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Objective To evaluate the effectiveness and safety of MRI-navigation system EMT-100 in assisting the performance of precise percutaneous puncture biopsy.Methods With the help of MRI-navigation system EMT-100,percutaneous puncture biopsy of thoracic and abdominal lesions was performed in 42 patients.The puncture success rate was used as the main index to evaluate the effectiveness of MRI-navigation system EMT-100.The success rate of puncture biopsy,the total time used for procedure,the average number of puncturing,the average number of scanning,and the incidence of complications were recorded.Results In the 42 patients,the success rates with single and twice puncturing were 86％ (36/42) and 14％ (6/42) respectively.The success rate of puncture biopsy was 100％.The mean time used for locating puncture site was (11.5±5.5) min;the average number of puncturing was (1.4±0.5) times,and the average number of scanningwas(4.2±0.8) times.Among the 32 patients with pulmonary lesions,bloody sputum occurred in 2 patients (6.2％) and small amount pneumothorax in one patient (3.1％),and no serious complications occurred in other patients.Conclusion In performing percutaneous puncture biopsy of thoracic and abdominal lesions,the use of MRI-navigation system is safe.This technique has certain advantages,such as accurate positioning,high puncture success rate,wide range of application,radiationless,etc.It can help precisely obtain the lesion tissue and get pathological diagnosis.Therefore,it is really a valuable guiding technology.(J Intervent Radiol,2017,26:263-265)
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Objective To discuss the safety and efficacy of transcatheter arterial chemoembolization (TACE) in treating patients with inoperable hepatocellular carcinoma (HCC) who has a history of hepatic failure. Methods A total of 7 HCC patients who had a history of hepatic failure (study group) were enrolled in this study. TACE was carried out in all these 7 patients. Other 51 patients who had no liver failure history were used as the control group. All the patients were followed up for at least six months. The postoperative adverse events, changes of liver function and the prognosis were recorded, and the results were compared between the two groups. Results In the study group, neither treatment-related death nor severe adverse events occurred. No significant difference in the occurrence of mild adverse events existed between the two groups. After TACE the liver functions, including alanine aminotransferase, total bilirubin, prolonged prothrombin time, albumin, etc. in the study group were significantly worse than those in the control group,groups. Conclusion For patients with inoperable hepatocellular carcinoma who has a history of hepatic failure, TACE is a safe and effective treatment.
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Objective To review the diagnosis and treatment of basal cell carcinoma of the scrorum. Methods Clinical data of 7 patients with basal cell carcinoma of the scrotum were analyzed retrospectively. The mean age of the patients was 66 years. The most common presenting symptom was a plaque or nodular lesion with pruritis on the scrotum. The lesions ranged from 1.5 cm to 4.5 cm in diameter. Five of the 7 patients had a history of misdiagnosis. The diagnosis was established by biopsy of the lesion in all the patients. All of the 7 patients had no distant metastasis at the time of diagnosis and were treated by wide surgical resection.Results Histopathologic examination of the specimens confirmed the negative surgical margins in all cases.The most common histological feature was lobules, columns, bands and cords of basaloid cells associated with a surrounding loose fibromucinous stroma.One patient developed left inguinal lymph node metastasis at 21 months postoperatively,and was treated by bilateral inguinal lymph node dissection.The patient was free of cancer for 36 months after that. Another patient developed lung metastasis 48 months after the first operation.He was treated by systemic chemotherapy with cyclophosph amide, epirubicin and cisplatin for 6 cycles and obtained complete remission.This patient was free of cancer for 13 months after the chemotherapy.The remaining 5 patients were all free of cancer after the operation. Conclusions Basal cell carcinoma of the scrotum is rare.Wide surgical resection alone is usually considered to be curative. Because of its potential of metastasis, long-term followup is indicated for this disease.
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Objective To analyze the predictive factors of anti-androgen withdrawal in the treatment of androgen independent prostate cancer. Methods 347 cases of advanced metastatic prostate cancer in our prostate cancer database were filtered. All the cases were treated with maximal androgen blockade and had full pathological and clinical information. 237 cases developed to the androgen independent stage during the maximal androgen blockade treatment. Among them, 90 cases were treated with anti-androgen withdrawal. This 90 cases were followed up and the last follow-up date was 30 September 2009. The Logistic regression of univariate and multivariate analysis were used to find the predictive factors for the effectiveness of anti-androgen withdrawal, which including baseline PSA, Gleason score, clinical stage, way of castration, kind of anti-androgen, PSA nadir during maximal androgen blockade, time to PSA nadir, PSAV at the time of AIPC, PSADT at the time of AIPC, the effective duration of maximal androgen blockade, age at the time of AIPC and PSA at the initiation of anti-androgen withdrawal. Results Of the 90 cases treated with anti-androgen withdrawal, 3 cases were excluded for analysis because of the incomplete information. Among the 87 cases, 17 cases were effective with the anti-androgen withdrawal treatment while the other 70 cases were ineffective. At the last follow-up, 3 cases were still effective. The median effective duration of anti-androgen withdrawal was 4 months. The univariate analysis indicated that PSAV at the time of AIPC (P=0.033), PSADT at the time of AIPC (P=0.009) and PSA at the initiation of anti-androgen withdrawal (P=0.002)were predictive factors. The multivariate analysis indicated that PSAV (P=0.042) and PSADT at the time of AIPC (P= 0.036) were independent predictive factors for the effectiveness of anti-androgen withdrawal. Conclusions Among the androgen independent advanced metastatic prostate cancer patient, there were about 19. 5% cases effective with the anti-androgen withdrawal treatment and the median effective duration was 4 months. PSAV and PSADT at the time of AIPC were independent predictive factors for the effectiveness of anti-androgen withdrawal.
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Objective To find the predictive factors that related to the effect of hormonal therapy and the survival of advanced metastatic prostate cancer. Methods Three hundred and Sixty-four cases of metastatic prostate cancer were treated with hormonal therapy in Cancer Hospital Fudan University in Shanghai from December 1996 to March 2008. The patients were followed up to the 31 March 2008 and the median follow-up time was 24 months. Two hundred and fifty cases have progressed into the stage of hormonal independent. The statistic software used in this study was SPSS 15. 0. Cumulative survival was analyzed by Kaplan-Meier method. Cox regression was used for univa-riate and multivariate analysis. Log-rank method was used for the significance test. The statistical difference was accepted when the P-value was lower than 0. 05. Results The effective rate of hormonal therapy for advanced metastatic prostate cancer was 98%. The median time of progression free survival of hormonal therapy was 20 months, and the one-year, two-year, three-year progression free survival rate was 69%, 39%, 27%, respectively. The survival analysis indicated that baseline PSA level more than 20ng/ml, with visceral organ metastasis, the PSA nadir more than Ing/ml during hormonal therapy, the time from the start of hormonal therapy to the PSA nadir less than 5 months were poor prognostic factors of progression free survival. Conclusions The baseline PSA level, clinicalstage, the PSA nadir during hormonal therapy and the time form the start of hormonal therapy to the PSA nadir could be the factors that predict the progression free survival time during hormonal therapy.