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Objective To study the risk factors related to recurrence of gastrointestinal stromal tumor (GIST) after discontinuing postoperative adjuvant imatinib mesylate (IM) treatment.Methods We retrospectively analyzed our clinical database of 138 GIST patients who received radical resection and subsequent IM adjuvant treatment at the Renji Hospital,Shanghai Jiaotong University School of Medicine between January 2006 and January 2014.Results For the entire Multivariate analysis study group,the overall 5-year recurrent free survival (RFS) rate was 54.5％.There were two tumor characteristics which were independent prognostic factors of GIST treated by postoperative IM:Ki67 index (P =0.005),and serosal invasion (P =0.026).The accuracy of comprehensive evaluation based on the two weighted variables was better than NIH staging criteria(AUC:0.714 vs.0.631).Furthermore,two risk groups were created according to the risk model with 5-year RFS of 81.3％ and 31.1％ as low-risk and high-risk groups,respectively (P ＜0.05).Conclusions For patients with intermediate or high risk in NIH classification,if there was tumor serosal invasion,or if there was no local invasion but Ki67 index ＞ 8％,extended continuous IM adjuvant treatment should be recommended after the primary tumor was radically resected.
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Objective: To investigate the feasibility of molecular diagnostic techniques to guide individualized treatment of lung cancer. Methods:A total of 360 patients with lung cancer confirmed by pathological diagnosis received clinical chemotherapy from Jan 2011 to Dec 2013 were selected as the experimental group who chose chemotherapy drugs for drug?sensitive individualized treat?ment based on molecular diagnostic technology test results. Another 180 patients with lung cancer were selected as the control group who did not carry out individual testing only chose conventional chemotherapy. The efficacy and side effects of drugs were assessed. The progression?free survival and median survival time were followed and recorded, and the survival curve was drawn by the Kaplan?Meier method. Results: There was significant difference in the efficacy between the two groups ( P<0?05) , and there was no signifi?cant difference in side effects of drugs. The progression?free survival time and median survival time were significantly different ( P<0?01) . Conclusions: Molecular diagnostic techniques to guide individual treatment of lung cancer have some clinical significance, it will help to improve the efficacy and worthy of further study.
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BACKGROUND:Over the years, muscle, skin, skeletal muscle flaps and luminal tissues, such as stomach and intestines, are used as an artificial esophagus to repair esophagus defects, but the results are not good. OBJECTIVE:To investigate the feasibility of chitosan tube stent combined with muscle flaps to repair partial defects of the cervical esophagus. METHODS:Thirty white rabbits were used to make animal models of partial cervical esophageal defects, and randomly divided into experimental group (n=20) and control group (n=10). Esophagus defect in rabbits of experimental group was repaired using autologous muscle flap with a chitosan tube stent, and esophagus defect in the control group was repaired only with muscle flap. Gross and histological appearance was observed at weeks 2, 4 and 8 after operation, and barium sulphate X-ray screen was performed at week 10 after operation. RESULTS AND CONCLUSION:After 2 weeks, muscle tissue structure, cellswel ing, and inflammatory cellinfiltration could be seen in the experiment and control groups, exhibiting an acute inflammatory reaction. After 4 weeks, the experimental group showed clear muscle flaps, reduced inflammatory reaction, and no obvious fibrosis;while in the control group, muscle tissue could be seen at defect site, with growth of fibrous tissue cells and a few of inflammatory cells. After 8 weeks, in the experimental group, squamous metaplasia could be seen on the gross surface of the muscle flaps,esophageal mucosa could be seen, accompanied by chronic inflammatory reaction under the mucosas that had a clear abate than that at 4 weeks after implantation;in the control group, chronic inflammatory reaction could be found, accompanied by clear fibrosis but no squamous metaplasia and mucosal regeneration. Barium sulphate examination found that the esophagus was smooth with a slight motility in the experimental group, but there was a part of stricture in the esophagus without motility. These findings suggest that the chitosan tube stent combined with muscle flaps could better repair partial defects of the cervical esophagus.