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Cervical lymph metastasis carcinoma from unknown primary tumor (CCUP) accounts for 3% to 5% of all malignant tumors of head and neck. With the development of PET-CT, molecular pathology, endoscopy and other auxiliary examinations and the advancement of radiotherapy technology, the diagnostic and treatment levels of CCUP have been gradually improved. Surgery and radiotherapy are the most important treatment methods of CCUP. However, due to its low incidence and heterogeneity, prospective clinical trial data are still lacking. Hence, the optimal therapy of CCUP remains highly controversial. In this article, research progresses on the diagnosis and treatment of CCUP in recent years were reviewed.
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Objective To analyze the prognostic importance of lymph node metastasis and the significance of regional lymphadenectomy in surgical treatment of nonfunctional pancreatic neuroendocrine tumors(NF-PanNET).Methods The clinical and pathological data of patients who underwent resection of NF-PanNET in Tianjin Medical University Cancer Institute and Hospital from January 2000 to December 2013 were retrospectively studied.The data included age,sex,tumor location,tumor size,lymph node metastasis,surgical resection margins,pathological grades and followed-up visits.Results Of 75 patients in this study,16 (21.3％) had lymph node metastases.Patients with larger tumors (＞3 cm) and higher tumor gradings (G3) had higher rates of lymph nodal metastasis.The overall 3-and 5-year disease-free survival (DFS) were 92.0％ and 89.2％ respectively.The 5-year DFS for patients with and without nodal metastasis were 75.0％ and 93.0％ (P＜0.05) respectively.Significantly lower 5-year DFS rates were found in patients with lymph nodal metastases,large tumor sizes (＞3 cm),high pathological gradings (G3) and positive surgical resection margins (all P＜0.05).Multivariable analysis showed that lymph nodal metastasis and surgical resection margin were independent factors associated with DFS (all P＜0.05).Conclusions Patients with NF-PanNET with lymph node metastasis had significantly higher risks of recurrence and metastasis.Patients with large tumor sizes (＞3 cm) had a higher rate of lymph node metastasis,and radical surgery with lymph node dissection is recommended for these patients.
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Lymph metastasis has great impact on the prognosis of pancreatic cancer patients, which can relfect the biological and invasive potential of pancreatic cancer. However, currently, there is no standard in the clinical management of the lymph metastasis in pancreatic cancer. In this report, we will discuss and summarize the followings:lymph metastatic rate and its impact on prognosis, the rule of lymph metastasis, sentinel lymph node, intra-operative lymph nodes mapping, TNM staging, regional lymph nodes resection, number of lymph nodes examined, lymph node ratio, guiding adjuvant treatments, lymphatic targeted therapy.
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Objective To explore the clinicopathology characteristics of endometrial adenocarcinoma and non-endometrial adenocarcinoma.Methods The clinical data of 306 patients with endometrioid cancer were analyzed retrospectively.Results The patients with endometrial adenocarcinoma accounted for 90％ of all patients,and the patients with non-endometrial adenocarcinoma accounted for 10％.Compared with the patients with endometrial adenocarcinoma,the average age of the patients with non-endometrial adenocarcinoma was older[(59.32 ± 7.77)years],the constitution ratio of postmenopausal patients was higher(90％),the clinicopathologic stage was later(P =0.000),the grade of histology was higher(P =0.000),the myometrial invasion was deeper(P =0.014).The patients with nonendometrial adenocarcinoma were prone to occur lymph metastasis(P =0.006),and the recurrence rate was higher(P =0.000).Conclusion There is significant defference between endometrial adenocarcinoma and non-endometrial adenocarcinoma,the patients with non-endometrial adenocarcinoma has poor pronosis,and we should pay more attention to it.
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Objective To discuss the value of dual-time-point 18FDG PET-CT imaging on involved field radiotherapy for hilar and mediastinal metastatic lymph nodes in patients with non-small cell lung cancer (NSCLC).Methods Fifty-four patients with NSCLC were included in this analysis,including 34 men and 20 women with mean age of 59(34-76)years.Two sequential PET-CT scans given 3-5 days before surgery were standard single-time-point imaging for the whole body and delayed imaging for the thorax.The pathologic data were used as golden standard to determine the difference between the standard single-time-point and dual-time-point FET-CT imaging in the definition of gross target volume(GTV)of involved-field radiotherapy for metastatic lymph nodes. Results For hilar metastatic lymph nodes,the GTV defined by single-time-point imaging was consistent with pathologic GTV in 21 patients(39%),comparing with 31 patients(57%) by dual-time-point imaging.Using pathologic data as golden standard,GTV alteration defined by single-time-point imaging had statisticaly significant difference comparing with that defined by dual-time-point imaging(u=519.00,P=0.023).For mediastinal metastatic lymph nodes,the GTV defined by single-time-point imaging was consistent with pathologic GTV in 30 patients(56%),comparing with 36 patients(67%)by dual-time-point imaging.Using pathologic data as golden standard.GTV alteration defined by single-time-point imaging had no statisticaly significant difference comparing with that defined by dual-time-point imaging(u=397.50,P=0.616).Conclusions For patients with NSCLC receiving involved-field radiotherapy,GTV definition for hilar and mediastinal metastatic lymph nodes by dual-time-point imaging is more consistent with that by pathologic data.Dual-time-point imaging has a larger value in terms of target delineation for hilar and mediastinal metastatic lymph nodes.
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Objective To investigate the expression of nm23,integrin ? 5? 1 and VEGF in breast cancer(BC),and the effect of the expression on the development of BC. Methods The expression of nm23, integrin ? 5? 1 and VEGF in 51 patients with breast cancer were examined by immunohistochemistry,and their correlatios were ananlyzed. Results The low expression of nm23 in BC tissue was associated with lymph nodes metastasis. The low expression of integrin ? 5? 1 and the high expression of VEGF in BC tissues were associated with the lymph nodes metastasis and low differentiation of the tumor.The expression of nm23 and integrin ? 5? 1 in breast cancer tissues had positive correlation(P