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Objective:To investigate the influencing of inferior mediastinum and esophageal hiatus lymph node metastasis by submucosal different venous divisions of esophagogastric junction (EGJ) invaded in Siewert type Ⅱ adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospective case-control study was conducted. The clinicopathological data of 547 patients with Siewert type Ⅱ AEG who were admitted to Shanxi Cancer Hospital from January 2018 to December 2021 were collected. There were 461 males and 86 females, aged 61 (range, 33?75)years. Observa-tion indicators: (1) lymph node metastasis rate in different groups; (2) influencing factors of inferior mediastinum lymph node metastasis in Siewert type Ⅱ AEG; (3) influencing factors of esophageal hiatus lymph node metastasis in Siewert type Ⅱ AEG. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and com-parison between groups was conducted using the Mann-Whitney U test. Count data were described as percentages or absolute numbers, and comparison between groups was conducted using the chi-square test. The univariate analysis was conducted using the corresponding statistical methods based on data type. The Logistic regression model was used for multivariate analysis. Results:(1) Lymph node metastasis rate in different groups. The lymph node metastasis rate in No. 1, 2, 3, 4sa, 4sb, 7, 8a, 9, 11,20, 108, 110 of the 547 patients was 17.37%(95/547), 6.76%(37/547), 46.44%(254/547), 1.65%(9/547), 1.10%(6/547), 23.22%(127/547), 4.39%(24/547), 3.11%(17/547), 3.47%(19/547), 3.66%(20/547), 0.55%(3/547), 4.20%(23/547), respectively. Of the 547 patients, there were 456 cases with proximal of AEG invading submucosal palisade venous of EGJ including 4 cases with inferior mediastinum lymph node metastasis and no case with media mediastinum or up media-stinum lymph node metastasis. There were 91 cases with proximal of AEG invading submucosal perforator venous of EGJ including 18 cases with inferior mediastinum lymph node metastasis, 3 cases with media mediastinum lymph node metastasis and no case with up mediastinum lymph node metastasis. (2) Influencing factors of inferior mediastinum lymph node metastasis in Siewert type Ⅱ AEG. Results of multivariate analysis showed that age, tumor invading submucosal perforator venous of EGJ and histological classification were independent influencing factors for inferior media-stinum lymph node metastasis of Siewert type Ⅱ AEG ( odds ratio=0.93, 23.33, 0.31, 95% confidence interval as 0.87?0.99, 4.18?130.28, 0.12?0.78, P<0.05). (3) Influencing factors of esophageal hiatus lymph node metastasis in Siewert type Ⅱ AEG. Tumor invading submucosal perforator venous of EGJ was an independent influencing factor for esophageal hiatus lymph node metastasis of Siewert type Ⅱ AEG ( odds ratio=14.95, 95% confidence interval as 2.46?90.76, P<0.05). Conclusion:Age, tumor invading submucosal perforator venous of EGJ and histological classification are independent influencing factors for inferior mediastinum lymph node metastasis of Siewert type Ⅱ AEG, and tumor invading submucosal perforator venous of EGJ is an independent influencing factor for esophageal hiatus lymph node metastasis.
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Objective:To investigate the expression of monoubiquitination histone H2B (H2Bub) in esophageal cancer tissues and its correlation with the prognosis of patients.Methods:A total of 75 patients who underwent thoracic esophagectomy in Shanxi Province Cancer Hospital from May 2010 to December 2015 were selected. The expression of H2Bub protein in esophageal carcinoma and para-carcinoma tissues was detected by using immunohistochemical method. The relationship between H2Bub expression level and the clinicopathological characteristics was analyzed, Kaplan-Meier method was used to analyze the relationship H2Bub expression level and the survival.Results:H2Bub was positively expressed in esophageal carcinoma and para-carcinoma tissues, and weakly positive expressed H2Bub was found in para-carcinoma tissues, while not found in esophageal carcinoma tissues. The strongly positive expression rate of H2Bub in esophageal carcinoma tissues was higher than that in para-carcinoma tissues [84.0% (63/75) vs. 22.7% (17/75), χ2 = 34.68, P < 0.001]. Compared with para-carcinoma tissues, 64.0% (48/75) of H2Bub expression level in carcinoma tissues was up-regulated, and 2.7% (2/75) of H2Bub expression level was down-regulated. The up-regulated expression of H2Bub in esophageal carcinoma tissues compared with para-carcinoma tissues was not related with the gender, age, tumor diameter, lymph node metastasis and T staging (all P > 0.05). The proportion of patients with up-regulated expression of H2Bub in poorly differentiated carcinoma tissues was lower than that in moderately and highly differentiated carcinoma tissues [43.8% (7/16) vs. 66.7% (34/51), 87.5% (7/8), P = 0.037]. The median overall survival time was 70 months (95% CI 45-95 months) and 68 months (95% CI 54-82 months), respectively in 12 esophageal carcinoma patients with moderately positive expressed H2Bub and 63 esophageal carcinoma patients with strongly positive expressed H2Bub, and the difference was statistically significant ( P = 0.606). Among 48 patients with up-regulated expression of H2Bub in esophageal carcinoma tissues compared with para-carcinoma tissues, the median overall survival time of poorly differentiated esophageal carcinoma group (7 cases) was shorter than that of highly differentiated (7 cases) and moderately differentiated (34 cases) esophageal carcinoma group [36 months (95% CI 24-37 months) vs. 68 months (95% CI 38-98 months), 68 months (95% CI 44-91 months)], and the differences were statistically significant (all P < 0.05). Conclusions:The expression level of H2Bub in esophageal carcinoma tissues is up-regulated compared with that in para-carcinoma tissues. The up-regulated H2Bub expression level of patients with poorly differentiated esophageal carcinoma with poor prognosis is obvious.
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Objective@#To explore the efficacy of thoracoscopic bronchial sleeve lobectomy for central non-small cell lung cancer (NSCLC), and to evaluate the safety of this operation.@*Methods@#The clinical data of 29 patients who underwent thoracoscopic bronchial sleeve lobectomy at Shanxi Provincial Cancer Hospital from May 2015 to September 2018 were retrospectively analyzed, and the surgical effect and safety were analyzed.@*Results@#Twenty-nine cases underwent thoracoscopic bronchial sleeve lobectomy. The types of resection included 13 cases of right upper, 10 cases of left upper, and 6 cases of left lower sleeve lobectomy. The operation time was 180-400 min, and the median time was 240 min. The bronchial anastomosis time was 35-60 min, and the median time was 48 min. The intraoperative blood loss was 150-460 ml, and the median blood loss was 220 ml. The number of lymph node dissection was 12-39 lymph nodes per patient, with a median of 19.6 lymph nodes per patient. The thoracic drainage tube was placed for 4-16 days after operation, with a median of 6 days; the postoperative hospital stay was 6-16 days, with a median of 9 days. The postoperative complication rate was 24.1% (7/29), including 1 case with pulmonary air leakage (> 7 days), 2 cases with pulmonary infections, 3 cases with arrhythmia, and 1 patient discharged from the hospital on the 7th day after surgery, but died of anastomotic fistula bleeding on the 40th day. The rest of the patients recovered smoothly after surgery. The median follow-up time was 6 months (3-12 months). No tumor recurrence or anastomotic stenosis was observed.@*Conclusion@#Thoracoscopic bronchial sleeve lobectomy is a safe and feasible surgical treatment for central NSCLC.
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Objective:To explore the efficacy of thoracoscopic bronchial sleeve lobectomy for central non-small cell lung cancer (NSCLC), and to evaluate the safety of this operation.Methods:The clinical data of 29 patients who underwent thoracoscopic bronchial sleeve lobectomy at Shanxi Provincial Cancer Hospital from May 2015 to September 2018 were retrospectively analyzed, and the surgical effect and safety were analyzed.Results:Twenty-nine cases underwent thoracoscopic bronchial sleeve lobectomy. The types of resection included 13 cases of right upper, 10 cases of left upper, and 6 cases of left lower sleeve lobectomy. The operation time was 180-400 min, and the median time was 240 min. The bronchial anastomosis time was 35-60 min, and the median time was 48 min. The intraoperative blood loss was 150-460 ml, and the median blood loss was 220 ml. The number of lymph node dissection was 12-39 lymph nodes per patient, with a median of 19.6 lymph nodes per patient. The thoracic drainage tube was placed for 4-16 days after operation, with a median of 6 days; the postoperative hospital stay was 6-16 days, with a median of 9 days. The postoperative complication rate was 24.1% (7/29), including 1 case with pulmonary air leakage (> 7 days), 2 cases with pulmonary infections, 3 cases with arrhythmia, and 1 patient discharged from the hospital on the 7th day after surgery, but died of anastomotic fistula bleeding on the 40th day. The rest of the patients recovered smoothly after surgery. The median follow-up time was 6 months (3-12 months). No tumor recurrence or anastomotic stenosis was observed.Conclusion:Thoracoscopic bronchial sleeve lobectomy is a safe and feasible surgical treatment for central NSCLC.
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Objective To analyze the prognostic factors of patients with adenocarcinoma of gastroesophageal junction (AGEJ) after radical resection. Methods In this retrospective study, 269 patients with AGEJ who underwent curative resection from March 2004 to June 2007 were enrolled.The survival curve was drawn by Kaplan-Meier method and the survival analysis was done by Log-rank test. Univariate and multivariate analyses of the prognostic factors of AGEJ were made by Cox model. Results The overall 5-year survival rate of 269 patients was 25.0 % with the median survival time of 22 months.The Siewert type and the number of positive lymph nodes could influence the survival rate (both P < 0.05). Among the 269 patients, 216 (80.3 %) were Siewert Ⅱ type, their median survival time was 30 and 12 months in the thoracic surgery group and the laparotomy group when the tumor diameter was 3-7 cm, the difference was statistically significant (χ2= 5.036, P= 0.025). Univariate analysis showed that tumor diameter, pT, pN, operation time, age and sex were significantly associated with survival rate (all P < 0.05). Cox multivariate analysis showed that patients with a more advanced tumor size suffered from a poorer prognosis (P< 0.05). The risk of postoperative death in patients with lymph node metastasis was 1.854 times that of patients without lymph node metastasis. Conclusions Patients with AGEJ are predominantly Siewert Ⅱ type, the transthoracic approach or thoracoabdominal approach are reasonable selections for these patients. Tumor diameter and pN are independent prognostic factors of AGEJ patients.
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Objective To investigate the diagnosis value of homocysteine (Hcy) combined with carcinoembryonic antigen (CEA) and squamous cell carcinoma (SCC) antigen for esophageal cancer.Methods The serum levels of Hcy,CEA,CA199,CA724,CA50 and SCC antigen in 163 patients with esophageal cancer and 49 healthy people were measured.The diagnosis efficacy between the combination of Hcy,CEA and SCC antigen and the combination of CEA,CA199,CA724,CA50 and SCC antigen was compared.Results The levels of Hcy,CEA and SCC antigen were significantly raised in patients group as compared with the levels in control group (all P ＜ 0.05).The area under the ROC curve of Hcy was 0.722 (95 ％ CI 0.633-0.811),CEA was 0.619 (95 ％ CI 0.533-0.704) and SCC antigen was 0.685 (95 ％ CI 0.608-0.762),respectively.There were no significant differences among the three area under the ROC curve.The sensitivity,specificity and accuracy of the combination of CEA,CA199,CA724,CA50,SCC antigen were 69.9 ％,59.2 ％ and 67.5 ％,respectively,but the sensitivity,specificity and accuracy of the combination of Hcy,CEA,SCC antigen were 96.3 ％,69.4 ％ and 90.1％,respectively.There was significant difference between the combination of Hcy,CEA,SCC antigen and the combination of CEA,CA199,CA724,CA50,SCC antigen (P ＜ 0.05).Conclusion The combination of Hcy,CEA,SCC antigen is helpful to determine the diagnosis and efficacy of esophageal cancer.
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Objective To evaluate the changes and clinical significance ot the serum levels of homocysteine (Hcy) in gastric cardia cancer patients before and after surgery.Methods Serum Hcy concentrations of 102 patients with gastric cardia cancer (including 69 case of males) and 50 healthy human were measured by enzymatic cycling assay.Results Total Hcy levels were significantly increased in male patient group compared with the levels in control group (t =5.143,P =0.001).Hcy levels were significantly lower in postoperative group compared with preoperative group [(17.08±5.31) μmol/L vs (20.34±9.26) μmol/L,(14.07±4.87) μmol/L vs (20.34±9.26) μmol/L,P ＜ 0.05].Compared with Ⅳ stage group and other TNM stage groups,significantly lower levels of Hcy were detected in patients with gastric cardia cancer (t =2.306,3.285,P =0.030,0.002).Hcy levels in patients with gastric cardia cancer were also significantly higher than those in the tumor length ＜ 3 cm,3-5 cm and ＞ 5 cm groups (t =2.461,2.147,P =0.017,0.038).Multiple logistic regression analysis indicated a statistically significant association between serum Hcy concentration and gastric cardia cancer incidence (OR =1.136,95 ％ CI 1.010-1.278,P =0.033).Increasing serum Hcy levels were significantly associated with a decreasing risk of metastatic lymph node (OR =0.865,P =0.010).Conclusion Serum Hcy levels are directly associated with risk of male patients with gastric cardia cancer,and play important roles in the development of gastric cardia cancer.
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Objective To investigate the diagnostic value of combined examination of homocysteine (Hcy) and CEA for male patients with gastric cardia cancer.Methods Serum concentration of Hcy,CEA,CA199,CA724,CA242 and TPS in 54 male patients with gastric cardia cancer and in 30 healthy men were measured.The diagnostic efficacy was analyzed between the combination of Hcy,CEA and the combination of Hcy,CEA,CA199,CA724,CA242,TPS.Results Total Hcy,CEA levels were significantly increased in patients group compared with control group ((20.3±9.2) μmol/L vs (13.7±3.1) μmol/L,(7.8±3.5) μg/L vs (1.6±1.2) μg/L,P ＜ 0.05).The sensitivity,specificity and accuracy of the combination of CEA,CA199,CA724,CA242 and TPS were 73.6 ％,64.5 ％ and 70.2 ％ respectively,while those of the combination of Hcy,CEA were 92.5 ％,64.5 ％ and 82.1％,respectively.There was significant difference between the combination of Hcy,CEA and the combination of CEA,CA199,CA724,CA242 and TPS (P ＜ 0.05).Conclusion Combined detection of Hcy and CEA is helpful for diagnosis in male patients with gastric cardia cancer.
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Objective To explore the relationship of leptin,leptin receptor and esophageal squamous cell carcinoma,and provide a scientific basis for prevention and treatment of esophageal cancer.Methods Samples were collected from 32 patients with esophageal squamous cell carcinoma,20 healthy control subjects in Shanxi Tumor Hospital.ELISA and immunohistochemistry were used to analyze leptin and leptin receptor,respectively.The correlation between their expression and clinicopathologieal parameters was also analysized.Results Patients with esophageal squamous cell carcinoma had significandy(t =4.64,P ＜ 0.001)higher leptin levels [(4.7 ±1.9)ng/ml] compared with normal [(2.54±1.01)ng/ml] oesophagus tissues.The expression rate of leptin receptor in esophageal carcinoma and normal esophagus was 81.25 ％ and 75.00 ％ respectively,not differ significantly.The expression levels of leptin was associated with position,(l)ymphatic metastasis.Conclusion Higher leptin levels seem to represent an additional,independent risk factor for esophageal squamous cell carcinoma,leptin receptor expression on oesophageal epithelial cells provides a pathway for leptin-mediated signal transduction.
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Objectiveto investigate serum leptin concentration and lipdid levels in patients with esophageal squamous cell carcinoma and their clinical significance. MethodsBlood samples were collected from 47 patients with esophageal cancer, 20 healthy control subjects. Serum leptin was measured by ELISA and serum lipids was measured by biochemistry auto-analyzer. ResultsThe serum leptin concentration and LP α levels in patients group were significantly higher than those in control group[(13.09±5.94) ng/ml vs (7.584±4.15) ng/ml,(216.50±752.52) ng/ml vs(87.85±10.73) mg/L](P=0.001).However,the TG concentration was significantly lower than control group [(1.23±0.46) mmol/L vs (1.58±0.07) mmol/L]( P=0.001 ).Multiple logistic regression analysis revealed statistically significant association between serum leptin levels and esophageal squamous cell carcinoma incident(ORLeptm =1.442,95％ CI 1.094-1.848). ConclusionThe increased serum leptin levels maybe the risk factors of esophageal cancer,elevated LP α levels in patients might be a compensatory reactions.
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Objective To evaluate the changes and clinical significance of the serum level of homocysteine (Hcy) in esophageal cancer patients before and after surgery.Methods The serum Hcy concentrations of 168 patients with esophageal cancer and 50 healthy individuals were measured by enzymatic cycling.Results Total Hcy levels were significantly raised in patients group when compared with the levels in control group [(19.6±6.1) μmol/L vs (13.0±2.3) μmol/L,P =0.001].Hcy levels were significantly lower in postoperativepatients groups compared with preoperativegroup [(17.0±8.5),(15.8±6.4),(12.8±5.6) μmol/L vs (20.6±9.1) μmol/L,all P ＜ 0.05].Also,Hcy levels in patients with esophageal cancer were significantly higher than in the tumor length＞ 5cm group and the ＜3 cm,3-5 cm group [(23.6±9.6) μmol/L vs (18.1±6.3),(19.6±6.6) μmol/L,P =0.036,P =0.021].Compared with other T stage groups,significantly higher level of Hcy was found in T4 stage group [(29.5±1.7) μmol/L vs (18.5±6.9),(18.8±8.0),(20.6±8.8) μmol/L,all P ＜ 0.001].There was no significant difference between the mean Hcy concentrations of the node-positive and nodenegative group [(20.2±9.3) μmol/L vs (20.3±7.6) μmol/L,P =0.897].Compared with negative lymphaugial tumor-cells thrombus group,positive group had low Hcy level [(16.7±3.4) μmol/L vs (21.1±8.9) μmol/L,P =0.007].Conclusion These results showed that serum Hcy levels play important roles in the development of esophageal cancer.
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Objective To investigate midkine (MK) level in serum of patients with esophageal squamous cell carcinoma (ESCC) before and after operation,detect the expression of MK protein in tissues and analyze its relationship with the malignant biological behavior of ESCC.Methods The MK levels in serum were detected by enzyme-linked immunosorbent assay in 30 healthy cases and 55 patients with ESCC when the day before operation and the tenth-day after operation.Then the expression of MK protein in 55 patients surgically removed ESCC were detected by immunohistochemistry using monoclonal antibodies against human MK.Results The average optical density of MK in serum of ESCC patients before operation was 0.1006±0.0624,0.0455±0.0155 in normal control group,0.0752±0.0267 in postoperative control group (t =6.203,P ＜ 0.001).The MK levels in serum of ESCC patients before operation were significantly higher than those after operation (t =4.357,P ＜ 0.001) and those in healthy controls (P ＜ 0.05).The expression of MK protein was no statistically significant correlation with tumor size (x2 =0.131),TNM stage (x2 =0.315) and lymph node metastasis (x2 =0.282) in ESCC (all P ＞ 0.05).But significant correlation was noted between the expression of MK protein and the vasculature involving of the cutting edge (x2 =4.223),degree of cellular differentiation (x2 =10.326),invasive extent of the carcinoma (x2 =20.556) (all P ＜ 0.05).Conclusion MK is overexpressed in ESCC patient' s serum and tissue.The high level of preoperative serum MK is caused by the tumor.
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Objective To explore the relationship of serum leptin concentration,body mass index (BMI) and esophageal squamous cell carcinoma.Methods Blood samples were collected from 47 patients with esophageal squamous cell carcinoma and 20 healthy controls in Shanxi Cancer Hospital.Serum leptin was measured by ELISA.Results Serum leptin concentration in patients group was significantly higher than control group[(13.09±5.94) ng/ml vs (7.58±4.16) ng/ml,(t =3.76,P =0.001)].In 47 patients,BMI,albumin and lymphocytes were (25.20±3.14) kg/m2,(43.58±2.15) g/L and (2.02±0.55)×109/L,respectively.The serum leptin concentration of all patients (47 cases) were positive correlation with BMI (r =0.561,P =0.006),not with blood albumin and lymphocytes (r =0.206,P =0.242; r =0.122,P =0.412).Multiple logistic regressionanalysis reveal statistically significant association between serum leptin and esophageal squamous cell carcinoma incidence (OR =1.442,95 ％ CI 1.094-1.848,P=0.09).Conclusion Higher serum leptin levels seem to represent an additional and independent risk factor for esophageal squamous cell carcinoma.
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Objective To study the function of γδT lymphocytes in patients with lung cancer.Methods γδT lymphocytes in peripheral blood of the 124 preoperative patients with lung cancer(experiment group) and 56 healthy donors(control group) were detected by Flow Cytometry. Results The percentage of γδT cells(CD+3 γδTCR+) was (6.54±2.90) % in control group and (3.76±2.81) % in experiment group (t =3.568,P ＜0.001). The γδT cells in peripheral blood of patients with lung cancer was less than that of healthy donors (t =3.568, P ＜0.001). There was significant difference in expression of γδT cells in the peripheral blood between the all test groups and healthy control group (P =0.000). Compared with control group, γδT cells of the peripheral blood in experiment group were correlated with TNM stage, general types, pathological changes position and histology grades (P ＜0.05). The expression of γδT cells in the peripheral blood were not associated with age, gender (P ＞0.05). Conclusion The results suggested that the dysfunction of γδT had important function on the development of lung cancer.
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Objective To investigate the effect of tumor length and number of positive lymph nodes and the ratio of positive lymph nodes on survival in patients with esophageal squamous cell carcinoma.Methods From July 1995 to July 2005, a total of 6,691 resected lymph nodes were obtained from 526patients who underwent curative resection of the primary tumour with systematic lymphadenectomy. The survivals were analysed by life tables and Kaplan-Meier methods. Results Among patients with regional disease, the number of positive lymph nodes (＞3) was related to an increasing risk. The proportion of positive lymph nodes compared with the number of lymph nodes dissected (20 %) conferred an increased risk. The tumor length (≤5 cm, 5 cm ＜ length ＜ 7 cm, ＞7 cm) was related to an increasing risk (84.74 %, 47.79 %,36.90 %, 35.52 %; 73.41%, 46.29 %, 23.87 %, 20.64 %; 64.44 %, 13.92 %, 0, 0). Conclusion Tumor length,the number of positive lymph nodes, and the ratio of positive lymph nodes are important prognostic factors for survival in patients with esophageal carcinoma. The PTNM classification system for patients with esophageal carcinoma might consider adding number of positive lymph nodes as an important prognostic factor.
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Objective To investigate the drug sensitivity of cardia tumors in vitro by ATP-TCA, and to provide basis of clinic chemotherapy. Methods 42 cardia tumors were tested by ATP-TCA to determine and assess the drug sensitivity of 8 common chemotherapeutics. Correlation analysis was done between the clinical classification and the drug sensitivity. Results The drug sensitivity had significant difference among cardia tumors. From high to low, it was ADM>MMC>PTX> 5-Fu>HCT =VP16>CDDP>IFO, Sensitive degree were 50.00 %, 35.45 %, 31.25 %, 23.53 %, 10.53 %, 10.53 %, 7.69 %, 5 %. Sensitivity of the same drug in different pathologic stages had no significant difference. Conclusion ATP-TCA can play a guiding role in individual chemotherapy for human cardia cancer.
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Objective To explore the clinical significance and the impact on prognosis of blood micrometastasis in the patients with pN0 esophageal squamous cell carcinoma. Methods Total RNA was extracted with TRIzol and mRNA was transcribed reversely into cDNA. RT-PCR was used to detect MMP-7 mRNA and hTERT mRNA in blood. △△Ct sample values were calculated with post-operative follow-up of 3 month, 6 month, 12 month. Results Statistical results suggested that blood micrometastasis was related to differentiation grade and pTNM staging (P=0.000, P=0.000 respectively), but not to age, sex, length of turnout (P0.05). Follow-up results suggested that the degree of invasion and tumor metastasis (recurrence) was no correlation; follow-up to 6 month and 12 month, tumor metastasis (recurrence) was associated with blood micrometastasis, and follow-up to 12 month, compared with the tumor metastasis (recurrence) probability of blood micrometastasis-positive patients and negative patients, the former was as 6.44 times as the latter. (OR=6.440, 95 % CI 1.547-26.822). Conclusion Blood micrometastasis testing is of great significance to early diagnosis and prognosis judgment in pN0 esophageal squamous cell carcinoma patients.
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Objective To investigate the difference of complication incidence, death rate, quantity of lymphadeneetomy, lymphatic metastasis rate and long-term survival rate in thoracic squamons cell carcinoma of esophagus between three fields lymphadenectomy (3-FL) and traditional method. Methods Homoehronous 96 esophageal cancer patients were fractionated in two groups, 46 patients for 3-FL, the other 50 patients for traditional method. Results The average quantity of lymphadenectomy was 39.28 pieces per patient in 3-FL, and was significantly higher than 13.30 pieces per patient in traditional method (P <0.01). The rate of metastatic lymphatic nodes was 73.91%(34/46) in 3-FL patients, significantly higher than38.00%(19/50) in traditional method patients. For incidence of postoperative complications, recurrent laryngeal nerve damage and respiratory complication in 3-FL patients was significantly higher than patients in traditional method (P <0.05). The chest fluid obviously inereasod in 3-FL patients than in traditional method patients. There was significant contrast in 3-year survival rate between 3-FL patients and traditional method patients. Conclusion The there fields lymphadenectomy expand scope of lymphdenectomy effectually, accurate the staging of thoracic esophageal carcinoma. At the same time, a lot of evidence was found in raising survival rate for 3-FL. Disadvantage of 3-FL was severe surgical trauma, high incidence of complication, and a long recovery time after operation.
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Objective To study the effect of positive lymph node number on the survival of patients with esophageal carcinoma. Methods From July 1995 to July 2005, a total of 11,447 resected lymph nodes were obtained from 1140 patients who underwent curative resection of the primary tumor with systematic lymphadenectomy at Shanxi cancer hospital. The survivals were analysed by life tables and Kaplan-Meier methods, the related factors of lymph node metastasis were assessed by Chi-square test. Results The number of positive lymph nodes was negatively related to survival rates of esophageal carcinoma. According to the number of lymph nodes resected (≥8 nodes versus <8 nodes), there was significant difference in metastatic lymph node ratio. Conclusion The number of positive lymph node can reflect the prognosis of patients better. The authors suggest that the modification of the tumor-lymphnode-metastasis (TNM) staging classification (TNM) to include the number of positive lymph nodes in the N1 category.
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<p><b>BACKGROUND</b>Bronchoplasty plus pulmonary arterioplasty has become one of the standard surgical operation for central-type lung cancer. The aim of this study is to review the surgical experience of bronchoplasty and pulmonary arterioplasty in treatment of central-type lung cancer.</p><p><b>METHODS</b>From 1987 to 2005, 56 patients with central-type lung cancer underwent bronchoplasty and pulmonary arterioplasty. There were 45 males and 11 females with a mean age of 56 years. According to pTNM classification, 18 cases were in stage IIB, and 32 in stage IIIA and 6 in stage IIIB. Histologically, there were 35 cases of squamous cell carcinoma, 14 cases of adenocarcinoma, 4 cases of small cell lung cancer and 3 cases of carcinoid. The surgical procedures included sleeve resection of bronchus for 30 cases, wedge resection of bronchus for 26 cases, and sleeve resection of pulmonary artery for 16 cases and wedge resection of pulmonary artery for 40 cases.</p><p><b>RESULTS</b>One patient died in the perioperative period. The overall 1-, 3-, and 5-year survival rate was 79.6% (43/54), 48.1% (25/52) and 34.0% (17/50), respectively.</p><p><b>CONCLUSIONS</b>The results suggest that bronchoplasty and pulmonary arterioplasty can decrease the proportions of total pneumonectomy and exploratory thoracotomy and expand the indication of operation. Bronchoplasty and pulmonary arterioplasty can be achieved with satisfactory outcome for central-type lung cancer, especially for those patients with advanced lesions or poor pulmonary function.</p>