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Objective@#To investigate the clinicopathologic features, immunophenotype, pathological diagnosis and treatment of malignant mixed tumor (MMT).@*Methods@#Clinical and pathological features including immunohistochemical phenotypes were analyzed in a case of MMT accompanied with eccrine porocarcinoma (EP) involving both hands, diagnosed definitely in January 2018 along with review of relevant literature.@*Results@#A 64-year-old man presented with multiple rash on both hands for 4 years. Three lesions of 0.5 to 2.2 cm were removed for pathological evaluation. The pathological changes on little finger of left and right hands were MMT with EP, whereas that removed from the right ring finger was EP. MMT showed infiltrative growth with vascular wall invasion and consisted of epithelial (glandular or tube differentiation) and mesenchymal components (mucinous and/or cartilage stroma). The endothelial cells showed moderate to severe cytological atypia, nuclear pleomorphism and increased mitotic activity. The glandular component had histological characteristics of syringocarcinoma with moderately atypical chondrocytes but without myoepithelium. EP was composed of basal cells with visible vacuoles in cytoplasm and the presence of tubular and squamous differentiation, along with obvious atypia. Immunohistochemically cavosurface epithelium of glandular differentiation of MMT showed positivity for CK7, EMA and CD117. Myoepithelium showed S-100, CK5/6 and p63 positivity and stromal cells were positive for S-100. Differential diagnoses included metaplastic carcinoma, malignant myoepithelioma and atypical mixed tumor of skin.@*Conclusions@#MMT with EP is extremely rare.The diagnosis of MMT depends on the morphologic features. Immunohistochemical staining is helpful for differential diagnosis. Surgical excision with safety margins is the treatment of choice. Complementary radiotherapy and/or chemotherapy is still controversial. The clinical course of MMT is deemed unpredictable and long-term follow-up is necessary.
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Objective To evaluate the safety, efficacy and local control effect of CT- guided radiofrequency ablation (RFA) in treating non-small-cell lung cancer (NSCLC) that is inoperable or the surgical treatment is refused by the patient. Methods Between March 2007 and March 2010 at authors’ hospital, a total of 68 procedures of CT-guided RFA were carried out in 60 patients with early stage NSCLC. The patients included 37 males and 23 females with a mean age of 68.5 years. Pathologically, the lesions included squamous cell carcinoma (n=23, 38.3%), adenocarcinoma (n=31, 51.7%), large cell carcinoma (n=2, 3.3%) and adeno-squamous carcinoma (n=4, 6.7%). The mean diameter of the lesions was 3.8 cm (1.8-6.8 cm). The overall survival rate, cancer-specific survival rate and local progression-free survival rate were evaluated. Results RFA procedure was well tolerated by all patients with an average ablation time of 35 min (18-63 min). The main intraprocedural complication was pneumothorax (n=17, 28.3%). No death occurred during perioperative period. The median local progression-free survival time was 28 months, the median survival time was 32 months, and the one-, 2- and 3-year local progression-free survival rate were 94.6%, 83.1%and 73.6%, respectively. Conclusion For patients with inoperable NSCLC and patients with NSCLC who refuse to receive surgery, CT-guided RFA is a safe and effective treatment. This therapy can significantly improve the local progression-free survival rate.
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Objective To evaluate the safety,local efficacy and survival rates of isolated pulmonary metastases from colorectal carcinoma treated with CT-guided radiofrequency ablation.Methods A total of 28 patients with isolated pulmonary metastases from colorectal carcinoma were performed with CT-guided radiofrequency ablation (radiofrequency ablation group).The size of the lesion was 1.2-5.0 (2.9 ± 1.0) cm.During the same time,9 patients,who did not take any treatment for isolated pulmonary metastases from colorectal carcinoma,were collected as control group.The size of the lesion was 2.0-5.0 (3.6 ± 1.0) cm.The local progression-free rates and overall survival rates were compared.Results All the cases were able to complete the radiofrequency ablation in radiofrequency ablation group.During and after the procedure,no major complications occurred.The 1-,2-,and 3-year local progression-free rates and overall survival rates in radiofrequency ablation group were significantly higher than those in control group.The local progression-free rates were 89.3％ vs.76.2％,78.6％ vs.33.9％,70.7％ vs.16.9％.The overall survival rates were 96.4％ vs.77.8％,85.7％ vs.44.4％,56.7％ vs.22.2％.The differences between two groups had statistical significance (P ＜ 0.01).Conclusion CT-guided radiofrequency ablation for isolated pulmonary metastasis from colorectal carcinoma is a safe,effective,minimally invasive treatment,and can significantly improve the local progression-free rates and overall survival rates.
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Objective To evaluate the clinical effect of lumbar intervertebral disc herniation (LIDH) by CT-guided precise injection around nerve root and in epidural cavity. Methods One hundred and eight patients of LIDH were treated by CT-guided precise injection around nerve root and in epidural cavity, and followed-up after 1, 3 and 6 months. Visual analogue score (VAS) for pain was used to evaluate the efficacy before and after treatment. Results In 108 cases, there were 83 patients (76.9%) with good result whose improvement of VAS was greater than or equal 50% after treatment 1, 3 and 6 months. There were 19 patients (17.6%) with fair result whose improvement of VAS was less than 50% after treatment 1, 3 and 6 months. There were 6 patients (5.6%) with invalid result whose improvement of VAS was unobvious after treatment 1, 3 and 6 months. Conclusion CT-guided therapy of LIDH by precise injection around nerve root and in epidural cavity is safe, accurate, effective, minimally aggressive technique and worth being practiced clinically.
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Objective: To determine the predictive value of excision repair cross complement 1 (ERCC1) expression in non-small cell lung cancer (NSCLC) and the sensitivity of NSCLC to non-cisplatin based chemo-therapy and cisplatin based chemotherapy. Methods: The expression of ERCC1 was examined by immunohis-tochemical technique in 130 patients with advanced NSCLC seen in our hospital between February 1st 2006 and October 30th 2007. These 130 patients were divied into three groups. Patients in group A (n=68) had neg-ative ERCC1 expression and received cisplatin based chemotherapy. Patients in group B (n=31) had positive expression of ERCC1 and received non-cisplatin based chemotherapy. Patients in group C (n=31) had posi-tive expression of ERCC1 and received cisplatin based chemotherapy. Results: The expression rate of ER-CC1 was 62 of 130 (47.8%). The rate of ERCC1 in pulmonary adenocarcinoma was higher than that in squa-mous carcinoma. The response rates of chemotherapy in group A, B, and C group were 58.8 %, 51.6%, and 41.5%, respecitvely. There was no significant difference in the response rate between group A and group B (X~2=0.451, P=0.502). There was a significant difference in the response rate between group A and group C (X~2= 6.011, P=0.014). The response rate in group B was higher than that in group C (X~2=2.384, P=1.123). The average survival time in group A, group B, and group C were 12.0 months, 11.0 months, and 7.8 months, respecit-vely. There was no significant difference in patient survival between group A and group B (X~2=3.809, P=0.051). There was significant difference in patient survival between group A and group C (X~2=46.368, P=0.000). Con-clusion: ERCC1 may be an important indicator of the sensitivity of advanced NSCLC to cisplatin or non-cisplat-in based chemotherapy.