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Objective To investigate the sequential biological effects and outcomes of microbubble-enhanced ultrasound (MEUS) combined with prothrombin on microwave ablation (MWA) in rabbit VX2 liver tumors using examination of transmission electron microscopy ,histopathology and contrast-enhanced ultrasound(CEUS) . Methods Eighty New Zealand rabbits with VX2 liver tumors were randomly divided into 4 groups ( 20 per group ) , including physiological saline group , prothrombin group , cavitation of microbubbles group ( cavitation group ) and cavitation of microbubbles combined prothrombin group (combined group) . After treatment ,the targeted liver tumors in all groups were ablated with MWA . On the 0 ,3 ,7 and 14 d ,the volumes of coagulated areas of 5 rabbits of each group randomly were measured using CEUS . Tissues in ablated areas ,transition areas and surrounding areas were examined under light microscopy with histopathology and transmission electron microscopy to observe the differences among 4 groups . Tumor metastasis was graded using visual method . Results On the 0 ,3 ,7 and 14 d ,the coagulated volumes in combined group were larger than those in remaining 3 groups ( all P ＜ 0 .001) . Under light microscopy with HE stain ,in transition area ,the fibra band in combined group was wider than those in remaining 3 groups on the 7 and 14 d ( all P ＜ 0 .05 ) . The observations under transmission electron microscopy showed that the cellular ultrastructure disorder in ablated area on the 0 d and mitochondrial injury in transition area on the 7 d were more severe in combined group than those in remaining 3 groups . Compared with the remaining 3 groups ,the degree of tumor metastasis in combined group was less ,and the time of ocurrence was later . Conclusions MEUS combined with prothrombin can significantly expand ablation volume ,enhance the necrosis of ablated tissues ,and inhibit tumor metastasis on rabbit VX 2 liver tumors . The fibra bands in the transition areas can promote the organization and repair the surrounding tissue in the ablation areas .
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Objective Toinvestigatethepossibilityandquantitativerangeofpepsinogen(PG)usedas the screening marker of gastric cancer by detecting serum pepsinogen level in different gastric mucous pathologic status.Method ThelevelofserumpepsinogenⅠ(PGⅠ)andpepsinogenⅡ(PGⅡ)bytimeresolvedfluoro-immunoassay(TRFIA)in 64 chronic atrophic gastritis patients,63 gastric mucous atypical hyperplasia patients, 67 gastric cancer patients and 20 healthy volunteers were defeeted ,and the ratio of PGR(PGⅠ/PGⅡ)was calculated.Then the three kinds of diseases were graded.The data was analyzed between groups and sub-groups.Result ①Compared with normal control group,the median PGⅠvalues were 1 24.01 ,91 .23 and 71 .23 respectively,which were all lower than that of healthy group (1 52.00).There were significant differ-ences(Z=-2.52,P=0.01 7 0;Z=-3.42,P=0.001 4;Z=-3.57,P=0.000 9).The median PGR values were 7.61 ,5.21 and 4.32 respectively,which were also lower than that of healthy group,the differences were significant(Z=-2.98,P=0.002 9;Z=-3.1 7,P=0.000 2;Z=-2.89,P=0.000 1 ).The PGⅡlevel of these diseases were not significantly different with control group.②The serum PGⅠlevel of gastric mucous atypical hyperplasia and gastric cancer were reduced significantly in contrast with atrophic gastritis (Z =-3.42,P =0.001 4;Z=-3.62,P=0.000 9);the levels of PGⅡand PGR were varied without significance (P>0.05 );③The levels of PGⅠamong atrophy gastritis and gastric cancer subgroup have no significant difference(χ2 =2.86,P=0.41 4 3;χ2 =1 .67,P=0.1 36 8).But the level of PGⅠwas significantly different in gastric atypical hyperplasia(χ2 =0.83,P=0.043 0).It decreased in light and medium grade dysplasia and went up in severe grade dysplasia.The levels of PGⅡ and PGR were varied without significance(P>0.05).④The areas under the ROC curves performed by the PGⅠ and PGR from normal control group and atypical hyperplasia group were 0.782 and 0.831 respectively;The sensitivity and specificity of PGⅠ≤72.1 2 μg/L and PGR≤4.32 for gastric dysplasia were 89.48%and 76.31%respectively.Conclusion ①The level of PGⅠand PGR were decreased along with the seriousness of gastric pathological changes and probably regarded as the screening markers of gastric mucous malignant transformation.②Serum pepsinogen level is closely correlated with gastric precancerous lesion,PGI≤72.1 2 μg/L and PGR≤4.32 has better specificity and sensitivity for gastric atypical hyperplasia in this area.
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Objective To explore the influence of some factors on long-term survival of postoperative stage Ⅰ NSCLC patients. Methods 91 patients of NSCLC who underwent radical surgery of the primary tumor with dissection of the hilar and mediastinal lymph nodes were diagnosed as stage Ⅰ NSCLC postoperatively by pathology and followed up for 5 years. Its hilar and subcarinal lymph nodes were detected occult micrometastastic tumor cells by immunohistochemistry (SP method) by using the binoclonal antibody multicytokeratin (AE1/AE3) as a micrometastatic marker. To analyse the influence of micrometastasis and the clinicopathologic characteristics on long-term survivals. Results The rate of micromatastasis of stage Ⅰ NSCLC was 49 %. The five-year overall survival rate was 70.3 %. The median of survival time was 48.5months. The rate of metastasis was 32 % and the meantime of relapse and metastasis was 36.6months. Tumor size, differentiation, stage, and micrometastasis were significantly associated with relapse and metastasis (P <0.05). The tumor differentiation, stage, and micrometastasis were found to be significant independent factor on survival in multivariate analysis (P<0.05). Conclusion There was nodal micrometastasis in completely resected stage Ⅰ NSCLC, and the tumor differentiation, stage, and micrometastasis were found to be significant independent factor on survival.
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Objective To detect the nodal occult micrometastasis in stage Ⅰ non-small-cell lung cancer(NSCLC),and further investigate the main factor of affecting the nodal occult micrometastasis and the rule of micrometastasis in stage Ⅰ NSCLC. Methods Occult micrometastatic tumor cells by in hilar and subcarinal lymph nodes(LN)were detected immunohistochemistry (SP method),which were removed from 91patients with completely resected stage Ⅰ NSCLC.The monoclonal antibody muhicytokeratin(MCK)was used as a micrometastatic marker.Another 45 hilar LN removed from benign pulmonary lesion patients and 45 hilar LN removed from Ⅱ and Ⅲ stage NSCLC were detected, respectively by conventional histopathologic examination as negative and positive control.Results Micrometastasis was detected in all lymph nodes that were removed from stageⅡand Ⅲ NSCLC.but no one was detected in lymph nodes that were removed from benign pulmonary lesion patients.There were 45 positive cases in 91 patients.The rate of micrometastasis in stage Ⅰ NSCLC was 49%(45/91).among them 39 subcarinal lymph nodes and 11 hilar lymph nodes were detected as positive,5 cases were detected as positive both in subcrinal and hilar lymph nodes.Logistic regression analysis indicated that tumor size,stage and differentiation affected micrometastasis significantly,odd ratios(OR) were 8.444,6.946 and 14.566 respectively.The multivariate analysis indicated that cell difierentiation and T stage may be the adverse factors for nodal micrometastasis,odd ratios(OR)were 7.028and 14.509 respectively.Conclusion There is nodal micrometastasis in completely resected stage Ⅰ NSCLC patients.The micrometastasis frequency of stage ⅠB is significantly higher than stage ⅠA;It is necessary for stage ⅠB NSCLC to be given chemotherapy after operation;cell differentiation and T stage may be the adverse factors for nodal micrometastasis.The method of lymph node micrometastasis is from hilum to mediastinum.The skip micrometastasis may be taken place in adenocarcinoma.