ABSTRACT
Objective:To investigate the impact of the clinicopathological characteristics of anorectal malignant melanoma (ARMM) on the prognosis.Methods:The clinicopathological data of 40 ARMM patients undergoing surgery at the Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences from Apr 2012 to Apr 2022 were collected, and the impact of different clinicopathological factors and treatment modalities on the overall survival of ARMM patients was investigated using Kaplan-Meier survival analysis and multifactorial Cox proportional risk model analysis.Results:Among 40 ARMM patients , 16 were male and 24 were female. The median age of onset was 61 yr. The median follow-up period for all patients was 47 (25-69) months, with a median survival of 19 (15-23) months and 1-year and 3-year survival rates of 74.3% and 21.7%, respectively. There was no statistically significant difference in survival time between the two groups of patients receiving wide local excision and abdominoperineal resection( χ2=1.281, P=0.258). Univariate analysis showed that overall survival in patients with ARMM was related to tumour diameter, depth of infiltration, specimen margin and lymph node metastasis ( χ2=1.281, P=0.039; χ2=3.760, P=0.042; χ2=6.581, P=0.010; χ2=21.683, P<0.001), and multivariate analysis suggested that lymph node metastasis was an independent risk factor for overall survival in patients with ARMM. Conclusion:Tumour diameter, depth of infiltration, specimen margin and lymph node metastasis were important prognostic influences in ARMM, and lymph node metastasis was an independent risk factor for overall survival in ARMM patients.
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Objective To explore the Clinicopathological characteristics of patients with primary adenosquamous and squamous carcinoma of stomach. Methods The clinical data of 12 cases of primary squamous and adenosquamous carcinoma of the stomach were reviewed retrospectively, and the immunohistochemical staining of CK17 and CKI8 protein were performed in primary gastric adenosquamous carcinoma. Results Primary adenosquamous and squamous carcinoma of the stomach accounted for 0.28% of all the 4352 patients with gastric cancer during the same period. Of the 12 patients, 10 were adenosquamous carcinoma and other two were squamous carcinoma. There were 10 males and 2 females in this group, with their mean age being 65 years. The main clinical presentation included epigastric pain and discomfort, followed by hematemesis and melena. The definite diagnosis rate was 33% (4/12) by gastroscopy and biopsy before operation. The tumors were less than 5 cm in diameter in 3 patients, and more than 5 cm in 9 patients. The surgical procedure was radical resection in 8 patients and palliative resection in 4 patients. There were 1 case of stage Ⅰ, 5 cases of stage Ⅲ, 6 cases of stage Ⅳ. 10 patients died of tumor recurrence and metastasis within 2 years after operation, one died of other unrelated disease, and one was alive for more than 5 months. The component of both adenosquamous and squamous carcinoma were more than 30% in 4 patients with adenosquamous carcinoma who underwent palliative resection and died within 6 months after operation. Conclusions Primary adenosquamous and squamous carcinoma of the stomach were rare, and had specific clinicopathological characteristics. Having both biological behaviours of adenocarcinoma and squamous carcinoma may lead to poor prognosis in adenosquamous carcinoma of stomach.
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Objective To evaluate the status of lymph node micrometastases in "non-metastatic" No11P lymph nodes as judged by conventional pathology in the lower third of gastric cancer. Methods In this study 43 No11P lymph nodes harvested from 43 patients which was histologically free of metastasis were examined by consecutive sections and TRAP( telomeric repeat amplification protocol)-ELISA (enzyme linked immunosorbent assay). The data were statistically analyzed according to the clinicopathological features of the patients. Results Micrometastasis was discovered in 4 lymph nodes from 4 patients by consecutive sections. The micrometastatic rate of the conventional pathologic non-metastatic No11P lymph nodes was 9%. The micrometastatic rate of the conventional pathologic non-metastasis No11P lymph nodes detected by TRAP-ELISA was 44%, including 4 lymph nodes observed by consecutive sections It revealed that lymph nodes micrometastases were correlated with the size of the tumor( x2 = 8. 488, P < 0. 05 )、and tumor stage (x2 = 12. 022,P < 0. 05 ). It also showed that the micrometastatic rate increased proportionally to tumor infiltration depth(x2 =6. 473, P <0. 05), not correlated with patients' demographic features, general type and histological differentiation of the tumor. Conclusions There was a high rate of micrometastasis in No11P lymph nodes. This lymph nodes micrometastasis was correlated with the size of the tumor, invasion depth of primary tumor and patients' clinical stage.