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Objective To investigate the treatment options and prognostic factors of limited-stage small cell cancer of the esophagus.Methods A retrospective analysis of 58 limited-stage cases admitted to Shandong Cancer Hospital Affiliated to Shandong University from June 2009 to July 2017 was performed.Kaplan-Meier and log-rank methods were used for survival analysis.Cox regression model was used for prognostic factors analysis.Results The median overall survival (OS) of the whole group was 21.3 months (5.3-97.2 months).The 6-month,1-year,2-year,3-year and 5-year survival rates were 93％,84％,44％,28％ and 11％ respectively.Univariate analysis suggested that treatment and stage affected patient survival.The median OS of the chemotherapy,chemotherapy + radiotherapy,surgery + chemotherapy and surgery + chemotherapy + radiotherapy groups were 14.5,18.0,23.8 and 46.5 months respectively,with a significant difference (x2 =11.148,P =0.011).The combination therapy was better than chemotherapy alone (all P ＜ 0.05),but there was no significant difference between the different combinations of treatments (all P ＞ 0.05).The median OS of the stage Ⅱ,Ⅲ,patients were 27.0,17.8 and 9.9 months respectively,with a significant difference (x2 =48.114,P ＜ 0.001).The prognosis of patients with stage Ⅱ and Ⅲ was better than that of patients with stage Ⅳ (both P ＜0.001),but there was no significant difference in OS between stage Ⅱ and stage Ⅲ patients (P ＞0.05).Multivariate analysis found that treatment (HR =0.567,95％ CI:0.387-0.830,P =0.004) and stage (HR =3.009,95 ％ CI:1.811-4.999,P ＜ 0.00 1) were independent prognostic factors for OS.The stratified analysis found no significant difference in the prognosis between the surgical and non-surgical patients (median OS:28.6 and 16.9 months;x2 =3.938,P =0.052).Preoperative neoadjuvant therapy did not improve the prognosis of the patients (17.8 months vs.43.4 months;x2 =0.571,P =0.450).The analysis showed that there was no statistical difference in OS between patients with Ki-67 index ≤ 80％ and ＞ 80％(median OS:16.9 and 24.5 months;x2 =3.341,P =0.068).Conclusion The treatment and stage are independent prognostic factors for patients with limited-stage small cell cancer of the esophagus.The effect of chemotherapy alone is poor for patients with limited-stage small cell cancer of the esophagus.Multimodality therapy can benefit patients.
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Objective To explore the correlation between 18F-FLT SUVmax and intratumoral microvessel density (MVD) in NSCLC patients.Methods From January 2008 to December 2010,68 patients (48males and 20 females; age ranging from 36 to 84 years) with NSCLC underwent 18F-FLT PET/CT followed by surgery within two weeks.Tumor proliferation was evaluated in terms of Ki67 labeling index (LI) with SP.MVD was determined using anti-CD31 mAb (CD31-MVD),anti-CD34 mAb (CD34-MVD) and anti-CD105 mAb (CD105-MVD) for each resected tumor.Linear correlation analysis was used to analyze data.Results The mean values of CD31-MVD,CD34-MVD and CD105-MVD were 159.6,166.1,and 38.0 per view field,respectively.Tumor SUVmax was 4.1±2.9,and Ki67 LI was (37.0± 14.5) ％,both of which had significantly correlations with CD105-MVD (r=0.550,0.633 ; both P＜0.05),but there was no significant relationship between SUVmax and CD31-MVD,CD34-MVD (r=0.228,0.235; both P＞0.05).Conclusion 18F-FLT PET/CT imaging has a positive relationship with CD105-MVD of NSCLC,and it could reflect the ability of tumor angiogenesis.
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Objective To evaluate the role of transrectal ultrasonography (TRUS) in preoperative evaluation of the depth of invasion in rectal carcinoma.Methods Fifty-eight cases with rectal carcinoma confirmed by pathology underwent TRUS before surgery.Preoperative staging was performed using the T staging system on the basis of TRUS sonogram.The T staging results by TRUS were compared with those of postoperative pathologic staging.Results The preoperative overall accuracy rate of TRUS was 82.76％ (48/58).The diagnostic accuracy rates in T1-T4 stage by TRUS were 94.83％(55/58),86.21％(50/58),86.21％ (50/58) and 98.28％ (57/58).Staging rectal carcinoma with TRUS showed better consistency with postoperative pathologic staging.Conclusions TRUS has a better accuracy in preoperative evaluation of the depth of invasion in rectal carcinoma.TRUS is an important factor in rational treatment.
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[Objective]To explore the correlation of the expression of alpha-fetoprotein(AFP)mRNA in the peripheral blood and postoperative survival and metastasis of patients with liver cancer.[Methods] A total of 66 patients with liver cancer who received radical resection surgery from January 2005to December 2006 was enrolled in this study.The cell total RNA was extracted from peripheral blood and the expression of AFP mRNA was detected by nested PCR.All the patients were followed up for 60 months after surgery.[Results]The expression rate of AFP mRNA in the peripheral blood was 40.91％(27/66).The expression of AFP mRNA in the peripheral blood in patients with liver cancer was significantly related to microvascular invasion and metastasis(P ＜ 0.05 or ＜ 0.01),but the expression had no relationship with sex,age,HBV infection,cirrhosis,AFP concentration,tumour size and number,and Edmondson grading(P＞0.05).The overall 1,2,and ＞ 3 years survival rates of patients with positive AFP mRNA after surgery were 66.7％(18/27),38.9％(7/18),28.6％(2/7),respectively.The overall 1,2,and ≥3 years survival rates of patients with negative AFP mRNA after surgery were 84.6％(33/39),60.6％(20/33),45.0％(9/20).There was statistical significance between the survival rates of AFP mRNA-negative patients and AFP mRNApositive patients(P ＜ 0.01).[Conclusions] The detection of AFP mRNA in the peripheral blood may provide clue for early microscopic metastasis.It can be a prediction index for postoperative recurrence.