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Objective To evaluate the role of preoperative serological indexes in predicting long-term survival and tumor recurrence of hepatocellular carcinoma (HCC) patients after liver transplantation, aiming to explore its significance in expanding the Milan criteria. Methods Clinical data of 669 recipients undergoing liver transplantation for HCC were retrospectively analyzed. The optimal cut-off value was calculated by the receiver operating characteristic (ROC) curve. The risk factors affecting the overall survival and recurrence-free survival rates of HCC patients after liver transplantation were identified by univariate and multivariate regression analyses. The correlation between preoperative serum liver enzymes and pathological characteristics in HCC patients was analyzed. The predictive values of alpha-fetoprotein (AFP) combined with γ -glutamyl transferase (GGT) and different liver transplant criteria for the survival and recurrence of HCC patients after liver transplantation were compared. Results Exceeded Milan criteria, total tumor diameter (TTD) > 8 cm, AFP > 200 ng/mL and GGT > 84 U/L were the independent risk factors for the overall survival and recurrence-free survival rates of HCC patients after liver transplantation (all P < 0.05). Correlation analysis showed that preoperative serum GGT level was correlated with TTD, number of tumor, venous invasion, microsatellite lesions, capsular invasion, tumor, node, metastasis (TNM) stage, Child-Pugh score and exceeded Milan criteria (all P < 0.05). Milan-AFP-GGT-TTD (M-AGT) criteria were proposed by combining Milan criteria, TTD with serum liver enzyme indexes (AFP and GGT). The 5-year overall survival and recurrence-free survival rates of HCC recipients who met the M-AGT criteria (111 cases of exceeded Milan criteria) were significantly higher than those who met Hangzhou criteria (both P < 0.05), whereas had no significant difference from their counterparts who met the University of California at San Francisco (UCSF) criteria (both P > 0.05). Conclusions Preoperative serological indexes of AFP and GGT could effectively predict the long-term survival and tumor recurrence of HCC patients after liver transplantation. Establishing the M-AGT criteria based on serological indexes contributes to expanding the Milan criteria, which is convenient and feasible.
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Objective:To investigate the risk factors for recurrence after liver transplantation in patients with hepatitis B virus (HBV) infection-related hepatocellular carcinoma (HCC), and to further construct a predictive model.Methods:The clinical data of 106 patients with HCC undergoing liver transplantation in the First Affiliated Hospital of Hebei North University from January 2015 to May 2020 were retrospec-tively analyzed. The χ2 test was used to analyze the factors influencing HCC recurrence, and multivariate logistic regression was used to analyze the influencing factors of HCC recurrence. According to the selected risk factors, the predictive model of HCC recurrence was constructed, and the receiver operating characteristic (ROC) curve was used to evaluate the predictive model. Results:Of the 106 HCC patients, 23 had recurrence, with a recurrence rate of 21.70%, and 20 died. Tumor differentiation ( χ2=6.066, P=0.014), maximum tumor diameter ( χ2=4.916, P=0.027), with or without envelope invasion ( χ2=5.543, P=0.019), preoperative alpha fetoprotein (AFP) ( χ2=5.458, P=0.019), HBV-DNA ( χ2=5.446, P=0.020), neutrophil lymphocyte ratio (NLR) ( χ2=12.161, P<0.001), the expressions of miR-424 ( χ2=4.400, P=0.036), chromodomain helicase DNA-binding protein 8 (CHD8) ( χ2=10.561, P=0.001), T-cadherin (T-cad) ( χ2=48.723, P<0.001), laminin (LN) ( χ2=18.506, P<0.001) and hepatocyte growth factor (HGF) ( χ2=11.178, P=0.001) were related to the recurrence of HCC. Multivariate logistic regression analysis showed that the maximum tumor diameter≥6.5 cm ( OR=1.69, 95% CI: 1.25-3.17, P=0.002), preoperative AFP>400 ng/ml ( OR=1.38, 95% CI: 1.09-1.92, P=0.038), positive CHD8 ( OR=0.77, 95% CI: 0.52-0.89, P=0.021), positive T-cad ( OR=0.84, 95% CI: 0.68-0.92, P=0.006), positive LN ( OR=1.22, 95% CI: 1.03-1.50, P=0.013) were the risk factors of HCC recurrence. According to the results of logistic analysis, the regression equation logit( P)=0.262+ 0.523 X1+ 0.326 X2-0.259 X3-0.286 X4+ 0.203 X5 was constructed, where X1, X2, X3, X4, X5 were the maximum tumor diameter, AFP, CHD8, T-cad and LN. ROC curve analysis showed that the area under the curve for predicting HCC recurrence was 0.849 (95% CI: 0.763-0.894, P<0.001), the accuracy rate was 83.02%, the sensitivity was 86.96%, the specificity was 81.93%, and the cut-off value was 0.736. According to the logit( P) function model, P=1/(1+ e - Y), where Y=0.262+ 0.523 X1+ 0.326 X2-0.259 X3-0.286 X4+ 0.203 X5. One patient was randomly selected. According to his clinical data, P=0.564, which was less than the cut-off value (0.736). It could be considered that this patient would not have HCC recurrence with an accuracy rate of 83.02%. Conclusion:Tumor maximum diameter, preoperative AFP, CHD8, T-cad, LN expression are related to the recurrence of HCC after liver transplantation. The prediction model constructed based on this can effectively predict the risk of HCC recurrence.
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Objective: This study aimed to classify hepatocellular carcinomas (HCCs) according to their diameter using statistic technology and evaluate the prognosis of the classified groups after the combined use of transarterial chemoembolization (TACE) and radiofrequency ablation (RFA). Materials and Methods: Electronic medical records of 128 consecutive patients who underwent TACE-RFA as the initial treatment for HCC from January 2010 to April 2018 were retrospectively analyzed. TACE was initially performed with subsequent RFA performed after 3–7 days. The decision tree model was used to classify overall survival (OS), progression-free survival (PFS), local recurrence rate (LRR), and treatment complications in HCC. Results: The tumors were divided into three groups of sizes ≤2.9 cm, 2.9–4.8 cm, and >4.8 cm. The group of tumors >4.8 cm showed inferior OS, PFS, and LRR than the other two groups (P < 0.05) on long-term follow-up but not in thefirst 6 months (P > 0.05). The groups of tumors ≤2.9 cm and 2.9–4.8 cm showed no statistically significant difference in OS, PFS, and LRR (P > 0.05). Conclusions: The cutoff points of 2.9 and 4.8 cm were achieved using the objective decision tree model rather than the artificial division of 3 and 5 cm. The prognosis was not significantly different between the groups of tumors ≤2.9 cm and 2.9–4.8 cm, and the prognosis of the two groups was better than the group of tumors >4.8 cm in the long-term follow-up but not in thefirst 6 months
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Objective To analyze the risk factors of microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC),and to establish a preoperative prediction model for MVI.Methods The clinical data of 159 patients with HCC from the First Hospital of Jilin University treated from January 2012 to December 2014 were retrospectively analyzed.There were 128 males and 31 females.Univariate and multivariate logistic regression analysis of factors influencing the presence of MVI in HCC patients were carried out.Independent risk factors were scored based on the β values of multivariate analysis.Receiver operating characteristics (ROC) curves were used to evaluate the predictive value of the scores for the risk factor for MVI.Results Univariate and multivariate logistic regression analyses showed that age ≥ 60 years (OR=0.263,95％ CI:0.112 ～ 0.614),tumor diameter ≥5 cm (OR=3.902,95％ CI:1.784 ～ 8.583),neutrophil to lymphocyte ratio (NLR) ≥ 1.83 (OR=2.414,95％ CI:1.065～5.472) and platelet to lymphocyte ratio (PLR) ≥ 72.30 (OR =2.578,95％ CI:1.068～ 6.223) were the influencing factors of MVI in patients with HCC (P＜0.05).The preoperative prediction model of MVI was established using the MVI independent risk factor scores.The area under the ROC curve was 0.793 (95％ CI:0.723～ 0.862).The optimal cutoff value for the presence of MVI was 2.75 points,and the sensitivity was 0.72 and the specificity was 0.78.The MVI positive rates of patients with risk scores of 0 to 1.5,2.0 to 3.5,and 4.0 to 5.0 were 18.6％,42.9％,and 78.3％,respectively.Conclusion Age,tumor diameter,NLR,and PLR were independent factors influencing MVI in patients with HCC.The preoperative model based on the independent risk factor scores can be used to predict the presence of MVI in HCC patients.
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Objective@#To investigate the correlation between the expression of extracellular matrix metalloproteinase-inducible factor (CD147), matrix metalloproteinase-9 (MMP-9) and human epidermal growth factor receptor-2 (HER-2) in gastric cancer tissues and clinical pathology and prognosis.@*Methods@#From June 2016 to June 2018, 80 gastric cancer specimens from the First People's Hospital of Taizhou were collected as observation group, and another 60 normal specimens of gastric mucosa adjacent to cancer were selected as control group.The expressions of CD147, MMP-9 and HER-2 were detected by SP immunohistochemical method.The positive rates of CD147, MMP-9 and HER-2 protein expression, the positive rates of CD147, MMP-9 and HER-2 protein expression in different pathological characteristics, and the positive rates of CD147, MMP-9 and HER-2 protein expression in different prognosis were compared between the two groups.@*Results@#The positive rates of CD147 (73.75%), MMP-9 (76.25%) and HER-2 (42.50%) in the observation group were higher than those in the control group (21.67%, 25.00%, 5.00%), the differences were statistically significant (χ2=37.233, 36.288, 24.797, all P<0.05). There were no statisticallysignificant differences in the positive expression rates of CD147, MMP-9 and HER-2 protein among different gender, age, tumor diameter and differentiation (all P>0.05). The positive rates of CD147 (93.88%), MMP-9 (95.92%) and HER-2 (61.22%) with lymph node metastasis were higher than those without lymph node metastasis (41.94%, 45.16%, 12.90%), the differences were statistically significant (χ2=26.462, 27.012, 18.142, all P<0.05). The positive rates of CD147 (96.15%), MMP-9 (92.31%) and HER-2 (69.23%) in the death group were higher than those in the survival group (62.96%, 68.52%, 29.63%), the differences were statistically significant(χ2=9.987, 5.484, 11.263, all P<0.05).@*Conclusion@#High expression of CD147, MMP-9 and HER-2 proteins in gastric cancer tissues is closely related to invasion and metastasis, which can become a new prognostic marker and therapeutic target of gastric cancer.
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Objective To analyze the clinical characteristics and prognostic factors of rectal neuroendocrine neoplasm (r-NEN) with the maximum diameter of 1 cm to 2 cm,and to provide a theoretical evidence for selection of resection method.Methods From 1988 to 2015,the data of patients pathologically diagnosed as r-NEN with the maximum diameter less than 2 cm were selected from American surveillance,epidemiology,and end results (SEER) database with SEER * Stat 8.3.5 software.According to the resection method,the patients were divided into local resection group and radical resection group.T test and chi-square test were performed to compare the clinicopathological features.Kaplan-Meier survival analysis and Cox multivariate analysis were used to analyze the prognostic factors analysis.Results The maximum diameter of tumors of 1 831 patients with r-NEN was less than 1 cm,and that of 338 patients with r-NEN was between 1 cm and 2 cm.There were significant differences between two groups in tumor grade,tumor stage,T stage,lymph node metastasis,distant metastasis and resection method (x2 =7.120,144.728,86.296,133.096,42.842 and 52.048,all P ＜ 0.05).The prognosis of the former was better than that of the latter (x2 =11.590,P =0.001).Among the patients with r-NEN with the maximum diameter of 1 cm to 2 cm,279 (82.5％) patients received local resection and 59 (17.5％) patients underwent radical surgery.Propensity score matching was used to pair the r-NEN patients with the maximum diameter of 1 cm to 2 cm who received different resection methods,and 41 pairs of cases were enrolled.The results of univariate analysis showed that age and tumor grade affected the survival prognosis of patients with r-NEN of the maximum diameter of 1 cm to 2 cm (x2 =6.837 and 10.852,P =0.009 and 0.004).The results of Cox multivariate analysis indicated that age was an independent prognostic factor of patients with r-NEN of the maximum diameter of 1 cm to 2 cm (hazard ratio (HR) =1.110,95％ confidence interval (CI) 1.040 to 1.184,P =0.002).Analysis of subgroups without lymph nodes or distant metastases demonstrated that age (HR =1.101,95％ CI 1.042 to 1.162,P =0.001) and resection method (HR =3.128,95％ CI 1.003 to 9.754,P =0.049) were the independent factors.Conclusions Age is an independent factor of patients with r-NEN of the maximum diameter of 1 cm to 2 cm.Among the patients without lymph nodes or distant metastasis the younger cases and those with local resection have better prognosis.
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Objective To study the differences of endoscopic submucosal dissection ( ESD ) for colorectal tumors of different diameters. Methods Data of 210 cases which were treated with ESD for colorectal tumors at the Endoscopy Center, the Seventh Medical Center of PLA General Hospital from October 2012 to December 2015 were retrospectively analyzed. The lesions were divided into two groups according to different diameters (≥4. 0 cm group and <4. 0 cm group) for comparative analysis of related factors. Results The mean procedure time of ESD for 210 colorectal tumor cases was 50. 3±42. 7 min and the mean size of lesions was 7. 98 ± 10. 84 cm2 . En bloc resection rate was 91. 4％, R0 resection rate was 90. 5％, and the curative resection rate was 88. 6％. Perforation rate was 5. 2％ (11/210), and the late hemorrhage rate was 0. 5％ (1/210). Compared with lesions < 4. 0 cm, those ≥ 4. 0 cm required longer resection time (79. 63±53. 91 min VS 35. 28±24. 99 min, P<0. 001); and the lesions were mainly located in the rectum ( 61. 97％) . LSTs were mainly mixed granular/nongranular type ( 54. 93％);en bloc resection rate, complete resection rate and curative resection rate of the tumors≥4. 0 cm were all lower than those of tumors < 4. 0 cm. The difference in complete resection rate was statistically significant ( 85. 92％ VS 94. 24％;P=0. 041) . The perforation rate ( 7. 04％) was higher in≥4. 0 cm group, but the difference was not statistically significant. Conclusions ESD of colorectal tumors of diameters ≥ 4. 0 cm requires longer time with higher operation risk. Additionally, physicians should be more careful with non-rectal lesions.
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Objective To investigate the influence factors of tumor diameter and related prognostic factors on the prognosis of hilar cholangiocarcinoma.Methods The retrospective case-control study was conducted.The clinicopathological data of 240 patients who underwent resection of hilar cholangiocarcinoma in the West China Hospital of Sichuan University between January 1995 and January 2013 were collected,including 104 patients with tumor diameter ≤ 2 cm (8 with tumor diameter ≤ 1 cm and 96 with 1 cm ＜ tumor diameter ≤ 2 cm),85 with 2 cm ＜ tumor diameter ≤ 3 cm and 51 with tumor diameter ＞ 3 cm (40 with 3 cm ＜ tumor diameter ≤ 4 cm and 11 with tumor diameter ＞ 4 cm).Observation indicators:(1) surgical situations;(2) follow-up situations;(3) risk factors analysis affecting the prognosis of patients;(4) correlation analysis between related prognostic indicators and tumor diameter.The follow-up using outpatient examination and telephone interview was performed to detect the survival up to August 2016.The survival curve and survival rate were respectively drawn and calculated by the Kaplan-Meier method,and the Log-rank test was used for survival analysis.The prognostic factors and correlation between related prognostic indicators and tumor diameter were respectively analyzed using the COX proportional hazard model and logistic regression model.Results (1) Surgical situations:240 patients underwent successful resection of hilar cholangiocarcinoma and lymph node dissection.Of 73 patients with postoperative complications,1 died of intraperitoneal infection induced to systemic infection and multiple organ failure,1 diel of renal failure,and other patients were cured by symptomatic treatment.(2) Follow-up situations:240 patients were followed up for 12.0-98.0 months,with a median time of 47.4 months.The overall median survival time,1-,3-and 5-year overall survival rates were respectively 30.6 months,81％,47％ and 29％.The median survival time and 5-year survival rate were 46.5 months,34％ in patients with tumor diameter ≤ 2 cm and 30.5 months,30％ in patients with 2 cm ＜ tumor diameter ≤ 3 cm and 13.8 months,20％ in patients with tumor diameter ＞ 3 cm,respectively,with a statistically significant difference (x2 =17.83,P＜0.05).Results of further analysis showed the median survival time and 5-year survival rate were 31.3 months,38％ in patients with tumor diameter ≤ 1 cm and 46.5 months,34％ in patients with 1 cm ＜ tumor diameter ≤ 2 cm,respectively,with no statistically significant difference (x2=1.16,P＞O.05).The median survival time and 1-year survival rate were 14.7 months,62％ in patients with 3 cm ＜ tumor diameter ≤ 4 cm and 13.0 months,55％ in patients with tumor diameter ＞ 4 cm,respectively,with no statistically significant difference (x2 =2.34,P＞O.05).(3) Risk factors analysis affecting the prognosis of patients:univariate analysis showed that tumor diameter,surgical margin,lymph node metastasis,vascular invasion and histological differentiation were the related factors affecting patients' prognosis [hazard ratio (HR)=1.456,8.714,1.737,2.246,1.665;95％ confidence interval (C I):1.212-1.748,5.558-13.663,1.311-2.301,1.494-3.378,1.375-2.016,P ＜ 0.05].The multivariate analysis showed that 2 cm ＜ tumor diameter ≤ 3 cm,tumor diameter ＞ 3 cm,R1 resection,lymph node metastasis and low-differentiated tumor were the independent risk factors affecting poor prognosis of patients (HR =1.559,1.868,7.410,1.521,2.274,95％ CI:1.125-2.160,1.265-2.759,4.497-12.212,1.136-2.037,1.525-3.390,P＜0.05).(4) Correlation analysis between related prognostic indicators and tumor diameter:the results of univariate analysis showed that there was a correlation between lymph node metastasis,vascular invasion,histological differentiation and T staging of American Joint Committee on Cancer (AJCC) and tumor diameter of 2 cm as a cut-off point (x2 =6.063,4.950,8.770,9.069,P＜0.05).There was a correlation between surgical margin,lymph node metastasis,vascular invasion and histological differentiation and tumor diameter of 3 cm as a cut-off point (x2=10.251,9.919,5.485,15.632,P＜0.05).The results of multivariate analysis showed that lymph node metastasis and T staging of AJCC were independent related factors affecting tumor diameter of 2 cm as a cut-off point[odds ratio (OR) =1.882,2.104,95 ％CI:1.075-3.293,1.220-3.631,P＜0.05];surgical margin and lymph node metastasis were independent related factors affecting tumor diameter of 3 cm as a cut-off point (OR=3.187,2.211,95 ％CI:1.377-7.379,1.133-4.314,P＜0.05).Conclusions The 2 cm ＜ tumor diameter ≤ 3 cm,tumor diameter ＞ 3 cm,R1 resection,lymph node metastasis and low-differentiated tumor are the independent risk factors affecting the prognosis of patients with hilar cholangiocarcinoma.Three cm (T staging in De Oliveira staging system) as the second cut-off point is feasible,meanwhile,2 cm cut-off point may be become another potential tumor dividing point described in De Oliveira staging system.
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Objective To study the values of change of diameter (ΔD%)on DCE-MRI and ΔD% combined with ADC for the therapeutic effect evaluation in the neoadjuvant chemotherapy(NAC)of each subtype of breast cancer.Methods 121 women with invasive breast cancer were enrolled in this study,including 56 cases of Luminal A type,42 cases of Luminal B type,13 cases of Her-2 type and 10 cases of triple negative type.Results Imaging evaluation results obtained by single applying DCE-MRI was analyzed with the pathological results after surgery for the consistency,and the Kappa values of Luminal A,Luminal B,Her-2 and triple negative type were 0.594,0.617,0.401,0.690,0.800,respectively.When combining ΔD% with ΔADC%,the Kappa values were 0.844,0.792,0.854, 0.847 and 0.800,respectively.The sensitivity of combined parameters in evaluating pCR after NAC was significantly increased in Luminal type cancers,however,with a slightly increasing in Her-2 type,and constant in triple negative type.Conclusion ΔD% combining with ΔADC% is better than single parameter in evaluating pCR for Luminal and Her-2 types cancer,but not for triple negative type.
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Objective:To explore the Papillary thyroid carcinoma(PTC) in patients with the expression of BRAF protein and correlation with clinical indicators.Methods:During the selection from June 2015 to June 2016 in our hospital diagnosis and treatment of 120 patients with PTC as the observation group,the other choice during the same period in our hospital make a diagnosis and give treatment of PCT 57 cases as control group,patients with thyroid cancer by immunohistochemical method to detect mutated BRAF protein expression in two groups of patients,and analyze the BRAF protein positive expression and the correlation of PTC clinical indicators.Results:Observation group of patients BRAF protein positive rate was 74.17％,the negative rate was 25.83％,control group patients BRAF protein positive rate was 7.02％,the negative rate was 92.98％,the comparison between groups have significant statistical difference(P＜0.01);Age≤45 years,diameter of tumor＞1 cm,TNM staging for Ⅲ ～Ⅳ stage of PTC patients of BRAF protein positive rate were 96.43％,82.35％,95.65％,significantly higher than the age＞45 years,tumor diameter＜1cm,TNM staging for Ⅰ ～ Ⅱ stage were 67.39％,63.46％,69.07％,and the corresponding comparison have significant statistical difference(P＜0.05).Conclusion:PTC mutated BRAF protein positive rate was significantly higher in patients with non PTC thyroid cancer patients,patients with PTC BRAF protein positive expression related to age,tumor diameter and tumor stage.
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Objective To investigate the tumor diameter on the prognosis of patients with advanced esophageal squamous cell carcinoma(ESCC) after Ivor-Lewis surgical resection.Methods The clinical data of 254 patients with advanced ESCC who received Ivor-Lewis surgical resection at the Affiliated Hospital of Tianjin Medical University from January 2005 to December 2008 were retrospectively analyzed.All the patients were followed up via outpatient examination,telephone interview and correspondence till December 2013.Survival curve was drawn by the Kaplan-Meier method,and survival rate was analyzed using the Log-rank test.Receiver-operating-characteristic (ROC) curve analysis was used to determine the appropriate cutoff value of tumor size.Univariate and multivariate analysis were done using the chi-square test and COX regression model.Results Of 254 patients,223 patients were followed up for a median time of 30 months (range,3-108 months) with a follow-up rate of 87.80％ (223/254).The median total survival time was 27 months,and the 1,3,5-year overall survival rates were 72.7％,42.2％ and 31.3％,respectively.ROC analysis showed that the appropriate cutoff value of tumor diameter was 3.5 cm.The median survival time and 5-year survival rate were 36 months and 39.3％ in patients with tumor diameter ≤ 3.5 cm and 18 months and 25.4％ in patients with tumor diameter ＞ 3.5 cm,respectively,with a significant difference (x2 =9.494,P ＜ 0.05).The results of univariate analysis showed that the age,tumor diameter,depth of tumor invasion,lymph node metastasis and postoperative adjuvant therapy were related factors affecting the prognosis of patients with advanced ESCC after Ivor-Lewis surgical resection (x2=4.459,9.494,6.993,10.382,5.507,P ＜ 0.05).The results of multivariate analysis showed that tumor diameter ＞ 3.5 cm,lymph node metastasis and no postoperative adjuvant therapy were the independent factors affecting the prognosis of patients with advanced ESCC after Ivor-Lewis surgical resection (HR =1.631,1.681,0.677,95％ confidence interval:1.151-2.312,1.198-2.358,0.487-0.942,P ＜ 0.05).Of 159 patients without postoperative lymph node metastasis,median survival time and 5-year accumulated survival rate were 49 months and 46.4％ in patients with tumor diameter ≤ 3.5 cm and 23 months and 32.0％ in patients with tumor diameter ＞ 3.5 cm,respectively,with a significant difference (x2 =6.412,P ＜ 0.05).Conclusions The tumor diameter ＞ 3.5 cm,lymph node metastasis and no postoperative adjuvant therapy are the independent factors affecting the prognosis of patients with advanced ESCC after Ivor-Lewis surgical resection,meanwhile there is an assessed value of tumor diameter on the prognosis of patients without lymph node metastasis.
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Tumors of the mammary glands are the most common neoplasms in dogs in our country; however, there are few Brazilian reports dedicated to clinicopathological and survival studies about this disease. This report aims the clinical and pathological study of canine mammary tumors in the Santos Metropolitan Region, an area in Sao Paulo state with an estimated canine population of 120,000 animals. Data of 14,298 dogs were collected retrospectively from the medical records of the Veterinary Medical Teaching Hospital of the Metropolitan University of Santos São Paulo Brazil. During the study period, from records of 317 females with histopathological diagnosis of neoplasia, 170 were mammary epithelial lesions distributed in 13 benign tumors, 152 malignant (89.4% of diagnosis) and 5 non-neoplasic epithelial lesions (ductal hyperplasia). The highest prevalent malignant tumor was tubular carcinoma (38.2% of diagnosis) and Grade I tumors, corresponding to 73.0% of all diagnosis. The results have shown clinical staging of canine mammary neoplasms as an important prognostic survival factor and, in a multivariate analysis, tumor diameter, tumor grade, adjuvant chemotherapy and recurrence as covariates with predictive value for survival. Moreover, the high prevalence of tubular carcinoma qualifies the canine population of Santos as a promising model for the translational study of this disease.
Os tumores das glândulas mamárias são as neoplasias mais comuns em cadelas em nosso país; no entanto, são poucos os trabalhos brasileiros dedicados ao estudo clinicopatológico e de sobrevida nesta doença. O presente trabalho teve por objetivo o estudo clínico e patológico dos tumores mamários caninos na Região Metropolitana de Santos, uma área no estado de São Paulo com uma população canina estimada em 120 mil animais. Dados de 14.298 cães foram coletados retrospectivamente dos prontuários médicos do Hospital Veterinário da Universidade Metropolitana de Santos São Paulo Brasil. Durante o período do estudo, foram atendidas 317 fêmeas com diagnóstico histopatológico de neoplasia, dos quais, 170 se referiam a lesões mamárias epiteliais distribuídas em 13 tumores benignos, 152 malignos (89,4% dos diagnósticos) e 5 lesões epiteliais não-neoplásicas (hiperplasia ductal). O tumor mais frequente foi o carcinoma tubular (38,2% dos tumores malignos) e tumores de grau I, respondendo por 73,0% do total diagnosticado. Estudos de sobrevida apontaram para o estadiamento clínico das neoplasias mamárias caninas como importante fator prognóstico, e na análise multivariada, diâmetro do tumor, grau histológico, quimioterapia adjuvante e recorrência apresentaram-se como covariáveis com valor preditivo de sobrevida. Levando-se em conta a elevada prevalência de carcinoma tubular simples na população canina de Santos, pode-se considerá-la como promissor modelo translacional para o estudo da doença.
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Animals , Breast Neoplasms , Neoplasms/pathology , Survival , Drug TherapyABSTRACT
Objective To study the metastasis frequencies and areas of solitary bronchioloalveolar carcinoma (BAC) of different diameters, so as to guide the intraoperative lymph node dissection. Methods A total of 137 patients with pathologically-confirmed solitary BAC received surgical treatment. The patients were divided into 3 groups according to tumor diameters: ≤2 cm group,2-3 cm group,and >3 cm group. The N1 and N2 lymph node metastasis rates of the 3 groups were analyzed. Results The N1 lymph node metastasis rates were significantly different between the 3 groups (P<0. 05); for tumors with greater diameter, the tenth group lymph nodes should be completely dissected. The N2 lymph node metastasis rates were not significantly between the 3 groups (P<0. 05). Conclusion The tumor diameter of BAC may be used to guide the dissection extent of N1 group lymph nodes, but not that of N2 group lymph nodes.
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Objective To study the metastasis frequencies and areas of solitary bronchioloalveolar carcinoma (BAC) of different diameters, so as to guide the intraoperative lymph node dissection. Methods A total of 137 patients with pathologically-confirmed solitary BAC received surgical treatment. The patients were divided into 3 groups according to tumor diameters: ≤2 cm group,2-3 cm group,and >3 cm group. The N1 and N2 lymph node metastasis rates of the 3 groups were analyzed. Results The N1 lymph node metastasis rates were significantly different between the 3 groups (P<0. 05); for tumors with greater diameter, the tenth group lymph nodes should be completely dissected. The N2 lymph node metastasis rates were not significantly between the 3 groups (P<0. 05). Conclusion The tumor diameter of BAC may be used to guide the dissection extent of N1 group lymph nodes, but not that of N2 group lymph nodes.
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Objective To retrospectively evaluate the diagnostic accuracy of endoscopic ultrasonog raphy ( EUS) in pancreatic cancer, analyze the value of EUS in measurement of tumor diameters, TNM staging, and investigate the effectiveness of endoscopic ultrasonography-guided fine needle aspiration ( EUS-FNA). Methods All the data adopted from the patients underwent EUS in PUMC Hospital between 1997 and 2003. Eighty-eight patients with a final diagnosis of pancreatic cancer (56 is proven by surgical pathology, 10 by surgical findings and 22 by clinical diagnosis) and 47 patients with a final diagnosis of benign pancreatic disease were included and analyzed. Results The sensitivity, specificity, accuracy, positive and negative predictive values of EUS in the diagnosis of pancreatic cancer were 95. 5% , 59. 6% , 83. 0% , 81. 6% and 87. 5% respectively. Tumor diameters measured by EUS (2. 8?1. 0)cm were obviously smaller than those by surgical findings (6.5 ? 2. 9) cm. For TNM stage, compared with surgical findings, the accordance rates of EUS in T and N staging were 43. 1% and 61. 1% respectively. The accuracy of EUS-FNA in the diagnosis of pancreatic cancer was 76. 5% ( 13/17). Conclusions The sensitivity of EUS in pancreatic cancer is highest among all imaging procedures. Tumor diameters measured through EUS are smaller than those by surgery.
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The surgical specimens of ninety-eight patients with cervical carcinoma Stage IB to IIA who underwent radical hysterectomy with pelvic lymphadenectomy at the Philippine General Hospital from February, 1990 to August, 1992 were examined tod etermine tumor diameter, tumor volume, and cervical stromal invasion for the purpose of determining 1) the interrelationship of tumor diameter, tumor volume and cervical stromal invasion; 2) the use of the above factors to predict lymph node metastasis and tumor recurrence; 3) the use of these three prognostic variables plus lumph node metastasis to predict recurrence rate; 4) to detemine the relationship between lymph node involvement and recurrence rateUsing multivariate dicriminant analysis, the following were noted: 1) There is a very significant positive relationship among the three prognostic factors, 2) Among the three variables, only tumor diameter and stromal invasion were significant in predicting lymph node metastasis. 3) All these three variables - tumor diameter, tumor volume and cervical stromal invasion have significant relationship with tumor recurrence. 4) The presence of lymph node involvement, when added to the three variables mentioned, contributed significantly in predicting recurrence rate. Using chi-square test, 5) the presence of lymph node metastasis significantly correlates with tunor recurrence.