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Objective@#To investigate the correlation between ultrasonographic features of papillary thyroid carcinoma and central cervical lymph node metastasis.@*Methods@#We retrospectively analyzed 486 patients with papillary thyroid carcinoma(PTC), pathologically confirmed after surgery in Tianjin Medical University Cancer Institute & Hospital. All patients were divided into central cervical lymph node metastasis group and non-metastasis group. No lateral cervical lymph node metastasis was found in preoperative ultrasonography and postoperative pathology. The characteristics of the ultrasound was observed and analyzed.@*Results@#297 out of 486 patients with papillary thyroid carcinomahad central metastasis, and the other 189 cases did not. Take pathology results as a standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of preoperative ultrasound diagnosis in PTC patients with central cervical lymph node metastasis were 35.3%, 88.6%, 83.2%, 47.4%, 56.6%, respectively. Univariate analysis showed that multi-focus, taller-than-wide, diameter>1 cm, located in the lower pole, ill-defined margin, hypoechogenicity, micro-calcification, capsule invasion more than 1/4 perimeter of papillary thyroid carcinoma were significantly associated with central cervical lymph node metastasis (all P<0.05). Multivariate analysis showed that diameter>1 cm, micro-calcification, capsule invasion more than 1/4 perimeter of papillary thyroid carcinoma became independent risk factors of central cervical neck lymph node metastasis (all P<0.05).@*Conclusions@#Preoperative description of ultrasonographical features has important value to assess central cervical lymph node metastasis in patients with papillary thyroid carcinoma. More information could be provided for clinical treatment. When the papillary thyroid carcinoma presented as diameter>1 cm, micro-calcification, and capsule invasion more than 1/4 perimeter of, there will be a greater risk of central cervical lymph node metastasis, and we shall suggest prophylactic central lymph cervical node dissection.
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Objective@#To investigate the expression of LIM and SH3 protein 1 (LASP1) in renal cell carcinoma and its significance in the invasion and migration of renal clear cell carcinoma 786-O cell line.@*Methods@#The expression level of LASP1 in 41 cases of renal cell carcinoma tissues and normal renal tissues was analyzed by immunohistochemistry. The relationship between the expression level of LASP1 and clinical characteristics was further analyzed. Expression of LASP1 in 10 cases of tumor tissues with or without lymph node metastasis was analyzed by Western blot. Furthermore, small interfering RNA (siRNA) targeting LASP1 was constructed and transfected into 786-O cells to downregulate LASP1 expression. The interference effect of LASP1 siRNA on LASP1 protein and the expression of related proteins in epithelial mesenchymal transition (EMT) pathway were detected by Western blot. The effects of LASP1 knockdown on cell proliferation, migration and invasion and gene expression were then assessed using CCK8 assay, transwell cell migration system and western blot analysis, respectively.@*Results@#The positive rate of LASP1 expression in renal clear cell carcinoma tissues was 90.2% (37/41), which was significantly higher than that in the adjacent tissues (29.3%, P=0.002). The expression of LASP1 in renal cell carcinoma was positively correlated with lymph node metastasis and TNM stage of renal cell carcinoma (P<0.05). The results of Western blot showed that LASP1 (0.696±0.053) was highly expressed in renal cell carcinoma (1.459±0.628), especially in cases with lymph node metastasis (2.692±0.186, P<0.05). The LASP1 siRNA remarkably down-regulated the expression of LASP1 protein in 786-O cells. The abilities of proliferation, invasion and migration of 786-O cells were decreased significantly in the LASP1 siRNA groups.The relative expression of E-cadherin protein in the siRNA group (0.848±0.020) was significantly higher than those in the siRNA-NC group (0.671±0.018) and control group (0.691±0.037, P<0.05). The relative expression of N-cadherin protein in the siRNA group (0.449±0.047) was significantly lower than those in the siRNA-NC group (0.613±0.018) and control group (0.633±0.045, P<0.05). The relative expression of vimentin protein in the siRNA group (0.477±0.029) was significantly lower than those in the siRNA-NC group (0.598±0.069) and control group (0.633±0.045, P<0.05 for both).@*Conclusions@#LASP1 is highly expressed in renal clear cell carcinoma, which is closely related to the development of the cancer. The effects of LASP1 on the invasion and migration of 786-O cells and lymph node metastasis may be related to the EMT.
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Objective To explore the reasonable radiotherapy range by analyzing the patterns and characteristics of intra-thoracic lymph node metastasis in small cell lung cancer (SCLC).Methods One hundred and fifty patients with limited-stage SCLC who received radical resection of primary tumor and systemic intra-thoracic lymph node dissection were included in the study.All the lymph nodes in each area were recorded and examined pathologically to analyze the patterns and characteristics of intra-thoracic lymph node metastasis.Results A total of 2372 lymph nodes were found in 631 areas,and a total of 413 positive lymph nodes (17.4％) were found in 188 lymph node areas (29.8％ ).Intra-thoracic lymph node metastasis were found in 88 patients,with a positive rate of 58.7％.The frequencies of metastasis in the area 11,10,7,5,4 were much higher than those in the other areas,and central located lesions and the higher T-stage lung tumors were more likely to develop intra-thoracic lymph node metastasis (x2 =15.32,39.72;P =0.000,0.000,respectively).Tumors located in the right upper lobe and right middle/lower lobe had a higher tendency of metastasis to the areas 4,7,10 and 4,7,10,11,respectively.Tumors located in the left upper lobe and left lower lobe had a higher tendency of metastasis to the areas 4,5,6,10 and 4,7,9,10,11,respectively.Mediastinal lymph node metastasis (N2 ) were found in 72 patients,among whom 29 patients (40.3％ ) had skipping N2 metastasis without hilar metastasis.Tumors located in the upper lobe had a tendency of skipping metastasis to the upper mediastinum,while tumors located in the middle/lower lobe had a tendency of skipping metastasis to the upper and lower mediastinum.Conclusions The lymph node metastases in SCLC follow the lymphatic drainage routes,that is,from intrapulmonary to the hilar and then to the mediastinum,but with some skipping metastases.Tumors located in different lobes have different high risk lymph node areas for metastasis,and elective irradiation to these lymph node areas maybe increase radiotherapy gain ratio in SCLC.
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Objective To explore the prognosis and related factor of esophageal carcinoma with locoregional lymph node metastasis ( N1 ) treated with three-dimensional conformal radiotherapy (3DCRT) or intensity modulated radiation therapy (IMRT).Methods From January 2001 to December 2008,60 patients of esophageal carcinoma with localregional lymph node metastasis were treated with 3DCRT and 52 with IMRT.For all patients,dose of tumor was 56 - 70 Gy/28 - 35 fraction/5.6 - 7.0 weeks.Among them,58 cases was treated with chemotherapy including cisplatin and 5-fluorouracil;40 with concurrent chemoradiotherapy and 18 with sequential radiotherapy and chemotherapy.Results After radiotherapy,the total efficiency rate was 98.2％,96.7％ in 3DCRT and 100％ in IMRT ( x2 =1.77,P =0.184 ).The follow-up rate was 99.1％.The number of patients completed follow-up were 68 and 53,respectively at 2-year and 3-year.The 1 and 3-year overall survival rates were 62.5％,23.7％,respectively; the median survival time was 17 months.The 1and 3-year survival rates and median were 52％,19％ and 12.4 months in 3DCRT and 75％,40％ and 17 months in IMRT,respectively (x2 =4.74,P =0.030).The 1 and 3-year free-recurrence survival rates were 64％,45％ in 3DCRT and 72％,59％ in IMRT ( x2 =2.27,P =0.132),respectively.With uninvariate analysis,for female,ages ≤ 65,tumor located in cervical and upper-thoracic,＞5 cm lesion length in barium esophagogram,≤4 cm the largest diameter of lesion in CT scanning image,T4 stage,or semiliquid or liquid diet before radiotherapy,survival rate were higher in IMRT than in 3DCRT group (x2 =4.63,5.56,7.19,5.08,4.43,4.48,8.25;P=0.031,0.018,0.007,0.025,0.035,0.034,0.004,respectively) ; but for male,ages ＞ 65,tumor located in middle and lower-thoracic,≤5 cm lesion length in barium esophagogram,＞4 cm the largest diameter of lesion in CT scanning image,T1 -3 stage,or normal diet before radiotherapy,chemotherapy and dose of radiotherapy ( ＜66 Gy vs ≥66 Gy),no significant difference were found between IMRT and 3DCRT (x2 =1.28,0.27,0.17,0.03,1.98,0.01,0.43,2.45,1.73,1.24,2.64;P=0.258,0.602,0.684,0.859,0.160,0.973,0.511,0.117,0.189,0.234,0.104,respectively).By Cox multivariable regression,only T stage was independent prognostic factor (x2=9.50,P =0.002 ).Conclusions There was some advantage treated with IMRT compared with 3DCRT in patients of esophageal cancer with locoregional lymph node metastasis,but further prospective clinical study is needed to support the conclusion.