Expert guidance on overall management of liver cancer during the COVID-19 / 中华消化外科杂志

The pandemic of Corona Virus Disease 2019 (COVID-19) continues, which shows the concentrated or sporadic cases in multiple places. Current COVID situation is still complex. During the COVID-19, routine diagnosis and treatment of liver cancer patients has been affected in different degrees. Under the premise of following the treatment guidelines, how to reduce the risk of infection of patients and medical staff, utilize limited medical resources to maximally ensure anti-tumor treatment and related emergency treatment, and help patients get through the epidemic period is a problem for liver oncologists. Thus, experts of liver cancer treatment related disciplines of Zhongshan Hospital, Fudan University have written the Expert guidance on overall management of liver cancer during the COVID-19, which aims to provide references for liver oncolo-gists to conduct clinical work safely and effectively under the epidemic prevention and control, and to help patients fight against the epidemic smoothly.

Recent advances in the combined use of radiation therapy and multimodality therapies for hepatocellular carcinoma with portal vein tumor thrombus / 中华放射医学与防护杂志

Hepatocellular carcinoma (HCC) is prone to invading portal vein system known as portal vein tumor thrombus (PVTT). PVTT is one of the main reasons for poor prognosis of HCC because of its rapid progress and lack of effective treatments, and the optimal treatment strategy remains controversial. With recent advances in techniques, the efficacy and safety of radiation therapy for PVTT has been improved. The optimization of individualized radiotherapy and multimodality treatment is the future direction of research. In this review, we will investigate the current state and future opportunities of radiation therapy and multimodality treatment for HCC with PVTT.

Primary malignant melanoma of the lung: a case report and literature review / 中国医师杂志

Objective:To analyze and summarize the clinical features, diagnosis and treatment of primary malignant melanoma of the lung (PMML).Methods:To report a confirmed case. And searched the keywords " malignant melanoma, primary, lung" from the databases of CNKI, Weipu, Wanfang and PubMed, then reviewed the relevant literature.Results:A 65-year-old male admitted to the First Affiliated Hospital of Zhengzhou University with the complaint of frequent coughs with bloody sputum for 2 months. Computed tomography (CT) showed a large space-occupying lesion in the upper lobe of the right lung and to be a hyper metabolic tumor by positron emission tomography-CT. The pathological biopsy of the mass confirmed a malignant tumor cell, immunohistochemical results showed S-100(+ ), SOX-10(+ ), HMB45(+ ), MelanA(-), AE1/AE3(-), CK5/6(-), Ki-67(40%). The patient died after 3 months of diagnosis because of refusing any further therapy. There were 36 papers searched from mentioned databases reported 41 Chinese patients with PMML. And we analyzed the clinical data of 42 cases (include the present case) and discussed the diagnosis and treatment while referring to the existing literatures.Conclusions:PMML is extremely rare, and difficult to differentiate from lung cancer, A diagnosis of PMML is based on the combination of clinical, imaging characteristics and pathological outcomes. The choice of treatment is an aggressive surgical approach, combined with radiation therapy and chemotherapy. Because of high degree of malignancy, powerful capacity for invasiveness and recurrence, the overall prognosis is poor.

Analysis of the factors associated with the long-term curative effect and prognosis of primary vaginal carcinoma / 中华肿瘤杂志

Objective@#To investigate the clinical factors that affect the prognosis of patients with primary vaginal cancer.@*Methods@#Clinical data of 118 primary vaginal cancer patients with pathological diagnosis and clinical follow-up data from the Department of Gynecology of Liaoning Cancer Hospital & Institute from 1999 to 2014 were collected and retrospectively analyzed. The relationship of prognosis and factors including age, history of hysterectomy, pathological types, International Federation of Gynecology and Obstetrics (FIGO) stage, tumor size, tumor location and therapeutic methods were analyzed, respectively.@*Results@#The median survival time of the 118 patients was 93 months. The survival rates of 1, 3, 5, 10 and 15-year were 89.7%, 68.1%, 60.4%, 37.3% and 19.0%, respectively.The results of univariate analysis showed that the FIGO stage, pathological types, tumor size, therapeutic methods and tumor location were related to the prognosis of patients with primary vaginal cancer (all P<0.05), while the patients′ age, history of hysterectomy were not (all P>0.05). The results of Cox multivariate regression analysis indicated that FIGO stage (P=0.008), tumor location (P=0.001) and therapeutic methods (P=0.007) were independent prognostic factors of the patients with primary vaginal cancer.@*Conclusions@#Prognostic factorsofpatients with primary vaginal cancer include FIGO stage, pathological types, tumor size, therapeutic methods and tumor location. Among them, therapeutic methods and tumor location are the independent prognostic factors.

Improving the standardized diagnosis level for primary liver cancer / 中华消化外科杂志

At present,the early diagnosis rate of primary liver cancer is still low in China.The early diagnosis rate according with Milan standard is only 20％-30％,which affects the survival rate of liver cancer after treatment.This phenomenon has some reasons.The first,regular screening of high risk population of liver cancer is not enough;the second,Hepatitis carriers have low awareness of the correlation between hepatitis and liver cancer;the third,diagnosis of liver occupying lesions by medical staff is nonstandard.The diagnostic specification and detailed process of primary liver cancer have been released and regularly updated at home and abroad.However,the implementation of the diagnostic process is still not very strict,which leads to delayed diagnosis and treatment.Based on the direction of primary liver cancer and the analysis for the causes of early diagnosis rate of primary liver cancer at home and abroad,this paper focused on the problems that should be paid attention to in the standardized diagnosis process of primary liver cancer,and systematically elaborated the way to improving early diagnosis rate of primary liver cancer.

Conhecimentos e atitudes das mulheres em relação ao exame preventivo do câncer do colo uterino / Women's knowledge and attitudes regarding cervical cancer screening

Este estudo teve por objetivo avaliar os conhecimentos e atitudes das mulheres em relação a importância do exame preventivo do câncer do colo uterino. Estudo descritivo e exploratório de abordagem qualitativa, realizado com 14 mulheres atendidas em um serviço de saúde de Moçambique. A coleta de dados foi por meio do roteiro de entrevista semiestruturada, entre os meses de fevereiro a março de 2015. Os resultados foram analisados pela técnica de análise de conteúdo. A maior parte das mulheres embora tenha ouvido falar do câncer do colo uterino (CCU) na televisão e nas palestras dos hospitais, tem pouco conhecimento em relação à prevenção, desconhece a importância do exame preventivo e realiza o exame devido a queixas ginecológicas. O conhecimento das mulheres é incipiente e aquém do esperado sobre a temática da importância do exame preventivo.

This study aimed to evaluate women's knowledge and attitudes regarding the importance of cervical cancer screening. This is a descriptive, exploratory, with a qualitative approach study, carried out with 14 women assisted at a health service in Mozambique. Data collection occurred with a semi-structured interview from February to March 2015. The results were analyzed using the content analysis technique. Although most women have heard of cervical cancer (CC) on television and in hospital lectures, they have little knowledge about prevention, are unaware of the importance of the screening and have the exam due to gynecological complaints. Women's knowledge is incipient and below the expectations about the importance of the screening.

Renal transplant from donors with primary central nervous system tumors: single center experience / 中华器官移植杂志

Objective To analyze the safety of renal transplant from donors with primary central nervous system (CNS) tumors.Methods We retrospectively analyzed the clinical data of 33 donors with primary CNS tumors and the 63 corresponding renal recipients between January 2013 and December 2016 in Tongji Hospital.Results The mean period from diagnosis as primary CNS tumor to donation was about (21.8± 46.4) months (range:0.5 to 192.0 months).The pathological classification of these tumors included gliomas,meningioma,medulloblastoma,etc.Besides,there were 10 donors with high-grade CNS malignancies.Eleven donors have ever been through at least one of the four treatments (craniotomy,V-P/V-A shunt,radiotherapy and chemotherapy),14 donors have undergone none,and the clinical data of rest were unavailable.All the 63 recipients got well renal function after transplant.During an average follow-up of (15.9 ± 8.2) months (range:2.7 to 35.5 months),one recipient got donor-derived rhabdoid tumor 4 months posttransplant,underwent comprehensive treatments,including allograft nephrectomy,radiotherapy,chemotherpy and returned to hemodialysis,while the 62 cases got no donor-derived tumors.Conclusion Tumor transmission of renal allograft from donors with primary CNS tumors is inevitable but with low risk,which means this kind of donors can be used with careful assessment,full informed consent and good balance between wait-list death and tumor transmission.

Research progresses of primary liver cancer from 2017 annual meeting of Chinese Society of Clinical Oncology / 中华消化外科杂志

In the twentieth session of the National Clinical Oncology Conference and 2017 annual meeting of Chinese Society of Clinical Oncology (CSCO),many progressions have been made in the diagnosis and treatment of primary liver cancer.(1) A preliminary report of the real world study of primary liver cancer in China was released.(2) Emerging diagnostic techniques and predictive models can detect preoperative liver cirrhosis and risk of postoperative liver failure in patients with hepatocellular carcinoma (HCC).(3) Photodynamic diagnostic technology can ensure histological clearance with negative surgical margin and preserve as much liver parenchyma as possible.(4) Lenvatinib is expected to be the first-line targeted drug for the treatment of patients with unresectable HCC following sorafenib.(5) Immunotherapy with Nivolumab and Pembrolizumab is still a hot topic in the field of HCC management.(6) Though a vast heterogeneity of patterns of liver resection for HCC exists between two large centers from the East and the West,their surgical safety and long-term efficacy are actually comparable.(7) Routine lymphadenectomy,active surgical intervention for patients with late-stage tumors,ensuring the negative margins of resection and comprehensive treatment of postoperative recurrence are expected to improve the long-term outcomes of intrahepatic cholangiocarcinoma (ICC).

Thymic epithelial tumors: Can fluorodeoxyglucose positron emission tomography help in predicting histologic type and stage.

OBJECTIVES: To study the utility of fluorodeoxyglucose (FDG) positron emission tomography (PET) in predicting (1) the World Health Organization (WHO) histologic type and differentiating low‑risk from high‑risk types. (2) Tumor stage and differentiate early from advanced stage disease. MATERIALS AND METHODS: Patients with thymic epithelial neoplasia who underwent a pretreatment FDG‑PET study were included. Tumor maximum standardized uptake value (SUVmax) was correlated with the WHO histologic type and also with the Masaoka‑Koga (MK) staging system. Patients with WHO Type A, AB, and B1 were classified as low risk and those with B2 and B3 as high risk. Thymic carcinomas belonged to Type C. Patients with MK Stage I and II disease were grouped as early stage and those with Stage III and IV as an advanced stage. Differences in SUVmax between the various groups were calculated. RESULTS: The SUVmax of thymic carcinomas was significantly higher as compared to low‑risk (P = 0.001) and high‑risk groups (P = 0.007). The SUVmax of high‑risk group was also significantly higher than the low‑risk group (P = 0.002). SUVmax cutoff of 6.5 was able to differentiate thymic carcinomas from thymomas with 100% sensitivity and 87.2% specificity. The SUVmax in patients with advanced stage disease showed a higher trend compared to those with early stage, but the difference was not significant (P = 0.167). CONCLUSION: PET can differentiate thymic carcinomas from rest of the thymoma subtypes by the virtue of their higher FDG uptake. It can also provide valuable information in differentiating high‑risk from low‑risk thymomas and in predicting disease stage.

Clinical efficacy of microwave ablation and surgical resection for the treatment of early hepatocellular carcinoma: a Meta analysis / 中华消化外科杂志

Objective To evaluate the clinical efficacy of microwave ablation and surgical resection for the treatment of early primary hepatocellular carcinoma (HCC).Methods The Cochrane Library, Medline,PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang database, VIP database were searched with the key words of tumor, liver cancer, primary hepatic carcinoma, hepatocellular carcinoma, HCC,surgery, surgical, surgical resection, liver resection, hepatic resection, thermal ablation, percutaneous thermal ablation, microwave coagulation, microwave ablation, 肝癌, 原发性肝癌, 肝细胞癌, 手术, 切除, 手术切除, 肝切除, 微波, 热消融, 微波治疗, 微波凝固, 微波消融 between the database establishment and February 2015.Chinese and English literatures on microwave ablation and surgical resection for the treatment of early primary HCC were retrieved, and data were extracted and analyzed by 2 independent researchers.All the patients were divided into the microwave ablation group and the surgical resection group.Measurement data were represented by the standardized mean difference (SMD) and 95％ confidence interval (CI), and count data were represented by the odds ratio (OR) and 95％ CI.Heterogeneity of the publication was analyzed using the I2 test.Results Seven literature including 6 retrospective cohort studies and 1 randomized controlled trial were retrieved, and total sample size were 993 patients including 648 in the microwave ablation group and 345 in the surgical resection group.There were significant differences in the volume of blood loss and duration of postoperative hospital stay between the2groups (SMD=-5.03,-1.74, 95％ CI:-6.21-3.85,-2.21--1.28, P＜0.05).There were no significant difference in the incidence of postoperative complications, 1-, 3-year overall survival rates, 1-, 3-year tumor-free survival rates and 1-, 2-, 3-year recurrence rates between the 2 groups (OR =1.57, 1.10, 1.20,0.77, 1.23, 1.32, 2.31, 1.39, 95％CI: 0.25-9.78, 0.43-2.86, 0.70-2.06, 0.19-3.12, 0.54-2.81,0.62-2.80, 0.96-5.55, 0.47-4.14, P ＞ 0.05).Conclusions The safety, feasibility and clinical efficacy of microwave ablation for the treatment of early primary HCC is comparable to surgical resection, and microwave ablation has the advantages of lesser blood loss and shorter duration of hospital stay.

Research progress on primary mediastinal large B-cell lymphoma / 白血病·淋巴瘤

Primary mediastinal large B-cell lymphoma (PMBCL) has specific phenotypical features, pathological features and clinical presentation.PMBCL patients are predominantly female and typically present early stage disease and mediastinal involvement.Due to the lack of randomized studies, most patients with PMBCL usually receive combination chemotherapy with consolidation IF-RT.Considering IF-RT can improve the complete remission rates and recurrence-free survival, the combined therapy achieved good results.The different chemotherapeutic regimens were used in clinical practice of different institutions and clinicians, including CHOP or CHOP-like, intensive chemotherapy or the third-generation regimens.Recent studies have showed promising outcomes when rituximab is added to doxorubicin-containing chemotherapy.Patients treated with R-CHOP with radiotherapy had significantly better local control rates compared with R-CHOP without radiotherapy, especially for bulky diseases.Intensity-modulated radiation therapy offers excellent target coverage, favorable outcome and minimal toxicity in PMBCL.Although the majority of patients with PMBCL receive radiotherapy following chemotherapy, few studies have specifically addressed the role of consolidation radiotherapy for the treatment of PMBCL.The prognostic importance of rituximab and radiotherapy has not been clearly defined in patients with PMBCL.Heterogeneous treatment options and small number of patients have made it difficult to draw definitive conclusions about the potential advantages of rituximab and radiotherapy in patients with PMBCL.

Clinical characteristics and treatment analysis of 51 cases of primary gastric non-Hodgkin lymphoma / 白血病·淋巴瘤

Objective To investigate the clinical characteristics and prognostic factors in patients with primary gastric non-Hodgkin lymphoma (PG-NHL).Methods The pathological data of 51 PG-NHL patients admitted in our hospital from 2003 to 2013 were analyzed retrospectively.Results In 51 patients with PG-NHL,there were 26 males and 25 females.The patients' age ranged from 18 to 80 years old with median age as 56 years old.The median survival time was 32 months (range from 1 to 114 months).The oneyear overall survival (OS),three-year OS and five-year OS were 90.2 ％,82.4 ％ and 80.4 ％,respectively.The surgery did not significantly improve PG-NHL patients' progress free survival and OS.Only 1 (2.0 ％) patient had gastrointestinal hemorrhage and perforation after chemotherapy.However,6 (46.2 ％) patients suffered from early satiety,gastric emptying disorder,alkaline reflux gastritis and dumping syndrome in surgery group.Conclusions Surgery did not improve the survival of PG-NHL patients.The life quality in chemotherapygroup is better than that in surgical group.

Experience of emergency treatment of spontaneous rupture of primary liver cancer / 国际外科学杂志

Objective To summarize the experience of emergency treatment of primary liver cancer rupture bleeding and improve the level of diagnosis and treatment of the disease.Methods From October 2008 to December 2012.The clinical data of 11 patients with spontaneous rupture of primary liver cancer were analyzed retrospectively.Results Three cases were given conservative treatment.Among them,1 case died,2 bleeding cases were hemostasis,8 cases were operated.Surgical operation is the main method of emergency treatment.The effect after operation was satisfactory.1 case with liver tumor resection died in the first days after the operation,1 case was transferred to higher level hospitals for further treatment because massive ascities in third days after operation,6 cases were successfully discharged,survival rate was over 3 months.Conclusions In the process of emergency treatment we should pay attention to reduce the rate of misdiagnosis and missed diagnosis.When the diagnosis was confirmed,we must treat the shock and plan an active operation scheme.Operation mode can be selected of tumor resection or simple hemostatic gauze tamponade suture hemostasis,saving lives of patients in the shortest time is the goal of emergency treatment.

Diagnosis value of expression of inserum macrophage inhibitory factor 1 combined with alpha-fetoprotein isoforms 3 in primary liver cancer / 肿瘤研究与临床

Objective Study on the diagnosis value of expression of serum macrophage inhibitory factor 1 (MIC-1) combined with alpha-fetoprotein isoforms 3 (AFP-L3) in primary liver cancer detected by enzyme linked immunosorbent assay (ELISA).Methods MIC-1 and AFP-L3 concentrations were detected by ELISA from selected 116 patients of primary liver cancer.Results were compared both in combined and sigle detection.Results In primary liver cancer group AFP-L3 concentration [(127.12±51.43) ngmml] was significantly higher than that in normal control group [(27.11±7.26) ng/ml,P ＜ 0.001].With AFP-L3 ＞ 38.0 ng/ml as the critical value,the sensitivity was 85.34 ％ (99/116),specificity was 88.33 ％ (53/60) and the diagnostic accuracy was 86.36 ％ (152/176).In primary liver cancer group MIC-1 concentration [(3140.43±1138.23) pg/ml]was significantly higher than that in normal the control group [(701.88±302.34) pg/ml,P ＜ 0.001],the sensitivity was 91.38 ％ (106/116),specificity was 85.00 ％ (51/60),the diagnostic accuracy was 89.20 ％(157/176).The two combined detection sensitivity was 83.62 ％ (97/116),specificity was 91.67 ％ (55/60),diagnostic accuracy was 86.36 ％ (152/176).Conclusion MIC-1 combined with AFP-L3 concentration detection can improve the specificity of the diagnosis of primary liver cancer,which has certain clinical value.

Clinical value of alpha-fetoprotein heterogeneity 3, golgin 73 and glypican 3 in diagnosis of primary hepatic cancer / 肿瘤研究与临床

Objective To investigate the clinical value of serum tumor marker alpha-fetoprotein heterogeneity 3 (AFP-L3),golgin 73 (GP73) and glypican 3 (GPC-3) in primary hepatic cancer by ROC curve.Methods The AFP-L3,GP73,GPC-3 levels in serum were detected in 34 patients of primary hepatic cancer by enzyme immunoassay.Meanwhile,same terms from 20 healthy volunteers were detected as normal group.The area under curve was made by SPSS 17.0.Each laboratory indicator levels were compared and analyzed.Results The AFP-L3,GP73,GPC-3 levels in primary hepatic cancer group were significantly higher than those in normal control [(1890.13±506.47) ng/L vs (623.40±317.89) ng/L,(219.53±136.33) ng/ml vs (56.40± 25.63) ng/ml,(14.28±7.15) μg/L vs (7.33±3.71) μg/L,P ＜ 0.01].The areas under the concentration-time curve of receiver operating characteristic of single tumor marker were 0.909,0.832,0.817,the areas of AFP-L3+ GP73,AFP-L3+GPC-3,GP73+GPC-3 were 0.935,0.945,0.912,the area of combined detection of primaryhepatic cancer was 0.96.Conclusion AFP-L3 combines with GP73 and GPC-3 can increase the positive rate in patients with primary hepatic cancer and has important clinical significance.

Prognosis of primary liver cancer with different pathological types after hepatectomy: a report of 567 cases / 中华消化外科杂志

Objective To investigate the prognosis of patients with primary liver cancer in different pathological types after hepatectomy,and to analyze the effects of clinicopathological factors on the survival.Methods The clinical data of 567 patients with primary liver cancer who received hepatectomy at the Affiliated Hospital of Qingdao University from January 1997 to December 2008 were retrospectively analyzed.All patients were divided into hepatocellular carcinoma (HCC) group,cholangiocarcinoma (CC) group and combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) group.The survival and risk factors of the patients were analyzed.All data were analyzed by using the chi-square test,t test,analysis of variance.The survival curve was drawn by the Kaplan-Meier method and the survival of the 3 groups was compared by the Log-rank test.The risk factors were analyzed by the one-way analysis of variance and COX regression model.Results The results of pathological examination confirmed that 92.9％ (527/567) patients were with HCC,4.6％ (26/576) with CC and 2.5％ (14/567)with cHCC-CC.The median cumulative survival time of patients with HCC was 48 months,which was significantly longer than 19 months of patients with CC and 14 months of patients with cHCC-CC (Log-rank value =4.354,8.847,P ＜ 0.05).The median tumor-free survival time of patients with HCC was 26 months,which was significantly longer than 9 months of patients with CC and 9 months of patients with cHCC-CC (Log-rank value =6.479,7.708,P ＜ 0.05).The tumor recurrence rate within 1 year of patients with HCC was 28.8％ (152/527),which was significantly lower than 57.7％ (15/26) of patients with CC or 9/14 of patients with cHCC-CC (F =17.046,P ＜ 0.05).No vascular thrombosis was detected in patients with CC,but the regional lymph node metastasis rate was 19.2％ (5/26),which was significantly higher than 2.8％ (15/527) of patients with HCC (x2 =19.082,P ＜ 0.05).Level of alpha-fetoprotein,TNM staging,tumor diameter,multiple foci,liver capsule invasion,satellite foci and lymph node metastasis were risk factors for the survivals of patients with primary liver cancer after hepateetomy (x2 =8.648,118.786,59.548,7.639,13.200,43.842,15.540,P ＜ 0.05).Vascular tumor thrombosis and Child-Pugh classification were the risk factors for the survivals of patients with HCC or cHCC-CC (x2 =70.446,6.230,P ＜ 0.05).TNM staging,tumor diameter,satellite foci and vascular tumor thrombusis were the independent risk factors for the survivals of patients with primary liver cancer (RR =1.420,1.050,1.513,1.899,P ＜ 0.05) ; TNM staging,tumor diameter and vascular tumor thrombosis were the independent risk factors for the survivals of patients with HCC (RR =1.432,1.888,1.052,P ＜ 0.05).TNM staging and tumor diameter were the independent risk factors for the survivals patients with CC (RR =1.473,1.503,P ＜ 0.05).Conclusion Although CC and cHCC-CC take small proportion in the primary liver cancer,the tumor recurrence rate is higher and the survival rate is lower when compared with patients with HCC.

Analysis of treatment and prognosis of primary gallbladder cancer / 中华消化外科杂志

ObjectiveTo investigate the treatment strategies and factors influencing the prognosis of patients with primary gallbladder carcinoma.MethodsThe clinical data of 135 patients with primary gallbladder cancer who were admitted to the Cancer Hospital of Tianjin Medical University from January 2000 to December 2009 were retrospectively analyzed.The survival curve was drawn by the Kaplan-Meier method,and the survival rates were analyzed by using the Log-rank test.Factors which may have influences on the prognosis were analyzed by univariate analysis and COX multivariate analysis.ResultsThe overall 1-,3-,5-year survival rates of the 135 patients were 46.7％,10.4％ and 5.2％,respectively.The 1-,3-,5-year survival rates of 74 patients who received radical resection of gallbladder cancer were 68.9％,18.9％ and 9.5％,respectively.The 1-,3-,5-year survival rates of 50 patients who received palliative treatment were 24.0％,0 and 0,respectively.The 1-,3-,5-year survival rates of 11 patients who received conservative treatment were 0,0 and 0,respectively.There was no significant difference in the survival rates among patients who received different treatment methods (x2 =5.642,P ＜ 0.05 ). Of the 9 patients with gallbladder cancer who received reoperation after laparoscopic choledochotomy,the survival time of 1 patient in stage Ⅰ and 1 of the 3 patients in stage Ⅱ who received radical surgery exceeded 5 years,while the survival time of 5 patients in stage Ⅱ who received palliative treatment was shorter than 5 years.There was a significant difference in the survival time among the 3 groups of patients ( x2 =5.642,P＜0.05).Under the condition of same TNM stages ( Ⅱ,ⅢA,ⅢB,ⅣA,ⅣB),the survival rates of patients who received radical resection of gallbladder cancer were significantly higher than those who received palliative or conservative treatment ( x2 =8.971,21.250,44.153,6.696,21.722,P ＜ 0.05 ).The results of univariate analysis showed that age,CA19-9,TNM stages and treatment methods were risk factors influencing the median survival time ( x2 =8.466,3.977,9.837,5.642,P ＜ 0.05 ).The results of multivariate analysis showed that age,TNM stages and treatment methods were the independent risk factors influencing the median survival time ( Wald=5.779,14.724,11.640,P＜0.05).ConclusionThe prognosis of primary gallbladder cancer is poor.Age,TNM stages and treatment methods are the independent factors influencing the prognosis of patients with gallbladder cancer,and patients who receive radical resection have relatively good prognosis.

The occurrence and evolution of portal vein tumor thrombus in primary liver cancer / 肿瘤研究与临床

Primary liver cancer is a high incidence and common malignant tumor in China. Portal vein tumor thrombus is one of the biologic marks of advanced liver cancer and difficult to be cured, and the prognosis is extremely poor. This paper systematically describes the formation mechanism, diagnosis,classification and prognosis of portal vein tumor thrombus. It would provide a theoretical basis for this clinical problem in order to reasonably understand and actively treat it.