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Objective:To explore the strategies and complications of the submucosal tunneling endoscopic resection (STER) in the treatment of esophageal duplicated cyst (EDC).Methods:From January 2013 to December 2019, at Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, the clinical data of 11 hospitalized patients with EDC diagnosed by pathological examination who underwent STER were collected. The clinical featured, computed tomography (CT) findings, endoscopic findings, postoperative efficacy, complications and pathological results after operation were summarized.Results:Among the 11 patients, there were 6 males and 5 females, the age ranged from 13 to 67 years, and the mean age was (43.0±18.2) years. One case presented with swallowing obstruction, 1 case with belching, 4 cases with upper abdominal pain, and the remaining 5 cases had no specific clinical symptoms. Under endoscopy, the lesions of 11 patients were hemispherical or mound-shaped with smooth surface submucosal masses in the esophageal cavity, which were soft to touch. Under endoscopic ultrasonography, they all appeared as hypoechoic masses with clear boundary located in the esophageal muscularis propria. The results of CT scan of 9 patients showed round low-density cystic masses, among them 7 cases showed mild enhancement. The maximum diameter of the cysts was 1.5 to 4.4 cm, with mean maximum diameter being (2.8±0.8) cm, and the maximum diameter of most patients (7 cases) were 2 to 3 cm. The other two patients showed only slightly thickened esophageal wall on CT. Five lesions occurred in the horizontal mediastinum of the lower esophagus. All the 11 patients underwent STER operation successfully, among them 6 patients received simple STER and the cysts were completely resected, and the other 5 patients received STER and cauterization with argon ion for the residual cyst wall. The pathological results after operation indicated that 6 cases were congenital esophageal cysts and 5 cases were bronchogenic cysts. The median follow-up time (range) of 11 patients was 42 months (12-86 months). Ten patients recovered well after the operation, and local recurrence, malignant transformation or metastasis were not found. One case had recurrence, and was treated with STER and cauterization with argon ion for residual cyst wall and cured. No complications such as bleeding, fistula, mediastinal infection or death occurred during and after operation in all the 11 patients.Conclusions:STER is a minimally invasive, safe and effective treatment for EDC, and may be a new treatment for EDC.
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Objective To investigate the effect of cetuximab combined with FOLFOX4 chemotherapy on expressions of cancer suppressor gene PTEN and P13K in colon cancer tissue of elderly patients.Methods 62 cases of elderly patients with colon cancer from October 2013 to July 2015 in our hospital were selected and divided into two groups according to the different therapy.The control group (n=27) received pure FOLFOX4 chemotherapy and treatment group(n=35)received cetuximab on the basis of FOLFOX4 chemotherapy, with a consecutive treatment of 4 courses.The clinical curative effect and expressions of PTEN and P13K in colon cancer tissue were compared between two groups.Results There were no significant difference in effective rate and disease control rate between treatment group and control group (51.4% vs.44.4%,χ2 =0.298,P=0.585;80.0%vs.62.9%,χ2 =2.223, P=0.136 ).After treatment, the cells positive rate of PTEN in treatment group was higher than that in control group post-treatment (82.86%vs.59.26%, P<0.05), and the cells positive rate of P13K in treatment group was lower than that in control group (37.14%vs.62.96%, P<0.05). Conclusion Cetuximab combined FOLFOX4 chemotherapy regimen could increase expression of PTEN and reduce P13K expression, which effect is remarkable in the treatment of elderly colon cancer.
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The clinicopathological data of 13 patients with Langerhans cell histiocytosis (LCH) from January 2004 to January 2014 were retrospectively analyzed.There were 8 males and 5 females with a mean age of 35 (6-63)years.For all 13 cases,there were 15 lesions.Histologically,there was a diffuse distribution of Langerhans cells accompanied by a variable number of eosinophils and some other inflammatory cells.Immunohistochemical study showed tumor cells were positive for S-100 protein,CD1a and Langerin.During a follow-up period of 6-101 months,all survived.The diagnosis of LCH was assisted by immunophenotypic analyses for S-100,CD1a and Langerin.Combination therapy was effective.Most patients had an excellent prognosis.