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Objective To investigate the clinical significance of Notch-1 expression in small cell lung cancer(SCLC) and non-small cell lung cancer(NSCLC),and analyze the role of it in prognosis.Methods SP immunohistochemistry was used to detect the expression of Notch-1 antibody in 43 of SCLC and 40 of NSCLC tissues.Further analysis was carried out to interpret the association of Notch-1 antibody expression with clinicopathological features,lymph node metastasis and prognosis in SCLC.Results The positive rate of Notch-1 expression was 20.93％ ( 9/43 ) in SCLC,while 65.00％ ( 26/40 ) in NSCLC.The expression of Notch-1 antibody was associated with clinical stage and lymph node metastasis ( x2 =5.42,P ＜ 0.05 ; x2 =4.88,P ＜ 0.05respectively),but was not associated with age,sex,tumor location,tumor size ( Ps ＞ 0.05 ).Compared with NSCLC,the expression rates of Notch-1 antibody were significantly higher in SCLC ( x2 =16.50,P ＜ 0.05 ).Kaplan-Meier survival analysis indicated that the survival time of patients with positive Notch-1 expression was significantly longer than that of patients with negative staining( x2 =19.87,P ＜ 0.05 ).Cox regression analysis showed that Notch-1 antibody could significantly reduce the risk of death in patients with SCLC.Conclusion The positive expressions of Notch-1 were significantly different in SCLC and NSCLC,which linked to the clinicalstage,lymph node metastasis and poor prognosis.Accordingly,the expression of Notch-1 may have good value in diagnosis and prognosis.
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Objective To evaluate the feasibility and effectiveness of endoluminal grafting for the treatment of abdominal aortic aneurysms in high-risk patients with serious co-morbidities.Methods Endoluminal stent grafting was performed in fifty-one patients(45 males and 6 females,with a mean age of 71.6±7.5 years)with abdominal aortic aneurysms.Of all the patients,21(37.7%)were high-risk surgical candidates because of associated co-morbidities.These patients were classified in grade Ⅱ and Ⅲ according to the criteria assigned by the"Society for Vascular Surgery"and"International Society for Cardiovascular Surgery".Based on the preoperative CT and DSA findings,the appropriate stent was selected for every patient.Post-operative clinical observation and CT scan were regularly carried out,the occurrence of complications and the morphological changes of the aneurysms were observed.The results were evaluated and analyzed.Results Primary technical success was achieved in all patients(100%).No death occurred during the procedure or in 30 days after the procedure.An average follow-up period of(29.1±20.5)months was made.Minor endoleak was noted on CT scans in 10 patients,and the endoleak disappeared in 5 patients during the follow-up period.One patient died from unknown cause.The total mortality rate was 2.0%(1/51).The major complications rate was 9.8%(5/51),including stent thrombosis(n=2),thrombosis at femoral artery(n=1),lymphatic fistula at femoral incision(n=1) and stent dislocation(n=1).Conclusion Endoluminal stent grafting is a safe and feasible technique for the treatment of abdominal aortic aneurysms with excellent medium-term results.This technique is especially suitable for the patients with high surgical risk.
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Objective To assess the value of CT angiography (CTA) in diagnosis of re-entry tears in type B aortic dissection. Methods One hundred and ten patients with typical type B aortic dissection were enrolled. Data derived from the CTA scans of all the patients and DSA of 70 patients were reviewed. The number, location and size of the re-entry tears were calculated and analyzed. CTA findings were compared with DSA results by using Kappa statistics. Results The mean number of re-entry tears was 3.41±1.90, and 83.64% (92/110) patients had multiple tears. Re-entry tears occurred in the middle of the abdominal aorta were more common than that in the other palce of aorta. The large ones commonly located in the most remote position of dissection. The sensitivity and specificity of finding re-entry tears with CTA was 93.78% and 88.89% respectively, the Kappa value was 0.827 (P＜0.01). Conclusion The consistency between CTA and DSA was good. The re-entry tears in type B aortic dissection can be depicted clearly with CTA, and CTA can be used as the main method for further observation and follow-up of this disease.
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Objective To evaluate the efficacy of emergency transcatheter arterial embolization(TAE)for spontaneous rupture of hepatocellular carcinoma(HCC).Methods We retrospectively reviewed 16 cases of spontaneous ruptured HCC which had been treated in our hospital between 1997 and 2005.Emergency TAE was performed in the 16 patients,with 6 cases complicated by hypovolemic.Results Bleeding from the ruptured HCC was stopped at the end of the procedure in 16 patients who had undergone successful embolization.The time from the onset of clinical symprtom to TAE been completed was 1.5-5 hours(mean,3.6 hours),The shortest time was 1.5 hours in 3 patients.Following the achievement of hemostasis by TAE,transcatheter arterial chemoembolization(TACE)2-6 times for each case with average 3.7 and CT guided percutaneous ethanol injection(CT-PEI)5-9 times for every case with arerage 6.8 were performed in 12 cases.3 cases were given up for further treatment.The liver transplantation was carried out in 1 case 3 days after TAE.The average survival time was 14.3 months.Conclusions Emergency TAE is safe and effective for bleeding due to spontaneous rupture in HCC and would achieve better result by adding TACE and CT-PEI.Liver transplantation is one of the options for the patients with poor liver function.The combination of all methods above can prolong patients survival time.(J Intervent Radiol,2006,15:228-231)