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OBJECTIVE:To observe the efficacy of capecitabine combined with cisplatin in the treatment of advanced gastric cancer and its effect on invasion and metastasis of gastric cancer. METHODS:94 patients with advanced gastric cancer were ran-domly divided into control group(47 cases)and observation group(47 cases). Control group received 65-75 mg/m2 Docetaxel injec-tion,d1,continuous intravenous infusion of 2 h+15-20 mg/m2 Cisplatin for injection,d1-5,continuous intravenous infusion of 2 h in the dark. Observation group received 1 000 mg/m2 Capecitabine tablet,orally,twice a day+Cisplatin for injection(the same us-age and dosage with control group). 3-week was regarded as a treatment course,and it lasted 3 courses. Clinical efficacy,matrix metalloproteinase-2(MMP-2)and MMP-9 levels were observed,6 and 12 months survival rate and incidence of adverse reactions were followed-up. RESULTS:There was no significant difference in the total effective rate in 2 groups(P>0.05). Grade 1-2 liver dysfunction,thrombocytopenia,and the incidence of nausea and vomiting in observation group were significantly lower than con-trol group,6 and 12 months survival rates were significantly higher than control group,the differences were statistically significant (P0.05). After treat-ment,MMP-2 and MMP-9 levels in 2 groups were significantly lower than before,and observation group was lower than control group,the differences were statistically significant(P<0.05). CONCLUSIONS:The efficacy of capecitabine combined with cispla-tin is similar to docetaxel combined with cisplatin in the treatment of advanced gastric cancer,but docetaxel combined with cisplat-in is superior in terms of reducing MMP-2 and MMP-9 and safety.
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Objective To investigate the value of endoscopic ultrasonography (EUS) and abdominal CT (CT) in diagnosis of periampullary lesions and to make comparison between the two procedures. Methods The patients suspected of surrounding lesions of ampullary from 2009 to 2013 in our hospital were included in this study. All the patients received both EUS and abdominal CT. The accuracy rate of these two examination methods was compared. Results 151 patients were confirmed as surrounding lesions of ampullary, including choledocholithiasis, ampullary tumors, ampullary inflammation, tumors of the pancreatic head and pancreatic cysts. The accuracy rate of these diseases was 83.6%, 90.6%, 6.5%, 100.0%, and 100.0%for EUS;while was 52.2%, 56.3%, 43.5%, 91.3%, and 100.0%for abdominal CT. The tatal accuracy rate for diagnosing periampullary lesions by EUS was significantly higher than that by abdominal CT (84.1% vs. 59.6%). Conclusions Endoscopic ultrasonography has higher value in diagnosis of periampullary lesions, and its accurate rate was higher than that of abdominal CT.
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Objective Endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNA) was performed for diagnosis and treatment of the pelvic Lesions and safety of this method were evaluated.Methods EUS-FNA was performed in 52 patients with pelvic Lesions selected by EUS,CT or MRI between March 2009 and June 2012.Both 19 and 22 gauge needles were used for EUS-FNA.The tissue specimens were analyzed by cytologic or histologic examination.The pelvic cystic lesions were drained and in which purulent lesions were lavaged with Metronidazole repeatedly.Results All patients recieved fine needle biopsy of the pelvic lesions.Among the 52 lesions,there were 42 solid lesions,10 cystic lesions.In solid lesions,cytology and pathology demonstrated malignant tumors in 28 patients,3 cases of malignant stromal tumors,3 cases of Inflammatory mass cases,2 cases of lymphoma,1 case of dermoid cyst,5 cases of other.In cystic lesions,2 cases of serous cystadenoma,perirectal abscess in 8 cases.6 purulent lesions were lavaged with Metronidazole repeatedly.Diagnosis rates of samples for immunohistology remained similar between 22 gauge and 19 gauge needles (P ＞0.05).During the operation,8 cases of perirectal abscess patients have different degree of pain.There were no other complications after the procedures except one patient suffering from fever.Conclusion EUS-guided FNA is minimaly invasive,a safe and accurate method for diagnosis of pelvic lesions.
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ObjectiveTo evaluate the role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for diagnosing lesions of gastrointestinal tract and the nearby organs. MethodsClinical and pathological data of 161 EUS-FNA lesions in 133 consecutive patients were retrospectively analyzed. ResultsOf the 161 lesions, there were 142 solid lesions, 15 cystic lesions and 4 pancreatic solid-cystic lesions. EUS-FNA was performed at lesions of upper gastrointestinal tract, rectum and anal canal. 160 cytologic diagnoses (99. 4％ ) were obtained in all 161 lesions. 143 histological diagnoses (97.9％) and 113 immunohistological diagnoses (77.4％) were obtained in 146 solid lesions (including 4 pancreatic solid-cystic ones). Diagnosis rates of samples for immunohistology remained similar between 22-gauge and 19-gauge needles and also similar among different sites (P ＞ 0. 05). But immunohistological diagnosis rate of smaller lesions ( ＜ 1 cm) was lower than that of bigger ones ( ≥ 1 cm) ( P ＜ 0. 05). The diagnosis rates of cytology,histology and pathology in solid lesions were 81.2％ ( 120/146), 82. 9％ (121/146) and 89. 7％ ( 131/146), respectively. Size of needles and lesion location did not exert influence on diagnosis, but the diagnosis rate of smaller lesions ( ＜ 1 cm) was lower than that of bigger ones ( ≥ 1 cm). Cytological diagnosis was consistent with histological diagnosis ( k =1. 0, P =0. 00), 11 cases that could not be diagnosed by cytology was confirmed by histology and 10 cases that could not diagnosed by histology was confirmed by cytology.There were no complications during the procedures. ConclusionEUS-FNA is a valuable diagnostic tool for lesions of gastrointestinal tract and nearby organs. The needle size and lesion site were not influential factors for diagnosis. Smaller lesions ( ＜ 1 cm) yielded lower diagnosis rate than bigger ones ( ≥ 1 cm). The cytologic diagnosis combined with histology can improve the diagnostic value of EUS-FNA.