Role of preoperative morphologic classification in solitary small hepatocellular carcinoma treated by RFA / 国际外科学杂志

Objective To invcstigate the value of preoperative imaging morphologic classification in solitary small hepatocellular carcinoma treated by RFA.Methods The clinical data of 73 patients with small hepatocellular carcinoma who rcccivcd radiofrequency ablation at the Affiliated Drum Tower Hospital of Medical School of Nanjing University from January 2008 to December 2012 were analyzed retrospectively.The lesions were classified into three types according to gross appearance in preoperative contrast-enhanced computed tomography (CT):single nodular type (type 1);single nodular with extranodular growth type or confluent multinodular type (type 2);infiltrating type (type 3).Thc clinicopathological features of patients with 3 types of tumors were compared by statistical methods.Patients were followed up via outpatient examination and telephone interview up to August 2014 or death.Results There were 24 cases of type 1,35 cases of type 2,14 cases of type 3,and the proportion were 20.2％,32.9％,47.9％,19.2％,respectively.The preoperative alpha-fetoprotein of type 3 was significantly higher than othcr types.The disease-free survival time of the three types were (37.2 ± 3.3) months,(20.9 ± 4.0) months,(14.4 ±4.9) months.The prognosis of the irregular types (type 2,type 3) is poor than the regular types (type 1).The overall survival time were (72.5 ± 4.7) months,(66.2 ± 7.3) months,(31.2 ± 5.3) months.The type 3 was the worst.The results of univariate analysis showed that morphologic classification,preoperative AFP,tumor size were related factors affecting the prognosis of patients (P ＜ 0.05).The results of multivariate analysis showed that morphologic classification was the independent risk factors affecting the prognosis of patients (P ＜ 0.05).Conclusion The preoperative imaging morphologic classification is the independent risk factors affecting the prognoses of patients with small HCC,which is help to choose the best treatment for patients with small hepatocellular.

Nutritional Status and Anaemia with Special Reference to Morphological Classification in Underfive Children.

Nutrition of pre-school children (0-5 years age group) is of paramount importance because the foundation for lifetime health, strength and intellectual vitality is laid during this period. Aims: To assess the nutritional status and hemaoglobin status and morphological classification of anaemia of children below five years of age. Settings and Design : Community based cross-sectional study in children below five years of age from urban slum, Nagpur. Methods and Material : A house-to-house survey was done. By systematic random sampling 434 children below five years of age were included in the study. Every child was subjected to anthropometric measurements using standard technique. Haemoglobin estimation was done by using Sahli’s haemoglobinometer and peripheral smear was prepared. Statistical analysis : Data was analyzed on Epi- Info Software 3.2 version. Chi square test is used to test the significance. Result : 52.23 % were suffering from various grades of malnutrition. 32.18 % children were in grade I, 16.09 % in grade II, 3.46 % in grade III and 0.5 % in grade IV malnutrition. 78.71 children had anaemia (Hb < 11gm/dl). It was observed that 34.9 % children had microcytic and hypochromic anaemia, 19.6 % had dimorphic, 13.7% had normocytic normochromic and 7.5% had macrocytic anaemia. Out of these 2 children had sickle cell disease. A statistically significant association was observed between malnutrition and anaemia. Conclusion : Nutritional rehabilitation centers should be started in the community and linked with health centers to treat less severely affected undernourished children.

Characteristics of Laterally Spreading Colorectal Tumors according to Morphologic Classifications / 대한소화기내시경학회지

BACKGROUND/AIMS: Laterally spreading tumors (LSTs) are similar in color to the adjacent mucosa, so they are difficult to recognize. This study aimed to investigate the features of LSTs by morphologic classification and find effective diagnoses and treatments. METHODS: This retrospective study was done between March 2006 and August 2008. We reviewed patients' medical records, endoscopic findings, and histological findings. RESULTS: A total of 151 patients met criteria for LSTs. Eighty-seven lesions (57.6%) were of the granular type. The most frequent location was ascending colon (37.1%), followed by rectum and sigmoid colon (36.4%). The cecum is a common site in the granular type, but the transverse colon is common in the nongranular type. The overall malignancy rate was 21.2%, and the malignant rate increased in proportion to size. Malignant rates were higher for the mixed nodular type (25.9%) and pseudo-depressed type (41.2%) than for the homogeneous granular type (3.0%) or flat elevated type (10.0%). CONCLUSIONS: LSTs showed different clinicopathologic characteristics according to their morphologic classification. The homogenous type has a lower malignant potential. Piecemeal resection for those with a large diameter is possible, while the pseudo-depressed and mixed nodular types have a higher malignant potential and should receive en-bloc resection as soon as possible.