIN and SCC[0(0/5), 36.2%(38/105), 70.0%(7/10), χ2=4.382, P=0.036; 0(0/5), 40.0%(42/105), 80.0%(8/10), χ2=5.945, P=0.015]. The patients with CIN were followed up for 21~36 months, median time 29.5 months.Twenty-six patients progressed to SCC, at the end of follow-up, the positive rates of P16 and Ki-67 proteins in patients with SCC were significantly higher than those in the CIN patients without progress[61.5%(16/26) vs.39.2%(31/79), χ2=3.934, P=0.047; 69.2%(18/26) vs.41.8%(33/79), χ2=5.905, P=0.015].@*Conclusion@#The positive expression rates of P16 and Ki-67 proteins in cervical biopsy tissues are significantly higher in patients with high-risk HPV infection and abnormal TCT, which in patients with pathologically diagnosis of SCC are higher than CIN patients, the same results in CIN patients with SCC progression than non-progressing patients, suggesting that P16 and Ki-67 proteins are of great value in predicting occurrence of early cervical cancer.
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Objective To explore the positive expressions of P 16 and Ki -67 proteins in cervical biopsy lesions of patients with high-risk HPV infection and abnormal detection of liquid -based thin-layer cytology test (TCT),and the clinical value in predicting occurrence of early cervical cancer .Methods A total of 120 patients with high-risk HPV infection(16 and 18 subtypes positive) and abnormal TCT in the Traditional Chinese Medicine Hospital of Linhai from January 2016 to July 2017 were enrolled in the study.The colposcopy was used to get cervical biopsy lesions for pathological diagnosis ,immunohistochemical staining was used to detect P 16 and Ki-67 proteins. Results There were up to 66 patients with HPV-16 positive,34 cases with HPV-18 positive,other 20 cases with 16 and 18 positive;6 cases of atypical squamous epithelial cells (ASC),46 cases of low-grade squamous intraepithelial lesions (LSIL),60 cases of high-grade SIL(HSIL),other 8 cases of cervical squamous cell carcinoma (SCC) were diagnosed by TCT;5 cases of inflammation,105 cases of CIN and 10 cases of SCC by pathologically diagnosis.The positive rates of P16 and Ki-67 proteins were gradually increased in patients with inflammation ,CIN and SCC[0(0／5),36.2%(38／105),70.0%(7／10),χ2 ＝4.382,P＝0.036;0 (0／5),40.0%(42／105),80.0%(8／10),χ2 ＝5.945,P＝0.015].The patients with CIN were followed up for 21～36 months,median time 29.5 months.Twenty-six patients progressed to SCC ,at the end of follow-up,the positive rates of P16 and Ki-67 proteins in patients with SCC were significantly higher than those in the CIN patients without progress [61.5%(16／26) vs.39.2%(31／79), χ2 ＝3.934,P＝0.047;69.2%(18／26) vs.41.8%(33／79),χ2 ＝5.905,P＝0.015].Conclusion The positive expression rates of P16 and Ki-67 proteins in cervical biopsy tissues are significantly higher in patients with high -risk HPV infection and abnormal TCT ,which in patients with pathologically diagnosis of SCC are higher than CIN patients,the same results in CIN patients with SCC progression than non -progressing patients,suggesting that P16 and Ki-67 proteins are of great value in predicting occurrence of early cervical cancer .
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Objective To compare the sonographic features as well as clinical histopathological features of follicular variant papillary thyroid carcinoma(FVPTC) and conventional papillary thyroid carcinoma (CPTC) in pediatric patients.Methods From Jan.2006 to Dec.2017,26 FVPTC patients and 82 CPTC patients were enrolled in this study.The clinical histopathological findings and the sonographic features were compared between the two groups.FVPTCs and CPTCs were divided into PTC-like and follicular neoplasm(FN)-like based on sonographic characteristics.Results The mean nodule size of FVPTCs was larger than that of conventional PTCs.Extrathyroid invasion and cervical lymph node metastasis did not have significant difference between CPTC and FVPTC patients(53.8％ vs 62.2％ and 76.9％ vs 82.9％,respectively).Multiple nodules(P=0.000)and distant pulmonary metastases(P=0.024) were more frequent in CPTCs than in FVPTCs(P＜0.05).The rate of an ill-defined margin (P=0.000) and calcification (P=0.003)in terms of sonographic features were lower in FVPTCs than conventional PTCs(P＜0.05).A Ⅴ+Ⅵ diagnosis of PTC on FNAC of FVPTCs was less common than that of conventional PTCs (P=0.014).Multifocality(P=0.000),extrathyroidal invasion (P=0.000),and lymph node metastasis (P=0.000) were significantly different between PTC-like FVPTCs and FN-like FVPTCs.Conclusion FVPTC in children and adolescents shows a relatively larger size,more benign sonographic features,and a lower diagnostic rate of PTC by FNAC compared with conventional PTCs in pediatric patients.
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Objective To evaluate the diagnostic value of ultrasound-guided fine needle aspiration cytology(US-FNAC)in the assessment of radiologically detected ovarian neoplasms and retroperitoneal metastatic lymph nodes. Methods FNAC was performed under ultrasound guidance on 126 patients suspected of ovarian neoplasms and retroperitoneal metastatic lymph nodes. Cytologic examination was performed after staining smears with the haematoxylin and eosin method. Clinical data were retrieved from the medical records and all cytological specimens were reviewed. In these cases, the cytologic findings were correlated with histology of the primary tumor and were compared with surgical pathology. Results Satisfactory sampling was obtained in 86.2% of punctures, and cytological diagnosis was made in 85.7% cases. The size of the lymph nodes punctured was less than 20 mm in 93.5% cases, with the sensitivity of 81.6%、86.2%, specificity of 95.8%、100.0%, positive predictive value of 98.3%、100.0%, negative predictive value of 63.9%、33.3%, and accuracy of 85.3%、87.1%. Seven patients presented slight abdominal discomfort, and relieved without clinical treatment. Conclusions The fine needle aspiration technique has excellent positive predictive value and low morbidity. US-FNAC, as the valuable investigation, is not only useful in the diagnosis of ovarian masses and lymph nodes but can also help in choosing appropriate management. From our experience, US-FNAC can be added in follow-up of selected patients in whom the cytological identification of such masses and nodes is significant for the patient′s treatment.
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Objective To study the application value of the cervical cell pathology liquid production technol-ogy in cervical intraepithelial neoplasia (CIN)screening.Methods 4 212 patients were chosen and detected by TCT and the pap staining,TBS (the Bethesda system)to finish thin layer liquid based cytology grading diagnosis,including 558 patients with cervical biopsy,the pathological results were analyzed.Results for histopathological examination results of CIN1,CIN2,CIN3 and cervical cancer cases,a thin layer of liquid based cytology detection rate was 76.00%(57 /75),78.21%(61 /78),95.76%(113 /118),100.00%(7 /7),the comparison between the CIN3 CIN2 group,a thin layer of liquid based cytology detection rate had differences in significant statistical significance (χ2 =14.53,P <0.01),with the histopathological detection of cervical lesions,thin layer of liquid based cytology detection rate was obviously rising trend.Cervical liquid based cytology screening cervical lesion (CIN and above),the sensitiv-ity was 85.61%(238 /278),83.73%(206 /246),positive predictive value 76.28%(238 /312),negative predictive value 72.79%(206 /283).Conclusion The positive results and histopathological results coincidence rate of using thinprep cytologic test to screening for cervical intraepithelial neoplasia (CIN)is high,the precancerous lesions in screening and prevention has important significance,which is worth clinical promotion.
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OBJECTIVE To study the feature of liver disease and liver failure complicated with fungous infection. METHODS The patients with liver disease complicated with fungous infection were collected form 1986 to 2005. The time was divided into four stages:from 1986 to 1990,from 1991 to 1995,from 1996 to 2000 and from 2001 to 2005. All patients with liver failure complicated with fungous infection in different stages were investigated for the incidence,the use of antibiotics and corticosteroids,the category and site of fungous infection and prognosis. RESULTS End-stage liver disease accounted for 82.6% and HBV infection was the main etiology in 475 cases of fungous infection. Fungous infection occurred mainly in hospital. Hospital acquired infection and community acquired infection were similar in different stages. The use of antibiotics and corticosteroids accounted for 88.8% and 48% in all patients before fungous infection,respectively. The use of antibiotics had no difference and the use of corticosteroids decreased in different stages. Candida were the main infection strains and the lungs and pharynx oralis were the main infection sites. The rate of healing and improvement of fungous infection and underlying diseases increased year by year. Healing and improvement rate of underlaying disease positively correlated with that of fungous infection. CONCLUSIONS End-stage liver disease patients are susceptible to fungous infection and Candida are the common infection strains. Lungs and pharynx oralis are the common infection sites. Anti-fungous therapy is important in the treatment of liver failure complicated with fungous infection.
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OBJECTIVE To study clinical characteristics of liver failure with fungal infections in the elderly patients and risk factors associated with treatment failure.METHODS Eighty four elderly patients with liver failure followed by fungal infections since 1986 were divided into two groups: effective group and ineffective group.RESULTS The common pathogens were Candida albicans(58.33%),Aspergillus fumigatus(9.52%) and Candida tropicalis(8.33%).The lungs(43.88%),mouth(32.65%),intestinal tract(9.18%) and blood(5.10%) were the main sites of fungal infection.Among them after treatment,35 cases(41.67%) were effective compared with 49 cases(58.33%) ineffective.The risk factors for treatment failure included age,complication with multiple organ dysfunction syndrome(MODS) and aspergillosis.In multivariate analysis,we found MODS in patients was an independent factor in predicting the prognosis.CONCLUSIONS To improve the treatment outcome,important measures include preventing infection,enhancing the treatment of liver failure,monitoring and supporting multiple organs: heart,brain,lungs and kidneys,and promptly rational administration of antifungal agents in elderly patient with liver failure.