Nomograms to Predict the Individual Survival of Patients with Solitary Hepatocellular Carcinoma after Hepatectomy

BACKGROUND/AIMS: Solitary hepatocellular carcinoma (HCC) is a subgroup of HCCs. We aimed to establish nomograms for predicting the survival of solitary HCC patients after hepatectomy. METHODS: A total of 538 solitary HCC patients were randomly classified into training and validation sets. A Cox model was used to identify predictors of overall survival (OS) in the training set. A nomogram was generated based on these predictors and was validated using the validation set. RESULTS: Tumor size, microvascular invasion, and major vascular invasion were significantly associated with OS in the training set. Nomograms were developed based on these predictors in the multivariate analysis. The C-index was 0.75 for the OS nomogram and 0.72 for the recurrence-free survival nomogram. Compared to the index of conventional staging systems for predicting survival (0.71 for Barcelona Clinic Liver Cancer, 0.66 for the seventh American Joint Committee on Cancer, 0.68 for Cancer of the Liver Italian Program, and 0.70 for Hong Kong Liver Cancer), the index of the OS nomogram was significantly higher. Moreover, the calibration curve fitted well between the predicted and observed survival rate. Similarly, in the validation set, the nomogram discrimination was superior to those of the four staging systems (p<0.001). CONCLUSIONS: The nomograms demonstrated good discrimination performance in predicting 3- and 5-year survival rates for solitary HCCs after hepatectomy.

The Expression of Aldehyde Dehydrogenase Family in Breast Cancer / 한국유방암학회지

PURPOSE: It is widely accepted that aldehyde dehydrogenase (ALDH) activity is a signature of breast cancer stem cells, and high activity has been reported to be associated with poor clinical outcome. The aim of this study was to assess the expression of members of the ALDH family of isozymes in breast cancer tissues and to evaluate the implications of the results. METHODS: We analyzed paraffin-embedded tumor tissue from 160 patients with breast cancer. Immunohistochemistry (IHC) staining was performed on the slides using antibodies against different ALDH family members. We collated the IHC results with patient clinical characteristics and determined their prognostic value. In addition, we analyzed normal, hyperplastic, and carcinomatous tissues in situ to check their ALDH distributions. RESULTS: All the tested ALDH members were detected in the various tissue types, but at different levels. Only ALDH 1A3 was found to be significantly associated with distant metastasis (p=0.001), disease-free survival (p<0.001), and overall survival (p<0.001). CONCLUSION: The level of ALDH 1A3 in breast cancer tissue is a predictive marker of a poor clinical outcome.

Protection and functional repair of vagus nerve during the operation of cervical vagal paraganglioma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the clinical anatomy and the methods to protect or reconstruct the continuity and function of vagus nerve during the operation of cervical vagal paraganglioma.@*METHOD@#Six cases of vagal paraganglioma were reviewed. All tumors were identified to wrap the cervical vagus nerve stem and excised during surgery. The operative modality was to trace the vagus nerve stem inside the tumor as far as possible, to reconstruct the continuity by way of vagus nerve anastomosis (3/6) or alternatively, other motor nerve transplantation (3/6). Postoperative treatment included steroid, neurotrophic medication and voice and swallowing rehabilitation.@*RESULT@#Two cases of the recurrent paraganglioma experienced aspiration during swallowing preoperatively and no aspiration after surgery. Choking was gradually reduced in four recurrent cases half to one year postoperatively. Hoarseness was improved in five cases (5/6) half to one year postoperatively, while one case remained prolonged obvious hoarseness. Three months postoperatively, the vocal cord fibrillation at the tumor-related side was observed during pronunciation in the end-to-end anastomosis cases (3/6), sublingual nerve-transplanted case (1/6) and deep cervical nerve-transplanted cases (1/6) under fiberoptic laryngoscope, and the mobility was even more obvious at the time of half an year postoperatively. While in another deep cervical nerve-transplanted case (1/6), the vocal cord demonstrated no obvious fibrillation.@*CONCLUSION@#To carefully identify and preserve the vagus nerve fibers as much as possible during the operation of cervical vagal paraganglioma could significantly eliminate postoperative hoarseness and aspiration. End-to-end anastomosis, deep cervical nerve or sublingual nerve transplantation to resume the continuity of vagus nerve may improve the mobility of vocal cord thus the quality of voice and swallowing.

Solitary bronchial papilloma: a clinicopathological study of four cases and review of literature / 临床与实验病理学杂志

Purpose To explore the clinicopathological features, differential diagnosis of solitary bronchial papilloma, and its relation with and human papilloma virus infection.Methods Four cases of SBP were studied by routine histologic,immunohistochemical staining and in situ hybridization, together with review of the literature.Results One of four lesions was squamous cell papilloma, with focal malignant change of squamous cell carcinoma with microinvasion. The case was an old woman and the cancer located in central bronchus. Others were mixed squamous cell and glandular papilloma, and two cases with features of moderate cytologic atypia. The age ranged from 25 to 73 years (average 54), and tumors were located in the bronchi and segmental bronchi. Papillary arborizing connective tissue stalks were lined by both squamous and glandular epithelium. Four papillomas were exophytic, with one case inverted partly. Four cases were examined for HPV DNA and all were negative.Conclusions SBP in adults is a rare lung neoplasm. Based on uncommon cases association with malignant change, all endobronchial papillomas should be completely excised.

Primitive study of the cell lineage and Epstein-Barr virus infection in so called malignant histiocytosis with tissue microarray technique / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the cell lineage and Epstein-Barr virus infection in previously diagnosed cases of malignant histiocytosis (MH) with tissue microarray technique.</p><p><b>METHODS</b>Using tissue-chips, immunohistochemical staining, in situ hybridization and PCR to analyze 5 autopsy cases of MH.</p><p><b>RESULTS</b>(1) In all 5 cases, positive reactions of CD45RO, CD3 epsilon, TIA-1, Granzyme B were detected in the neoplastic cells, whereas negative reactions were found with CD30, CD20, CD56. (2) All cases revealed EBER1/2 positivity in neoplastic cells.</p><p><b>CONCLUSION</b>Previously diagnosed malignant histiocytosis is an EBV-associated aggressive NK/T cell lymphoma.</p>